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Objective: The study was conducted to evaluate the safety and efficacy of mild internal jugular (IJV) compression via an FDA approved compression collar for symptomatic treatment of venous pulsatile tinnitus. Methods: This is a prospective study that recruited 20 adult patients with venous pulsatile tinnitus. Participants completed the Tinnitus Handicap Inventory (THI), were fitted with the collar, and rated symptom intensity on a 10‐point tinnitus intensity scale before and during collar use. Once weekly for 4 weeks, they answered a survey quantifying days used, average tinnitus intensity before and after wearing the collar each day of use, and any safety concerns. Lastly, they completed an exit interview. The primary outcome was symptomatic relief, with secondary outcomes of safety, effect of treatment setting, effect of time, and quality of life assessed via nonparametric testing. Results: 18 participants completed the study, and 276 paired daily before use/during use intensity scores were submitted. The median symptom intensity without the collar was 6 (IQR 4, 7), whereas with the collar it was 3 (IQR 2, 5), for a median symptomatic relief of 50%. The collar had a significant effect in reducing symptom intensity (p < 0.0001) and burden of illness via the THI (p < 0.0001). There was no effect of setting, frequency, or time on symptomatic relief with the collar. There were no adverse safety events reported aside from minor discomfort upon initial application. Conclusions: Venous compression collars offer acute symptom relief for patients with venous pulsatile tinnitus. Further study is needed to assess safety and efficacy of longitudinal use. Level of Evidence: 4 Laryngoscope, 134:3342–3348, 2024 [ABSTRACT FROM AUTHOR]

Objective: To detail a modified surgical technique for implantation of the Osia 2 Bone Conduction Hearing Aid (BCHA) system and to assess intra‐ and postoperative outcomes of this technique. Methods: A retrospective review was performed for cases undergoing implantation of an Osia 2 BCHA at a tertiary academic medical center. Modifications were made to the surgical procedure including: horizontal or curvilinear incisions, placement of the osseointegrated screw slightly superior to the plane of the external auditory canal, and double layer wound closure. Data regarding outcomes including demographics, incision type, surgical time, drilling requirements, and complications were collected using the electronic medical record. Results: A total of twenty‐eight cases were evaluated with 57.1% and 42.9% utilizing horizontal and curved incisions, respectively. The median age for recipients was 43.1 years with six pediatric cases included in the study. Median operative time was 58 min (43–126 min). The majority of cases required minimal (60.7%) or no drilling (28.6%) with a significant increase in operative time for those requiring moderate drilling versus minimal to no drilling (F = 8.02, p = 0.002). There were no intraoperative complications. One (3.6%) postoperative seroma occurred which resolved with conservative management. Conclusion: The proposed modified surgical technique is a safe and effective method for implantation of the transcutaneous BCHA system with a low complication rate. Keys include incision design, implant placement, and two‐layered closure to minimize wound tension. These modifications can improve ease of the procedure and reduce operative time. These techniques also appear to be applicable to the pediatric population. Level of Evidence: 3 Laryngoscope, 134:2401–2404, 2024 [ABSTRACT FROM AUTHOR]

Objective: Determine variables that influence post‐activation performance for cochlear implant (CI) recipients who lost low‐frequency acoustic hearing. Methods: A retrospective review evaluated CNC word recognition for adults with normal to moderately severe low‐frequency hearing (preoperative unaided thresholds of ≤70 dB HL at 250 Hz) who were implanted between 2012 and 2021 at a tertiary academic center, lost functional acoustic hearing, and were fit with a CI‐alone device. Performance scores were queried from the 1, 3, 6, 12, and 24‐month post‐activation visits. A linear mixed model evaluated the effects of age at implantation, array length (long vs. mid/short), and preoperative low‐frequency hearing (normal to mild, moderate, and moderately severe) on speech recognition with a CI alone. Results: 113 patients met the inclusion criteria. There was a significant main effect of interval (p < 0.001), indicating improved word recognition post‐activation despite loss of residual hearing. There were significant main effects of age (p = 0.029) and array length (p = 0.038), with no effect of preoperative low‐frequency hearing (p = 0.171). There was a significant 2‐way interaction between age and array length (p = 0.018), indicating that older adults with mid/short arrays performed more poorly than younger adults with long lateral wall arrays when functional acoustic hearing was lost. Conclusion: CI recipients with preoperative functional low‐frequency hearing experience a significant improvement in speech recognition with a CI alone as compared to preoperative performance—despite the loss of low‐frequency hearing. Age and electrode array length may play a role in post‐activation performance. These data have implications for the preoperative counseling and device selection for hearing preservation candidates. Level of Evidence: 4 Laryngoscope, 134:1868–1873, 2024 [ABSTRACT FROM AUTHOR]

This article, published in the Journal of Neurological Surgery, compares the outcomes of cochlear implant (CI) speech perception in 100 patients with sporadic vestibular schwannoma (VS) who were managed with observation, radiosurgery, or microsurgery. The study found that patients who underwent microsurgery had poorer implant outcomes compared to those managed with observation or radiosurgery. Open-set speech perception was achieved in 56% of patients managed with microsurgery, 94% with observation, and 80% with radiosurgery. The data suggest that cochlear implants can benefit selected patients with sporadic VS, and that observation or radiosurgery may be more reliable options for achieving open-set speech perception compared to microsurgical resection. [Extracted from the article]

The field of plasmonics, which studies the resonant interactions of electromagnetic waves and free electrons in solid-state materials.sup.1, has yet to be put to large-scale commercial application.sup.2 owing to the large amount of loss that usually occurs in plasmonic materials.sup.3. Organic light-emitting devices (OLEDs).sup.4-7 have been incorporated into billions of commercial products because of their good colour saturation, versatile form factor.sup.8 and low power consumption.sup.9, but could still be improved in terms of efficiency and stability. Although OLEDs incorporating organic phosphors achieve an internal charge-to-light conversion of unity.sup.10, their refractive index contrast reduces the observable fraction of photons outside the device to around 25 per cent.sup.11-13. Further, during OLED operation, a localized buildup of slow-decaying.sup.14 triplet excitons and charges.sup.15 gradually reduces the brightness of the device in a process called ageing.sup.16,17, which can result in 'burn-in' effects on the display. Simultaneously improving device efficiency and stability is of paramount importance for OLED technology. Here we demonstrate an OLED that uses the decay rate enhancement.sup.18 of a plasmonic system to increase device stability, while maintaining efficiency by incorporating a nanoparticle-based out-coupling scheme to extract energy from the plasmon mode. Using an archetypal phosphorescent emitter, we achieve a two-fold increase in operational stability at the same brightness as a reference conventional device while simultaneously extracting 16 per cent of the energy from the plasmon mode as light. Our approach to increasing OLED stability avoids material-specific designs.sup.19-22 and is applicable to all commercial OLEDs that are currently used for lighting panels, televisions and mobile displays. Plasmonic effects in organic light-emitting devices, which are normally considered a source of energy loss, are harnessed to enhance the stability of these devices while maintaining operational efficiency., Author(s): Michael A. Fusella [sup.1] , Renata Saramak [sup.1] , Rezlind Bushati [sup.1] , Vinod M. Menon [sup.1] , Michael S. Weaver [sup.1] , Nicholas J. Thompson [sup.1] , Julia [...]

Objective: Comparison of acute speech recognition for cochlear implant (CI) alone and electric‐acoustic stimulation (EAS) users listening with default maps or place‐based maps using either a spiral ganglion (SG) or a new Synchrotron Radiation‐Artificial Intelligence (SR‐AI) frequency‐to‐place function. Methods: Thirteen adult CI‐alone or EAS users completed a task of speech recognition at initial device activation with maps that differed in the electric filter frequency assignments. The three map conditions were: (1) maps with the default filter settings (default map), (2) place‐based maps with filters aligned to cochlear SG tonotopicity using the SG function (SG place‐based map), and (3) place‐based maps with filters aligned to cochlear Organ of Corti (OC) tonotopicity using the SR‐AI function (SR‐AI place‐based map). Speech recognition was evaluated using a vowel recognition task. Performance was scored as the percent correct for formant 1 recognition due to the rationale that the maps would deviate the most in the estimated cochlear place frequency for low frequencies. Results: On average, participants had better performance with the OC SR‐AI place‐based map as compared to the SG place‐based map and the default map. A larger performance benefit was observed for EAS users than for CI‐alone users. Conclusion: These pilot data suggest that EAS and CI‐alone users may experience better performance with a patient‐centered mapping approach that accounts for the variability in cochlear morphology (OC SR‐AI frequency‐to‐place function) in the individualization of the electric filter frequencies (place‐based mapping procedure). Level of Evidence: 3 Laryngoscope, 133:3540–3547, 2023 [ABSTRACT FROM AUTHOR]

Objective: To assess long‐term binaural hearing abilities for cochlear implant (CI) users with unilateral hearing loss (UHL) or asymmetric hearing loss (AHL). Methods: A prospective, longitudinal, repeated measures study was completed at a tertiary referral center evaluating adults with UHL or AHL undergoing cochlear implantation. Binaural hearing abilities were assessed with masked speech recognition tasks using AzBio sentences in a 10‐talker masker. Performance was evaluated as the ability to benefit from spatial release from masking (SRM). SRM was calculated as the difference in scores when the masker was presented toward the CI‐ear (SRMci) or the contralateral ear (SRMcontra) relative to the co‐located condition (0°). Assessments were completed pre‐operatively and at annual intervals out to 5 years post‐activation. Results: Twenty UHL and 19 AHL participants were included in the study. Linear Mixed Models showed significant main effects of interval and group for SRMcontra. There was a significant interaction between interval and group, with UHL participants reaching asymptotic performance early and AHL participants demonstrating continued growth in binaural abilities to 5 years post‐activation. The improvement in SRM showed a significant positive correlation with contralateral unaided hearing thresholds (p = 0.050) as well as age at implantation (p = 0.031). Conclusions: CI recipients with UHL and AHL showed improved SRM with long‐term device use. The time course of improvement varied by cohort, with the UHL cohort reaching asymptotic performance early and the AHL cohort continuing to improve beyond 1 year. Differences between cohorts could be driven by differences in age at implantation as well as contralateral unaided hearing thresholds. Level of Evidence: 3 Laryngoscope, 133:1480–1485, 2023 [ABSTRACT FROM AUTHOR]

Introduction: Cochlear implant (CI) recipients with normal hearing (NH) in the contralateral ear experience a significant improvement in sound source localization when listening with the CI in combination with their NH-ear (CI + NH) as compared to with the NH-ear alone. The improvement in localization is primarily due to sensitivity to interaural level differences (ILDs). Sensitivity to interaural timing differences (ITDs) may be limited by auditory aging, frequency-to-place mismatches, the signal coding strategy, and duration of CI use. The present report assessed the sensitivity of ILD and ITD cues in CI + NH listeners who were recipients of long electrode arrays that provide minimal frequency-to-place mismatches and were mapped with a coding strategy that presents fine structure cues on apical channels. Methods: Sensitivity to ILDs and ITDs for localization was assessed using broadband noise (BBN), as well as high-pass (HP) and low-pass (LP) filtered noise for adult CI + NH listeners. Stimuli were 200-ms noise bursts presented from 11 speakers spaced evenly over an 180° arc. Performance was quantified in root-mean-squared error and response patterns were analyzed to evaluate the consistency, accuracy, and side bias of the responses. Fifteen listeners completed the task at the 2-year post-activation visit; seven listeners repeated the task at a later annual visit. Results: Performance at the 2-year visit was best with the BBN and HP stimuli and poorer with the LP stimulus. Responses to the BBN and HP stimuli were significantly correlated, consistent with the idea that CI + NH listeners primarily use ILD cues for localization. For the LP stimulus, some listeners responded consistently and accurately and with limited side bias, which may indicate sensitivity to ITD cues. Two of the 7 listeners who repeated the task at a later annual visit experienced a significant improvement in performance with the LP stimulus, which may indicate that sensitivity to ITD cues may improve with long-term CI use. Conclusions: CI recipients with a NH-ear primarily use ILD cues for sound source localization, though some may use ITD cues as well. Sensitivity to ITD cues may improve with long-term CI listening experience. [ABSTRACT FROM AUTHOR]