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One of the most widely used measures of scientific impact is the number of citations. However, due to its heavy-tailed distribution, citations are fundamentally difficult to predict but can be improved. This study was aimed at investigating the factors and parts influencing the citation number of a scientific paper in the otology field. Therefore, this work proposes a new solution that utilizes machine learning and natural language processing to process English text and provides a paper citation as the predicted results. Different algorithms are implemented in this solution, such as linear regression, boosted decision tree, decision forest, and neural networks. The application of neural network regression revealed that papers’ abstracts have more influence on the citation numbers of otological articles. This new solution has been developed in visual programming using Microsoft Azure machine learning at the back end and Programming Without Coding Technology at the front end. We recommend using machine learning models to improve the abstracts of research articles to get more citations.

The ultimate goal of a cochlear implant device is to mimic the hearing through normal cochlea. A better understanding of normal cochlear function can help reaching this goal. The normal cochlea has a tonotopic mapping of the frequency representation in which each area on the cochlea is the most sensitive to a specific frequency. The array of the cochlear implant device has a number of electrodes each presenting a different frequency to the nearest area of the cochlea to where they are located. An anatomy-based programming strategy aims to present the frequency by the electrode contacts to which the cochlea is most sensitive to, according to the location of that electrode contact inside the cochlea. This chapter explores the details of the current understanding of the anatomy-based programming.

Background: In some patients with cochlear implants, bony resorption at the internal receiver-stimulator site can be observed on postoperative computed tomography. Therefore, it is essential to elucidate the effects of the internal receiver-stimulator on the scalp and bony bed over time. Objective: We aimed to evaluate how the internal receiver-stimulator of a cochlear implant device changed the thickness of the surrounding scalp and skull over time using computed tomography. Methods: This retrospective study evaluated patients who underwent cochlear implantation and received two computed tomography scans postoperatively for different indications at a tertiary referral centre. The main outcomes were scalp thickness and bony bed depth. Results: Fourteen ears were included in this study. There was very good inter-rater reliability, with a Cronbach’s alpha of 0.94. The mean scalp thickness over the internal receiver-stimulator was 6.02 (+/-2.4) mm in the first scan and decreased with no significant change to 5.62 mm (+/-1.64) in the second scan (p = 0.59, paired t-test). The mean depth of the bony bed increased significantly from 1.39 mm (+/-0.93) to 2.62 mm (+/-1.24) (p = 0.03). Conclusion : There was no change in the thickness of the scalp overlying the internal receiver-stimulator indicating that the scalp was more resistant than the bony skull to the tensile pressure exerted by the internal receiver-stimulator. In contrast, the bony bed depth of the internal receiver-stimulator increased over time. This can result in decreased internal receiver-stimulator protrusion and decreased risk of device displacement and migration.

Although it is surgically more challenging, patients with bilateral temporal bone fractures (TBFs) are potential candidates for successful bilateral cochlear implantation (CI). This study aimed to investigate the feasibility of bilateral implantation in patients with sustained bilateral TBFs.Retrospective database study.Seven patients with bilateral cochlear implants who were diagnosed with TBFs were included in this study. Preoperative radiological and audiological evaluations were performed. The outcomes of the CI were also investigated.Hearing levels were restored to the mild-moderate range (40 dB) for nearly all patients and they reported an improved quality of life.CI in patients with TBF is safe and offers a solution for the restoration of hearing in a population who may experience sudden bilateral deafness. However, preoperative confirmation of intact auditory nerves and patent cochlea is essential to maximize the success of CI in this population.4 Laryngoscope, 132:2050-2055, 2022.

Background In this study, we aimed to investigate the effect of the coronavirus disease 2019 (COVID-19) pandemic-induced social restrictions, including face masks, on patients with hearing problems. Methodology This cross-sectional survey study was conducted in an ENT tertiary care center. After signing the consent form, we invited study subjects with hearing disabilities who were using unilateral or bilateral hearing aids to participate in filling out the study survey. The study questionnaire was completed by 80 subjects. The questionnaire included various questions about the respondent's demographics, hearing aids, and communication with a face mask during COVID-19 restrictions. All statistical analyses were performed using SPSS version 19 (IBM Corp., Armonk, NY, USA). Results Overall, 40% of the study sample agreed that understanding people wearing face masks is harder because their speech is muffled, whereas 10% disagreed, and 50% were neutral. While 41.3% agreed that understanding is harder because they cannot see their mouth moving, 23.8% disagreed, and 35% were neutral. More than half of the study sample (55%) agreed that they are worried about how they will communicate with others if wearing face masks becomes more common. However, 50% of the participants thought that they can still hear people when they speak to them from a safe distance. Of note, 71.3% of subjects disagreed about tinnitus being worse since the lockdown. Conclusions The widespread use of face masks had a significant impact on the daily communication and interactions of people with hearing impairments. More research is needed to find creative ways to help these patients improve their daily communication and social interactions.

Background Speech audiometry materials are widely available in many different languages. However, there are no known standardized materials for the assessment of speech recognition in Arabic-speaking children. Purpose The aim of the study was to develop and validate phonetically balanced and psychometrically equivalent monosyllabic word recognition lists for children through a picture identification task. Research Design A prospective repeated-measure design was used. Monosyllabic words were chosen from children's storybooks and were evaluated for familiarity. The selected words were then divided into four phonetically balanced word lists. The final lists were evaluated for homogeneity and equivalency. Study Sample Ten adults and 32 children with normal hearing sensitivity were recruited. Data Collection and Analyses Lists were presented to adult subjects in 5 dB increment from 0 to 60 dB hearing level. Individual data were then fitted using a sigmoid function from which the 50% threshold, slopes at the 50% points, and slopes at the 20 to 80% points were derived to determine list psychometric properties. Lists were next presented to children in two separate sessions to assess their equivalency, validity, and reliability. Data were subjected to a mixed design analysis of variance. Results No statistically significant difference was found among the word lists. Conclusion This study provided an evidence that the monosyllabic word lists had comparable psychometric characteristics and reliability. This supports that the constructed speech corpus is a valid tool that can be used in assessing speech recognition in Arabic-speaking children.

Cochlear nerve deficiency is one of the known causes of congenital sensorineural hearing loss. Management of hearing loss in children with cochlear nerve deficiency poses a multidimensional challenge. The absent or hypoplastic cochlear nerve may prevent electrical stimulation from reaching the brainstem and the auditory cortex. A deficient cochlear nerve can be associated with other inner ear malformations, which may diminish the success of cochlear implantation in those children. Promising results in adults after auditory brainstem implantation led to the expansion of candidacy to include the pediatric populations who were contraindicated for CIs. To review the outcomes of cochlear implantation versus that of auditory brainstem implantation in children with various conditions of the auditory nerve. This retrospective chart review study comprised two pediatric groups. The first group consisted of seven ABI recipients with cochlear nerve aplasia and the second group consisted of another seven children with cochlear nerve deficiencies who underwent CI surgery. The participants’ auditory skills and speech outcomes were assessed using different tests selected from the Evaluation of Auditory Responses to Speech (EARS) test battery. There were some individual variations in outcomes depending on the status of the auditory nerve. The mean CAP score of the ABI group was 2.87, while the mean SIR score was 0.62. On the other hand, the mean CAP score of the CI group was 1.29, while the mean SIR score was 0.42. Our results are in good agreement with the reported auditory perception and speech and language development outcomes of pediatric auditory brainstem implantation. We added to the growing body of literature on the importance of verifying and identifying the status of the cochlear nerve in the decision-making process of the surgical management of those pediatric groups.

Purpose Magnetic resonance imaging (MRI) is often used to visualize and diagnose soft tissues. Hearing implant (HI) recipients are likely to require at least one MRI scan during their lifetime. However, the MRI scanner can interact with the implant magnet, resulting in complications for the HI recipient. This survey, which was conducted in two phases, aimed to evaluate the safety and performance of MRI scans for individuals with a HI manufactured by MED-EL (MED-EL GmbH, Innsbruck, Austria). Methods A survey was developed and distributed in two phases to HEARRING clinics to obtain information about the use of MRI for recipients of MED-EL devices. Phase 1 focused on how often MRI is used in diagnostic imaging of the head region of the cochlear implant (CI) recipients. Phase 2 collected safety information about MRI scans performed on HI recipients. Results 106 of the 126 MRI scans reported in this survey were performed at a field strength of 1.5 T, on HI recipients who wore the SYNCHRONY CI or SYNCHRONY ABI. The head and spine were the most frequently imaged regions. 123 of the 126 scans were performed without any complications; two HI recipients experienced discomfort/pain. One recipient required reimplantation after an MRI was performed using a scanner that had not been approved for that implant. There was only one case that required surgical removal of the implant to reduce the imaging artefact. Conclusion Individuals with either a SYNCHRONY CI or SYNCHRONY ABI from MED-EL can safely undergo a 1.5 T MRI when it is performed according to the manufacturer’s safety policies and procedures.

BACKGROUND: Consanguinity is a commonly recognized practice among marriages in the Middle East and may lead to an increase in the prevalence of inherited disorders. Autosomal recessive deafness is the most common form of inherited congenital hearing loss (CHL). OBJECTIVES: Determine the association of consanguineous marriages with congenital sensorineural hearing loss (SNHL) and auditory neuropathy. DESIGN: Descriptive and analytical cross-sectional study. SETTING: Ear specialist hospital. PATIENTS AND METHODS: Children with severe-to-profound congenital SNHL, who had been referred to the specialist hospital for cochlear implant were analyzed. Patients were divided into subgroups based on degree of consanguinity. MAIN OUTCOME MEASURE: The relative risk of having more than one child with SNHL in offspring of a consanguineous marriage. SAMPLE SIZE: 189 parents and children with CHL. RESULTS: The parents of 157 children (83.1%) were blood-related. Of those, 48 had more than one child with CHL (31.4%), while only two parents who were not blood-related had more than one child with CHL (6.25%; P =.005). Among the 189 children, 131 (69.3%) parents were direct cousins. Only 39 (20.6%) and 43 (22.8%) children had family histories of CHL on the paternal and maternal sides, respectively. There was no statistically significant difference in the prevalence of auditory neuropathy between the offspring of consanguineous and non-consanguineous marriages ( P =.648). CONCLUSION: The risk of having more than one child with SNHL in the offspring from a consanguineous marriage is 3.5 times higher than that of a non-consanguineous mating. LIMITATION: The association of hearing loss degree with consanguinity was not studied. CONFLICT OF INTEREST: None.

BACKGROUND: Cochlear implant (CI) recipients with a cochleovestibular malformation (CVM) are at a higher risk of experiencing an intra-operative cerebrospinal fluid (CSF) gusher and, therefore are at greater risk of developing postoperative meningitis than are CI recipients with normal cochlear anatomy. To control CSF gushers, the FORM electrode array was developed. OBJECTIVES: To assess the ability of the FORM24 electrode array in managing intraoperative CSF gushers and preventing postoperative CSF leakage in a population of CI recipients. DESIGN: Retrospective. SETTING: Tertiary health care center. PATIENTS AND METHODS: All CIs in which a FORM24 was used between January 2014 and March 2018 were reviewed for demographic and safety results. MAIN OUTCOME MEASURES: Safety results were assessed as the intraoperative or postoperative presence of an episode of CSF leakage or meningitis. SAMPLE SIZE: 177 CI recipients. RESULTS: Thirty-six (20.3%) had a CVM and 141 had normal anatomy (79.7%). Of the 36 participants with a CVM, 20 (55.6%) experienced an intraoperative CSF gusher, all of which were resolved. No cases of postoperative leakage or meningitis were recorded after a mean follow-up time of 36 months. CONCLUSION: The FORM24 array is able to help surgeons stop intraoperative CSF gushers and prevent postoperative CSF leakage and meningitis in CI recipients with a CVM. LIMITATIONS: Further studies are needed. CONFLICT OF INTEREST: None.

OBJECTIVES: To evaluate the feasibility of performing cochlear implantation under conscious sedation (CS) as day surgery with same-day fitting. MATERIALS AND METHODS: All patients underwent cochlear implantation under CS between November 2017 and April 2018. The data collected included demographic information, preoperative clinical characteristics, surgical details, postoperative fitting information, and side effects, if any. RESULTS: Nine patients had 11 cochlear implants (CIs) placed under CS (2 patients received bilateral CIs). One patient’s data were excluded from the audiological results because conversion to general anesthesia (GA) was necessary. One patient (11%) vomited just before the end of the procedure. Seven patients had uneventful procedures. Eight (88%) patients were discharged home the same day. There was a statistically significant difference in recovery time between the CS group and the GA group (t=−2.26, df=12, p

Objectives To understand the growth rate of mastoid thickness and skull width associated with the age for both normal and malformed inner-ear anatomy groups. Also, to determine if there is any mathematical relation between cochlear size as measured by the "A" value against the age, mastoid thickness, and skull width. Methods Ninety-two computed tomography image datasets of human temporal bone were made available that contained normal (n = 44) and malformed inner-ear (n = 48) anatomies. The age of the subjects ranged from 6 months to 79 years. CE marked OTOPLAN preplanning otology software was used to load the patient's preoperative images for making all the measurements including mastoid thickness, skull width, and the cochlear size as measured by the "A" value. Mastoid thickness was measured both in axial and coronal planes starting from the cochlear entrance to the skull surface, with the line in plane with the basal turn of the cochlea. Skull width was measured from side to side in both axial and coronal planes from the image slice that gave the highest width. The cochlear size in terms of basal turn diameter "A" was measured from "Cochlear View" in the oblique coronal plane. Results Mastoid thickness and skull width increased with age in a logarithmic manner. The mastoid thickness increased from a minimum of 17 mm to around 34 mm and the skull width increased from 105 mm to around 146 mm as the age increased from 6 months to 20 years. At the age of around 20, both the mastoid thickness and skull width reached the plateau and thereafter with a very little growth. The skull width was linearly correlated with the mastoid thickness conveying the fact that bigger the head size is, thicker will be the mastoid. The size of the cochlea as measured by the "A" value did not have any meaningful correlation with the age, mastoid thickness, and skull width. This conveys the message that the cochlear size is independent of the overall size of head and the age of patient. Conclusions Mastoid thickness and skull width increased with age, while the cochlear size was independent of age, mastoid thickness, and the size of the skull.

Objective: To understand the anatomical and dimensional variations of the human inner ear using 3-dimensional (3D) segmentation within the Middle East population. Design: Retrospective study. Setting: King Abdullah Ear Specialist Center (KAESC) Riyadh, Saudi Arabia. Participant: Forty computed tomography (CT) images of patients with sensorineural hearing loss who underwent cochlear implant (CI) were taken for analysis. Main outcome Measures: Three-dimensional images showing the anatomical variations of the inner ear including various pathological conditions, cochlear parameters including basal turn diameter (“A” value), “B” value which is perpendicular to “A” value, cochlear height, length, and width of the internal auditory canal (IAC), intercochlear spacing, and electrode angular insertion depth (AID). Results: Out of 40 CT image data sets, 12 had normal inner-ear anatomy (NA), 4 with enlarged vestibular aqueduct syndrome (EVAS), 8 with only 2 turns of the cochlea (2TL), 7 with incomplete partition (IP) type II, 5 with cochlear hypoplasia, 1 with common cavity, and 3 with abnormal IAC. Taking the NA, EVAS, 2TL, and the IP type II cases altogether, age of the patient had no correlation with the “A” value; however, the “A” value had a linear correlation with the “B” value. The age of the patient had an increasing logarithmic correlation with the IAC length and the intercochlear spacing. The “A” value did not have any meaningful correlation with the cochlear height. Three data sets showed asymmetric inner-ear malformation types on either side of the ears. All these 40 cases were implanted with various CI electrode array variants and the corresponding postoperative plain film X-ray images showing the electrode AID are given separately in figures. Conclusions: Three-dimensional segmentation of the inner ear from the temporal bone CT is a valuable clinical and training tool for surgeons and radiologists especially in difficult cases which will certainly help to understand the overall anatomical and dimensional variations.

Objectives: Image guidance has been well characterized in spinal, orthopedic, sinonasal, and skull base surgery, but there is limited information on the use of these systems in cochlear implant and ear surgery. The aim of this study was to evaluate the use of image guidance systems to facilitate cochlear and bone-anchored hearing aid (BAHA) implant surgery. Study Design: Cohort. Materials and Methods: Eleven patients, including 10 who underwent cochlear implantation and 1 who underwent BAHA implantation with the assistance of the navigation system, were included in the study. Patient's data (age, gender, type and cause of hearing loss, and type of surgery), preoperative computed tomography scan findings, accuracy of the navigation system, operating time, and postoperative complications were collected and analyzed. Results: All 11 patients underwent uneventful surgeries finding the desired sites for implantation with ease by using the navigation system. All surgeries were completed without any complications. Conclusion: Performing cochlear and BAHA implantation with the assistance of the navigation system is a safe way to treat patients with normal or abnormal anatomy. In particular, it is helpful for identifying the round window for electrode insertion in cochlear implantation and for choosing the site with the thickest bone for BAHA implantation.

The effect of insertion depth and position of cochlear implant (CI) electrode arrays on speech perception remains unclear. This study aimed to determine the relationship between cochlear coverage and speech performance in children with prelingual hearing loss with CI. Pure tone audiometry (PTA) and speech audiometry, including speech reception threshold (SRT) using spondee words and speech discrimination score (SDS) using phonetically balanced monosyllabic words, were tested. The Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scales were also used. Thirty-one ears were implanted with the FLEX 28 electrode array, and 54 with the FORM 24 were included in the current study. For the studied ear, the mean cochlear duct length was 30.82 ± 2.24 mm; the mean cochlear coverage was 82.78 ± 7.49%. Cochlear coverage was a significant negative predictor for the mean pure tone threshold across frequecnies of 0.5, 1, 2, and 4 kHz (PTA4) (p = 0.019). Cochlear coverage was a significant positive predictor of SDS (p = 0.009). In children with cochlear coverage ≥ 82.78%, SDS was significantly better than in those with coverage < 82.78% (p = 0.04). Cochlear coverage was not a significant predictor of the SRT, CAP, or SIR. In conclusion, the cochlear coverage of the CI electrode array has an impact on the users’ SDS. Further long-term studies with larger sample sizes should be conducted to address the most critical factors affecting CI recipients’ outcomes.

Objectives This study aimed to define the best electrode trajectory line in cochlear implant (CI) surgery using the OTOPLAN (otology planning software) reconstructed 3D model and to investigate the surgical distance of the retro-facial approach as a direct access to the round window. Methods Computed tomography (CT) scans of the normal temporal bone were included for analysis in this study. OTOPLAN reconstruction was used to build 3D models with specific ear structures for study analysis. Results Twenty-five scans were included; the average age at the time of CT scan was 6.8±12 years. Twelve scans (48%) were right-sided and thirteen (52%) were left-sided. The best trajectory line to the round window was identified in all scans. The retro-facial approach was the optimal approach for 52% of cases (13/25). In all scans, the safe distance from the facial nerve were in favor of the retro-facial approach (P = 0.0011). Conclusion The OTOPLAN reconstructed imaging provided a good analysis of the retro-facial approach and helped in planning the surgical trajectory line towards the round window. Additionally, calculation of the surgical distance can help the surgeon compare the retro-facial approach to the standard facial recess for preoperative planning. These findings may help in robotic surgery.

This study aimed to compare the predicted anatomy-based frequency allocation of cochlear implant electrodes with the default standard frequencies.Retrospective study.A retrospective analysis was performed using computed tomography (CT) images of patients who received cochlear implants at a tertiary referral center. Patients were excluded if they had any congenital or acquired cochlear anatomical anomalies. The CT images of the patients were uploaded to the surgical planning software. Two independent reviewers allocated the anatomical parameters of the cochlea. The software then used these parameters to calculate the frequency allocation for each electrode according to the type of electrode and the length of the organ of Corti (OC) in each patient. These anatomy-based frequency allocations were compared with the default frequency settings.Frequency-to-place mismatch in semitones.A total of 169 implanted ears in 102 patients were included in this study. The readings of the two reviewers were homogenous, with a Cronbach's alpha of 0.98. The mean anatomy-based frequency allocation was 487.3 ± 202.9 Hz in electrode 1; 9,298.6 ± 490.6 Hz in electrode 12. The anatomy-based frequency allocations were found to be significantly higher than the frequencies of the default frequencies for each corresponding electrode (one-sample t-test, P .001). The frequency-to-place mismatch was negatively correlated with cochlear coverage and positively correlated with the cochlear duct length (Pearson correlation 0.65, P .003).The anatomy-based frequency allocation of each electrode is significantly different from the default frequency setting. This frequency-to-place mismatch was affected mainly by the cochlear coverage.3 Laryngoscope, 132:2224-2231, 2022.

Identification of the inner ear malformation types from radiographs is a complex process. We hypothesize that each inner ear anatomical type has a uniqueness in its appearance in radiographs. The outer contour of the inner ear was captured from the mid-modiolar section, perpendicular to the oblique-coronal plane, from which the A-value was determined from CT scans with different inner ear anatomical types. The mean A-value of normal anatomy (NA) and enlarged vestibular aqueduct syndrome (EVAS) anatomical types was greater than for Incomplete Partition (IP) type I, II, III and cochlear hypoplasia. The outer contour of the cochlear portion within the mid-modiolar section of NA and EVAS resembles the side view of Aladdin’s lamp; IP type I resembles the side-view of the Sphinx pyramid and type II a Pomeranian dog’s face. The steep spiraling cochlear turns of IP type III resemble an Auger screw tip. Drawing a line parallel to the posterior margin of internal auditory canal (IAC) in axial-view, bisecting the cavity into cochlear and vestibular portions, identifies common-cavity; whereas a cavity that falls under the straight-line leaving no cochlear portion identifies cochlear aplasia. An atlas of the outer contour of seventy-eight inner ears was created for the identification of the inner malformation types precisely.

Objective To evaluate cochlear implantation in Vogt-Koyanagi-Harada syndrome with regard to surgical difficulties and hearing outcomes. Patients Single case report. Intervention(s) Therapeutic complete electrode insertion during surgery despite evident intra-cochlear fibrosis. Main outcome measure(s) Postoperative speech audiometry, categories of auditory performance, and speech intelligibility rating. Results Vogt-Koyanagi-Harada syndrome is a multisystem autoimmune disease that affects tissues containing melanin. It is characterized by bilateral uveitis with auditory, vestibular, and dermatologic manifestations. Standard treatment comprises aggressive administration of systemic corticosteroids.This report describes the use of bilateral cochlear implants in a 30-year-old Saudi woman who presented with uveitis and was diagnosed with Vogt-Koyanagi-Harada syndrome. She had progressive hearing loss in both ears and experienced minimal improvement with hearing aids. The patient underwent sequential cochlear implantation, which was challenging because it was difficult to insert the electrode in the right ear due to intra-cochlear fibrosis. After more than 5 years of follow-up, she has good hearing in both ears, despite the advancement of ocular disease and recurring visual complaints. Conclusion This study suggests that patients with Vogt-Koyanagi-Harada syndrome could develop intra-cochlear fibrosis during cochlear implantation due to the autoimmune nature of disease. Moreover, cochlear implantation becomes more difficult with disease advancement. Therefore, it is essential that healthcare professionals consider early detection and prompt treatment of hearing loss in patients with this syndrome.

Objective To determine the effect of cochlear coverage on audiological and speech parameters in patients with cochlear implants. Previous work has investigated the effect of tailoring electrode size to a cochlear implant recipient's individual cochlear duct length (CDL). However, no clear relationship has been found between speech development and the extent of electrode insertion, and the benefits of apical stimulation are not yet clear. Methodology In this retrospective study, we assessed the effect of cochlear coverage on audiological and speech performance. Participants were prelingually deaf children who received cochlear implants between June 2013 and December 2014 under the care of a single cochlear implant surgeon. Cochlear coverage was estimated for each ear according to electrode type, depth of insertion, and the number of active electrodes. Electrode type and length were determined by the individual's CDL, measured by computed tomography (CT), and full insertion was documented intraoperatively. The number of active electrodes was recorded using intraoperative audiological response telemetry. Audiological assessments were obtained 6 months and 1 year postoperatively. Results of the categories of auditory performance-II and speech intelligibility rating scales were obtained after 3 years. Patients were divided into two groups based on their cochlear coverage and their audiological and speech outcomes were compared. Results Of the 97 children recruited, 47 were girls. Temporal bone CT scans showed the right and left mean CDLs among girls were 27.7 and 27.9 mm, respectively, and 29.2 mm for both ears in boys. For each sex, the right and left CDLs did not differ significantly (p = 0.07). Twenty patients were lost to follow-up, leaving 77 patients (120 ears), which were divided into groups according to cochlear coverage (complete vs. incomplete). Significant between-group differences were not found in assessments of audiology, categories of auditory performances, or speech intelligibility ratings after 3 years. Conclusion Audiological parameters do not differ according to the degree of cochlear coverage, specifically for low-frequency tones. Speech parameters are also comparable. Therefore, complete cochlear coverage does not appear to provide significant benefit over incomplete coverage for prelingually deaf cochlear implant recipients.

Objectives To study the changes in the coiled configuration of electrode excess lead in the mastoid cavity in the cochlear implant recipients over time. Methods Post-operative CT scans at two different appointments of fourteen patients with cochlear implants (CI) were retrospectively analyzed using a DICOM viewer software (3D-slicer). Mastoid thickness (MT) was measured in the oblique coronal plane from the round window (RW) entrance to the mastoid edge and inter-cochlear distance (ICD) was measured in the axial plane at the fundus level between two ears. 3D segmentation of the entire inner ear of both sides and coiled electrode excess lead was performed to visually compare the changes in coiled configuration between the two CT scan time points. Result MT and ICD increased logarithmically with the patient’s age, as has been measured from both the 1st and the 2nd CT scans and a weak linear correlation between MT and ICD was observed. Growth in MT and ICT measured between the time of 1st and 2nd CT scans showed a strong linear correlation. In eight cases, changes in the electrode excess lead have been observed in the 2nd CT scan, either a change in the coiling configuration of electrode excess lead or shifted laterally toward the mastoid edge. The ICD growth between the 1st and the 2nd CT scans was >2 mm in only seven cases and all of them were children. All other six cases had no observed changes in the coiled electrode lead. In addition, the mastoid growth between the 1st and the 2nd CT scan was >2.5 mm in only 4 cases. Conclusion Coiled configuration of electrode excess lead could change when the MT and ICD increased over time.

Objectives: To translate and validate the short form of the speech, spatial, and qualities of hearing scale (SSQ12). This will help in the assessment of hearing disability in the daily life of hearing-impaired populations, as well as the improvement of their quality of life. Methods: This cross-sectional study was conducted at the King Abdullah Ear Specialist Center, Riyadh, Saudi Arabia, between April and June 2021. The study included 102 hearing-impaired participants as the patient group and 84 normal-hearing participants as the control group. The English SSQ12 was translated according to the International Quality of Life Assessment method. Internal consistency and reliability of the Arabic SSQ12 were then assessed using Cronbach’s alpha (α) and test-retest reliability. Discriminant validity was also assessed by comparing the patients’ scores with the control participants. Results: The overall internal consistency of the Arabic SSQ12 was excellent (α=0.9), with good test-retest reliability (intraclass correlation coefficient [ICC]=0.8). There was a significant difference between the Arabic SSQ12 scores of the patient and control groups (p Conclusion: The Arabic version of the SSQ12 appears to be a valid and reliable tool that can be used to assess the communication ability of hearing-impaired patients in audiology clinics.

Cochlear nerve deficiency is one of the known causes of congenital sensorineural hearing loss. Management of hearing loss in children with cochlear nerve deficiency poses a multidimensional challenge. The absent or hypoplastic cochlear nerve may prevent electrical stimulation from reaching the brainstem and the auditory cortex. A deficient cochlear nerve can be associated with other inner ear malformations, which may diminish the success of cochlear implantation in those children. Promising results in adults after auditory brainstem implantation led to the expansion of candidacy to include the pediatric populations who were contraindicated for CIs.To review the outcomes of cochlear implantation versus that of auditory brainstem implantation in children with various conditions of the auditory nerve.This retrospective chart review study comprised two pediatric groups. The first group consisted of seven ABI recipients with cochlear nerve aplasia and the second group consisted of another seven children with cochlear nerve deficiencies who underwent CI surgery. The participants' auditory skills and speech outcomes were assessed using different tests selected from the Evaluation of Auditory Responses to Speech (EARS) test battery.There were some individual variations in outcomes depending on the status of the auditory nerve. The mean CAP score of the ABI group was 2.87, while the mean SIR score was 0.62. On the other hand, the mean CAP score of the CI group was 1.29, while the mean SIR score was 0.42.Our results are in good agreement with the reported auditory perception and speech and language development outcomes of pediatric auditory brainstem implantation. We added to the growing body of literature on the importance of verifying and identifying the status of the cochlear nerve in the decision-making process of the surgical management of those pediatric groups.

To assess the evolution of electrode impedance after the early fitting of audio processors (activation after one-day) and classical fitting (activation after one-month) over an up-to-one year after cochlear implant (CI) surgery.A retrospective cohort study on Fifty-two CI recipients divided into two groups. The study group included 24 recipients (40 ears) who underwent early fitting, whereas the control group contained 28 recipients (40 ears) who underwent classical fitting. The electrode impedance was recorded during the surgery, switch-on session and at one, three, six, and twelve-months after the surgery.In the study group, electrode impedance values obtained intraoperatively and at switch-on and one, three, six, and twelve-months were 4.89, 3.69, 6.52, 6.24, 6.05, and 5.81 KΩ, respectively, and only the switch-on and one-month values were significantly different (p 0.0001). In the control group, electrode impedance values obtained intraoperatively and at switch-on and one, three, six, and twelve-months were 4.71, 7.19, 6.40, 6.05, and 5.73 KΩ, respectively. Thus, the electrode impedance value at switch-on was 52.65% (p 0.001) greater than it intraoperatively. For both groups, the electrode impedance value at twelve-months was significantly higher than the respective intraoperative values (study group: 18.6% higher, P = 0.04; control group: 21.65% higher, P = 0.0001).Electrode impedance was significantly lower in the study group compared to the control group until one month after the surgery. However, the electrode impedance at twelve-months after the CI was similar in both groups.

OBJECTIVE/HYPOTHESIS The aim of this study was to investigate cochlear implantation (CI) outcome in children with nerve deficiency. STUDY DESIGN Retrospective chart review. METHODS A total of seven children with prelingual profound deficiency (hypoplasia or aplasia) were included. A control group of 10 CI children with no cochlear nerve anomalies was also included. In addition to implant stimulation levels, children's performance on pure-tone audiometry, speech reception measure, and auditory and speech skills ratings were compared across groups. Additionally, pre- and postoperative audiologic results were evaluated for the group with nerve deficiency. RESULTS In general, children with nerve deficiency performed poorer than those without nerve deficiency on all tested measures. Stimulation levels were considerably higher and more variable than the control group. Results further showed that performance was dependent on the diameter of the internal auditory canal. CONCLUSION Overall, cochlear implantation outcome in children with auditory nerve deficiency is poorer and extremely more variable than those without nerve deficiency. However, three of the patients had a noticeable improvement in auditory performance postimplantation suggesting that CI is a viable option in this population but expected benefit can be dependent on the status of the cochlear nerve.

One of the concerns during the cochlear implant candidacy process is the presence of chronic otitis media which could delay the implantation process. The aim of this study was to evaluate the surgical difficulties and the long-term complications in children with otitis media and to examine whether it is necessary to delay the implantation until the infection is resolved. The study used a comparative retrospective design based on chart review of all patients who received their implant(s) from January to December of 2012. A total of 200 patients were identified and were followed for 4 years post surgery. Patients were divided into three groups based on their history of otitis media (non-otitis media, chronic otitis media with effusion, and acute otitis media). Data included long-term complications, operative time and duration from first clinical visit to the time until implantation was received. None of study participants had long-term complications during the study period. The operative time was longer in the acute otitis media group with a difference of 45 min. The average delay in cochlear implantation due to the presence of otitis media in chronic group was more than 5 months. Pediatric patients with otitis media could be implanted in one stage safely and effectively.

Background Datalogging feature of the cochlear implant audio processor has been utilized to calculate the average daily wearing hours for cochlear implant devices by patients. Objectives To assess the relationship between the time use of cochlear implant audio processor and speech development as well as to identify the lowest acceptable duration of audio processor use to achieve an acceptable language development. Methods A retrospective study design including prelingual thirty-four ears (24 patients) who received the same electrode array of cochlear implant with 2 years follow up. The audiological and speech evaluations were done for all patients postoperatively and the last postoperative follow-up visit was used for analysis in this study. Results The average daily use of the audio processor was 11.3 ± 2.7 h per day. The pure tone average was 30.55 ± 4.64 dB whereas the speech reception threshold was 30.88 ± 6.12 dB. The average speech discrimination score at 65 dB was 68.59 ± 16.80%. A significant positive correlation (r = 0.54, p value = 0.0009) was found between the daily use of the audio processor and the speech discrimination score. The lowest wearing time needed to have more than 60% of the speech discrimination score was 8.3 h/day. Conclusion The present study revealed a positive correlation between the daily duration of the audio processor usage and speech performance. Moreover, we found that pediatric patients need to use their cochlear implant device for at least 8.3 h/day to achieve acceptable language development.