Objective: To assess the efficacy of cochlear implantation (CI) after surgical removal of sporadic intracochlear or intravestibulocochlear schwannomas. Study Design: Nonconcurrent cohort study. Setting: Monocentric study at a tertiary referral center. Patients: Patients with tumor resection and CI between 2011 and 2018 and a historic control group of CI patients matched by age, CI electrode type, and follow-up. Interventions: Partial or subtotal cochleoectomy for tumor removal and single-stage CI. Outcome Measures: Main outcome measure: word recognition score for monosyllables in quiet at 65 dB SPL. Results: Sixteen patients with tumor removal and CI (6 female, 10 male; mean age 55 ± 14 years) and 16 control patients (6 female, 10 male; mean age 55 ± 15 years) were identified. In the tumor group, surprisingly good word recognition scores were reached even after substantial structural defects in the cochlear capsule. While 12 months after cochlear implantation mean word recognition score for monosyllables in quiet was 58% (SD: 26) and 41% (SD: 26) in the control groups, it was 75% (SD: 19%) in the tumor group. Conclusions: In patients with intracochlear schwannomas, despite substantial structural damage to the cochlear capsule by partial or subtotal cochleoectomy, a tendency toward better performance with respect to word recognition with CI was observed as compared with other CI patients. The surprisingly good functional results despite substantial cochlear trauma may change clinical thinking with respect to cochlear implantation also beyond this special indication.

Background: The aim of this review was to systematically assess the literature on herbal medicine for cough as a symptom of upper respiratory tract infections and common cold. Methods: The Cochrane Library, Scopus, MEDLINE/PubMed, and Embase were searched through March 2012 for RCTs testing the effects of herbal medicine for cough. Risk of bias was assessed using the Cochrane tool. Results: 34 RCTs (N = 7,083) on Pelargonium sidoides (11 RCTs), Echinacea (8 RCTs), Andrographis paniculata (6 RCTs), ivy/primrose/thyme (4 RCTs), essential oils (4 RCTs) and bakumondoto (1 RCT) were included. Controls were mainly placebo. Most studies had a low risk of bias. The meta-analysis revealed strong evidence for A. paniculata (SMD = -1.00, 95% CI = -1.85, -0.15; P<0.001) and ivy/primrose/thyme (RR = 1.40, 95% CI = 1.23, 1.60; P<0.001) in treating cough; moderate evidence for P. sidiodes (RR = 4.60; 95% CI = 2.89,7.31; P<0.001), and limited evidence for Echinacea (SMD = -0.68; 95% CI = -1.32, -0.04; P = 0.04). Conclusion: This review found strong evidence for A. paniculata and ivy/primrose/thyme-based preparations and moderate evidence for P. sidoides being significantly superior to placebo in alleviating the frequency and severity of patients' cough symptoms. Additional research, including other herbal treatments, is needed in this area.

Daily-life conversation relies on speech perception in quiet and noise. Because of the COVID-19 pandemic, face masks have become mandatory in many situations. Acoustic attenuation of sound pressure by the mask tissue reduces speech perception ability, especially in noisy situations. Masks also can impede the process of speech comprehension by concealing the movements of the mouth, interfering with lip reading. In this prospective observational, cross-sectional study including 17 participants with normal hearing, we measured the influence of acoustic attenuation caused by medical face masks (mouth and nose protection) according to EN 14683 and of N95 masks according to EN 1149 (EN 14683) on the speech recognition threshold and listening effort in various types of background noise. Averaged over all noise signals, a surgical mask significantly reduced the speech perception threshold in noise was by 1.6 dB (95% confidence interval [CI], 1.0, 2.1) and an N95 mask reduced it significantly by 2.7 dB (95% CI, 2.2, 3.2). Use of a surgical mask did not significantly increase the 50% listening effort signal-to-noise ratio (increase of 0.58 dB; 95% CI, 0.4, 1.5), but use of an N95 mask did so significantly, by 2.2 dB (95% CI, 1.2, 3.1). In acoustic measures, mask tissue reduced amplitudes by up to 8 dB at frequencies above 1 kHz, whereas no reduction was observed below 1 kHz. We conclude that face masks reduce speech perception and increase listening effort in different noise signals. Together with additional interference because of impeded lip reading, the compound effect of face masks could have a relevant impact on daily life communication even in those with normal hearing.

The CI EEG artifact for speech appears more difficult to detect than for simple stimuli. Since the artifact differs across CI users, due to their individual clinical maps, the method presented enables insight into the individual manifestations of the artifact.

Purpose The Vibrant Soundbridge (VSB) was introduced in 1996, and the fourth generation of the audio processor recently released. This clinical study evaluates the audiological performance and subjective satisfaction of the new SAMBA 2 audio processor compared to its predecessor, SAMBA. Method Fifteen VSB users tested both audio processors for approximately 3 weeks. Air conduction and bone conduction thresholds and unaided and aided sound field thresholds were measured with both devices. Speech performance in quiet (Freiburg monosyllables) and noise (OLSA) was evaluated as well as subjective listening effort (ACALES) and questionnaire outcomes (SSQ12 and APSQ). In addition, data from 16 subjects with normal hearing were gathered on sound field tests and ACALES. Results Both audio processors showed substantial improvement compared to the unaided condition. The SAMBA and SAMBA 2 had comparable performance in sound filed thresholds, while the SAMBA 2 was significantly better in speech in quiet, speech in noise, reduced listening effort, and improved subjective satisfaction compared with the SAMBA. Conclusion The SAMBA 2 audio processor, compared to its predecessor SAMBA, offers improved performance throughout the parameters investigated in this study. Patients with a VSB implant would benefit from an upgrade to SAMBA 2.