Uncovering Vulnerable Phases in Cochlear Implant Electrode Array Insertion: Insights from an In Vitro Model.

Objectives: The aim of this study is to improve our understanding of the mechanics involved in the insertion of lateral wall cochlear implant electrode arrays.

Design: A series of 30 insertion experiments were conducted by three experienced surgeons. The experiments were carried out in a previously validated artificial temporal bone model according to established soft surgery guidelines.

A Sleeve-Based, Micromotion Avoiding, Retractable and Tear-Opening (SMART) Insertion Tool for Cochlear Implantation.

Objective: In conventional cochlear implantation, the insertion of the electrode array is strongly affected by the local anatomy and human kinematics. Herein, we present a concept for an insertion tool that allows to optimize the insertion trajectory beyond anatomical constraints and stabilizes the electrode array in manual implantation. A novel sleeve-based design allows the instrument to be compliant and potentially protective to intracochlear structures, while a tear-open mechanism allows it to be removed after insertion by simply retracting the tool.

Cochlear base length as predictor for angular insertion depth in incomplete partition type 2 malformations.

Introduction: The preoperative determination of suitable electrode array lengths for cochlear implantation in inner ear malformations is a matter of debate. The choice is usually based on individual experience and the use of intraoperative probe electrodes. The purpose of this case series was to evaluate the applicability and precision of an angular insertion depth (AID) prediction method, based on a single measurement of the cochlear base length (CBL).

Bilateral congenital deafness: What investigations should be performed?

Background: The introduction of newborn hearing screening has led to earlier identification of children with congenital sensorineural hearing loss (SNHL). Aetiological clarification offers several benefits. There is currently a lack of agreement on which examinations should be recommended.

Significant Artifact Reduction at 1.5T and 3T MRI by the Use of a Cochlear Implant with Removable Magnet: An Experimental Human Cadaver Study.

Objective: Cochlear implants (CIs) are standard treatment for postlingually deafened individuals and prelingually deafened children. This human cadaver study evaluated diagnostic usefulness, image quality and artifacts in 1.5T and 3T magnetic resonance (MR) brain scans after CI with a removable magnet.

Retrograde cochlear implantation in postmeningitic basal turn ossification.

Objectives/hypothesis: Postmeningitic basal turn ossification is a challenge for successful cochlear implantation despite the availability of sophisticated implants and advanced drill-out procedures. A less complex concept consisting of a cochleostomy near the apex with retrograde array insertion is evaluated clinically and experimentally with emphasis on imaging of intracochlear array morphology.

Study Design: Retrospective case-control study.

In-the-canal versus behind-the-ear microphones improve spatial discrimination on the side of the head in bilateral cochlear implant users.

Objective: To test whether in-the-canal (ITC) microphones have an impact on spatial discrimination and speech perception by taking advantage of auricular cues.

Study Design: Experimental clinical study.

Setting: Audiologic laboratory in a tertiary referral center.

A reservoir of Moraxella catarrhalis in human pharyngeal lymphoid tissue.

Background: Early exposure of infants and long-term immunity suggest that colonization with Moraxella catarrhalis is more frequent than is determined by routine culture. We characterized a reservoir of M. catarrhalis in pharyngeal lymphoid tissue.

Comparison of musical activities of cochlear implant users with different speech-coding strategies.

Speech coding might have an impact on music perception of cochlear implant users. This questionnaire study compares the musical activities and perception of postlingually deafened cochlear implant users with three different coding strategies (CIS, ACE, SPEAK) using the Munich Music Questionnaire. Overall, the self-reported perception of music of CIS, SPEAK, and ACE users did not differ by very much.

Minimum audible angle, just noticeable interaural differences and speech intelligibility with bilateral cochlear implants using clinical speech processors.

Sound localization and speech intelligibility were assessed in 5 patients implanted bilaterally with Medel C40+ or Medel C40 cochlear implant (CI) systems. The minimum audible angle (MAA) around the head in the horizontal plane was assessed in patients with bilateral CI using white noise bursts of 1000 ms duration presented from a loudspeaker mounted on a rotating boom and compared with the MAA of age-matched normal hearing controls. Spatial discrimination was found to be good in front and in the back of the head with near-normal MAA values (patients: 3-8 degrees , controls: 1-4 degrees ).

Scuba diving with cochlear implants.

We report on a patient with bilateral cochlear implants (a Med-El Combi40 and a Med-El Combi40+), as well as considerable experience in scuba diving with both of his implants. After having been exposed to 68 and 89 dives, respectively, in depths of up to 43 m, both cochlear implants are in working order and the patient continues to receive excellent speech recognition scores with both cochlear implant systems. The presented data show that scuba diving after cochlear implantation is possible over a considerable number of dives without any major negative impact on the implants.

Intra- and intersubject comparison of cochlear implant systems using the Esprit and the Tempo+ behind-the-ear speech processor.

A patient with bilateral profound deafness was implanted with a Nucleus CI24M cochlear implant (CI) and used an Esprit behind-the-ear (BTE) speech processor. Thirteen months later, the implant had to be removed because of a cholesteatoma. As the same electrode could not be reinserted, a Medel combi40s CI was implanted in the same ear, and the patient used a Tempo+ BTE processor.

Changes of voice and articulation in children with cochlear implants.

Objective: The different speech sounds are formed by the primary voice signal and by the shape of the articulation tract. With this mechanism, specific overtones, the formants, are generated for each vowel. The objective of this study was to investigate the fundamental frequency (F0) of the voice signal and the first three formants (F1-F3) as a parameter of the articulation in prelingually deafened children at different timepoints after cochlear implantation (CI) compared with children with normal speech development.