Sequential Implantation Research Articles

The Effect of Noise and Reverberation on Spatial Perception in Sequential Bilateral Cochlear Implant Users

Abstract Background Spatial orientation is an executive function which includes vital activities and auditory organization according to daily bodily movements, directionality, and environmental information. It is directly linked to the vision and hearing and used throughout life, building complex relationships with these systems, based on learning. Purpose Our purpose in our study is to try to see the effects of noise and reverberation on the users by comparing the localization and auditory performances of the cochlear implant (CI) user individuals in a silent, noisy environment and reverberation. Research Design All subjects were subjected to immitancemetric/audiological tests, language development test (TIFALDI, Receptive/Expressive Language Test score 7 years and above), localization determination in noise, and localization determination test in reverberation. Study sample: In our study, 18 female and 16 male bilateral CI users with profound sensorineural hearing loss were included. The age range of subjects was 8 years 4 months and 10 years 11 months. Data Collection and Analysis Data from subjects were collected prospectively. Data analysis was analyzed with SPSS 21 program. Results It was observed that the subjects did not have difficulty in determining the direction in silent condition, but they had a significant difficulty in localizing the 135-, 225-, and 315-degree angles especially when the noise was signal-to-noise ratio (SNR) –10 dB and the reverberation was 06 and 09 second (p ≤ 0.005). Subjects' performances were significantly altered in sequential implanted users both when the SNR was changed and in the presence of reverberation (p < 0.05). Conclusion As a result of our study, it is thought that individuals with hearing loss will experience intense difficulties, especially in noisy and reverberant environments such as schools, and using assistive listening devices in these environmental conditions will contribute positively to their academic development.

Timing of bilateral sequential cochlear implantation for children: determination of its benefit.

To evaluate monosyllable word recognition in noise under different conditions in bilateral sequential cochlear implants (CIs). Second, to assess subjective hearing benefits among bilateral sequential CIs, bimodal hearing, and CI-only groups. Lastly, to analyze the prognostic factors affecting CI outcomes in children with bilateral sequential CIs. Sixty-five children with CI were enrolled. Mandarin monosyllable recognition tests in noise and the Speech, Spatial, and Qualities of Hearing Scale (SSQ) were used to assess post-CI outcomes. The SSQ benefits were compared among children with bilateral CIs, bimodal hearing, and CI-only. Bilateral CIs significantly outperformed the first or second CI alone using in noise. The bilateral CI group had significantly better SSQ scores for speech, qualities, and total scores compared to the CI-only group. Additionally, 41% of the variance in speech perception of the second CI can be attributed to the inter-implantation interval between bilateral CIs. Bilateral sequential CIs can enhance speech perception in noise and daily life-functioning for children. Earlier implantation of bilateral sequential CIs results in better outcomes, while inter-implantation interval exceeding 9.6 years between bilateral CIs may lead to poor second CI performance in noise. Therefore, early bilateral sequential CIs should be encouraged.

Audiological and Subjective Benefits in a Child with Microtia and Atresia After Sequential Bilateral Implantation with Active Bone Conduction Devices: A Case Study

Background: With bilateral hearing loss, the main problems for the patient are speech understanding in noise and, especially in asymmetrical hearing loss, an inability to correctly localize sound sources. There are multiple methods of treatment and rehabilitation for people with conductive hearing loss, and one of them is to use an active bone conduction implant. This case study is designed to evaluate the auditory benefits and sound localization accuracy with active bilateral bone conduction implants—in comparison to unilateral ones—in a patient with congenital bilateral conductive hearing loss caused by a congenital malformation. We assess subjective and audiological benefits (functional, directional hearing, speech comprehension in quiet and noise). Case report: This study describes the results in a 15-year-old patient with bilateral congenital malformation of the outer ears and associated conductive hearing loss who was treated with two Bonebridge active bone conduction implants. Speech recognition ability, hearing thresholds, and sound localization were tested under three conditions: unaided, unilateral on the right-side, and bilateral on both sides. The patient filled in an Abbreviated Profile of Hearing Aid Benefit questionnaire (APHAB) to evaluate limitations in daily life caused by hearing impairment. The results show an improvement in free-field hearing thresholds and the ability to discriminate speech, both in quiet and in noise after implantation. Subjectively, the patient had significantly fewer problems with two implants than with one (or with no implant) in terms of hearing in everyday situations. Conclusions: Unilateral use of the Bonebridge device in a patient with congenital bilateral conductive hearing loss did not provide full benefits. However, bilateral implantation improved speech understanding in noise and sound localization.

Surgical treatment of paralytic mydriasis caused by belladonna preparation intake (a clinical case)

This rare clinical case demonstrates the treatment of paralytic mydriasis caused by taking a herbal drug, Atropa belladonna, which is extremely rare in the treatment of diseases today, using sequential implantation of an intraocular lens (IOL) and an artificial iris with simultaneous correction of refractive errors. The patient took Atropa belladonna extract for 5 years to prevent exacerbation of gastric ulcer according to the scheme 2 times a year (spring, autumn) for 2 weeks, 5-7 drops 3 times a day with meals. The uniqueness is explained by the fact that paralytic mydriasis arose as a result of long-term drug exposure. Analysis of the state of the iris stroma showed the impossibility of performing suture plasty of the pupil. In addition, patients with this pathology have been denied treatment in other medical institutions for decades.

Comprehensive treatment approach for hemifacial microsomia: Integrating orthognathic surgery with sequential customized implantation

ObjectiveThis study aims to evaluate the clinical outcomes of combining orthognathic surgery with staged patient-specific implants (PSIs) for comprehensive craniofacial asymmetry reconstruction in adult hemifacial microsomia (HFM) patients. MethodsSix adult HFM patients (1 Type I and 5 Type IIa) underwent orthognathic surgery to correct skeletal malocclusion and chin deviation. Sequential PSIs were implanted to address craniofacial asymmetry. Digital lateral cephalograms and cranial CT scans were obtained at four time points: pre-orthognathic surgery (T0), within three months after orthognathic surgery (T1), one year after orthognathic surgery and just before personalized implantation (T2), and after personalized implantation (T3). Evaluation parameters included skeletal and dentoalveolar measures, occlusal cant, chin deviation, skeletal stability, and facial contour symmetry. ResultsAt T1, no significant differences were observed in skeletal movements compared to planned surgical movements (p > 0.05). Similarly, at T2, skeletal movements did not significantly differ from those observed at T1 (p > 0.05), indicating surgical precision and stability. Analysis of skeletal and dentoalveolar parameters, occlusal cant, and chin deviation revealed significant increases in SNB, FH-NPo, and ST N vert-Pog at T1 compared to T0 (p < 0.05), along with notable improvements in chin deviation and occlusal cant (p < 0.05). Comparison of T2 to T1 showed no significant changes in SNB, FH-NPo, ST N vert-Pog, chin deviation, or occlusal cant (p > 0.05), indicating substantial postoperative stability. Following personalized implantation (T3), further significant improvements were observed in skeletal symmetry. ConclusionCombining orthognathic surgery with staged PSIs effectively reconstructs craniofacial asymmetry in adult HFM patients, achieving significant improvements in skeletal alignment, occlusal cant, and chin deviation, with stable outcomes over time.

Evaluating the Efficacy of Conbercept and Dexamethasone Implants Sequentially in the Treatment of Refractory Macular Edema Secondary to Central Retinal Vein Occlusion (CRVO): A One-Year Follow-Up Study.

The objective of this research was to assess the effectiveness and safety of using Conbercept injection and dexamethasone implant (DEX I) in sequence for treating refractory macular edema (ME) caused by central retinal vein occlusion (CRVO) in patients. A study was conducted on 34 patients with persistent macular edema caused by central retinal vein occlusion, reviewing their medical history and interventions performed. Sequential implantation of DEX I was performed 1week after the Conbercept injection. OCTA images were used to measure central retinal thickness (CRT), best-corrected visual acuity (BCVA), intraocular pressure (IOP), and pre- and post-treatment vessel density of the superficial capillary plexus (SCP) and deep capillary plexus (DCP), with a 1-year follow-up period. At the 12-month follow-up, participants demonstrated notable improvements in central retinal thickness and intraocular pressure (p < 0.05). Throughout the monitoring period, no significant differences were found in BCVA improvement or vessel density reduction (p > 0.05). Two patients required topical treatment to lower their intraocular pressure during the study period. In conclusion, patients experiencing persistent ME due to secondary CRVO may benefit from transitioning to a treatment regimen involving Conbercept and DEX I, potentially resulting in a reduction in CRT. However, no significant improvement was observed in BCVA or deep and superficial capillary plexus vessel density.

Билатеральная последовательная имплантация интраокулярной линзы специального дизайна с четырехточечной склерокорнеальной фланцевой фиксацией при афакии

Bilateral, sequential implantation of an intraocular lens of special design with four-point sclero-corneal flange fixation in aphakia A.F. Teshev, A.V. Malyshev, K.P. Telegin, R.Kh. Adzhiev Adygea Republican Clinical Hospital, Maykop, Republic of Adygea, Russian Federation Maykop State Technological University, Republic of Adygea, Russian Federation Research Institute – Regional Clinical Hospital No. 1 named after Professor S. V. Ochapovskii Krasnodar, Russian Federation City Hospital No. 40 of the Kurortnii district Sestroretsk, St. Petersburg, The article describes a clinical case with surgical treatment of bilateral aphakia in a patient who underwent cataract removal 50 years ago through a wide limbal incision. This case is interesting due to the approach to surgical treatment, namely the choice of intraocular lens, the method of fixing the intraocular lens in the absence of a capsular bag, and the results of visual acuity obtained. Key words: aphakia, sclerocorneal fixation of IOLs, intraocular lens, IOL stitching, Aquamarine nanocrystal model ACQ11.03IOL (Aquamarine TT)

Cochlear implantation in patients with inner ear schwannomas: a systematic review and meta-analysis of audiological outcomes.

In patients with inner ear schwannomas (IES), reports on hearing rehabilitation with cochlear implants (CI) have increased over the past decade, most of which are case reports or small case series. The aim of this study is to systematically review the reported hearing results with CI in patients with IES considering thedifferent audiologic outcome measures used in different countries. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, a search of published literature was conducted. We included patients with IES (primary or with secondary extension from the internal auditory canal (IAC) to the inner ear, sporadic or NF2 related) undergoing cochlear implantation with or without tumour removal. The audiological results were divided into the categories "monosyllables", "disyllables", "multisyllabic words or numbers", and "sentences". Predefined audiological outcome measures were available from 110 patients and 111 ears in 27 reports. The mean recognition scores for monosyllabic words with CI were 55% (SD:24), for bisyllabic words 61% (SD:36), for multisyllabic words and numbers 87% (SD:25), and 71% (SD:30) for sentences. Results from for multisyllabic words and numbers in general showed a tendency towards a ceiling effect. Possible risk factors for performance below average were higher complexity tumours (inner ear plus IAC/CPA), NF2, CI without tumour removal ("CI through tumour"), and sequential cochlear implantation after tumour removal (staged surgery). Hearing loss in patients with inner ear schwannomas can be successfully rehabilitated with CI with above average speech performance in most cases. Cochlear implantation thus represents a valuable option for hearing rehabilitation also in patients with IES while at the same time maintaining the possibility of MRI follow-up. Further studies should investigate possible risk factors for poor performance. Audiological tests and outcome parameters should be reported in detail and ideally be harmonized to allow better comparison between languages.

A simultaneous post-LASIK sequential bilateral implantation of multifocal IOLs aimed at refraction correction. A clinical case

The article presents a clinical example of intraocular presbyopia correction in a patient who previously underwent laser vision correction by LASIK for mild myopia. Before the surgery, the distance VA mono- and binocular was 1.0, ADD for reading distance 40 cm +2.0 D, objective refraction sph +0.5 D cyl -0.25 D ax 980, left eye sph +0.75 D cyl -0.25 D ax 660. The patient was given a simultaneous bilateral refractive lens exchange with an implantation of a trifocal aspheric intraocular lens in the right eye and a trifocal toric aspheric intraocular lens in the left eye. We used the following IOL calculation formulas: ASCRS mean IOL power, Shammas formula, Barrett true K formula, Masket formula, Modified Masket formula, Haigis-L formula. 1 week postop: UDVA OU = 1.0, UNVA 40 cm = 1.0, UVA 70 cm = 0.7. The objective refraction OD was sph +0.0, D cyl -0.75 D ax 163, OS sph +0.25 D, cyl -0.0 D. The compliance with the modified algorithms of pre-and intraoperative behavior of the operating team, thorough preparation of the patient, careful calculation of the IOL allowed us to obtain the predictive refractive result with a high level of visual satisfaction and absence of undesirable postoperative phenomena. The patient underwent the examination with Salzburg reading desk before and after the surgery, to confirm the excellent functional results of the treatment. Despite the fact that simultaneous same day IOL implantation in both eyes, especially in eyes with previously operated corneas, is still disputable, the above case confirms that with modern equipment, precise multi formula calculation, and ample experience help achieve excellent functional and refractive results.

Double implantation of Xen 45 gel stent in primary open-angle glaucoma: a pilot study.

To describe the outcomes of double implantation of Xen 45 Gel Stent (Xen) using an ab externo approach with closed conjunctiva. Retrospective single-centre case series of primary open-angle glaucoma patients with at least six months of follow-up after implantation of a second Xen in the same eye via ab externo technique without conjunctival opening. Eight pseudophakic eyes of 8 patients were included. Intraocular pressure (IOP) dropped from 30 ± 2.6mmHg pre-operatively to 22.4 ± 2.3mmHg one month after the first Xen implant (mean difference: -7.6mmHg [95% confidence interval: -9.4, -5.9mmHg], p = 0.0092). A second Xen was then implanted to achieve the target IOP. The procedure showed no significant intraoperative or postoperative complications. The IOP dropped to 16.1 ± 2.7mmHg six months following this second implant (mean difference: -6.3mmHg [95% confidence interval: -7.2, -5.3mmHg], p = 0.0183); however, 3 patients needed medical therapy to further reduce the IOP towards the target value. Sequential implantation of two Xen 45 Gel Stents using an ab externo approach with closed conjunctiva appears a promising procedure that showed a favorable safety and efficacy profile in this small case series. This pilot data might pave the way for further studies to evaluate the safety and efficacy of the procedure.

Adsorption and electron injection studies in N719 sensitized Ag[formula omitted], Au[formula omitted] implanted and O2 annealed titania films

The device performance of novel solar cell configurations with porphyrin, hybrid perovskite-based materials as sensitizers depends on the interfacial processes and engineered interfaces with characteristic material properties can be fabricated employing energetic ion implantations. In this experimental work, the dye adsorption, optical absorption and interfacial electron injection in N719 sensitized Ag−, Au−, sequentially impinged and O2 annealed titania films were studied. Prior to the dye sensitization process, impinged samples were fabricated employing mono-ion type, sequential implantations and a set of the as-implanted films were annealed at 450 °C for 1 h in O2 environment. The N719 molecules are adsorbed onto Ag−, Au− impinged films through SCN ligands, indicated by the appearance of new Raman modes ν(Ag-S), ν(Au-S) respectively. The 1MLCT, 3MLCT bands of the dye molecules are altered upon implantation and annealing processes. A fast interfacial electron injection process with τ2∼3.7 ps has been observed in the sensitized annealed sequentially impinged film at 6 × 1015 ions cm−2 (sensitized pristine TiO2 exhibits τ2∼51 ps) and is attributed to Ag−, Au− implants introducing new states to the conduction band of anatase TiO2. The ability of ion-implantation technique to introduce new states to the band structure of materials has enormous significance in photo-catalytic, water-splitting, solar cell and hot electron injection technologies.

Simultaneous versus Sequential Cochlear Implantation in Adults: Quantitative and Qualitative Outcomes.

To compare speech recognition and quality of life outcomes between bilateral sequentially and simultaneously implanted adult cochlear implant (CI) recipients who initially qualify for a CI in both ears. Retrospective chart review. Tertiary referral center. Retrospective chart review identified adults who underwent bilateral CI, either simultaneously or sequentially, at a high-volume center between 2012 and 2022. Sequentially implanted patients were only included if the second ear qualified for CI in quiet (defined as best-aided AzBio quiet testing <60%), at time of initial CI evaluation. Of 112 bilateral CI patients who qualified in both ears at initial evaluation, 95 underwent sequential implantation and 17 simultaneous. Age, duration, and etiology of hearing loss, and CI usage were similar between groups. Preoperatively, the sequential group had lower pure-tone average (PTA) in the 1st ear than the simultaneously implanted group (P = <.001) but, no difference in 2nd ear PTA (P = .657). Preoperative speech recognition scores were significantly higher for the sequential group; however, this was not true for postoperative scores. There was no difference in the proportion of patients showing significant CI-only or bilateral performance improvement between the groups. Both groups demonstrated similar benefit in quality of life measures. Our findings indicate both simultaneous and sequential cochlear implantation are effective in improving hearing performance and quality of life. Thus, bilateral versus simultaneous implantation should be discussed and tailored for each individual patient.

Suppression of helium migration in arc-melted and 3D-printed CoCrFeMnNi high entropy alloy

We compare the evolution and migration of helium cavities in 3D-printed and arc-melted CoCrFeMnNi high entropy alloys (HEAs), and 304 stainless steel (SS), using transmission electron microscopy (TEM). The materials are subjected to Ni and He sequential implantation as well as subsequent thermal annealing. After irradiation at room temperature, all samples initially display similar He cavity sizes. Annealing up to 673 K has a minimal impact on cavity size. However, annealing at 873 K leads to significant cavity growth. Both HEA materials exhibit larger average cavity sizes compared to 304 SS, while a higher proportion of small cavities is found in the 304 SS. This indicates that Ostwald Ripening is more prevalent in 304 SS, confirmed by in-situ thermal annealing in TEM. Depth distribution analysis reveals distinct cavity belts after annealing: from the narrowest in 3D printed HEA to the broadest belts in 304 SS. These results indicate that the He concentration at the peak of irradiation damage decreases in the same order. We suggest that the long-range migration of He atoms is limited in both the Cantor and 3D-printed Cantor HEAs, potentially due to the complex diffusion paths of the He atoms.

Investigation of subclinical ocular inflammation in the aqueous humor of patients with myopia following bilateral sequential collamer lens implantation

BackgroundThe aqueous humor, a transparent fluid secreted by the ciliary body, supports the lens of the eyeball. In this study, we analyzed the cytokine and chemokine profiles within the aqueous humor of the contralateral eye post-implantation of an implantable collamer lens (ICL) to evaluate potential subclinical inflammation in the second eye subsequent to ICL implantation in the first eye. MethodsAqueous humor samples were procured from both eyes of 40 patients (totaling 80 eyes) prior to bilateral ICL insertion. Subsequently, a comprehensive statistical analysis was conducted using the Luminex assay to quantify 30 different cytokines in these samples. ResultsCompared to the first eye, the aqueous humor of the second eye demonstrated decreased concentrations of IFN-γ (P = 0.038), IL-13 (P = 0.027), IL-17/IL-17 A (P = 0.012), and IL-4 (P = 0.025). No significant differences were observed in other cytokine levels between the two groups. Patients were then categorized based on the postoperative rise in intraocular pressure (IOP) in the first eye. The group with elevated IOP displayed elevated levels of EGF in the aqueous humor of the first eye (P = 0.013) and higher levels of PDGF-AB/BB in the aqueous humor of the second eye (P = 0.032) compared to the group with normal IOP. Within the elevated IOP group, the levels of EGF (P = 0.013) and IL-17/IL-17 A (P = 0.016) in the aqueous humor were lower in the second eye than in the first eye. In the normal IOP group, cytokine levels did not differ notably between eyes. ConclusionFollowing sequential ICL implantation, it appears that a protective response may be activated to mitigate subclinical inflammation in the second eye induced by the initial implantation in the first eye. Additionally, the increase in IOP subsequent to surgery in the first eye may correlate with the presence of inflammatory mediators in the aqueous humor.

Immediate versus delayed sequential bilateral ICL implantation: A retrospective comparison of vault height and visual outcomes

PurposeTo compare the visual outcomes and risks of suboptimal vault-related complications between immediate sequential bilateral ICL surgery (ISBICLS) and delayed sequential bilateral ICL surgery (DSBICLS). DesignA retrospective cohort study. MethodsPatients who underwent bilateral ICL implantation between November 2014 and December 2021 at the Eye and ENT Hospital of Fudan University (Shanghai, China) were included and divided into two groups: (1) ISBICLS: both eye surgeries performed on the same day, and (2) DSBICLS: second eye surgery performed < 7 days following the first one. Propensity score matching (PSM) was performed to compare the visual outcomes. Multivariable logistic regression models were used to estimate the odds ratios (ORs) of the suboptimal vaults. ResultsFinally, 10,985 eyes were included. After PSM, 204 first surgery eyes and 162 s surgery eyes with complete postoperative data were matched. The safety and efficacy indices did not statistically differ between groups (all > 1.00), except that ISBICLS first surgery eyes achieved better efficacy index than DSBICLS group (1.03 ± 0.26 vs. 1.08 ± 0.23, P = 0.034). Excessive vault was observed in eight (4.06 %) ISBICLS first eyes, one (0.50 %) DSBICLS first eye, and none in the second surgery eye in either group. An insufficient vault was observed in one second eye and one DSBICLS second eye. We found no evidence of differences in the rate of excessive vault (OR = 0.831, 95 % CI: 0.426–1.622, P = 0.588) or insufficient vault (OR = 0.609, 95 % CI:0.062–5.850, P = 0.668). ConclusionISBICLS provided safety, efficacy, and refraction predictability comparable to DSBICLS without increasing the risk of suboptimal vault-related complications.

Comprehensive Treatment of Generalized Tuberculosis with Endobronchial Valves

The article describes a clinical case of generalized tuberculosis manifested by tuberculous spondylodiscitis and disseminated pulmonary tuberculosis with extensive drug resistance and bilateral multiple destruction. The chemotherapy regimen compiled according to the sensitivity pattern of the pathogen, sequential implantation of two endobronchial valves and their long-term (18 months) synergic effect made it possible to cure pulmonary tuberculosis with healing of all multiple bilateral destruction. The same chemotherapy regimens allowed achieving cure of tuberculous spondylodiscitis. Co-infection of hepatitis C provided no negative impact on the treatment course.

Importance of age at 2nd implantation and interimplant interval to the outcome of bilateral prelingually deafened pediatric cochlear implantation.

In Taiwan, the number of cases of sequential bilateral pediatric cochlear implantation (CI) is increasing but data regarding its effectiveness and impact of the reimbursement policy are lacking. We examined the speech perception and quality of life (QOL) of bilateral prelingually deaf children who underwent sequential CI, considering the effects of age at the time of second implantation and interimplant interval. We enrolled 124 Mandarin-speaking participants who underwent initial cochlear implant (CI1) in 2001-2019 and a second CI (CI2) in 2015-2020. Patients were followed up for ≥2 years and were categorized into groups based on age at the time of CI2 implantation (<3.5, 3.6-7, 7.1-10, 10.1-13, and 13.1-18 years) and interimplant interval (0.5-3, 3.1-5, 5.1-7, 7.1-10, and >10 years). We evaluated speech perception, device usage rates, and QOL using subjective questionnaires (Speech, Spatial, and Qualities of Hearing and Comprehension Cochlear Implant Questionnaire). Speech perception scores of CI2 were negatively correlated with ages at the time of CI1 and CI2 implantation and interimplant interval. Older age and a longer interimplant interval were associated with higher nonuse rates for CI2 and worse auditory performance and QOL. Among individuals aged >13 years with interimplant intervals >10 years, up to 44% did not use their second ear. Patients aged 7.1 to 10 years had better speech perception and higher questionnaire scores than those aged 10.1 to 13 and 13.1 to 18 years. Furthermore, patients aged 10.1 to 13 years had a lower rate of continuous CI2 usage compared to those aged 7.1 to 10 years. Timely implantation of CI2 is essential to achieve optimal outcomes, particularly among sequentially implanted patients with long-term deafness in the second ear and no improvement with hearing aids following CI1 implantation. For CI2 implantation, an upper limit of age of 10 years and interimplant interval of 7 years are essential to prevent suboptimal outcomes. These data can provide useful information to implant recipients, their families, and medical and audiological professionals, enabling a comprehensive understanding of the benefits and potential impacts of the timing of CI2 implantation.

Late Bilateral Sequential Cochlear Implant and Quality of Life.

Introduction Hearing impairment is one of the main disorders that can interfere with the development of speech and language. In an individual, it can cause significant communication difficulties, social isolation, negative feelings, and depressive disorders. The hearing aids (HAs) and cochlear implant (CI) are options for profound and severe hearing loss, and the CI can be indicated for individuals who do not obtain benefits from HAs. Objective To evaluate the quality of life of individuals who underwent sequential bilateral CIs with a long surgical interval between procedures. Methods Fifteen patients, aged 8 to 70 years old, who underwent sequential bilateral CI, with an interval ≥ 4 years between surgeries, were evaluated. Quality of life was evaluated using three questionnaires: WHOQOL-BREF, SSQ-12 and HHIA in Portuguese. Results The WHOQOL-BREF questionnaire showed that the study participants had a good quality of life in all domains assessed. According to the SSQ-12, few reported inability to listen in communication situations. Most individuals were classified as having medium disability by the HHIA, but the social and emotional effects did not significantly affect the quality of life. Conclusion The use of questionnaires to assess the quality of life of patients with hearing impairment is a valuable tool to measure adaptation to CI. Patients undergoing bilateral sequential CI, even with a long interval between procedures, presented high indices of quality of life.

A study on the Raman response of TiO2 upon ion-implantation and annealing in O2 atmosphere

The doped TiO2 materials exhibit extraordinary opto-electronic properties and in this regard, Ion-Implantation process offers extreme control and flexibility to fabricate such materials. In this work, it is shown that the electronic structure, optical absorption and raman response of TiO2 to be modified by single ion and sequential implantation process with Ag− (65 KeV), Au− (80 KeV) ions and post-implantation annealing at 450 °C for an hour in O2 atmosphere. The raman spectra of implanted and implanted/annealed TiO2 films depict anatase phase characteristics and implantation-induced effects are believed to alter the crystallinity in these materials. The sequentially implanted films Au_Ag_1 × 1016/TiO2, Au_Ag_1.5 × 1016/TiO2 depict an additional band at 65 cm−1 prior to Eg(1) band at 144.35 cm−1 and are further bettered upon annealing. The absorbance of the implanted TiO2 films is increased in the visible spectral region when compared to pristine TiO2 and are further enhanced upon annealing. The film Au_Ag_1 × 1016/TiO2 (A) exhibited optical band gap ∼2.96 eV when compared to 3.13 eV of pristine TiO2 and these materials with modified optical properties have implications for Photocatalysis, Photo-electrochemical water-splitting and Photovoltaic applications.

Language, cognitive, and speech in noise perception abilities of children with cochlear ımplants: a comparative analysis by implantation period and bilateral versus unilateral cochlear implants

PurposeThe purpose of this study was to compare the language, cognitive, and speech in noise (SiN) perception abilities of children with cochlear implants (CIs) to those of their peers with NH by grouping them according to their implantation period (12–18 months/19–24 months) and unilateral/bilateral CI use.MethodsThe sample comprised 50 children with cochlear implants (CIs) and 20 children with normal hearing (NH), ages 6–9 years. Children’s language, cognitive, and speech in noise (SiN) perception skills were assessed.ResultsChildren with CIs between 12 and 18 months and 19 and 24 months performed more poorly than children with NH on language, verbal memory (VM), verbal-short-term memory (V-STM), verbal working memory (V-WM), rapid naming, and speech in noise (SiN) perception abilities measures (p < 0.001). In addition, children with CIs between 19 and 24 months performed worse on rapid naming and V-WM tasks than children with CIs between 12 and 18 months (p < 0.017). Children with unilateral and bilateral CI performed more poorly than children with NH on language, VM, V-STM, V-WM, rapid naming, and SiN perception abilities assessments (p < 0.001). Additionally children with unilateral CI users performed poorly than children with bilateral CI users on SiN perception (p < 0.017).ConclusionsIn children with congenital hearing loss (CHL), cochlear implantation between 12 and 18 months or sequential bilateral implantation is not sufficient for these children to perform like their NH peers in language, cognitive, and SiN perception abilities. In addition, intervention approaches should focus not only on increasing language skills, but also on cognitive abilities.