A Multicenter Clinical Evaluation of Data Logging in Cochlear Implant Recipients Using Automated Scene Classification Technologies.

Currently, there are no studies assessing everyday use of cochlear implant (CI) processors by recipients by means of objective tools. The Nucleus 6 sound processor features a data logging system capable of real-time recording of CI use in different acoustic environments and under various categories of loudness levels. In this study, we report data logged for the different scenes and different loudness levels of 1,366 CI patients, as recorded by SCAN. Monitoring device use in cochlear implant recipients of all ages provides important information about the listening conditions encountered in recipients' daily lives that may support counseling and assist in the further management of their device settings. The findings for this large cohort of active CI users confirm differences between age groups concerning device use and exposure to various noise environments, especially between the youngest and oldest age groups, while similar levels of loudness were observed.

Single-stage canal wall-down tympanoplasty: long-term results and prognostic factors.

OBJECTIVES: We sought to identify factors associated with anatomic and functional results of canal wall-down tympanoplasty. METHODS: One hundred eighty-nine primary or relapsing cholesteatomas were consecutively operated on by a single surgeon. Cholesteatoma recurrence rates were evaluated. Predictive values of the patient, disease, and surgical characteristics on cholesteatoma recurrence were estimated. The effect of these variables on keratin pearl development, recurrent otorrhea or granulation tissue formation, and hearing function was tested. RESULTS: The mean follow-up was 8 years (range, 4 to 15 years). The cholesteatoma relapse rate (+/- SE) estimated by the Kaplan-Meier method was 2.1% +/-1.1%. No variables were associated with relapsing disease. The log-rank test showed a significantly higher probability of keratin pearls in male patients (16.7% versus 2.1%; p = 0.001), young patients (less than 16 years; 51.4% versus 6.2%; p = 0.0001), patients with unencapsulated cholesteatomas (19.5% versus 5.3%; p = 0.06), patients with petrous or accessory cellularity invasion (17.9% versus 7.1%; p = 0.02), and patients with overlay myringoplasty (25% versus 7.9%; p = 0.03). Recurrent otorrhea and granulation tissue were associated with homograft temporalis fascia myringoplasty (14.3% versus 3.8%; p = 0.04). The overall postoperative air-bone gap was within 20 dB in 30.7%; it was within 20 dB in 43.9% (47/107) for intact or reconstructed ossicular chains and in 13.4% (11/82) for nonreconstructed, eroded ossicular chains (p = 0.0001). The air-bone gap was within 20 dB in 42.6% (46/108) when the mucosa of the tympanic cavity was normal and in 14.8% (12/81) when there was granulation tissue within the tympanic cavity (p = 0.0001). CONCLUSIONS: Single-stage canal wall-down tympanoplasty is an appropriate treatment for acquired tympanomastoid cholesteatoma.

Favorable outcome of cochlear implant in VIIIth nerve deficiency.

OBJECTIVE: To report on the outcomes of cochlear implantation (CI) in a child with cochleovestibular nerves (CVN) hypoplasia. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center, University hospital. PATIENTS: An 18-month-old child with profound bilateral congenital hearing loss and bilateral hypoplasia of the CVN at imaging. INTERVENTION: Left CI at age 29 months with a Nucleus Contour device (Cochlear Ltd., Lane Cove, New South Wales, Australia) after unsatisfactory results of hearing aid use for 10 months. MAIN OUTCOME MEASURES: Speech perception tests, behavioral observation, electrophysiologic tests, and cognitive evaluation. RESULTS: Although the child scores poorly in every perceptive category with the CI alone, the device greatly enhances his speech understanding with the hearing aid in the opposite ear. In the bimodal condition, his words and sentences identification, recognition, and comprehension far exceed the monaural figures. The Meaningful Auditory Integration Scale (MAIS) tests reaches a score of 26/40, and the MacArthur's questionnaires confirm the improvement of language production and comprehension. These results became noticeable after 5 to 6 months and continued to improve up to the 10th month. The child's cognitive scores and overall performance competences greatly benefit from the CI, with the mental age overcoming the chronological age. CONCLUSION: We can confirm the chance of achieving satisfactory results by CI even when the imaging of CVN is doubtful and the electrophysiological tests are disappointing. In our experience, a CI in Type IIb dysplasia of the CVN is a feasible option, provided that the candidate shows some responses at aided audiogram and at least minimal signs of language development. Adequate counseling is necessary for these children because the expected outcome is somewhat lower than that of their deaf peers with normal appearance of the nerves.

Internal jugular vein thrombosis associated with acute mastoiditis in a pediatric age.

OBJECTIVE: To discuss the clinical aspects and management of internal jugular vein thrombosis associated with acute otitis media. STUDY DESIGN: Case reports and review of the literature. SETTING: University hospital, tertiary referral center. PATIENT: The authors describe two cases of internal jugular vein thrombosis, without sigmoid sinus thrombosis, secondary to acute otomastoiditis. INTERVENTION: Jugular vein thrombosis was diagnosed in both cases by observation of filling defects of the involved jugular bulb on contrast-enhanced computed tomography and confirmed by conventional magnetic resonance and magnetic resonance venography. RESULTS: Both patients recovered after recanalization of the vessel concomitant to anticoagulation and antibiotic treatment associated with a simple mastoidectomy. CONCLUSION: Internal jugular vein thrombosis may be a complication of acute otitis media, without involvement of the sigmoid sinus and with a starting point in the jugular bulb. Anticoagulation associated with antibiotic therapy can be considered a safe and effective treatment. Surgery should only be performed to eliminate the source of infection from the middle ear and mastoid.

Multicentre Evaluation of the Naída CI Q70 Sound Processor: Feedback from Cochlear Implant Users and Professionals.

The aim of this survey was to gather data from both implant recipients and professionals on the ease of use of the Naída CI Q70 (Naída CI) sound processor from Advanced Bionics and on the usefulness of the new functions and features available. A secondary objective was to investigate fitting practices with the new processor. A comprehensive user satisfaction survey was conducted in a total of 186 subjects from 24 centres. In parallel, 23 professional questionnaires were collected from 11 centres. Overall, there was high satisfaction with the Naída CI processor from adults, children, experienced and new CI users as well as from professionals. The Naída CI processor was shown as being easy to use by all ages of recipients and by professionals. The majority of experienced CI users rated the Naída CI processor as being similar or better than their previous processor in all areas surveyed. The Naída CI was recommended by the professionals for fitting in all populations. Features like UltraZoom, ZoomControl and DuoPhone would not be fitted to very young children in contrast to adults. Positive ratings were obtained for ease of use, comfort and usefulness of the new functions and features of the Naída CI sound processor. Seventy-seven percent of the experienced CI users rated the new processor as being better than their previous sound processor from a general point of view. The survey also showed that fitting practices were influenced by the age of the user.