Assessment of Binaural Benefits in Hearing and Hearing-Impaired Listeners.

PURPOSE: The purpose of this study was to (a) investigate which speech material is most appropriate as stimulus in head shadow effect (HSE) and binaural squelch (SQ) tests, (b) obtain normative values of both tests using the material decided to be optimal, and (c) explore the results in bilateral cochlear implant (CI) users. METHOD: Study participants consisted of 30 normal-hearing (NH) persons and 34 bilateral CI users. This study consisted of three phases. In the first phase, three different speech materials (1) monosyllabic words, (2) spondee words, and (3) sentences were compared in terms of (a) effect size, (b) test-retest reliability, and (c) interindividual variability. In the second phase, the speech material selected in the first phase was used to test a further 24 NHs to obtain normative values for both tests. In the third phase, tests were administered to a further 23 bilateral CI users, together with localization test and the Speech, Spatial, and Qualities of Hearing scale. RESULTS: The results of the first phase indicated that spondees and sentences were more robust materials compared with monosyllables. Although the effect size and interindividual variability were comparable for spondees and sentences, sentences had higher test-retest reliability in this sample of CI users. With sentences, the mean (± standard deviation) HSE and SQ in the NH group were 58 ± 14% and 22 ± 11%, respectively. In the CI group, the mean HSE and SQ were 49 ± 13% and 13 ± 14%, respectively. There were no statistically significant correlations between the test results and the interval between the implantations, the length of binaural listening experience, or the asymmetry between the ears. CONCLUSIONS: Sentences are preferred as stimulus material in the binaural HSE and SQ tests. Normative data are given for HSE and SQ with the LiCoS (linguistically controlled sentences) test. HSE is present for all bilateral CI users, whereas SQ is present in approximately seven out of 10 cases.

Speech Perception and Sound Localization Skills in Inner Ear Malformations: Children With Incomplete Partition Type-II.

OBJECTIVE: The present study aimed to evaluate binaural auditory skills in bimodal and bilateral pediatric cochlear implant (CI) users with incomplete partition type-II (IP-II) and to reveal the effect of IP-II on performance by comparing the results to pediatric CI users with normal cochlear morphology. STUDY DESIGN: Cross-sectional study. SETTING: Tertiary referral center. METHODS: Forty-one CI users (mean age 8.8 ± 1.9) were grouped as bimodal (BIM-IP) and bilateral (BIL-IP) users with IP-II; bimodal (BIM-N) and bilateral (BIL-N) users with normal cochlear anatomy. Speech perception in noise and sound localization skills were compared under 2 conditions; binaural (bilateral or bimodal) and monaural (first CI alone). RESULTS: BIM-IP and BIL-IP showed no performance difference in binaural tasks. The BIM-N group showed remarkably poor performance in comparison to the groups of BIL-IP (p = .007), BIM-IP (p < .001), and BIL-N (p = .004) in terms of speech-in-noise skills. In sound localization abilities, similar significant differences were found between the group of BIM-N and the groups of BIL-IP (p = .001), BIM-IP (p < .001), and BIL-N (p = .004). All groups showed statistically significant improvements in binaural condition on both tasks (p < .05). CONCLUSION: We revealed that bilateral and bimodal pediatric CI users with IP-II benefitted from implantation as much as bilateral users with normal anatomy. Differences in residual hearing between groups may explain the poor performance of bimodal users with normal cochlear morphology. To the best of our knowledge, it is the first study to unveil binaural performance characteristics in children diagnosed with a specific inner ear malformation subgroup.

Validity, Discriminative Ability, and Reliability of the Turkish Hearing-Related Quality of Life Questionnaire for Children and Adolescents.

PURPOSE: The aim of this study was to translate the versions of the Hearing Environments and Reflection on Quality of Life (HEAR-QL) into Turkish and investigate the validity and reliability of the Turkish 26-item HEAR-QL (HEAR-QL-26) for children and Turkish 28-item HEAR-QL (HEAR-QL-28) for adolescents. METHOD: The protocol included translation into Turkish and linguistic adaptation. The HEAR-QL-26 and HEAR-QL-28, respectively, were administered to 249 children (130 with hearing loss, 119 without hearing loss) and 249 adolescents (140 with hearing loss, 109 without hearing loss) between the ages of 8 and 18 years. To determine the internal consistency (reliability) of the Turkish HEAR-QL scale, Cronbach's alpha coefficient (α) was calculated for the subcategories and the total score. We measured the construct validity of the Turkish HEAR-QL-26 and HEAR-QL-28 using Pearson r correlation coefficients comparing the Turkish HEAR-QL and the Turkish Child and Adolescent Quality of Life Scale (PedsQL). RESULTS: The reliability for both children and adolescents (Cronbach's alpha = .973 for HEAR-QL-26 and .977 for HEAR-QL-28) was high, and test-retest reliability showed strong to excellent correlations (intraclass correlation coefficient = .980 and .979, respectively) for the total scores. In terms of known-group validity, the total HEAR-QL mean scores were lower for participants with hearing loss than for children/adolescents with normal hearing (p < .05). Confirmatory factor analysis showed that the number of original items was sufficient in the Turkish version. Both HEAR-QL versions provided a higher area under the curve (AUC = .984 and .972, respectively) than the PedsQL (AUC = .773 and .581, respectively). CONCLUSION: The Turkish versions of the HEAR-QL-26 child and HEAR-QL-28 adolescent questionnaires are sensitive, reliable, and valid measurement tools to evaluate the hearing-related quality of life in children and adolescents aged between 8 and 18 years.

Evaluation of the non-auditory responses in individuals with auditory brainstem implant.

OBJECTIVES: After auditory brainstem implant (ABI) surgery, stimulation of certain cranial nerves may result in a non-auditory response, and the electrodes that stimulate these nerves may be deactivated. The goals of this study are to compare the number of active electrodes in the initial activation and the last fitting, to investigate non-auditory response types and their frequency as a result of non-auditory stimulation, to compare the placements of deactivated electrodes as a result of non-auditory stimulation in the initial activation and the last fitting. METHODS: The computer software system was used to perform a retrospective analysis of the fitting data of 69 ABI users who underwent auditory brainstem implant surgery between January 1997 and January 2019. The non-auditory response types, deactive electrodes, and the positioning of the deactive electrodes horizontally and vertically were recorded in these users during the initial activation and the last fitting. RESULTS: There was no statistically significant difference between the number of active electrodes in the initial activation and the last fitting. The proportion of the users with deactive electrodes in the initial activation and the last fitting was not statistically significant different. In the horizontal and vertical placement classification, the placement of the deactive electrodes was not statistically different between initial activation and last fitting. The most common type of non-auditory response was facial nerve stimulation at the initial activation and no auditory perception at the last fitting. According to the difference between the number of active and deactive electrodes in the initial activation and the last fitting, as well as the auditory and non-auditory responses, it was found that the ABI users were statistically different between the initial activation and the last fitting. CONCLUSION: The results of this study show that not only auditory but also non-auditory responses occur in most ABI users. In addition, to the best of our knowledge, this study is the first to examine the frequencies of non-auditory response types, and the placement of the electrodes that cause these responses according to horizontal and vertical classifications.

Views of Syrian Mothers in Ankara on Infant Hearing Loss: Cross-sectional Survey.

BACKGROUND: Mothers' awareness of hearing loss, its risk factors, and available detection and intervention choices have been well known to play an essential role in the early detection and intervention of hearing loss. OBJECTIVE: To investigate the knowledge and attitude of Syrian mothers toward infant hearing loss, early identification, and intervention. METHODS: The "Maternal Views on Infant Hearing Loss" questionnaire was adapted and translated into Arabic and then administered to 100 Syrian mothers living in different neighborhoods in Ankara within the age range of 18-68 years old. The internal consistency for the main domains of the questionnaire was tested by Cronbach's alpha coefficient. Descriptive statistics and Spearman's rank correlation coefficient were used to evaluate the responses. RESULTS: The highest level of knowledge about the risk factors was about noise exposure (76%), while the lowest level of knowledge was about jaundice (25%). While 98% of the mothers had a positive attitude toward early detection, 97% of them did not mind the early intervention. CONCLUSIONS: The present findings showed the need to improve mothers' awareness about infant hearing loss risk factors, available detection, and intervention. Such results may help in performing programs that aim to increase awareness about hearing loss.

Hearing-related quality of life assessment of pediatric cochlear implant users with inner ear malformations.

OBJECTIVES: To assess the quality of life (QoL) in child and adolescent cochlear implant users with inner ear malformations (IEM) and to compare their outcomes to their cochlear implant using peers with normal inner ear structures. METHODS: The present sample consisted of 100 children (45 with IEM, 55 without IEM) and 100 adolescents (46 with IEM, 54 without IEM). The following QoL questionnaires were used to assess the hearing-related QoL: The Hearing Environments and Reflection on Quality of Life 26 (HEAR-QL-26 for children between 7 and 12 years of age) and HEAR-QL-28 (for adolescents between 13 and 18 years of age). Both questionnaires were based on a 5-points Likert scale from 0 to 4, with higher scores indicating a better perception of QoL. The scores were converted to percentage values (never = 100, almost never = 75, sometimes = 50, often = 25, almost always = 0). RESULTS: For the patients with IEM, mean scores from the HEAR-QL-26 and HEAR-QL-28 were 50.4 (SD = 18.9) and 54.5 (SD = 19.6), respectively. For the patients without IEM, mean scores from the HEAR-QL-26 and HEAR-QL-28 were 72.7 (SD = 18.0) and 65.0 (SD = 19.1), respectively. For both child and adolescent subgroups, statistically significant differences were observed between QoL scores from patients with and without IEM (p < 0.001). There were no statistically significant effects of the malformation type on the QoL findings (p ≥ 0.05). CONCLUSION: Child and adolescent cochlear implant users with IEM had significantly lower scores on validated HEAR-QL versions in comparison to their implanted peers without IEM.

Auditory perception in pediatric cochlear implant users with cochlear nerve hypoplasia.

OBJECTIVES: The objectives of this study were to assess auditory perception and speech intelligibility outcomes in children with cochlear nerve (CN) hypoplasia who received cochlear implants (CIs) using Categories of Auditory Performance II (CAP II) and Speech Intelligibility Rating (SIR) scales. METHODS: In total, 40 children who received CI and who were aged between 3 and 18 years were included in this study. The study group included 20 children with CN hypoplasia at least one ear, while the control group included 20 children with normal cochleas and cochlear nerve structures. All children in the study and control groups who participated were evaluated using the CAP II and the SIR scale. Demographic data were collected. RESULTS: Significant differences were found between the study and control groups' CAP II and SIR scores (p < 0.001). It was found that CAP II scores were positively correlated with SIR scores in the study (r = 0.743, p < 0.001) and control (r = 0.601, p < 0.001) groups. In the study group, significant negative correlations were found between SIR scores and age at implantation (r = -0.674, p = 0.004) and between CAP II scores and age at implantation (r = 0.751, p = 0.003). In the control group, a significant negative correlation was found between age at implantation and CAP II scores (r = -0.805, p = 0.001). Similarly, a significant negative correlation was found between age at implantation and SIR scores (r = -0.702, p = 0.007). CONCLUSION: Even for children with severe inner ear malformation and CN hypoplasia, CI is an effective treatment modality for auditory perception and speech production. However, it should be noted that CN hypoplasia affects auditory performance negatively in children with CI.

Pediatric cochlear implant fitting parameters in inner ear malformation: Is it same with normal cochlea?

OBJECTIVES: The aim was to evaluate the cochlear implant (CI) mapping parameters of CI users with inner ear malformation (IEM) and to reveal the changes in parameters over time. METHODS: In total, 118 CI users were included with 127 ears (68-IEM; 59-normal cochlear anatomy) in present retrospective study. The impedance measurements, thresholds levels-THR, most comfortable levels- MCL, pulse width-PW and rate values were analyzed in both IEM and control group at the initial activation, 6th,12th and 24th months postoperatively. RESULTS: There were statistically significant differences in impedance measurements in several time points. And also, there was a remarkable difference in THR & MCL and PW values between IEM and control groups in all time points (p < 0.05). THR & MCL levels and PW values increased significantly between all time periods in both groups (p < 0,008) and values of parameters in IEM-group were higher than those of control group. When comparing rates, statistically significant difference was observed only at the initial activation in both within (p < 0.001) and between groups (p = 0.03). CONCLUSION: Pediatric CI users with IEM need individual changes in fitting parameters. More frequent map sessions should be planned as they require more PW, THR and MCL increase over time. The increase rate differs between IEM subgroups depending on the deviation of malformation from the normal cochlear anatomy. This study is the first to in its attempt to reveal the mapping characteristics and long-term changes in pediatric CI users with different IEM subgroups.

Effects of cognitive tasks on eye movements.

Eye movements are guided by vestibular and visual information. The vestibulo-ocular knowledge of the vestibule includes eye movements in the opposite direction of head movements. This study investigated the effect of auditory "what" and "where" tasks on the visual "where" to evaluate the effects of cognitive tasks on eye movements. All subjects underwent testing with videonystagmography (VNG). The VNG battery of saccade and tracking oculomotor tests were performed. The study design was planned in three stages: (1) without any cognitive tasks, eye movements were recorded with VNG, (2) participants were asked to tell "what" sound they heard during VNG recording, and (3) the subject was asked to tell from what direction, or "where," the sound had come from during VNG recording. Providing individuals with a cognitive task changed the test results negatively in all parameters. Giving cognitive tasks to individuals spoils all VNG parameters. The VNG oculomotor tests are affected by the dual tasks. Daily tasks such as sound object localization and recognition have a significant effect on scanning the visual environment in daily life such as during driving or walking in a crowded environment.

Factors affecting phoneme discrimination in children with sequential bilateral cochlear implants.

OBJECTIVES: To investigate the effects of a number of variables on phoneme discrimination (PD) performance in children with sequential bilateral cochlear implants (SeqBiCIs) and compare PD performance between the 2 implantation sides and between children with bilateral cochlear implants (BiCIs) and their age-matched peers with normal hearing (NH). DESIGN: All participants completed the Auditory Speech Sound Evaluation Phoneme Discrimination Test. STUDY SAMPLE: The sample included 23 children with SeqBiCIs as the study group and 23 with NH as the control group. RESULTS: A significant difference was found between the scores of the two groups under the CI1 and CI2 conditions (p = 0.001), CI1 and BiCI conditions (p = 0.002), and CI2 and BiCI conditions (p = 0.001). PD scores with CI1 significantly depend on age at CI1 and duration of bilateral use. PD scores with CI1 were significant predictors of PD performance with CI2. Duration of BiCI use was a significant predictor of PD scores with BiCI. CONCLUSIONS: The age at CI1 and the duration of bilateral cochlear implant use were found to improve phoneme discrimination performance in children with a sequential bilateral cochlear implant. According to the success of the CI1, it is possible to predict the success of CI2 use.

Revision Surgery for Pediatric Nontumor Auditory Brainstem Implant Users: Audiological, Rehabilitative, and Surgical Outcomes.

OBJECTIVE: To report the audiological, rehabilitative, and surgical outcomes of revision surgery for pediatric auditory brainstem implant (ABI) users. STUDY DESIGN: Retrospective cohort. SETTING: Tertiary referral center. PATIENTS: Five pediatric ABI users who had revision surgery for device malfunctions. INTERVENTIONS: Revision surgery for ABI malfunctions. MAIN OUTCOME MEASURES: The findings of free-field audiometry with the device, the Meaningful Auditory Integration Scale, and the pattern discrimination, word identification, sentence recognition, and expressive and receptive language tests before the device failure and after revision surgery were obtained from the patient records and compared. RESULTS: The revision rate for pediatric ABI was 6.45%. The Meaningful Auditory Integration Scale and expressive-receptive language scores showed improvements following revision surgery, while the aided thresholds, pattern perception, and word identification scores did not change. Individual differences in performance for these measures were observed. CONCLUSION: Equal or improved performance after the revision surgeries in the current study showed that revision surgery is successful and important for pediatric ABI users. It is essential to consider remedying the loss of auditory input in sensitive periods of pediatric development.

Auditory perception skills in children receiving simultaneous bilateral cochlear implants: early speech-discrimination results.

PURPOSE: The objective of the present study is to evaluate early speech-perception abilities using VRISD in toddlers who received simultaneous bilateral CIs between 12 and 36 months of age and to compare them with the findings in NH infants and to monitor the development of speech-perception skills within 6 months after cochlear implantation. METHODS: The VRISD test was performed using video visual reinforcement to assess speech-discrimination ability in the CI and NH groups. Four stimuli were used for testing in the present study: /a/, /i/, /ba/, and /da/. The two contrasts used for the research were /a-i/ and /ba-da/. Auditory and listening skills in the CI group were assessed using the IT-MAIS. RESULTS: The responses to the /a-i/ and /ba-da/ phoneme contrast were found to be similar in the NH and CI groups. No statistically significant difference was found between the groups (p > 0.05). VRISD test result and the IT-MAIS score were highly correlated in CI group (p = 0.001, r = 0.822). CONCLUSION: The VRISD test can be effectively used to evaluate the development of speech-discrimination skills in hearing-impaired babies before and after CI. This research suggests that the development of speech-perception ability with CI is seriously influenced by environmental exposure and sound access. To the best of our knowledge, this is the first study to evaluate the speech-perception skills in toddlers with simultaneous bilateral CI.

Social competence in children with cochlear implants: is it possible to catch up with their peers?

PURPOSE: The objective of this study is to compare social competence skills in children with CI and their normal hearing peers. METHODS: Forty-six children with normal hearing and 46 children with CI between the ages of 42 and 72 months were included in the control group and study group, respectively. Preschool teachers rated children's social competence in the classroom using the Social Competence and Behavior Evaluation-Preschool Edition. Three subscales constitute the structure of the SCBE-30 scale: anger-aggression, social competence, and anxiety-withdrawal. RESULTS: The analyses showed that there were statistically significant differences between social competence scores of the study group and the control group. However, there was no statistically significant difference between anger-aggression scores and anxiety-withdrawal scores of the study group and the control group. There was a significant correlation found between anger-aggression score and the age of starting rehabilitation. CONCLUSION: Anger-aggression scores and anxiety-withdrawal scores were similar between children using cochlear implant and normal hearing peers, whereas children with CI show lower social competence abilities than normal hearing peers. Earlier beginning to the rehabilitation programs coincide with lower anger-aggression scores. To the best of our knowledge, this is the first study to reflect these findings more objectively, from the view of teachers.

Evaluation of the postural balance and visual perception in young adults with acute sleep deprivation.

BACKGROUND/OBJECTIVE: Few studies have suggested a relationship between vestibular system and sleep deprivation. The aim of the present study is to investigate the effects of acute sleep deprivation lasting 24 hours or more on the postural balance and the visual abilities related to the vestibular system in healthy young adults. METHODS: Thirty-one healthy young adults (8 males, 23 female; ages 18- 36 years) who had experienced at least 24 hours of sleep deprivation were included in the study. Subjects made two visits to the test laboratory. One visit was scheduled during a sleep deprivation (SD) condition, and the other was scheduled during a daily life (DL) condition. Five tests- the Sensory Organization Test (SOT), Static Visual Acuity Test (SVA), Minimum Perception Time Test (mPT), Dynamic Visual Acuity Test (DVA), and Gaze Stabilization Test (GST)- were performed using a Computerized Dynamic Posturography System. RESULTS: A statistically significant difference was found between SD and DL measurements in somatosensorial (p = 0.003), visual (p = 0.037), vestibular (p = 0.008) ratios, and composite scores (p = 0.001) in SOT. The mPT results showed a statistically significant difference between SD and DL conditions (p = 0.001). No significant difference was found between SD and DL conditions in the comparison of the mean SVA (p = 0.466), DVA (p = 0.192), and GST head velocity values (p = 0.160). CONCLUSIONS: Sleep deprivation has a considerable impact on the vestibular system and visual perception time in young adults. Increased risk of accidents and performance loss after SD were thought to be due to the postural control and visual processing parameters rather than dynamic visual parameters of the vestibular system.

Simultaneous Cochlear and Auditory Brainstem Implantation in Children With Severe Inner Ear Malformations: Initial Surgical and Audiological Results.

OBJECTIVE: To report the initial surgical and audiological outcomes of three pediatric patients with severe inner ear malformations who were simultaneously implanted with cochlear and brainstem implants in the same surgical session. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Three pediatric patients with severe inner ear malformations between ages of 1.9 to 2.5 years, who were simultaneously implanted with cochlear implant in one ear and auditory brainstem implant in the other ear. INTERVENTION(S): Simultaneous application of cochlar implant in one ear, auditory brainstem implant in the other ear. MAIN OUTCOME MEASURES: Free field thresholds with cochlear and brainstem implants. Surgical issues are also discussed. RESULTS: The study is descriptive in nature. Free field thresholds with each device alone and together showed good progress. One of the patients had slower progress possibly due to comorbid CHARGE syndrome. CONCLUSIONS: The results showed good progress in terms of audition with both devices. Simultaneous cochlear and brainstem application serves as a remedy for pediatric patients who are candidates for cochlear implant on one side and brainstem implant on the other side. With this simultaneous application precious time for auditory development is not lost.

Bimodal stimulation in children with inner ear malformation: One side cochlear implant and contralateral auditory brainstem implant.

OBJECTIVE: To determine audiological outcomes of children who use a cochlear implant (CI) in one ear and an auditory brainstem implant (ABI) in the contralateral ear. DESIGN: Retrospective case review. SETTING: Tertiary referral hospital. PARTICIPANTS: Twelve children followed with CI and contralateral auditory brainstem implant (ABI) by Hacettepe University Department of Otorhinolaryngology and Audiology in Turkey. All children were diagnosed with different inner ear malformations with cochlear nerve aplasia/hypoplasia. CI was planned in the ear with better sound detection during behavioural testing with inserted ear phones and with better CN as seen on MRI. Due to the limited auditory and speech progress with the cochlear implant, ABI was performed on the contralateral ear in all subjects. MAIN OUTCOME MEASURES: Audiological performance and auditory perception skills of children with cochlear nerve deficiency (CND) who use bimodal electrical stimulation with CI and contralateral ABI. RESULTS: Mean age of the subjects was 84.00 ± 33.94 months. Age at CI surgery and ABI surgery was 25.00 ± 10.98 months and 41.50 ± 16.14 months, respectively. However, hearing thresholds only with CI and only with ABI did not reveal significant difference, and auditory perception scores improved with bimodal stimulation. The MAIS scores were significantly improved from unilateral CI to bimodal stimulation (P = .002). Pattern perception and word recognition scores were significantly higher with the bimodal condition when compared to CI only and ABI only conditions. CONCLUSION: Children with CND showed better performance with CI and contralateral ABI combined. Depending on the audiological and radiological results, bimodal stimulation should be advised for children with CND.

Is Early Cochlear Implant Device Activation Safe for All on-the-Ear and off-the-Ear Sound Processors?

BACKGROUND: Cochlear implantation (CI) is an effective treatment option for patients with severe-to-profound hearing loss. When CI first started, it was recommended to wait until at least 4 weeks after the CI surgery for the initial activation because of possible complications. Advances in the surgical techniques and experiences in fitting have made initial activation possible within 24 h. OBJECTIVES: To compare the complaints and complications after early activation between behind-the-ear (BTE) and off-the-ear (OTE) sound processors and to show the impact of early activation on the electrode impedance values. METHOD: CI surgeries performed between March 2013 and July 2018 were retrospectively analyzed from the database. In total, 294 CI users were included in the present study. The impedance measurements were analyzed postoperatively at the initial activation prior to the stimulation, and 4 weeks after the initial activation in the first-month follow-up visit. A customized questionnaire was administered in the first-month follow-up fitting session to caregivers and/or patients who were using CI at least for 6 months. Medical records were also reviewed to identify any postoperative complications. RESULTS: In the early activation group, impedance values were significantly lower than in the control group (p < 0.05) at first fitting. At the first-month follow-up, no significant difference was found between the groups (p > 0.05). The most common side effects were reported to be edema (6.1%) and pain (5.7%) in the early activation group. In patients with OTE sound processors, the rate of side effects such as skin infection, wound swelling, skin hyperemia, and pain was higher than in patients with BTE sound processors; however, a statistical significance was only observed in wound swelling (p = 0.005). Selecting the appropriate magnet was defined as a problem for the OTE sound processors during the initial activation. CONCLUSION: This study revealed that early activation of CI was clinically safe and feasible in patients with BTE sound processors. When using OTE sound processors, the audiologists should be careful during the activation period and inform patients of possible side effects. The first fitting should be delayed for 4 weeks after CI for OTE sound processors. This current study is the first to report this finding with 5 years of experience in a large cohort.

Cochlear Nerve Hypoplasia: Audiological Characteristics in Children and Adults.

BACKGROUND: Cochlear nerve deficiency is a general term used to describe both cochlear nerve hypoplasia (CNH) and cochlear nerve aplasia. Although these two conditions can have similar results on audiological evaluation, CNH yields more variation in audiological tests. OBJECTIVES: To describe the audiological characteristics of the CNH cases in our series in relation to radiological findings. METHODS: We reviewed the medical charts, audiological findings, and radiological findings on cases with CNH. We included cases with CNH in one ear or both ears. Out of 90 subjects with CNH, we included a total of 40 individuals (21 women and 19 men; 49 ears) in the current study. We reviewed and analyzed the participants' audiological test results according to the radiological findings. RESULTS: Cases with CNH showed variations according to the cochlear structure. There were 13 normal cochleae, 4 with incomplete partition type I, and 32 with cochlear hypoplasia. The accompanying cochlear apertures also showed variation: 17 were normal, 28 stenotic, and 4 aplastic cochlear apertures. The subjects displayed hearing loss ranging from moderate to profound; furthermore, 4 subjects had no response to sound whatsoever. The degree of hearing loss was not statistically significantly different with regard to the presence or absence of cochlear malformation with CNH (p > 0.005). We observed both sensorineural hearing loss and mixed-type hearing loss among the CNH cases. CONCLUSIONS: CNH is the presence of a cochlear nerve that is smaller in diameter than the facial nerve. It can be accompanied with other associated inner ear malformations of different degrees of severity. We observed degrees of hearing loss ranging from moderate to profound.

Evaluation of the quality of life in adults with cochlear implants: As good as the healthy adults?

PURPOSE: The aim of this study was to compare the quality of life (QoL) of adult CI users with the QoL of adults in the healthy and normal-hearing population. MATERIALS AND METHODS: 31 patients with CIs were included in the CI group, and 31 normal-hearing subjects were included in the control group. The QoL was evaluated using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) for all subjects. RESULTS: A comparison of the QoL of the CI group to that of the control group found that the QoL of healthy adults was better than that of the CI users. The results obtained for the subdomains of physical health, psychological health, and social relations showed statistically significant differences between the two groups (p < 0.05). There were no statistically significant differences between the groups in the subdomains of environment and general health (p > 0.05). CONCLUSIONS: The effect of a hearing disability on daily life continues after the CI. As expected, adults with CIs still face challenges in their daily lives due to the hearing impairment.