Ana Claudia Martinho de Carvalho

Introduction Remote programming can improve access and help overcome barriers related to distance, cost, and travel in the follow-up care of cochlear implant users. This study evaluates the ease of use, effectiveness, and acceptability of the remote programming system for cochlear implant users. Methods Cross-sectional study with 14 adult participants. The first phase included in-person and remote programming sessions at the hospital, while the second focused on remote programming sessions in participants' homes. In each phase, speech perception with the created programs was evaluated in a soundproof booth. Subjective feedback was obtained from audiologists and users through customized questionnaires. Results Speech scores indicated that both maps created remotely at the hospital (first phase of the study) and those created at home (second phase of the study) provided comprehension of phrases and words that was not inferior to that of the map created in person. Scores for disyllabic words with audiovisual cues, obtained through remote programming at home, were not inferior to those obtained through remote programming at the hospital. In the subjective evaluation, both participants and audiologists indicated that the experience with remote programming was satisfactory. Conclusions Remote programming was found to be as effective as in-person programming, as it provided access to the programming parameters and objective measures used in in-person sessions. Speech recognition results were similar for programs created in person and remotely. Participants indicated that the remote programming method and the resulting program were useful and acceptable, and that they experienced similar ease and quality of communication.

The purpose of the study was (1) to retrospectively analyze ECochG data and compare it with the current literature. (2) to explore the relationship between ECochG and post-op audiological assessments. This retrospective study included all patients with intraoperative and postoperative ECochG measurements and postoperative audiologic testing. ECochG were performed during CI insertion regardless of the preoperative hearing status. Preoperative and postoperative assessments were extracted from the medical records. A total of 35 patients (42 ears) met the inclusion criteria. Intra-op ECochG response was measurable in 17 of 42 ears (40.5%). The mean peak amplitude found was 103.3 µvolts. The type of electrode array was not associated with the ECochG amplitude (p = .630). Post-op ECochG thresholds were significantly correlated with behavioral thresholds after a month of CI implantation (p < 0.05). ECochG responses were measurable in individuals with mean preop pure tone thresholds of 66 dB HL at 250 Hz, 77 dB HL at 500 Hz, 84 dB HL at 1 kHz and 92 dB HL at 2kHz. The type of electrode was not associated with the ECochG peak nor with greater preservation of residual hearing. Post-op ECochG thresholds were significantly correlated with post-op thresholds.

Purpose The aim of this study was to evaluate the contribution of the CROS system on the head shadow effect in unilateral implant users. Methods Prospective cross-sectional study, approved by the ethics committee under protocol 2.128.869. Eleven adults with post-lingual deafness users of unilateral Advanced Bionics CI were selected. Speech recognition was evaluated with recorded words presented at 65dBA at 0o azimuth and at 90o on the side contralateral to the CI, with noise at 55dBA, using CI alone and CI + CROS system. The results were analyzed using paired t-test with a 0.05 alpha. Results The mean speech recognition scores were significantly better with CI + CROS in relation to the condition of CI alone (p <0.05, p <0.005 and p <0.005 respectively). In the presentation at 0o azimuth, no significant differences were found. Conclusion Users of unilateral CI without useful residual hearing for the use of hearing aids or unable to undergo bilateral surgery can benefit from the CROS device for speech recognition, especially when the speech is presented on the side contralateral to the CI.

The purpose of this study was to investigate, over a period of five years, the cortical maturation of the central auditory pathways and its impacts on the auditory and oral language development of children with effective use and without effective use of a Cochlear Implant (CI). A case series study was conducted with seven children who were CI users and seven children with normal hearing, with age- and gender-matched to CI users. The assessment was performed by long-latency auditory evoked potentials and auditory and oral language behavioral protocols. The results pronounced P1 latency decrease in all CI users in the first nine months. Over five years, five children with effective CI use presented decrease or stabilization of P1 latency and a gradual development of auditory and oral language skills, although, for most of the children, the electrophysiological and behavior results remained poor than their hearing peers’ results. Two children who stopped the effective use of CI after the first year of activation had worsened auditory and oral language behavioral skills and presented increased P1 latency. A negative correlation was observed between behavioral measures and the P1 latency, the P1 component being considered an important clinical resource capable of measuring the cortical maturation and the behavioral evolution.

RESUMO Objetivo Traduzir e adaptar culturalmente para o Português Brasileiro o Nijmegen Cochlear Implantation Questionnaire (NCIQ) e descrever os resultados de qualidade de vida em adultos. Método Tradução e adaptação cultural do NCIQ. Depois desta etapa, foi realizado um estudo transversal e clínico de avaliação da qualidade de vida em um grupo de 24 adultos usuários de implante coclear (IC). Resultados O título do questionário na versão traduzida para o Português Brasileiro foi definido em Questionário Nijmegen de Implantes Cocleares (NCIQ-P). A versão traduzida do questionário NCIQ-P apresentou boa consistência interna para todos os domínios existentes no questionário (0,78). Os resultados de qualidade de vida em adultos demonstraram que os domínios mais pontuados foram o social e o físico, sendo os subdomínios percepção básica e avançada os de maior pontuação. Não foi observada correlação entre gênero e tempo de uso do dispositivo para os domínios e subdomínios existentes no questionário. Conclusão A tradução e adaptação cultural do NCIQ-P sugeriu que o instrumento é válido e útil para o uso clínico e de pesquisa em adultos usuários de IC e falantes do Português Brasileiro.

Descritores Potenciais Evocados Auditivos; Audiologia; Sistema Nervoso Central; Plasticidade Neuronal; Criança

The purpose of this study was to longitudinally assess the behavioral and electrophysiological hearing changes of a girl inserted in a CI program, who had bilateral profound sensorineural hearing loss and underwent surgery of cochlear implantation with electrode activation at 21 months of age. She was evaluated using the P1 component of Long Latency Auditory Evoked Potential (LLAEP); speech perception tests of the Glendonald Auditory Screening Procedure (GASP); Infant Toddler Meaningful Auditory Integration Scale (IT-MAIS); and Meaningful Use of Speech Scales (MUSS). The study was conducted prior to activation and after three, nine, and 18 months of cochlear implant activation. The results of the LLAEP were compared with data from a hearing child matched by gender and chronological age. The results of the LLAEP of the child with cochlear implant showed gradual decrease in latency of the P1 component after auditory stimulation (172 ms–134 ms). In the GASP, IT-MAIS, and MUSS, gradual development of listening skills and oral language was observed. The values of the LLAEP of the hearing child were expected for chronological age (132 ms–128 ms). The use of different clinical instruments allow a better understanding of the auditory habilitation and rehabilitation process via CI.

PURPOSE: To evaluate the quality of life of children with cochlear implants from the perspective of their parents. METHODS: A clinical and cross-sectional study was conducted with 15 parents of children using cochlear implants of both genders aged between 2 and 12 years old. Parents of these children answered the questionnaire "Children with Cochlear Implants: Parental Perspective" (CCIPP). Data related to auditory category and time of cochlear implants use were collected from medical records of the children. The percentages of responses on the CCIPP domains were tabulated and descriptively and inferentially analyzed. RESULTS: The cochlear implants had a positive effect on the quality of life of children in the self-reliance (58.9%) and social relationships (56.7%) domains. No correlation was observed between the time of cochlear implants activation (months) and any of the CCIPP domains. However, children with 24 months or less of cochlear implant use presented higher percentages on the communication domain than those with more than 24 months of cochlear implants use. A negative correlation was observed between the auditory category and the effects of the implant domain. CONCLUSION: From the perspective of parents, the use of cochlear implants improves the quality of life of their children; the shorter the time of cochlear implants use, the higher the improvement in quality of life; and the more developed the auditory skills, the lower the percentage of quality of life improvement with the cochlear implants.