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Objectives/hypothesis: To determine the timing of acoustic hearing changes among hearing preservation Cochlear implant (CI) recipients. To determine differences in hearing outcomes based on device type and demographic factors. To determine if there is a relationship between the extent of early hearing loss after CI and the subsequent rate of continued hearing loss., Study Design: Prospective, single subject study., Methods: Two hundred and eleven subjects who received a hearing preservation CI were included in the study-80 Nucleus Hybrid L24 (Cochlear), 47 422/522 (Cochlear), 24 S8 (Cochlear), 14 S12 (Cochlear), 6 SRW (Cochlear), 21 SLIM J (Advanced Bionics), and 19 Flex (Med-EL). Of these, 127 were included in the subsequent analyses. Audiometric thresholds (low frequency pure-tone-averages) were collected and compared pre and postoperatively., Results: Long-term hearing preservation rates were 65% (52/80) for L24, 83% (20/24) for S8, 79% (11/14) for S12, 83% (5/6) for SRW, 54% (25/47) for 422/522, 91% (21/23) for SLIM J, and 84% (16/19) for Flex. Hearing loss was not related to device type (P = .9105) or gender (P = .2169). Older subjects (age ≥65) had worse hearing outcomes than younger subjects after initial device activation (age <65, P = .0262). There was no significant difference in rate of hearing loss over time between older and younger patients (P = .0938). Initial postoperative hearing loss was not associated with the rate of long-term hearing loss., Conclusions: Long-term low frequency hearing preservation is possible for CI recipients and is not associated with gender or device type. Rate of hearing loss over time is not dependent on patient age. Early hearing loss after CI does not predict the rate of long-term hearing loss., Level of Evidence: 3 Laryngoscope, 132:2036-2043, 2022., (© 2021 The American Laryngological, Rhinological and Otological Society, Inc.)

Children with developmental language disorder (DLD) served as a test case for determining the role of extant vocabulary knowledge, endogenous attention, and phonological working memory abilities in cross-situational word learning. First-graders (M age = 7 years; 3 months), 44 with typical development (TD) and 28 with DLD, completed a cross-situational word-learning task comprised six cycles, followed by retention tests and independent assessments of attention, memory, and vocabulary. Children with DLD scored lower than those with TD on all measures of learning and retention, a performance gap that emerged in the first cycle of the cross-situational protocol and that we attribute to weaknesses in initial encoding. Over cycles, children with DLD learned words at a similar rate as their TD peers but they were less flexible in their strategy use, demonstrating a propose-but-verify approach but never a statistical aggregation approach. Also, they drew upon different mechanisms to support their learning. Attention played a greater role for the children with DLD, whereas extant vocabulary size played a greater role for the children with TD. Children navigate the problem space of cross-situational learning via varied routes. This conclusion is offered as motivation for theorists to capture all learners, not just the most typical ones., (© 2022 Cognitive Science Society LLC.)

Objectives/hypothesis: The use of a short 10-mm/10-electrode cochlear implant to preserve low-frequency residual hearing was investigated. This report describes the 12-month outcomes of this multicenter clinical trial., Study Design: Single-subject design., Methods: Twenty-eight subjects with low-frequency hearing at or better than 60 dB HL at 500 Hz and severe high-frequency hearing loss were implanted with a Nucleus Hybrid S12 implant in their poorer ear. Speech perception in quiet using Consonant-Nucleus-Consonant (CNC) words and sentences in noise using AzBio sentences was collected pre- and postoperatively at 3, 6, and 12 months. Subjective reporting using the Speech, Spatial, and Qualities of Hearing Scale (SSQ) questionnaire was also collected pre- and postoperatively., Results: Functional hearing preservation was accomplished in 96% of subjects. At 3 and 6 months, 86% of the 28 subjects had maintained functional hearing. By 12 months, 23 out of 27 subjects (85%) had maintained functional hearing (one subject with functional hearing at 6 months withdrew from the study prior to the 12-month visit). Speech perception results demonstrated that 81% of the participants on CNC words and 77% with AzBio sentences in noise had significant improvements using their everyday listening condition at 12 months compared to preoperative performance with bilateral hearing aids. Furthermore, preoperative to 12 months postoperative subjective ratings showed significant improvements for the SSQ., Conclusions: This study demonstrates that a high degree of hearing preservation enabling acoustic-electric hearing and improvement in speech understanding in quiet and in noise can be accomplished using a short-electrode 10-mm cochlear implant., Level of Evidence: 2c Laryngoscope, 130:E548-E558, 2020., (© 2020 The American Laryngological, Rhinological and Otological Society, Inc.)

Objective: Few studies have investigated the stability of residual hearing and speech perception outcomes in individuals who were implanted with a shorter electrode device., Study Design: Longitudinal, single-subject design., Methods: Fifty subjects who received a Nucleus Hybrid (Cochlear, Sydney, Australia) short electrode cochlear implant (CI) and had a minimum of 2 years (and up to 15 years) of postoperative longitudinal experience were included in this study. Twenty-three subjects received a Nucleus Hybrid S8 (S8); 14 subjects received a Nucleus Hybrid L24 (L24); and 13 received a Nucleus Hybrid S12 (S12). Audiometric thresholds and consonant-nucleus-consonant (CNC) words were collected pre- and postoperatively for up to 15 years for the S8 subjects and for up to 7 years for the S12 and L24 subjects. AzBio Sentences in multi-talker babble was collected for up to 7 years on the S12 and L24 subjects., Results: Longitudinally, 83% of the S8 subjects, 92% of the S12 subjects, and 86% of the L24 subjects maintained a functional hearing pure-tone average (PTA) (125-500 Hz). Predicted change using a piecewise linear mixed model in PTA over time showed a postoperative linear decrease in hearing for each group until 0.5 years, after which the PTA stabilizes and is maintained. The averaged individual data for CNC and AzBio sentences show a significant improvement in scores by 0.25 to 0.5 years postimplantation, after which scores start to reach their maximum., Conclusion: This long-term study demonstrates that acoustic-electric processing hearing and improvement in speech understanding in quiet and in noise can be accomplished and sustained for many years with a short electrode CI., Level of Evidence: 2C. Laryngoscope, 128:473-481, 2018., (© 2017 The American Laryngological, Rhinological and Otological Society, Inc.)

Objectives/hypothesis: The concept of expanding electrical speech processing to those with more residual acoustic hearing with a less-invasive shorter cochlear implant (CI) has been ongoing since 1999. A multicenter study of the Nucleus Hybrid S8 CI took place between 2002 and 2011. This report describes the final outcomes of this clinical trial., Study Design: Multicenter, longitudinal, single-subject design., Methods: Eighty-seven subjects received a Nucleus Hybrid S8 CI in their poorer ear. Speech perception in quiet (Consonant-Nucleus-Consonant [CNC] words) and in noise (Bamford-Kowal-Bench Sentences-In-Noise [BKB-SIN]) were collected pre- and postoperatively at 3, 6, and 12 months. Subjective questionnaire data using the Abbreviated Profile for Hearing Aid Benefit (APHAB) were also collected., Results: Some level of hearing preservation was accomplished in 98% subjects, with 90% maintaining a functional low-frequency pure-tone average (LFPTA) at initial activation. By 12 months, five subjects had total hearing loss, and 80% of subjects maintained functional hearing. CNC words demonstrated that 82.5% and 87.5% of subjects had significant improvements in the hybrid and combined conditions, respectively. The majority had improvements with BKB-SIN. Results also indicated that as long as subjects maintained at least a severe LFPTA, there was significant improvement in speech understanding. Furthermore, all subjects reported positive improvements in hearing in three of the four subscales of the APHAB., Conclusions: The concept of hybrid speech processing has significant advantages for subjects with residual low-frequency hearing. In this study, the Nucleus Hybrid S8 provided improved word understanding in quiet and noise. Additionally, there appears to be stability of the residual hearing after initial activation of the device., Level of Evidence: 2c., (© 2016 The American Laryngological, Rhinological and Otological Society, Inc.)