Subjective Sound Quality Detection (HISQUI) over Time after Vibrant Soundbridge Implantation.

BACKGROUND: To evaluate the long-term audiological outcomes combined with the Hearing Implant Sound Quality Index (HISQUI) after Vibrant Soundbridge (VSB) implantation. METHODS: Prospective recall cohort study of patients who received a VSB in a tertiary academic medical center between 1996 and 2017. Air conduction (AC) and bone conduction (BC), sound field thresholds in aided and unaided conditions, and speech discrimination in noise (Oldenburger sentence test) were measured. Postoperative results were compared with preoperative audiograms. Furthermore, the HISQUI was evaluated. RESULTS: Ten patients (eleven implants) were included, the mean follow up period was nine years. The mean AC threshold preoperatively was between 63 and 70 dB, and the BC was between 38 and 49 dB from 500 to 4000 Hz. In the free-field audiogram, the mean threshold was between 61 and 77 dB unaided vs. between 28 and 52 dB in the aided condition. The average signal to noise ratio (SNR) in the Oldenburger sentence test in the unaided condition was 10 dB ± 6.7 dB vs. 2 dB ± 5.4 dB in the aided condition. Three patients reported a good to very good hearing result, four patients a moderate, and three patients a poor hearing result. There was a significant association between the years of implantation and the HISQUI (p = 0.013), as well as a significant decrease by 14 HISQUI points per 10 dB SPL decline (SE 5.2, p = 0.023). There was a significant difference between the change of BC over the years and the HISQUI, as well as the number of years after implantation and the HISQUI. On average, per dB decrease in BC, the HISQUI decreases by 1.4 points, and every year after implantation the HISQUI decreases by 2.7 points. CONCLUSIONS: The aided threshold in free field and speech understanding in noise improved significantly with VSB. An increase over time of BC thresholds was observed as well as a decrease in HISQUI score. This decrease in BC thresholds over time may be due to presbycusis. Therefore, monitoring of these patients over time should be considered to discuss alternative hearing rehabilitation measures in a timely manner.

Dynamic Postural Stability and Hearing Preservation after Cochlear Implantation.

OBJECTIVES: (1) To assess dynamic postural stability before and after cochlear implantation using a functional gait assessment (FGA). (2) To evaluate the correlation between loss of residual hearing and changes in dynamic postural stability after cochlear implantation. METHODS: Candidates for first-sided cochlear implantation were prospectively included. The FGAs and pure-tone audiograms were performed before and 4-6 weeks after cochlear implantation. RESULTS: Twenty-three subjects were included. Forty-eight percent (n = 11) showed FGA performance below the age-referenced norm before surgery. One subject had a clinically relevant decrease of the FGA score after cochlear implantation. No significant difference between the mean pre- and postoperative FGA scores was detectable (p = 0.4). Postoperative hearing loss showed no correlation with a change in FGA score after surgery (r = 0.3, p = 0.3, n = 16). CONCLUSION: Single-sided cochlear implantation does not adversely affect dynamic postural stability 5 weeks after surgery. Loss of functional residual hearing is not correlated with a decrease in dynamic postural stability.

A comparison of medley and freestyle performance for national and international swimmers between 1994 and 2011.

The change in swim performance over time has been investigated for freestyle, but not for other strokes, such as in the medley. The aim of the study was to examine changes in 200 m and 400 m swim performances in medley swimmers at national (Switzerland) and international level (world championship finals) from 1994 to 2011. The 200 m and 400 m freestyle performances were also analyzed for comparison. Swim performances were analyzed using linear regression and one-way analysis of variance. Male Swiss swimmers improved swim speed by 5.4% in the 200 m medley, 5.3% in the 200 m freestyle, 5.1% in the 400 m medley, and 5.7% in the 400 m freestyle (P < 0.01). Female Swiss swimmers improved swim speed by 4.4% in the 200 m medley, 3.3% in the 200 m freestyle, 3.9% in the 400 m medley, and 3.4% in the 400 m freestyle (P < 0.05). Male swimmers at international level improved swim speed by 4.5% in the 200 m medley, 4.6% in the 200 m freestyle, 2.6% in the 400 m medley, and 2.7% in the 400 m freestyle (P < 0.01). Female swimmers improved swim speed by 4.3% in the 200 m medley, 3.5% in the 400 m medley, and 3.1% in the 400 m freestyle (P ≤ 0.02), but 200 m freestyle performance remained unchanged (P > 0.05). The sex difference in national swim performance remained unchanged at 10.2% ± 0.6% for the 200 m medley (P > 0.05) and increased from 8.8% to 9.8% for the 400 m medley (P < 0.05). In freestyle, it increased from 8.8% to 10.7% in the 200 m, and from 7.8% to 9.4% in the 400 m (P < 0.01). The sex difference in international athletes remained unchanged at 11.1% ± 0.9% in the 200 m medley, 10.1% ± 0.8% in the 400 m medley, 10.0% ± 1.3% in the 200 m, and 9.2% ± 0.6% in the 400 m freestyle (P > 0.05). For the 400 m medley, the sex difference was lower compared to the 200 m medley for national (9.3% ± 0.8% vs 10.2% ± 0.6%, P = 0.01) and for international (10.1% ± 0.8% vs 11.1% ± 0.9%) athletes. For the 400 m freestyle, the sex difference was lower compared to the 200 m freestyle for national (7.9% ± 0.9% vs 9.3% ± 0.8%) and international (9.2% ± 0.6% vs 10.0% ± 1.3%) athletes (P < 0.01), and lower in the freestyle than the medley for the same distances (P < 0.01). Future studies should investigate the reasons for the greater sex difference in the medley than the freestyle.