OBJECTIVE: Evaluation of the Slim Modiolar (SM) electrode in temporal bones (TB) will elucidate the electrode\'s insertion outcomes.
BACKGROUND: The SM electrode was designed for atraumatic insertion into the scala tympani, for ideal perimodiolar positioning and with a smaller caliber to minimize interference with cochlear biological processes.
METHODS: The SM electrode was inserted into TBs via a cochleostomy. First, the axial force of insertion was measured. Next, TBs were inserted under fluoroscopy to study insertion dynamics, followed by histologic evaluation of electrode placement and cochlear trauma. A subset of TBs were inserted with the Contour Advance (CA) electrode for comparison.
RESULTS: Sixteen of 22 insertions performed to measure the axial force of insertion had flat or near zero insertion force profiles. Six insertions had increased insertion forces, which were attributed to improper sheath depth before electrode insertion. Under real-time fluoroscopy, 23 of 25 TBs had uneventful insertion and good perimodiolar placement. There was 1 scala vestibuli insertion due to suboptimal cochleostomy position and 1 tip roll over related to premature electrode deployment. When compared with the CA electrode, 14 of 15 insertions with the SM electrode resulted in a more perimodiolar electrode position. No evidence of trauma was found in histologic evaluation of the 24 TBs with scala tympani insertions.
CONCLUSIONS: TB evaluation revealed that the SM electrode exerts minimal insertion forces on cochlear structures, produces no histologic evidence of trauma, and reliably assumes the perimodiolar position. Nonstandard cochleostomy location, improper sheath insertion depth, or premature deployment of the electrode may lead to suboptimal outcomes.

BACKGROUND: Post-meningitis deafness (PMD) is a potentially devastating cause of hearing loss among pediatric and adult patients, for which hearing rehabilitation with cochlear implants (CIs) remains the standard of care. To date, there have been limited systematic studies on the impact of cochlear ossification (CO) and time-to-implantation (TTI) on audiological outcomes.
METHODS: An online database search was performed on the PubMed, Embase, and Scopus databases for articles within the past 20 years pertaining to audiological outcomes among pediatric and adult patients with PMD. Information on study characteristics, patient demographics, clinical outcomes, and postoperative complications was collected and analyzed.
RESULTS: From 8,325 articles generated in the original search, 11 were included in the final analysis, representing 376 patients in total. Of the articles discussing TTI, the majority (3 of 4) found that a shorter TTI of 6 months on average led to improved audiological outcomes compared with control groups with a longer TTI. Of the articles that discussed the impact of preoperative CO, the majority (4 of 6) found that the presence of CO had a detrimental effect on postoperative audiological outcomes after CI. Finally, of the articles that discussed long-term audiological outcomes for PMD compared with the non-PMD control group after CI, the majority (4 of 7) found that PMD patients had inferior long-term outcomes.
CONCLUSIONS: CI is a safe and effective treatment modality for PMD, with the majority of literature demonstrating improved long-term outcomes for patients without CO and a reduced TTI.

暂无摘要。

Millions of people worldwide suffer from hearing loss, a common sensory condition. However, new developments in cochlear implants have drastically transformed children\'s lives. However, there is still much to learn about the complex effects of cochlear implant interventions on children\'s lives and the unique difficulties experienced by Nepalese families. This study aims to comprehensively evaluate parents\' perspectives regarding the quality of life of children with cochlear implants in Nepal. This study utilized the \'Children with Cochlear Implants: Parental Perspectives\' (CCIPP) questionnaire, focusing on parents\' viewpoints to assess the quality of life of Nepalese children with cochlear implants. A purposive sampling approach encompassed 22 families who completed the questionnaire. The study showed good parental ratings; the mean overall quality of life score was more than three (out of five), indicating significant gains following cochlear implantation. The greatest scores were for communication abilities, but issues with the implantation procedure and educational components persisted. A strong relationship existed between communication and several quality-of-life dimensions, highlighting communication\'s critical role in improving social interactions, well-being, and self-reliance. From the viewpoint of the parents of Nepalese children with cochlear implants, the current research represents a significant change in our knowledge of their quality of life. Even though there have been significant gains, targeted interventions are necessary to address post-implantation problems and educational challenges. The study recommends customized support networks and academic achievements to help Nepal\'s children with cochlear implant treatments.

BACKGROUND:  Incomplete partition type II (IP-II) malformation is often accompanied by a large vestibular aqueduct (LVA). In IP anomalies, the patient\'s auditory rehabilitation requirements are decided according to the presence of inner ear structures and the degree of hearing loss (HL). There has been limited research on auditory rehabilitation (AR) requirement selection in patients diagnosed with IP-II and LVA. This study investigated the typical characteristics of HL and AR choices in patients diagnosed with IP-II and LVA.
METHODS:  Patients with IP-II and LVA (n=55; 25 women and 30 men) were identified, and audiological evaluations were performed. The patient\'s demographic characteristics, the type and degree of HL, the AR method, age at diagnosis, and educational status were retrospectively compared.
RESULTS:  The distribution of our 55 patients according to cochlear implants, hearing aids (HA), and bimodal applications was 29.1% (n=16), 43.6% (n=24), and 27.3% (n=15), respectively. Statistical analyses using chi-square tests found no significant differences in the incidence of dizziness/imbalance, tinnitus, HL progression, or the degree and onset of HL among the patients.
CONCLUSIONS:  The data revealed different audiological characteristics among patients with IP-II and LVA, as well as different AR solutions. The most widely used AR modality was found to be HA. Prediction of sudden versus progressive HL development among patients is challenging, and the characteristics of IP-II vary. Therefore, they should be interpreted with caution.

UNASSIGNED: The emotional prosodic expression potential of children with cochlear implants is poorer than that of normal hearing peers. Though little is known about children with hearing aids.
UNASSIGNED: This study was set up to generate a better understanding of hearing aid users\' prosodic identifiability compared to cochlear implant users and peers without hearing loss.
UNASSIGNED: Emotional utterances of 75 Dutch speaking children (7 - 12 yr; 26 CHA, 23 CCI, 26 CNH) were gathered. Utterances were evaluated blindly by normal hearing Dutch listeners: 22 children and 9 adults (17 - 24 yrs) for resemblance to three emotions (happiness, sadness, anger).
UNASSIGNED: Emotions were more accurately recognised by adults than by children. Both children and adults correctly judged happiness significantly less often in CCI than in CNH. Also, adult listeners confused happiness with sadness more often in both CHA and CCI than in CNH.
UNASSIGNED: Children and adults are able to accurately evaluate the emotions expressed through speech by children with varying degrees of hearing loss, ranging from mild to profound, nearly as well as they can with typically hearing children. The favourable outcomes emphasise the resilience of children with hearing loss in developing effective emotional communication skills.

OBJECTIVE: To assess the influence of three factors using retrospective chart review: age at which 2nd cochlear implant (CI) is implanted, prior hearing aid (HA) experience in the 2nd CI ear, and long-term experience with bilateral cochlear implants (BICIs) on sound localization in children with sequential BICIs.
METHODS: Mean absolute error (MAE) in localizing speech noise of 60 children with sequential BICIs was compared across four age groups of the 2nd CI (1-5.0; 5.1-10.0; 10.1-14.0; & 14.1-19.0 years) and two extents of prior HA experience (more than and less than one year). MAE was also longitudinally analyzed after 4-6 years of experience with BICI involving 18 participants out of 60.
RESULTS: Children who received 2nd CI before five years of age demonstrated significantly better localization than those who received it after ten years of age. More than one year of prior HA experience in the 2nd CI ear and extensive experience with sequential BICIs significantly enhanced localization performance. Inter-implant intervals and age at the 2nd CI showed a significant positive correlation with the MAE (poorer localization).
CONCLUSIONS: The results indicate that age at 2nd CI is important in developing sound localization skills. Based on the results, obtaining 2nd CI within the first five years of life and no later than ten years old is recommended. The results also suggest that longer use of amplification before 2nd CI and prolonged BICI experience significantly fosters localization development.

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。.

Conventional signal processing implemented on clinical cochlear implant (CI) sound processors is based on envelope signals extracted from overlapping frequency regions. Conventional strategies do not encode temporal envelope or temporal fine-structure cues with high fidelity. In contrast, several research strategies have been developed recently to enhance the encoding of temporal envelope and fine-structure cues. The present study examines the salience of temporal envelope cues when encoded into vocoder representations of CI signal processing. Normal-hearing listeners were evaluated on measures of speech reception, speech quality ratings, and spatial hearing when listening to vocoder representations of CI signal processing. Conventional vocoder techniques using envelope signals with noise- or tone-excited reconstruction were evaluated in comparison to a novel approach based on impulse-response reconstruction. A variation of this impulse-response approach was based on a research strategy, the Fundamentally Asynchronous Stimulus Timing (FAST) algorithm, designed to improve temporal precision of envelope cues. The results indicate that the introduced impulse-response approach, combined with the FAST algorithm, produces similar results on speech reception measures as the conventional vocoder approaches, while providing significantly better sound quality and spatial hearing outcomes. This novel approach for stimulating how temporal envelope cues are encoded into CI stimulation has potential for examining diverse aspects of hearing, particularly in aspects of musical pitch perception and spatial hearing.