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Objectives/Hypothesis: To identify barriers to and opportunities for referral among children who could be considered for cochlear implantation. Study Design: Retrospective review. Methods: Audiological and medical records were reviewed on all children who had diagnostic or hearing aid care through a statewide healthcare system over 5‐year span to identify children who met newly established clinical cochlear implant (CI) referral criteria. Data were collected for 869 potential CI candidates regarding demographic, socio‐economic, audiological, medical, and family factors that may influence referral. A binomial logistic regression was completed to investigate the potential contributions of these predictors toward referral for a CI evaluation. Results: Children who met traditional candidacy criteria of severe‐to‐profound bilateral hearing loss were referred at very high rates, while nontraditional candidates were referred less frequently. Factors influencing referral included race, age, insurance source, hearing thresholds, audiologist, physician, and family request. Conclusions: Results suggest that bilateral traditional candidates are being referred at high percentages; however, current practices and trends in pediatric cochlear implantation should be shared with families and providers to increase referral rates for nontraditional candidates. Level of Evidence: 3 Laryngoscope, 131:E2904–E2910, 2021 [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: Speech recognition with a cochlear implant (CI) tends to be better for younger adults than older adults. However, older adults may take longer to reach asymptotic performance than younger adults. The present study aimed to characterize speech recognition as a function of age at implantation and listening experience for adult CI users.Study Design: Retrospective review.Methods: A retrospective review identified 352 adult CI recipients (387 ears) with at least 5 years of device listening experience. Speech recognition, as measured with consonant-nucleus-consonant (CNC) words in quiet and AzBio sentences in a 10-talker noise masker (10 dB signal-to-noise ratio), was reviewed at 1, 5, and 10 years postactivation.Results: Speech recognition was better in younger listeners, and performance was stable or continued to improve through 10 years of CI listening experience. There was no indication of differences in acclimatization as a function of age at implantation. For the better performing CI recipients, an effect of age at implantation was more apparent for sentence recognition in noise than for word recognition in quiet.Conclusions: Adult CI recipients across the age range examined here experience speech recognition benefit with a CI. However, older adults perform more poorly than young adults for speech recognition in quiet and noise, with similar age effects through 5 to 10 years of listening experience.Level Of Evidence: 3 Laryngoscope, 131:2106-2111, 2021. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: Results from a prospective trial demonstrated better speech recognition for cochlear implant (CI) recipients implanted with a long lateral wall electrode array compared to subjects with a short array after 1 year of listening experience. As short array recipients may require an extended adaptation period, this study investigated whether differences in speech recognition continued through 4 years of CI use. Study Design Long‐term follow‐up of a prospective randomized trial. Methods: Subjects were randomized to receive a MED‐EL medium (24 mm) or standard (31.5 mm) array. Linear mixed models compared speech recognition between cohorts with word recognition in quiet and sentence recognition in noise at 1, 3, 6, 12, 24, and 48 months postactivation. Postoperative imaging and electric frequency filters were reviewed to assess the influence of frequency‐to‐place mismatch and angular separation between neighboring contacts, a metric associated with peripheral spectral selectivity. Results: Long (31.5 mm) array recipients demonstrated superior speech recognition out to 4 years postactivation. There was a significant effect of angular separation between contacts, with more closely spaced contacts associated with poorer speech recognition. There was no significant effect of mismatch, yet this may have been obscured by changes in frequency filters over time. Conclusions: Conventional MED‐EL CI recipients implanted with 31.5‐mm arrays experience better speech recognition than 24‐mm array recipients, initially and with long‐term listening experience. The benefit conferred by longer arrays in the present cohort can be partially attributed to more widely spaced electrode contacts, presumably a result of reduced channel interaction. Level of Evidence: 2 Laryngoscope, 131:892–897, 2021 [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: To evaluate speech perception outcomes and hearing preservation after cochlear implantation in patients with Meniere's disease (MD). Study Design: Retrospective chart review. Methods: Fifty‐one adult patients, accounting for a total of 63 implants, with MD treated at a tertiary care center were included in the study. Patients with unaided preoperative air‐conduction thresholds ≤80 dB at 250 Hz were included in hearing preservation analyses. The primary outcome measure was Consonant‐Nucleus‐Consonant (CNC) score. Hearing preservation was assessed as follows: 1) maintenance of functional hearing, defined as a postoperative unaided air‐conduction threshold ≤80 dB at 250 Hz and 2) low‐frequency pure‐tone average (LFPTA) shift. Results: Speech perception scores improved significantly postimplantation; specifically, the CNC mean score was 9% preoperatively and increased to 57% by 1 year postoperatively (P <.001). Eighteen ears were included in hearing preservation analysis; the mean preoperative LFPTA was 65 dB (standard deviation [SD] = 10). The mean postoperative LFPTA at activation was 93 dB (SD = 21), and at 1 year was 102 dB (SD = 11). Twenty‐seven percent of patients achieved short‐term functional hearing preservation, whereas the longer‐term outcomes were less favorable (11%). Conclusions: Speech perception scores improve after implantation in patients with MD. Hearing preservation is possible in patients with MD, albeit at lower rates than reported non‐MD populations. Our data suggest that there can be degradation in acoustic hearing over time. Level of Evidence: 4 Laryngoscope, 2019 [ABSTRACT FROM AUTHOR]

Objective: To investigate the influence of cochlear implant (CI) use on subjective benefits in quality of life in cases of asymmetric hearing loss (AHL).Study Design: Prospective clinical trial.Setting: Tertiary academic center.Subjects and Methods: Subjects included CI recipients with AHL (n = 20), defined as moderate-to-profound hearing loss in the affected ear and mild-to-moderate hearing loss in the contralateral ear. Quality of life was assessed with the Speech, Spatial, and Qualities of Hearing Scale (SSQ) pragmatic subscales, which assess binaural benefits. Subjective benefit on the pragmatic subscales was compared to word recognition in quiet and spatial hearing abilities (ie, masked sentence recognition and localization).Results: Subjects demonstrated an early, significant improvement (P < .01) in abilities with the CI as compared to preoperative abilities on the SSQ pragmatic subscales by the 1-month interval. Perceived abilities were either maintained or continued to improve over the study period. There were no significant correlations between results on the Speech in Quiet subscale and word recognition in quiet, the Speech in Speech Contexts subscale and masked sentence recognition, or the Localization subscale and sound field localization.Conclusions: CI recipients with AHL report a significant improvement in quality of life as measured by the SSQ pragmatic subscales over preoperative abilities. Reported improvements are observed as early as 1 month postactivation, which likely reflect the binaural benefits of listening with bimodal stimulation (CI and contralateral hearing aid). The SSQ pragmatic subscales may provide a more in-depth insight into CI recipient experience as compared to behavioral sound field measures alone. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis To report on single-center data of an FDA-approved clinical trial on the objective benefits of cochlear implantation and subsequent ipsilateral Electric-Acoustic Stimulation (EAS). Study Design Single-center data from a prospective, multicenter clinical trial. Methods Eighteen subjects completed the 12-month EAS evaluation and were included in this evaluation. Each patient underwent cochlear implantation using a standardized hearing preservation approach. Both hearing preservation and speech perception abilities were evaluated at various intervals. Speech testing included performance measures obtained in quiet (CNC words) and noise (adaptive CUNY protocol) in three listening conditions: hearing aid (HA) alone, cochlear implant (CI) only, and combined ipsilateral EAS. Results Various levels of hearing preservation were achieved with cochleostomy and round-window surgical approaches in 17 of the 18 subjects. Mean CNC word scores at the 12-month interval were 14.9 ± 12.1, 45.3 ± 15.4, and 70.7 ± 11.7% correct in the HA only, CI only, and EAS conditions, respectively. Average CUNY scores at 0 dB SNR were 14.6 ± 17.2, 47.1 ± 22.1, and 72.2 ± 21.5 for the three test conditions obtained after 12 months. Conclusions Data obtained during this clinical trial correlate well with previous reports. Hearing preservation appears successful in a high number of subjects, and combined EAS offers excellent speech perception abilities in quiet and in noise. Laryngoscope, 123:2509-2515, 2013 [ABSTRACT FROM AUTHOR]