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Objectives/hypothesis: To determine the improvement in word recognition score (WRS65 ) after cochlear implant (CI) surgery in hearing aid (HA) users with preoperative hearing threshold ≤80 dB HL and inadequate speech recognition scores with HA. Secondarily, to identify predictive factors for WRS65 with a CI (WRS65 [CI]) 6 months after surgery, derived from the standard German CI preoperative assessment.Study Design: Retrospective chart review.Methods: Retrospective review of all adult patients who received a Nucleus cochlear implant in the ear, nose, and throat department of the University Hospital of Erlangen between January 2010 and April 2019. The inclusion criteria were a preoperative hearing threshold ≤80 dB HL in the ear to receive the implantation, German as the native language, and at least 6 months postimplantation care at our center.Results: The inclusion criteria were met by 128 patients. All but two patients (98.4%) showed a significant improvement, WRS65 (CI) versus WRS65 with an (HA) (WRS65 [HA]), of at least 15 percentage points (pp). The median improvement was 55 pp with a median WRS65 (CI) of 70%. Three preoperative audiometric measures, the maximum word recognition score, age at implantation, and WRS65 (HA) were identified as predictive factors for WRS65 (CI). For three-quarters of the CI recipients, the score was not poorer than 12 pp below the predicted WRS65 (CI).Conclusions: For patients with a hearing loss ≤80 dB HL, cochlear implantation should be considered when speech perception with an HA is insufficient. The prediction model can support counseling in this patient group.Level Of Evidence: 4 Laryngoscope, 131:E940-E945, 2021. [ABSTRACT FROM AUTHOR]

Objectives: Cochlear implantation requires acclimatization to the electrical input. Usually, cochlear implant (CI) listeners undergo an auditory rehabilitation program that includes auditory training sessions. Recently, it was shown that a phoneme-based training may improve speech perception abilities even in experienced CI listeners. The current study focuses on whether the effect of an auditory training program depends on the age of CI listeners. Design: Fifteen CI listeners took part in an auditory phoneme-based computer training program. Before and after training, speech recognition tests in moderate and difficult noise (+5 dB SNR and 0 dB SNR, respectively) were administered. Additionally, speech recognition was tested 6 months after the training (follow-up). A control group consisting of 12 subjects underwent audiometric testing without any auditory training. Results: Speech perception in moderate noise improved significantly during the training as revealed by comparing pre- and posttraining scores evaluated in the moderate noise condition. No significant change was observed for the difficult noise situation at 0 dB SNR. The speech perception measures of the control group remained unchanged. No significant effect of age on the training effect was observed. Conclusion: Speech recognition can be improved even in experienced CI listeners. When motivated to participate, senior CI users with long-term CI experience may benefit in a similar way from an auditory, phoneme-based computer training program as younger CI users. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

OBJECTIVE: In the literature, there is no evidence for the general ability of glimpsing in CI-listeners, which is better speech comprehension by the use of temporal gaps in noise. However, preliminary data in a pilot study indicated, that glimpsing is present in CI-listeners and possibly dependent on the preprocessing algorithms. Hence, glimpsing in CI listeners was investigated systematically in the present study. MATERIALS and METHODS: Twenty postlingually deafened CI-listeners (CI24RE und CI512) with a CI-experience of at least one year and bilateral residual hearing of less than 40 dB HL were investigated. The Göttingen sentence test was performed in quiet and with an SNR of +5dB, both for CCITT-noise and for a speech modulated noise (Fastlnoise). All tests were conducted with two different preprocessing strategies: ASC (automatic sensitivity control) and ASC+ADRO (adaptive dynamic range optimization). RESULTS: The mean sentence recognition rate improved significantly in Fastl-noise compared to the CCITT-noise by 14.1 percentage points (PP) with ASC preprocessing and by 11.4 PP with ASC+ADRO preprocessing. The inclusion of ADRO led to an improvement of 10.3 PP for the CCITT-noise and 7.6 PP in the Fastl-noise. CONCLUSION: The majority of CI-listeners benefited from gaps in fluctuating Fastl-noise, largely independent of the use of ADRO. A general improvement of sentence recognition was found for the inclusion of ADRO to the signal processing. Apparently, there are additional factors, why glimpsing was not observed in other studies with CI-listeners. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Over the past decade the number of cochlear implant candidates with substantial residual hearing on the contralateral side increased. Therefore, bimodal hearing becomes more and more important. The aim of this study was to investigate the contribution of the cochlear implant as well as of the hearing aid postoperatively in quiet and in noise and to determine the bimodal gain. MATERIALS and METHODS: 86 adult CI users implanted at least 3 months ago using a hearing aid on the contralateral side have been investigated. Postoperative speech perception in quiet as well as in noise has been measured using Göttingen sentences (65 dB). Speech understanding in noise was determined using an adaptive measurement method. Speech perception has been tested for the cochlear implant, the hearing aid and bilateral. RESULTS: A significantly higher bimodal speech understanding (89%±12%) in comparison to each of the monaural measurements (cochlear implant (75%±20%); hearing aid (69%±25%)) respectively has been detected in quiet. In noise, increased speech understanding reflected by an improved speech-to-noise ratio was also present for the bimodal hearing situation (bimodal hearing (2.9dB±2.4dB); cochlear implant (7.6dB±5.5dB); hearing aid (6.6dB±4.6dB)). For our patient cohort, there was no significant difference between cochlear implant and hearing aid concerning speech understanding results in quiet and in noise. CONCLUSION: The results of this study show that CI listeners benefit from the hearing aid as well as from the cochlear implant in quiet situations and in noise. [ABSTRACT FROM AUTHOR]

During the last decade it turned out that normal hearing on the contralateral side is not a contraindication for cochlear implantation and for each ear the optimum treatment has to be chosen. Concerning the ear which will be implanted, cochlear implants are required when conventional hearing aids do not allow for sufficient speech understanding. Usually, extensive hearing aid trials with hearing aids of different types and quality were performed before cochlear implantation takes place. Until now, no clear criteria exist, which enables to decide whether hearing aids or cochlear implants will provide better speech understanding. Therefore, analyzing outcome data for hearing aids in subjects with different degrees of sensorineural hearing losses are necessary. Audiometric measurements of 185 sensorineural hearing-impaired subjects were evaluated retrospectively. The data were collected as a part of clinical routine for hearing aid performance assessment. All subjects had been supplied with hearing aids and had at least 3 months experience. Speech perception with hearing aids varied even for very similar puretone thresholds. With puretone thresholds above 50 dB the average recognition is worse with hearing aids than with cochlear implants. By combining information from speech and puretone audiometry hearing aid performance can be estimated. Therefore, an audiometric criterion can be derived which indicates that cochlear implantation is superior to acoustic amplification. This criterion is supported by comparing hearing related quality of life with conventional hearing aids and with cochlear implants as determined by several questionnaires (Oldenburg Inventory, Nijmegen Cochlear implant questionnaire, and Hearing Implant Sound Quality Index). [ABSTRACT FROM AUTHOR]

This study gives an estimation of the long term outcome of a screening procedure for cochlear implant candidacy in hearing aid users.In a recent retrospective study, hearing aid performance and audiometric measures in 185 subjects (318 ears) were analyzed. In the context of 2 years follow-up, the outcome of the ipsilateral screening procedure was analyzed. For patients who did receive a cochlear implant, their audiometric outcome measures were viewed into relation to their preoperative results.From the 96 ears identified as cochlear implant candidates, 34 were provided with a cochlear implant. 222 ears were identified as hearing aid users. Only 4 of these 222 ears were provided with a cochlear implant. Cochlear implant recipients with a preoperative speech recognition score with hearing aids above zero showed a mean improvement of 65% points in Freiburg monosyllabics.The audiometry-based screening procedure enables an effective management of the referral process of cochlear implant candidates., (© Georg Thieme Verlag KG Stuttgart · New York.)