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Introduction: This study examines the effect of cochlear implant (CI) device usage metrics on post-operative outcomes in unilateral CI recipients. The primary objective is to investigate the relationship between CI usage frequency (average daily CI use) and duration (total years of CI use) on electrically evoked cortical auditory-evoked potential (eCAEP) response peak latency (ms) and amplitude (μV). Methods: Adult CI users (n = 41) who previously exhibited absent acoustically evoked CAEP responses participated in the study. The peak latency and amplitude of eCAEP P1-N1-P2 responses were recorded, when present for the apical, medial, and basal test electrode contacts. CI duration was defined as the number of years between the date of CI activation and date that eCAEP testing was performed. CI usage frequency was defined as the average number of hours per day of audio processor use, which was recorded using the CI programming software. Results: Overall, 27 participants (65.85%) exhibited detectable eCAEP responses across one or more electrode contacts. Among these, 18 participants (43.9%) elicited eCAEP responses at all three electrode contacts, while 7 (17.07%) showed responses at two contacts, and 2 (4.88%) at one contact. For the remaining 14 participants (34.15%), eCAEP responses were either absent or undetectable. CI usage frequency (average daily CI use [hours/day]) was captured for 32 (78%) of the participants (median 10.35 h/day, range 0.2–16 h/day). Participants with present eCAEP responses for the basal electrode (n = 14) showed significantly higher CI usage frequency (11.8 h/day, p = 0.026) compared to those with non-detectable responses (6.25 h/day). An association was found between higher CI usage frequency and reduced N1 (p = 0.002), P2 (p = 0.0037) and P1-N1 inter-peak (p = 0.015) response latency (ms). While CI duration (total CI use [years]) did not differ significantly between groups based on the presence of eCAEP responses, an association was found between greater CI duration and increased eCAEP response amplitude (μV) for the P2 (p = 0.008) and N1-P2 peak-peak (p = 0.009) response components. Discussion: Additionally, most (65.85%) participants who previously exhibited absent acoustic CAEP responses developed eCAEP responses after consistent CI use and increased CI experience. These findings may suggest a potential for cortical plasticity and adaptation with consistent CI use over time. Recognizing the impact of device usage metrics on neural responses post-implantation enhances our understanding of the importance of consistent daily CI use. Overall, these findings contribute to addressing the variability among CI users, improving post-operative outcomes and advancing the standard of personalized care in auditory rehabilitation. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignStudy sampleResultsConclusionTo evaluate the role of Extended Scope (ES) audiologists in managing adult Ear Nose and Throat (ENT)/Otology waitlists and analyse patient re-presentation rate to the ENT service within 12 months of being discharged from the clinic.A retrospective cohort study assessing the efficacy of ES audiologists, measuring the discharge rate from ENT waitlists, the rate of escalation to ENT care, and the rate and reasons for any re-presentations to care.394 adult patients.Of the referred patients, 95% (n = 374) were deemed suitable for ES care. Of these, 75% were discharged without further ENT intervention, 20% required escalation to ENT, and 5% were returned to the waitlist. Only one patient re-presented for care within 12 months. The inclusion of patients with CHL/MHL and vestibular symptoms marked an expansion from our previous work. The re-presentation rate was notably lower compared to other allied health ES clinics.The ES Audiology clinic demonstrates a high discharge rate with a low incidence of patient re-presentation, highlighting the ES audiologists’ efficiency in managing non-urgent ENT cases. The study supports the continued use and expansion of ES roles to ensuring timely and quality care for patients on ENT waitlists. [ABSTRACT FROM AUTHOR]

Introduction: Hearing loss is a major global public health issue that negatively impacts quality of life, communication, cognition, social participation, and mental health. The cochlear implant (CI) is the most efficacious treatment for severe-to-profound sensorineural hearing loss. However, variability in outcomes remains high among CI users. Our previous research demonstrated that the existing subjective methodology of CI programming does not consistently produce optimal stimulation for speech perception, thereby limiting the potential for CI users to derive the maximum device benefit to achieve their peak potential. We demonstrated the benefit of utilising the objective method of measuring auditory-evoked cortical responses to speech stimuli as a reliable tool to guide and verify CI programming and, in turn, significantly improve speech perception performance. The present study was designed to investigate the impact of patient- and device-specific factors on the application of acoustically-evoked cortical auditory-evoked potential (aCAEP) measures as an objective clinical tool to verify CI mapping in adult CI users with bilateral deafness (BD). Methods: aCAEP responses were elicited using binaural peripheral auditory stimulation for four speech tokens (/m/, /g/, /t/, and /s/) and recorded by HEARLab™ software in adult BD CI users. Participants were classified into groups according to subjective or objective CI mapping procedures to elicit present aCAEP responses to all four speech tokens. The impact of patient- and device-specific factors on the presence of aCAEP responses and speech perception was investigated between participant groups. Results: Participants were categorised based on the presence or absence of the P1-N1-P2 aCAEP response to speech tokens. Out of the total cohort of adult CI users (n = 132), 63 participants demonstrated present responses pre-optimisation, 37 participants exhibited present responses post-optimisation, and the remaining 32 participants either showed an absent response for at least one speech token post-optimisation or did not accept the optimised CI map adjustments. Overall, no significant correlation was shown between patient and device-specific factors and the presence of aCAEP responses or speech perception scores. Conclusion: This study reinforces that aCAEP measures offer an objective, non-invasive approach to verify CI mapping, irrespective of patient or device factors. These findings further our understanding of the importance of personalised CI rehabilitation through CI mapping to minimise the degree of speech perception variation post-CI and allow all CI users to achieve maximum device benefit. [ABSTRACT FROM AUTHOR]

Introduction: Electrically evoked cortical auditory evoked potentials (ECAEPs) are central brain responses to auditory stimuli that correlate with postoperative cochlear implant (CI) hearing outcomes. They differ from electrically evoked compound action potentials (ECAPs) which are peripheral responses that can be elicited intraoperatively and may also predict CI hearing outcomes. It is not known to what degree ECAP and ECAEP responses are associated with each other. Such a correlation, if present, may allow for an earlier and more accurate prediction of postoperative hearing outcomes., Methods: This retrospective study involved 42 adult CI users. Threshold levels and amplitude growth function slopes of intraoperative ECAPs were compared to the latencies and peak-to-peak amplitudes of postoperative ECAEP responses at three different cochlear electrode array sites (apical, medial, and basal)., Results: A weak positive relationship was found between intraoperative ECAP thresholds and ECAEP N1-P2 peak-to-peak amplitude (r = 0.301, p = 0.005). Time between ECAP and ECAEP measurements was weakly correlated with P1-N1 peak-to-peak amplitude (r = 0.321, p = 0.002) and ECAEP N1-P2 peak-to-peak amplitude (r = 0.340, p = 0.001). ECAP amplitude growth function slopes varied by electrode location (χ2 = 26.701, df = 2, p = 0. 000002)., Conclusion: These results suggest that intraoperative ECAP responses do not robustly predict postoperative ECAEP responses, providing caution against the use of ECAPs as a predictive tool for CI hearing outcomes., (© 2024 The Author(s). Published by S. Karger AG, Basel.)