Insertion of a sufficient number of electrodes is important for a successful use of cochlear implants. We investigated the results of scala vestibuli insertion for cochlear implantation in cases of obstructed scala tympani. In a series of 200 cochlear implantations, scala vestibuli insertion was successfully performed in 4 cases with obstruction of the scala tympani. Etiologies included a temporal bone fracture, severe otosclerosis and malformations of the cochlea. The maximum insertion depth obtained via the scala vestibuli was 30 mm. Postoperative results were comparable to patients in whom conventional scala tympani insertion was performed. No adverse effects related to the site of insertion were observed. Scala vestibuli insertion offers a valuable alternative in cases of obstructed scala tympani that can be employed for a variety of etiologies.
A study was conducted to compare the new MED-EL TEMPO+ ear-level speech processor with the CIS PRO+ body-worn processor in the COMBI 40/COMBI 40+ implant system. Speech tests were performed in 46 experienced subjects in two test sessions approximately 4 weeks apart. Subjects were switched over from the CIS PRO+ to the TEMPO+ in the first session and used only the TEMPO+ in the time between the two sessions. Speech tests included monosyllabic word tests and sentence tests via the telephone. An adaptive noise method was used to adjust each subject’s scores to approximately 50%. Additionally, subjects had to complete a questionnaire based on their 4 weeks of experience with the TEMPO+. The speech test results showed a statistically significant improvement in the monosyllabic word scores with the TEMPO+. In addition, in the second session, subjects showed a significant improvement when using the telephone with the TEMPO+, indicating some learning in this task. In the questionnaire, the vast majority of subjects found that the TEMPO+ allows equal or better speech understanding and rated the sound quality of the TEMPO+ higher. All these objective and subjective results indicate the superiority of the TEMPO+ and are mainly attributed to a new coding strategy called CIS+ and its implementation in the TEMPO+. In other words, based on the results of this study, it appears that after switching over from the CIS PRO+ to the TEMPO+, subjects are able to maintain or even improve their own speech understanding capability.
Objectives: The performance of cochlear implanted children was evaluated in comparison with results of children wearing hearing aids. Patients and Methods: 88 cochlear implanted children were included in this study. Onset of deafness was prelingual (except 1 perilingual), mean age at implantation was 5.4 years (range 1–17.2), preoperative pure tone average (PTA) ranged from 130 to 83 dB HL in the better ear with a mean value of 110.5 dB HL. The hearing aid group consisted of 34 children with prelingual onset of hearing loss. PTA ranged from 122 to 46 dB HL, mean age at test was 5.3 years (range 1.3–15.4). The ‘Frankfurt Functional Hearing Test’ was used for evaluation. Based on the results of the hearing aid group, predicted performance with hearing aids was calculated individually for all cochlear implanted children and compared to the actual results with cochlear implants. Results and Conclusions: Results of cochlear implanted children improved steadily after implantation, progressing from a compound score of 22% prior to implantation to 72.2% after 4–9 years. Actual performance with cochlear implants was significantly better than predicted values with hearing aids. Children implanted prior to age 6 showed a greater benefit and faster improvements after implantation than children implanted later. The performance of children implanted beween age 2 and 4 was equivalent to the mean performance of children with hearing loss of 70–85 dB wearing hearing aids.
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