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Voice cues, such as fundamental frequency (F0) and vocal tract length (VTL), help listeners identify the speaker's gender, perceive the linguistic and emotional prosody, and segregate competing talkers. Postlingually implanted adult cochlear implant (CI) users seem to have difficulty in perceiving and making use of voice cues, especially of VTL. Early implanted child CI users, in contrast, perceive and make use of both voice cues better than CI adults, and in patterns similar to their peers with normal hearing (NH). In our study, we investigated the perception and use of voice cues in children with single-sided deafness (SSD) who received their CI at an early age (SSD+CI), in an attempt to bridge the gap between these two groups. The SSD+CI children have access to bilateral auditory information and often receive their CI at an early age, similar to CI children. They may also have dominant acoustic representations, similar to CI adults who acquired hearing loss at a later age. As such, the current study aimed to investigate the perception and use of voice cues by a group of nine early-implanted children with prelingual SSD. The study consisted of three experiments: F0 and VTL discrimination, voice gender categorization, and speech-in-speech perception. In each experiment, the results of the SSD group are compared to children and adults with CIs (for their CI ear) and with typical hearing (for their NH ear). Overall, the SSD+CI children had poorer VTL detection thresholds with their CI compared to their NH ear, while their F0 perception was similar across ears. Detection thresholds for both F0 and VTL with their CI ear was comparable to those of bilaterally implanted CI children, suggesting that SSD+CI children do not only rely on their NH ear, but actually make use of their CI. SSD+CI children relied more heavily on F0 cues than on VTL cues for voice gender categorization, with cue weighting patterns comparable to those of CI adults. In contrast to CI children, the SSD+CI children showed limited speech perception benefit based on F0 and VTL differences between the target and masker speaker, which again corresponded to the results of CI adults. Altogether, the SSD+CI children make good use of their CI, despite a good-hearing ear, however, the perceptual patterns seem to fall in-between those of CI children and CI adults. Perhaps a combination of childhood neuroplasticity, limited experience with relying only on the CI, and a dominant acoustic representation of voice gender explain these results., Competing Interests: Declaration of competing interest Financial support was provided by Cochlear Ltd, in the form of cochlear implants and the funding of the clinical mapping. Tine Arras is a research employee of Cochlear Technology Centre, Belgium, and a shareholder of Cochlear Ltd. The other authors have no interests to declare., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

As part of a longitudinal study regarding the benefit of early cochlear implantation for children with single-sided deafness, the current work explored the children's daily device use, potential barriers to full-time device use, and the children's ability to understand speech with the cochlear implant (CI). Data were collected from 20 children with prelingual SSD who received a CI before the age of 2.5 years, from the initial activation of the sound processor until the children were 4.8 to 11.0 years old. Daily device use was extracted from the CI's data logging, while word perception in quiet was assessed using direct audio input to the children's sound processor. The children's caregivers completed a questionnaire about habits, motivations, and barriers to device use. The children with SSD and a CI used their device on average 8.3 h per day, corresponding to 63 % of their time spent awake. All children except one could understand speech through the CI, with an average score of 59 % on a closed-set test and 73 % on an open-set test. More device use was associated with higher speech perception scores. Parents were happy with their decision to pursue a CI for their child. Certain habits, like taking off the sound processor during illness, were associated with lower device use. Providing timely counselling to the children's parents, focused on SSD-specific challenges, may be helpful to improve daily device use in these children., Competing Interests: Declaration of competing interest Financial support was provided by Cochlear Ltd, in the form of cochlear implants and the funding of the clinical mapping. Dr. Tine Arras and Dr. Birgit Philips are research employees of Cochlear Technology Centre Belgium, and they are both shareholders of Cochlear Ltd. The other authors have no interests to declare., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Patients with single-sided deafness (SSD) and a cochlear implant (CI) can compare the pitch of stimulated electrodes and acoustic tones. A pitch mismatch may negatively bear on the fusion of the signals from the two ears, which may limit auditory performance. We aimed to explore this mismatch, correlate it to performance, and finally to discuss its possible clinical consequences. Ten patients with SSD and a CI (Cochlear Ltd.) compared the pitch of electrical and acoustic stimuli. Patients had to choose one of two acoustic stimuli, with the pitch closest to the pitch of the electrical stimulus at electrodes 3, 7, 11, 15, and 19. The difference between the two acoustic stimuli iteratively decreased from 2 octaves to 1/8 octave, resulting in a "pitch match" per electrode. Furthermore, we computed the insertion angle of the CI electrode array based on high-resolution computed-tomography scans. Subsequently, we created frequency-place maps. The difference between our pitch matches and two references (the spiral ganglion map and the default frequency allocation by Cochlear Ltd.) was defined as "mismatch". We observed large intra- and intersubject variability. Following the tonotopic organization of the cochlea, we observed that the pitch matches decreased with increasing insertion angle. The pitch-matched frequencies were on average 2.0 and 1.3 octaves lower than the spiral ganglion map and the default frequency allocation, respectively. There was no significant correlation between performance (consonant-vowel-consonant phoneme recognition score) and mismatch (R 2  = 0.06, P > 0.1). Given the methodological considerations, and the insignificant correlation between mismatch and performance, pitch matching results must not necessarily lead to a change in clinical fitting strategies., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Introduction: The authors previously demonstrated that tinnitus resulting from unilateral hearing loss (UHL) can be treated with electrical stimulation via a Cochlear Implant (CI). The study aimed to do a long-term (LT) evaluation of CI in subjects suffering from UHL and accompanied incapacitating tinnitus up to 10 years. The primary focus of the study is on LT tinnitus reduction., Subjects: LT evaluation was derived from 23 subjects suffering from UHL and accompanied incapacitating tinnitus (Pre-operative Tinnitus Loudness Visual Analogue Scale (VAS) score >6/10). They were cochlear implanted at a median age of 55 years (22-71 yr) and had 8 years (3-10 yr) experience with their CI at the LT testing. The subjects were categorized into two groups: a Single-Sided Deaf Group (SSD) and an Asymmetric Hearing Loss Group (AHL). The SSD group comprises subjects with contralateral normal hearing (i.e. air conduction pure tone average (PTA0.5, 1, 2 and 4 kHz) ≤ 30 dB HL) and the AHL group subjects with contralateral mild to moderate hearing loss (i.e. air conduction PTA0.5, 1, 2 and 4 kHz > 30 dB HL)., Methods: In order to obtain a LT structural overview of the CI use in UHL subjects, a structured interview was conducted including questions about daily amount of CI use, residual inhibition of the tinnitus after switch off, tinnitus type, etc. The VAStinnitus loudness and the Tinnitus Questionnaire were obtained pre-operatively, one, three, six, 12, and 36-months post-operatively and at the long-term test interval (8 (3-10 years) post-operative). The Hyperacusis Questionnaire was administered in the CION and the CIOFF condition., Results: The structural interview revealed that all patients (23/23) still wear their CI seven days a week, eight (3-10) years after cochlear implantation. It appeared that in all subjects but one CI switch-on is the first act when rising and CI switch-off is the last act before bedtime. In the SSD group, tinnitus suppression is still the primary benefit reported (83%), whereas in the AHL the majority of the subjects (55%) report that the primary benefit shifted to improved hearing. In the majority of the subjects the tinnitus reduction starts within 1 min (in 70% of the cases) and the residual inhibition after CI switch-off is less than a minute (in 65% of the cases). The VAS and TQ scores significantly improved up to three months after the first-fitting and remain stable up to the LT test interval. The median score on the Hyperacusis Questionnaire was 17 (7-36) in the CIOFF condition and improved to 23,5 (12-39) in the CION condition in the SSD group., Conclusion: This is the first study to report on LT results in a large number of UHL CI users, up to 10 years. Structured interviews shows that 100% of the subjects wears their CI seven days a week. The tinnitus reduces significantly up to three months after the first-fitting and the tinnitus reduction remain stable up to the LT test interval. The SSD group report tinnitus reduction as the primary benefit, whereas the majority of the AHL group report improved hearing as the primary benefit, eight (3-10) years after implantation. In addition to the tinnitus reduction, the CI provides also a benefit regarding reported., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: Cochlear implantation (CI) has proven in long term prospective trials to reduce significantly incapacitating tinnitus in single sided deafness (SSD). Discussion arises whether electrical stimulation near the round window (RW) is also able to reduce tinnitus., Aim: to assess whether electrical stimulation of the basal first 4 intracochlear electrodes of a CI could sufficiently reduce tinnitus and to compare these results with stimulation with all CI electrodes., Material and Methods: 7 patients who met the criteria of severe tinnitus due to SSD were implanted with a Med-El Sonata Ti100 with a FlexSoftTM or Flex24TM electrode. After 4 weeks only the basal electrode pair (E12) nearest to the RW was activated. Each week the following pair was activated until the 4th pair.Thereafter all electrodes were activated. Tinnitus was assessed before CI surgery and before each electrode pair was activated. When all electrodes were fitted, evaluation was done after 1, 3 and 6 months.Tinnitus was assessed with Visual Analogue Scale (VAS) for loudness, psychoacoustic tinnitus loudness comparison at 1 kHz and Tinnitus Questionnaire (TQ) for the effect on quality of life. To evaluate the natural evolution, a tightly matched control group with severe tinnitus due to SSD was followed prospectively., Results: All the tinnitus outcome measures remained unchanged with 1, 2, 3 or 4 activated electrode pairs. With complete CI activation, the tinnitus decreased significantly comparable with earlier reports.Pre-implantation the tinnitus loudness was 8.2/10 on the VAS and was reduced to 4.1/10 6 months postimplantation.Psychometrically the loudness level went from 21.7 dB SL (SD: 16.02) to 7.5 dB SL (SD: 5.24)and the TQ from 60/84 to 39/84. The non-implanted group had no decrease of the tinnitus, the average VAS remained stable at 8.9/10 throughout the follow-up period of 6 months., Conclusion: with the current stimulation parameters electrical stimulation in the first 8e10 mm of the basal part of the scala tympani is insufficient to reduce tinnitus. However, stimulation over the complete CI length yields immediate tinnitus reduction confirming earlier results.