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The "Marginal benefit from acoustic amplification" version 2 (MBAA2) sentence test has been used in France in the routine evaluation of cochlear implant (CI) users for 20 years. Here we present four studies that characterise and validate the test, and compare it with the French matrix sentence test.An analytic method was developed to obtain speech recognition threshold in noise (SNR50) from testing at a fixed signal to noise ratios (SNRs). Speech recognition was measured at several fixed SNRs in 18 normal-hearing listeners and 15 CI listeners. Then, the test-retest reliability of the MBAA2 was measured in an additional 15 CI listeners. Finally, list equivalence was evaluated in eight CI listeners.The MBAA2 test produced lower SNR50s and SNR50s were obtained in more CI listeners than with the French matrix test. For the MBAA2, the standard deviation of test-retest differences in CI listeners was around 1 dB SNR. Three lists had deviant difficulty and nine low item-to-total correlations.We propose to reduce the number of MBAA2 test lists to reduce variability. The MBAA2 test has high test-retest reliability for percent correct and SNR50, and is suitable for the assessment of cochlear implant patients.

Introduction Cochlear implantation (CI) has been available for over 25 years in many countries worldwide. From very early on, it was quite clear that successful implantation was only possible when three major requirements were satisfied: qualified pre-operative patient selection, sophisticated CI surgery, and extensive post-operative rehabilitation. The whole process, assessment for the implantation, the surgery, and the post-operative rehabilitation, involves considerable time and energy as well as great expense to both the patient and the implant team. The decision to embark upon implantation in any individual case should be made jointly by the team and the patient after thoughtful consideration of the likely outcome. The patient should make his or her decision in the light of as much information as the team can provide. In order to ensure optimum benefit from the device, the suitability of the implant for a particular individual must be determined. Expectations about the implant procedure, its potential outcomes, and the considerable post-implant rehabilitation required must be clear and realistic. The implant team needs to provide a service that meets the needs of its patients (Mawman et al., 1996). From the very beginning of CI it was quite clear that the post-operative rehabilitation consists out of two phases: first the acute part soon after surgery to adjust the implantee to his/her new device and to fit the device to his/her individual need, and second the long-term part to ensure the functioning of the device for lifelong use, here referred to as ‘aftercare’. As advances in CI technology expand, the need/ demand for CI services continues to grow. Therefore, a major question for every CI program is how can access to CI services be assured for the increasing number of CI recipients without degrading the basic quality of their individual long-term care? Methods A group of five cochlear implant specialists from five different European countries discussed the issue of aftercare based on their experience and the specific settings of their CI programs. In order to provide a baseline for the discussion, a questionnaire was sent out before the meeting to the five centers to learn more about the experiences and settings in their specific countries; all five responded to the questionnaire. The aim of the meeting was to conclude the results and work out a proposal for future standardization of basic aftercare.