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Purpose: Three experiments were carried out to evaluate the low-frequency pitch perception of adults with unilateral hearing loss who received a cochlear implant (CI). Method: Participants were recruited from a cohort of CI users with unilateral hearing loss and normal hearing in the contralateral ear. First, low-frequency pitch perception was assessed for the 5 most apical electrodes at 1, 3, 6, and 12 months after CI activation using an adaptive pitch-matching task. Participants listened with a coding strategy that presents low-frequency temporal fine structure (TFS) and compared the pitch to that of an acoustic target presented to the normal hearing ear. Next, participants listened with an envelope-only, continuous interleaved sampling strategy. Pitch perception was compared between coding strategies to assess the influence of TFS cues on lowfrequency pitch perception. Finally, participants completed a vocal pitch-matching task to corroborate the results obtained with the adaptive pitch-matching task. Results: Pitch matches roughly corresponded to electrode center frequencies (CFs) in the CI map. Adaptive pitch matches exceeded the CF for the most apical electrode, an effect that was larger for continuous interleaved sampling than TFS. Vocal pitch matches were variable but correlated with the CF of the 3 most apical electrodes. There was no evidence that pitch matches changed between the 1- and 12-month intervals. Conclusions: Relatively accurate and asymptotic pitch perception was observed at the 1-month interval, indicating either very rapid acclimatization or the provision of familiar place and rate cues. Early availability of appropriate pitch cues could have played a role in the early improvements in localization and masked speech recognition previously observed in this cohort.

Purpose: The Minimum Speech Test Battery (MSTB) for adults was introduced in 1996 (Nilsson et al., 1996) and subsequently updated in 2011 (Advanced-Bionics et al., 2011). The MSTB has been widely used by clinicians as a guide for cochlear implant (CI) candidacy evaluations and to document post-operative speech recognition performance. Due to changes in candidacy over the past 10 years, a revision to the MSTB was needed. Method: In 2022, the Institute for Cochlear Implant Training (ICIT) recruited a panel of expert CI audiologists to update and revise the MSTB. This panel utilized a modified Delphi consensus process to revise the test battery and to improve its applicability considering recent changes in CI care. Results: This resulted in the MTSB--Version 3 (MSTB-3), which includes test protocols for identifying not only traditional CI candidates but also possible candidates for electric--acoustic stimulation and patients with single-sided deafness and asymmetric hearing loss. The MSTB-3 provides information that supplements the earlier versions of the MSTB, such as recommendations of when to refer patients for a CI, recommended patient-reported outcome measures, considerations regarding the use of cognitive screeners, and sample report templates for clinical documentation of pre- and post-operative care. Electronic versions of test stimuli, along with all the materials described above, will be available to clinicians via the ICIT website (https://www.cochlearimplanttraining.com). Conclusion: The goal of the MSTB-3 is to be an evidence-based test battery that will facilitate a streamlined standard of care for adult CI candidates and recipients that will be widely used by CI clinicians. [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: Patients with moderate-to-profound sensorineural hearing loss in 1 ear and normal hearing in the contralateral ear, known as unilateral hearing loss (UHL) or single-sided deafness (SSD), may experience improved quality of life with the use of a cochlear implant (CI) in the affected ear. Quality of life assessment before and after implantation may reveal changes to aspects of hearing beyond those explicitly evaluated with behavioral measures.Methods: The present report completed 2 experiments investigating quality of life outcomes in CI recipients with UHL. The first experiment assessed quality of life during the 1st year of device use with 3 questionnaires: the Speech, Spatial, and Qualities of Hearing Scale (SSQ), the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the Tinnitus Handicap Inventory. Twenty subjects were evaluated preoperatively and 1, 3, 6, 9, and 12 months post-activation. Quality of life results were compared over the study period using traditional scoring methods and the SSQ pragmatic subscales. Subscales specific to localization and speech perception in noise were compared to behavioral measures at the preoperative and 12-month intervals. The 2nd experiment evaluated quality of life preoperatively and at the 12-month interval for CI recipients with UHL and CI recipients with bilateral hearing loss, including conventional CI users and those listening with electric-acoustic stimulation (EAS). The 3 cohorts differed in CI candidacy criteria, including the amount of residual hearing in the contralateral ear.Results: For subjects with moderate-to-profound UHL, receipt of a CI significantly improved quality of life, with benefits noted as early as 1 month after initial activation. The UHL cohort reported less perceived difficulty at the pre- and postoperative intervals than the conventional CI and EAS cohorts, which may be due to the presence of the normal-hearing ear. Each group experienced a significant benefit in quality of life on the APHAB with CI use.Conclusions: Cochlear implantation in cases of substantial UHL may offer significant improvements in quality of life. Quality of life measures revealed a reduction in perceived tinnitus severity and subjective improvements in speech perception in noise, spatial hearing, and listening effort. While self-report of difficulties were lower for the UHL cohort than the conventional CI and EAS cohorts, subjects in all 3 groups reported an improvement in quality of life with CI use. [ABSTRACT FROM AUTHOR]

Importance: This study reviewed whether advanced age should be a consideration when revision cochlear implantation is warranted., Objective: To examine whether age at revision cochlear implantation is related to postrevision speech perception performance., Design, Setting, and Participants: A retrospective analysis was performed in an academic tertiary care center. Participants included 14 younger adults (<65 years) and 15 older adults (≥65 years) who underwent revision cochlear implantation., Intervention: Revision cochlear implantation., Main Outcomes and Measures: Speech perception performance, as measured with consonant-nucleus-consonant [CNC] words in quiet, at the best prerevision interval as well as the 3- and 6-month postrevision intervals were compared between the 2 cohorts. The CNC word test consists of 10 lists of 50 phonemically balanced monosyllabic words, scored with a range of 0% to 100% correct., Results: Both cohorts experienced a restoration in speech perception scores after revision cochlear implantation compared with their best performance before the revision (mean [SD] CNC word test scores for the younger cohort: 43.9% [25.6%] before revision and 47.7% [21.3%] at 3 months and 47.6% [19.8%] at 6 months after revision; for the older cohort: 36.3% [19.1%] before revision and 35.3% [17.2%] at 3 months and 39.9% [16.3%] at 6 months after revision; F₂,₅₄= 0.93; P = .40). There was no interaction between age at revision surgery and speech perception performance at each assessment interval (F₂,₅₄= 0.51; P = .60)., Conclusions and Relevance: In this study, age at revision cochlear implantation was not related to postrevision speech perception performance. Advanced age should not be considered a contraindication to revision cochlear implantation.

Importance: A review of a test battery presented in both quiet and noise may clarify what the progression of speech perception abilities is in older adult cochlear implant users and whether the performance declines with advancing age., Objective: To examine whether older adults (≥65 years) with cochlear implants maintain stable speech perception performance after at least 10 years of listening experience with an external speech processor., Design and Setting: Retrospective analysis performed in an academic tertiary care center., Participants: Fourteen older adult cochlear implant recipients with at least 10 years of listening experience., Main Outcome Measures: Speech perception outcomes as measured with Consonant-Nucleus-Consonant words in quiet and Hearing in Noise Test sentences in quiet and steady-state noise were analyzed retrospectively at the 6-month and 1-, 5-, and 10-year postoperative follow-up intervals., Results: Consonant-Nucleus-Consonant word scores remained stable between 6 months and 1 year of listening experience, improved significantly (P < .001) between 1 year and 5 years, and remained stable between 5 years and 10 years. Hearing in Noise Test sentence scores in quiet and noise showed a similar pattern, with stability in performance between the 6-month to 1-year and 5-year to 10-year follow-up intervals, and significantly improved performance (P = .04) between the 1-year and 5-year follow-up intervals., Conclusions and Relevance: On average, patients who undergo cochlear implantation at age 65 years or older do not experience a decline in speech perception performance with extended listening experience and may potentially continue to see improvements beyond the 1-year follow-up interval.