Evaluation of Neural Response Telemetry (NRT™) with focus on long-term rate adaptation over a wide range of stimulation rates

Custom Sound EP™ (CSEP) is an advanced flexible software tool dedicated to recording of electrically evoked compound action potentials (ECAPs) in Nucleus® recipients using Neural Response Telemetry™ (NRT™). European multi-centre studies of the Freedom™ cochlear implant system confirmed that CSEP offers tools to effectively record ECAP thresholds, amplitude growth functions, recovery functions, spread of excitation functions, and rate adaptation functions and an automated algorithm (AutoNRT™) to measure threshold profiles. This paper reports on rate adaptation measurements. Rate adaptation of ECAP amplitudes can successfully be measured up to rates of 495 pulses per second (pps) by repeating conventional ECAP measurements and over a wide range of rates up to 8000 pps using the masked response extraction technique. Rate adaptation did not show a predictable relationship with speech perception and coding strategy channel rate preference. The masked response extraction method offers opportunities to study long-term rate adaptation with well-defined and controlled stimulation paradigms

One year results for patients with unilateral hearing loss and accompanying severe tinnitus and hyperacusis treated with a cochlear implant

Objective: To show that patients with unilateral hearing loss (UHL), with one ear fulfilling cochlear implant (CI) indication criteria, and an additional severe tinnitus handicap can be treated effectively with a CI. Method: A prospective multicentre study was conducted in five Spanish centres. Sixteen adult patients with UHL and a mean Tinnitus Handicap Inventory (THI) score of at least 58 were implanted. The study design included repeated within-subject measures of quality of life (Health Utility Index Mark 3 [HUI3]), tinnitus (THI, Visual Analogue Scale [VAS] on tinnitus loudness), hearing (Speech, Spatial, and Qualities of Hearing Scale– [SSQ]), and hyperacusis (Test de Hipersensibilidad al Sonido [THS]) up to 12 months after the initial CI fitting

A Series of Case Studies of Tinnitus Suppression with Mixed Background Stimuli in a Cochlear Implant

Purpose: Background sounds provided by a wearable sound playback device were mixed with the acoustical input picked up by a cochlear implant (CI) speech processor in an attempt to suppress tinnitus. Method: First, patients were allowed to listen to several sounds and select up to four sounds that they thought might be effective. These stimuli were programmed to loop continuously in the wearable playback device. Second, subjects were instructed to use one background sound each day on the wearable device, and sequenced the selected background sounds during a 28 day trial. Patients were instructed to go to a website at the end of each day and rate the loudness and annoyance of the tinnitus, and the acceptability of the background sound. Patients completed the Tinnitus Primary Function Questionnaire at the beginning of the trial. Results: Results indicated that background sounds were very effective at suppressing tinnitus. There was considerable variability in sounds preferred by the subjects. Conclusions: The study shows that a background sound mixed with the microphone input can be effective for suppressing tinnitus during daily use of the sound processor in selected CI users

Sound therapy for cochlear implant users with tinnitus

Objective: Despite the positive effect of a cochlear implant (CI) on tinnitus in many patients, tinnitus remains a problem for a significant proportion of CI users. We investigated the acceptability and effect of sound therapy (a combination of natural background sounds and one concise tinnitus counselling session) on tinnitus and speech perception in CI users who still experienced tinnitus during CI use. Design and study sample: Thirty-two CI users (32–78 years) participated in phase 1: a test at the clinic to evaluate six background sounds provided by the sound processor. Eighteen out of the 32 CI users participated in phase 2: an optional take-home evaluation of 2 weeks without sound therapy, followed by 5 weeks with sound therapy, ending with an evaluation visit. Results: Thirty subjects (93.8%) found at least one background sound acceptable. In phase 2, a small improvement with sound therapy was found for tinnitus loudness, annoyance, and intrusiveness. 50% of the subjects subjectively reported benefit of sound therapy. Especially the sense of control on their tinnitus was highly appreciated. No detrimental effect on speech perception was observed. Conclusion: The background sounds were acceptable and provided tinnitus relief in some CI users with tinnitus during CI use