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Cochlear Implants International[JOURNAL]

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Editor-in-Chief position, Cochlear Implants International from 1 January 2023.

Cullington H

Cochlear Implants Int · 2023 Jul · PMID 37431059 · Publisher ↗

Abstract loading — click title to view on PubMed.

Electrode impedances in children with cochlear implants: Comparison between intra-operative Switch ON and post-operative Switch ON.

Meghanadh KR, Saxena U, Kumar SBR … +4 more , Chacko G, N V, S S, Mehta G

Cochlear Implants Int · 2023 Mar · PMID 37354550 · Publisher ↗

INTRODUCTION: Intra-operative Switch ON (IOSO) is a novel clinical approach of activating the cochlear implant during the surgery adopted at our cochlear implantation center.We compared the electrode impedances in two co... INTRODUCTION: Intra-operative Switch ON (IOSO) is a novel clinical approach of activating the cochlear implant during the surgery adopted at our cochlear implantation center.We compared the electrode impedances in two conditions of Switch ON of cochlear implants; IOSO and post-operative Switch ON (POSO, 21st day of surgery). METHODS: Electrode impedances of 185 cochlear implants, 93 of whom received IOSO and 92 POSO, recorded over 10 years were analyzed retrospectively. RESULTS: Electrode impedances of IOSO group were significantly lower than POSO group at Switch ON and 3rd, 6th, 9th, and 12th months post cochlear implantation. In IOSO group, 3rd month's electrode impedances were high when compared to electrode impedances at Switch ON. Beyond the 3rd months, electrode impedance remained unchanged. In POSO group, there were no significant differences in electrode impedances between any measurement schedule. CONCLUSIONS: To our knowledge, this is the first study to investigate in detail the electrode impedances of the two above-said conditions of Switch ON in the process of cochlear implantation. This study concludes that timing of CI Switch ON has a significant effect on the electrode impedances. These results may affect the choice of cochlear implant Switch ON timing.

Pediatric cochlear implants and myringotomy tubes: a systematic review.

Patel S, Robbins A, Tey CS … +3 more , Zhang C, Peterson S, Govil N

Cochlear Implants Int · 2023 Jul · PMID 37343953 · Publisher ↗

OBJECTIVE: To evaluate the intraoperative findings and post-operative complications associated with patients who have current or history of myringotomy tubes undergoing a cochlear implantation. METHODS: Preferred Reporti... OBJECTIVE: To evaluate the intraoperative findings and post-operative complications associated with patients who have current or history of myringotomy tubes undergoing a cochlear implantation. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement were followed. Studies from Pubmed, Cochrane, Embase, Web of Science, and Scopus were included. Studies were independently screened and analyzed by 2 reviewers. Publications assessing pediatric patients with current or history of myringotomy tubes at time of cochlear implantation were reviewed. Discrepancies were resolved by a team of 4 reviewers. RESULTS: 172 studies were screened, 15 met inclusion criteria, and 12 were incorporated into the study. All 12 of the studies were retrospective cohort studies. Meta-analysis showed no significant relationship between intraoperative findings at time of cochlear implantation (presence of effusion, granulation tissue, edematous middle ear tissue) and myringotomy tube insertion ( = 0.63). Additionally, there was no significant relationship between current or history of myringotomy tube and acute otitis media episode after CI ( = 0.25). CONCLUSION: There was no association noted between perioperative outcomes of pediatric cochlear implantation and myringotomy tube. This information will be helpful for surgeons planning to perform cochlear implantation in the pediatric population.

The effect of cochlear implant age and duration of intervention on ESRT in children with cochlear implant.

Tyagi Y, Chatterjee I

Cochlear Implants Int · 2023 Jul · PMID 37302120 · Publisher ↗

OBJECTIVE: To study the effect of cochlear implant age and duration of the intervention (auditory rehabilitation post-cochlear implantation) on ESRT in children with cochlear implants. METHODS: A total of 90 pre-lingual... OBJECTIVE: To study the effect of cochlear implant age and duration of the intervention (auditory rehabilitation post-cochlear implantation) on ESRT in children with cochlear implants. METHODS: A total of 90 pre-lingual cochlear implant users were included. For the measurement of ESRTs the recipient's processor was connected to the programming pod and electrode numbers 22, 11 and 3 (apical, middle and basal), respectively, were activated to give stimulation sequentially and elicit deflection as a response. RESULTS: There were significant differences in the measured T, C and ESRT levels with respect to the duration of the intervention (auditory rehabilitation post-cochlear implantation) and cochlear implant age obtained at < 0.05*, 0.01**. DISCUSSION: The differences in the T, C and ESRT levels after continued device usage and after attending auditory rehabilitation sessions post-cochlear implantation are subjected to optimal benefit from implantation during the critical period. CONCLUSION: The differences in T, C and ESRT levels can be utilised clinically to study the importance of duration of cochlear implant device usage and the importance of auditory rehabilitation post-cochlear implantation in children with cochlear implantation.

Short-term overstimulation affects peripheral but not central excitability in an animal model of cochlear implantation.

Schwitzer S, Gröschel M, Hessel H … +2 more , Ernst A, Basta D

Cochlear Implants Int · 2023 Sep · PMID 37127529 · Publisher ↗

Upper current limits (C-levels) are sometimes extremely increased over time since this procedure can enhance speech perception. It should be clarified if a larger amount of electrical stimulation is tolerated by the rema... Upper current limits (C-levels) are sometimes extremely increased over time since this procedure can enhance speech perception. It should be clarified if a larger amount of electrical stimulation is tolerated by the remaining peripheral and central auditory pathway. An animal electrode array was inserted in mechanically deafened guinea pigs. C-levels were adjusted to a mean of approximately 10 CL ('LOS' group), 40 CL ('MOS' group) or 60 CL ('HOS' group) above the electrode specific electrically evoked compound action potential (eCAP) threshold. The stimulation was performed via a sound processor in standardized auditory environment. Implanted and not stimulated animals served as controls. A significant eCAP threshold shift was observed in the 'HOS'-group aftereight hours of stimulation at basal electrodes. Electrically evoked auditory brainstem thresholds were stable over time in all stimulation groups. The ratio between eCAP- and eABR threshold shifts was significantly enhanced in the 'HOS'- group. Even short-time overstimulation reduces the excitability of peripheral but not central auditory structures. The changed relationship between the excitability of spiral ganglion neurons and inferior colliculus neurons seems to indicate an overstimulation. The results are of utmost importance for a safe CI-processor fitting especially in children or non-compliant patients.

Cochlear implant services for children, young people and adults. Quality standard.

Cullington HE, Jiang D, Broomfield SJ … +14 more , Chung M, Craddock LC, Driver S, Edwards D, Gallacher JM, Jones LL, Koleva T, Martin J, Meakin H, Nash R, Rocca C, Schramm DR, Willmott NS, Vanat ZH

Cochlear Implants Int · 2023 · PMID 37114384 · Publisher ↗

Abstract loading — click title to view on PubMed.

Outcomes after revision of Advanced Bionics Clarion 1.2 cochlear implants.

Andresen NS, Yesantharao LV, Bowditch SP … +4 more , Galaiya DJ, Della Santina CC, Creighton FX, Sun DQ

Cochlear Implants Int · 2023 Jul · PMID 37095648 · Full text

INTRODUCTION: Cochlear implant reimplantation (CIR) for external processor upgrade or device failure is becoming increasingly common as the population of cochlear implant recipients ages. Patients with Advanced Bionics (... INTRODUCTION: Cochlear implant reimplantation (CIR) for external processor upgrade or device failure is becoming increasingly common as the population of cochlear implant recipients ages. Patients with Advanced Bionics (AB) Clarion 1.2 cochlear implants may undergo CIR for device age/failure or desired technology upgrade so that they may use newer external processors that have improved connectivity features. The objective of this study was to evaluate audiologic outcomes for patients who were initially implanted with an AB Clarion 1.2 internal device and underwent CIR for technology upgrade or device failure. METHODS: Retrospective chart review was performed at a single academic medical center for patients (pediatric and adult) with an AB Clarion 1.2 internal device who underwent CIR to a later generation AB internal device and had available audiologic data. RESULTS: Forty-eight individuals with a Clarion 1.2 implant underwent CIR. Pre- and post-CIR speech understanding did not change for AzBio (p-value = 0.11, mean change = 12.1%, 95% CI = -2.9-27.2%), CNCw (p-value = 0.74, mean change = -1%, 95% CI = -10.4-12.4%), or HINT (p-value = 0.12, mean change = 19.9%, 95% CI = -2.6-42.4%) scores. Pure-tone averages improved following CIR (p-value < 0.01, mean change = 4.3 dB, 95% CI = 1.5-7.1 dB). CONCLUSIONS: Revision of AB Clarion 1.2 cochlear implants does not significantly worsen audiologic outcomes and may improve hearing in some individuals, but individual patient-level outcomes are variable.

Leveraging real-world data to improve cochlear implant outcomes: Is the data available?

Findlay C, Edwards M, Hough K … +2 more , Grasmeder M, Newman TA

Cochlear Implants Int · 2023 Jul · PMID 37088565 · Publisher ↗

OBJECTIVES: A small but persistent proportion of individuals do not gain the expected benefit from cochlear implants(CI). A step-change in the understanding of factors affecting outcomes could come through data science.... OBJECTIVES: A small but persistent proportion of individuals do not gain the expected benefit from cochlear implants(CI). A step-change in the understanding of factors affecting outcomes could come through data science. This study evaluates clinical data capture to assess the quality and utility of CI user's health records for data science, by assessing the recording of otitis media. Otitis media was selected as it is associated with the development of sensorineural hearing loss and may affect cochlear implant outcomes. METHODS: A retrospective service improvement project evaluating the medical records of 594 people with a CI under the care of the University of Southampton Auditory Implant Service between 2014 and 2020. RESULTS: The clinical records are suitable for data science research. Of the cohort studied 20% of Adults and more than 40% of the paediatric cases have a history of middle ear inflammation. DISCUSSION: Data science has potential to improve cochlear implant outcomes and improve understanding of the mechanisms underlying poor performance, through retrospective secondary analysis of real-world data. CONCLUSION: Implant centres and the British Cochlear Implant Group National Hearing Implant Registry are urged to consider the importance of consistently and accurate recording of patient data over time for each CI user. Data where links to hearing loss have been identified, such as middle ear inflammation, may be particularly valuable in future analyses and to inform clinical trials.

Bilateral cochlear implantation after immunotherapy-related profound hearing loss: A case report.

Schlacter JA, Kay-Rivest E, McMenomey SO … +3 more , Roland JT, Friedmann DR, Jethanamest D

Cochlear Implants Int · 2023 Sep · PMID 36988037 · Publisher ↗

OBJECTIVES: Immune-checkpoint inhibitors (ICI) are being utilized with increasing frequency and may be linked to neurologic and audiovestibular toxicities. This report aimed to describe a case of ICI-induced sensorineura... OBJECTIVES: Immune-checkpoint inhibitors (ICI) are being utilized with increasing frequency and may be linked to neurologic and audiovestibular toxicities. This report aimed to describe a case of ICI-induced sensorineural hearing loss ultimately requiring bilateral cochlear implantation. METHODS: A 42-year-old female with stage IV metastatic melanoma of the perianal skin was treated with ipilimumab (blocker of cytotoxic T-lymphocyte associated protein 4 [CTLA-4]) and nivolumab (anti-programmed cell death protein 1 [PD1]). After 21 weeks of therapy, she developed sudden vertigo and bilateral hearing loss. A full workup including MRI and lumbar puncture ruled out intracranial parenchymal metastases, leptomeningeal metastases, stroke and intracranial infection. ICI-associated aseptic meningoencephalitis was therefore diagnosed. The patient received systemic steroids as well as intratympanic steroids, which temporarily improved hearing, but eventually developed permanent, bilateral profound sensorineural hearing loss. RESULTS: The patient received bilateral cochlear implants and has demonstrated good performance one year after implantation. DISCUSSION: ICI are being increasingly used to treat a variety of advanced malignancies. This is the first report of bilateral cochlear implants in the context of profound hearing loss after an immunotherapy induced meningoencephalitis. CONCLUSION: ICI carries the risk of potential ototoxicity, including profound SNHL as depicted in our case. Cochlear implantation proved to be beneficial and may be considered in patients with ICI-related hearing loss.

Does the duration matter? Effect of cochlear implantation on language development in Mandarin-speaking children with hearing loss.

Lim TZ, Chen PH

Cochlear Implants Int · 2023 Jul · PMID 36972402 · Publisher ↗

OBJECTIVE: Several studies have shown that cochlear implantation (CI) can influence language development in children with severe-to-profound hearing loss. However, whether the age of implantation and duration of CI use i... OBJECTIVE: Several studies have shown that cochlear implantation (CI) can influence language development in children with severe-to-profound hearing loss. However, whether the age of implantation and duration of CI use influence language development remains unclear, particularly in Mandarin-speaking children with hearing loss. Therefore, this study investigated the effects of CI-related variables on language development in these children. METHODS: The present study recruited 133 Mandarin-speaking children with hearing loss, aged between 36 and 71 months chronologically, from a nonprofit organisation in Taiwan. The Revised Preschool Language Assessment (RPLA) was used to evaluate the children's language performance. RESULTS: Children with hearing loss demonstrated delayed language comprehension and oral expression. Among them, 34% achieved age-appropriate language development. The duration of CI use had a significant direct effect on language-related abilities. Conversely, the age of implantation did not have a significant direct effect. Furthermore, the age of initial interventions (auditory-oral) had a significant direct effect only on language comprehension. Compared with the age of implantation, the duration of CI use was a significant mediator of language-related abilities. CONCLUSION: In Mandarin-speaking children with late CIs, the duration of CI use is a more effective mediator of language development than the age of implantation.

The experience of auditory implant recipients undergoing magnetic resonance imaging: Factors associated with pain.

Smith ME, Moualed DJ, Freeman SR … +6 more , Stapleton EJ, Anup R, Kurian J, Jarvis N, Thomas OM, Lloyd SKW

Cochlear Implants Int · 2023 Sep · PMID 36938810 · Publisher ↗

OBJECTIVE: Many patients with cochlear implants (CI) and auditory brainstem implants (ABI) require magnetic resonance imaging (MRI) following implantation. This study explores the patient experience of MRI, identifying f... OBJECTIVE: Many patients with cochlear implants (CI) and auditory brainstem implants (ABI) require magnetic resonance imaging (MRI) following implantation. This study explores the patient experience of MRI, identifying factors associated with pain, and the effect of interventions designed to enhance comfort and safety. METHODS: A prospective observational case series from a tertiary referral unit. Tight head bandaging ± local anaesthetic injection (devices with non-MRI-compatible magnets) or observation alone (implants with MRI-compatible magnets) were employed for 1.5 T MRI of consecutive adult patients with CI or ABI without magnet removal. Pain was recorded via visual analogue scale (1 = no pain, 5 = extreme pain) at three time points; (1) baseline, (2) head bandage applied (3) during scanning. Patient age, device type, body area imaged and total scan time were recorded as variables, alongside adverse events. RESULTS: Data were collected for 227 MRI scans (34 patients with ABI, 32 with CI). In patients managed with bandaging, pain score after bandaging but prior to scanning (median 2.2) did not differ from pain during scanning (2.1), but both were significantly higher than baseline (1.4, both P≤0.001). Scanning areas other than the head/cervical spine was associated with higher pain scores (P = 0.036). Pain during MRI differed between different manufacturers implants (P≤0.001). Adverse events occurred in 8/227 scans (3.5%), none occurring with devices containing an MRI-compatible magnet. CONCLUSION: MRI scanning with auditory implant magnets in situ is safe and well tolerated by patients.

Effects of an evidence-based model for cochlear implant aftercare delivery on clinical efficiency and patient outcomes.

Porps SL, Bennett DM, Gilden J … +4 more , Ravelo K, Buck B, Reinhart P, Hong RS

Cochlear Implants Int · 2023 Nov · PMID 36927486 · Publisher ↗

OBJECTIVES: To assess an evidence-based model (EBM) approach to cochlear implant (CI) aftercare that includes a modified, reduced treatment schedule for newly-implanted adult CI recipients consisting of four appointments... OBJECTIVES: To assess an evidence-based model (EBM) approach to cochlear implant (CI) aftercare that includes a modified, reduced treatment schedule for newly-implanted adult CI recipients consisting of four appointments (initial activation, 1-, 3- and 6- months postactivation) in the first year post-surgery. METHOD: This prospective multicenter proof-of-concept study was conducted across three clinics in the United States by five experienced CI clinicians. Seventeen newly-implanted adult patients with postlingual hearing loss enrolled in the study. Hearing outcomes were measured using objective speech testing and subjective self-report measures. RESULTS: Most recipients (14/17; 82%) were able to follow the four-appointment EBM schedule. The reduced number of visits translated into an average time savings of 3 hours per patient. Significant improvements in speech perception were observed at both 3- and 6-months postactivation, as measured by CNC words in quiet and AzBio sentences at +10 dB SNR, consistent with published results achieved by traditional practices. Recipients were significantly satisfied with telephone, music, small group conversation, and television listening at 6 months postactivation. Recipient satisfaction with overall service was rated as "excellent" by 14/14 (100%) respondents. CONCLUSION: The four-appointment EBM approach delivered efficient and effective audiological aftercare to CI recipients in the first year following CI implantation.

Development of the Turkish hearing in noise test for children.

Kartal Özcan E, Çekiç Ş, Sennaroglu G … +1 more , Soli SD

Cochlear Implants Int · 2023 Sep · PMID 36856533 · Publisher ↗

The aim of this study is to develop the Turkish version of hearing in noise test for children (HINT-C) by providing norms and correction factors for the children in different age groups. A total of 77 individuals with no... The aim of this study is to develop the Turkish version of hearing in noise test for children (HINT-C) by providing norms and correction factors for the children in different age groups. A total of 77 individuals with normal hearing - 62 children (6-12 years old) and 15 adults (18-30 years old) - were included. Twelve phonemically balanced 10-sentence lists were created from the adult version of the Turkish HINT (Study 1). Age-specific norms, correction factors and maturation effects were examined using the Turkish HINT-C (Study 2). Mean performances under different listening conditions and Spatial Release from Masking (SRM) advantage values were obtained for the 6-, 8-, 10-, and 12-year-old and estimated for the 7-, 9-, and 11-year-old age groups, and correction factors were calculated for all children age groups. Turkish-speaking children did not achieve adult-like hearing in noise performance, until they were 12 years old. Twelve phonemically balanced 10-sentence lists of Turkish HINT-C were created, and the mean performances of children in different age groups were measured. In addition to the age-specific HINT-C norms and correction factors for the 6-, 8-, 10-, and 12-year-old age groups, the maturation effects were determined. The assessment of speech-in-noise perception is highly critical for children.To evaluate the speech-in-noise perception ability, 12 phonemically balanced 10-sentence lists of Turkish HINT-C were created.Speech-in-noise perception ability improves with age.Turkish-speaking children do not achieve adult-like hearing in noise performance, until they were 12 years old.

Influence of listening environment on usage patterns in cochlear implant patients with single-sided deafness.

Garcia A, Haleem A, Chari DA … +3 more , Morse-Fortier C, Arenberg JG, Lee DJ

Cochlear Implants Int · 2023 Nov · PMID 36846887 · Publisher ↗

OBJECTIVE: To compare cochlear implant (CI) data logging of patients with single-sided deafness (SSD) and bilateral sensorineural hearing loss (biSNHL) in various acoustic environments and study the implications of data... OBJECTIVE: To compare cochlear implant (CI) data logging of patients with single-sided deafness (SSD) and bilateral sensorineural hearing loss (biSNHL) in various acoustic environments and study the implications of data logging on auditory performance. STUDY DESIGN: Retrospective case control study. METHODS: Adult CI patients with SSD or biSNHL from 2010 to 2021 with usage data collected at 3-, 6-, and 12-months following device activation were identified. The CI listening environment was defined as speech in noise, speech in quiet, quiet, music or noise. Auditory performance was measured using the CNC word, AzBio sentence tests and the Tinnitus Handicap Index (THI). RESULTS: 60 adults with SSD or biSNHL were included. CI patients with biSNHL wore their devices more than those with SSD at 3-months post-activation (11.18 versus 8.97 hours/day, = 0.04), though there were no significant differences at 6-12 months. Device usage was highest in the speech in quiet environment. In SSD CI users, there was a positive correlation ( = 0.03) between device use and CNC scores at 12-months and an improvement in THI scores at 12-months ( = 0.0004). CONCLUSIONS: CI users with SSD and biSNHL have comparable duration of device usage at longer follow-up periods with greatest device usage recorded in speech in quiet environments.

Survey of selective electrode deactivation attitudes and practices by cochlear implant audiologists.

Sander KL, Warren SE, Mendel LL

Cochlear Implants Int · 2023 May · PMID 36732065 · Publisher ↗

OBJECTIVES: The purpose of this study was to explore clinician attitudes regarding selective electrode deactivation and to investigate the primary methodology used to identify poorly encoded electrodes, deactivate identi... OBJECTIVES: The purpose of this study was to explore clinician attitudes regarding selective electrode deactivation and to investigate the primary methodology used to identify poorly encoded electrodes, deactivate identified electrodes, and measure outcomes. METHODS: An online survey consisting of 32 questions was administered to certified clinical and research cochlear implant (CI) audiologists. Questions asked participants about their demographic information, device programming patterns, and attitudes regarding selective electrode deactivation. RESULTS: Fifty-four audiologists completed the survey. When asked whether they believed selectively deactivating poorly encoded electrodes could improve speech perception outcomes, 43% of respondents selected 'Probably Yes,' 39% selected 'Definitely Yes,' and 18% selected 'Might or Might Not.' Of those who reported deactivating electrodes as part of CI programming, various methodology was reported to identify and deactivate poorly encoding electrodes and evaluate effectiveness of deactivation. General reasons against deactivation were also reported. DISCUSSION: CI audiologists generally believed selective electrode deactivation could be used to improve speech perception outcomes for patients; however, few reported implementing selective electrode deactivation in practice. Among those who do perform selective electrode deactivation, the reported methodology was highly variable. CONCLUSION: These findings support the need for clinical practice guidelines to assist audiologists in performing selective electrode deactivation.

Language and academic outcomes of children with cochlear implants in an inclusive setting: Evidence from 18 years of data.

Wilson Ottley SM, Ouellette M, Mellon NK … +3 more , Caverly C, Mitchell CM, Adams Costa E

Cochlear Implants Int · 2023 May · PMID 36670525 · Publisher ↗

OBJECTIVE: This study examined outcomes in core and pragmatic language, receptive vocabulary, and academic skills in children with cochlear implants (CIs) enrolled in an inclusive educational setting. METHODS: Eighty-eig... OBJECTIVE: This study examined outcomes in core and pragmatic language, receptive vocabulary, and academic skills in children with cochlear implants (CIs) enrolled in an inclusive educational setting. METHODS: Eighty-eight children with CIs were included in the analyses. Data was collected over an 18-year period, at six-month intervals for core language, vocabulary, and pragmatic skills and in kindergarten and second grade for academic skills. Kaplan-Meier analyses were used to estimate the median time to achieve age-appropriate scores. RESULTS: Results indicated the median time to obtain age-appropriate skills for children with CIs enrolled in our program was less than three years for core language and pragmatic skills and less than two years for vocabulary. Over 90% of the sample had academic skills in the average range in both kindergarten and second grade. DISCUSSION: This study shares outcomes of children with CIs who received consistent and intensive transdisciplinary intervention in an inclusive educational setting, revealing the trajectory required to obtain age-appropriate skills, when compared to normative data. CONCLUSION: Results were favorable, indicating that children with CIs in an inclusive program, with intensive intervention and strong language and social models, can develop skills commensurate with typically developing peers across a variety of core skills.

Assessing the risk of magnetic interaction between auditory implants and programmable ventriculoperitoneal shunts.

Shrivastava M, Abdul-Hamid A, Zilani G … +3 more , Qureishi A, Jeyaretna S, Mackeith S

Cochlear Implants Int · 2023 Mar · PMID 36647577 · Publisher ↗

PURPOSE: This study investigated whether the magnetic field of the internal magnet of cochlear implants and bone-anchored hearing aids (BAHA) would be sufficient to affect a programmable ventriculoperitoneal (VP) shunt.... PURPOSE: This study investigated whether the magnetic field of the internal magnet of cochlear implants and bone-anchored hearing aids (BAHA) would be sufficient to affect a programmable ventriculoperitoneal (VP) shunt. Current guidelines suggest against implanting these hearing devices ipsilateral to a programmable VP shunt, but the exact nature of the interaction has not been quantified. METHODS: The magnetic field strength (mT) was measured at 0 and 10 mm from the edge of both the Cochlear Implant CI512 (Cochlear Corporation) magnet and BAHA Attract magnet. Next, the hearing devices were placed into their anatomical positions in a 3-D clay model, along with three different types of programmable VP shunts. The valve setting was measured before and after exposure. RESULTS: At 10 mm, neither device generated a magnetic field sufficient to adjust the VP shunt valve. In the clay model, the valve settings were not affected by the presence of any device. CONCLUSION: Neither the cochlear implant nor the BAHA subcutaneous internal magnets generated sufficient magnetic field to reprogramme the valves of commonly used programmable VP shunts. The magnetic field from each device decreases dramatically at 10 mm. Further clinical studies to help mitigate the current restrictive guidance should consider involvement of VP shunt manufacturers to inform future shunt development and design.

The effect of telepractice on vocal turn-taking between a provider, children with cochlear implants, and caregivers: A preliminary report.

Kondaurova MV, Zheng Q, Donaldson CW … +3 more , Betts A, Smith AF, Fagan MK

Cochlear Implants Int · 2023 May · PMID 36624981 · Publisher ↗

OBJECTIVES: To examine the effect of telepractice on vocal turn-taking between one clinical provider and children with cochlear implants and their caregivers during child-centered auditory rehabilitation intervention. ME... OBJECTIVES: To examine the effect of telepractice on vocal turn-taking between one clinical provider and children with cochlear implants and their caregivers during child-centered auditory rehabilitation intervention. METHODS: Seven dyads of children with cochlear implants (mean age 4:11 years) and their hearing mothers and one speech-language pathologist participated together in a telepractice session and an in-person intervention session. Dependent variables were vocalization rate, turn taking rate, rate of speech overlap per second, and between-speaker pause duration. RESULTS: The speech-language pathologist and children had lower rates of vocalization in the telepractice session than the in-person session. However, maternal vocalization rate was higher in the telepractice than in-person session. The rate of turn-taking between the provider and children was lower in telepractice than in-person sessions but the rate of turn taking between mothers and children was higher in telepractice than in-person sessions. Between-speaker pause duration between children and the provider and between mothers and children was longer in telepractice than in-person sessions. Rate of speech overlap did not vary significantly by session type. DISCUSSION: The quantity and temporal characteristics of vocal turn-taking were impacted by remote communication during tele-intervention suggesting a potential increase in the cognitive effort required of participants.

From hearing aids to cochlear implants: The journey for private patients in New Zealand.

Looi V, de Jongh N, Kelly-Campbell R

Cochlear Implants Int · 2023 May · PMID 36624980 · Publisher ↗

OBJECTIVES: To understand adults' journey from hearing aids to cochlear implants (CIs). METHODS: Qualitative, exploratory design using semi-structured interviews with twelve postlingually-deafened adults. RESULTS AND DIS... OBJECTIVES: To understand adults' journey from hearing aids to cochlear implants (CIs). METHODS: Qualitative, exploratory design using semi-structured interviews with twelve postlingually-deafened adults. RESULTS AND DISCUSSION: All participants reported social isolation and/or depression. 'Not hearing well enough' was the most-common motivator to seek a CI. Due to the long wait for a public CI, they opted to pay for their implant privately. Funding was the most prominent barrier identified, with most participants using their own savings. The biggest struggle was in the period 3-months post switch-on. Many participants felt progress was slow and that they should have been doing better. After this period, benefits were most noted in quiet, with environmental sounds, and in helping them become more sociable. Music and telephone use were still areas many struggled with. CONCLUSIONS: Participants reported the CI was worth the cost, that they would recommend it to others, and would do it again. Self-motivation was the biggest facilitator to success, with hearing professionals playing an integral role throughout the entire journey. There was a large variety of subthemes reflecting the diversity and individuality of the transition.

Auditory rehabilitation after temporal bone fracture with cochlear implants - a case control study.

Heine K, Timm ME, Gärtner L … +2 more , Lenarz T, Lesinski-Schiedat A

Cochlear Implants Int · 2023 Jul · PMID 36617461 · Publisher ↗

OBJECTIVES: Temporal bone fracture can cause posttraumatic deafness. Sequelae like ossification or obliteration of the cochlea can impact the outcome of cochlear implantation. This study highlights the effect of localisa... OBJECTIVES: Temporal bone fracture can cause posttraumatic deafness. Sequelae like ossification or obliteration of the cochlea can impact the outcome of cochlear implantation. This study highlights the effect of localisation of the fracture to morphologic, electric and functional criteria. METHODS: The study group consists of patients suffering from hearing loss caused by temporal bone fracture ( = 61 ears). Patients were divided into otic capsule sparing (OCS) and otic capsule involving (OCI) fractures. The OCI group was additionally divided into subgroups with or without signs of ossification inside the cochlea. Postoperative imaging, hearing tests and electrode impedances were analysed. RESULTS: The results of postoperative hearing rehabilitation showed lower speech understanding scores for the OCI group, especially for the ossification group. OCI fractures with signs of ossification showed increased impedances. Patients in the OCI group suffered more frequently from facial nerve stimulation (FNS). FNS was most frequently observed within the ossification group. CONCLUSION: Cochlear implantation in patients with temporal bone fracture is adequate therapy for the treatment of fracture-induced deafness. In long-term observation, these patients show comparable results with regular cochlear implant (CI) patients. Implantation should be performed as soon as possible after hearing loss, before obstructing obliteration or ossification of the cochlea start.
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