PURPOSE:To answer the following question: what are the expectations of families of children and adolescents regarding the benefits of cochlear implant (CI) use? METHOD:This systematic review included studies assessing family expectations regarding the benefits of CI use in children and adolescents. Searches were performed across Embase, LILACS, PubMed, Scopus, Web of Science, Google Scholar, and ProQuest, without language or year restrictions. A meta-analysis of proportions with a random-effects model (DerSimonian-Laird) was performed, considering only 'strongly agree' responses as high expectations. An odds ratio meta-analysis was also conducted to compare expectations before and after CI activation. RESULTS:Thirty-four studies were included, most presenting a high risk of bias. Approximately 55% of family members reported high expectations for exclusive oral communication, and 39% believed their child would understand speech without lip reading. Around 38% expected enrollment in mainstream schools, although only 14% strongly agreed that their child would keep up with hearing peers. Between 48% and 54% expressed high expectations regarding socialization in different contexts, and about 45% expected satisfactory CI functioning. The meta-analysis suggested a significant increase in expectations after CI activation, particularly for auditory and spoken language development. CONCLUSION:Family expectations regarding the benefits of CI are generally high but vary across domains. Although the meta-analysis suggested an increase in expectations after device activation, the overall certainty of the evidence was low to very low, warranting cautious interpretation.
BACKGROUND:Bone conduction hearing implants were introduced in the late 1970s and have since undergone multiple iterations in mechanical and electronic design, as well as surgical requirements. While there have been reports of hearing outcomes and complications, limited population-level data exist. This study examined the number of bone conduction implant (BCI) procedures in Australia over 20 years (July 2004 to June 2024), exploring age, sex and temporal factors. METHODS:Procedural data were obtained from the Australian Institute of Health and Welfare (AIHW) and population data from the Australian Bureau of Statistics (ABS). The number of procedures was categorised by year, age group, sex, and adjusted for the population. RESULTS:There were a total of 4536 BCI implants over the 20-year period, and 118 BCI explants during the last five reporting periods. There was a gradual increase in BCI procedures from 2004 to 2005, peaking at 434 procedures in 2016-2017, followed by a slow decline to 2022-2023, with a noticeable dip in 2021-2022, which coincided with the COVID-19 pandemic. The 60-79 year age group underwent the highest number of procedures across all periods investigated, followed by the 40-59 year age group. Minimal sex differences were observed between males and females; however, overall, females aged 40-59 years had more BCI procedures than males of the same age group. DISCUSSION:This study provides valuable insights into BCI procedures in Australia, supporting future healthcare planning and policy development.
OBJECTIVES:Although assessing listening effort is clinically essential, no validated Turkish self-report measure currently exists. This study aimed to translate and culturally adapt the Extended version of the Effort Assessment Scale (EEAS) into Turkish and to evaluate the validity and reliability of the Turkish EEAS (T-EEAS) in adults with typical hearing (TH) and cochlear implant (CI) users. METHODS:A standardized cross-cultural adaptation protocol was followed. Psychometric properties were evaluated in 567 adults (463 TH and 104 CI users). Construct validity was examined using confirmatory factor analysis. Reliability was assessed using Cronbach's alpha, test-retest correlation, intraclass correlation coefficient (ICC), and Bland-Altman agreement analysis. Discriminant validity was evaluated by comparing T-EEAS scores between groups. RESULTS:Confirmatory factor analysis supported a two-factor structure with good model fit. The T-EEAS showed high internal consistency (Cronbach's alpha = 0.938) and excellent test-retest reliability (Spearman's r = 0.867; ICC = 0.877). CI users reported higher listening effort than the TH group (P < 0.001), with a large effect size (Cliff's δ = 0.838). DISCUSSION:The T-EEAS captures subjective listening effort in Turkish-speaking populations. The two-factor structure distinguishes effort in quiet versus noise, which may support outcome monitoring in audiological rehabilitation. The higher scores observed in CI users support the discriminant validity of the scale. CONCLUSIONS:The T-EEAS is a valid and reliable measure of subjective listening effort in Turkish-speaking adults and can distinguish between TH adults and CI users, supporting its use in clinical and research settings.
We present a case of unintended displacement of a manufacturer-provided external magnetic puck (splint), which occurred during an MRI scan in a patient with an auditory implant, highlighting the associated risks and potential for harm. Despite established safety protocols and secure head bandaging, the strong magnetic field resulted in the puck becoming a dangerous projectile, posing a potentially serious risk to both the patient and MRI staff. This report discusses the rationale for the new magnetic puck introduced by the auditory implant manufacturer to try to reduce internal implant magnet displacement. We offer an alternative technique to minimise the risk of splint slippage during head bandaging with non-magnetic standard plastic splints, with the aim of mitigating the risk of internal magnet displacement whilst avoiding the use of this magnetic puck with the potential risks of a magnetic projectile in the MRI scanner.
INTRODUCTION:Age-related hearing loss is increasingly prevalent and impacts psychosocial wellbeing, cognitive health, and quality of life in older adults. While cochlear implants (CIs) are effective for severe-to-profound loss, their use in the elderly was historically cautious. This umbrella review synthesizes evidence on CI effects on auditory, cognitive, postural, and quality-of-life outcomes in this population. METHOD:Following PRISMA guidelines and a protocol registered in PROSPERO, we searched PubMed, Cochrane, Web of Science, and Embase up to September 30, 2025 for systematic reviews and meta-analyses on adults ≥60 years undergoing CI. Two reviewers independently extracted data and assessed quality using AMSTAR 2 and PRISMA. RESULT:Analysis of 21 reviews across five domains showed CI generally improves auditory and speech functions. Cognitive improvements were partial, especially in executive function and verbal memory. Postural stability evidence was inconsistent. Quality of life improved overall, particularly in sound perception and social functioning, with social outcomes affirming enhanced communication and independence. However, methodological quality revealed that most reviews had critically low confidence ratings, highlighting the need for higher-quality evidence. CONCLUSION:CI offers meaningful benefits in auditory restoration, certain cognitive functions, and social engagement for older adults. Despite this, evidence is limited by methodological heterogeneity and low study quality. Future research requires standardized protocols and robust designs. Clinically, CI remains a valuable option for eligible older adults with severe hearing loss.
OBJECTIVE:The objective was to examine the relationship between phonological processing skills and speech recognition outcomes after cochlear implantation in adults with acquired hearing loss, using both pre- and post-implantation measures. METHODS:A systematic review was conducted in accordance with PRISMA guidelines. MEDLINE, CINAHL, and EMBASE databases were searched for studies investigating phonological processing and cochlear implantation. Two reviewers independently screened studies according to predefined PICOST criteria. Eligible studies included randomized and non-randomized (cross-sectional or longitudinal) studies published in English or French between 1998 and 2024, involving adults (≥18 years) with acquired hearing loss who received at least a cochlear implant. Studies were required to assess phonological processing before and/or after implantation and report speech recognition outcomes. Methodological quality was also evaluated. RESULTS:Of 1649 records identified, 26 full-text articles were screened, and 9 studies met the inclusion criteria. Extracted data included study design, participant characteristics, hearing loss history, implant use duration, assessment methods, and performance on phonological, speech recognition outcomes, and cognitive measures. The available evidence was limited and highly heterogeneous in terms of study design, assessment tools, and outcome measures. Quality assessment revealed predominantly low-to-moderate levels of evidence, reflecting methodological limitations. CONCLUSION:Current evidence is low to support the hypothesis that stronger pre-implantation phonological processing skills predict speech recognition outcomes after cochlear implantation. Further studies using standardized assessments and more robust methodologies are needed to clarify the role of phonological processing in cochlear implant outcomes.
OBJECTIVES:Active transcutaneous bone conduction devices have expanded rehabilitation options for children with conductive, mixed, and single-sided deafness (SSD). The Cochlear™ OSIA® system improves hearing while preserving intact skin. We hypothesised that postoperative outcomes vary by operative context and that incision design may influence complication risk. METHODS:A prospectively maintained database of paediatric patients implanted between September 2021 and April 2026 was retrospectively analysed. Patients were grouped by operative context: (1) microtia/craniofacial anomalies, (2) surgically altered tissues (chronic ear disease/post-mastoidectomy or conversion from percutaneous devices), and (3) normal anatomy (SSD). The primary outcome was soft tissue complications. Secondary outcomes included audiological improvement and subjective benefit (SAC-A). RESULTS:Thirty-four children underwent 46 OSIA® implants (22 unilateral, 12 bilateral); they were aged between 7-19 years and 56% were female. Seventeen had microtia/craniofacial syndromes, twelve had chronic ear disease (including four conversions), and five had SSD. No perioperative complications occurred. Postoperative soft tissue complications occurred in 4/46 implants (8.7%), exclusively in the microtia/craniofacial and surgically altered tissue groups. One explantation was required for late infection; the remainder were managed conservatively or with revision surgery. Significant improvements were seen at 2 kHz (P = 0.009), 4 kHz (P < 0.001), and in speech recognition (86% to 95%, P = 0.004). SAC-A scores improved significantly (36 to 24; P = 0.002), with 94.1% reporting satisfactory usability. CONCLUSIONS:Paediatric OSIA® implantation provides substantial audiological benefit with low complication rates. Complications clustered in anatomically or surgically altered tissues, supporting context-specific counselling and surgical planning.
INTRODUCTION:Cochlear Nerve Deficiency, particularly Hypoplastic Auditory Nerve (HAN), creates uncertainty regarding Cochlear Implant (CI) outcomes. This study evaluated the utility of Transtympanic Electrically Evoked Auditory Brainstem Response (TT-EABR) in managing HAN cases. METHODS:Twenty-two children with MRI-confirmed HAN were assessed using TT-EABR to guide ear selection for CI vs Auditory Brainstem Implantation (ABI) candidacy. Consequently, 13 children received CIs (HAN -CI group). Their auditory and speech outcomes -measured via CAP, SIR, and MAIS/IT-MAIS at baseline and 12 months post-implantation (with Auditory-Verbal Therapy) -were compared against an age-matched control group of 13 children with normal auditory nerves. RESULTS:The HAN -CI group demonstrated significant improvements from baseline to 12 months in CAP (p=0.001), SIR (p=0.005), and MAIS/IT-MAIS (p=0.001) scores. Remarkably, no statistically significant differences were found between the HAN and control groups for CAP (p=0.93), SIR (p=0.70), and MAIS/IT-MAIS (p=0.97). Favorable outcomes correlated with Kumar-Dutt Type A and B TT-EABR responses, with Type A yielding the best results. DISCUSSION & CONCLUSION:While historical data associates HAN with poor outcomes, this study highlights that precise preoperative TT-EABR assessment and ear selection can lead to outcomes comparable to non-anomalous cases. TT-EABR is a pivotal prognostic tool, crucial for ear selection and managing parental expectations. Preoperative TT-EABR is essential for tailored clinical management and successful CI intervention in selected HAN cases.
OBJECTIVE:The objective of this cross-sectional study was to compare the auditory memory scores obtained using the verbal and picture-pointing response modes in children with cochlear implants and implant-age matched typically developing children. METHOD:The short-term auditory memory test consisting of word sequences ranging from two-word sequences to five-word sequences was developed and administered to 53 children using unilateral cochlear implants and 53 typically developing children matched in terms of implant age and gender. The implant age of the children ranged from 2 years 8 months to 7 years 9 months, and the mean age of implantation was 3 years 5 months. Each participant was tested twice, once using a verbal response task and once using a picture-pointing response task in two different sessions. RESULTS:The total auditory memory scores were significantly higher (P < 0.05) for the picture-pointing task as compared to the verbal recall task, especially when the memory task placed a high auditory demand and cognitive load on the children. The total auditory memory scores obtained using both the response tasks were lower in children using cochlear implants as compared to implant-age matched typically developing children (P < 0.05). CONCLUSION:The present findings indicate that the type of response task affects the performance on the short-term auditory memory test in children using cochlear implants and typically developing children, with the picture-pointing response task yielding better scores than the verbal response.
OBJECTIVES:To identify barriers that audiologists face in adopting telemedicine in adult cochlear implant care, and to determine what is needed to overcome these barriers. METHODS:Prospective mixed-methods anonymous online survey of cochlear implant audiologists working with adults in the United Kingdom. RESULTS:Thirty-one complete responses were received in August - September 2024. Eighty-seven percent (27) had used remote care tools in their care of adults with cochlear implants. Twenty-nine percent (9) had never used remote care tools or used them rarely; no respondents used them daily. Sixty-eight percent of respondents reported frequent technical issues with remote care tools. Respondents were split equally when asked if remote care is less effective than in-person care, but 81% felt that the gold standard of clinical care is in-person care. Barriers to remote care could be overcome by improvements and enhancements to the cochlear implant manufacturers' tools, and easier and fuller integration into patient pathways and systems. CONCLUSION:The main barriers to audiologists using remote care were frequent technical problems and the perception that the gold standard of clinical care was in-person care. When telemedicine offers a seamless, accessible, person-centred care experience, perceptions about the gold standard of care may change.
OBJECTIVES:To assess the effects of frequency overlap across ears on functional listening outcomes in postlingually deafened experienced bimodal users with aidable low-to-mid frequency acoustic hearing. METHODS:Two experimental conditions were compared: (1) frequency overlap (full cochlear implant [CI] bandwidth) and (2) frequency non-overlap (CI stimulation restricted to frequencies beyond the 65 dB HL threshold). Hearing aid (HA) amplification remained constant, with gain applied up to and including the 65 dB HL threshold. Fourteen participants were assessed on speech perception in quiet, co-located, and spatially separated noise, localisation, and subjective evaluation of sound quality. RESULTS:Frequency overlap resulted in significantly better outcomes on all measures except localisation, which showed no difference. Bimodal listening resulted in better speech perception in quiet and co-located noise compared to CI or HA alone. When noise was presented to the HA side, speech perception improved relative to noise on the CI side. Participants preferred the frequency overlap condition. DISCUSSION:Findings suggested that providing full CI frequency bandwidth may offer perceptual benefits for some experienced bimodal users under specific programming conditions. No evidence of signal interference across ears was observed. The consistent absence of interference may reflect, in part, the restriction of HA amplification to below cochlear dead region thresholds; however, further studies are required to investigate this relationship. CONCLUSION:While this study provides preliminary evidence supporting the potential benefits of frequency overlap in bimodal fittings, further research involving larger and more diverse samples is necessary to confirm these effects and to assess longer-term outcomes.
OBJECTIVES:Langerhans cell histiocytosis (LCH) is a rare disorder that may involve the temporal bone and, in rare cases, result in sensorineural hearing loss. This report highlights the importance of close radiological surveillance and timely cochlear implantation in the setting of progressive otic capsule ossification. METHODS:A 21-year-old male presented with a five-year history of progressive bilateral hearing loss, tinnitus, vertigo and imbalance. Following multidisciplinary team (MDT) discussion, cochlear implantation was deferred until completion of chemotherapy. RESULTS:Repeat CT imaging demonstrated progressive cochlear ossification involving the otic capsules. A repeat discussion followed, which led to an expedited cochlear implantation. The left side was implanted first due to lesser ossification, achieving full electrode insertion. Sequential implantation of the contralateral ear was performed four months later. However, insertion was limited due to advanced ossification. DISCUSSION:The second implantation was technically more challenging, with only partial electrode insertion possible due to advanced ossification. We advocate for close surveillance in the case of LCH to monitor for signs of otic capsule ossification. CONCLUSION:This case demonstrates that cochlear ossification in LCH may progress rapidly, narrowing the window for optimal implantation. Early cochlear implantation should be strongly considered in such cases.
OBJECTIVE:This study aimed to assess the long-term results in speech discrimination and quality of life (QoL) in a population of adults with congenital hearing loss who received a cochlear implant during their childhood. METHODS:This was a cross-sectional and observational study including three otology referral hospitals in Bogotá (Colombia). Audiological outcomes (Hearing in Noise Test - HINT results), Speech, Spatial, and Qualities of hearing scale-12 (SSQ-12) scores, Glasgow Benefit Inventory (GBI) scores, and sociodemographic questionnaires were applied to adults with hearing loss who received a cochlear implant between 1995 and 2011. RESULTS:A total of 19 adults with hearing loss were included. For the Hearing in Noise Test (HINT) results, the study sample showed an average word repetition rate of 72.8% in fixed noise and 82.3% in a quiet environment. The SSQ-12 scores were p50 of 6.4 for the speech scale, 6.6 for the spatial scale, and 6.75 for the quality of hearing scale. In terms of QoL, 78% of participants reported improvement in GBI score. A positive correlation was observed between older age of implantation, higher quality of life, and better speech discrimination in noisy environments (higher SSQ-12 score). CONCLUSIONS:The patients with cochlear implants from a low/middle-income country included in this study, demonstrated long-term benefits in hearing, speech perception, and quality of life after more than 10 years of implantation.
OBJECTIVES:Inner ear malformations (IEMs) represent a major structural cause of congenital sensorineural hearing loss. This study aimed to examine the impact of IEM subtype on auditory perception and language development outcomes in pediatric cochlear implant (CI) users. DESIGN:A total of 51 children with IEMs who underwent cochlear implantation were included. Of these, 12 (23.5%) had an incomplete partition type 1 (IP-1), 21 (41.2%) had incomplete partition type 2 (IP-2), 11 (21.6%) had enlarged vestibular aqueduct (EVA), and seven (13.7%) had cochlear aperture abnormalities. STUDY SAMPLE:In this cross-sectional study, auditory perception and language development were assessed in pediatric CI users with different types of IEM. RESULTS:The mean age of implantation was 37.29 ± 23.24 months, and the mean age at language assessment was 112.84 ± 38.67 months. Significant differences in auditory and language test scores were observed among the IEM subgroups (P = 0.001). CONCLUSIONS:IEM subtype significantly influences auditory performance and language development outcomes in pediatric CI users. These anatomical differences should be considered during preoperative counseling and in the planning of postoperative rehabilitation. Notably, despite intergroup variability, all participants demonstrated measurable improvements in auditory perception and speech production following cochlear implantation.
AIM:This study aims to investigate the language and listening development of children with cochlear implants (CI) in the Gulf Cooperation Council (GCC) region over 24 months. It seeks to identify factors influencing progress and the impact of challenges on CI outcomes, focusing on children without additional disabilities. MATERIALS AND METHODS:The project design is explorative, with a descriptive, longitudinal, ambispective analysis conducted across six hospitals in four GCC countries. Qualified speech and language therapists evaluated children diagnosed with prelingual severe to profound bilateral sensorineural hearing loss who received CIs between 2018 and 2024. The Integrated Scales of Development (ISD) assessed progress in six developmental domains at five intervals (T0-T4). Data also included demographics, prior hearing aid use, and parental education. RESULTS:The results indicated significant improvements across all six developmental domains over the 24-month period, with median scores increasing consistently. Statistical analysis revealed a strong linear trend in development (P = 0.000). Children who received CIs earlier showed better outcomes, whereas prior hearing aid use did not significantly affect results. Parental education levels had no impact on developmental outcomes. CONCLUSION:The study underscores the importance of early cochlear implantation and ongoing auditory-focused intervention for enhancing listening and spoken language skills in children with CIs in the GCC. Despite significant progress, children did not fully match their hearing peers within the 24-month timeframe, suggesting the need for extended support.
Background: Meniere's Disease (MD) may present as a complication in the hearing outcomes of patients with hearing loss who are treated with either hearing aids or cochlear implants (CI).Objective: This case study aims to highlight the course of treatment for MED as well as being inflicted by MD, which was discovered after transferring care from a private practice to an academic medical center for treatment of internal failure of her left device, as indicated by manufacturer recall.Case Presentation: This patient is a long-time user of bilateral cochlear implants who has experienced multiple fluctuations in performance, most notably in her dominant right CI. Pressure changes in patients with middle ear dysfunction (MED) may impact the programming levels.Results: The patient has shown significant improvement following substantial programming changes in her right CI. She has become more aware of Meniere's attacks and is utilizing available self-adjustment of current parameters. In doing so, she is able to improve her hearing status regardless of the presence of Meniere's attacks through programming changes.
ObjectivesTo assess functional language performance on paediatric cochlear implant patients in Malawi.MethodsSixteen patients who received cochlear implantation before the age of 18 years from a single site were invited for an interview. Parents or guardians of twelve of these participated in the PEACH and BAPP questionnaires, whilst four others who had become adults answered independently. The PEACH scale is a 13-question survey with a maximum score of 52. The BAPP score has four domains with a total score of 16.ResultsMost patients acquired profound hearing loss through either mumps, meningitis, malaria or a combination (15/16). The mean age of onset of profound deafness was 8.8 years of age (range = 4-16 years) and implantation was 10.6 years (range = 4-18 years). The mean 'Quiet Sounds' questions were 23.56/24 (sd +/-1.75) and 'Loud Sounds' were 27.06/28 (sd +/-1.57). The mean total PEACH score was 50.63/52 (sd +/-2.73). There was no correlation with age of implant and PEACH score. The BAPP score was 16/16 for each patient.ConclusionDespite a very low socio-economic environment, this cohort shows cochlear implantation has a strong perceived benefit from the parents and guardians of post-lingually profoundly deaf children.
INTRODUCTION:Cochlear implant (CI) pathways are well established in the general population, but data on pediatric and young adult cancer survivors are limited. This study evaluated the feasibility and safety of cochlear implantation in this population, described demographic and clinical characteristics, examined timelines to hearing rehabilitation, and reported short-term outcomes and complications. MATERIALS AND METHODS:Retrospective case-control study on patients aged 0-22 years with cancer-related hearing loss and matched peers who underwent CI between December 2010 and January 2023. RESULTS:Eight oncologic patients and 20 controls (37 implantations) were analyzed. All had bilateral progressive hearing loss. Except for three oncologic patients, all used bilateral hearing aids before implantation. The time from meeting candidacy criteria to CI was significantly longer in cases than controls (2.8 vs. 0.5 years; p = 0.004). Although most cases qualified for bilateral implants, only two received them. Five of eight oncologic patients demonstrated excellent CI use with good speech recognition. CONCLUSION:Pediatric and young adult oncology patients with limited benefit from hearing aids may be good candidates for cochlear implantation. Multidisciplinary care is essential to guide timely, evidence-based implantation in this population.
