Minimum intraoperative testing battery for cochlear implantation: the international practice trend.

Purpose: In cochlear implantation (CI) surgery, there are a wide variety of intraoperative tests available. However, no clear guide exists on which tests must be performed as the minimum intraoperative testing battery. Toward this end, we studied the usage patterns, recommendations, and attitudes of practitioners toward intraoperative testing.

Using Pupillometry to Evaluate Balance in Patients Implanted with a Cochleo-Vestibular Implant.

Maintaining balance comes naturally to healthy people. In subjects with vestibulopathy, even when compensated, and especially if it is bilateral, maintaining balance requires cognitive effort. Pupillometry is an established method of quantifying cognitive effort.

International Consensus Statements on Intraoperative Testing for Cochlear Implantation Surgery.

Objectives: A wide variety of intraoperative tests are available in cochlear implantation. However, no consensus exists on which tests constitute the minimum necessary battery. We assembled an international panel of clinical experts to develop, refine, and vote upon a set of core consensus statements.

Stimulation Crosstalk Between Cochlear And Vestibular Spaces During Cochlear Electrical Stimulation.

Objectives: Possible beneficial "crosstalk" during cochlear implant stimulation on otolith end organs has been hypothesized. The aim of this case-control study is to analyze the effect of electrical cochlear stimulation on the vestibule (otolith end-organ), when using a cochleo-vestibular implant, comparing vestibular stimulation (VI) and cochlear stimulation (CI).

Methods: Four patients with bilateral vestibulopathy were included.

COVID-19 era: Hearing handicaps behind face mask use in hearing aid users.

Background: The aim of this study was to assess the effect on speech perception and lack of hearing devices gain with surgical masks worn in hearing aid users.

Methods: This prospective cohort study enrolled consecutive patients between November 2020 and February 2021 in a tertiary care medical center from Spain. Fifty-five subjects have been included, 10 as control group, with normal hearing, and 45 patients with sensory-neural hearing loss and hearing aid users, ranging in age between 31 and 83 years old, and were recruited randomized in 4 months.

Dynamic Visual Acuity Results in Otolith Electrical Stimulation in Bilateral Vestibular Dysfunction.

(1) Background. Patients with bilateral vestibular disease (BVD) experience oscillopsia with a detriment to visual acuity (VA). This VA is driven mainly by the VOR that has two components: rotational and translational.

Assessing the Placement of the Cochlear Slim Perimodiolar Electrode Array by Trans Impedance Matrix Analysis: A Temporal Bone Study.

Unlabelled: New cochlear implant (CI) electrode arrays provide softer insertion dynamics; however, due to their high flexibility, the possibilities of fold-overs or intraoperative displacements must be taken into account. The position of each individual electrode can only be determined by using high-resolution computed tomography or cone-beam CT. The trans-impedance matrix test (TIM) is an electrophysiological method based on electric field imaging that can provide images of electrode position and electrode folding.

A phenomenological computational model of the evoked action potential fitted to human cochlear implant responses.

There is a growing interest in biomedical engineering in developing procedures that provide accurate simulations of the neural response to electrical stimulus produced by implants. Moreover, recent research focuses on models that take into account individual patient characteristics. We present a phenomenological computational model that is customized with the patient's data provided by the electrically evoked compound action potential (ECAP) for simulating the neural response to electrical stimulus produced by the electrodes of cochlear implants (CIs).

Evaluation of a Transimpedance Matrix Algorithm to Detect Anomalous Cochlear Implant Electrode Position.

Introduction: Transimpedance measurements from cochlear implant electrodes have the potential to identify anomalous electrode array placement, such as tip fold-over (TFO) or fold-back, basal electrode kinking, or buckling. Analysing transimpedance may thus replace intraoperative or post-operative radiological imaging to detect any potential misplacements. A transimpedance algorithm was previously developed to detect deviations from a normal electrode position with the aim of intraoperatively detecting TFO.

Why Should Constant Stimulation of Saccular Afferents Modify the Posture and Gait of Patients with Bilateral Vestibular Dysfunction? The Saccular Substitution Hypothesis.

An ongoing EU Horizon 2020 Project called BionicVEST is investigating the effect of constant electrical stimulation (ES) of the inferior vestibular nerve in patients with bilateral vestibular dysfunction (BVD). The evidence is that constant ES results in improved postural stability and gait performance, and so the question of central importance concerns how constant ES of mainly saccular afferents in these BVD patients could cause this improved performance. We suggest that the constant ES substitutes for the absent saccular neural input to the vestibular nuclei and the cerebellum in these BVD patients and indirectly via these structures to other structures, which have been of great recent interest in motor control.

Cochlear Implants in Single-Sided Deafness. Comparison Between Children and Adult Populations With Post-lingually Acquired Severe to Profound Hearing Loss.

To determine audiological and clinical results of cochlear implantation (CI) comparing two populations with single-sided deafness (SSD): post-lingually deaf children between 6 and 12 years of age, and post-lingually deaf adults, in order to evaluate the effect of CI in different age groups. Retrospective case review. Tertiary clinic.

Transcutaneous Osseo-integrated Auditory Devices: Analysis of Two Different Implants in Adults With Different Audiological Inclusion Criteria.

Objective: To determine and compare audiological and speech/language discrimination results in patients with osteo-integrated auditory devices, by comparing two different systems including different audiological indications in adult population.

Study Design: Descriptive and analytic, cross-sectional, cohort, and retrospective case review.

Setting: Tertiary referral center.

Analysis of Neural Interface When Using Modiolar Electrode Stimulation. Radiological Evaluation, Trans-Impedance Matrix Analysis and Effect on Listening Effort in Cochlear Implantation.

Background: The proximity of the electrode to the modiolar wall may be of interest to investigate the effect of pitch discrimination. This research establishes the relation between these factors and whether perimodiolar positions may provide benefits regarding improved electrode discrimination.

Methods: A prospective randomized study including 24 post-lingual deaf adults was performed.

Differences in Vestibular-Evoked Myogenic Potential Responses by Using Cochlear Implant and Otolith Organ Direct Stimulation.

Several studies have demonstrated the possibility to obtain vestibular potentials elicited with electrical stimulation from cochlear and vestibular implants. The objective of this study is to analyze the vestibular-evoked myogenic potentials (VEMPs) obtained from patients implanted with cochlear and vestibulo-cochlear implant. We compared two groups: in the first group, four cochlear implant (CI) recipients with present acoustic cVEMPs before CI surgery were included.

The Superiority of the Otolith System.

Background: The peripheral vestibular end organ is considered to consist of semi-circular canals (SCC) for detection of angular accelerations and the otoliths for detection of linear accelerations. However, otoliths being phylogenetically the oldest part of the vestibular sensory organs are involved in detection of all motions.

Summary: This study elaborates on this property of the otolith organ, as this concept can be of importance for the currently designed vestibular implant devices.

Chronic Electrical Stimulation of the Otolith Organ: Preliminary Results in Humans with Bilateral Vestibulopathy and Sensorineural Hearing Loss.

Introduction: Bilateral vestibulopathy is an important cause of imbalance that is misdiagnosed. The clinical management of patients with bilateral vestibular loss remains difficult as there is no clear evidence for an effective treatment. In this paper, we try to analyze the effect of chronic electrical stimulation and adaptation to electrical stimulation of the vestibular system in humans when stimulating the otolith organ with a constant pulse train to mitigate imbalance due to bilateral vestibular dysfunction (BVD).

Electrical Vestibular Stimulation in Humans: A Narrative Review.

Background: In patients with bilateral vestibulopathy, the regular treatment options, such as medication, surgery, and/or vestibular rehabilitation, do not always suffice. Therefore, the focus in this field of vestibular research shifted to electrical vestibular stimulation (EVS) and the development of a system capable of artificially restoring the vestibular function. Key Message: Currently, three approaches are being investigated: vestibular co-stimulation with a cochlear implant (CI), EVS with a vestibular implant (VI), and galvanic vestibular stimulation (GVS).

Intraoperative Intracochlear Electrocochleography and Residual Hearing Preservation Outcomes When Using Two Types of Slim Electrode Arrays in Cochlear Implantation.

Objectives: To report residual hearing preservation outcomes in patients with low frequency hearing, after cochlear implant (CI) electrode insertion with two types of electrode arrays: one straight and other perimodiolar, when using intraoperative intracochlear electrocochleography (ECochG) during (CI) electrode insertion.

Study Design: Prospective, randomized study.

Setting: Tertiary referral otology center.

Evaluation of Intracochlear Position of a Slim Modiolar Electrode Array, by Using Different Radiological Analyses.

Introduction: The radiological analysis following a cochlear implantation offers insight into the audiological outcomes of cochlear implant recipients. The wrapping factor (WF) is the most common radiological analysis measuring the modiolar position and depth of insertion of an electrode array. New measurements like the intracochlear position index (ICPI) or the homogeneity factor (HF) can offer more accurate information regarding the electrode's intracochlear position.

Single-sided deafness and cochlear implantation in congenital and acquired hearing loss in children.

Objective: To determine the audiological and clinical results of cochlear implantation in children below the age of 12 years old with congenital and acquired single-sided deafness.

Design: Observational, descriptive, transversal study.

Main Outcome Measures: Speech reception thresholds, Cortical responses, Auditory Lateralization Test and SSQ questionnaire.

A multiobjective optimization procedure for the electrode design of cochlear implants.

This paper presents a new procedure to design optimal electrodes for cochlear implants. The main objective of this study is to find a set of electrode designs that maximize the focalization and minimize the power consumption simultaneously. To achieve that, a criterion to measure the ability of focalization of an electrode is proposed.

Imaging evaluation of electrode placement and effect on electrode discrimination on different cochlear implant electrode arrays.

The aim of the present study is to evaluate the effect of electrode discrimination based on electrode to modiolus distance in different cochlear implant models, using image information to estimate the outcomes after an implantation on electrode discrimination METHODS: A descriptive prospective randomized study performed during 16 months. A psychoacoustic platform was used to evaluate patients' electrode discrimination capabilities of patients. For the acquisition of the images, a cone beam computed tomography was used to assess postcochlear implantation of electrodes' position.

Importance of Perimodiolar Electrode Position for Psychoacoustic Discrimination in Cochlear Implantation.

Hypothesis: Modiolar proximity of the cochlear implant electrodes and low impedance values have a positive effect on electrical pitch discrimination.

Background: The proximity of the cochlear electrode to the modiolar wall can determine changes in tissue and fluid environment. With the onset of soft-surgery techniques, the trauma caused during surgery has been reduced, minimizing fibrous growth.

Vestibular Response to Electrical Stimulation of the Otolith Organs. Implications in the Development of A Vestibular Implant for the Improvement of the Sensation of Gravitoinertial Accelerations.

Objective: Electrical stimulation of the utricular and saccular portions of the vestibular nerve improves stability in patients suffering from vestibular dysfunction. The main objective of this study was to evaluate a new technique, vestibular response telemetry (VRT), for measuring the electrically evoked vestibular compound action potential (saccular and utricular) after stimulating the otolith organ (saccular and utricular) in adults. This study used evidence that the otolith organ can be electrically stimulated in order to develop a new vestibular implant design to improve the sensation of gravitoinertial acceleration.

Health-Related Quality of Life in Adult Cochlear Implant Users: A Descriptive Observational Study.

Cochlear implantation has a significant impact on patients' social life, performance of activities, and self-esteem. The objective of this retrospective study was to assess the health-related quality of life of cochlear implant users aged under and over 60 years by a self-report using the Glasgow Health Status Inventory and the Abbreviated Profile of Hearing Aid Benefit. It was observed that quality of life values increased very rapidly straight after implantation regardless of age.