Effect of exceeding compliance voltage on speech perception in cochlear implants.

Objectives: In cochlear implants, the maximum current I (Amperes) that can be delivered on a cochlear implant electrode is determined by V = I * R, where V = compliance voltage (Volts) and R = electrode impedance (Ohms). Generally, electrode impedances are measured during each clinical visit and are used to set electrical stimulation parameters in cochlear implants. However, electrode impedances can rise during the course of cochlear implant use and lead to electrical stimulation voltage requirements exceeding the maximum compliance voltage of the medical device.

Increase in cochlear implant electrode impedances with the use of electrical stimulation.

Objective: Electrode impedances play a critical role in cochlear implant programming. It has been previously shown that impedances rise during periods of non-use, such as the post-operative recovery period. Then when the device is activated and use is initiated, impedances fall and are typically stable.

Monitoring Cochlear Nerve Integrity During Vestibular Schwannoma Microsurgery in Real-Time Using Cochlear Implant Evoked Auditory Brainstem Response and Streaming Neural Response Imaging.

Objective: Intraoperative far-field auditory brainstem response (ABR) and direct cochlear nerve action potential monitoring using neural response imaging (NRI) are techniques for monitoring the cochlear nerve during vestibular schwannoma (VS) surgery. A new paradigm has developed where the cochlear nerve is anatomically preserved during tumor removal to facilitate cochlear implantation in select circumstances. This report describes the use of an unmodified commercial cochlear implant (CI) to elicit electrically-evoked direct cochlear nerve and far-field ABR monitoring to evaluate the status of the cochlear nerve during tumor resection in real time.

Assessment of Temporal Fine Structure Processing Among Older Adults With Cochlear Implants.

Objectives: The purpose of this study was to determine if older adults with cochlear implants are able to take advantage of coding schemes that preserve temporal fine structure (TFS) cues.

Design: A total of 19 older adults with cochlear implants participated in a prospective, repeated measures, A to B design. Participants entered the study using TFS.

Application of Kaizen Principles to a Large Cochlear Implant Practice: A Continuous Quality Improvement Initiative at Mayo Clinic.

Objective: To remove barriers and improve access for patients seeking cochlear implantation.

Study Design: Prospective quality improvement study at a large tertiary academic care center.

Methods: A Kaizen quality improvement model was applied over the course of a year.

Cochlear Implantation in Charcot-Marie-Tooth Disease: Case Report and Review of the Literature.

Introduction: Charcot-Marie-Tooth (CMT) disease is a peripheral hereditary neuropathy associated with motor and sensory impairment and can result in profound sensorineural hearing loss (SNHL). Currently, the role of cochlear implantation in the setting of CMT and other progressive peripheral neurodegenerative disorders is not well established.

Methods: Case report and review of the English literature.

Health-related quality of life outcomes following adult cochlear implantation: A prospective cohort study.

Introduction: The benefits of cochlear implantation extend beyond improved speech recognition and into overall health-related quality of life (HRQoL). Several measures of HRQoL, categorized as generic or disease specific, have been used in the cochlear implant literature. The clinical utility of generic HRQoL measures have been reported to be variable by previous investigators.

Early outcomes after cochlear implantation for adults and children with unilateral hearing loss.

Objectives/hypothesis: This study was designed to examine speech recognition and self-perceived health-related quality of life (HRQoL) received from cochlear implantation among a cohort of adults and children with a short duration of unilateral hearing loss greater than 6 months, but less than 2 years.

Study Design: Single-subject repeated measures prospective study.

Methods: This study assessed changes in speech recognition and self-perceived quality of life by prospectively analyzing data at the preoperative evaluation and at the 3-month and 6-month postactivation intervals.

Availability of binaural cues for bilateral implant recipients and bimodal listeners with and without preserved hearing in the implanted ear.

The purpose of this study was to examine the availability of binaural cues for adult, bilateral cochlear implant (CI) patients, bimodal patients and hearing preservation patients using a multiple-baseline, observational study design. Speech recognition was assessed using the Bamford-Kowal-Bench Speech-in-Noise (BKB-SIN) test as well as the AzBio sentences [Spahr AJ, et al: Ear Hear 2012;33:112-117] presented in a multi-talker babble at a +5 dB signal-to-noise ratio (SNR). Test conditions included speech at 0° with noise presented at 0° (S0N0), 90° (S0N90) and 270° (S0N270).

Improving speech perception in noise for children with cochlear implants.

Background: Current cochlear implant recipients are achieving increasingly higher levels of speech recognition; however, the presence of background noise continues to significantly degrade speech understanding for even the best performers. Newer generation Nucleus cochlear implant sound processors can be programmed with SmartSound strategies that have been shown to improve speech understanding in noise for adult cochlear implant recipients. The applicability of these strategies for use in children, however, is not fully understood nor widely accepted.

Cochlear implantation in the octogenarian and nonagenarian.

Objective: Previous studies have shown that cochlear implant outcomes with respect to surgical morbidity and speech perception may be poorer in elderly patients as compared with younger adults. However, recent anecdotal reports suggest that elderly cochlear implant recipients are achieving increasingly higher speech perception performance and fewer surgical complications than previously noted. Our objective is to review cochlear implant outcomes using newer generation implants and minimally traumatic cochleostomy techniques in patients 80 years and older compared with younger adult recipients.