Variability in Receptive Language Development Following Bilateral Cochlear Implantation.

OBJECTIVES: The primary aim was to investigate the variability in language development in children aged 5-7.5 years after bilateral cochlear implantation (CI) up to the age of 2 years, and any impact of the age at implantation and additional noncognitive or anatomical disorders at implantation. DESIGN: Data of 84 congenitally deaf children that had received simultaneous bilateral CI at the age of ≤ 24 months were included in this retrospective study. The results of language comprehension acquisition were evaluated using a standardized German language acquisition test for normal hearing preschoolers and first graders. Data on speech perception of monosyllables and sentences in quiet and noise were added. RESULTS: In a monosyllabic test, the children achieved a median performance of 75.0 ± 12.88%. In the sentence test in quiet, the median performance was 89 ± 12.69%, but dropped to 54 ± 18.92% in noise. A simple analysis showed a significant main effect of age at implantation on monosyllabic word comprehension (p < .001), but no significant effect of comorbidities that lacked cognitive effects (p = .24). Language acquisition values correspond to the normal range of children with normal hearing. Approximately 25% of the variability in the language acquisition tests is due to the outcome of the monosyllabic speech perception test. CONCLUSIONS: Congenitally deaf children who were fitted bilaterally in the 1st year of life can develop age-appropriate language skills by the time they start school. The high variability in the data is partly due to the age of implantation, but additional factors such as cognitive factors (e.g., working memory) are likely to influence the variability.

Hearing loss, depression, and cognition in younger and older adult CI candidates.

Background and Aim: Hearing loss in old age is associated with cognitive decline and with depression. Our study aimed to investigate the relationship between hearing loss, cognitive decline, and secondary depressive symptoms in a sample of younger and older cochlear implant candidates with profound to severe hearing loss. Methods: This study is part of a larger cohort study designated to provide information on baseline data before CI. Sixty-one cochlear implant candidates with hearing loss from adulthood onwards (>18 years) were enrolled in this study. All had symmetrical sensorineural hearing loss in both ears (four-frequency hearing threshold difference of no more than 20 dB, PTA). Individuals with primary affective disorders, psychosis, below-average intelligence, poor German language skills, visual impairment, and a medical diagnosis with potential impact on cognition (e.g., neurodegenerative diseases,) were excluded. Four-frequency hearing thresholds (dB, PTA, better ear) were collected. Using the Abbreviated Profile of Hearing Aid Benefit, we assessed subjective hearing in noise. Clinical and subclinical depressive symptoms were assessed with the Beck Depression Inventory (BDI II). Cognitive status was assessed with a neurocognitive test battery. Results: Our findings revealed a significant negative association between subjective hearing in noise (APHAB subscale "Background Noise") and BDII. However, we did not observe any link between hearing thresholds, depression, and cognition. Additionally, no differences emerged between younger (25-54 years) and older subjects (55-75 years). Unexpectedly, further unplanned analyses unveiled correlations between subjective hearing in quiet environments (APHAB) and cognitive performance [phonemic fluency (Regensburg Word Fluency), cognitive flexibility (TMTB), and nonverbal episodic memory (Nonverbal Learning Test), as well as subjective hearing of aversive/loud sounds (APHAB)], cognitive performance [semantic word fluency (RWT), and inhibition (Go/Nogo) and depression]. Duration of hearing loss and speech recognition at quiet (Freiburg Monosyllables) were not related to depression and cognitive performance. Conclusion: Impact of hearing loss on mood and cognition appears to be independent, suggesting a relationship with distinct aspects of hearing loss. These results underscore the importance of considering not only conventional audiometric measures like hearing thresholds but also variables related to hearing abilities during verbal communication in everyday life, both in quiet and noisy settings.

Do Not Go Gentle into That Deaf Night: A Holistic Perspective on Cochlear Implant Use as Part of Healthy Aging.

Research suggests that cochlear implant (CI) use in elderly people improves speech perception and health-related quality of life (HRQOL). CI provision could also prevent dementia and other comorbidities and support healthy aging. The aim of this study was (1) to prospectively investigate potential changes in HRQOL and speech perception and (2) to identify clinical action points to improve CI treatment. Participants (n = 45) were CI recipients aged 60-90 with postlingual deafness. They were divided into groups, according to age: Group 1 (n = 20) received a CI between the age of 60-70 years; group 2 (n = 25) between the age of 71-90 years. HRQOL and speech perception were assessed preoperatively, and three and twelve months postoperatively. HRQOL and speech perception increased significantly within one year postoperatively in both groups. No difference between groups was found. We conclude that CI treatment improves speech perception and HRQOL in elderly users. Improvement of the referral process for CI treatment and a holistic approach when discussing CI treatment in the elderly population could prevent auditory deprivation and the deterioration of cognitive abilities.

Subjective Voice Handicap and Vocal Tract Discomfort in Patients With Cochlear Implant.

OBJECTIVES: Changes in the auditory system, for example due to hearing impairment, can cause changes in breathing, phonation, and articulation. Aim of this study was to provide first data on subjective Voice Handicap and Vocal Tract Discomfort in subjects with hearing impairment and cochlear implant (CI) after initial fitting. STUDY DESIGN: Prospective cross-sectional study METHODS: A total of 111 participants (57 female and 54 male) between 20 and 85 years of age (mean = 58.21, SD = 14.96) were recruited between October 2019 and March 2020 from the Clinic of Otorhinolaryngology at Medical University of Hannover. Participants were tested after initial CI fitting, six weeks after implantation, using the German version of the VTD (Vocal Tract Discomfort) Scale and VHI (9i) (Voice Handicap Index) as well as speech comprehension tests and a specifically developed questionnaire evaluating data concerning voice usage and other influential factors. Statistics included descriptive analysis, group comparisons (t-Test), Pearson correlation coefficient between VTD Scale and VHI, and hearing status. RESULTS: Patients with CI did show low scores in VTD Scale and VHI-9i (VTD mean = 7.85 [SD = 10.4]; VHI-9i mean = 4.04 [SD = 5.77]). We found neither a correlation between any of the speech comprehension tests and the VTD Scale nor the VHI-9i. Further, we could show no correlation between subjective Voice Handicap and/or Vocal Tract Discomfort and age or the kind of treatment. CONCLUSION: Patients included in this study did not show more subjective Voice Handicap or Vocal Tract Discomfort than normal hearing peers. Scores of VTD Scale and VHI-9i did not depend on the duration of hearing loss, speech comprehension, kind of treatment or age.

Cochlear Implantation in Hearing-Impaired Elderly: Clinical Challenges and Opportunities to Optimize Outcome.

Cochlear implant (CI) overall provides a very good outcome, but speech comprehension outcome in the elderly is more variable. Several clinical factors play an important role. The management of residual hearing, the presence of comorbidities, and especially the progression of cognitive decline seem to be the clinical parameters that strongly determine the outcome of cochlear implantation and need to be discussed prospectively in the consultation process with the elderly hearing impaired. In the context of this review article, strategies for dealing with these will be discussed. Timely cochlear implantation should already be considered by hearing aid acousticians or practicing otolaryngologists and communicated or initiated with the patient. This requires intensive cooperation between hearing aid acousticians and experts in the clinic. In addition, residual hearing and comorbidities in the elderly need to be considered to make realistic predictions about speech comprehension with CI. Long-term aftercare and its different implementations should be discussed preoperatively, so that the elderly person with hearing impairments feels well taken care of together with his or her relatives. Elderly patients with hearing impairments benefit most from a CI in terms of speech comprehension if there is a large cochlear coverage (electrical or acoustic electrical) and the therapy is not hampered by comorbidities, especially cognitive decline.

CI decision making and expectations by older adults.

OBJECTIVE: To document and analyze the cochlear implant (CI) decision-making process of hearing-impaired older adults. The aim of this study is to assess what support could be helpful during this process in order to improve care delivery. METHODS: 32 older adult CI recipients (≥ 60 years) with severe to profound sensorineural hearing loss were interviewed about their CI decision-making process 3-12 months after obtaining their first CI. RESULTS: Minimal information was provided to CI candidates by hearing aid acousticians or patient associations. High to very high expectations were reported by patients concerning issues beyond hearing improvement per se. Even though not all expectations were fulfilled by the CI, nearly all recipients who used an implant for at least six months would recommend a CI to others. DISCUSSION: We identified an opportunity for those professionals to play a greater role in supporting older CI candidates during the decision-making process. It is desirable to establish a comprehensive network of hearing care professionals to collaborate with CI clinics. CONCLUSION: In order to support older patients adequately in deciding about CI, intensive training should be offered to hearing care professionals in order to provide realistic expectations and reduce fear and uncertainty about the implantation process. These topics need to be communicated in a professional manner and adapted to the candidate's age and personality.

Cochlear Implantation in Elderly Patients with Residual Hearing.

This retrospective study aimed to investigate the range of hearing levels in a cochlear implant (CI) elderly population receiving electric-acoustic-stimulation (EAS) or electric-stimulation (ES) alone. The investigation evaluates the degree of hearing preservation (HP) and the speech comprehension resulting from EAS or ES-only to identify audiometric factors that predict adequate EAS and ES use. We analyzed the pure tone audiometry and speech perception in quiet and noise preoperatively and 12-months after activation of 89 elderly adults (age of 65 years old or older), yielding in total 97 CIs. Thirty-two (33.1%) patients were potential EAS candidates preoperatively, of which 18 patients used EAS at the time of first fitting and the other 14 patients continued to use their residual hearing for EAS at 12-months. Post-treatment, patients with EAS system and ES-only users' with longer electrodes showed better results in monosyllable word scores in quiet than ES-only users with shorter electrodes. A similar trend was revealed for the speech recognition in noise. Patients with an EAS system benefit from maintaining their natural residual hearing. Nevertheless, strict preoperative patient selection is warranted particularly in elderly patients, in whom the hearing thresholds for EAS indication differ slightly from that in younger adults.

Can Cochlear Implantation in Older Adults Reverse Cognitive Decline Due to Hearing Loss?

INTRODUCTION: Older adults with late-onset hearing loss are at risk for cognitive decline. Our study addresses the question of whether cochlear implantation (CI) can counteract this potential influence. We investigated whether cognitive performance in older adults with severe and profound hearing loss improves 12 months after CI to a level comparable to controls with normal hearing, matched for age, sex, and education level. DESIGN: This cohort study was performed at two tertiary referral centers. The study included 29 patients, of age between 60 and 80 years, with adult-onset, severe to profound bilateral sensorineural hearing loss and indication for CI (study group), as well as 29 volunteers with age-adjusted hearing abilities, according to the norm curves of ISO-702 9:2000-01, (control group). Before CI and 12 months after CI, participants completed a neurocognitive test battery including tests of global cognition, verbal and figural episodic memory, and executive functions (attentional control, inhibition, and cognitive flexibility). RESULTS: Twelve months after CI, the performance of the study group improved significantly in global cognition, compared to the situation before CI. Differences in verbal episodic memory, figural episodic memory, and executive function were not significant. Moreover, the improvement of the study group was significantly larger only in global cognition compared to the control group. Noninferiority tests on the cognitive performances of the study group after CI revealed that comparable levels to normal hearing controls were reached only in global cognition, figural episodic memory (immediate recall), and attentional control. The improvement in global cognition was significantly associated with speech recognition 3 months after CI, but not with speech recognition 12 months after CI. CONCLUSION: One year after CI, cognitive deficits in older individuals with adult-onset hearing loss, compared to normal-hearing peers, could only improve some cognitive skills.

Auditory performance in a group of elderly patients after cochlear implantation.

PURPOSE: The retrospective case review investigated the effect of cochlear implantation in subjects aged 61 years or older with respect to their auditory performance. The study also analysed the effect of age on the performance, and it drew a comparison between the outcomes of older and younger adults. METHODS: The outcome in a group of 446 patients aged 61 to 89 years at the time of unilateral cochlear implantation was compared with the outcome in a group of 110 patients aged 17 to 42 years. Auditory performance was measured with open-set monosyllabic word testing and sentences in quiet and in noise. RESULTS: In the monosyllabic word recognition test, the group of older adults performed significantly better after cochlear implantation compared with their scores prior to implantation (p < 0.001; r = 0.59). Their auditory performance correlated negatively with their age. However, the correlation was of small strength. Significant differences in auditory performance were detected between sexagenarians and octogenarians (p < 0.001; r = 0.27). Additionally, a statistically significant difference was revealed between the groups of older and younger adults in the monosyllabic word test (p = 0.001; r = 0.15). CONCLUSION: Elderly cochlear implant recipients can benefit significantly from cochlear implantation. Although higher age correlates negatively with auditory performance, its influence in the presented sample is small.

Hidden Electrode Failure in a Cochlear Implant User.

When the impedance of an electrode contact is highly increased in a cochlear implant, a failure of the appropriate electrode seems obvious. We present a case where impedances of some electrodes were at the lower edge of the normal range and not regarded as suspicious neither by the clinical fitting software nor by in-vivo tests conducted by the implant manufacturer. However, speech comprehension was substantially degraded and sound perception distorted. Also, on the affected electrodes, loudness perception was compromised and responses of the electrically evoked compound action potential were no longer measureable. After re-implantation, the subjective sound percept was clear again and speech comprehension scored much better than before. Later, inspection of the explant revealed shorts on the device and the implant was classified as device failure. Our case shows the importance of collecting longitudinal data of cochlear implant patients, i.e. device related technical measurements and hearing performance data, and the consideration of all these data in cases of patient complaints or suspected implant failures. Laryngoscope, 131:E1275-E1278, 2021.

[Diagnosis and Therapy of Hearing Impairment and Cochlear Implant in Migrants in Germany]. / Diagnostik und Therapie von Schwerhörigkeit inkl. Cochlea-Implantat bei Migranten in Deutschland.

In addition to medical issues, the medical care of migrants is an administrative and regulatory challenge. Although it seems to be complicated, comprehensible and legal requirements and professional administrative structures are available 1. Often discussed by physicians and the media is the assumption that the medical care will be decided not by the medical professionals but the administrative authorities 2.In this paper the legal requirements are exemplified and out of the experiences of the authors, the requirements within the clinical routine work with the migrants highlighted.

Speech Perception, Dichotic Listening, and Ear Advantage in Simultaneous Bilateral Cochlear Implanted Children.

OBJECTIVE: To study the development of dichotic listening, ear advantage, and speech perception in cochlear implant (CI) recipients using five audiometric tests. STUDY DESIGN: Prospective cohort analysis. SETTING: University Hospital. PATIENTS: One hundred twenty one participants who received simultaneous bilateral CIs and had at least 12 months of regular bilateral CI use. Age at time of testing ranged from 4 to 18 years with a mean age of 9 years (standard deviation [SD]: 3.0). Mean duration of CI use was 7.073 years (SD: 2.86). INTERVENTION: Bilateral simultaneous cochlear implantation. MAIN OUTCOME MEASURE: Goettinger and Freiburger monosyllabic word test, Hochmair, Schulz and Desoyer sentence (HSM) test in noise and in quiet conditions and the dichotic listening test by Uttenweiler were applied according to the childrens' age. The results were evaluated using a two-sided t test for dependent samples. RESULTS: In all tests applied, we could not show significant differences in performance between left and right CI and therefore could not demonstrate an ear advantage. Dichotic listening was challenging, only one subject produced results required for normal hearing subjects to pass the test. The older the CI recipients get and duration of CI use increases, the more results in all speech perception tests improve. CONCLUSIONS: Our results cannot lend further support to the existence of ear advantage in CI recipients. We do not recommend the Uttenweiler dichotic listening test to determine lateralization. Further research to gather more information on dichotic listening and ear advantage in CI recipients is necessary and should use consonant-vowel stimuli as more comparable stimuli.

Cognition in older adults with severe to profound sensorineural hearing loss compared to peers with normal hearing for age.

Objective: Cognitive performance of older adults with severe to profound sensorineural hearing loss and indication for cochlear implantation was evaluated compared to peers with age appropriate hearing.Design: Prospective matched case control study.Study sample: Study group consisted of n = 30 patients aged between 60 and 80 years, with adult onset, severe to profound sensorineural hearing loss on both sides and indication for cochlear implantation. Matched control group consisted of n = 30 peers with age-adjusted hearing abilities, based on age- appropriate norms.Results: Differences in Constructional Praxis and Recall, Trail Making Test A and Stroop were not significant between both groups. However, the differences in Clock Drawing Test, Word Lists and Trail Making Test B were significant. The impairment in TMT B (cognitive flexibility) was mediated via the severity of depressive problems. Cognitive performance was not related to word recognition, the percentage and duration of hearing loss and hearing aid use.Conclusion: Severely hearing-impaired older adults show widespread impairments in cognitive performance.

The Optimal inter-implant interval in pediatric sequential bilateral implantation.

An increasing number of children receive bilateral cochlear implants (CIs) sequentially. Outcomes of bilateral implantation show high variability. This retrospective analysis investigates the optimal inter-implant interval. For this purpose, speech comprehension results of 250 children who underwent sequential bilateral cochlear implantation were evaluated. All individuals underwent periodic speech perception testing in quiet and noise. The most recent unilateral data for each side were statistically analyzed. Speech test outcomes were evaluated with reference to age at first implantation and interval between implantations. A statistically significant difference for speech test performance was obtained between the first-implanted ear and the second-implanted ear for all children (expressed as a mean). These outcomes were dependent on the inter-implant interval. There was a significant correlation (r = - 0.497; p = 0.000) between speech test results and the inter-implant interval. Nevertheless, one subgroup of 27 children had the same or better results for the second side as compared with the first. In conclusion, the evaluation of the inter-implant interval and age groups at first implantation showed a preferred interval of up to four years in children under the age of 4 at first implantation. The older the children were at first implantation, the shorter the inter-implant interval had to be. It is as a direct consequence of this interval that children for whom it was longer were also older.

Evaluation of pediatric cochlear implant care throughout Europe: Is European pediatric cochlear implant care performed according to guidelines?

OBJECTIVES: International guidelines indicate that children with profound hearing loss should receive a cochlear implant (CI) soon after diagnosis in order to optimize speech and language rehabilitation. Although prompt rehabilitation is encouraged by current guidelines, delays in cochlear implantation are still present. This study investigated whether European countries establish timely pediatric CI care based on epidemiological, commercial, and clinical data. METHODS: An estimation of the number of pediatric CI candidates in European countries was performed and compared to epidemiological (Euro-CIU), commercial (Cochlear®), and clinical (institutional) age-at-implantation data. The ages at implantation of pediatric patients in eight countries (the Netherlands, Belgium, Germany, the United Kingdom, France, Turkey, Portugal, and Italy) between 2005 and 2015 were evaluated. RESULTS: From 2010 onwards, over 30% of the pediatric CI candidates were implanted before 24 months of age. Northern European institutions implanted children on average around 12 months of age, whereas southern European institutions implanted children after 18 months of age. The Netherlands and Germany implanted earliest (between 6 and 11 months). DISCUSSION: Implemented newborn hearing screening programs and reimbursement rates of CIs vary greatly within Europe due to local, social, financial, and political differences. However, internationally accepted recommendations are applicable to this heterogeneous European CI practice. Although consensus on early pediatric cochlear implantation exists, this study identified marked delays in European care. CONCLUSION: Regardless of the great heterogeneity in European practice, reasons for latency should be identified on a national level and possibilities to prevent avoidable future implantation delays should be explored to provide national recommendations.

Cochlear implant effectiveness in postlingual single-sided deaf individuals: what's the point?

OBJECTIVES: By extending the indication criteria for cochlear implants (CI), the population of CI candidates increased in age, as well as range and type of hearing loss. This qualitative study identified factors that contributed to seek CI treatment in single-sided deaf individuals and gained insights how single-sided deafness (SSD) and hearing with a CI affect their lives. DESIGN: An open-ended questionnaire and a standardised inventory (IOI-HA) were used. Qualitative data reflecting the reasons to seek CI treatment and the individual experiences after CI switch-on were collected. STUDY SAMPLE: A total of 19 postlingually deafened single-sided deaf CI users. RESULTS: Participants use their CI daily and stated that their life satisfaction increased since CI activation. The analysis of the qualitative data revealed four core categories: sound localisation, tinnitus and noise sensitivity, fear to lose the second ear and quality of life. CONCLUSIONS: Our results show how strongly and diversely quality of hearing and quality of life is affected by acquired SSD and improved after CI activation. Our data suggest that the fear of hearing loss (HL) on the normal hearing (NH) ear is an important but so far neglected reason to seek treatment with a CI in individuals with postlingual SSD.

Investigation of the effect of cochlear implant electrode length on speech comprehension in quiet and noise compared with the results with users of electro-acoustic-stimulation, a retrospective analysis.

OBJECTIVES: This investigation evaluated the effect of cochlear implant (CI) electrode length on speech comprehension in quiet and noise and compare the results with those of EAS users. METHODES: 91 adults with some degree of residual hearing were implanted with a FLEX20, FLEX24, or FLEX28 electrode. Some subjects were postoperative electric-acoustic-stimulation (EAS) users; the other subjects were in the groups of electric stimulation-only (ES-only). Speech perception was tested in quiet and noise at 3 and 6 months of ES or EAS use. Speech comprehension results were analyzed and correlated to electrode length. RESULTS: While the FLEX20 ES and FLEX24 ES groups were still in their learning phase between the 3 to 6 months interval, the FLEX28 ES group was already reaching a performance plateau at the three months appointment yielding remarkably high test scores. EAS subjects using FLEX20 or FLEX24 electrodes outscored ES-only subjects with the same short electrodes on all 3 tests at each interval, reaching significance with FLEX20 ES and FLEX24 ES subjects on all 3 tests at the 3-months interval and on 2 tests at the 6- months interval. Amongst ES-only subjects at the 3- months interval, FLEX28 ES subjects significantly outscored FLEX20 ES subjects on all 3 tests and the FLEX24 ES subjects on 2 tests. At the-6 months interval, FLEX28 ES subjects still exceeded the other ES-only subjects although the difference did not reach significance. CONCLUSIONS: Among ES-only users, the FLEX28 ES users had the best speech comprehension scores, at the 3- months appointment and tendentially at the 6 months appointment. EAS users showed significantly better speech comprehension results compared to ES-only users with the same short electrodes.

Long-Term Outcomes, Education, and Occupational Level in Cochlear Implant Recipients Who Were Implanted in Childhood.

OBJECTIVES: To document the long-term outcomes of auditory performance, educational status, vocational training, and occupational situation in users of cochlear implants (CIs) who were implanted in childhood. DESIGN: This retrospective cross-sectional study of 933 recipients of CIs examined auditory performance, education and vocational training, and occupational outcomes. All participants received their first CI during their childhood between 1986 and 2000. Speech comprehension results were categorized using the categories of auditory performance (CAP) arranged in order of increasing difficulty ranging from 0 to 8. 174 of the 933 pediatric recipients of CIs completed a self-assessment questionnaire regarding their education and occupational outcomes. To measure and compare school education, qualifications were converted into International Standard Classification of Education levels (ISCED-97). Occupations were converted into International Standard Classification of Occupation-88 skill levels. Data from the German General Social Survey (Allgemeine Bevölkerungsumfrage der Sozialwissenschaften/ALLBUS) for 2012 were used as a basis for comparing some of the collected data with the general population in Germany. RESULTS: The results showed that 86.8% of the 174 participants who completed the survey used their devices more than 11 hr per day. Only 2% of the surveyed individuals were nonusers. Median CAP was 4.00 (0 to 8). Age at implantation was significantly correlated with CAP level (r = -0.472; p < 0.001). The mean ISCED level of the 174 surveyed recipients was 2.24 (SD = 0.59; range: 1 to 3). A significant difference (p = 0.001) between users' ISCED levels and those of respondents was found. Participants' ISCED levels and maternal educational levels were significantly correlated (r = 0.271; p = 0.008). The International Standard Classification of Occupation-88 skill levels were as follows: 5% achieved skill level 1; 77% skill level 2; 16% skill level 3; and 5% skill level 4. The average skill level achieved was 2.24 (range 1 to 4; SD = 0.57) which was significantly poorer (t(127) = 4.886; p = 0.001) than the mean skill level of the respondents (mean = 2.54; SD = 0.85). CONCLUSIONS: Data collection up to 17.75 (SD = 3.08; range 13 to 28) years post implant demonstrated that the majority of participants who underwent implantation at an early age achieved discrimination of speech sounds without lipreading (CAP category 4.00). Educational, vocational, and occupational level achieved by this cohort were significantly poorer compared with the German and worldwide population average. Children implanted today who are younger at implantation, and with whom more advanced up-to-date CIs are used, are expected to exhibit better auditory performance and have enhanced educational and occupational opportunities. Compared with the circumstances immediately after World War II in the 20th century, children with hearing impairment who use these implants have improved prospects in this regard.

Speech intelligibility and subjective benefit in single-sided deaf adults after cochlear implantation.

Treatment with cochlear implants (CIs) in single-sided deaf individuals started less than a decade ago. CIs can successfully reduce incapacitating tinnitus on the deaf ear and allow, so some extent, the restoration of binaural hearing. Until now, systematic evaluations of subjective CI benefit in post-lingually single-sided deaf individuals and analyses of speech intelligibility outcome for the CI in isolation have been lacking. For the prospective part of this study, the Bern Benefit in Single-Sided Deafness Questionnaire (BBSS) was administered to 48 single-sided deaf CI users to evaluate the subjectively perceived CI benefit across different listening situations. In the retrospective part, speech intelligibility outcome with the CI up to 12 month post-activation was compared between 100 single-sided deaf CI users and 125 bilaterally implanted CI users (2nd implant). The positive median ratings in the BBSS differed significantly from zero for all items suggesting that most individuals with single-sided deafness rate their CI as beneficial across listening situations. The speech perception scores in quiet and noise improved significantly over time in both groups of CI users. Speech intelligibility with the CI in isolation was significantly better in bilaterally implanted CI users (2nd implant) compared to the scores obtained from single-sided deaf CI users. Our results indicate that CI users with single-sided deafness can reach open set speech understanding with their CI in isolation, encouraging the extension of the CI indication to individuals with normal hearing on the contralateral ear. Compared to the performance reached with bilateral CI users' second implant, speech reception threshold are lower, indicating an aural preference and dominance of the normal hearing ear. The results from the BBSS propose good satisfaction with the CI across several listening situations.

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.