Evaluation of a clinical method for selective electrode deactivation in cochlear implant programming

BackgroundCochlear implants are a neural prosthesis used to restore the perception of hearing in individuals with severe-to-profound hearing loss by stimulating the auditory nerve with electrical current through a surgically implanted electrode array. The integrity of the interface between the implanted electrode array and the auditory nerve contributes to the variability in outcomes experienced by cochlear implant users. Strategies to identify and eliminate poorly encoding electrodes have been found to be effective in improving outcomes with the device, but application is limited in a clinical setting.ObjectiveThe purpose of this study was to evaluate a clinical method used to identify and selectively deactivate cochlear implants (CI) electrodes related to poor electrode-neural interface.MethodsThirteen adult CI users participated in a pitch ranking task to identify indiscriminate electrode pairs. Electrodes associated with indiscriminate pairs were selectively deactivated, creating an individualized experimental program. Speech perception was evaluated in the baseline condition and with the experimental program before and after an acclimation period. Participant preference responses were recorded at each visit.ResultsStatistically significant improvements using the experimental program were found in at least one measure of speech perception at the individual level in four out of 13 participants when tested before acclimation. Following an acclimation period, ten out of 13 participants demonstrated statistically significant improvements in at least one measure of speech perception. Statistically significant improvements were found with the experimental program at the group level for both monosyllabic words (p = 0.006) and sentences in noise (p = 0.020). Additionally, ten participants preferred the experimental program prior to the acclimation period and eleven preferred the experimental program following the acclimation period.ConclusionResults from this study suggest that electrode deactivation may yield improvement in speech perception following an acclimation period. A majority of CI users in our study reported a preference for the experimental program. This method proved to be a suitable clinical strategy for identifying and deactivating poorly encoding electrodes in adult CI users

Audiology Students’ Perception of Hybrid Simulation Experiences: Qualitative Evaluation of Debriefing Sessions

Simulation-based research is still new in the audiology field and requires more research to better understand students’ perspectives on standardized patients/parents (SPs) and manikins use. There is also limited research about debriefing practices in audiology. This qualitative study used a baby simulator and SPs to evaluate audiology students’ reflection during three debriefing sessions conducted at the University of Arkansas for Medical Science (UAMS) Simulation Center. Seventeen Doctor of Audiology (AuD) students participated in the simulation event, and the data were collected using the transcripts of videotaped debriefing sessions. The qualitative content analysis of the transcripts revealed eight sub-themes: support, compassion, respect, teamwork, limited academic knowledge and practice, insufficient communication skills, low self-confidence, and undesirable emotional reactions. These items, in turn, fell under two main themes of Qualification and Lack of Preparation. Both main themes were included in one core category named Professional Dispositions and Competencies. Study findings indicated that audiology students demonstrated both promising professional dispositions and competencies as well as characteristics that may hinder students from developing their professional abilities. Thus, audiology programs will benefit from simulation use, including debriefing sessions, to emphasize professional efficiency

Readability, User-Friendliness, and Key Content Analysis of Newborn Hearing Screening Brochures

Readability, user-friendliness, and key content are important components of newborn screening brochure design. Health information at a sixth grade or below reading level, designed for ease of navigation, with easily identifiable “action steps” can help adults with limited literacy skills find, understand, and use health information. The purpose of this study was to quantify the readability, user-friendliness, and key content components of newborn hearing screening brochures. Five readability formulae (FRE, F–K GL, FOG, FORCAST, and SMOG) were used to estimate reading levels of English language EHDI brochures (N = 48). Twenty-three participants assessed brochures for user-friendliness. Three participants assessed brochures to determine if key content elements were included and if so, the ease of locating them. Readers are provided with simple steps to follow during brochure design to maximize the message in parent education materials. This study forms the framework for quality improvement efforts and research-to-practice initiatives in the field

Showstoppers! On the Red Carpet in San Diego

Trends reporters set out like paparazzi to get a glimpse of this year\u27s new premieres, stars and major players in the exhibit hall of AudiologyNOW!, the annual conference of the American Academy of Audiologists held in San Diego in May

Simultaneous Extratympanic Electrocochleography and Auditory Brainstem Responses Revisited

The purpose of this study was to revisit the two-channel, simultaneous click-evoked extratympanic electrocochleography and auditory brainstem response (ECoG/ABR) recording technique for clinical use in normal hearing participants. Recording the compound action potential (AP) of the ECoG simultaneously with ABR may be useful when Wave I of the ABR is small or diminished in patients with sensorineural or retrocochlear disorder and minimizes overall test time. In contrast to some previous studies that used the extratympanic electrode both as non-inverting electrode for the ECoG and inverting electrode for ABR, this study maintained separate recording channel montages unique to conventional click-evoked ECoG and ABR recordings. That is, the ABR was recorded using a vertical channel (Cz to ipsilateral earlobe), while the ECoG with custom extratympanic electrode was recorded using a horizontal channel (tympanic membrane to contralateral earlobe). The extratympanic electrode is easy to fabricate inhouse, or can be purchased commercially. Maintaining the conventional ABR montage permits continued use of traditional normative data. Broadband clicks at a fixed level of 85 dB nHL were presented with alternating polarity at stimulus rates of 9.3, 11.3, and 15.3/s. Different stimulation rates were explored to identify the most efficient rate without sacrificing time or waveform morphology. Results revealed larger ECoG AP than ABR Wave I, as expected, and no significant difference across stimulation rate and no interaction effect. Extratympanic electrode placement takes little additional clinic time and may improve the neurodiagnostic utility of the ABR

Impulse Noise: Can Hitting a Softball Harm Your Hearing?

The purpose of this study is to identify whether or not different materials of softball bats (wooden, aluminum, and composite) are a potential risk harm to hearing when batting players strike a 12′′ core .40 softball during slow, underhand pitch typical of recreational games. Peak sound pressure level measurements and spectral analyses were conducted for three controlled softball pitches to a batting participant using each of the different bat materials in an unused outdoor playing field with regulation distances between the pitcher’s mound and batter’s box. The results revealed that highest recorded peak sound pressure level was recorded from the aluminum (124.6 dBC) bat followed by the composite (121.2 dBC) and wooden (120.0 dBC) bats. Spectral analysis revealed composite and wooden bats with similar broadly distributed amplitude-frequency response. The aluminum bat also produced a broadly distributed amplitude-frequency response, but there were also two very distinct peaks at around 1700 Hz and 2260 Hz above the noise floor that produced its ringing (or ping) sound after being struck. Impulse (transient) sounds less than 140 dBC may permit multiple exposures, and softball bats used in a recreational slow pitch may pose little to no risk to hearing

Distortion-product otoacoustic emissions: body position effects with simultaneous presentation of tone pairs

This study examined the effect of three different body positions on distortion-product otoacoustic emission (DPOAE) amplitude and noise levels with multiple primary tone pairs simultaneously-presented to 36 normal-hearing female human adults. Other studies have demonstrated that the simultaneously presented tone pairs method shows clinical promise as a screener, but the sequential method remains in widespread clinical use. Postural changes have been suggested to have an effect not only on DPOAEs, but also transient-evoked OAEs and stimulus- frequency OAEs. DPOAE amplitude and noise levels were recorded in seated, supine, and side-lying positions to the following order of simultaneously-presented tone pairs relative to the f2 frequencies: 1187, 2375, and 4812 Hz; 1500, 3000, and 6062 Hz; and 1875, 3812, and 7625 Hz. No DPOAE could be detected reliably at 7625 Hz as result of poor signal-to-noise ratio. For remaining DPOAEs, statistical analyses revealed that amplitudes were not significantly different among the three body positions. However, at 1500 Hz and below, body position did have a statistically significant effect on noise levels though they are likely clinically negligible. Except at 7625 Hz, results suggest that DPOAEs recorded using a simultaneously presented tone pairs appear to be comparably recorded regardless of an individual’s body position

Evaluation of a clinical method for selective electrode deactivation in cochlear implant programming

Cochlear implants are a neural prosthesis used to restore the perception of hearing in individuals with severe-to-profound hearing loss by stimulating the auditory nerve with electrical current through a surgically implanted electrode array. The integrity of the interface between the implanted electrode array and the auditory nerve contributes to the variability in outcomes experienced by cochlear implant users. Strategies to identify and eliminate poorly encoding electrodes have been found to be effective in improving outcomes with the device, but application is limited in a clinical setting