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Objectives: The present study was performed to evaluate the efficacy and clinical feasibility of using monopolar stimulation with the Clarion Simultaneous Analog Stimulation (SAS) strategy in patients with cochlear implants. Methods: Speech recognition by 10 Clarion cochlear implant users was evaluated by means of 4 different speech processing strategy/electrode configuration combinations; ie, SAS and Continuous Interleaved Sampling (CIS) strategies were each used with monopolar (MP) and bipolar (BP) electrode configurations. The test measures included consonants, vowels, consonant nucleus-consonant words, and Hearing in Noise Test sentences with a +10 dB signal-to-noise ratio. Additionally, subjective judgments of sound quality were obtained for each strategy/configuration combination. Results: All subjects but I demonstrated open-set speech recognition with the SAS/MP combination. The group mean Hearing in Noise Test sentence score for the SAS/MP combination was 31.6% (range, 0% to 92%) correct, as compared to 25.0%, 46.7%, and 37.8% correct for the CIS/BP, CIS/MP, and SAS/BP combinations, respectively, iniersubject variability was high, and there were no significant differences in mean speech recognition scores or mean preference ratings among the 4 strategy/configuration combinations tested. Individually, the best speech recognition performance was with the subject's everyday strategy/configuration combination in 72% of the applicable cases. If the everyday strategy was excluded from the analysis, the subjects performed best with the SAS/MP combination in 37.5% of the remaining cases. Conclusions: The SAS processing strategy with an MP electrode configuration gave reasonable speech recognition in most subjects, even though subjects had minimal previous experience with this strategy/con figuration combination. The SAS/MP combination might be particularly appropriate for patients for whom a full dynamic range of electrical hearing could not be achieved with a BP configuration. [ABSTRACT FROM AUTHOR]

The purpose of this study was to characterize the transtympanically evoked, perioperative electrically evoked auditors brainstem response (EABR) and define its relationship with preoperative hearing, age and hearing loss etiology in 59 children (10-60 months of age) who had received cochlear implants. The results indicate that there was no difference between wave V latency obtained from the younger (10-36 months) and the older (37-60 months) children. There was a statistically significant difference in the preoperative pure-tone average between the higher-EABR threshold group (650 µA and above) and the lower-EABR threshold group (600 µA or less). Patients with post-meningitic deafness exhibited the longest EABR wave V latencies. Perioporative, transtympanic, promontory EABR is an effective clinical procedure which can decrease the likelihood of placing a cochlear implant in a non-stimulable ear, and may provide the clinician with a valuable tool for selecting the most appropriate ear for implantation. [ABSTRACT FROM AUTHOR]

Two adult cochlear implant users, with a history of hearing aid use in their non-implanted ear, underwent speech perception and sound localization testing to investigate whether the use of a hearing aid programmed for low-frequency gain only, would be superior to a hearing aid programmed for both low- and high-frequency gain. [Copyright &y& Elsevier]

Importance: Current indications for Medicare beneficiaries to receive a cochlear implant are outdated. Multichannel cochlear implant systems may be effective when provided to Medicare beneficiaries using expanded indications., Objective: To examine the effectiveness of cochlear implants, as measured by improvement on the AzBio Sentence Test, for newly implanted Medicare beneficiaries who meet the expanded indications of an AzBio Sentence Test score of 41% to 60% in their best-aided condition., Design, Setting, and Participants: A multicenter nonrandomized trial examined preoperative and postoperative speech recognition, telephone communication, hearing device benefit, health utility, and quality of life for 34 participants enrolled at 8 different centers who received a cochlear implant between September 17, 2014, and July 10, 2018. All participants were 65 years or older, had bilateral moderate to profound hearing loss, and had a best-aided preoperative AzBio Sentence Test score in quiet of 41% to 60%. Analysis was performed on an intention-to-treat basis. Statistical analysis of final results took place from July 29 to October 1, 2019., Intervention: Multichannel cochlear implants., Main Outcomes and Measures: The study examined the a priori hypothesis that the cochlear implant would improve the AzBio Sentence Test score in the best-aided condition by 25% or more and in the implanted ear-alone condition by 30% or more. The study additionally examined word and telephone recognition and examined device benefit, health utility, and quality of life., Results: A total of 34 participants received a cochlear implant; 31 (23 men [74%]; median age, 73.6 years [range, 65.7-85.1 years]) completed testing through the 6-month evaluation, and 29 completed testing through the 12-month evaluation. Median preoperative AzBio Sentence Test scores were 53% (range, 26%-60%) for the best-aided condition and 24% (range, 0%-53%) for the cochlear implant-alone condition; median scores 12 months after implantation improved to 89% (range, 36%-100%) for the best-aided condition and 77% (range, 13%-100%) for the cochlear implant-alone condition. This outcome represents a median change of 36% (range, -22% to 75%) for the best-aided condition (lower bound of 1-sided 95% CI, 31%) and a median change of 53% (range, -15% to 93%) for the cochlear implant-alone condition (lower bound of 1-sided 95% CI, 45%)., Conclusions and Relevance: Intervention with a cochlear implant was associated with improved sentence, word, and telephone recognition in adult Medicare beneficiaries whose preoperative AzBio Sentence Test scores were between 41% and 60%. These findings support expansion of the Center for Medicare & Medicaid current indications for cochlear implants., Trial Registration: ClinicalTrials.gov Identifier: NCT02075229.

The purpose of this study was to characterize the transtympanically evoked, perioperative electrically evoked auditory brainstem response (EABR) and define its relationship with preoperative hearing, age and hearing loss etiology in 59 children (10-60 months of age) who had received cochlear implants. The results indicate that there was no difference between wave V latency obtained from the younger (10-36 months) and the older (37-60 months) children. There was a statistically significant difference in the preoperative pure-tone average between the higher-EABR threshold group (650 microA and above) and the lower-EABR threshold group (600 microA or less). Patients with post-meningitic deafness exhibited the longest EABR wave V latencies. Perioperative, transtympanic, promontory EABR is an effective clinical procedure which can decrease the likelihood of placing a cochlear implant in a non-stimulable ear, and may provide the clinician with a valuable tool for selecting the most appropriate ear for implantation.

Objective: To quantify progress after cochlear implantation for children with autism spectrum disorder (ASD)., Study Design: Retrospective review of speech and language and speech perception test scores of children with autism who have received a cochlear implant at our center., Setting: University of Michigan Medical Center, Cochlear Implant Program., Patients: Six children, ages 3 to 16 years, who received cochlear implants at the our center. All children were diagnosed as having ASD by a neuropsychologist, either before or after receiving a cochlear implant., Main Outcome Measures: Children participated in preoperative and postoperative speech and language and speech perception testing. A survey was administered to parents to evaluate subjective impressions of cochlear implant benefit and quality of life before and after implantation., Results: Improved scores were recorded for children on whom standardized expressive and receptive vocabulary testing was possible. Children who could not complete standardized tests demonstrated improvement in raw scores. Improvement on the Meaningful Auditory Integration Scale was noted for the 4 of 7 children who completed the scale preoperatively and postoperatively. Survey results suggested changes in responsiveness to sound, interest in music, vocalization, and eye contact following implantation. Five of the 6 families indicated that they would recommend a cochlear implant to another family in a similar situation., Conclusions: Gains made by children in our study were small compared with the general implant population; however, when compared with themselves preoperatively, these children did demonstrate progress. Improvements in behaviors and interaction point to a quality of life benefit following implantation that is difficult to quantify.