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Otosclerosis is an otologic disease characterized by disordered resorption and deposition of the otic capsule bone. It can lead to progressive conductive, mixed or sensorineural Hearing Loss (HL). In rare cases, it manifests itself with a tendency for massive bone resorption with subsequent formation of cavities (“cavitating otosclerosis”). Cavities can sometimes realize communication between the Cerebrospinal Fluid (CSF) at the Internal Auditory Canal (IAC) and the cochlear duct. In these uncommon cases, a “third-window” phenomenon may be established as a concomitant cause of conductive HL. Therefore, the feasibility of stapes surgery should be evaluated, without underestimating the risk of gusher complications. In this report, we discuss the case of a female patient affected by cavitating otosclerosis realizing a connection between IAC and cochlear duct, with mixed hearing loss.

Purpose Auditory selective attention (ASA) is crucial to focus on significant auditory stimuli without being distracted by irrelevant auditory signals and plays an important role in language development. The present study aimed to investigate the unique contribution of ASA to the linguistic levels achieved by a group of cochlear implanted (CI) children. Methods Thirty-four CI children with a median age of 10.05 years were tested using both the “Batteria per la Valutazione dell’Attenzione Uditiva e della Memoria di Lavoro Fonologica nell’età evolutiva-VAUM-ELF” to assess their ASA skills, and two Italian standardized tests to measure lexical and morphosyntactic skills. A regression analysis, including demographic and audiological variables, was conducted to assess the unique contribution of ASA to language skills. Results The percentages of CI children with adequate ASA performances ranged from 50 to 29.4%. Bilateral CI children performed better than their monolateral peers. ASA skills contributed significantly to linguistic skills, accounting alone for the 25% of the observed variance. Conclusions The present findings are clinically relevant as they highlight the importance to assess ASA skills as early as possible, reflecting their important role in language development. Using simple clinical tools, ASA skills could be studied at early developmental stages. This may provide additional information to outcomes from traditional auditory tests and may allow us to implement specific training programs that could positively contribute to the development of neural mechanisms of ASA and, consequently, induce improvements in language skills.

Purpose This study investigates the acoustic environment of children with cochlear implants (CIs) and the relationship between exposure to speech, in noise and in quiet, and the children's lexical production up to 1 year after CI activation, while controlling for the effect of early individual differences in receptive vocabulary growth. Method Eighteen children with CIs were observed at 3, 6, and 12 months after CI activation. Children's spontaneous word production during interaction with their mothers (types and tokens) and their expressive and receptive vocabulary size were considered. The characteristics of the acoustic environments in terms of acoustic scenes (speech in noise or in quiet, quiet, noise, music, and other) and of loudness ranges were assessed using data logging of the children's devices. Results Data analysis showed that both the number of tokens and the number of types produced 1 year after CI activation were affected by the children's exposure to speech in quiet with a loudness range between 40 and 69 dB. Expressive vocabulary size and types were affected by the receptive vocabulary knowledge that the children achieved over the first 3 months after CI activation. Conclusions Our data support the role of speech environment and individual differences in early comprehension on lexical production. The importance of exposure to speech with particular characteristics for the lexical development of children with CIs and the implications for clinical practice are discussed.

To evaluate mean surgical time, incidence of soft tissue reactions, implant survival and intraoperative complications in both minimally invasive ponto surgery (MIPS) and the linear incision with tissue preservation technique (LT).A retrospective review was carried out on 48 bone anchored hearing system (BAHS) patients between 2014 and 2019: 13 patients had undergone LT and formed one group, while 35 patients had undergone MIPS and formed the second group. Mean surgical time, intraoperative complications, implant loss and skin reaction were assessed at each post-operative examination. The Mann-Whitney U test was used for statistical analysis.The difference in the mean surgical time of 15 mins for MIPS and 36 mins for LT was statistically significant. No intraoperative complications were reported and implant survival was 100% in both groups. The incidence of adverse skin reactions was 7.7% for the LT group and 0% for the MIPS group at first follow-up examination.Surgical mean time is shorter for MIPS, making this procedure more suitable for local anaesthesia and more cost effective. Moreover, both LT and MIPS demonstrate good surgical outcomes in terms of skin reactions according to Holgers score and equally excellent implant survival.Confronto tra incisione lineare e tecnica punch nella chirurgia degli impianti a conduzione ossea.Confrontare la tecnica dell’incisione lineare con conservazione del tessuto sottocutaneo (LT) e la tecnica MIPS valutando le differenze nella durata della chirurgia, l’incidenza delle reazioni cutanee avverse, la perdita dell’impianto e le complicanze intraoperatorie.Presso il nostro centro di Audiologia tra il 2014 e 2019 sono stati sottoposti ad intervento chirurgico per l’applicazione di BAHS 48 pazienti: 13 pazienti mediante LT e 35 pazienti mediante MIPS.La durata media della chirurgia è stata di 15 minuti per la tecnica MIPS e 36 minuti per la LT con una differenza statisticamente significativa. Non sono state riscontrate complicanze intraoperatorie, la perdita dell’impianto è stata dello 0% in entrambi i gruppi. L’incidenza di reazioni avverse cutanee è stata del 7,7% per il gruppo LT e dello 0% per il gruppo MIPS alla prima visita post-operatoria.La durata dell’intervento chirurgico è più breve per la MIPS rispetto alla tecnica LT, rendendo questa procedura più adatta all’anestesia locale e più vantaggiosa in termini di costi sanitari. Inoltre, sia la LT che la MIPS mostrano buoni risultati chirurgici per quanto riguarda la riduzione delle reazioni cutanee avverse, le complicanze intraoperatorie e la perdita dell’impianto.

Background: Population ageing is a global phenomenon. Hearing loss prevalence, indeed, increases with age. Hearing loss in elderly deteriorates hearing abilities and consequently cognition, sociality, sensitivity and the quality of life. Different studies reported that hearing aids have a positive effect on the cognitive outcome but most of them do not compare the performances before and after the hearing aids (HA) fitting. The primary aim of this study is to investigate the adherence to HA use in a group of elderly people one year after their first fitting. In particular, we want to analyze which factors influence the adherence. Subsequently, we evaluated the evolution of the different parameters analyzed after one year of HA use. Methods: 86 elderly patients affected by moderate or moderate to severe hearing loss were consecutively recruited. They were evaluated during two assessments: one before (Pre) and one after one year of first HA experience (Post). Audiometric measures, questionnaires and a cognitive test were performed at each assessment. More details about study design and inclusion/exclusion criteria are reported in our previously published study protocol. Results: 69.8% of the participants continued to use HA one year after the first fitting. At the comparisons USERS were younger than NON-USERS. Furthermore users have a statistically better unaided auditory threshold and basic cognitive status. No differences were found in speech audiometry, HHIE and Quality of life score. 39 patients completed Pre and Post evaluations. Significant improvements in speech audiometry and auditory threshold, HHIE, AQoL and IOI-HA score were observed. No difference was found in MOCA score. Conclusions: An high percentage of adherence to HA use has been observed in elderly with moderate or moderate to severe HL. The adherence to HA use is correlated with lower age, lower hearing loss degree, good basal cognitive capacities and better quality of life perception at first fitting. Use of hearing aids over time, leads to an improvement of the auditory performances, a reduction of the effect of the hearing impairment in everyday situations and absence of deterioration of the cognitive functions. Bilateral device users experience better performances and satisfaction than monolateral. Trial registration: This research was retrospectively registered under no. NCT04333043 at ClinicalTrials.gov (http://www.clinicaltrials.gov/) on the 26 March 2020. This research has been registered with the Ethics Committee of the Area Vasta Emilia Nord under number 104, date of approval 17/07/2017.

Introduction Bone anchored hearing solutions are a well-known option for patients with a conductive, mixed conductive-sensorineural hearing loss and those with single-sided deafness. Objective The aim of the present study was to evaluate the Ponto bone-anchored hearing system in terms of behavioral performance and self-reported outcomes, by comparing unaided and aided performance (softband and abutment), as well as aided performance with the sound processor on softband (preoperatively) versus abutment (postoperatively). Methods Fourteen adult bone-anchored candidates, with either a bilateral (n = 12) or unilateral (n = 2) conductive or mixed hearing loss, participated in the present study. Sound-field hearing thresholds were evaluated unaided and aided (softband and abutment). A speech-in-noise test was also performed unaided and aided for two spatial configurations (S0N90; implanted side; S0N90; nonimplanted side). The Glasgow Health Status Inventory and the Speech, Spatial and Quality of sound questionnaires were administered pre- and postsurgery to compare quality of life and perceived unaided and aided performance. Skin reaction (Holgers scores) was evaluated at 15 days, 6 weeks, and 10 weeks after surgery. Results Significant improvements postoperatively relative to unaided were obtained for sound-field thresholds at all tested frequencies. Additionally, sound-field thresholds were significantly improved with the sound processor on abutment relative to the softband at frequencies > 1 kHz. Improved performance postoperatively relative to unaided was also obtained in the speech-in-noise test and in self-reported outcomes. Conclusions Improvements in behavioral performance and self-reported outcomes were obtained with the sound processor mounted on abutment.

The objective of this analysis was to estimate the incremental cost–utility ratio (ICUR) of dupilumab as an add-on treatment to best supportive care (BSC), versus BSC alone, in Italy for severe uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP). A simulation of outcomes and costs was undertaken using a 1-year decision tree, followed by a lifetime horizon Markov model. Clinical data were derived from a pooled analysis of two studies (SINUS-24 NCT02912468 and SINUS-52 NCT02898454). The Italian National Healthcare Service (NHS) perspective was considered. Model robustness was tested through sensitivity analyses. In the base-case analysis, treatment with dupilumab + BSC resulted in an increase in quality of life-adjusted survival (+1.02 quality-adjusted life years (QALY-gained)), compared to the BSC alone. The resulted ICUR was €21,817 per QALY-gained and it is below the acceptability threshold commonly used in Italy. Both one-way deterministic and probabilistic sensitivity analyses confirmed the robustness of base-case results. The cost–utility analysis showed that dupilumab, as an add-on treatment to BSC, is a cost-effective therapeutic alternative to BSC in the treatment of patients with severe uncontrolled chronic rhinosinusitis with nasal polyps, confirming that it is economically sustainable.

Purpose Executive Functions (EFs) are fundamental to every aspect of life. The present study was implemented to evaluate factors influencing their development in a group of preschools orally educated profoundly deaf children of hearing parents, who received CI within 2 years of age. Methods Twenty-five preschool CI children were tested using the Battery for Assessment of Executive Functions (BAFE) to assess their flexibility, inhibition, and non-verbal visuo-spatial working memory skills. The percentage of children performing in normal range was reported for each of the EF subtests. Mann–Whitney and Kruskal–Wallis were performed to assess differences between gender, listening mode, and degree of parents’ education subgroups. The Spearman Rank Correlation Coefficient was calculated to investigate the relationship between EF scores of audiological and linguistic variables. Results Percentages ranging from 76 to 92% of the children reached adequate EF scores at BAFE. Significant relations (p Conclusions The present study is one of the first to focus attention on the development of EFs in preschool CI children, providing an initial understanding of the characteristics of EFs at the age when these skills emerge. Clinical practice must pay increasing attention to these aspects which are becoming the new emerging challenge of rehabilitation programs.

Background: Local and systemic corticosteroids have long been the workhorse in management of chronic rhinosinusitis with nasal polyps (CRSwNP), although there is no universally accepted modality of prescription. We carried out a survey in Italy to capture current trends in the use of topical and systemic corticosteroids in patients with CRSwNP. Methods: A survey was set up on Survey Monkey®. Each author distributed the link to the survey in an ad hoc manner and a total of 437 participants filled out the survey. Results: Mometasone furoate (79.3%) was the most frequently prescribed, administered daily by 61.9% of participants; the remaining preferred to discontinue treatment for brief periods to reduce side effects or to modulate the therapy in mild cases. The majority believe that a short cycle of systemic steroids should be prescribed for re-exacerbation of symptoms and that the number of cycles in the previous year should be evaluated to define control of the disease even if international guidelines do not provide clear indications on this topic. A certain degree of divergence emerged from responses regarding how long and the maximal dose of systemic steroids which place patients at high risk for adverse events. Finally, systemic corticosteroids seem to offer only temporary benefit on recovery of smell without guaranteeing long-term control even if the patient is adherent to topical corticosteroids. Conclusions: Our results highlight the need for clear guidelines on oral steroids, which could help supporting the use of a precision medicine approach, including indications for new biological agents.

The aim of the study was to investigate the listening comprehension (LC) skills in deaf and hard of hearing children (DHH) using cochlear implants (CI). Besides, personal and audiological variables that could influence the levels of competence reached were analyzed.Thirty-four children using CI were enrolled. LC skills were assessed through the standardized Italian test "Comprensione Orale-Test e Trattamento" (CO-TT). A univariate analysis was conducted to compare LC with gender, listening mode (unilateral or bilateral), maternal level of education and family income. A bivariate analysis was performed to search possible connections between children's performances and their individual characteristics, audiological conditions, and language levels. Finally, a multivariate analysis was performed using a stepwise hierarchical linear regression model which included all variables whose p value resulted ≤ 0.05.Twenty-one children using CI (61.8%) showed adequate performances in terms of chronological age, while 13 (38.2%) showed difficulties in LC. Maternal level of education, age at diagnosis and non-verbal cognitive level accounted for 43% of the observed variance. Auditory attention skills explained an additional 15% of variance. Morphosyntactic comprehension added a further 12% of variance.CI can really help many DHH children to reach adequate LC skills, but in some cases difficulties remain. Factors influencing LC need to be early investigated and considered when planning an appropriate rehabilitative intervention.

The present study aimed to investigate the communicative characteristics of children with cochlear implants (CIs) and their mothers in interaction, whether and how they differ from those of mother–child dyads with normal hearing, and whether mother and child influence each other over the first year after implantation. Eighteen Italian-speaking children with CIs were assessed longitudinally across four time points, from before implantation (ages: 10–33 months) to 1 year after implantation. Two groups of normally-hearing children matched for age or lexical production level were used as comparison groups. The language used by mothers in semi-structured play sessions with their children was analyzed for use of specific techniques aimed at eliciting language in children with CIs (or Facilitating Language Techniques [FLTs]: questions, labeling, comments, parallel talk, reformulations, and directives); children’s language was analyzed for communicative functions (initiatives and adequate responses). Results showed delayed communicative development for children with CIs with respect to both control groups and different use of FLTs such as directives between mothers of children with or without normal hearing. Findings also highlighted an effect of the interlocutor’s communicative behavior for both children and mothers: In the group of children with CIs, children’s initiatives were hindered by a higher use of questions; mothers’ labeling was negatively affected by children’s responsivity. Findings may have important implications for language development support programs, families, and professionals.

Il beneficio protesico e il ruolo delle abilità cognitive, dell’età e del deficit uditivo nel paziente anziano.Questo studio analizza il beneficio protesico in un campione di soggetti anziani (n = 102, età media 81,1 anni), indagando il ruolo svolto dall’età, dal deficit uditivo e dalle abilità cognitive. Il beneficio protesico è stato valutato sia come miglioramento delle caratteristiche audiometriche con protesi (in termini di soglie tonali e soglie di percezione del parlato in quiete e nel rumore) sia come diminuzione della percezione della disabilità e dell’handicap dovuti alla ipoacusia. Sono state valutate diverse abilità cognitive, tra cui la memoria a breve termine, le funzioni esecutive e l’attenzione. I dati raccolti sono stati analizzati tramite un’analisi multivariata, seguita da un’analisi di correlazione e regressione per evidenziare possibili fattori latenti tra le variabili in gioco e valutare come l’età, il deficit uditivo e le abilità cognitive influenzavano il beneficio protesico. L’analisi ha rivelato un miglioramento significativo del profilo audiometrico con protesi e una diminuzione della disabilità e dell’handicap percepiti. L’analisi multivariata, insieme con quella di correlazione e di regressione ha evidenziato che i soggetti con migliori abilità cognitive e minor deficit uditivo erano significativamente caratterizzati da un più evidente miglioramento del profilo audiometrico con protesi. Inoltre, è stata rilevata una relazione significativa tra la disabilità e l’handicap percepiti, il profilo audiometrico con protesi e il grado di ipoacusia: i soggetti con miglior profilo audiometrico con protesi e minor deficit uditivo erano significativamente caratterizzati da una più evidente diminuzione dell’handicap e della disabilità percepiti. Lo studio non ha invece evidenziato alcuna relazione diretta tra le abilità cognitive e il beneficio protesico riguardante la percezione dell’handicap e della disabilità.This study describes the benefits of hearing aid (HA) use in a sample of elderly experienced HA users (n = 102, mean age 81.1 years), investigating the role of the age, hearing impairment and cognitive function. The benefit was assessed in aided condition by measuring audiometric outcomes (aided thresholds and speech reception in quiet and in noise) and self-assessed outcomes addressing the disability and the handicap domains of auditory dysfunction. Several cognitive abilities were assessed, including short-term memory, working memory and executive functions. To discover potential latent factors and assess which factors significantly influenced the benefit of HA use, age, hearing impairment, cognitive function, audiometric and self-assessed outcomes were examined with multivariate analysis, followed by correlation and regression analysis. The analysis revealed a significant improvement in aided audiometric outcomes and a decrease in the perceived disability and handicap in the sample population. Multivariate, correlation and regression analyses showed that better aided audiometric outcomes were significantly associated with hearing impairment of lower degree and higher cognitive abilities. Moreover, self-assessed outcomes were significantly associated with audiometric outcomes and hearing impairment: subjects with better audiometric outcomes and lower hearing impairment tend to perceive more benefit in using their HAs. Cognition was only indirectly associated with self-assessed outcomes through its direct correlation with aided audiometric outcomes, meaning that the perceived subjective benefit with HA was not directly associated with better cognitive abilities.

Background Prevalence of hearing loss increases with age. Its estimated prevalence is 40–50 % in people over 75 years of age. Recent studies agree that declinein hearing threshold contribute to deterioration in sociality, sensitivity, cognition, and quality of life for elderly subjects. The aim of the study presented in this paper is to verify whether or not rehabilitation using first time applied Hearing Aids (HA) in a cohort of old people with hearing impairment improves both speech perception in a noisy environment over time and the overall health-related quality of life. Methods The monocentric, prospective, repeated measurements, single-subject, clinical observational study is to recruit 100 older adults, first-time HA recipients (≥ 65 years).The evaluation protocol is designed to analyze changes in specific measurement tools a year after the first HA usage in comparison with the evaluation before HA fitting. Evaluations will consist of multiparametric details collected through self-report questionnaires completed by the recipients and a series of commonly used audiometric measures and geriatric assessment tools. The primary indicator of changes in speech perception in noise to be used is the Italian version of Oldenburg Satz (OLSA) test whereas the indicator of changes in overall quality of life will be the Assessment of Quality of Life (AQoL) and Hearing Handicap Inventory for the Elderly (HHIE) questionnaires. The Montreal Cognitive Assessment (MoCA) will help in screening the cognitive state of the subjects. Discussion The protocol is designed to make use of measurement tools that have already been applied to the hearing-impaired population in order to compare the effects of HA rehabilitation in the older adults immediately before first HA usage (Pre) and after 1 year of experience (Post). This broad approach will lead to a greater understanding of how useful hearing influences the quality of life in older individuals, and therefore improves potentials for healthy aging. The data is to be analyzed by using an intrasubject endpoint comparison. Outcomes will be described and analyzed in detail. Trial registration This research was retrospectively registered underno. NCT04333043at ClinicalTrials.gov (http://www.clinicaltrials.gov/) on the 26 March 2020. This research has been registered with the Ethics Committee of the Area Vasta Emilia Nord under number 104, date of approval 17/07/2017.

Background Given an increase in the aging population and its impact on healthcare systems, policy makers for provision of health and social services are aiming to keep older adults in good health for longer, in other words towards ‘healthy aging’. Our study objective is to show that rehabilitation with cochlear implant treatment in the elderly with hearing impairment improves the overall health-related quality of life and general well-being that translate into healthy aging. Methods The multicentre, prospective, repeated measures, single-subject, clinical observational study will accrue 100 elderly, first-time, unilateral CI recipients (≥ 60 years) and analyze changes on specific measurement tools over ca. 20 months from preimplant to postimplant. Evaluations will consist of details collected through case history and interview questionnaires by clinicians, data logging, self-report questionnaires completed by the recipients and a series of commonly used audiometric measures and geriatric assessment tools. The primary indicator of changes in overall quality of life will be the HUI-3. Discussion The protocol is designed to make use of measurement tools that have already been applied to the hearing-impaired population in order to compare effects of CI rehabilitation in adults immediately before their implantation, (pre-implant) and after gaining 1–1.5 years of experience (post-implant). The broad approach will lead to a greater understanding of how useful hearing impacts the quality of life in elderly individuals, and thus improves potentials for healthy aging. Outcomes will be described and analyzed in detail. Trial registration This research has been registered in ClinicalTrials.gov (http://www.clinicaltrials.gov/), 7 March 2017 under the n° NCT03072862.

Objectives The present study aims to assess the emotional experiences, specifically parenting stress, of mothers of children with cochlear implants (CIs), and their children's language development before surgery and at three and six months after CI activation. Methods Twenty mothers of children with CIs were interviewed before their children's surgery about their experiences in connection with the diagnosis of deafness, the surgery and the activation of the CI. The Parenting Stress Index questionnaire and the MacArthur-Bates-Communication Development Inventory were administered before the surgery and at 3 and 6 months after the CI activation. Results Analysis of the qualitative data resulting from the interviews showed that the mothers’ emotional experiences before the CI surgery were complex. Mothers reported both positive and negative emotions related to deafness, diagnosis and surgery, benefits of the CI, coping strategies and future expectations. The mothers of children with more advanced lexical production six months after CI activation displayed a high frequency of themes related to positive emotions, thoughts and coping strategies before the surgery. Distress on the part of the mothers, perceptions of difficulties in their child and instances of parent-child dysfunctional interaction were negatively and significantly related to the child's language and communication development. Conclusions The findings support the importance of assessing the mother's emotional experience in relation to diagnosis and CI activation before the surgery. Implications for clinical practice are discussed specifically, the importance of the support offered to the parents, aimed at enhancing both their awareness of their expectations about their child's rehabilitation process and their self-efficacy in supporting the child's adaptation to the use of the CI.

COVID-19 infection can cause a wide spectrum of symptoms. The audio-vestibular system can also be involved, but there is still debate about this so findings need to be considered carefully. Furthermore, mother to fetus intrauterine transmission of COVID-19 infection in pregnant women is controversial. Few studies are available about the audio-vestibular symptomatology of newborns with intrauterine COVID19 exposure. Objectives This study investigates the possible correlation between the COVID19 gestational infection and hearing impairment onset in newborns. The involvement of hearing in COVID19 is verified so the timing and methodology of audiological evaluation of children can be planned. Methods Children were subject to newborn hearing screening and audiological evaluation. Newborn hearing screening is carried out prior to hospital discharge using the Automatic Transient Evoked Otoacoustic Emissions test. Audiological evaluation is performed within the child age of 4 months by using maternal, pregnancy, and perinatal case history, COVID19 case history, otoscopy, acoustic immittance test, Distortion Product Otoacoustic Emissions test, and the Auditory Brainstem Response test. Results 63 children were included in the study. 82.5% of these children were subjects of the newborn hearing screening program. The remaining 11 newborns were not subjected to hearing screening due to isolation measures and their audiological evaluation was carried out directly. Only one of 52 screened neonates showed a bilateral REFER test result but hearing threshold was normal at audiological evaluation. Audiological evaluation showed normal bilateral ABR thresholds in 59/63 children. Four children (6.3% of the total) had ABR threshold alterations but two showed normal threshold at ABR retest performed within 1 month of the first. The other two infants showed monolateral ABR alterations but one of these had a concomitant middle ear effusion. In conclusion, only one child (1.6% of the sample) had an altered ABR. This child had shown one positive SARS-CoV-2 swab in the absence of risk factors for hearing loss. Conclusion This study finds no evidence that maternal COVID19 infection is a risk factor in the development of congenital hearing loss in newborns.

The formation of a pseudoaneurysm in a revascularized free flap is an extremely rare complication in microsurgery. The most effective treatment modality is still the subject of debate.We present the management of a case of pseudoaneurysm of the arterial pedicle of a radial free flap used after hemiglossopelvectomy in a patient with squamous cell carcinoma of the tongue.In our case, a 74-year-old man with the pseudoaneurism was successfully treated by endovascular stenting. Endovascular stenting can be considered an effective and safe procedure and a relevant alternative to open neck surgical treatment. Keywords: Pseudoaneurysm, Radial forearm free flap, Microvascular anastomosis, Endovascular stenting

Recent studies have reported contrasting results in the socio-emotional adjustment of Italian adolescents with cochlear implants (CIs). The aim of the present study is to explore the relationship between the socio-emotional adjustment of adolescents with CIs, the quality of their hospital stay, and their age at CI activation. The participants were 29 adolescents with CIs (CI group) and 29 typically developing adolescents (TD group). The Emotional Autonomy Scale, the Loneliness and Aloneness Scale for Children and Adolescents, and the Multidimensional Self-Concept Scale were administered to each participant. The emotional experience reported during the hospital stay was considered for each participant in the CI group. The adolescents with CIs displayed significantly higher levels of loneliness and lower levels of aversion toward aloneness than the TD group participants. Adolescents who had received the CI in preschool displayed a higher level of physical self-concept than adolescents who had received it later. The adolescents’ emotional experiences at the hospital were reported to be quite complex and related to their relationships with parents. In summary, the findings point to a specific type of fragility in socio-emotional adjustment—focused on loneliness/aloneness—rather than a general one.

To combine the benefits of perimodiolar stimulation with minimal insertion trauma, a thin, pre-curved electrode (CI532) was recently developed by Cochlear Ltd. (Sidney). This array is held straight prior to insertion by an external polymer reloadable sheath that is removed after full electrode insertion. Sixty-seven patients suffering from severe-to-profound sensorineural hearing loss (mean age 42.2 years; mean duration of the hearing loss 19.6 years; mean PTA thresholds at 250-2000 Hz 92.4 dB HL) were implanted with the CI532. Mean duration of surgery was 58.7 min. In 61 patients, a round window (RW) approach was used. In the remaining six cases, a cochleostomy was done because of RW ossification. Impedances and NRT for each electrode are reported. NRT ratio average value was 0.86 ± 0.12 predicting correct scala tympani electrode placement. Post-operative PTA threshold in the implanted ear was 102.9 dB HL. Finally, speech recognition level in quiet at 65 dB HL was 44.6%, after a short follow-up (mean 5.2 months). Our preliminary experience with the new CI532 shows good surgical, electrophysiological, and audiological outcomes. In particular, our results are promising regarding the possibility to achieve minimal insertion trauma and good residual hearing preservation with the use of a deep inserted close modiolar electrode.

To analyse the value of listening-data logged in the speech processor on the prediction of the early auditory and linguistic skills in children who received a cochlear implant in their first 2 years of life.Prospective observational non-randomized study.Ten children with profound congenital sensorineural hearing loss were included in the study. The mean age at CI activation was 16.9 months (SD ± 7.2; range 10-24). The auditory skills were evaluated with the Infant Toddler Meaningful Inventory Scale and the Category of Auditory Performance. Lexical level was assessed with the MacArthur-Bates Communicative Development Inventory. The overall data of average daily use and acoustic scene-analyses were extracted from Data Logging system. The effect of the one-year cumulative listening time to speech (in quiet) and speech-in-noise on the auditory and lexical scores was analysed.A significant positive correlation was found between speech in quiet exposure time at low loudness level (70 dB) and lexical quotient after one year of CI use. Infant Toddler Meaningful Inventory Scale was negatively correlated with the highest speech-in-noise loudness levels (80 dB). The Category of Auditory Performance was not related to the logged data.The listening environment can influence the early functional outcomes in younger implanted children. In this perspective, the data logging system is a promising tool in predicting early linguistic and auditory outcomes.

The aim of this study was to compare the new Cochlear™ Nucleus® Profile with Slim Modiolar Electrode (CI532, Cochlear Ltd., Sidney, Australia) with the previous Contour Advance® (CI512) implant through postoperative residual hearing (RH) threshold shift and telemetry measurements as indirect measures of cochlear trauma. We compared 21 patients implanted with the CI532 and 20 patients implanted with the CI512, matching the 2 groups for age and for hearing loss etiology. All subjects received audiological pure tone average (PTA) calculation pre- and postimplant. Electrode impedance was measured, followed by AutoNRT® to measure and evaluate the Neural Response Telemetry (NRT®) thresholds. Telemetry recordings were made intraoperatively, one month after surgery and one month after activation. The NRT-Ratio was calculated to evaluate full scala tympani (ST) insertion. The results showed a higher number of patients with preserved measurable hearing with the CI532 (10/15; P>0.05) compared to the CI512 (5/14; P

The population of unilateral cochlear implant (CI) users with aidable residual hearing in the contralateral ear is continuously growing. Aiding the contralateral ear with a hearing aid has been shown to provide substantial benefit regarding speech intelligibility in quiet and in noise, sound quality, localization ability and listening effort. In this study, a dedicated hearing aid with the accompanying fitting prescription, tailored to the needs of bimodal listeners was evaluated in nine bimodal CI users. Speech intelligibility scores in noise revealed on-par performance of the dedicated bimodal fitting compared to the clinical standard prescription. 78% of the bimodal CI users preferred the dedicated bimodal fitting over the clinical standard. The minimal subject-specific finetuning effort required during the dedicated bimodal fitting process emphasizes the clinical efficiency.