Purpose The purpose of this retrospective study was to investigate the outcome and critical age of cochlear implantation in congenital single-sided deafness (SSD). Methods 11 children with congenital SSD were implanted with a cochlear implant (CI). Auditory performance was measured through the results of speech discrimination, subjective assessment by the Categories of auditory performance (CAP) score, the Speech, Spatial and Qualities scale questionnaire (SSQ) and the German version of the IOI-HA [Internationales Inventar zur Evaluation von Hörgeräten (IIEH, version for CI)]. Results Long-term follow-up [median: 3 years and 5 months (3;5 years)] revealed that nine children use their CI (> 8 h/day) and two became nonusers. In children aged below 3;2 years at surgery, there was a substantial long-term increase in speech discrimination and subjective benefit. Children over 4;4 years of age at CI surgery improved partially in audiological/subjective measurements. Among children above 5 years, the SSQ score did not improve despite further slight improvement in speech discrimination long-term. Conclusion Our data suggest a critical age for CI surgery below 3 years in children with congenital SSD for successful hearing rehabilitation. It is mandatory to identify children with SSD as early as bilaterally deaf children.

Purpose The new active transcutaneous partially implantable osseointegrated system Cochlear™ Osia® System is indicated in case of conductive or mixed hearing loss (CHL/MHL) with a maximum average bone conduction hearing loss of 55 dB, or in single-sided deafness (SSD). The implant directly stimulates the bone via a piezoelectric transducer and is directed by an external sound processor. We conducted a monocentric retrospective longitudinal within-subject clinical study at our tertiary academic referral center. The aim was to investigate long-term data (2017–2021) on audiological outcomes and hearing-related quality of life for the Osia system. Methods Between 2017 and 2020, 22 adults (18: CHL/MHL; 3: SSD) were implanted with the Osia100 implant; seven received bilateral implants. As of 10/2020, the sound processor was upgraded to Osia 2. Results Mean Osia system use by 04/2021 was 30.9 ± 8.6 months (range 17–40 months). Unaided bone conduction thresholds were unchanged postoperatively. One patient had to be explanted because of prolonged wound infection. Aided hearing thresholds were significantly lower compared to the unaided thresholds preoperatively, along with a marked increase in speech recognition in quiet. Speech processor upgrade resulted in a stable benefit. Patients with CHL/MHL and SSD showed a similar improvement in self-rated hearing performance revealed by SSQ, APHAB, and HUI questionnaires. Conclusion The Osia system is a safe, effective and sustainable option for treatment of conductive and mixed hearing loss or single-sided deafness.

Purpose We investigated the long-term results of cochlear implant (CI) recipients with asymmetric hearing loss (AHL) or single-sided deafness (SSD). We focused on wearing behavior, audiometric hearing rehabilitation, and subjective benefits of the CI. CI is expected to improve audiological results, subjective hearing perception, and tinnitus burden. Methods Speech recognition in background noise and sound localization were assessed preoperatively and after at least six years of CI experience. Validated questionnaires determined the subjective benefit of CI use and the subjective evaluation of tinnitus. Results Over 80% of the included AHL and SSD CI recipients used their CI between 6 and 10 h daily; four subjects with SSD were non-users. Speech recognition in background noise and sound localization improved significantly compared with the unaided preoperative situation. Additionally, CI improved subjective speech intelligibility and spatial hearing impression while reducing tinnitus burden. Conclusion Subjects with AHL and SSD benefit from CI, subjectively and audiologically. Cochlear implant is a successful long-term treatment for AHL and SSD.

Our purpose was to use PET to evaluate the glucose metabolism of the inferior colliculus (IC) and primary auditory cortex (PAC) in patients with asymmetric hearing loss (AHL). Methods: Normalized regional 18 F-FDG uptake of the IC and PAC (reference: cerebellum) was assessed in 13 subjects with AHL using a fully digital clinical PET/CT system. Results: Regional metabolism of both the IC and the PAC was significantly reduced contralateral to the most hearing-impaired ear compared with the ipsilateral side. Duration of deafness correlated positively with metabolism of the contralateral PAC but not with metabolism of the ipsilateral PAC or either of the ICs. Conclusion: Fully digital, high-resolution clinical PET scanners allow for investigating small brain stem nuclei. AHL has a significant impact on the regional glucose metabolism of the auditory pathway. Mitigation of this effect by a longer duration of deafness might indicate reorganization at the cortical level.

Previous research in cochlear implant (CI) recipients with bilateral severe-to-profound sensorineural hearing loss showed improvements in speech recognition in noise using remote wireless microphone systems. However, to our knowledge, no previous studies have addressed the benefit of these systems in CI recipients with single-sided deafness.The objective of this study was to evaluate the potential improvement in speech recognition in noise for distant speakers in single-sided deaf (SSD) CI recipients obtained using the digital remote wireless microphone system, Roger. In addition, we evaluated the potential benefit in normal hearing (NH) participants gained by applying this system.Speech recognition in noise for a distant speaker in different conditions with and without Roger was evaluated with a two-way repeated-measures design in each group, SSD CI recipients, and NH participants. Post hoc analyses were conducted using pairwise comparison t-tests with Bonferroni correction.Eleven adult SSD participants aided with CIs and eleven adult NH participants were included in this study.All participants were assessed in 15 test conditions (5 listening conditions × 3 noise levels) each. The listening conditions for SSD CI recipients included the following: (I) only NH ear and CI turned off, (II) NH ear and CI (turned on), (III) NH ear and CI with Roger 14, (IV) NH ear with Roger Focus and CI, and (V) NH ear with Roger Focus and CI with Roger 14. For the NH participants, five corresponding listening conditions were chosen: (I) only better ear and weaker ear masked, (II) both ears, (III) better ear and weaker ear with Roger Focus, (IV) better ear with Roger Focus and weaker ear, and (V) both ears with Roger Focus. The speech level was fixed at 65 dB(A) at 1 meter from the speech-presenting loudspeaker, yielding a speech level of 56.5 dB(A) at the recipient's head. Noise levels were 55, 65, and 75 dB(A). Digitally altered noise recorded in school classrooms was used as competing noise. Speech recognition was measured in percent correct using the Oldenburg sentence test.In SSD CI recipients, a significant improvement in speech recognition was found for all listening conditions with Roger (III, IV, and V) versus all no-Roger conditions (I and II) at the higher noise levels (65 and 75 dB[A]). NH participants significantly benefited from the application of Roger in noise for higher levels, too. In both groups, no significant difference was detected between any of the different listening conditions at 55 dB(A) competing noise. There was also no significant difference between any of the Roger conditions III, IV, and V across all noise levels.The application of the advanced remote wireless microphone system, Roger, in SSD CI recipients provided significant benefits in speech recognition for distant speakers at higher noise levels. In NH participants, the application of Roger also produced a significant benefit in speech recognition in noise.

This article presents a case of sudden bilateral deafness in the context of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection and resultant coronavirus disease 2019 (COVID-19). After treatment in the intensive care unit for acute respiratory distress syndrome and acute kidney failure, hearing ability had drastically changed. While hearing had been subjectively normal before the infection, deafness was now measured on the left and profound hearing loss on the right ear. The patient was treated with cochlea implants on the left and a hearing aid in the right ear. The hearing loss is most likely a complication of COVID-19.

Objectives: To determine and compare the benefit of binaural hearing rehabilitation via cochlear implantation (CI) on speech perception, assessment of auditory abilities, tinnitus distress, health-related quality of life (HRQoL) and psychological comorbidities in patients suffering from asymmetric hearing loss (AHL) as well as bilaterally-deafened and sequentially bilaterally-implanted patients. Methods: 53 patients were implanted between 2011 and 2016. 24 AHL patients were implanted unilaterally, using a hearing aid on the other side. 29 bilaterally-deafened patients were sequentially implanted bilaterally. Speech perception, subjective hearing quality, HRQoL, tinnitus distress, anxiety, depressiveness, perceived stress level and coping abilities were evaluated before implantation, as well as 6 and 24 months postoperatively. Results: Before CI, AHL and bilaterally-deaf patients showed significant differences regarding assessment of auditory abilities, speech discrimination, tinnitus distress and HRQoL. 24 months after CI both groups significantly improved in those scales. We could not find a significant difference between the groups after 2 years. Tinnitus distress significantly decreased 6 and 24 months postoperatively in both groups. Conclusions: This study demonstrates the long-term benefit of binaural hearing rehabilitation in AHL and bilaterally-deaf patients not only regarding speech perception but also HRQoL, tinnitus distress and subjective hearing quality. Bilaterally-deafened patients present lower scores preoperatively, but they did not differ from AHL patients 2 years after CI. Up to now, this is the first study evaluating the outcome of CI in AHL patients compared to bilaterally-implanted patients and demonstrating the benefit of binaural hearing rehabilitation in these specific groups.

Background The Cochlear™ Osia® System leaves a retroauricular bump that can cause discomfort and poor aesthetic outcome. Method To reduce the retroauricular bump, we introduced an implant well in the bone behind the ear for the transducer. We used cutting and diamond drills to create the implant well with an average depth of 4–5 mm. The surgical time including the implant well (40 min) was within the range of reported average surgical time (52 min). Conclusion Introduction of an implant well resulted in a better aesthetic outcome and improved patients’ comfort. The reduced distance between BI300 and ear canal might improve audiological outcome.