Does cochlear implant electrode array design affect audiologic outcomes? A systematic review and meta-analysis.

Background: There is conflicting literature regarding whether cochlear implants (CI) electrode array (EA) selection impacts audiologic outcomes.

Objective: To compare outcomes for the two EA designs, precurved and straight.

Methods: A systematic search of CINAHL, Cochrane Library, PubMed, and SCOPUS was conducted according to PRISMA guidelines.

Cochlear Implant Electrode Placement and Music Perception.

Importance: Cochlear implants enable improvements in speech perception, but music perception outcomes remain variable. Image-guided cochlear implant programming has emerged as a potential programming strategy for increasing the quality of spectral information delivered through the cochlear implant to improve outcomes.

Objectives: To perform 2 experiments, the first of which modeled the variance in music perception scores as a function of electrode positioning factors, and the second of which evaluated image-guided cochlear implant programming as a strategy to improve music perception with a cochlear implant.

Assessing Academic Preferential Hiring Practices in Highly Ranked Otolaryngology Departments.

To assess whether preferential hiring practices, particularly self-hiring, are present in academic otolaryngology departments. A list of academic Otolaryngology-Head and Neck Surgery (O-HNS) departments ranked #1-40 was generated from the Doximity 2021 rankings. The educational background and training information of clinical faculty members and departmental leadership was extracted from each department's online directories.

Amplitude Parameters Are Predictive of Hearing Preservation in a Randomized Controlled Trial of Intracochlear Electrocochleography During Cochlear Implant Surgery.

Objective: To prospectively evaluate the association between hearing preservation after cochlear implantation (CI) and intracochlear electrocochleography (ECochG) amplitude parameters.

Study Design: Multi-institutional, prospective randomized clinical trial.

Setting: Ten high-volume, tertiary care CI centers.

Clinical Applications for Spread of Excitation Functions Obtained Via Electrically Evoked Compound Action Potentials (eCAP).

Objectives: To assess the clinical utility of spread of excitation (SOE) functions obtained via electrically evoked compound action potentials (eCAP) to 1) identify electrode array tip fold-over, 2) predict electrode placement factors confirmed via postoperative computed tomography (CT) imaging, and 3) predict postoperative speech recognition through the first year post-activation in a large clinical sample.

Study Design: Retrospective case review.

Setting: Cochlear implant (CI) program at a tertiary medical center.

A Unified Deep-Learning-Based Framework for Cochlear Implant Electrode Array Localization.

Cochlear implants (CIs) are neuroprosthetics that can provide a sense of sound to people with severe-to-profound hearing loss. A CI contains an electrode array (EA) that is threaded into the cochlea during surgery. Recent studies have shown that hearing outcomes are correlated with EA placement.

Towards inferring positioning of straight cochlear-implant electrode arrays during insertion using real-time impedance sensing.

Background: Cochlear-implant electrode arrays (EAs) are currently inserted with limited feedback, and impedance sensing has recently shown promise for EA localisation.

Methods: We investigate the use of impedance sensing to infer the progression of an EA during insertion.

Results: We show that the access resistance component of bipolar impedance sensing can detect when a straight EA reaches key anatomical locations in a plastic cochlea and when each electrode contact enters/exits the cochlea.

The Use of Portable, Very Low-field (0.064T) MRI to Image Cochlear Implants: Metallic Image Artifact in Comparison to Traditional, Stationary 3T MRI.

Objective: To assess image artifact when imaging a cochlear implant (CI) with a conventional 3T MRI machine compared with a very low-field (0.064T) MRI.

Patients: None.

Prognosis of Bilateral Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-Analysis.

Objectives: To comprehensively examine the characteristics and prognosis of bilateral sudden sensorineural hearing loss (BSSHL) and its subtypes compared to unilateral sudden sensorineural hearing loss (USSHL).

Data Sources: PubMed, Scopus, and CINAHL.

Review Methods: Databases were searched from inception to December 5, 2023, for studies reporting patient characteristics and audiometric outcomes for BSSHL and its simultaneous (Si-BSSHL) and sequential (Se-BSSHL) subtypes.

Neuromodulation for Treatment of Tinnitus: A Systematic Review and Meta-Analysis.

Objective: To evaluate the treatment efficacy of neuromodulation versus sham for the treatment of tinnitus.

Data Sources: Cochrane Library, CINAHL, PubMed, Scopus.

Review Methods: The Cochrane Library, CINAHL, PubMed, and Scopus were searched from inception through May 2023 for English language articles documenting "neuromodulation" and "tinnitus" stratified by sham-controlled randomized control trials with 40 or more patients.

Effect of Hepatic Impairment on the Pharmacokinetics of Nirmatrelvir/Ritonavir, the First Oral Protease Inhibitor for the Treatment of COVID-19.

Nirmatrelvir, a novel, potent, orally bioavailable severe acute respiratory syndrome coronavirus 2 main protease inhibitor, coadministered with ritonavir for pharmacokinetic (PK) enhancement is licensed for the treatment of mild to moderate COVID-19 in individuals at increased risk of progression to severe disease. Cytochrome P450 3A4 is the primary metabolic enzyme responsible for nirmatrelvir metabolism; however, when cytochrome P450 3A4 is inhibited by ritonavir, nirmatrelvir is primarily excreted, unchanged, in urine. Because of intended use of nirmatrelvir among individuals with hepatic impairment, this Phase 1 study (NCT05005312) evaluated the effects of hepatic impairment on nirmatrelvir PK parameters to assess the potential need for any dose adjustments in this population.

Content Validity of a High-Fidelity Surgical Middle Ear Simulator: A Randomized Prospective International Multicenter Trial.

Objective: After demonstration of face validity of a surgical middle ear simulator (SMS) previously, we assessed the content validity of the simulator with otolaryngology residents.

Study Design: Multicenter randomized prospective international study.

Setting: Four academic institutions.

Electrode array positioning after cochlear reimplantation from single manufacturer.

Objective: To investigate whether revision surgery with the same device results in a change in three key indicators of electrode positioning: scalar location, mean modiolar distance (), and angular insertion depth (AID).

Methods: Retrospective analysis of a cochlear implant database at a university-based tertiary medical center. Intra-operative CT scans were obtained after initial and revision implantation.

Validation of active shape model techniques for intracochlear anatomy segmentation in computed tomography images.

Purpose: Cochlear implants (CIs) have been shown to be highly effective restorative devices for patients suffering from severe-to-profound hearing loss. Hearing outcomes with CIs depend on electrode positions with respect to intracochlear anatomy. Intracochlear anatomy can only be directly visualized using high-resolution modalities, such as micro-computed tomography (), which cannot be used .

Effects of nirmatrelvir/ritonavir on midazolam and dabigatran pharmacokinetics in healthy participants.

Aims: To evaluate pharmacokinetics (PK) and safety after coadministration of nirmatrelvir/ritonavir or ritonavir alone with midazolam (a cytochrome P450 3A4 substrate) and dabigatran (a P-glycoprotein substrate).

Methods: PK was studied in 2 phase 1, open-label, fixed-sequence studies in healthy adults. Single oral doses of midazolam 2 mg (n = 12) or dabigatran 75 mg (n = 24) were administered alone and after steady state (i.

Effects of the Number of Channels and Channel Stimulation Rate on Speech Recognition and Sound Quality Using Precurved Electrode Arrays.

Purpose: This study investigated the relationship between the number of active electrodes, channel stimulation rate, and their interaction on speech recognition and sound quality measures while controlling for electrode placement. Cochlear implant (CI) recipients with precurved electrode arrays placed entirely within scala tympani and closer to the modiolus were hypothesized to be able to utilize more channels and possibly higher stimulation rates to achieve better speech recognition performance and sound quality ratings than recipients in previous studies.

Method: Participants included seven postlingually deafened adult CI recipients with Advanced Bionics Mid-Scala electrode arrays confirmed to be entirely within scala tympani using postoperative computerized tomography.

Effects of itraconazole and carbamazepine on the pharmacokinetics of nirmatrelvir/ritonavir in healthy adults.

Aims: The objective of this study was to evaluate the effects of a strong cytochrome P450 family (CYP) 3A4 inhibitor (itraconazole) and inducer (carbamazepine) on the pharmacokinetics and safety of nirmatrelvir/ritonavir.

Methods: Pharmacokinetics were measured in two phase 1, open-label, fixed-sequence studies in healthy adults. During Period 1, oral nirmatrelvir/ritonavir 300 mg/100 mg twice daily was administered alone; during Period 2, it was administered with itraconazole or carbamazepine.

The Impact of Surgical Indication on Posttonsillectomy Hemorrhage: A Systematic Review and Meta-Analysis.

Objective: To investigate the impact of the surgical indication on posttonsillectomy bleed rates.

Data Sources: PubMed, Scopus, CINAHL.

Review Methods: A systematic review was performed searching for articles published from the date of inception to July 6, 2022.

Dynamic Behavior and Insertional Forces of a Precurved Electrode Using the Pull-Back Technique in a Fresh Microdissected Cochlea.

Hypothesis: This study evaluated the utility of the pull-back technique in improving perimodiolar positioning of a precurved cochlear implant (CI) electrode array (EA) with simultaneous insertion force profile measurement and direct observation of dynamic EA behavior.

Background: Precurved EAs with perimodiolar positioning have improved outcomes compared with straight EAs because of lowered charge requirements for stimulation and decreased spread of excitation. The safety and efficacy of the pull-back technique in further improving perimodiolar positioning and its associated force profile have not been adequately demonstrated.

Activation region overlap visualization for image-guided cochlear implant programming.

. The cochlear implant is a neural prosthesis designed to directly stimulate auditory nerve fibers to induce the sensation of hearing in those experiencing severe-to-profound hearing loss. After surgical implantation, audiologists program the implant's external processor with settings intended to produce optimal hearing outcomes.

Robotic pullback technique of a precurved cochlear-implant electrode array using real-time impedance sensing feedback.

Purpose: During traditional insertion of cochlear implant (CI) electrode arrays (EAs), surgeons rely on limited tactile feedback and visualization of the EA entering the cochlea to control the insertion. One insertion approach for precurved EAs involves slightly overinserting the EA and then retracting it slightly to achieve closer hugging of the modiolus. In this work, we investigate whether electrical impedance sensing could be a valuable real-time feedback tool to advise this pullback technique.

Guidelines for Best Practice in the Audiological Management of Adults Using Bimodal Hearing Configurations.

Clinics are treating a growing number of patients with greater amounts of residual hearing. These patients often benefit from a bimodal hearing configuration in which acoustic input from a hearing aid on 1 ear is combined with electrical stimulation from a cochlear implant on the other ear. The current guidelines aim to review the literature and provide best practice recommendations for the evaluation and treatment of individuals with bilateral sensorineural hearing loss who may benefit from bimodal hearing configurations.

Cochlear implant spectral bandwidth for optimizing electric and acoustic stimulation (EAS).

Cochlear implantation with acoustic hearing preservation is becoming increasingly prevalent allowing cochlear implant (CI) users to combine electric and acoustic stimulation (EAS) in the implanted ears. Despite a growing EAS population, our field does not have definitive guidance regarding EAS technology optimization and the majority of previous studies investigating hearing aid (HA) and cochlear implant (CI) programming for EAS listeners have been mixed. Thus, the purpose of this exploratory study was to explore the effects of various EAS crossover frequencies-defined as the low-frequency (LF) CI cutoff-relative to the underlying spiral ganglion (SG) characteristic frequency associated with the most distal or apical electrode in the array.