Objectives: To evaluate the effect of electrode type and time of activation on battery performance in cochlear implant (CI) users. Design: A retrospective cross-sectional study was conducted on 39 CI recipients (57 ears) implanted between 2019 and 2023 at a tertiary center. Participants were grouped based on electrode type, Slim Modiolar/Perimodiolar (PM) vs. Slim Straight/Lateral Wall (LW) and activation timing, early (1–5 days) vs. late (3–6 weeks). Battery performance (standard, standard rechargeable, compact rechargeable) was assessed at five time points at: activation, 1,3,6, and 12 months post-activation. Data were analyzed using Mann–Whitney U tests. Results: Battery life declined progressively over the 12-month follow-up period. On average, standard batteries declined by approximately 16 hours (∼35%), standard rechargeable batteries by 7–9 hours (∼30–35%), and compact rechargeable batteries by 3–4 hours (∼30–35%). This trend was consistent across activation groups and electrode types, although absolute values varied slightly depending on configuration. Standard batteries consistently outperformed rechargeable options. Early activation was associated with significantly higher energy consumption at 1 month post-activation for standard batteries (median: 35 vs. 45 hours; p = 0.032), with no sustained differences thereafter. In the long term, PM electrodes demonstrated significantly longer battery life than LW electrodes at 12 months for standard (p = 0.016), standard rechargeable (p = 0.005*), and compact rechargeable (p = 0.001*) batteries. Conclusion: Battery consumption was mainly influenced by electrode design, with PM electrode showing superior energy efficiency. Although early activation increases short-term battery use, it does not affect long-term consumption. These findings support PM electrode selection to enhance device efficiency and users experience.
Background: Benign Paroxysmal Positional Vertigo (BPPV) of the posterior canal is commonly treated using the Epley Maneuver (EM). New maneuvers have been developed with potential benefits in ease and self-administration. Objective: To evaluate and compare the effectiveness of the EM with newly developed alternative maneuvers for treating posterior canal BPPV (PC-BPPV). Methods: A systematic review and meta-analysis was conducted of randomized controlled trials (RCTs) comparing the EM or placebo with new treatment maneuvers for PC-BPPV. Electronic databases (Scopus, PubMed, ScienceDirect, OVID MEDLINE, PROSPERO, and Cochrane Library) were searched. A pairwise meta-analysis using random-effects models was conducted, and the risk difference (RD) with 95% confidence intervals (CI) was calculated. Doi plots and the Luis Furuya-Kanamori (LFK) index were used to assess publication bias. Results: Five RCTs involving 422 patients were identified; three studies met criteria for meta-analysis. The pooled immediate treatment effect showed a rate ratio of 1.66 (95% CI: 0.534–5.151), and the follow-up effect showed a rate ratio of 1.64 (95% CI: 0.520–5.152), indicating that the new maneuvers (Half Somersault, Li Maneuver, Rolling over and New Alternate maneuver) demonstrated treatment outcomes comparable to the EM, while the wide confidence intervals reflect the limited number of available studies. The LFK indices were 1.74 (immediate) and 2.16 (follow-up), suggesting minor and major publication bias, respectively. Conclusions: Statistical data indicated that newly developed procedures for treating PC-BPPV are potentially advantageous as the EM. These techniques appear simple, and generally well-tolerated, indicating their potential as alternative options to the traditional EM; however, more robust and maneuver-specific studies are needed before firm conclusions can be drawn. Registration: PROSPERO ID: CRD42023466129
Purpose: Sound can be divided into 2 forms of temporal information: envelope and fine structure. While cochlear implants are effective in speech recognition in quiet, they are less effective for listening in noise and for music perception. This study aimed to compare a fine structure processing strategy (FS4) with a previous coding strategy (HDCIS) in newly implanted CI users. Methods: This prospective, randomized, cross-over, double-blind study included 19 participants between January 2017 and July 2018. Each participant was randomized to receive a map programmed with FS4 followed by a map programmed with HDCIS or vice versa. Tonal/vocal audiometry in quiet, music perception tests (Gabrielsson scale, interval test, melodic contour identification), and quality of life (HISQUI) assessments were conducted after 1 month of adaptation to each setting. Results: FS4 significantly improved speech recognition in quiet (mean effect (ME) = 8.4%, 95% confidence interval (CI95%) = 3.5% to 13.2%, p = 0.004, standardized effect size (SES) = 1.06), Gabrielsson scale scores (ME = 4.8, CI95% = 0.4 to 9.1, p = 0.047, SES = 0.67), and interval perception (ME = 18 Hz, CI95% = 2.7 to 32.4 Hz, p = 0.024, SES=0.78). No significant difference was found for melodic contour identification or HISQUI. A period effect was observed for speech recognition in quiet (p = 0.002), Gabrielsson scale (p = 0.005), interval test (p = 0.032), and HISQUI (p = 0.039). Eighty percent of the participants kept the FS4 setting after the study period. Conclusion: FS4 was associated with improved music perception and speech recognition in quiet compared to HDCIS in newly implanted cochlear implant users, suggesting potential advantages of fine structure processing strategies. N° West V Ethics Committee: 2016-A01952-49. December 28, 2016
Introduction: Precise interaural timing and level cues are critical for spatial hearing and speech understanding in noise. Bilateral cochlear implant (CI) users provide a controlled model to investigate how artificially introduced interaural timing disparities affect binaural hearing. This study investigates whether introducing a unilateral time delay in CI stimulation affects speech perception in noise and spatial release from masking (SRM). Methods: Eleven bilateral CI users were tested using the German Oldenburger Sentence Test (OLSA) under three spatial noise conditions (S0N0, S0N+90°, S0N–90°), with and without a 10-ms delay introduced to the right CI processor. Speech reception thresholds (SRTs) and SRM were analyzed using repeated-measures ANOVA. Results: No significant differences in SRT or SRM were found between the delay and non-delay conditions across all spatial configurations. A consistent right-ear advantage was observed, but the induced interaural delay did not significantly impair speech-in-noise performance. Conclusion: A unilateral 10-ms delay in CI stimulation does not significantly affect speech perception or SRM in bilateral CI users. These findings indicate that a unilateral 10-ms interaural delay does not measurably affect speech perception or SRM in bilateral CI users. This observation is consistent with previous reports suggesting limited functional use of fine-grained interaural timing cues during speech-in-noise processing, although the present study cannot draw conclusions about smaller interaural delays.
Introduction Superior semicircular canal dehiscence (SSCD) creates a pathological “third window” in the inner ear, leading to characteristic auditory and vestibular symptoms. Although 0.5 kHz vestibular evoked myogenic potential (VEMPs) are commonly used, we aimed to evaluate the sensitivity, specificity, and reproducibility of VEMPs elicited with high-frequency tone bursts. Methods This prospective, multicenter, observational, longitudinal study included adults with strictly unilateral SSCD confirmed by high-resolution CT, using the contralateral ear as an intra-individual control. Participants attended three visits over four weeks. Cervical (2 kHz) and ocular (4 kHz) VEMPs were recorded with two traces per ear per session using standard electrode placement and 95 dB nHL tone bursts. Sensitivity, specificity, ROC/AUC, and reproducibility (intra- and inter-visit) were assessed. Results Twenty-eight patients with strictly unilateral SSCD were included (mean age 57.6 ± 12.5 years; 17 women). No VEMP responses were observed in unaffected ears, yielding a specificity of 100% for both 2 kHz cVEMPs and 4 kHz oVEMPs. Sensitivity in dehiscent ears ranged from 71.4% to 60.7% for cVEMPs and from 60.7% to 50.0% for oVEMPs across the three visits. Overall, the analyzed electrophysiological markers demonstrated good to excellent intra- and inter-visit reproducibility. Conclusions In conclusion, high-frequency VEMPs, including 2 kHz cVEMPs and 4 kHz oVEMPs, show perfect specificity for detecting ears with SSCD and good to excellent intra- and inter-visit reproducibility. A fixed stimulation intensity of 95 dB nHL provides a balance between patient comfort and test duration.
