Hearing preservation in paediatric cochlear implantation with the Nucleus Slim Straight Electrode - our experience.

Objective: to evaluate the levels of successful hearing preservation and preservation of functional hearing following cochlear implantation (HPCI) in children using the Cochlear Nucleus® Slim Straight Electrode (SSE).

Design: retrospective case note review of paediatric HPCI cases in our CI centre from 2013 to 2023. Inclusion criteria were attempted hearing preservation surgery, SSE used for implantation, pre-operative hearing thresholds ≤80dBHL at 250 Hz, CI before 18 years of age.

Blinded comparison of computed tomography, ultrasound and needle methods to measure skin flap thickness for cochlear implantation.

Purpose: Patient suitability for cochlear implant (CI) devices compatible with magnetic resonance imaging and CI processor configuration is dependent on their retro-auricular skin flap thickness. This is typically measured intra-operatively using a needle and therefore patients are not guaranteed their implant of choice prior to surgery. We aimed to identify an accurate method to measure skin flap thickness pre-operatively to streamline CI selection and simplify the consent process.

Children using a unilateral cochlear implant and contralateral hearing aid: bimodal hearing outcomes when one ear is outside the UK (NICE 2009) audiological criteria for cochlear implantation - a single site case-control study.

Introduction: In the new revised National Institute for Health & Care Excellence (NICE, TA566, 2019) guidelines for cochlear implantation (CI) have clearly stipulated that the hearing loss must be bilateral. Prior to this revision, children and young people (CYP) with asymmetrical thresholds have been considered for unilateral CI when one ear was in audiological criteria. Children with asymmetrical hearing loss represent an important cohort of potential CI candidates, who will continue to be prevented from benefiting from CI unless evidence is produced to support implantation and maximise subsequent benefit.

'Real-life' benefit of hearing preservation cochlear implantation in the paediatric population: a single-site case-control study.

Introduction: Cochlear implantation with hearing preservation (HPCI) has allowed a cochlear implant (CI) electrode to be implanted while trying to preserve residual acoustic low-frequency hearing. The concept arises from the importance of this low-frequency information and the limitations of a CI in several auditory domains. The combination of electrical hearing with either preserved acoustic hearing or amplified 'natural' hearing has the potential to address these issues and enable children with HPCI to closely follow normal auditory development.

Translabyrinthine resection of NF2 associated vestibular schwannoma with cochlear implant insertion.

The authors present the case of a 24-year-old female with neurofibromatosis type 2. Growth of the left vestibular schwannoma and progressive hearing loss prompted the decision to proceed to translabyrinthine resection with cochlear nerve preservation and cochlear implant insertion. Complete resection with preservation of the facial and cochlear nerves was achieved.

Worldwide Variation in Cochlear Implant Candidacy.

Background: The aim of this study was to find out how candidacy criteria have evolved differently across the globe.

Methods: Candidacy criteria and outcome measurements applied in 19 HEARRING clinics were analyzed.

Results: Candidacy criteria vary between clinics.

Cochlear Implantation in Neurofibromatosis Type 2: Experience From the UK Neurofibromatosis Type 2 Service.

Objective: To review the outcomes of cochlear implants (CI) in patients with neurofibromatosis type 2 (NF2) in a large cohort, and identify factors associated with poor hearing benefit.

Study Design: Fifteen-year retrospective national observational case series.

Setting: United Kingdom regional NF2 multidisciplinary teams.

Speech Auditory Brainstem Responses in Adult Hearing Aid Users: Effects of Aiding and Background Noise, and Prediction of Behavioral Measures.

Evaluation of patients who are unable to provide behavioral responses on standard clinical measures is challenging due to the lack of standard objective (non-behavioral) clinical audiological measures that assess the outcome of an intervention (e.g., hearing aids).

Speech-ABRs in cochlear implant recipients: feasibility study.

The aim of this study was to assess the feasibility of recording speech-ABRs from cochlear implant (CI) recipients, and to remove the artefact using a clinically applicable single-channel approach. Speech-ABRs were recorded to a 40 ms [da] presented loudspeaker using a two-channel electrode montage. Additionally, artefacts were recorded using an artificial-head incorporating a MED-EL CI with stimulation parameters as similar as possible to those of three MED-EL participants.

Extracochlear Stimulation of Electrically Evoked Auditory Brainstem Responses (eABRs) Remains the Preferred Pre-implant Auditory Nerve Function Test in an Assessor-blinded Comparison.

Objective: Electrically evoked auditory brainstem responses (eABRs) can be recorded before cochlear implant (CI) surgery to verify auditory nerve function, and is particularly helpful in to assess the function of the auditory nerve in cases of auditory nerve hypoplasia. This is the first study to compare three preimplant eABRs recording techniques: 1) standard extracochlear, 2) novel intracochlear, and 3) conventional intracochlear with the CI.

Study Design: A within-participants design was used where eABRs were sequentially measured during CI surgery using three methods with stimulation from: 1) an extracochlear electrode placed at the round window niche, 2) two different electrodes on a recently developed Intracochlear Test Array (ITA), and 3) two different electrodes on a CI electrode array.

Speech Auditory Brainstem Responses: Effects of Background, Stimulus Duration, Consonant-Vowel, and Number of Epochs.

Objectives: The aims of this study were to systematically explore the effects of stimulus duration, background (quiet versus noise), and three consonant-vowels on speech-auditory brainstem responses (ABRs). Additionally, the minimum number of epochs required to record speech-ABRs with clearly identifiable waveform components was assessed. The purpose was to evaluate whether shorter duration stimuli could be reliably used to record speech-ABRs both in quiet and in background noise to the three consonant-vowels, as opposed to longer duration stimuli that are commonly used in the literature.

Hearing preservation cochlear implantation in children: The HEARRING Group consensus and practice guide.

Objectives: To provide multidisciplinary cochlear implant teams with a current consensus statement to support hearing preservation cochlear implantation (HPCI) in children, including those children with symptomatic partial deafness (PD) where the intention is to use electric-acoustic stimulation (EAS). The main objectives are to provide guidelines on who is a candidate, how to assess these children and when to implant if Med-El Flex electrode arrays are chosen for implantation.

Methods: The HEARRING group reviewed the current evidence and practice regarding the management of children to be considered for HPCI surgery emphasizing the assessment needed prior to implantation in order to demonstrate the benefits in these children over time.

Outcomes of cochlear implantation in patients with neurofibromatosis type 2.

In neurofibromatosis type 2 (NF2) bilateral vestibular schwannomas (VS) or their treatment usually results in bilateral hearing loss. Cochlear implantation (CI) was traditionally not used in these patients due to concern that retrocochlear disease would render the implant ineffective. This paper describes the auditory outcomes of CI in 13 patients with NF2 and includes patients with untreated VS and patients undergoing VS removal with cochlear nerve preservation.

Auditory Brainstem Implantation in Neurofibromatosis Type 2: Experience From the Manchester Programme.

Objective: To describe the experience of auditory brainstem implantation (ABI) in patients with Neurofibromatosis type 2 (NF2).

Study Design: Retrospective case review.

Setting: Tertiary referral centre.

Cochlear implantation in early deafened, late implanted adults: Do they benefit?

Objectives: The aim of this study was to quantify the benefit gained from cochlear implantation in pre- or peri-lingually deafened patients who were implanted as adults Methods: This was a retrospective case-control study. Auditory (BKB/CUNY/3AFC/Environmental sounds), quality of life (GBI/HUI3) and cognitive (customized questionnaire) outcomes in 26 late implanted pre- or peri-lingually deafened adults were compared to those of 30 matched post-lingually deafened, traditional cochlear implant users.

Results: There was a statistically significant improvement in all scores in the study group following cochlear implantation.

Preliminary assessment of the feasibility of using AB words to assess candidacy in adults.

Background: Adult cochlear implant (CI) candidacy is assessed in part by the use of speech perception measures. In the United Kingdom the current cut-off point to fall within the CI candidacy range is a score of less than 50% on the BKB sentences presented in quiet (presented at 70 dBSPL).

Goal: The specific goal of this article was to review the benefit of adding the AB word test to the assessment test battery for candidacy.

Quality standards for bone conduction implants.

Conclusion: Bone conduction implants are useful in patients with conductive and mixed hearing loss for whom conventional surgery or hearing aids are no longer an option. They may also be used in patients affected by single-sided deafness.

Objectives: To establish a consensus on the quality standards required for centers willing to create a bone conduction implant program.

Electrode Selection and Speech Understanding in Patients With Auditory Brainstem Implants.

Objectives: The objective of this study was to evaluate whether speech understanding in auditory brainstem implant (ABI) users who have a tumor pathology could be improved by the selection of a subset of electrodes that were appropriately pitch ranked and distinguishable. It was hypothesized that disordered pitch or spectral percepts and channel interactions may contribute significantly to the poor outcomes in most ABI users.

Design: A single-subject design was used with five participants.

Subjective outcomes of auditory brainstem implantation.

Aim: To assess the long-term subjective benefits of auditory brainstem implants (ABIs) and investigate the extent to which ABI users perceive it to be a useful device.

Methods: Using the Manchester database, all 31 living patients registered as ABI users were identified and sent the ABI performance questionnaire. Data regarding daily duration of use, auditory fatigue, ability to differentiate between speech and environmental sounds, and subjective usefulness of the ABI in different listening conditions were collected.

Progress of hearing loss in neurofibromatosis type 2: implications for future management.

The objective of this study was to describe changes in hearing over time in patients with neurofibromatosis type 2 (NF2) treated conservatively. A retrospective case review was conducted in a tertiary referral centre. Pure tone audiometry, speech discrimination scores, serviceable hearing (American Academy of Otolaryngology class A or B) and measurement of vestibular schwannoma (VS) size on magnetic resonance imaging were evaluated in 56 patients (89 ears) with NF2 with at least one conservatively managed VS.

Comparison of the benefits of cochlear implantation versus contra-lateral routing of signal hearing aids in adult patients with single-sided deafness: study protocol for a prospective within-subject longitudinal trial.

Background: Individuals with a unilateral severe-to-profound hearing loss, or single-sided deafness, report difficulty with listening in many everyday situations despite having access to well-preserved acoustic hearing in one ear. The standard of care for single-sided deafness available on the UK National Health Service is a contra-lateral routing of signals hearing aid which transfers sounds from the impaired ear to the non-impaired ear. This hearing aid has been found to improve speech understanding in noise when the signal-to-noise ratio is more favourable at the impaired ear than the non-impaired ear.

Cochlear implantation in children with auditory neuropathy spectrum disorders.

Aim: To present the outcomes of cochlear implantation (CI) in children with auditory neuropathy spectrum disorders (ANSD).

Materials And Methods: The pre- and post-CI hearing outcomes in children with ANSD were retrospectively evaluated. Performance was assessed with categories of auditory performance (CAP) and the Manchester spoken language development scale (MSLDS).