Pediatric cochlear implantation: associated with minimal postoperative pain and dizziness.

Objective: To prospectively document the surgical pain, assessing analgesia use as a proxy, and postoperative dizziness in children over the first week after cochlear implantation.

Study Design: Prospective.

Setting: Tertiary referral hospital and cochlear implant program.

Impedance, neural response telemetry, and speech perception outcomes after reimplantation of cochlear implants in children.

Objective: To compare mean impedance levels, neural response telemetry (NRT), and auditory perception after initial and explant-reimplant pediatric cochlear implants.

Study Design: Retrospective case review.

Setting: Tertiary referral hospital and cochlear implant program.

Oral communicating children using a cochlear implant: good reading outcomes are linked to better language and phonological processing abilities.

Introduction/objective: Cochlear implantation provides children with a significant hearing loss the potential to engage in phonological processing via audition; however these children can still have poor or inadequately detailed mental (phonological) representations of speech and as such phonological awareness and reading difficulties. Heterogeneous participant profiles, particularly varying modes of communication have clouded the research regarding reading outcomes of children using a cochlear implant. The objective of this study was to explore the relationships between word reading and reading comprehension outcomes, and a range of variables of a relatively homogenous group of children using cochlear implants.

Cochlear function following implantation with a full electrode array.

Objectives: Clinicians traditionally advise patients that implantation with a conventional full cochlear implant array will lead to loss of any remaining hearing in the implanted ear. We sought to assess the extent to which 'standard' insertion of a full electrode array affects cochlear function.

Methods: Air conduction pure tone audiometry was performed as part of the routine 6-month postimplantation audiological assessment for 81 adult patients who preoperatively had identifiable pure tone thresholds.

Department of Otolaryngology and Audiology, Hôpital D'Enfants Armand Trousseau, Paris, France, 2009.

Towards the end of my time at Trousseau, it was a huge honour to be asked if I would like to consider staying on as an observer until October, with a view to continuing on, after that, in a Chef de Clinique appointment. This was a golden opportunity that I would have dearly snapped up. Unfortunately, the timing clashed with other previously made, very solid, arrangements.

Cochlear implant surgical issues in the very young child.

Early cochlear implantation has become more acceptable due to neonatal hearing screening programmes with neurophysiological hearing assessments, allowing early diagnosis in the first few months of life, of profound hearing loss. Cochlear implantation is considered for the child with profound hearing loss, 12 months and younger, in order to enhance early access to hearing and enabling better language outcomes. Surgical issues for the very young child include; reliable pre-operative work up, with objective audiological testing and radiology; limited anatomical access and facial nerve monitoring; bone marrow distribution in the petrous temporal bone in the younger child, and how that resolves in the first 12 months; and the influence of acute otitis media and otitis media with effusion on cochlear implantation in children 12 months and younger.

Cortical potentials as predictors of outcomes with adult cochlear implant recipients - preliminary findings.

A proportion of adult cochlear implant recipients report an inability to use the signal from their cochlear implant effectively at varying post-operative intervals following cochlear implantation. Some of these recipients report deterioration in their ability to use the implant signal and do not benefit from map optimization. Others never attain the level of outcome that they had expected.

The use of intra-operative electrical auditory brainstem responses to predict the speech perception outcome after cochlear implantation.

Electrically evoked auditory brainstem responses (EABR) were obtained intra-operatively from children receiving full insertion of Cochlear CI24 implant. The EABR waveform was quantified according to the presence or absence of waves (eII-eV). Each trace was scored from 0-3 providing a maximum score for all 22 electrodes of 66 in the monopolar mode.

The association of codeine, macrocytosis and bilateral sudden or rapidly progressive profound sensorineural deafness.

Conclusions: Codeine shows a similar association with profound deafness to other opiates. Good cochlear implant outcomes suggest a sensory disorder. Although macrocytosis could be due to confounding factors, the lack of other consistent findings may signify a vascular pathology.

Cochlear implantations in children with Waardenburg syndrome: an electrophysiological and psychophysical review.

Waardenburg syndrome presents with dystopia canthorum, pigmentary abnormalities of hair, iris and skin (often a white forelock and heterochromia iridis) and sensorineural deafness. The authors review the electrophysiological and psychophysical findings of implanted children with Waardenburg syndrome at the Sydney Cochlear Implant Centre. Twenty children with Waardenburg syndrome received cochlear implants between 1985 and 2001.

Trans-tympanic electric auditory brainstem response (TT-EABR): the importance of the positioning of the stimulating electrode.

Trans-tympanic electric auditory brainstem response (TT-EABR) is an established pre-operative investigation in cochlear implantation surgery. Various techniques have been employed to obtain electrical responses but there has been no universal agreement on the exact positioning of the stimulating electrode on the medial wall of the mesotympanum. The authors investigate the relationship of the positioning of the electrode and the brainstem response.

Meningitis resulting in hearing loss and labyrinthitis ossificans - does the causative organism matter?

Our aim was to demonstrate whether one causative agent of meningitis is more likely to cause profound hearing loss and labyrinthitis ossificans. We obtained data from the New South Wales health department for cases of meningitis between 1995 and 2005 (1568 cases) and the Sydney Cochlear Implant Centre for cochlear implant patients with hearing loss secondary to meningitis from 1984 to 2005 (70 ears in 59 patients). The aetiological agents were compared with regard to their ability to cause profound hearing loss and cochlear ossification.

Auditory neuropathy: an update.

Objectives: To describe the round window electrocochleography (RWECochG) and electric auditory brainstem responses (EABR) in ears affected by auditory neuropathy (AN), and to determine if these electrophysiological tests can predict the outcome following cochlear implant surgery.

Methods: A longitudinal study of all pediatric cochlear implant patients between 1994 and 2005 was undertaken. Speech perception outcomes after cochlear implantation and electrophysiological data were collected prospectively and analyzed.

Displacement of electrodes of a cochlear implant into the vestibular system: intra- and postoperative electrophysiological analyses.

A cochlear implant device is normally inserted into the scala tympani via a posterior tympanotomy and cochleostomy. There has been no previous report of displacement of the array into the vestibular part of the labyrinth. The authors present and discuss the audiological and electrophysiological measurements of a case in which part of the array herniated through into the vestibule.

Role of auditory stimulation in maturation of the auditory pathway.

Objective: To compare the maturation of the auditory pathway, as shown by electrical brainstem auditory potentials (EABRs), in ears with and without prior auditory stimulation.

Material And Methods: Electrophysiological data were collected prospectively from ears which had received cochlear implants. Implant-evoked (Imp)EABRs were recorded.

Binaural benefits for adults who use hearing aids and cochlear implants in opposite ears.

Objective: This study aimed to investigate 1) how a hearing aid needs to be adjusted for an adult who uses a cochlear implant in the contralateral ear; 2) whether the use of a hearing aid with a cochlear implant leads to interference; and 3) whether adults derive binaural benefits from using a hearing aid with a cochlear implant for speech perception, localization, and functional performance in everyday life.

Design: Twenty-one adults (11 female and 10 male) who used either a Nucleus CI-22 (N = 3) or a Nucleus CI-24 (N = 18) cochlear implant system in one ear participated in this study. Twelve of the adults were experienced hearing aid and implant users, whereas nine did not use a hearing aid after implantation.

Evidence for surviving outer hair cell function in congenitally deaf ears.

Objectives/hypothesis: The hypotheses of the study were that congenital hearing impairment in infants can result from the isolated loss of inner hair cells of the cochlea and that this is shown by the presence of abnormal positive summating potentials on round window electrocochleography. The objectives were to establish the proportion of infants with hearing loss affected, the nature of the cochlear lesion, and its etiology. And to highlight the important implications for otoacoustic emissions testing and universal neonatal screening.