Contralateral non-auditory stimulation in auditory brainstem implantation: A case report

Auditory brainstem implants (ABIs) are neuroprosthetic devices that stimulate the cochlear nuclei without any connection between the inner ear and brainstem [1,2]. The first pediatric ABI surgery was performed in 2000 on a prelingually deafened child with common cavity and cochlear nerve aplasia [3]. More than one thousand ABIs have been placed in adults and children around the world since the late 1970sWo

Risk Factors For Hearing Loss And Results Of Newborn Hearing Screening In Rural Area

Objective: This article reports the results of newborn hearing screening which has been performed between March 2009-2010 in Cizre State Hospital. The results of the first step hearing screening were discussed together with the risk factors for hearing loss. Materials and Methods: All 1840 babies that were born in Cizre State Hospital between March 2009 and March 2010 were enrolled in the study. They all underwent TEOAE (transient otoacoustic emissions) test as the first step of hearing screening. Results: Of the 1840 babies who were screened, 1441 (78.3%) passed the first test and remaining 399 (21.7%) were called again for the second test. Hundred and fourteen (6.2 %) of these babies were not brought for control. Among the latter patients 29 had various risk factors for hearing loss. 249 (13.5%) of the 285 (15.5%) babies who were re-evaluated, passed the test and remaining 36 (1.96%) were referred to the second step institutions. Conclusion: In rural areas more intensive protocols should be employed. Those babies delivered during weekends and nights should be screened before discharge and a member of the hearing screening team should be present during this time period as well. AABR (Automated Auditory Brainstem Response) and TEAOE should be done together in these high risk areas. More efficient way of follow-up of these babies is also necessary.Wo

Effects Of Multi-Channel Compression On Speech Intelligibility At The Patients With Loudness-Recruitment

Objective: In this study, the effects of different limiting methods on speech discrimination at the patients with recruitment had been investigated. For this purpose, audiologic, impedansmetric and speech discrimination tests were carried out on 43 ears with cochlear pathology. Materials and Methods: The patients aged between 30 and 70 years (average 53.43 +/- 13.41). The sound pressure level at which the maximum speech discrimination score obtained was determined for each patient. A digital behind-the-ear four-channel hearing aid in which compression settings can be programmed independently in each channel was used for all listeners. The hearing aid was fitted to the test ear of the subjects and programmed according to WDRC, PC, CL, BILL and TILL limiting methods. Then speech discrimination scores with hearing aid were examined. This examination was done for the situations the speech noise is absent and S/N ratios of OdB and +5dB. NN Results: Although for noiseless situations there was no significant difference between CL and TILL, it has been found that with TILL method statistically better speech discrimination scores were obtained for both OdB and +5dB S/N ratios. No any significant differences have been marked among the scores obtained with WDRC, PC and BILL methods both in noise and noiseless situations. Any statistically significant correlation was not found between the determined speech discrimination scores and the sound pressure level that rollover occurred. Conclusion: Examination of the results statistically shows that, the highest speech recognition performance obtained with TILL limiting method. The results obtained with CL method were worse than TILL but better than WDRC, BILL and PC. It can be stated that, it is better to adjust the hearing aids used for the patients with recruitment phenomenon for TILL type operation. The CL limiting method could be second choice for limiting but PC, WDRC and BILL methods may not be good candidates for these patients.Wo

Audiological And Radiological Characteristics In Incomplete Partition Malformations

OBJECTIVE: To compare the audiological and radiological findings of patients with incomplete partition malformations (IPs) and analyze the relationship between the audiological and radiological findings. MATERIALS and METHODS: The study included 84 patients (168 ears) with IPs as follows: 26 patients with Type I; IP-I (41 ears), 54 patients with Type II; IP-II (108 ears), and 4 patients with Type III; IP-III (8 ears). Remaining 11 ears were diagnosed with other inner ear malformations. Air and bone conduction thresholds were determined with pure tone audiometry, and the air bone gap was recorded in all patients with IPs. Magnetic resonance imaging studies and computerized tomography scans of the temporal bones were analyzed using the PACS system of our university. RESULTS: It was found that all the ears with IP-I were diagnosed with severe to profound hearing loss. The degree of the hearing loss varied from mild to severe/profound in patients with IP-II. Severe to profound mixed hearing loss (MHL) was determined in all ears with IP-III. The air bone gap was larger in the lower frequencies in the IP-II cases diagnosed with MHL. There was not a significant difference between the air bone gap and the size of the vestibular aqueduct in ears with IP-II (p>0.05). CONCLUSION: Each type of IP has different audiological findings. Depending on the type and degree of the hearing loss, it is possible to choose the appropriate audiological intervention. Patients with IP should be evaluated according to the type of malformation.WoSScopu

Relationship Between Age Of Cochlear Implantation With Written Language Skills In Children

Objective: In this study, written language skills of deaf children as a function of age at implantation was examined and results were compared to normal hearing peers. Subjects and Methods: Thirty five children fitted with cochlear implants, aged between 6 and 11 years, were evaluated in terms of their written language abilities and were compared with results those of 35 age- matched normal hearing children. The children with cochlear implants were analyzed in two groups according to their age at implantation; under 4 years and at/over 4 years old. A Written Expression Skills Assessment Form was used to evaluate the written language skills of the two group of implanted children with those of normal hearing peers. Five different feautures of written expression points were scored and analysed, yielding composite score for written expression skills. Results: The results revealed significantly different language skill composite scores of children who underwent cochlear implantation before and after the age of four. The children who were implanted before the age of four years had significantly higher scores compared to children implanted after four years of age. Moreover, scores obtained from group of children implanted before four years were similar to scores by the normal hearing group. The most difficult skill for the implanted group before the age of four years was in assisting keytone. Expression formation and productiveness was most difficult for children implanted after the age of four years. The findings indicate that children implanted at a relatively late age (i.e. after the age of four years) entered primary school later than their peers implanted at a younger age demonstrated lower academic skills, and have continued in special education. Conclusion: These findings highlighted the importance of cochlear implantation during the critical period of language development. It is known that written language competency facilitates academic achivement and career choice. Written language skills should be assessed at regular test intervals, and training programs should promote development of written language skills.Wo

Brain stem responses evoked by stimulation with an auditory brain stem implant in children with cochlear nerve aplasia or hypoplasia

Objectives: The inclusion criteria for an auditory brain stem implant (ABI) have been extended beyond the traditional, postlingually deafened adult with Neurofibromatosis type 2, to include children who are born deaf due to cochlear nerve aplasia or hypoplasia and for whom a cochlear implant is not an option. Fitting the ABI for these new candidates presents a challenge, and intraoperative electrically evoked auditory brain stem responses (EABRs) may assist in the surgical placement of the electrode array over the dorsal and ventral cochlear nucleus in the brain stem and in the postoperative programming of the device. This study had four objectives: (1) to characterize the EABR by stimulation of the cochlear nucleus in children, (2) to establish whether there are any changes between the EABR recorded intraoperatively and again just before initial behavioral testing with the device, (3) to establish whether there is evidence of morphology changes in the EABR depending on the site of stimulation with the ABI, and (4) to investigate how the EABR relates to behavioral measurements and the presence of auditory and nonauditory sensations perceived with the ABI at initial device activation

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

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.Wo