Meaningful Auditory Integration Scale Research Articles

Early prelingual auditory and language development in children with simultaneous bilateral and unilateral cochlear implants.

This current study aimed to explore early prelingual auditory development (EPLAD) and early language development in Mandarin-speaking children who received simultaneous bilateral cochlear implants (BICI) during the first year of cochlear implantation and compare the performance of the children who received BICI with those received unilateral cochlear implant (UCI). 39 Mandarin-speaking children who received BICIs simultaneously and 36 children with UCIs were enrolled in this study. To access the EPLAD, the Infant-Toddler Meaningful Auditory Integration Scale (IT/MAIS) was conducted, and a subtest of the simplified short-form version of the Mandarin Communicative Development Inventory (SSF-MCDI) was used to evaluate the development of expressive and receptive vocabulary for the children at indicated time points after surgery. In both the simultaneous BICI and UCI groups, we observed significantly increased scores of the SSF-MCDI and IT/MAIS 1 year after the surgery. There are indications of early advantages in children with BICI in IT/MAIS scores (at 1, 3, and 6 months after activation). For early development of language, a great difference between the expressive vocabulary scores and the receptive vocabulary scores was observed in both groups. We found there were not significant differences between the two groups on expressive or receptive vocabulary scores, the use of more differentiated measures might be required in future research. We further found that the development of the receptive or expressive vocabulary is dramatically correlated with the age at implantation and the total scores of IT/MAIS for children with simultaneous BICIs. These results may supplement the skills development of early language and auditory in Mandarin-native children with simultaneous CIs. It is obvious that children with normal hearing have mastery of receptive vocabulary before that of expressive vocabulary, which is the same as children with unilateral and bilateral CIs in this research. IT/MAIS total scores and age at CI were important factors for early language performance in children with simultaneous BICIs.

Simultaneous Bilateral Cochlear Implantation in Very Young Children Improves Adaptability and Social Skills: A Prospective Cohort Study.

To investigate the value of using the Gesell Development Diagnosis Scale (GDDS) to predict developmental outcomes in very young children who undergo simultaneous bilateral cochlear implantation. In this prospective cohort study, a repeated-measures investigation was conducted in a tertiary referral hospital. A total of 62 children receiving simultaneous bilateral cochlear implantations were enrolled from April 2017 to August 2018. They were divided into 2 groups depending on the operative age: "Infants" group (6 to 12 months, N = 38) or "Children" group (12 to 36 months, N = 24). Data on the surgical outcomes, auditory development, speech production, and developmental indicators were collected until 2 years after the initial fitting. The primary outcome measure was the GDDS, a neuropsychological development examination. Secondary outcomes included the following: complication rate, aided pure-tone average, Infant-Toddler Meaningful Auditory Integration Scale, Categories of Auditory Performance-II, Meaningful Use of Speech Scale, Speech Intelligibility Rating, and the LittlEARS Auditory Questionnaire. The mean ages at implantation in infants and children groups were 9.2 ± 1.17 and 16.6 ± 3.60 months, respectively. Significant differences were found in the social skills ( p = 0.001) and adaptability ( p = 0.031) domains of GDDS. The younger the age of bilateral cochlear implants surgery, the higher developmental quotient of language, social skills, and adaptability the child could achieve after 2 years. The complication rates in the infants and children groups were 0% versus 2.1% ( p = 0.57). There was no surgical complication in the infants group. In the children group, 1 case with enlarged vestibular aqueduct and Mondini malformation had a receiver-implant misplacement on the right side (2%, 1/48). In the two groups, auditory performance and speech production had improved similarly. In the infants group, social skills developmental quotient at baseline had a significant positive relationship with Meaningful Use of Speech Scale after 2 years. Simultaneous bilateral cochlear implantation in younger children improves adaptability and social skills. GDDS is a sensitive tool of evaluating short-term effect of bilateral cochlear implants in neuropsychological development and constitutes a reliable predictor of speech production for the very younger pediatric cochlear implant users.

Assessment of the correlation between residual hearing and audiologic outcomes after cochlear implantation in patients with cochlear nerve deficiency.

ObjectiveThis study aimed to assess the correlation between residual hearing and audiologic outcomes after cochlear implant (CI) surgery in patients with cochlear nerve deficiency (CND).MethodsThis retrospective study included 57 patients with CND who underwent CI surgery. Patients were divided into four groups according to hearing level (80–95, 95–110, 110–120, and >120 dB) and three groups according to residual hearing (entire spectrum hearing, partial spectrum hearing, and no spectrum hearing) based on the measured response at each frequency. Auditory performance (categorical auditory performance [CAP], Infant–Toddler Meaningful Auditory Integration Scale [IT‐MAIS]) and speech perception (speech intelligibility rating [SIR] and meaningful use of speech scale [MUSS]) were assessed before and 2 years after the surgery.ResultsForty‐seven (82.5%) patients had complete or total hearing loss (≥95 dB) and 17 (29.8%) had no spectrum hearing before CI surgery. Twenty‐nine (50.9%) patients did not exhibit residual hearing at 4 kHz. All patients demonstrated an improvement in auditory performance and speech perception: the CAP score in the 80–95 dB group was significantly higher than that in the 110–120 and >120 dB groups, and the entire spectrum hearing group showed significantly higher CAP, SIR, and IT‐MAIS scores than the partial spectrum hearing group and significantly higher CAP, SIR, IT‐MAIS, and MUSS scores than the no spectrum hearing group.ConclusionFor patients with CND, residual hearing, especially high‐frequency residual hearing, was poor and postoperative audiologic outcomes were significantly associated with the range of residual hearing.Level of Evidence4

Comprehensive Prediction Model, Including Genetic Testing, for the Outcomes of Cochlear Implantation.

Despite growing interest in the genetic contribution to cochlear implant (CI) outcomes, only a few studies with limited samples have examined the association of CI outcomes with genetic etiologies. We analyzed CI outcomes using known predictors and genetic testing results to obtain a comprehensive understanding of the impact of genetic etiologies. We retrospectively reviewed the medical records and images of patients who underwent cochlear implantation and genetic testing at a single tertiary medical institution, between May 2008 and December 2020. After excluding those whose speech test results were unavailable, and those in whom the implant was removed due to complications, such as infection or device failure, 203 patients were included in this study. The participants were categorized into adult (≥19 years), child (2-18 years), and infant (<24 months) groups. Outcomes were measured based on categories of auditory perception, monosyllable, disyllable, and sentence scores. For the infant group, the Infant-Toddler Meaningful Auditory Integration Scale score was used. Among the 203 participants, a causative genetic variant was identified in 117 (57.6%) individuals. The presence of a causative variant was significantly associated with better CI outcomes in the infant group (β = 0.23; 95% confidence interval, 0.01 to 0.47; p = 0.044), but not in the child and adult groups. In the genetically confirmed patients without cochlear malformation, genetic variants involving the spiral ganglion was a poor prognostic factor in the child group (β = -57.24; 95% confidence interval, -90.63 to -23.75; p = 0.004). The presence of known genetic etiology of hearing loss was associated with better CI outcomes in the infant group, but not in the child and adult groups. A neural-type genetic variant was a poor prognostic factor in the genetically diagnosed child subgroup without cochlear malformation. Careful genetic counseling should be performed before cochlear implantation.

Residual Hearing Improves Early Auditory Perception and Speech Intelligibility in Mandarin-Speaking Children with Cochlear Implants.

Background:To investigate the relationship between residual hearing and early auditory speech performance in Mandarin-speaking children with cochlear implants.Methods:Twenty-four prelingually deaf children implanted with a cochlear implants participated in the study. Auditory performance and speech intelligibility were longitudinally evaluated by categories of auditory performance, infant-toddler meaningful auditory integration scale/meaningful auditory integration scale, speech intelligibility rating, and meaningful use of speech scale. According to the postoperative pure tone average threshold, children were grouped as “better” and “worse” residual hearing.Results:Better hearing preservation was observed in 7 children (29.2%) and worse preservation in 17 children (70.8%). The scores of categories of auditory performance, infant-toddler meaningful auditory integration scale/meaningful auditory integration scale, speech intelligibility rating, and meaningful use of speech scalewere higher in children with better residual hearing. The residual hearing level was significantly associated with the performance of meaningful use of speech scale (P = .004), as well as the performance of speech intelligibility rating (P = .049).CONCLUSION:The present study showed that children with better residual hearing exhibited advantages in the early auditory and speech outcomes. The study highlighted the effects of residual hearing on early auditory performance and speech intelligibility development in Mandarin-speaking children with cochlear implants.

Machine Learning-Based Prediction of the Outcomes of Cochlear Implantation in Patients With Cochlear Nerve Deficiency and Normal Cochlea: A 2-Year Follow-Up of 70 Children.

Cochlear nerve deficiency (CND) is often associated with variable outcomes of cochlear implantation (CI). We assessed previous investigations aiming to identify the main factors that determine CI outcomes, which would enable us to develop predictive models. Seventy patients with CND and normal cochlea who underwent CI surgery were retrospectively examined. First, using a data-driven approach, we collected demographic information, radiographic measurements, audiological findings, and audition and speech assessments. Next, CI outcomes were evaluated based on the scores obtained after 2 years of CI from the Categories of Auditory Performance index, Speech Intelligibility Rating, Infant/Toddler Meaningful Auditory Integration Scale or Meaningful Auditory Integration Scale, and Meaningful Use of Speech Scale. Then, we measured and averaged the audiological and radiographic characteristics of the patients to form feature vectors, adopting a multivariate feature selection method, called stability selection, to select the features that were consistent within a certain range of model parameters. Stability selection analysis identified two out of six characteristics, namely the vestibulocochlear nerve (VCN) area and the number of nerve bundles, which played an important role in predicting the hearing and speech rehabilitation results of CND patients. Finally, we used a parameter-optimized support vector machine (SVM) as a classifier to study the postoperative hearing and speech rehabilitation of the patients. For hearing rehabilitation, the accuracy rate was 71% for both the SVM classification and the area under the curve (AUC), whereas for speech rehabilitation, the accuracy rate for SVM classification and AUC was 93% and 94%, respectively. Our results identified that a greater number of nerve bundles and a larger VCN area were associated with better CI outcomes. The number of nerve bundles and VCN area can predict CI outcomes in patients with CND. These findings can help surgeons in selecting the side for CI and provide reasonable expectations for the outcomes of CI surgery.

Efficacy of cochlear implants in children with borderline hearing who have already achieved significant language development with hearing aids.

There are still debates about timing and effectiveness of cochlear implants (CI) in pediatric subjects with significant residual hearing who do not belong to traditional indication of CI. In this study, we aimed to investigate the outcomes of CI, specifically on improvement of pronunciation, among hearing-impaired children already with a substantial degree of language skills as evaluated by Categories of Auditory Perception (CAP) scores or sentence score. Our cohort comprised pediatric CI recipients from July 2018 through October 2020. Among them, cases with CAP scores of 5 or 6 preoperatively were defined as "borderline cases". We investigated prevalence and etiologies, and compared speech evaluation data preoperatively and postoperatively at three time points (3, 6 and 9-12 months after implantation). Among 86 pediatric CI recipients, 13 subjects (15.12%) had language development that reached CAP scores of 5 or 6 before implantation. Postoperative speech evaluation data 6 months after implantation revealed significant improvement of pronunciation (Urimal Test of Articulation and Phonation scores: UTAP), Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) and word perception scores, but not of CAP and sentence perception scores. Notably, the significant improvement of pronunciation based on UTAP scores outstripped that of other speech parameters and this continued steadily up to one-year postoperatively. The result of the study serves as evidence for what to expect from cochlear implantation in hearing-impaired children who have already achieved a substantial degree of language development in terms of CAP scores or sentence perception scores, preoperatively.

The Results of Cochlear Implantation in the Inner Ear Malformations.

Cochlear implants are arguably the most successful neural prosthesis today. Cochlear implantation has several difficulties in patients with internal ear anomalies. This study was performed to analyze intraoperative, postoperative findings, and auditory performance of 55 patients who had inner ear malformations and were treated with cochlear implants at Otorhinolaryngology Department of Çukurova University Hospital. Auditory performances were analyzed in 30 of 55 patients. Patients with cochlear anomalies were evaluated as group I, patients with vestibular malformation as group II, and patients with the normal bone labyrinth as group III. Listening progress profiles and meaningful auditory integration scale tests were used to determine performances. Comparison between the listening progress profiles test performance of the groups at 12th and 18th month of group I was significantly lower than other groups (P < .05) and reached at the same level after the 24th month. Comparison between the meaningful auditory integration scale test performance of groups at 24th and 36th month of group I was significantly lower than other groups (P < .05). Perilymph gusher was observed in 3 patients who had incomplete partition I malformation. Oozing was observed in 50% of incomplete partition II patients. Facial nerve traced a variant course in 4 of 55 patients and 6 patients had postoperative meningitis. Initially patients with inner ear anomalies showed that the level of language development was worse than patients with normal bone anatomy. However, it was shown that they both reached the same point as a result. Facial nerve anomaly and meningitis risk is higher in patients with inner ear malformations.

Analysis of Long-Term Cochlear Implantation Outcomes and Correlation With Imaging Characteristics in Patients With Common Cavity Deformity.

ObjectTo investigate the long-term development of auditory and speech in patients with common cavity deformity (CCD) after cochlear implantation (CI) and its relationship to imaging characteristics.MethodsTwenty-three CCD patients and 59 age- and sex-matched CI children with normal inner ear structure were recruited. The auditory and speech development of these two groups were evaluated at 0, 1, 3, 6, 12, and 18 months after CI activation using four parent reports questionnaires [Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR), Meaningful Auditory Integration Scale/Infant-Toddler Meaningful Auditory Integration Scale (MAIS/ITMAIS), and Meaningful Use of Speech Scale (MUSS)]. Computed tomography-based 3-dimensional reconstruction of the surgical side of 18 CCD children was performed, the volume and surface area were calculated. Correlation analysis was performed on the imaging performance and post-operative outcomes.ResultsThe percentages of MAIS/IT-MAIS scores and CAP scores at different evaluation time points are significantly different (p < 0.05). When comparing SIR results across time points, significant growth was observed in most of the comparisons. In addition, significant differences (p < 0.05) are observed among the percentages of MUSS scores at different time points except the comparison between 0 and 1 month after CI activation. Patients in the CCD group had poorer auditory and speech performances at different stages after CI compared with those in the control group. According to the reconstruction of CCD patients, the volume ranged from 12.21 to 291.96 mm3; the surface area ranged from 27.81 to 284.7 mm2. When the lumen surface area was <190.45 mm2 or the volume was <157.91 mm3, the survival time for CCD children to achieve a CAP score of 4 after CI was significantly shorter.ConclusionCochlear implantation are less effective in CCD patients than in patients with normal inner ear structures, but they can still achieve significant improvement post-operatively. The morphology and size of the inner ear vary in CCD patients, which reflects the degree of inner ear development influences the outcome after CI surgery.

Validity and Reliability of Turkish Version of the Auditory Behavior in Everyday Life Questionnaire.

This study aimed to investigate the validity and reliability of the Turkish version of the Auditory Behavior in Everyday Life (ABEL) questionnaire. The ABEL questionnaire was translated into Turkish using the "back-translation" method. The study included 130 parents of children with cochlear implantation, and 126 parents of children with typical hearing were included as a control group. In the study group, there were 62 unilateral and 68 bilateral cochlear implant (CI) users. The age at implantation ranged from 1 to 10 years, as they have substantial auditory skills. The participants' parents completed the ABEL individually, and 73 parents (28, study group; 45, control group) completed the ABEL again for test-retest reliability. Construct validity was tested using confirmatory factor analysis (CFA), and internal consistency was tested using Cronbach's alpha. Spearman's correlation test was used to assess the external validity of the total and all subscales of the ABEL and the Meaningful Auditory Integration Scale (MAIS). Test-retest reliability was measured using the intraclass correlation coefficient. The Cronbach's α values for subscales ranged from .67 to .89, and the value was .93 (excellent) for the overall scale. External validity analyses showed moderate to strong correlations between the total and subscale scores of the ABEL and the MAIS, indicating high external validity. According to the CFA findings, the construct validity of the Turkish version of the ABEL was satisfactory. For the three-factor structure, the goodness-of-fit indices revealed a good fit, and only the normed fit index revealed an acceptable fit. The Turkish version of the ABEL is a reliable and valid assessment tool for children with CIs.

Diagnostic value of IT-MAIS scores by logistic regression and ROC curve in predicting the degree of hearing loss in infants and toddlers aged 0-36 months

Objective:This study is inorder to compare the early prelingual auditory development trajectory of infants and toddlers with normal hearing and different degrees of hearing loss, and to explore the value of the Infant-Toddler Meaningful Auditory Integration Scale （IT-MAIS） scores in the diagnosis of hearing loss severity in infants and toddlers aged 0-36 months. Methods:Eight hundred and forty-two cases of infant-toddler from March 2009 to March 2021 were selected as participants, including 231 cases with normal hearing and 611 cases with hearing loss. The IT-MAIS scores of participants with different degrees of hearing loss were fitted with nonlinear regression with age. By respectively constructing three logistic regression models of IT-MAIS total scores, perception scores, discrimination scores and evaluation age, the ROC curve was drawn to evaluate the diagnostic efficacy. Results:The IT-MAIS scores of children with mild, moderate, severe, and profound hearing loss participants changes with age are similar to the development of infants with normal hearing, and they all increase with age. And the more severe the hearing loss, the slower the growth rate, and the lower the peak value that can be reached. The logistic model constructed by combining IT-MAIS total score and evaluation age is the best to distinguish mild and above, moderate and above, severe and above, and profound hearing loss, whose AUC are 0.827, 0.889, 0.948, 0.946. The diagnostic efficiency is the best for infant-toddlers with profound hearing loss, with a sensitivity of 89.6% and a specificity of 88.4%. The more severe the hearing loss, the higher the discrimination accuracy of IT-MAIS and the better the diagnostic efficiency. Conclusion:The logistic model based on the IT-MAIS scale and the ROC curve method have a good efficiency in the diagnosis of hearing loss severity in infants and toddlers aged 0-36 months. When the child cannot cooperate with behavioral audiometry, the results of behavioral audiometry are unreliable, and there is no electrophysiological condition, the IT-MAIS scale is expected to evaluate the degree of infants' hearing loss as an auxiliary tool. It can understand the children's auditory function state more and provides a basis for the subsequent formulation of rehabilitation intervention strategies with certain clinical application value.

Different modes of cochlear implantation in children: a comparative study on hearing and speech rehabilitation effects.

To study the effectiveness of unilateral cochlear implantation, binaural-bimodal hearing devices, and bilateral cochlear implantation in children with inner-ear malformation. This study comprised 261 patients who were allocated to inner-ear malformation or control groups. Twenty-four months after surgery, aided sound-field thresholds were tested, and the Meaningful Auditory Integration Scale, Infant-Toddler Meaningful Auditory Integration Scale, Meaningful Use of Speech Scale, Categories of Auditory Performance scale and Speech Intelligibility Rating test were completed. Aided sound-field thresholds were significantly better for bilateral cochlear implantation patients than for unilateral cochlear implantation or binaural-bimodal hearing device patients. There was no significant difference in Meaningful Auditory Integration Scale, Infant-Toddler Meaningful Auditory Integration Scale, or Categories of Auditory Performance scores among the three groups. The binaural-bimodal hearing device patients outperformed unilateral cochlear implantation patients on both Meaningful Use of Speech Scale and Speech Intelligibility Rating scores. No statistical difference was observed between the two subgroups. Children who received bilateral cochlear implants have the best auditory awareness in a quiet environment. Children with binaural-bimodal hearing devices have better voice control and verbal skills than unilateral cochlear implantation patients, and people are more likely to understand them. Children with inner-ear malformations benefit from cochlear implantation.

Outcome of Cochlear Implantation in Children with Auditory Neuropathy-A Dual Case Study

Objectives: The aim of this study is to compare the outcome of cochlear implantation in two pediatric auditory neuropathy cases. Methods: Two cases with auditory neuropathy were taken. Case 1 was 10 year old male. Case 2 was 11 year old male. In preoperative assessment both have bilateral severe to profound sensory-neural hearing loss. Case 1 was implanted by MED-EL using sonata Ti100 opus 2 processor. Case 2 was implanted using MED-EL using sonata Ti100 opus 2 processor. Both cases were given auditory verbal therapy. Both cases attended auditory verbal therapy for a period of 2 years. In postoperative assessment for each individual subject, electrically evoked compound action potentials (ECAPs), electrically evoked stapedius reflex threshold (ESRT), and electrically evoked auditory brainstem response (EABR) thresholds were determined. The following questionnaire extended receptive expressive emergent language scale (E-REELS) , Categories of Auditory Performance (CAP) score, Speech Intelligibility Rating (SIR) scale, Meaningful Auditory-Integration Scale (MAIS) and Meaningful Use of Speech Scale (MUSS) are scales were administered. Results: In the postoperative assessment, ECAP, ESRT, EABR, MUSS, MAIS shows that case 1 with auditory neuropathy have better performance than case 2. Conclusion: It is essential that all possible complications and postoperative performance should be considered in cochlear implantation for auditory neuropathy individuals

Desenvolvimento de habilidades auditivas de crianças no primeiro ano após o implante coclear unilateral e bilateral

ABSTRACT Purpose To identify the development of initial auditory skills in children with unilateral and bilateral cochlear implant during the first year of use. Methods Retrospective longitudinal study of medical records of children who received cochlear implant under the age of four, separated into two groups. The first, composed of children implanted unilaterally and the second, by children implanted and simultaneously. Data on the IT-MAIS scale (Infant-Toddler Meaningful Auditory Integration Scale) were collected before surgery and three months, six months and one year after surgery. These results were compared with the existing Clinical Markers. In addition, the family’s classification was noted, according to the Family Involvement Assessment Scale. Results The data of 29 children with bilateral cochlear implant and 30 children with unilateral cochlear implant were evaluated. The IT-MAIS score of the two groups was similar to the Clinical Markers. Regarding the Family Involvement Assessment Scale, there was a difference, showing that families in the bilateral group were more involved. Conclusion In the first year of use of the cochlear implant, the development of children implanted bilaterally did not differ from the development of children implanted unilaterally, suggesting that initial auditory skills are likely to develop with unilateral auditory input.

Evaluation of the language development of children with cochlear implant users living in a multilingual environment

ObjectiveTo evaluate the effect of second language exposure on Turkish speaking skills in cochlear implant (CI) users. MethodsChildren living in mono and bilingual families, who underwent unilateral cochlear implant due to congenital severe to profound, or profound hearing loss, were examined. The fifty six children with a chronological age younger than 8 and a language age of 2–6 years were included the study. The Denver II Developmental Screening Test was used for identifying of pre-implant speech and development. The duration of implant use was also documented. Languages spoken at the patients' homes were divided into 4 categories: T/K: Predominantly Turkish/Kurdish, K/T: Predominantly Kurdish/Turkish, T/T: Just Turkish, A/T: Predominantly Arabic/Turkish. The CAP (Categories of Auditory Performance), SIR (Speech Intelligibility Rating), The Turkish Version Test of The Early Language Development (TELD-3:T),. The IT-MAIS (Infant Toddler Meaningful Auditory Integration Scale), MUSS (Meaningful Use of Speech Scale) were used to evaluate the language development of the patients. Changes in IT-MAIS and MUSS scores in the last two years were also evaluated. ResultsThe all children received their implants before age of 6 years. The average duration of cochlear implant use of children was 38,43 ± 11,64 months. The mean pre-implant speech age was 6,8 ± 2,13 months. There was no significant difference between the groups in terms of the CAP and SIR scores. In TELD-3:T scores, there was no significant difference between the groups except for the receptive raw scores. The Arabic/Turkish group had significantly lower receptive raw scores. This group also had significantly lower mother educational level.In IT-MAIS and MUSS scores, no significant difference was found between the groups. ConclusionsOur study supports the opinion that exposure to a second language at home does not affect the acquisition of the language of education in children using CI.

Revision Surgery for Pediatric Nontumor Auditory Brainstem Implant Users: Audiological, Rehabilitative, and Surgical Outcomes.

To report the audiological, rehabilitative, and surgical outcomes of revision surgery for pediatric auditory brainstem implant (ABI) users. Retrospective cohort. Tertiary referral center. Five pediatric ABI users who had revision surgery for device malfunctions. Revision surgery for ABI malfunctions. The findings of free-field audiometry with the device, the Meaningful Auditory Integration Scale, and the pattern discrimination, word identification, sentence recognition, and expressive and receptive language tests before the device failure and after revision surgery were obtained from the patient records and compared. The revision rate for pediatric ABI was 6.45%. The Meaningful Auditory Integration Scale and expressive-receptive language scores showed improvements following revision surgery, while the aided thresholds, pattern perception, and word identification scores did not change. Individual differences in performance for these measures were observed. Equal or improved performance after the revision surgeries in the current study showed that revision surgery is successful and important for pediatric ABI users. It is essential to consider remedying the loss of auditory input in sensitive periods of pediatric development.

Auditory and speech performance after unilateral cochlear implantation for cochlear nerve canal stenosis.

To explore the correlation between the width of the bony cochlear nerve canal (CNC) and long-term auditory rehabilitation after unilateral cochlear implantation (CI) in pediatric patients with congenital deafness and bilateral cochlear nerve canal stenosis (CNCS). A retrospective review was performed on 10 patients with bilateral CNCS and bilateral congenital profound hearing loss who each underwent unilateral cochlear implantation. The width of the CNC was determined on computed tomography (CT) imaging and following CI, auditory and speech performance following CI were graded using categories of auditory performance (CAP), speech intelligibility rating (SIR), and the meaningful auditory integration scale (MAIS) at 24 months following implantation. No correlation was noted between CAP score and CNCS at 24 months post CI (P > .05). A positive correlation was noted between SIR score and CNC width (ρ = .81, P < .05). Similarly, a positive correlation was noted between MAIS and CNC width (ρ = .71, P < .05). The width of the CNC in patients with CNCS is positively correlated with some long-term auditory and speech outcomes after CI.

Language Outcomes in Cochlear Implanted Children with White Matter Disturbances.

Introduction: The present study reviews our experience with children with white matter disturbances and the benefits they get from rehabilitation post cochlear implantation.Materials and Methods:It is a retrospective cohort study of 7 cochlear implanted children with white matter disturbances. Preoperatively all the subjects had undergone a complete Audiological test battery for confirmation of hearing thresholds. Post assessment, a digital hearing aid trial was followed by three months’ therapy. Unilateral cochlear implant surgery and monitored auditory-verbal therapy sessions were the next line of treatment for at least one year. The therapist regularly monitored hearing and communication outcomes on an Auditory verbal ongoing scale, revised CAP, MAIS, word, and sentence discrimination scores.Results:The age range of Implantation was between 48 to 60 months. 5 out of 7 participants showed remarkable improvement with regular therapy. Their Meaningful Auditory Integration Scale (MAIS) scores were greater than 35 indicating good auditory integration and Categories of Auditory Performance (CAP) revealed scores of even 9 and higher indicating good telephone conversation. Speech Intelligibility Rating (SIR) showed a rating of 4 meaning thereby that an unfamiliar Listener could understand Speech without additional cues. However, all of them reported difficulty perceiving speech in noisy environments. Two cochlear implantees needed speech reading cues in conjunction with the audition.Conclusion:Our experience with cochlear Implantation in children with white matter abnormalities has been positive and satisfactory. The presence of white matter abnormalities on MRI should not be a contraindication for Implantation. Successful outcomes can be expected with regular and dedicated auditory-verbal therapy sessions.

Comparison of residual hearing preservation and auditory based performance after paediatric cochlear implantation by round window insertion versus cochleostomy technique: an ambispective cohort study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Cochlear implantation (CI) has revolutionized the treatment of sensorineural deafness. The aim of the study was to compare auditory based performance in cochlear implants who underwent round window insertion and cochleostomy.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Ambispective cohort study was done among the children who underwent perilingual cochlear implant in a tertiary care hospital for period of 1 year. Children who satisfied the inclusion criteria were selected and randomly subdivided into 2 groups: group A- round window insertion and group B-cochleostomy. Pre- and post-operative pure tone average (PTA) and residual hearing preserved were evaluated among the cochleostomy and round window insertion groups separately. Post-operatively, children were evaluated, from three months to 1 year from the activation of cochlear implant, with the use of scores such as Category of Auditory Performance (CAP), Meaningful Auditory Integration Scale (MAIS), Speech Intelligibility rating (SIR) and Meaningful use of speech scale (MUSS score) to measure speech production skills by auditory verbal therapist. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; A total of 80 patients were included in the study. Complete hearing preservation (within 10 dB) was significantly high in round window insertion group compared to cochleostomy technique (p&amp;lt;0.001). None the subjects had complete loss of residual hearing. On evaluating the post CI performance, MAIS score in the round window insertion group (9.34, 18.21, 27.79) were significantly better compared to cochleostomy group during the 3 months, 6 months and 12 months follow-up.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Round window insertion technique is significantly more successful in complete hearing preservation at low frequencies compared to cochleostomy technique. Among the auditory scores, only MAIS in the round window insertion group was found to be significantly better compared to cochleostomy group.&lt;/p&gt;

Outcomes of Acoustic and Linguistic Performances Following Cochlear Implantation in Large Vestibular Aqueduct Syndrome (LVAS).

This study aims to collate the outcomes in acoustic and linguistic performances after cochlear implantation in LVAS. In a hospital-based prospective interventional study, seven prelingual children with bilateral profound sensorineural hearing loss(SNHL) with LVAS were recruited. They underwent unilateral cochlear implantation between December 2013 and December 2015 in the Department of Otorhinolaryngology and Head Neck Surgery at a tertiary care center. Outcomes of auditory and speech performances were assessed in the form of revised categories of auditory perception (CAP), infant toddler meaningful auditory integration scale (IT-MAIS) and speech intelligibility rating (SIR) scores preoperatively, at one and two years follow up. The mean age of implantation was 4years. The median revised CAP, IT-MAIS, and SIR scores after one and two years of follow-up were 6, 27, 3, and 11, 36, 5 respectively. The mean follow-up duration was 21.3months. Pre op median revised CAP, IT-MAIS, and SIR scores of 0, 1, 1 showed improvement to 11, 36, 5 at two years follow up which was statistically significant. Hence, we conclude that good functional outcomes post-operatively advocate the significance of cochlear implantation in LVAS.