-Linked Metastatic Paraganglioma: A Case Report with Implications for Counseling and Follow-Up of Pathogenic Variant Carriers.

Head and neck paragangliomas are slow growing and highly vascular neuroendocrine tumors. It is currently assumed that variants exclusively cause benign and often multicentric head and neck paragangliomas. Here, we present a patient diagnosed with multiple -linked head and neck paragangliomas who in addition developed paraganglioma metastases to the lung and spine and a primary or metastatic paraganglioma in the head of the pancreas.

Dynamic Current Focusing Compared to Monopolar Stimulation in a Take-Home Trial of Cochlear Implant Users.

Objectives: This study compared the performance of a dynamic partial tripolar cochlear implant speech encoding strategy termed dynamic current focusing (DCF) to monopolar stimulation (MP) using spectro-temporal, temporal, and speech-in-noise recognition testing.

Design: DCF is a strategy that utilizes tripolar or high partial tripolar stimulation at threshold level and increases loudness by slowly widening current spread towards most comfortable level. Thirteen cochlear implant users were fitted with DCF and a non-steered MP matched on pulse rate, pulse width, and active electrodes.

Effectiveness of Phantom Stimulation in Shifting the Pitch Percept in Cochlear Implant Users.

Objectives: Phantom electrode stimulation was developed for cochlear implant (CI) systems to provide a lower pitch percept by stimulating more apical regions of the cochlea, without inserting the electrode array deeper into the cochlea. Phantom stimulation involves simultaneously stimulating a primary and a compensating electrode with opposite polarity, thereby shifting the electrical field toward the apex and eliciting a lower pitch percept. The current study compared the effect sizes (in shifts of place of excitation) of multiple phantom configurations by matching the perceived pitch with phantom stimulation to that perceived with monopolar stimulation.

Dynamic current focusing for loudness encoding in cochlear implants: a take-home trial.

This study aimed to evaluate a more energy-efficient dynamic current focussing (DCF) speech-processing strategy after long-term listening experience. In DCF, tripolar stimulation is used near the threshold and loudness is controlled by the compensation coefficient σ. A recent acute pilot study showed improved spectral-temporally modulated ripple test (SMRT) scores at low loudness levels, but battery life was reduced to 1.

Channel discrimination along all contacts of the cochlear implant electrode array and its relation to speech perception.

Objective: To test the channel discrimination of cochlear implant (CI) users along all contacts of the electrode array and assess whether this is related to speech perception.

Design: CI recipients were tested with a custom-made channel discrimination test. They were asked to distinguish a target stimulus from two reference stimuli in a three-alternative forced choice (3AFC) task.

Dynamic Current Focusing: A Novel Approach to Loudness Coding in Cochlear Implants.

Objectives: In an attempt to improve spectral resolution and speech intelligibility, several current focusing methods have been proposed to increase spatial selectivity by decreasing intracochlear current spread. For example, tripolar stimulation administers current to a central electrode and uses the two flanking electrodes as the return pathway, creating a narrower intracochlear electrical field and hence increases spectral resolution when compared with monopolar (MP) stimulation. However, more current is required, and in some patients, specifically the ones with high electrode impedances, full loudness growth cannot be supported because of compliance limits.

Take-Home Trial Comparing Fast Fourier Transformation-Based and Filter Bank-Based Cochlear Implant Speech Coding Strategies.

Previous studies have demonstrated no improved or deteriorated speech intelligibility with the HiResolution Fidelity 120™ speech coding strategy (HiResF120) over the original HiRes strategy. Improved spectral and deteriorated temporal sensitivities have been shown, making it plausible that the beneficial effect in the spectral domain was offset by the worsened temporal sensitivity. We hypothesize that the implementation of fast Fourier transform (FFT) processing, instead of the traditionally used bandpass filters, explains the reduction of temporal sensitivity.

Learning Effects in Psychophysical Tests of Spectral and Temporal Resolution.

Objectives: Psychophysical tests of spectral and temporal resolution, such as the spectral-ripple discrimination task and the temporal modulation detection test, are valuable tools for the evaluation of cochlear implant performance. Both tests correlate with speech intelligibility and are reported to show no instantaneous learning effect. However, some of our previous trials have suggested that there is a learning effect over time.

[Eosinophilic otitis media].

Background: Eosinophilic otitis media (EOM) is a rare middle ear disease that may closely resemble therapy-resistant otitis media with effusion (OME). The diagnosis is made if eosinophil-rich fluid is present with two or more of the following minor criteria: (a) history of nasal polyps or, (b) bronchial asthma, with (c) viscous fluid in the middle-ear, or (d) conventional otitis media treatment has no effect.

Case Description: A 70-year-old male with a history of the ASA triad (bronchial asthma, nasal/ethmoidal polyposis and aspirin intolerance) presented with progressive mixed hearing loss.