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The aims of this study were to collect data on electrically evoked compound action potential (eCAP) and electrically evoked stapedius reflex thresholds (eSRT) in HiResolution(TM) cochlear implant (CI) users, and to explore the relationships between these objective measures and behavioural measures of comfort levels (M-levels).A prospective study on newly implanted subjects was designed. The eCAP was measured intra-operatively and at first fitting through neural response imaging (NRI), using the SoundWave(TM) fitting software. The eSRT was measured intra-operatively by visual monitoring of the stapes, using both single-electrode stimulation and speech bursts (four electrodes stimulated at the same time). Measures of M-levels were performed according to standard clinical practice and collected at first fitting, 3 and 6 months of CI use.One hundred seventeen subjects from 14 centres, all implanted unilaterally with a HiResolution CII Bionic Ear(®) or HiRes 90K(®), were included in the study. Speech burst stimulation elicited a significantly higher eSRT success rate than single-electrode stimulation, 84 vs. 64% respectively. The NRI success rate was 81% intra-operatively, significantly increasing to 96% after 6 months. Fitting guidelines were defined on the basis of a single NRI measurement. Correlations, analysis of variance, and multiple regression analysis were applied to generate a predictive model for the M-levels.Useful insights were produced into the behaviour of objective measures according to time, electrode location, and fitting parameters. They may usefully assist in programming the CI when no reliable feedback is obtained through standard behavioural procedures.

Objective The purpose of this study was to evaluate the reliability of the vestibular evoked myogenic potential (VEMP) response in a clinical setting when only a feedback mechanism is available for monitoring background EMG. Methods Sixty-one healthy subjects participated in the investigation of the within-session reliability, whereas fourteen of them were retested after one week for examination of the between-session reliability. VEMPs were recorded using 500Hz tone bursts with the subjects in a sitting position and their heads turned away from the test ear to the contralateral shoulder, thereby pushing their chin against the inflatable cuff of a blood pressure manometer, serving as feedback method. Results The feedback method revealed latency and amplitude values comparable to other data in the literature where different test conditions were applied. Excellent reliability with ICC values ranging from 0.78 to 0.96 and CV ME values ranging from 4% to 36%, was achieved for P1 and N1 latency, threshold and interpeak amplitude. Good reliability with ICC values of 0.65 and 0.68 and CV ME values of 170% and 189%, was obtained for the asymmetry ratio. Conclusions A unilateral muscle contraction controlled by a feedback mechanism resulted in reliable response parameters, comparable right to left and corresponding to literature data obtained in different test conditions. Significance The use of a blood pressure manometer as feedback mechanism combined with a meticulously controlled positioning of the head and contraction of the SCM muscle provides a reliable alternative in clinical settings, when the background muscle contraction cannot be measured or software related correction algorithms are not accessible.

The aim of the present study was to construct and compare two caloric test protocols, one for water irrigation, and one for air insufflation. A set of reference data was constructed and tabulated as well as the intersubject variability. The effect of age, sex, ear, and temperature, as well as a possible priming effect and order effect were investigated. Forty-seven subjects (18-58 years) without otological or vestibular history participated. Four response parameters were investigated: slow component velocity (SCV), frequency, unilateral weakness (UW), and directional preponderance (DP). Statistically higher SCV values were obtained for water compared to air, with statistically higher standard deviations for SCV water values. No influences of age, sex, ear, or temperature could be demonstrated on any of the response parameters. The same applied for the presence of an order effect and a priming effect. Comparing the two protocols to one another led the present authors to favour water as the standard irrigation medium, and air only in situations where water is contra-indicated.

In order to develop a sensitive audiometric protocol for identifying ototoxicity in children, a retrospective study of 16 children treated with cisplatin and/or carboplatin was performed. Audiometric testing was done by means of pure-tone threshold audiometry (PTA), high-frequency audiometry (HFA), and distortion product otoacoustic emissions (DPOAEs).Cisplatin caused a sensorineural high-frequency hearing loss in the study group compared to the controls (p

The purpose of this study was to determine and to compare the overall intelligibility, articulation, resonance, and voice characteristics in children using cochlear implants (CI) and children using conventional hearing aids (HA). Nine prelingually deaf children using CI and six children with a prelingual severe hearing loss using HA, were selected to participate. Objective (DSI, nasalance scores) as well as subjective assessment techniques (perceptual evaluations) were used. Both the CI and HA children demonstrated normal vocal quality and resonance but showed the presence of articulation disorders. In the CI children, intelligibility was significantly better compared to the HA children. Significantly more phonetic and phonological disorders were present in the HA children. The results of this study show a poorer intelligibility of the HA children in comparison with the CI children which is probably due to the occurrence of significantly more phonetic and phonological disorders. Future detailed analysis i...

In this study 22 patients (44 ears) with noise-induced permanent hearing loss were audiologically evaluated using transient-evoked otoacoustic emissions (TEOAE) and auditory brain-stem response (ABR). Twenty-one normal subjects (42 ears) without exposure to occupational noise were used as controls. Based upon the hearing loss at 4, 3, 2 and 1 kHz on the pure-tone audiogram, they were classified into four groups. In group 1 (eight ears), emissions were present in all ears but their TEOAE-noise level and their reproducibility (percentage) proved to be weak. The auditory brain-stem response (ABR) indicated that the I/V amplitude ratio, the latency values of wave V and the I–V intervals fell within the normal range in all ears. In Group 2 (14 ears), 40 per cent had no emissions, whereas the remaining ears showed weak emissions. The ABR revealed that in all ears the I/V amplitude ratio became small while wave V peak latency as well as I–V intervals were within the normal range. In Group 3 (10 ears), emissions were absent in 50 per cent, while in the other ears the emissions were very weak. The ABR revealed that the I/V amplitude ratio, which could be calculated in the 60 per cent in which wave I was present, was smaller than in Group 2. Wave V latency as well as I–V intervals were within the normal range. In Group 4 (12 ears), none of the ears showed emissions. The ABR indicated that the I/V amplitude ratio was much smaller when wave I was present (27 per cent) as well as I–V interval values being within the normal range. Wave V absolute latency value (δV index) indicated a positive index in 17 per cent of this group (two ears) when wave I was absent. In the present study a dynamic process from cochlear outer hair cells to cochlear neurons was seen, correlating with an increasing hearing loss.

The effects of stimulus rise-fall and plateau times on the middle-latency response (MLR) waveform (Na-Pa amplitude and Pa latency) were investigated in 14 normally hearing subjects and an objective MLR threshold was evaluated at low and middle frequencies in ten normally hearing subjects and ten patients with slope of sensorineural hearing loss, using a selected stimulus-envelope time. After analyzing the effects of envelope times on the MLR waveform and the spectra of tone-pips, it was found that a rise-fall time of 4 ms with a plateau of 2 ms (4–2–4) is an acceptable compromise between a synchronous discharge and frequency specificity for estimating the MLR threshold. The MLR threshold produced by 4–2–4 tone-pips approximated the psychoacoustic threshold at low and middle frequencies in the normal and hearing impaired subjects. This demonstrates the clinical usefulness of the MLR in estimating low- and middle-frequency thresholds.

The main objective of this study was to assess the associations between self-reported listening habits and perception of music and speech perception outcomes in quiet and noise for both unilateral cochlear implant (CI) users and bimodal (CI in one ear, hearing aid in contra-lateral ear) users. Information concerning music appreciation was gathered by means of a newly developed questionnaire. Moreover, audiological data (pure-tone audiometry, speech tests in noise and quiet) were gathered and the relationship between speech perception and music appreciation is studied. Bimodal users enjoy listening to music more in comparison with unilateral CI users. Also, music training within rehabilitation is still uncommon, while CI recipients believe that music training might be helpful to maximize their potential with current CI technology. Music training should not be exclusively reserved for the good speech performers. Therefore, a music training program (MTP) that consists of different difficulty levels should be developed. Hopefully, early implementation of MTP in rehabilitation programs can enable adult CI users to enjoy and appreciate music and to maximize their potential with commercially available technology. Furthermore, because bimodal users consider the bimodal stimulation to be the most enjoyable way to listen to music, CI users with residual hearing in the contra-lateral ear should be encouraged to continue wearing their hearing aid in that ear.

Objectives/Hypothesis: To evaluate the impact of a newborn hearing screening program on the management and outcome of deaf children and to identify underlying factors that may be responsible for the differences between high and low performing implanted children. Study Design: Retrospective cohort study of 391 implanted children in Flanders (Belgium). Methods: First, implanted children were sorted into two groups on account of screening age (early screened, n = 195 vs. late screened, n = 196). Both groups were compared with respect to several variables. Second, outcome of cochlear implantation was measured in terms of the child's speech perception and production skills (n = 355). A subgroup of high performing cochlear implant (CI) users was compared with low performing CI users with regard to several variables. Results: Early screened children differ significantly from late screened children with respect to age of hearing loss detection and age at cochlear implantation. Furthermore, early screening and implantation is associated with better auditory receptive skills and speech intelligibility. Additional impairments negatively influence both receptive and productive skills. In addition, children who communicate orally and wear bilateral cochlear implants perform better on speech production, whereas a better speech perception was found in children who became progressively deaf as opposed to congenitally deaf children. Conclusions: The results of this extensive study of profoundly deaf children with CIs in Flanders indicate that a newborn hearing screening program results in earlier intervention in deaf children, which beneficially influences the auditory receptive skills and speech intelligibility.

To perform an assessment of the viability of cochlear implantation in a patient with superficial siderosis of the brain.Case review.Tertiary referral center.Patient with superficial siderosis of the brain.Cochlear implantation.Electrically evoked auditory brainstem responses and fitting strategy for cochlear implant based on patient's subjective responses.After some time, C levels and T levels showed a pattern comparable with the evoked auditory brainstem responses.Bilateral profound hearing loss after superficial siderosis of the brain is no absolute contraindication for implantation. Furthermore, evoked auditory brainstem measurements can potentially guide the fitting process of the implant in difficult cases.