An Adult Cochlear Implant Aural Rehabilitation Special Interest Group was formed in 2023. Members represent interdisciplinary collaborators, including audiologists, speech-language pathologists, surgeons, nonclinical administrators, manufacturer/industry representatives, and researchers. Current perspectives of adult cochlear implant (CI) recipients regarding aural rehabilitation (AR) remain unknown and understudied. The aim of this study is to survey adult CI recipients to determine their perspectives on the AR process. A web-based national survey was sent to adult CI recipients through multiple channels. The survey asked recipients about their demographics, state of residence, hearing loss history, and device configuration. Questions probed recipients' experiences of learning about AR options, services used, definitions of AR, and perceived value of services received. Questions were also asked about barriers to AR services, preoperative counseling, and satisfaction with their decision to pursue a CI. A total of 115 CI recipients responded to the survey. Results revealed a relative lack of information provided to many CI recipients regarding AR services. Many CI recipients reported wishing they had received additional resources in the areas of music training and equipment troubleshooting. Most participants reported that both one-on-one clinician-guided AR and independent listening practice were effective methods of AR. Findings shed light on current gaps in providing the most effective AR services, which will need to be addressed to optimize hearing health care and outcomes for adult CI recipients. Future work should include outreach to a broader representation of CI users to expand our understanding of AR resources, education, and limitations.

It is unknown how electrode array position in the cochlea influences long-term hearing preservation for cochlear implant (CI) recipients with preserved low-frequency hearing after surgery. The aim of this study was to evaluate the influence of electrode insertion depth relative to regions of post-operative acoustic hearing and hearing preservation ≥ 1 year after CI activation. A retrospective review of adult CI recipients of a straight electrode array from 2017 to 2022 with functional acoustic hearing preservation (≤ 80 dB HL at 250 Hz) at device activation was performed. Proximity was quantified as the angular insertion depth (AID) of the most apical contact relative to the region of preserved functional acoustic hearing. Positive values indicate placement within the functional acoustic region; negative values indicate placement basal to the functional acoustic region. Low-frequency pure tone average (LFPTA) was queried from the preoperative, device activation, and annual post-activation visits. Stepwise regression analyzed whether proximity, AID, age, biological sex, and pre-operative LFPTA were significant predictors for change in unaided hearing thresholds. One hundred and six CI recipients met inclusion criteria. AID ranged from 330° to 717° (mean 513°, SD 79°). Proximity values ranged from -183° to 442° (mean 35°, SD 110°). None of the reviewed independent variables, including proximity, significantly predicted unaided hearing threshold shifts at the 1-year or the ≥ 3-year visits (p ≥ 0.128). Deeper insertion depths and electrode array placement within the functional acoustic hearing region did not predispose CI recipients to delayed loss of residual hearing.

To assess the S-value in pediatric cochlear implant (CI) patients using high-resolution CT images and examine its correlation with main cochlear parameters and angular insertion depth (AID). A retrospective review of preoperative CT images from pediatric CI recipients with normal cochlear anatomy was conducted at a referral hearing implant center. Cases involving congenital or acquired inner-ear abnormalities were excluded. Two independent reviewers with equivalent expertise used OTOPLAN to measure the main cochlear parameters, and the interrater reliability study revealed good agreement. S-values (the straight section of the cochlear basal turn) were measured and examined, and their correlation to electrode insertion angles and cochlear parameters (A- and B-values) was evaluated. The average cochlear duct length (CDL) of the included patients was 36.14 ± 0.26 mm, with an average S-value of 7.06 ± 0.40 mm, insertion angle of 598.20° ± 48.72°, and cochlear coverage of 77.49% ± 0.57. A statistically significant relationship was found between A- and the S-values (r = 0.65, p = 0.004). However, the B-value showed a moderate, non-significant correlation with the S-value (r = 0.43). Furthermore, a consistent negative, but not statistically significant, association was found between the S-value and the angular insertion depths of all electrode contacts(r = -0.28 to - 0.30). The S-value is a dependable anatomical parameter that correlates positively with the A-value. The evaluated lateral-wall array showed consistent insertion depths among patients with similar CDL, even when S-values differed. Further studies are needed to investigate the impact of greater variability in S-values on clinical outcomes and electrode-array position among CI users.

To investigate the trajectory of spectral resolution in adult cochlear implant (CI) recipients and determine whether early spectral resolution measures can predict later speech recognition outcomes. Prospective, longitudinal study of 531 postlingually deafened adult CI recipients. Spectral resolution (EasyQSMD) and speech recognition (CNC words, AzBio sentences in quiet and noise) were evaluated from activation through 1-year post-activation. Growth curve models were fit to EasyQSMD thresholds across all timepoints to generate mode-based estimates of early spectral resolution at 1-month post-activation. These model-derived early thresholds were then used to predict later speech recognition outcomes (best of 6-months and 1-year) through linear regression analyses. EasyQSMD thresholds improved from activation to 1-week post-activation, then stabilized through the first year. Model-derived early EasyQSMD thresholds significantly predicted later speech recognition outcomes, explaining 3%-8% of the variance in performance. Spectral resolution rapidly stabilizes, reaching asymptotic performance by 1-week post-activation. The EasyQSMD provides a non-linguistic assessment tool that demonstrates significant predictive value for subsequent speech recognition outcomes. This early predictive capability enables the identification of poor performers during a critical window when speech recognition skills are still developing and the brain's neuroplasticity is at peak potential. Integrating spectral resolution assessment into early post-activation clinical protocols could improve individualized realistic expectations counseling and guide targeted interventions-potentially leading to improved overall CI adoption rates. The brief administration time and independence from linguistic content make the EasyQSMD particularly valuable for multilingual populations and during the earliest stages of auditory rehabilitation post-CI.

Objective To explore the potential of the internationally-renowned ‘Mini-Mental State Examination’ (MMSE) cognitive measure to explain variability in cochlear implant (CI) recipients’ speech recognition outcomes. The Stroop Color-Word Test (SCWT) was also employed as a measure of cognitive inhibition, an ability essential for focusing on target speech whilst ignoring background noise. The authors hypothesize that MMSE and SCWT scores correlate with CI users’ performance on established speech recognition tests. Methods Cognitive screening was assessed by the MMSE and SCWT in adult CI users one year postoperatively. In addition, speech recognition was assessed using word and sentence lists, in both quiet and noise. Study sample: 28 participants, postlingually deafened adult CI users, median age 75 years. Results Total MMSE scores correlated significantly with sentence recognition in noise (r = 0.621, P = .004), although no correlation was identified in quiet. Furthermore, the SCWT incongruent condition correlated significantly with CI users’ speech recognition in noise (r = −0.644, P = .007). Discussion Global cognition (as assessed using the MMSE), and inhibition-concentration (as assessed using the SCWT), seem to be important factors in influencing CI recipients’ speech intelligibility in noise. This pilot study recommends a larger-scale study; given the global popularity of the MMSE and SCWT as quick cognitive screening tests, they may be useful in CI clinics when speech perception outcomes are unexpectedly poor for older adults and when questions of cognition arise. Conclusion These standardized cognitive measures may prove helpful in counseling patients and families when coming to terms with CI outcomes and optimizing multidisciplinary rehabilitation strategies.

Intracochlear electrocochleography (ECochG) in cochlear implant (CI) recipients is a potential tool for monitoring cochlear function during and after electrode array (EA) insertion. However, mechanisms underlying ECochG amplitude variations along the cochlear duct, and their significance for hearing preservation (HP), remain unclear. Therefore, a longitudinal study was conducted to monitor maximum ECochG amplitude and its tonotopic location from EA insertion to 1 yr postimplantation. It was hypothesized that changes in maximum amplitude (>30%) and/or shifts in its location (>1 octave) across timepoints reflect intracochlear alterations associated with residual hearing changes. ECochG recordings were obtained in 80 adult CI recipients with measurable residual hearing. For Contour Advance (CI612) and Slim Straight (CI622) arrays (Cochlear Ltd.), recordings were taken from every second intracochlear electrode. For HiFocus SlimJ and MidScala arrays (Advanced Bionics LLC), recordings were obtained from all electrodes. Measurements were conducted at four timepoints: (1) intraoperatively, during EA insertion (Intraop1), (2) intraoperatively, immediately after full insertion (Intraop2), (3) approximately 7 wk after surgery (Postop1), and (4) approximately 1 yr after surgery (Postop2). 500 Hz tone bursts were used for acoustic stimulation and the magnitude of the difference between responses to alternating-polarity stimuli was analyzed. Tonotopic electrode locations were determined from postoperative cone beam computed tomography scans. Pure-tone audiograms were obtained preoperatively and at approximately 7 wk and 1 yr postoperatively. HP was determined using the HEARRING group formula. Maximum ECochG amplitudes remained largely stable intraoperatively, with no significant difference between Intraop1 and Intraop2 in complete-case analysis (n = 44). In contrast, a significant decrease in maximum amplitude was observed between Intraop2 and Postop1 (p < 0.001). Participants with >30% amplitude reduction between the 2 intraoperative recordings (Intraop1 versus Intraop2) did not differ significantly in HP from those with stable amplitudes. However, those showing a >30% reduction in the early postoperative period (Intraop2 versus Postop1) showed significantly lower HP (p = 0.028). Nonapical peak location during Intraop1 occurred in 41% of the cases, although tonotopic location of the maximum peak during insertion monitoring (Intraop1) did not show a relationship with HP. Tonotopic location shifts of the maximum amplitude (>1 octave) were observed in a small subset of cases between consecutive recordings up to Postop2. However, peak location changes (apical, basal, stable) were not associated with significant differences in HP. Our results suggest that nonapical peak patterns are not necessarily markers of insertion trauma and may instead reflect variability in cochlear integrity (e.g., dead regions). Peak location during insertion monitoring was not associated with postoperative HP, and both maximum amplitude and tonotopic peak location remained stable intraoperatively. In contrast, early postoperative reductions in ECochG amplitude were common and associated with HP, highlighting the need to investigate strategies to minimize early intracochlear reactions. Overall, the study demonstrates the value of ECochG for monitoring intracochlear processes over time.

Objective To evaluate the functional and surgical outcomes of cochlear implantation (CI) following subtotal petrosectomy (SP) in chronic otitis media (COM) and compare them with standard CI recipients. Methods A retrospective case-control study included 34 adults with postlingual deafness: 17 with COM undergoing SP and simultaneous CI (COM group) and 17 with no middle ear disease (CI group). Audiological performance was assessed by pure-tone audiometry (PTA 5 ), speech recognition in quiet and in noise (Oldenburg Sentence Test, OLSA), and the Speech, Spatial, and Qualities of Hearing Scale (SSQ). Results All surgeries were successful, with only two minor postoperative complications (one EAC closure breakdown, one abdominal hematoma). The analysis of hearing outcomes showed similar results between the two groups in terms of PTA 5 (36.6 vs. 35.6, p = 0.09), speech recognition in quiet (74.2 vs. 85.0, p = 0.07), speech-in-noise (2.7 vs. 0.7, p = 0.58). No significant intergroup differences were found in terms of self-perceived listening disability (SSQ) in the Speech (4.73 vs. 4.80, p = 0.69), Spatial (4.22 vs. 4.96, p = 0.50), or Qualities (5.17 vs. 5.25, p = 0.87) domains. There were no reported cases of disease recurrence, infection, or device extrusion during long-term follow-up (mean 36 months). Conclusion Cochlear implantation after SP provides hearing and quality-of-life outcomes comparable to standard CI, confirming its safety and efficacy in COM patients.

The Complete Cochlear Implant Care (CCIC) model is a highly coordinated care delivery model reducing and condensing in-person visits for cochlear implant (CI) patients, leveraging telehealth and remote programming. Clinical, quality-of-life, implementation, patient experience, and financial outcomes of the clinical trial are reported. Prospective, nonrandomized, 2-arm clinical trial. Tertiary referral CI center. Adult CI candidates. Cochlear implantation. Speech perception, quality of life, implementation, patient experience, and financial outcomes for both CCIC and traditional care delivery models. Patients participating in the traditional and CCIC delivery models demonstrated 12-month postoperative speech perception scores comparable to nationally reported outcomes (CNC 61% and 72% and AzBio in quiet 75% and 87% for traditional and CCIC cohorts, respectively). Quality-of-life evaluation using the CIQOL-10 demonstrated similar 12-month postoperative scores between groups (52 and 54 for traditional and CCIC cohorts, respectively). The CI Patient Experience Survey demonstrated high satisfaction outcomes in ease of communication, preparedness for surgery, and overall care in both cohorts. Implementation analysis of the CCIC model revealed perceived benefits from staff and clinicians; however, support for expansion of the program was contingent upon the availability of app-based or web-based remote programming technology. Finally, financial analysis revealed decreased out-of-pocket costs for CCIC patients. The CCIC model has the potential to dramatically streamline hearing health care delivery and reduce out-of-pocket costs for CI recipients. Clinical outcomes between cohorts were comparable in this feasibility study; however, a sufficiently powered trial is required to definitively comment on clinical outcomes with the new care delivery model.

Adults with severe to profound hearing loss have limited access to cochlear implants (CIs). The objective of this study was to assess the evidence to establish whether the uptake rate of CIs has changed over the past decade. A PubMed search, supplemented with manual searching, identified 15 relevant papers published from 2000 to 4 February 2025 reporting the uptake rate of CIs in adults. In addition, new calculations of uptake rates were made for 2019, based on total numbers of CIs implanted and the prevalence of hearing loss from the 2019 Global Burden of Disease Study. There was a lack of published data on the uptake rates for cochlear implants, with very little consensus in the methods used across studies. The overall uptake rates for adults and children combined, calculated for 2019 using the Lancet Global Burden of Disease Study, showed that uptake is still ≤20% for those with profound to complete hearing loss in most high-income countries. When the global population is considered (including high- to low-income countries), it is merely 2.5%. Despite the cochlear implant awareness activities of recent years, the percentage of profoundly deaf individuals with cochlear implants, even in high-income countries, remains low. Uptake rates are much worse than those for hearing aid use for severe to profound deafness. Better and more accurate data must be gathered on the number of CI recipients to meet the reporting requirements of the World Health Organisation's report on hearing.

There remain large variations in cochlear implant auditory-speech perception ability, which are poorly explained by patient history factors. This study aims to better understand how combinations of speech processing limitations, identified using psychophysical and functional brain imaging measures, are associated with long-term speech understanding outcomes of new cochlear implant recipients. Forty-three cochlear implant recipients (44 ears) were recruited to participate in a longitudinal study to evaluate limitations at various locations along the auditory processing pathway. At the periphery, intra-cochlear neural health was estimated using focused psychophysical thresholds. Higher-order across-electrode intensity discrimination ability was assessed using psychophysical "spectral tilt." At the cortical level, cross-modal activation of the auditory cortex was assessed using functional near-infrared spectroscopy. Speech understanding outcomes were evaluated in competing multi-talker babble noise at 1-year post-device switch-on. We found that greater abilities to discriminate smaller across-electrode stimulation intensities ( R2 = 0.138, p = 0.047) and smaller cross-modal activations of the auditory cortex ( R2 = 0.216, p = 0.01) were significantly associated with better speech understanding outcomes in cochlear implant recipients. Furthermore, both measures contributed significantly to better predict speech understanding outcomes in a multiple regression model (Adj R2 = 0.312, p = 0.009). The results suggest that recipient-specific psychophysical and functional brain imaging metrics contribute significantly toward individual differences in speech understanding outcomes. Different recipients can be affected by different limitations, which can be identified using these tests, and therefore lead to potential patient-specific methods to improve their speech understanding.

The main objective of this study was to examine the effect of a classifier-based noise management algorithm (AutoSense Sky OS 3.0) on speech perception in noise in pediatric cochlear implant (CI) recipients and to compare the speech perception outcomes with typically hearing peers. This prospective observational study included nine children (ages 9-15 years) with bilateral CIs and nine age-matched, typically hearing peers. Speech perception outcomes were measured in noise using Pediatric AzBio sentences to compare performance in the omnidirectional microphone mode with the classifier-based automatic noise management mode at four signal-to-noise ratios. Ratings of listening ease and speech clarity were recorded to obtain subjective measures of benefit. Results from the bilateral CI recipients were compared to a group of typically hearing children. Paired t tests were used to evaluate outcomes. Classifier-based noise management improved speech perception in noise compared to listening in the omnidirectional microphone mode. CI group averages revealed a 21.4 percentage point and 47.1 percentage point improvement in speech perception when using the Sky OS 3.0 algorithm at 0 and -5 dB SNR, respectively. Listening ease and speech clarity were improved when using the classifier-based noise management algorithm. Pediatric CI recipients can benefit from classifier-based noise management. Given the difficult listening environments children face, especially in typical classroom settings while listening for learning, audiologists should consider activating classifier-based noise management in this population.

In recent years, the critical role of parental involvement in the success of pediatric cochlear implants (CIs) has become increasingly evident. However, the impact of family structure-specifically, the presence of multiple CI-using siblings and CI-experienced parents-on outcomes is not fully understood. Investigating these dynamics has the potential to improve auditory rehabilitation strategies in complex family settings. This study aims to evaluate the influence of the number of siblings with CIs and parental CI experience on pediatric speech perception outcomes following cochlear implantation. We retrospectively collected data from 2018 to 2023 on families with multiple pediatric CI recipients and a control group comprising families with a single CI child. The analysis focused on evaluating the effects of sibling number, birth order, and parental CI experience on speech perception outcomes 5 years postimplantation. The primary outcome was the speech perception score, measured using the Hebrew version of the Arthur Boothroyd word test (HAB), a validated word recognition test. A multivariate analysis was conducted to evaluate the impact of various factors on speech perception outcomes, accounting for potential confounders within this intricate context. The cohort included 140 children, 102 from 41 philoprogenitive families (a mean of 3 siblings per family, range 2 to 6), and 38 children from families with a single CI recipient as controls. The presence of fewer CI-recipient siblings was associated with significantly better speech perception outcomes 5 years postimplantation (P=0.03). Children with CI-experienced parents had an earlier median age at surgery (1.1 vs. 1.8y, P=0.017) and significantly improved speech perception scores (17.2, 95% CI: 0.48-33.8, P=0.04). Fewer siblings with CIs and the presence of CI-experienced parents were associated with earlier intervention and better speech outcomes. These findings highlight the need for a family-centered approach to cochlear implantation to address disparities and enhance outcomes in pediatric CI recipients.

(1) Evaluate tinnitus outcomes in adults after cochlear implantation, (2) examine the impact of demographic/audiologic factors on tinnitus outcomes, and (3) determine the relationship between early tinnitus outcomes and long-term hearing-related quality of life (QoL). Retrospective review of prospectively collected data. Adult cochlear implant (CI) center. Eighty-three adult CI recipients aged 20 to 84 years old (mean=66.2, SD 16.4). Patient-reported outcome measures before and after cochlear implantation. Tinnitus Handicap Inventory (THI); Speech, Spatial, and Qualities of Hearing Scale-12 (SSQ-12); and the Cochlear Implant Quality of Life-10 measure (CIQOL-10) pre-CI and post-CI. (1) THI scores significantly improved from pre-CI to early (1 to 3mo) post-CI, with no additional gains by long-term (6 to 2mo) post-CI. Early post-CI, 77.2% of patients reported a clinically significant improvement in their tinnitus-induced distress from pre-CI to post-CI. (2) Patients with early clinical THI improvement had shorter durations of deafness and greater CI usage than those with a lack of improvement. (3) Early post-CI THI scores were negatively correlated with long-term overall SSQ-12 scores. Long-term post-CI THI scores were also negatively correlated with long-term CIQOL-10 scores and overall SSQ-12 scores. Adult CI recipients reported improved tinnitus-induced distress at early post-CI and maintained this improvement long-term. Patients with shorter durations of deafness and greater CI usage were more likely to report relief in tinnitus-induced distress. Early THI outcomes post-CI were associated with long-term QoL. Clinicians should consider early evaluation of tinnitus outcomes to inform patient counseling regarding long-term CI outcomes. Level IV-historical cohort or case-controlled studies. 24087.

Web-based applications are increasingly used in clinical audiology, driven by the development of mobile, remote technology, and strong demand. Remote applications also have large potential to increase statistical power, accessibility, and diversity in research studies, but their utility and validity are still unclear. We developed and evaluated a web-based listening test system called AUDITO for cochlear implant (CI) research. By exploiting the advances in wireless streaming technology and personal mobile devices, AUDITO can be used to flexibly implement and administer a wide range of listening tests remotely or in-the-lab. The system was designed to be easy to use without programming. Technical features were implemented to ensure signal quality over wireless streaming. A pilot study with 20 experienced CI recipients was performed to evaluate the validity of remote testing across test paradigms. Comparisons of interest included the presentation of stimuli via cable versus Bluetooth streaming and testing remotely versus in-the-lab. Three listening tests were implemented to measure speech perception for sentences, digits in noise and spectro-temporal resolution. A questionnaire was administered to collect user feedback. The system worked reliably with various Bluetooth-compatible setups including desktop and laptop computers, tablets, and smartphones. Test results were consistent between listening modalities and across tested conditions, confirming the validity of web-based testing for these measures. User feedback was positive for system usability and function, while signal quality was not reported to be compromised via streaming. Web-based systems such as AUDITO can facilitate data collection, enable research collaboration and improve accessibility and inclusion in CI research.

Recent advancements toward minimizing surgical trauma and preserving residual hearing during cochlear implantation have promoted the use of intracochlear electrocochleography (ECochG) for intraoperative surveillance. However, variations in the distribution of response generators throughout the cochlea complicate the interpretation of signal changes during electrode array insertion. This exploratory study aimed to investigate whether simultaneous recordings from 2 locations within the cochlea could address this issue. This was done by (1) comparing recordings acquired simultaneously from an apical and a more basal electrode contact during atraumatic electrode array insertions; and (2) comparing these response patterns with preoperative pure-tone audiograms. In 10 standard CI recipients, ECochG recordings were obtained during stepwise insertion of a short-temporary electrode array. Simultaneous intracochlear recordings were acquired from 2 contacts separated by 4.2mm in response to 500Hz tone bursts. For both electrode contacts, the differences between responses to alternating-polarity stimuli, hereafter named "ECochG responses," were derived. After completion of the recordings, the temporary electrode array was removed and a standard CI electrode array inserted. In 6 of 10 participants, ECochG response amplitude decreases of ≥3dB were recorded at the more basal electrode contact. In 4 cases, these amplitude drops were preceded by amplitude drops recorded at the apical electrode contact, with both occurring no more than 1.7mm apart along the cochlear duct. Trauma would be expected to produce a simultaneous amplitude drop-at different recording locations-for both electrodes. In contrast, a drop at the basal electrode that is preceded by a drop in the ECochG recording at the apical electrode, with both drops occurring at approximately the same location, is likely atraumatic. These atraumatic drops may also be associated with large phase shifts. Overall, the ECochG response tracks recorded at the apical and more basal contact were similar, while the ECochG response patterns and audiogram did not show a strong resemblance. The proposed approach could facilitate the detection of ECochG response changes relevant for predicting hearing preservation during cochlear implantation. By distinguishing between simultaneous and sequential amplitude drops, this method could provide additional insights into the atraumatic nature of certain ECochG response changes.

Objectives This study investigates whether pre-implantation cognitive function, assessed using the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing Impaired Individuals (RBANS-H) correlates with speech perception oneyear post-implantation, and whether it can serve as a factor explaining unexpected outcome variability in adult Cochlear implant (CI) recipients. Methods This prospective longitudinal study involved 68 postlingually deaf CI recipients (ClinicalTrials.gov NCT05525221). RBANS-H assesses five cognitive domains: Immediate Memory (List Learning and Story Memory), Visuospatial/Constructional (Figure Copy, Line Orientation), Language (Picture Naming, Semantic Fluency), Attention (Digit Span, Coding) and Delayed Memory (List Recall, List Recognition, Story Recall, Figure Recall). RBANS-H and vocabulary tests were conducted pre-implantation. Phoneme scores were derived using Dutch consonant–vowel–consonant words-in-quiet, collected oneyear post-implantation in best-aided condition. Results Moderate positive correlations were observed for Coding (r = 0.43, p = 0.007), List Learning (r = 0.39, = 0.015), Story Recall (r = 0.43, p = 0.019), and Story Memory (r = 0.34, p = 0.030). No significant relationships were found for other tasks, domains, total scores or the vocabulary tests. Discussion Correlations of Coding, Immediate Memory and Delayed Memory tasks with speech outcomes highlight the involvement of attention and memory in perceiving speech with CI or acquiring this ability. Conclusion RBANS-H as a battery may not be sensitive enough to predict outcomes, suggesting the need for a tailored test battery that covers relevant cognitive functions and is sensitive to the specific needs of CI users.

To identify patient factors and speech perception outcomes associated with selection of a remote programming cochlear implant (CI) strategy over traditional in-person programming 2-week post-activation. Prospective cohort study. Single high-volume, tertiary care adult CI center. Adult patients with sensorineural hearing loss and poor speech recognition meeting criteria for cochlear implantation. Patients with an advanced bionics CI were offered the choice of an in-person or remote programming session 2 weeks after CI activation. Patients who opted for an in-person follow-up represented the standard of care. Patients who opted for a virtual follow-up had the same programming that would be completed in-person and were asked to complete an additional questionnaire rating their perceived mobile device proficiencies. All patients were seen for a 1-month post-activation appointment and outcomes were compared between the 2 cohorts. Forty-one adult CI recipients completed either an in-person (N=21) or remote programming (N=20) visit 2 weeks post-activation. Average age at implantation was significantly younger (67.35y) for the remote programming cohort compared with those opting for an in-person visit (75.57y). Mobile Device Proficiency Questionnaire (MDPQ-16) indicated a wide range of mobile device proficiencies among patients who opted for remote programming. No significant differences in changes in questionnaires or aided speech perception testing post-implantation were noted between the in-person and remote programming cohorts at the 1-month visit. A remote programming visit is an acceptable option for all adult CI recipients, even those early in their CI journey or with limited mobile device proficiencies.

We sought to apply a previously developed transimpedance (TIM) heatmap pattern classification scheme in patients with no known risk factors for cochlear anomalies, in addition to patients implanted in the revision setting, to better understand the incidence of pattern variants, and potential clinical implications. Single-center retrospective review. Tertiary referral centre. Patients older than 6 months of age who underwent cochlear implantation between June 2020 and June 2024 with normal gross cochlear anatomy and no concern for fibrosis that had intraoperative TIM testing completed. Patients undergoing revision implantation were also included as a separate cohort. None. The number of patients with normal and variant TIM patterns was evaluated for each cohort. TIM patterns were subsequently compared with the electrode position found on intraoperative x-ray. There were 321 ears that underwent implantation and subsequent intraoperative TIM assessment meeting inclusion criteria. Of these, 310 (96.6%) were in the primary surgery setting, and 11 (3.4%) were in the revision surgical setting. In the primary surgical setting, 86.4% (n=268) of the implants demonstrated a normal TIM heatmap. Compared with the primary surgical setting, where only 45.5% (n=5) of revision surgery TIM heatmaps were interpreted as normal. One patient in the revision setting had a newly identified "double X" pattern corresponding to a normal electrode position on x-ray. There is a decreased incidence of previously developed TIM heatmap pattern variants in CI recipients with normal gross cochlear anatomy.

To compare hearing preservation (HP) outcomes between ears for adult sequential bilateral cochlear implant (CI) recipients. Within-subject, retrospective cohort. Tertiary referral CI center. Sixty adults with preoperative functional acoustic hearing [low-frequency pure-tone average (LFPTA; 125, 250, and 500 Hz) ≤80 dB HL] were implanted with the same electrode array in both ears. Sequential bilateral cochlear implantation from 2012 to 2022. Initial (1mo) and long-term (12mo) HP outcomes between ears were assessed by comparing the LFPTA shift in the first and second implanted ear. Correlations between LFPTA shift in the first and second implanted ear at 1 month ( rs = 0.221, P = 0.090) and 12 months ( rs = 0.234, P = 0.123) were weak and nonsignificant. However, a multilevel linear mixed-effects model demonstrated greater LFPTA shifts in the second implanted ear when compared with the first, with a mean difference of 6.3 dB HL (95% CI: 0.2-12.4, P = 0.048). In addition, the model showed that HP declined during the first 12 months following implantation, and younger patients had greater LFPTA shifts over time ( p interaction = 0.012). There were no significant associations between LFPTA shift and preoperative LFPTA, biological sex, electrode array design, or postoperative steroid use. In the present sample, HP in the first implanted ear was poorly predictive of the outcome in the second ear. Substantial variability in outcomes between ears could indicate that subtle differences in surgical technique and insertion dynamics have a relatively larger impact on HP than patient-specific factors.

Objectives Broad variability exists in the outcomes of adult cochlear implant (CI) recipients. This study assessed performance of adult CI recipients on Cognivue Thrive, a quick, automated cognitive screening device applied in a private Otolaryngology practice, and assessed its ability to predict CI outcomes. Methods Thirty-one adults who received CIs between September 2020 and December 2022 were enrolled and tested using Cognivue Thrive before implantation. Consonant Nucleus Consonant (CNC) words and AzBio sentence recognition scores were collected early (1–3 months) and late (6–12 months) after cochlear implantation. Results The group demonstrated poor-to-moderate mean scores relative to normative scores in the Cognivue domains of Memory, Visuospatial, and Executive Function and good performance in Reaction Time and Processing Speed. Controlling for age, the pre-operative Cognivue Memory domain score correlated positively with early post-CI CNC word score (rho = .6, P = .009) and AzBio sentence score (rho = .71, P = .002) with large effect sizes. The pre-operative Visuospatial domain score also correlated with early post-CI AzBio sentence score (rho = .62, P = .01) with large effect size. Correlations between Cognivue scores and late post-CI speech recognition were mostly weaker and non-significant. Discussion A pre-operative 5-minute, automated, visual cognitive screening test yields scores that are predictive of short-term adaptation after cochlear implantation but not longer-term speech recognition. A prospective study with larger sample is needed to validate findings. Conclusion This preliminary study demonstrates proof of concept of applying Cognivue Thrive in a private CI program and its potential to help clinicians and patients to predict CI outcomes.