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A new investigational method has been developed for patients those auditory nerves do not function. The method involves implantation of electrodes directly in an area of the brain that is responsible for relaying auditory information. The technique has been approved for patients who become deaf has a consequence of surgery for bilateral acoustic tumors. Frequently these tumors become quite large (approximately 2.5 inches) and there is concern that the tumors may deform the brain, making the insertion of electrodes into the brain stem difficult, or result in misplacement of electrodes. The present study examines the relationship of tumor size to success of auditory brain stem implantation for hearing. A group of 15 patients was reviewed and tumor size was related to outcome. Twelve of the patients had an expected level of hearing return, and the results did not to correlate with tumor size. These findings appear to indicate that even patients with large acoustic tumors may be candidates for auditory brain stem implantation, and that a significant number can experience at least some return of auditory function. (Consumer Summary produced by Reliance Medical Information, Inc.)

It is of great importance to compare the relative merits of different cochlear-implant speech-processing strategies. Some groups have compared different strategies within single subjects, but usually the subject has prior experience with one strategy, and no allowance is made for this prior experience. We show in the present study that this is inappropriate. We tested one subject using the Melbourne (Cochlear Corp.) multichannel implant with the device set to process sounds in two different ways. In the first processing scheme, the device functioned normally, extracting information about voicing frequency, amplitude and second-formant frequency. This information activated the 21-channel device, determining pulse rate, pulse amplitude and electrode position (respectively). In the second processing scheme, a single electrode (with the largest dynamic range) was activated. This electrode coded overall amplitude and voicing frequency. The subject was tested on an audiovisual test of a 14-choice consonant recognition in the form/iCi/ over a period of over 4 months. During this time the subject used the 21-channel processor outside of the laboratory. Upon initial connection, there was little difference between the results obtained with the two schemes when tested in sound alone or in sound plus vision. However, after about 4 months, scores obtained with the 21-channel processor in sound plus vigion were superior to the scores obtained with the one channel. This advantage came from a superiority in the features of voicing and nasality, but not place. Scores for sound-alone conditions between the two processing schemes remained similar for the 4-month period. Studies investigating the relative merits of speech processing systems (including tactile and conventional hearing aids) must consider previous experience as an important factor.

Two subjects who use the Melbourne multichannel cochlear implant were studied. Live-voice word, consonant, and vowel recognition tests, and a speech-tracking task were administered at regular intervals during the first 90 days after implantation. Results indicated 30-50% correct recognition of vowels (given 9 alternatives) and about 30-60% correct recognition of consonants (given 12 alternatives). Speech tracking showed from two to three times faster rates with the implant and vision compared to a vision-alone condition. After 3-4 months of implant experience, a number of recorded tests from the Minimal Auditory Capabilities battery and the Iowa Cochlear-Implant tests were then administered. These results indicated about 80% recognition of everyday sounds in a five-choice closed-set condition and about 50% recognition of everyday sounds in an open-set condition. The subjects were 50% correct at identifying the accented words in a sentence and about 50% correct at determining the number of syllables in a word. One subject was unable to recognize a sentence as a statement or a question. Background noise (+10 dB S/N) reduced their performance on a four-choice spondee test to chance. Both subjects were able to identify a sound as either a voice or a modulated noise at 95% correct, and both could recognize speaker sex at 95% correct. Neither could discriminate whether two (successive) sentences were spoken by the same speaker or by two different speakers. Remarkably, one subject identified 45% and the other 85% of the words in sentences that were preceded by a contextual picture using sound alone. One subject identified 13% of the words in sentences in sound alone even without contextual information.

Noise-induced sensorineural hearing loss has been associated with Industry for many years. One conservative estimate suggests that 10 million Americans may have industry-related, noise-induced hearing loss. Acoustic trauma from any source, whether associated with work or recreations, is detrimental to hearing. The Occupational Safety and Health Administration has set industrial standards for noise levels, with current standards limiting noise exposure to 95 dBA for 2 hours daily. To date, however, there are no recreational standards. Many portable headphone cassette radios produce peak outputs of more than 100 dBA. Temporary threshold shifts could result from listening levels near the maximum output. Permanent sensorineural loss may result with repeated exposure. A pilot study was conducted in which 16 volunteers listened to headphone sets for 3 hours at their usual maximum level. Six volunteers showed transient shifts of 10 dB, and one volunteer showed a transient shift of approximately 30 dB. These shifts returned to normal within 24 hours. As expected, transient shifts frequently occur with recreational use. Therefore, recreational warnings and standards should be established.

We tested six patients with single channel cochlear implants on several tests from the Minimal Auditory Capabilities battery and the Iowa Cochlear Implant Tests. All patients were able to discriminate some everyday sounds and to identify the number of syllables in the words presented. Five patients were able to identify speaker sex reliably. Surprisingly, some patients had difficulty discriminating between a modulated noise and a voice or between a question and a statement or identifying the accented word in a sentence. On several audiovisual tests, an improvement was observed for the sound plus vision condition compared to the vision only condition. This was particularly true for sentence tests, but was not uniform across patients or across tests.