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Current notions of “hearing impairment,” as reflected in clinical audiological practice, do not acknowledge the needs of individuals who have normal hearing pure tone sensitivity but who experience auditory processing difficulties in everyday life that are indexed by reduced performance in other more sophisticated audiometric tests such as speech audiometry in noise or complex non-speech sound perception. This disor-der, defined as “Auditory Processing Disorder” (APD) or “Central Auditory Processing Disorder” is classified in the current tenth version of the International Classification of diseases as H93.25 and in the forthcoming beta eleventh version. APDs may have detrimental effects on the affected individual, with low esteem, anxiety, and depression, and symptoms may remain into adulthood. These disorders may interfere with learning per se and with communication, social, emotional, and academic-work aspects of life. The objective of the present paper is to define a baseline European APD consensus formulated by experienced clinicians and researchers in this specific field of human auditory science. A secondary aim is to identify issues that future research needs to address in order to further clarify the nature of APD and thus assist in optimum diagnosis and evidence-based management. This European consensus presents the main symptoms, conditions, and specific medical history elements that should lead to auditory processing evaluation. Consensus on definition of the disorder, optimum diag-nostic pathway, and appropriate management are highlighted alongside a perspective on future research focus.

This study aimed at evaluation the feasibility of an implanted microphone for cochlear implants (CI) by comparison of hearing outcomes, sound quality and patient satisfaction of a subcutaneous microphone to a standard external microphone of a behind-the-ear sound processor. In this prospective feasibility study with a within-subject repeated measures design comparing the microphone modalities, ten experienced adult unilateral CI users received an implantable contralateral subcutaneous microphone attached to a percutaneous plug. The signal was pre-processed and fed into their CI sound processor. Subjects compared listening modes at home for a period of up to 4 months. At the end of the study the microphone was explanted. Aided audiometric thresholds, speech understanding in quiet, and sound quality questionnaires were assessed. On average thresholds (250, 500, 750, 1k, 2k, 3k, 4k and 6kHz) with the subcutaneous microphone were 44.9 dB, compared to 36.4 dB for the external mode. Speech understanding on sentences in quiet was high, within approximately 90% of performance levels compared to hearing with an external microphone. Body sounds were audible but no annoying to almost all subjects. This feasibility study with a research device shows significantly better results than previous studies with implanted microphones. This is attributed to technology enhancements and careful fitting. Listening effort was somewhat increased with an implanted microphone. Under good sound conditions, speech performance is nearly similar to that of external microphones demonstrating that an implanted microphone is feasible in a range of normal listening conditions.