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Objectives: One of the main elements of a fully implantable system is the totally implantable microphone (TIM). The Carina system uses a sub-cutaneous, omnidirectional microphone, which is surgically implanted on the mastoid bone behind the ear. The most frequently used TIM position is on the posterior inferior mastoid line, but due to anatomical reasons or surgeon's preference, it might also be positioned in other locations behind the ear. This may lead to variability in the directional response. Additionally, the retro-auricular microphone position does not seem ideal to pick up sounds from the front. The aim of this study was to investigate the directional response of the Carina TIM in various microphone positions on the mastoid to be able to make a judgement on which microphone position will be best for optimal speech discrimination. Materials & Methods: The Carina TIM was positioned in four different positions on two different artificial heads (Cochlear Haddock and Cortex MK2) and a human cadaveric whole head. The heads were placed in the middle of a horizontal arch with loudspeakers having a distance of 15° from each other. A broadband noise (MLS) with a duration of 1.5 s was played consecutively via the loudspeakers and recorded by the Carina TIM and a reference microphone. Results and Conclusions: The directivity index (DI) and directivity vector (DV) will be calculated for each microphone position on all heads. The DI and DV for the broadband signal as well as for the octave bands will be analyzed and compared for the various microphone positions. Differences between the artificial heads and the cadaver head will be presented. Preliminary results show differences in the DI and DV for the various microphone positions for both, the cadaver head and the artificial heads, which suggests that there is an optimal position for the TIM and that the microphone position may have an influence on the hearing performance. Polar plots with the different directional responses will be shown and discussed. [ABSTRACT FROM AUTHOR]

Audiological rehabilitation (AR) is important to improve auditory and communication skills of persons with hearing impairment (HI), in order to optimize participation in society. The complexity of encountered difficulties due to HI requires a holistic approach to AR, consisting of sensory management, auditory-cognitive training and counselling. Although the importance of providing a comprehensive AR program is widely acknowledged, the majority of people with HI is not entitled to it (e.g., people with SSD). Computerized AR offers an efficient, cost- and time-effective method for a large group of persons with disabling HI, adapted to their personal needs. We developed a prototype of the LUISTER AR e-health scheme that consists of an assessment battery to determine the communication status, a variety of linguistic auditory- cognitive exercises as well as a generic, non-linguistic training task and a binaural training task. We are currently evaluating the feasibility and usability of this prototype e-health scheme on a tablet in adults with SSD and a CI. These data will be presented, as well as on-task improvement and data logging of the intensity and frequency of training. [ABSTRACT FROM AUTHOR]

Objectives: Five transmission pathways are involved in bone conduction (BC) perception, of which the cochlea is the major contributor 1 . This contribution was confirmed by intracochlear pressure (ICP) measurements in chinchilla's and in one fresh-fresh frozen human temporal bone (TB) 2, 3 . The aim of this study is to evaluate an appropriate (reversible) fixation method to study BC transmission and to collect reference data to compute a standardized range. Results of intracochlear pressure measurements with BC stimulation on human temporal bones (TBs) are presented. Additionally relevant factors in relation to totally implantable systems such as CI will be discussed by the moderator. Methods: Four fresh-frozen human TBs, compliant to ASTM-standards, are used for the ICP experiment after surgical preparations. Sound stimulation is conducted either through an insert phone via an artificial ear canal (air conduction, AC) or via bone conduction stimulator. After drilling the cochleostomies (Ø 350 m) under saline, two fiber-optic pressure sensors (FOP-M260, FISO Technologies Inc.) are inserted in scala vestibuli (SV) and scala tympani (ST) followed by sealing with alginate and dental cement. Different conditions are investigated during the experiment for both AC and BC: normal, stapes fixation, incudo-stapedial-joint cut. Differential pressure between SV and ST is measured. Results & Conclusion: The use of alginate and dental cement and releasing the sensor from the micromanipulator was deemed the better fixation method, as sensor and promontory moved in phase and without relative motion. Relevance in relation to totally implantable systems will be presented during the session. References 1 S. Stenfelt and R. L. Goode, J. Acoust. Soc. Am., 2005 2 D. Chhan et al., Hear. Res., 2013 3 C. Stieger et al., AIP Conf. Proc., 2015 [ABSTRACT FROM AUTHOR]

A growing body of evidence suggests that musical activities can enhance the listening brain and develop executive functions, including Literacy. Empowering families of newly diagnosed babies and infants with a hearing loss, through early intervention home based support is proven to be beneficial. Music can captivate babies and allows them to explore and demonstrate their awareness of sound in an easy, more developmentally appropriate way, through body movements, facial expressions, vocalizations and playing instruments. Babies listen for predictable melodies and harmonies as found in lullabies (Barker & Macklinlay, 2006). The BabyBeats™ early intervention resource is a musical habilitation resource which was designed to help improve early parent- child bonding, listening behaviour, communication skills, and social emotional development, pre- and post-implantation. To give parents the opportunity to engage with their child in their daily routines a mobile application was created. The families visiting our centre used the app and audit data were collected based on a simple parental and professional questionnaire. The collected feedback was positive and ideas from the resource were carried over into the family's everyday routines. In the monitoring phase increased vocalization, attention, and anticipation of the activities were observed. Increased confidence in singing, moving, and playing with their baby was also reported by these families. These outcomes are encouraging as they support the aims of the musical rehabilitation resource and help the natural development of attachment, supporting babies and toddlers to build early developmental skills essential for later language development as they are waiting for a cochlear implant. [ABSTRACT FROM AUTHOR]

Objectives: Cochlear implantation (CI) in adult subjects with acquired single sided deafness (SSD) or asymmetric hearing loss (AHL) is investigated prospectively. Audiological performance is evaluated, as well as potential improvements of tinnitus and anxiety/depression. Materials and Methods: A multinational, multicenter, prospective study design was implemented with participating centers in Germany, Austria, and Belgium. Speech discrimination was tested in quiet, and in noise using an adaptive paradigm with the speech coming from the front and the noise from three different locations (either from the front, or the implant side, or the contralateral side). Tinnitus was evaluated by Visual Analogue Scale (VAS) and questionnaire, anxiety and depression by the Hospital Anxiety and Depression Scale (HAS). A pitch matching task was performed by some clinics, and localization abilities were also tested. Results and Conclusions: To date, 36 subjects from 7 clinics were included in the data analysis (mean age 53, range 18-81 years). No adverse events have been noted. After 3 months of CI use, a significant speech intelligibility benefit with the implant (noise on the contralateral side) was observed: 0.3 dB (N=23). The significant speech intelligibility benefit was maintained at 6 months (N=20) and increased to 1.75 dB (N=18) at 12 months. The tinnitus impairment decreased significantly by 2.5 points on the VAS after 3 months (N=26). A significant decrease of 2 points was maintained by 12 months (N=19). The tinnitus questionnaire was in line with this improvement. CI in subjects with SSD and AHL is able to improve speech discrimination in quiet and noise. Impairment by tinnitus decreased significantly. These benefits were apparent as short as 3 months after implantation and persisted with time. As CI is a safe procedure, it should continue to be considered in subjects with unilateral or asymmetric hearing loss. [ABSTRACT FROM AUTHOR]