Otolaryngic Allergy Patient Journey Mapping: A Framework for Allergy Immunotherapy Adherence.

Objectives: Allergen-specific immunotherapy (AIT) is an effective treatment for allergic disease but requires long treatment duration and premature cessation is of significant concern. Drivers of premature cessation remain poorly understood and no predictive models currently exist. We hypothesized that a novel patient journey map and de novo real-time patient electronic health status instruments (eHSIs) could effectively capture patient perceived cost, commitment, and treatment benefit to identify individual patients at risk for premature AIT cessation.

Assessment of cochlear synaptopathy by electrocochleography to low frequencies in a preclinical model and human subjects.

Cochlear synaptopathy is the loss of synapses between the inner hair cells and the auditory nerve despite survival of sensory hair cells. The findings of extensive cochlear synaptopathy in animals after moderate noise exposures challenged the long-held view that hair cells are the cochlear elements most sensitive to insults that lead to hearing loss. However, cochlear synaptopathy has been difficult to identify in humans.

Cochlear Implantation for Unilateral and Asymmetric Hearing Loss: Long-Term Subjective Benefit.

Objectives: Assess the long-term patterns of perceived tinnitus severity and subjective benefit for adult cochlear implant (CI) users with asymmetric or unilateral hearing loss (AHL or UHL).

Methods: Forty adults underwent cochlear implantation as part of a prospective clinical trial assessing the outcomes of CI use in cases of AHL (n = 20) and UHL (n = 20). Subjective measures included the Tinnitus Handicap Inventory (THI), the Speech, Spatial, & Qualities of Hearing Scale (SSQ), and the Abbreviated Profile of Hearing Aid Benefit (APHAB).

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.

Long-Term Improvement in Localization for Cochlear Implant Users with Single-Sided Deafness.

Objectives/hypothesis: To assess whether early, significant improvements in sound source localization observed in cochlear implant (CI) recipients with normal hearing (NH) in the contralateral ear are maintained after 5 years of CI use.

Study Design: Prospective, repeated measures study.

Methods: Participants were recruited from a sample of CI + NH listeners (n = 20) who received their device as part of a prospective clinical trial investigating outcomes of CI use for adult cases of single-sided deafness.

Insertion Depth and Cochlear Implant Speech Recognition Outcomes: A Comparative Study of 28- and 31.5-mm Lateral Wall Arrays.

Objectives: 1) To compare speech recognition outcomes between cochlear implant (CI) recipients of 28- and 31.5-mm lateral wall electrode arrays, and 2) to characterize the relationship between angular insertion depth (AID) and speech recognition.

Study Design: Retrospective review.

Influence of Cochlear Implant Use on Perceived Listening Effort in Adult and Pediatric Cases of Unilateral and Asymmetric Hearing Loss.

Objective: Assess the influence of cochlear implant (CI) use on the perceived listening effort of adult and pediatric subjects with unilateral hearing loss (UHL) or asymmetric hearing loss (AHL).

Study Design: Prospective cohort.

Setting: Tertiary referral center.

Initial Hearing Preservation Is Correlated With Cochlear Duct Length in Fully-inserted Long Flexible Lateral Wall Arrays.

Objectives: To characterize the relationship between cochlear duct length (CDL) and initial hearing preservation among cochlear implant recipients of a fully inserted 31.5 mm flexible lateral wall electrode array.

Study Design: Retrospective review.

Incidence of Complete Insertion in Cochlear Implant Recipients of Long Lateral Wall Arrays.

Objective: High rates of partial insertion have been reported for cochlear implant (CI) recipients of long lateral wall electrode arrays, presumably caused by resistance encountered during insertion due to cochlear morphology. With recent advances in long-electrode array design, we sought to investigate (1) the incidence of complete insertions among patients implanted with 31.5-mm flexible arrays and (2) whether complete insertion is limited by cochlear duct length (CDL).

Relationship Between Electrocochleography, Angular Insertion Depth, and Cochlear Implant Speech Perception Outcomes.

Objectives: Electrocochleography (ECochG), obtained before the insertion of a cochlear implant (CI) array, provides a measure of residual cochlear function that accounts for a substantial portion of variability in postoperative speech perception outcomes in adults. It is postulated that subsequent surgical factors represent independent sources of variance in outcomes. Prior work has demonstrated a positive correlation between angular insertion depth (AID) of straight arrays and speech perception under the CI-alone condition, with an inverse relationship observed for precurved arrays.

Cochlear Implantation in Cases of Asymmetric Hearing Loss: Subjective Benefit, Word Recognition, and Spatial Hearing.

A prospective clinical trial evaluated the effectiveness of cochlear implantation in adults with asymmetric hearing loss (AHL). Twenty subjects with mild-to-moderate hearing loss in the better ear and moderate-to-profound hearing loss in the poorer ear underwent cochlear implantation of the poorer hearing ear. Subjects were evaluated preoperatively and at 1, 3, 6, 9, and 12 months post-activation.

Long-Term Influence of Electrode Array Length on Speech Recognition in Cochlear Implant Users.

Objectives/hypothesis: Results from a prospective trial demonstrated better speech recognition for cochlear implant (CI) recipients implanted with a long lateral wall electrode array compared to subjects with a short array after 1 year of listening experience. As short array recipients may require an extended adaptation period, this study investigated whether differences in speech recognition continued through 4 years of CI use.

Study Design: Long-term follow-up of a prospective randomized trial.

Frequency-to-Place Mismatch: Characterizing Variability and the Influence on Speech Perception Outcomes in Cochlear Implant Recipients.

Objectives: The spatial position of a cochlear implant (CI) electrode array affects the spectral cues provided to the recipient. Differences in cochlear size and array length lead to substantial variability in angular insertion depth (AID) across and within array types. For CI-alone users, the variability in AID results in varying degrees of frequency-to-place mismatch between the default electric frequency filters and cochlear place of stimulation.

Subjective Benefits of Bimodal Listening in Cochlear Implant Recipients with Asymmetric Hearing Loss.

Objective: To investigate the influence of cochlear implant (CI) use on subjective benefits in quality of life in cases of asymmetric hearing loss (AHL).

Study Design: Prospective clinical trial.

Setting: Tertiary academic center.

Influence of Age at Cochlear Implantation and Frequency-to-Place Mismatch on Early Speech Recognition in Adults.

Objective: Default frequency filters of cochlear implant (CI) devices assign frequency information irrespective of intracochlear position, resulting in varying degrees of frequency-to-place mismatch. Substantial mismatch negatively influences speech recognition in postlingually deafened CI recipients, and acclimatization may be particularly challenging for older adults due to effects of aging on the auditory pathway. The present report investigated the influence of mismatch and age at implantation on speech recognition within the initial 6 months of CI use.

The reliability of hearing implants: report on the type and incidence of cochlear implant failures.

This study presents the data collected through a database on the type and incidence of cochlear implant device failures and major complications and quantifies the risk of failures across time based on the Association for the Advancement of Medical Instrumentation (AAMI) CI86:2017 standard. Information on reliability of MED-EL cochlear implants was collected from the MED-EL complaint database between 2003 and2013. Explants were categorized and device reliability was calculated according to the AAMI CI86:2017 standard principles.

Low-Frequency Hearing Preservation With Long Electrode Arrays: Inclusion of Unaided Hearing Threshold Assessment in the Postoperative Test Battery.

Purpose The goal of this work was to evaluate the low-frequency hearing preservation of long electrode array cochlear implant (CI) recipients. Method Twenty-five participants presented with an unaided hearing threshold of ≤ 80 dB HL at 125 Hz pre-operatively in the ear to be implanted. Participants were implanted with a long (31.

Hearing Preservation and Speech Outcomes After Cochlear Implantation in Meniere's Disease.

Objectives/hypothesis: To evaluate speech perception outcomes and hearing preservation after cochlear implantation in patients with Meniere's disease (MD).

Study Design: Retrospective chart review.

Methods: Fifty-one adult patients, accounting for a total of 63 implants, with MD treated at a tertiary care center were included in the study.

Electrode Array Type and Its Impact on Impedance Fluctuations and Loss of Residual Hearing in Cochlear Implantation.

Hypothesis/objective: Determine variables associated with electrode impedance fluctuations and loss of residual hearing in cochlear implant (CI) recipients.

Background: CI recipients with postoperative hearing preservation demonstrate superior speech perception with an electric-acoustic stimulation (EAS) device as compared with a CI-alone device. Maintaining superior speech perception over time relies on long-term hearing preservation; therefore, understanding variables that may contribute to loss of residual hearing is needed.

Pediatric cochlear implantation: A quarter century in review.

To review the growth of a pediatric cochlear implant (CI) program at one large tertiary care medical center over a 25-year period in order to (1) describe the population of pediatric cochlear implant recipients, (2) document word recognition outcomes, and (3) describe changes in candidacy criteria over time. A retrospective review of population demographics and trends included etiology of hearing loss, device use and type, expansion of inclusion criteria, and word recognition outcomes. Ninety-one percent of the children studied were from North Carolina and reflect the ethnic distribution of the state.

Low-Frequency Pitch Perception in Cochlear Implant Recipients With Normal Hearing in the Contralateral Ear.

Purpose Three experiments were carried out to evaluate the low-frequency pitch perception of adults with unilateral hearing loss who received a cochlear implant (CI). Method Participants were recruited from a cohort of CI users with unilateral hearing loss and normal hearing in the contralateral ear. First, low-frequency pitch perception was assessed for the 5 most apical electrodes at 1, 3, 6, and 12 months after CI activation using an adaptive pitch-matching task.

Validating a New Tablet-based Tool in the Determination of Cochlear Implant Angular Insertion Depth.

Objective: The objective of this study is to determine the reliability of a new tablet-based software that utilizes postoperative computed tomography to determine angular insertion depth (AID), cochlear duct length (CDL), and the cochlear place frequency of individual electrodes in cochlear implant recipients.

Patients: Twenty adult cochlear implant recipients with lateral-wall electrode arrays of varying lengths were included in the study.

Intervention: Cochlear and electrode array measurements were made by 2 otolaryngologists using a tablet-based software.

Contemporary analysis of otolaryngic allergy.

Objectives: Investigate the current trends in otolaryngic allergy (OA).

Study Design: Cross-sectional survey.

Methods: Survey of active AAOA membership.

Electric-Acoustic Stimulation After Reimplantation: Hearing Preservation and Speech Perception.

Objective: Hearing preservation after cochlear implantation allows for fitting of acoustic and cochlear implant technologies in the same ear, known as Electric-Acoustic Stimulation (EAS). Cochlear implant recipients with EAS who experience an internal device failure face the additional risk of residual hearing loss during reimplantation. This report reviews the case of an EAS recipient with long-term hearing preservation and significant benefit who experienced a device failure and underwent cochlear reimplantation.