Central Institute For The Deaf Research Articles

Cochlear implantation in far-advanced otosclerosis: hearing results and complications.

SUMMARYSevere forms of otosclerosis known as far-advanced otosclerosis (FAO) can lead to severe to profound sensorineural hearing loss and can justify cochlear implantation. Because of the pathophysiology of otosclerosis, patients implanted for FAO may experience an increased rate of complications, such as facial nerve stimulation or electrode dislocation, and may have poorer hearing outcomes than expected. This retrospective study aimed to compare cochlear implantation hearing outcomes, surgical difficulties and complications in FAO patients versus non-FAO patients. Moreover, we evaluated whether high resolution computed tomography (CT scan) findings were predictive of perioperative problems, complications and hearing outcomes. FAO patients were diagnosed based on medical history, examination and CT scan. Thirty-five ears from FAO patients were compared to 38 control ears. Audiometric results were assessed at least 12 months after implantation by pure tone average, speech reception threshold, monosyllabic and disyllabic word recognition score (WRS) and Central Institute for the Deaf (CID) sentences test. Complications and surgical difficulties were compiled. CT scan findings were categorised within 3 grades of otosclerotic extension. No significant difference was found between FAO and non-FAO hearing outcomes, except that monosyllabic WRS were lower for FAO patients, especially those who underwent previous stapedotomy. Facial nerve symptomatology occurred in 8.6% of FAO patients; among these, one required explantation-reimplantation surgery. 86% of FAO implanted patients had retrofenestral extension on CT. These were associated with poorer disyllabic WRS (51% vs 68%, p < 0.05) than those with only fenestral involvement. Although not significant, high grade of severity on CT tended to be associated with surgical difficulties and complications. Cochlear implantation in FAO patients is an effective treatment technique. Though the overall complication rate is low, it tends to be higher in cases of severe extension on CT. Patient counselling should be adjusted accordingly.

Behavioral Measures of Temporal Processing and Speech Perception in Cochlear Implant Users.

Although most cochlear implant (CI) users achieve improvements in speech perception, there is still a wide variability in speech perception outcomes. There is a growing body of literature that supports the relationship between individual differences in temporal processing and speech perception performance in CI users. Previous psychophysical studies have emphasized the importance of temporal acuity for overall speech perception performance. Measurement of gap detection thresholds (GDTs) is the most common measure currently used to assess temporal resolution. However, most GDT studies completed with CI participants used direct electrical stimulation not acoustic stimulation and they used psychoacoustic research paradigms that are not easy to administer clinically. Therefore, it is necessary to determine if the variance in GDTs assessed with clinical measures of temporal processing such as the Randomized Gap Detection Test (RGDT) can be used to explain the variability in speech perception performance. The primary goal of this study was to investigate the relationship between temporal processing and speech perception performance in CI users. A correlational study investigating the relationship between behavioral GDTs (assessed with the RGDT or the Expanded Randomized Gap Detection Test) and commonly used speech perception measures (assessed with the Speech Recognition Test [SRT], Central Institute for the Deaf W-22 Word Recognition Test [W-22], Consonant-Nucleus-Consonant Test [CNC], Arizona Biomedical Sentence Recognition Test [AzBio], Bamford-Kowal-Bench Speech-in-Noise Test [BKB-SIN]). Twelve postlingually deafened adult CI users (24-83 yr) and ten normal-hearing (NH; 22-30 yr) adults participated in the study. The data were collected in a sound-attenuated test booth. After measuring pure-tone thresholds, GDTs and speech perception performance were measured. The difference in performance between-participant groups on the aforementioned tests, as well as the correlation between GDTs and speech perception performance was examined. The correlations between participants' biologic factors, performance on the RGDT and speech perception measures were also explored. Although some CI participants performed as well as the NH listeners, the majority of the CI participants displayed temporal processing impairments (GDTs > 20 msec) and poorer speech perception performance than NH participants. A statistically significant difference was found between the NH and CI test groups in GDTs and some speech tests (SRT, W-22, and BKB-SIN). For the CI group, there were significant correlations between GDTs and some measures of speech perception (CNC Phoneme, AzBio, BKB-SIN); however, no significant correlations were found between biographic factors and GDTs or speech perception performance. Results support the theory that the variability in temporal acuity in CI users contributes to the variability in speech performance. Results also indicate that it is reasonable to use the clinically available RGDT to identify CI users with temporal processing impairments for further appropriate rehabilitation.

Band importance for sentences and words reexamined

Band-importance functions were created using the "compound" technique [Apoux and Healy, J. Acoust. Soc. Am. 132, 1078-1087 (2012)] that accounts for the multitude of synergistic and redundant interactions that take place among speech bands. Functions were created for standard recordings of the speech perception in noise (SPIN) sentences and the Central Institute for the Deaf (CID) W-22 words using 21 critical-band divisions and steep filtering to eliminate the influence of filter slopes. On a given trial, a band of interest was presented along with four other bands having spectral locations determined randomly on each trial. In corresponding trials, the band of interest was absent and only the four other bands were present. The importance of the band of interest was determined by the difference between paired band-present and band-absent trials. Because the locations of the other bands changed randomly from trial to trial, various interactions occurred between the band of interest and other speech bands which provided a general estimate of band importance. Obtained band-importance functions differed substantially from those currently available for identical speech recordings. In addition to differences in the overall shape of the functions, especially for the W-22 words, a complex microstructure was observed in which the importance of adjacent frequency bands often varied considerably. This microstructure may result in better predictive power of the current functions.

Speech-perception-in-noise and bilateral spatial abilities in adults with delayed sequential cochlear implantation

To determine speech-perception-in-noise (with speech and noise spatially distinct and coincident) and bilateral spatial benefits of head-shadow effect, summation, squelch and spatial release of masking in adults with delayed sequential cochlear implants. A cross-sectional one group post-test-only exploratory design was employed. Eleven adults (mean age 47 years; range 21-69 years) of the Pretoria Cochlear Implant Programme (PCIP) in South Africa with a bilateral severe-to-profound sensorineural hearing loss were recruited. Prerecorded Everyday Speech Sentences of The Central Institute for the Deaf (CID) were used to evaluate participants' speech-in-noise perception at sentence level. An adaptive procedure was used to determine the signal-to-noise ratio (SNR, in dB) at which the participant's speech reception threshold (SRT) was achieved. Specific calculations were used to estimate bilateral spatial benefit effects. A minimal bilateral benefit for speech-in-noise perception was observed with noise directed to the first implant (CI 1) (1.69 dB) and in the speech and noise spatial listening condition (0.78 dB), but was not statistically significant. The head-shadow effect at 180 degrees was the most robust bilateral spatial benefit. An improvement in speech perception in spatially distinct speech and noise indicates the contribution of the second implant (CI 2) is greater than that of the first implant (CI 1) for bilateral spatial benefit. Bilateral benefit for delayed sequentially implanted adults is less than previously reported for simultaneous and sequentially implanted adults. Delayed sequential implantation benefit seems to relate to the availability of the ear with the most favourable SNR.

Speech-perception-in-noise and bilateral spatial abilities in adults with delayed sequential cochlear implantation

Objective: To determine speech-perception-in-noise (with speech and noise spatially distinct and coincident) and bilateral spatial benefits of head-shadow effect, summation, squelch and spatial release of masking in adults with delayed sequential cochlear implants. Study design: A cross-sectional one group post-test-only exploratory design was employed. Eleven adults (mean age 47 years; range 21 – 69 years) of the Pretoria Cochlear Implant Programme (PCIP) in South Africa with a bilateral severe-to-profound sensorineural hearing loss were recruited. Prerecorded Everyday Speech Sentences of The Central Institute for the Deaf (CID) were used to evaluate participants’ speech-in-noise perception at sentence level. An adaptive procedure was used to determine the signal-to-noise ratio (SNR, in dB) at which the participant’s speech reception threshold (SRT) was achieved. Specific calculations were used to estimate bilateral spatial benefit effects. Results: A minimal bilateral benefit for speech-in-noise perception was observed with noise directed to the first implant (CI 1) (1.69 dB) and in the speech and noise spatial listening condition (0.78 dB), but was not statistically significant. The head-shadow effect at 180° was the most robust bilateral spatial benefit. An improvement in speech perception in spatially distinct speech and noise indicates the contribution of the second implant (CI 2) is greater than that of the first implant (CI 1) for bilateral spatial benefit. Conclusion: Bilateral benefit for delayed sequentially implanted adults is less than previously reported for simultaneous and sequentially implanted adults. Delayed sequential implantation benefit seems to relate to the availability of the ear with the most favourable SNR.

Effects of simulated cataracts on speech intelligibility

Limited research is available on how well visual cues integrate with auditory cues to improve speech intelligibility in persons with visual impairments, such as cataracts. We investigated whether simulated cataracts interfered with participants’ ability to use visual cues to help disambiguate a spoken message in the presence of spoken background noise. We tested 21 young adults with normal visual acuity and hearing sensitivity. Speech intelligibility was tested under three conditions: auditory only with no visual input, auditory-visual with normal viewing, and auditory-visual with simulated cataracts. Central Institute for the Deaf (CID) Everyday Speech Sentences were spoken by a live talker, mimicking a pre-recorded audio track, in the presence of pre-recorded four-person background babble at a signal-to-noise ratio (SNR) of −13dB. The talker was masked to the experimental conditions to control for experimenter bias. Relative to the normal vision condition, speech intelligibility was significantly poorer, [t(20)=4.17, p<.01, Cohen’s d=1.0], in the simulated cataract condition. These results suggest that cataracts can interfere with speech perception, which may occur through a reduction in visual cues, less effective integration or a combination of the two effects. These novel findings contribute to our understanding of the association between two common sensory problems in adults: reduced contrast sensitivity associated with cataracts and reduced face-to-face communication in noise.

Cochlear Implantation in Organ Transplantation

Compared to immunocompetent patients, organ transplant recipients receiving immunosuppressant medications may experience higher rates of postoperative complications. This study was designed to retrospectively review the outcomes of cochlear implantation among organ transplant patients. Retrospective case series. Five organ transplant patients received seven cochlear implantations at the University of Miami Ear Institute from January 1, 1992, until August 31, 2005. Inpatient and outpatient records were analyzed to identify healing problems, wound infections, and speech recognition after implantation. There were no healing problems, wound infections, or other complications noted among cochlear implant recipients who had also received organ transplantation. Open-set sentence discrimination as measured by the Hearing in Noise Test (HINT), City University of New York (CUNY) test, and/or Central Institute for the Deaf (CID) tests ranged from 46% to 89%. Open-set word recognition as measured by the Consonant Nucleus Consonant (CNC) or the Northwestern University number 6 (NU-6) test ranged from 26% to 64%. This series suggests that cochlear implantation can be safe and effective for solid organ transplant recipients on immunosuppressants, with discrimination performance within the expected ranges for cochlear implant patients

A Comparison of Postcochlear Implantation Speech Scores in an Adult Population

The vast majority of cochlear implant recipients realize significant improvement in speech perception. However, there continue to be a small group that does not realize such a benefit. In an effort to identify possible predictors for this, we have compared pre- and postimplant audiologic data using Hearing In Noise Test (HINT), City University of New York (CUNY), or Central Institute for the Deaf (CID) scores for 445 consecutive English-speaking adult patients followed for a minimum of 1 year postimplantation in two distinct groups, poor versus excellent performers. Retrospective. Poor performers were those who realized a worsening, no improvement, or an improvement of less than 10%. This group numbered 58 (13%). High performers consisted of a cadre of 194 (44%) patients who scored between 91 and 100% postimplantation. Demographic data relating to onset of deafness, education exposure, etiology, etc., were evaluated. Of the poor performers, 33 (57%) were pre-/perilingually deafened. Of these, 79% had not received any auditory/oral training in childhood. On the other hand, a total of 109 implant recipients were individuals who were pre-/perilingually deafened. Of these, 24 were in the excellent performer category. All were identified early and were recipients of a strong auditory/oral education. Of the high performers, 170 (88%) were deafened late. Other findings such as preoperative electronystagmography with caloric testing, hearing aid use, device type, and high-resolution computed tomography scan of the temporal bone will be discussed for both groups. A high preimplant speech score, auditory verbal therapy, and postlingual deafness statistically correlate with higher postimplant speech scores 1 year after cochlear implantation. Device type, caloric response and hearing aid use preimplantation, age at surgery, and sex do not statistically correlate with either poor or excellent speech discrimination scores postcochlear implantation.

The Consistency of Sentence Intelligibility Across Three Types of Signal Distortion

To examine the extent to which sentences retain their levels of spoken intelligibility relative to other sentences in a set (the sentence effect) across different types of signal distortion. The Central Institute for the Deaf (CID) sentences were rendered difficult to understand through the addition of broadband noise. These intelligibility data were compared with those from previous studies in which the sentences were distorted through filtering and visual-only conditions of speechreading. The extent to which the various sentences retained their intelligibility rankings was examined using an analysis of variance model and by correlating individual sentence means across conditions. The sentences accounted for a large portion of the variance, and individual sentence scores were highly correlated across conditions involving a single distortion type. However, correlations were lower when conditions involving noise were compared with those involving filtering. Surprisingly, correlations across auditory distortions were almost identical to those observed across auditory and visual modalities. These comparisons, reflecting the consistency of sentence difficulty independent of presentation characteristics, accounted for approximately 25% of the variance in sentence-recognition performance. There exists a sentence effect that holds across various types of signal distortion, but the strongest form is restricted not only within modalities but within particular forms of distortion.

Cochlear Implantation in Patients with Neurofibromatosis Type 2 and Bilateral Vestibular Schwannoma

To investigate the results of cochlear implantation in patients with neurofibromatosis Type 2 (NF2) and bilateral vestibular schwannoma. Retrospective case review. Three academic tertiary referral centers. Seven patients with NF2 and bilateral vestibular schwannoma who lost hearing in at least one ear after treatment of their tumor (surgery or radiation therapy). Cochlear implantation after treatment of their vestibular schwannoma. Postimplantation audiometric scores (pure-tone average thresholds, consonant-nucleus-consonant (CNC) words/phonemes, Central Institute for the Deaf (CID) sentences, Hearing in Noise Test (HINT) quiet/noise, and Monosyllable, Trochee, Spondee (MTS) recognition/category tests), patient satisfaction, and device use patterns. The average age at implantation was 40 years (range, 16-57 yr). Follow-up ranged from 6 to 88 months after implantation. Three patients were implanted with residual useful hearing in the contralateral ear, whereas four patients had no hearing in the contralateral ear. Hearing loss was due to surgical excision of tumor (n=5) or gamma-knife radiotherapy (n=2). Postactivation pure-tone average thresholds in the implanted ear ranged from 30 to 55 dB (average, 32.5 dB), although speech reception testing varied considerably among subjects. Despite this variability, all patients continue to use the device on a daily basis. In selected cases of deafness in patients with NF2 where there has been anatomic preservation of the auditory nerve after acoustic neuroma resection or radiation therapy, cochlear implantation may offer some improvement in communication skills, including the possibility of open-set speech communication in some patients. These results compare favorably to the auditory brainstem implant offering an alternative for hearing rehabilitation in patients with NF2.

Speechreading and Aging

Speechreading and Aging

Ira J. Hirsh and the Acronyms of Auditory Perception

In a career that spans more than 50 years to date, the name of Ira J. Hirsh has been associated with significant scientific contributions to psychoacoustics, outstanding mentoring of research scientists, and dedicated service to the fields of acoustics, audiology, and psychology. It is a career that can be traced by acronyms that are part of the daily vocabulary of hearing scientists. These include acronyms of location: the Psychoacoustics Laboratory at Harvard (PAL), the Central Institute for the Deaf (CID), and Washington University (WashU); acronyms of professional societies that have honored him: Acoustical Society of America (ASA), International Congress of Acoustics (ICA), American Psychological Association (APA), American Psychological Society (APS), American Speech-Language-Hearing Association (ASHA), and American Academy of Audiology (AAA); acronyms of his service to the National Academy of Science: National Research Council (NRC), Commission on Behavioral and Social Science and Education (CBASSE), and Committee on Hearing, Bioacoustics, and Biomechanics (CHABA); and acronyms of his contributions to psychoacoustics: masking level difference (MLD) and temporal order judgments (TOJ). In large part, these acronyms are part of our vocabulary because of Hirsh's contributions, and tracing them during the last half century yields a substantive look at the development of the field of hearing science.

The Ears of the Deaf Unstopped: Changes Associated with Cochlear Implantation

The Center for Applied Research on Childhood Deafness at Central Institute for the Deaf (St. Louis, MO) has been collecting data on the speech perception, speech production, language level, and reading skills of profoundly deaf children for over 30 years. A recent study examined children from across the United States and Canada who used cochlear implants. When these results are compared with those obtained in past studies with similar children who used hearing aids, the following trends are apparent: (1) Auditory speech perception ability has improved; (2) there is a stronger relation between auditory speech perception ability and oral communication; (3) there is a closer approximation to the language of hearing age-mates; (4) there is an increased use of speech by children in total communication programs; and (5) the acquisition of reading is accelerated. As Ira Hirsh predicted, even limited auditory skills play an important role in language development. This role is evidenced in the improved speech perception, spoken language and reading scores of profoundly deaf children who used cochlear implants compared to similarly impaired children who used hearing aids before implants were available.

All in Good Time: A Tribute to Ira Hirsh

The scientific career of Ira J. Hirsh has been one of truly epic proportions, with an enduring impact on the field of human communication and its disorders. In the spring of 1992, to acknowledge this long and illustrious history and on the occasion of his 80th year, a special session to honor him was held as part of the 143rd meeting of the Acoustical Society of America in Pittsburgh, PA. At this session, 10 invited papers were presented, contributed by 12 of Ira's colleagues, many of whom were former students, postdoctoral students, and faculty members at the Central Institute for the Deaf during the years he served as Research Director. The authors and titles of those 10 papers were as follows:

Nonword imitation by children with cochlear implants: consonant analyses.

To complete detailed linguistic analyses of archived recordings of pediatric cochlear implant users' imitations of nonwords; to gain insight into the children's developing phonological systems and the wide range of variability in nonword responses. Nonword repetition: repetition of 20 auditory-only English-sounding nonwords. Central Institute for the Deaf "Education of the Deaf Child" research program, St Louis, Mo. Eighty-eight 8- to 10-year-old experienced pediatric cochlear implant users. Several different consonant accuracy scores based on the linguistic structure (voicing, place, and manner of articulation) of the consonants being imitated; analysis of the errors produced for all consonants imitated incorrectly. Seventy-six children provided a response to at least 75% of the nonword stimuli. In these children's responses, 33% of the target consonants were imitated correctly, 25% of the target consonants were deleted, and substitutions were provided for 42% of the target consonants. The children tended to correctly reproduce target consonants with coronal place (which involve a mid-vocal tract constriction) more often than other consonants. Poorer performers tended to produce more deletions than the better performers, but their production errors tended to follow the same patterns as the better performers. Poorer performance on labial consonants suggests that scores were affected by the lack of visual cues such as lip closure. Oral communication users tended to perform better than total communication users, indicating that oral communication methods are beneficial to the development of pediatric cochlear implant users' phonological processing skills.

Speech Intelligibility of the Callsign Acquisition Test in a Quiet Environment

This paper reports on preliminary experiments aimed at standardizing speech intelligibility of military Callsign Acquisition Test (CAT) using average power levels of callsign items measured by the Root Mean Square (RMS) and maximum power levels of callsign items (Peak). The results obtained indicate that at a minimum sound pressure level (SPL) of 10.57 dBHL, the CAT tests were more difficult than NU-6 (Northwestern University, Auditory Test No. 6) and CID-W22 (Central Institute for the Deaf, Test W-22). At the maximum SPL values, the CAT tests reveal more intelligibility than NU-6 and CID-W22. The CAT-Peak test attained 95% intelligibility as NU-6 at 27.5 dBHL, and with CID-W22, 92.4% intelligibility at 27 dBHL. The CAT-RMS achieved 90% intelligibility when compared with NU-6, and 87% intelligibility score when compared with CID-W22; all at 24 dBHL.

Outcome Measures for Fitting FM Systems

No AccessPerspectives on Aural Rehabilitation and Its InstrumentationArticle1 Oct 2003Outcome Measures for Fitting FM Systems Linda M. Thibodeau Linda M. Thibodeau Google Scholar More articles by this author https://doi.org/10.1044/arii11.2.7 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationTrack Citations ShareFacebookTwitterLinked In References Anderson, K., & Smaldino, J. (1996). Listening Inventory for Education (LIFE): An efficacy tool: Tampa, FL: Educational Audiology Association. Google Scholar ASHA. (1999). Guidelines for Fitting and Monitoring FM Systems (ASHA Desk Reference). Rockville: Author. Google Scholar DeConde Johnson, C., Benson, P., & Sea ton, J. (1997). Educational audiology handbook. San Diego: Singular Publishing. Google Scholar Elliott, L., & Katz, D. (1980). Development of a new children's test of speech discrimination. St. Louis: Auditec. Google Scholar Haskins, H. (1949). A phonetically balanced test of speech discrimination for children. Unpublished Masters thesis, Northwestern University, Evanston, IL. Google Scholar Individuals with Disabilities Education Act of 1990 (IDEA), Public Law 101–476, 20, U.S.C. 1400 et seq.: U.S. Statutes at Large, 104, 1103–1151 (1990). Google Scholar Moeller, M., Donaghy, K.Beauchaine, K., Lewis, D., & Stelmachowicz, P. (1996). Longitudinal study of FM system use in nonacademic settings: effects on language development.Ear and Hearing, 17, 28–40. Google Scholar Moog, J., & Geers, A. (1979). Grammatical Analysis of Elicited Language. St. Louis: Central Institute for the Deaf. Google Scholar Moog, J, & Geers, A. (1990). The Early Speech Perception Test. St. Louis: Central Institute for the Deaf. Google Scholar Pediatric Working Group of the Conference on Amplification for Children with Auditory Deficits (1996). Amplification for infants and children with hearing loss.American Journal of Audiology, 5, 53–68. ASHAWireGoogle Scholar Ross, M., & Lerman, J. (1970). A picture identification test for hearing impaired children.Journal of Speech and Hearing Research, 13, 44–53. ASHAWireGoogle Scholar Smoski, W. (1990). Use of CHAPPS in a children's audiology clinic.Ear and Hearing, 11, 53S–56S. Google Scholar Thibodeau, L., Britt, L., & Garner, J. (2001, November). Interfacing programmable and digital behind-the-ear hearing aids with ear-level FM receivers. Poster presented at the ASHA annual Convention. New Orleans, LA. Google Scholar Thibodeau, L, & Schafer, E. (2002, May). Including FM technology in early intervention. Poster presented at the 2nd International Conference on Newborn Hearing Screening, Diagnosis, and Intervention. Como, Italy. Google Scholar Thibodeau, L, Schafer, E., & Matthews, S. (2000). Real ear evaluation of FM Microlink Systems.Educational Audiology Review, 17(4), 10–11. Google Scholar Additional Resources FiguresReferencesRelatedDetails Volume 11Issue 2October 2003Pages: 7-9 Get Permissions Add to your Mendeley library History Published in issue: Oct 1, 2003 Metrics Topicsasha-topicsasha-sigsasha-article-typesCopyright & Permissions© 2003 American Speech-Language-Hearing AssociationPDF downloadLoading ...

Cochlear implantation in patients with bilateral Ménière's syndrome.

To evaluate the indications and clinical outcomes (audiologic and vestibular) in patients with Ménière's syndrome who have undergone cochlear implantation. This is a retrospective review of patients at a large tertiary academic medical center. Nine patients were included in the study with AAO-HNS criteria for diagnosis of Ménière's syndrome as well as bilateral severe to profound sensorineural hearing loss as an indication for undergoing cochlear implantation. Audiologic criteria for implantation were considered in the context of speech recognition performance with well-fit, powerful hearing aids noting large fluctuations in performance levels in some patients. In all cases, the poorer hearing ear was implanted. Seven subjects had bilateral disease and had progressed to profound sensorineural hearing loss. The average age of the patients was 61 years. Six patients had undergone previous surgery to control vertigo, including endolymphatic shunt surgery and vestibular nerve section. No patient had received previous treatment with intra-tympanic gentamicin. Symptoms of Ménière's syndrome had been present in all patients for at least 10 years before implantation. Cochlear Implantation. Pre- and Postoperative audiometric scores (monosyllable words/phonemes, Central Institute for the Deaf (CID) sentences, Hearing in Noise Test (HINT) in quite/noise (+10 db)), pre- and postoperative vestibular symptoms (number of vestibular attacks, aural fullness, tinnitus). Follow-up after implantation ranged from 1 to 5 years. Average 6 month postimplantation scores were: monosyllable words/phonemes = 52%/65%, CID sentences = 82%, HINT in quiet/noise = 70%/50%. Average 1-year postimplant scores were: monosyllable words/phonemes = 60%/76%, CID sentences = 97%, HINT in quiet/noise = 89%/78%. Postoperative speech recognition scores were, on average, substantially greater than preoperative scores. While there were few complications associated with implantation, some patients experienced alterations in their implant performance in association with fluctuations in vestibular symptoms. Patients with advanced binaural involvement with Ménière's Disease may present a challenge to conventional criteria for cochlear implant candidacy because of fluctuating symptoms. We observed significant benefit over baseline in a consecutive series of patients with Ménière's syndrome who progressed to bilateral, severe-to-profound sensorineural hearing loss and underwent cochlear implantation. Further, previous vestibular surgery, including labyrinthectomy, does not contraindicate cochlear implantation.

Some contributions of Rafael Lorente de Nó to neuroscience: A reminiscence

Rafael Lorente de Nó is one of the towering neuroscientists of the 20th century. He was born in Zaragoza, Spain, in 1902. In 1920, he moved to Madrid where he became the youngest, and eventually the best known, of Ramón y Cajal’s disciples. In his youth, Lorente de Nó worked with Oskar and Cécile Vogt in Germany and with Robert Bárány in Sweden. In 1934, he moved to the United States, where he first worked at the Central Institute for the Deaf (CID); in 1936, he was invited by Herbert S. Gasser to work at the Rockefeller Institute. After his formal retirement from this institute in 1972, Lorente de Nó spent 5 years at the Head and Neck Surgery Department and Brain Research Institute of the University of California at Los Angeles. He died in Tucson, Arizona, in 1990. Lorente de Nó was a gifted person: a polyglot with a remarkable memory and a versatile intellect, which together with his strong, almost belligerent character, made him a rather controversial human. The strength of his scientific contributions is evident by their current impact. Among these are: the modular (i.e., columnar) organization of the cerebral cortex, the synaptic delay, nerve volume conduction, synaptic summation, and the cybernetic (feed-back) neuron circuit. The present article provides a comment upon some of his neurohistological studies (including the cerebral isocortex, Ammon’s horn, brainstem, and spinal cord), highlighted by transcripts from taped conversations with him, and illustrated by reproductions of some of his original figures.

Digit speech recognition thresholds (SRT) for non-native speakers of English.

Although Central Institute for the Deaf (CID) W-1 stimuli are routinely used for speech recognition threshold (SRT) testing, they are not always familiar to new learners of English and often lead to erroneous assessments. To improve test accuracy, alternative stimuli were constructed by pairing familiar English digits. These digit pairs were used to measure SRT for 12 non-native speakers of English and 12 native speakers of English. Results indicate that digit pairs effectively measure SRT for both participant groups; and more importantly, for non-native speakers of English, digit pairs are more accurate than CID W-1 words in measuring the hearing threshold for speech. Digit-pairs have cross-linguistic appeal and should greatly facilitate accurate SRT testing for listeners with minimal exposure to English.