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Objectives: To evaluate the outcomes of bimodal stimulation by means of cochlear implant (CI) and contralateral hearing aid (HA) in terms of speech perception and suprasegmental cues Material and Methods: A selected cohort of 12 adults with asymmetric hearing loss (profound in one ear and severe in the other) received an Oticon Neuro ZTI® cochlear implant and a Dynamo® hearing aid, respectively (bimodal stimulation). Patients' age ranged from 16 to 76 years (mean 47.5, SD 24.6). They were tested before implantation (time T0), at month 3, 6 and 12 after CI activation (time 3M, 6M, 12M respectively), by means of: pure-tone audiogram (PTA) in sound booth and in free-field (FF); speech perception (dysillabic words recognition) in free-field (FF) in quiet and with cocktail party noise masking; the 48 items SSQ questionnaire (Tyler, 2009); the ASSE test. The performances for all tests were checked in the 3 following conditions: bimodal (CI + HA); CI only; HA only. Results: As expected on the basis of the pre-op unaided contralateral residual speech perception ability, the speech recognition scores were slightly better in the CI+HA condition than with the CI alone but significantly better than with HA alone in quiet; quite surprisingly though, the differences in noise did not increase significantly in the bimodal condition. The SSQ for the bimodal stimulation showed a constant improvement over 12 months, especially for the "quality of sound" sub-scale. The ASSE test returned the most interesting results: the combined (CI+HA) stimulation provided a statistically significant advantage to CI recipients on all the 7 tasks, with a constant improvement over time. The greatest advantages were observed with the JND (just noticeable difference) and the PD (phoneme discrimination) subtests. [ABSTRACT FROM AUTHOR]

Objectives. To analyze the auditory percept measuring in children the electrically Evoked Compound Action Potential (eCAP) with the novel continuous intensity growth function („fine grain") at two rates of stimulation (40 and 80 Hz) versus the standard non-continuous stimuli recording paradigm on three representative electrodes in the apical / middle / basal region. In adults, a reduction in the loudest acceptable presentation level (LAPL) were observed between „fine-grain" and the standard paradigm. In particular, continuous stimulation growth function with larger charges steps at 44Hz gave smaller LAPL compared to 80Hz (~18qu versus ~21qu respectively) Materials and methods. Recordings were performed on 12 CI pediatric cochlear implant recipients (15 CI) aged 6 to 10 years at the Audiology Dept. of the University of Milan in the Audiology Unit of the IRCCS Ospedale Maggiore Policlinico. Starting from 0 qu up to the loudest acceptable presentation level (LAPL), in „fine grain" paradigm, stimulation intensity was continuously increased with 1 qu per second (1 qu~nano Coulomb). During the delivery of the stimuli, the threshold of electrical elicitation of the stapedius reflex (eSRT) was monitored and ECAPs were recorded. Results and conclusions, ECAP identification was found in > 90% of cases with an higher resolution of stimulation intensities with the novel paradigm. eSRT determination varied with respect according to the different differing LAPLs reached and those levels were not significantly different between the two paradigm. Our results support the use of objective measures such as eSRT, LAPLS and ECAP to assess the change in auditory percept. Besides these findings, our study confirmed the suitability of the fine-grain stimulation paradigm for a paediatric population. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the relation between the cochlear implant (CI) electrode frequency-place mismatch and auditory performances in a selected group of adult CI recipients. Materials and methods: 15 adult subjects (10 females and 5 males, mean age 64 ± 11) have been selected on a homogeneous series of CI patients admitted at a tertiary University activation and speech outcomes in EAS with 82.5 % (n=7; HSM 10 dB SNR) at 3 months are achieved. Conclusion: Taking cochlear geometry and the prediction of postoperative residual hearing into account an optimal electrode insertion depth can be selected to achieve best individual outcomes in EAS or ES. Partial insertion allows for further, patient specific adaptation of the insertion depth if hearing is progressive over time. [ABSTRACT FROM AUTHOR]