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Objectives: The growing adoption of cochlear implants (CIs) necessitates understanding the factors influencing long-term performance and improved outcomes. This work investigated the long-term effect of early activation of CIs on electrode impedance in a large sample of CI users at different time points. Methods: A retrospective study on 915 ears from CI patients who were implanted between 2015 and 2020. According to their CI audio processor activation time, the patients were categorized into early activation (activated 1 day after surgery, n = 481) and classical activation (activated 4 weeks after surgery, n = 434) groups. Then, the impact of the activation times on the electrode impedance values, along the electrode array contacts, at different time points up to two years was studied and analyzed. Results: The early activation group demonstrated lower impedance values across all the electrode array sections compared to the classical activation at 1 month, 1 year, and 2 years post-implantation. At 1 month, early activation was associated with a reduction of 0.34 kΩ, 0.46 kΩ, and 0.37 kΩ in the apical, middle, and basal sections, respectively. These differences persisted at subsequent intervals. Conclusions: Early activation leads to sustained reductions in the electrode impedance compared to classical activation (CA), suggesting that earlier activation might positively affect long-term CI outcomes. [ABSTRACT FROM AUTHOR]

BACKGROUND: RONDO 2 is a lightweight, compact, wirelessly charged, and fully integrated single-unit speech processor. Single-unit processors provide an effective and convenient alternative to behind-the-ear processors for adults. Therefore, the aim of this study was to investigate if RONDO 2 is suitable for and did not compromise the hearing performance of young children in everyday life. METHODS: Thirteen children aged <4 years were fitted with the RONDO 2 speech processor at the first activation of the cochlear implant. They were evaluated with the LittlEARS® Auditory Questionnaire, LittlEARS® Early Speech Production Questionnaire, and the Speech, Spatial, and Qualities of Hearing Scale 12 pre-implantation. In addition to these measures, they were evaluated with the Audio Processor Satisfaction Questionnaire post-implantation. Duration of daily use and troubleshooting data were acquired. Evaluation occurred at 4 time points: before implantation and 1, 3, and 12 months post-initial activation. RESULTS: Ten out of 13 children continued using RONDO 2 after the study. Twelve months after implantation, they used it on average 11.6 hours per day and had an average Audio Processor Satisfaction Questionnaire score of 9.1 out of 10. Average hearing performance scores continuously improved throughout the follow-up period across measures. Twelve months after implantation, the mean scores were 30.1 out of 35 for the LittlEARS® Auditory Questionnaire, 19.9 out of 27 for the LittlEARS® Early Speech Production Questionnaire, and 7.4 out of 10 for the Speech, Spatial, and Qualities of Hearing Scale 12. CONCLUSION: Participants demonstrated high levels of satisfaction and good hearing performance with RONDO 2, which indicates that this single-unit processor could be a viable and comfortable alternative to behind-the-ear processors in young children, although larger controlled experiments are warranted. [ABSTRACT FROM AUTHOR]

Cochlear implantation is the common treatment for severe to profound sensorineural hearing loss if there is no benefit from hearing aids. Measuring the electrode impedance along the electrode array at different time points after surgery is crucial in verifying the electrodes' status, determining the compliance levels, and helping to identify the electric dynamic range. Increased impedance values without proper reprogramming can affect the patient's performance. The prediction of acceptable levels of electrode impedance at different time points after the surgery could help clinicians during the fitting sessions through a comparison of the predicted with the measured levels. Accordingly, clinicians can decide if the measured levels are within the predicted normal range or not. In this work, we used a dataset of 80 pediatric patients who had received cochlear implants with the MED-EL FLEX 28 electrode array. We predicted the impedance of the electrode arrays in each channel at different time points: at one month, three months, six months, and one year after the date of surgery. We used different machine learning algorithms such as linear regression, Bayesian linear regression, decision forest regression, boosted decision tree regression, and neural networks. The used features include the patient's age and the intra-operative electrode impedance at different electrodes. Our results indicated that the best algorithm varies depending on the channel, while the Bayesian linear regression and neural networks provide the best results for 75% of the channels. Furthermore, the accuracy level ranges between 83% and 100% in half of the channels one year after the surgery, when an error range between 0 and 3 KΩ is defined as an acceptable threshold. Moreover, the use of the patient's age alone can provide the best prediction results for 50% of the channels at six months or one year after surgery. This reflects that the patient's age could be a predictor of the electrode impedance after the surgery. [ABSTRACT FROM AUTHOR]

Background: The ADHEAR device, a new nonsurgical bone conduction hearing device, has been developed for patients with conductive hearing loss. Objectives: This study aims to assess the impact of the ADHEAR device on the audiological performance and satisfaction level in subjects with conductive hearing loss. Methods: Twelve patients with conductive hearing loss were included. All patients received the device for 3 months. The audiological outcomes were determined using basic audiological assessments, including pure tone audiometry and sound field measurements of pure tone and speech audiometry with the contralateral ear occluded with a specific earplug. Additionally, the patients were subjectively evaluated using (1) the Speech, Spatial, and Qualities Questionnaire (SSQ), and (2) the custom-made ADHEAR questionnaire. Results: Analysis of the measured audiological outcomes revealed an average improvement in pure tone thresholds (functional gain) of 23 (± 4.4) dB HL when the ADHEAR system was used compared to the unaided condition in the sound field. Moreover, speech reception thresholds improved by an average of 23 (± 15.3) dB SPL in the aided condition with plugged contralateral ear. Additionally, when using ADHEAR in the sound field, subjects' speech recognition scores improved by 32% (± 17.7) in quiet and 21% (± 15.1) in the presence of interfering noise. The average SSQ questionnaire scores improved from 3.9 at the study initiation to 6.6 after 3 months of device usage. ADHEAR custom questionnaire assessments revealed high satisfaction and acceptance of the device with no pain or skin irritation. Conclusion: During the study period, this new adhesive system yielded improved audiological outcomes with high patient satisfaction and acceptance and no reported skin irritation or pain. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to determine the shape of cochlear basal turn through basic cochlear parameters measurement. The secondary aim was to overlay an image of the precurved electrode array on top of the three-dimensional (3D) image of the cochlea to determine which shape of the cochlear basal turn gives optimal electrode-to-modiolus proximity. Materials and Methods: Computed tomography (CT) preoperative image-data sets of 117 ears were made available for the measurements of cochlear parameters retrospectively. Three-dimensional slicer was used in the visualization and measurement of cochlear parameters from both 3D and 2D (2-dimensional) images of the inner ear. Cochlear parameters including basal turn diameter (A), width of the basal turn (B), and cochlear height (H) were measured from the appropriate planes. B / A ratio was made to investigate which ratios correspond to round and elliptical shape of the cochlear basal turn. Results: The cochlear size as measured by A value ranged between 7.4 mm and 10 mm. The B value and the cochlear height (H) showed a weak positive linear relation with A value. The ratio between the B and A values anything above or below 0.75 could be an indicator for a more round- or elliptical shaped cochlear basal turn, respectively. One sized/shaped commercially available precurved electrode array would not offer a tight electrode-to-modiolus in the cochlea that has an elliptical shaped basal turn as identified by the B/A ratio of <0.75. Conclusion: Accurate measurement of cochlear parameters adds value to the overall understanding of the cochlear geometry before a cochlear implantation procedure. The shape of cochlear basal turn could have clinical implications when comes to electrode-to-modiolus proximity. [ABSTRACT FROM AUTHOR]