Real-world evidence is increasingly used to support clinical and regulatory decisions globally and may be a useful tool to study the unique needs of cochlear implant users in China. The ability to recognize and understand speech in noise is critical for cochlear implant users, however, this remains a challenge in everyday settings with fluctuating competing noise levels. The Cochlear™ Sound Processor, Nucleus® 7 (CP1000), includes Forward Focus, a spatial noise algorithm aimed to improve speech-in-noise performance, and Made for iPhone/iPod/iPad functionality. We conducted a prospective, single-center, open-label, within-participant, real-world evidence investigation in participants with cochlear implants. The primary objective of this study, conducted in China, was to compare speech perception in spatially separated dynamic noise with the Nucleus 7 to the recipients\' current older Cochlear Sound Processor, including the Freedom and Nucleus 5 sound processors. A follow-up study monitored participants from the initial study up to 12-months post the fitting of their Nucleus 7 and investigated hearing ability, satisfaction, and usability of the device via a questionnaire. Forty participants were included in the initial study (age-range 3 to 49 years) and 29 continued to the follow-up study (age-range 5 to 28 years). The participants were heterogeneous in terms of age, cochlear implant experience, and duration of hearing loss. Nucleus 7 significantly improved participant speech recognition performance in noise by 7.54 dB when compared with the participants\' current older sound processor (p<0.0001). Overall satisfaction with Nucleus 7 was 72%. Satisfaction in different hearing contexts ranged from 93.1% for understanding a 1:1 conversation in a quiet setting, 62.1% for understanding on the phone, to 34.5% hearing in complex noisy situations. The study demonstrated the benefits of the Nucleus 7 sound processor across different hearing environments in a Chinese population and showed improved hearing ability, usability, and satisfaction in a real-world every-day environment.

UNASSIGNED: There exists an unfulfilled requirement for effective cochlear pharmacotherapy. Controlled local drug delivery could lead to effective bioavailability. The round window niche (RWN), a cavity in the middle ear, is connected to the cochlea via a membrane through which drug can diffuse. We are developing individualized drug-eluting RWN implants (RNIs). To test their effectiveness in guinea pigs, a commonly used model in cochlear pharmacology studies, it is first necessary to develop guinea pig RNIs (GP-RNI).
UNASSIGNED: Since guinea pigs do not have a RWN such as it is present in humans and to reduce the variables in in vivo studies, a one-size-fits-all GP-RNI model was designed using 12 data sets of Dunkin-Hartley guinea pigs. The model was 3D-printed using silicone. The accuracy and precision of printing, distribution of the sample ingredient dexamethasone (DEX), biocompatibility, bio-efficacy, implantability and drug release were tested in vitro. The GP-RNI efficacy was validated in cochlear implant-traumatized guinea pigs in vivo.
UNASSIGNED: The 3D-printed GP-RNI was precise, accurate and fitted in all tested guinea pig RWNs. DEX was homogeneously included in the silicone. The GP-RNI containing 1% DEX was biocompatible, bio-effective and showed a two-phase and sustained DEX release in vitro, while it reduced fibrous tissue growth around the cochlear implant in vivo.
UNASSIGNED: We developed a GP-RNI that can be used for precise inner ear drug delivery in guinea pigs, providing a reliable platform for testing the RNI\'s safety and efficacy, with potential implications for future clinical translation.

Objective: To investigate the early auditory discrimination of vowels, consonants and lexical tones in prelingually-deafened children with cochlear implants (CI) using auditory event-related potentials. Methods: Nineteen prelingually-deafened CI children and 19 normal hearing (NH) children were recruited in this study. A multi-deviant oddball paradigm was constructed using the monosyllable/ta1/as the standard stimulus and monosyllables/tu1/,/te1/, /da1/,/ra1/,/ta4/and/ta2/as the deviant stimuli. The event-related potentials evoked by vowel, consonant and lexical tone contrasts were recorded and analyzed in the two groups. Results: NH children showed robust mismatch negativities (MMNs) to vowel, consonant and lexical tone contrasts (P<0.05), whereas CI children only showed positive mismatch responses (pMMRs) and P3a responses to the vowel (P<0.05) and consonant contrasts (P<0.05) and no significant event-related potential to the lexical tone contrasts (P>0.05). The longer pMMR and P3a peak latencies (P<0.01) but similar amplitudes (P>0.05) were found in CI children than in NH children. CI children showed weaker phase synchronization of θ oscillations than NH children (P<0.05). The duration of CI use was positively correlated with the scores of Categories of Auditory Performance (CAP) (P=0.004), Speech Intelligibility Rate (SIR) (P=0.044) and Meaningful Auditory Integration Scale (MAIS) (P=0.001) in CI children. Conclusions: Prelingually-deafened CI children can process vowels and consonants at an early stage. However, their ability of processing speech, especially lexical tones, is still more immature compared with their NH peers. The event-related potentials could be objective electrophysiological indicators reflecting the maturity of CI children\'s auditory speech functions. Long-term CI use is beneficial for prelingually-deafened children to improve auditory and speech performance.
目的： 利用听觉事件相关电位评估语前聋儿童人工耳蜗（cochlear implant，CI）植入者对元音、辅音和声调的早期听觉加工能力。 方法： 2021年2月到2024年2月期间招募19例语前聋CI儿童（男12例、女7例，年龄3~8岁，平均6.0岁）和19例听力正常（normal hearing，NH）儿童（男12例、女7例，年龄4~9岁，平均6.8岁）。使用单音节/ta1/作为标准刺激，/tu1/，/te1/，/da1/，/ra1/，/ta4/和/ta2/作为偏差刺激，构建多偏差oddball范式。记录并分析两组儿童由元音、辅音和声调变化诱发的事件相关电位。应用SPSS 24.0软件对数据进行统计学分析。 结果： NH儿童对元音、辅音和声调变化均表现出显著的失匹配负波（mismatch negativity，MMN）（P<0.05），而CI儿童对元音和辅音变化仅表现出正向失匹配反应（positive mismatch response，pMMR）（P<0.05）和P3a反应（P<0.05），且未对声调变化表现出任何事件相关电位（P>0.05）。与NH儿童相比，CI儿童的pMMR和P3a潜伏期更长（P<0.01），两组间幅值差异无统计学意义（P>0.05）。时频分析显示，CI儿童的θ频段神经振荡同步性较NH儿童低（P<0.05）。相关性分析显示，CI儿童的CI使用时间与听觉能力分级量表（Categories of Auditory Performance，CAP）（P=0.004）、言语可懂度分级量表（Speech Intelligibility Rate，SIR）（P=0.044）和有意义听觉整合量表（Meaningful Auditory Integration Scale，MAIS）（P=0.001）得分呈正相关。 结论： 语前聋CI儿童对元音和辅音具备一定的早期听觉加工能力，但与同龄NH儿童相比，语前聋CI儿童对语音尤其是声调的加工能力仍不成熟。事件相关电位可作为反映CI儿童听觉言语功能成熟度的客观电生理指标。坚持长期佩戴CI有助于语前聋儿童听觉言语能力的提高。.

Objective: To investigate the development of receptive and expressive vocabulary in Mandarin-speaking children with cochlear implants (CI) during the first year after CI activation. Methods: A total of 827 children (411 boys and 416 girls) who were implanted CI before 2.5 years of age from October 2019 to December 2022 in the Department of Auditory Implantation, Shandong Provincial ENT Hospital were included in this study. The Infant Checklist of the Mandarin Early Vocabulary Inventory (EVI) was used to assess the quantity and content of receptive and expressive vocabulary at the time of CI activation and at the 1st, 3rd, 6th, 9th, 12th months post-activation. SPSS 22.0 was used to describe the receptive and expressive vocabulary of CI children at the first year after activation. Results: During the first year after CI activation, CI children\'s receptive and expressive vocabulary consistently increased with the CI usage. The average number of receptive vocabulary and expressive vocabulary respectively increased from 0 to 178, and from 0 to 97. At the first year of post-activation, the number of receptive and expressive vocabulary of CI children were superior to that of hearing-age matched typical-hearing children, but fell behind of that of chronological age matched typical-hearing children. In terms of lexical categories, receptive and expressive vocabulary was acquired in the following order: nouns, verbs, adjectives, and pronouns. Among the top 50 words that CI children could express, nouns were the most common, then followed by verbs, adjectives, and pronouns. Father\'s education level can significantly and positively predictethe receptive vocabulary of CI children at the first year post-activation. At the first year after CI activation, the 10th, 25th, 50th, 75th, and 90th percentiles were 113, 149, 178, 202, 223 for the receptive vocabulary, and 9, 37, 97, 148, 188 for expressive vocabulary. Conclusion: For Mandarin speaking children with CI, the receptive and expression vocabulary continuely increased within the first year after CI activation. The ability to grasp receptive vocabulary precedes the ability to express expressive vocabulary. Compared to hearing-age matched typical-hearing children, CI children showed faster rate of the vocabulary growth, and earlier and more frequently verb expression. However, it still larged behind that of chronological age matched hearing normal children. CI children respectively understood and expressed nouns and verbs the first. In children with CI, the first concepts understood and expressed were nouns and verbs. Among the first 50 words expressed, nouns were the most numerous, and the age at which verbs were acquired was earlier than that for hearing-age matched typical-hearing children.
目的： 通过对汉语普通话人工耳蜗植入（cochlear implantation，CI）儿童开机后词汇理解及表达的随访，了解其词汇的发展特征，建立普通话CI儿童早期词汇发展的参考数据。 方法： 选取山东省耳鼻喉医院听觉植入科2019年10月至2022年12月期间827例在2.5岁前植入人工耳蜗的儿童，其中男性411例、女性416例。分别在开机时及开机后1、3、6、9、12个月，使用普通话早期词汇量表（Early Vocabulary Inventory for Mandarin Chinese，EVI）中的婴儿版词表来评估CI儿童的理解性词汇和表达性词汇的数量及内容。应用SPSS 22.0软件统计CI儿童开机1年以内理解性词汇及表达性词汇量，采用R软件描绘不同百分位数下CI儿童理解性词汇及表达性词汇的数量及发展趋势，同时采用EXCEL软件计算并列出了CI儿童最先表达的前50个词汇。 结果： 开机1年以内，随人工耳蜗使用时间延长，CI儿童的理解性词汇量和表达性词汇量均持续增加。理解性词汇量从0个（中位数，下同）单词增加到178个单词，表达性词汇量从0个单词增加到97个单词。开机1年时理解及表达性词汇数量均优于听觉年龄匹配的正常听力儿童，但落后于生理年龄匹配的正常听力儿童。对于词性的理解和表达的掌握顺序依次为名词、动词、形容词和代词。在CI儿童会表达的前50个词中，名词占比最多，其次为动词、形容词和代词。父亲受教育水平可以显著正向预测CI儿童开机1年时的理解性词汇。开机1年时，处于第10、25、50、75、90百分位数的CI儿童对应的理解性词汇量和表达性词汇量分别为113、149、178、202、223以及9、37、97、148、188个。 结论： 普通话CI儿童开机1年以内早期词汇的发展特征为随着开机时间的延长，理解性词汇量和表达性词汇量也随之持续增加，且理解先与表达；词汇发展速度快于听觉年龄匹配的听力正常儿童，但仍落后于生理年龄匹配的听力正常儿童。CI儿童最先理解和表达的是名词和动词，最先表达的前50个词中名词最多，并且动词的习得年龄早于听觉年龄匹配的听力正常儿童。.

OBJECTIVE: The aim of this study was to present an institution\'s experience with cochlear reimplantation (CRI), to assess surgical challenges and post-operative outcomes and to increase the success rate of CRI.
METHODS: Retrospective single-institution study.
METHODS: Tertiary medical center.
METHODS: We retrospectively evaluated data from 76 reimplantation cases treated in a tertiary center between 2001 and 2022. Clinical features including etiology of hearing loss, type of failure, surgical issues, and auditory speech performance were analyzed. Categorical Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores were used to evaluate pre- and post-CRI outcomes.
RESULTS: The CRI population comprises of 7 patients from our institute,69 referred patients from other centers. Device failure was the most common reason (68/76, 89.5 %) for CRI; in addition, there were 7 medical failures and 1 had both soft device failure. Medical failures included flap rupture and device extrusion, magnet migration, auditory neuropathy, leukoencephalopathy, foreign-body residue and meningitis. In 21/76 patients, the electrode technology was upgraded. The mean time to failure was 0.58-13 years, with a mean of 4.97 years. The mean (± SD) CAP and SIR scores before and after CRI were 5.2 ± 1.2 versus 5.5 ± 1.1 and 3.4 ± 1.1 versus 3.5 ± 1.1, respectively. Performance was poor in six patients with severe cochlear malformation, auditory nerve dysplasia, leukoencephalopathy, and epilepsy.
CONCLUSIONS: CRI surgery is a challenging but relatively safe procedure, and most reimplanted patients experience favorable postoperative outcomes. Medical complications and intracochlear damage are the main causes of poor postoperative results. Therefore, adequate preoperative preparation and atraumatic CRI should be carried out for optimal results.

Cochlear implants can directly activate the auditory system\'s primary sensory neurons, the spiral ganglion neurons (SGNs), via circumvention of defective cochlear hair cells. This bypass restores auditory input to the brainstem. SGN loss etiologies are complex, with limited mammalian regeneration. Protecting and revitalizing SGN is critical. Tissue engineering offers a novel therapeutic strategy, utilizing seed cells, biomolecules, and scaffold materials to create a cellular environment and regulate molecular cues. This review encapsulates the spectrum of both human and animal research, collating the factors contributing to SGN loss, the latest advancements in the utilization of exogenous stem cells for auditory nerve repair and preservation, the taxonomy and mechanism of action of standard biomolecules, and the architectural components of scaffold materials tailored for the inner ear. Furthermore, we delineate the potential and benefits of the biohybrid neural interface, an incipient technology in the realm of implantable devices. Nonetheless, tissue engineering requires refined cell selection and differentiation protocols for consistent SGN quality. In addition, strategies to improve stem cell survival, scaffold biocompatibility, and molecular cue timing are essential for biohybrid neural interface integration.

Brain plasticity refers to the brain\'s ability to reorganize its structure or function in response to experiences, learning, and environmental influences. This phenomenon is particularly significant in individuals with deafness, as the brain adapts to compensate for the lack of auditory stimulation. The aim of this study is to investigate whether cochlear implantation can restore a normal pattern of brain activation following auditory stimulation in cases of asymmetric hearing loss. We used a PET-scan technique to assess brain activity after cochlear implantation, specifically during an auditory voice/non-voice discrimination task. The results indicated a nearly normal pattern of brain activity during the auditory discrimination task, except for increased activation in areas related to attentional processes compared to controls. Additionally, brain activity at rest showed significant changes in implanted participants, including cross modal visuo-auditory processing. Therefore, cochlear implants can restore the brain\'s activation pattern through long-term adaptive adjustments in intrinsic brain activity.

UNASSIGNED: The present study evaluated the applicability of the sentence-focused framework to Mandarin-speaking children with cochlear implants (CIs) by examining the relative contribution of receptive/expressive noun and verb lexicon sizes to later grammatical complexity.
UNASSIGNED: Participants were 51 Mandarin-speaking children who received cochlear implantation before 30 months of age. At 12 months after CI activation, parents were asked to endorse words that their child could understand only or understand and say using the infant version of the Early Vocabulary Inventory. At 24 months after CI activation, parents were asked to endorse the grammatical structures that their children were able to say using the Grammatical Complexity subtest in the Mandarin Communicative Development Inventory-Taiwan. Children\'s receptive/expressive noun and verb lexicon sizes and grammatical complexity scores were computed from these parent checklists.
UNASSIGNED: Correlational analyses showed that children\'s receptive/expressive noun and verb lexicon sizes at 12 months after CI activation were all highly correlated with their grammatical complexity scores at 24 months after CI activation (ρs = .52-.63, ps < .001). Regression analyses further revealed that verb lexicon sizes at 12 months after CI activation outweighed noun lexicon sizes in accounting for grammatical complexity at 24 months after CI activation.
UNASSIGNED: Our findings supported the prediction of the sentence-focused framework. Emphasizing the role of verbs in early intervention has the potential to enhance grammatical outcomes in Mandarin-speaking children with CIs.
UNASSIGNED: https://doi.org/10.23641/asha.26129044.

With the development of social economic and technology, Cochlear Implantation has became an effective therapy for patients who suffered from severe or profound hearing impairment. In the meantime, patients\' demands for sound and auditory quality are also increasing. In terms of speech recognition, localization, and auditory quality, bilateral hearing is closer to the auditory experience of normal individuals, so bilateral cochlear implantation（BCI） emerged as the times require. In this article, we will introduce the status and progress of bimodal regarding to the following aspects: the brief history, the advantages of BCI, different methods for BCI, and the problems encountered in BCI.
摘要: 目前人工耳蜗植入技术是帮助重度至极重度感音神经性聋患者重返有声世界的最有效治疗方式。随着社会经济技术的发展，患者对生活质量的要求也逐步提高，声音听觉质量作为其中重要组成部分也广受关注；双耳听觉在言语识别、声源定位及声音聆听质量方面往往优于单耳听觉，更接近正常听力者的听觉体验。双侧人工耳蜗作为双耳听觉重要组成部分，一直为国内外学者所重视。本文将从双侧人工耳蜗植入发展简史、双侧植入的主要优势、双侧植入不同方式选择和双侧植入目前遇到的问题等方面，介绍双侧人工耳蜗植入的现状及研究进展。.

Large vestibular aqueduct syndrome（LVAS） is a common recessive hereditary hearing loss disease, and some patients may also experience vestibular dysfunction. With the wide application of cochlear implant（CI） and the development of vestibular medicine, the pathophysiological mechanism of LVAS and the influence mechanism of CI on vestibular function are gradually elucidated. Consequently, the evaluation and rehabilitation of vestibular dysfunction function have also become research hotspots. This article reviews studies on vestibular function and related rehabilitation in patients with large vestibular aqueduct syndrome.
摘要: 大前庭水管综合征（large vestibular aqueduct syndrome，LVAS）是临床常见的常染色体隐性遗传性听力损失疾病，大部分患者可伴发前庭功能障碍。随着人工耳蜗植入（cochlear implant，CI）的广泛应用和前庭医学的发展，LVAS的病理、生理机制及CI对于前庭功能的影响得到了广泛关注，针对LVAS的前庭功能以及CI术后的前庭功能康复逐步成为研究热点，本文就LVAS患者的前庭功能及其相关康复研究做一综述。.