One of the many parameters that can affect cochlear implant (CI) users' performance is the site of presentation of electrical stimulation, from the CI, to the auditory nerve. Evoked compound action potential (ECAP) measurements are commonly used to verify nerve function by stimulating one electrode contact in the cochlea and recording the resulting action potentials on the other contacts of the electrode array.The present study aimed to determine if the ECAP amplitude differs between the apical, middle, and basal region of the cochlea, if double peak potentials were more likely in the apex than the basal region of the cochlea, and if there were differences in the ECAP threshold and recovery function across the cochlea.ECAP measurements were performed in the apical, middle, and basal region of the cochlea at fixed sites of stimulation with varying recording electrodes. One hundred and forty one adult subjects with severe to profound sensorineural hearing loss fitted with a Standard or FLEX SOFT electrode were included in this study. ECAP responses were captured using MAESTRO System Software (MED-EL). The ECAP amplitude, threshold, and slope were determined using amplitude growth sequences. The 50% recovery rate was assessed using independent single sequences that have two stimulation pulses (a masker and a probe pulse) separated by a variable inter-pulse interval. For all recordings, ECAP peaks were annotated semi-automatically.ECAP amplitudes were greater upon stimulation of the apical region compared to the basal region of the cochlea. ECAP slopes were steeper in the apical region compared to the basal region of the cochlea and 251 ECAP thresholds were lower in the middle region compared to the basal region of the cochlea. The incidence of double peaks was greater upon stimulation of the apical region compared to the basal region of the cochlea. This data indicates that the site and intensity of cochlear stimulation affect ECAP properties.

Auditory performance of cochlear implant (CI) children was assessed with the Listening Progress Profile (LiP) and the Monosyllabic-Trochee-Polysyllabic-Word Test (MTP) following the EARS protocol. Additionally, the ‘initial drop’ phenomenon, a recently reported decrease of auditory performance occurring immediately after first fitting, was investigated. Patients were 140 prelingually deafened children from various clinics and centers worldwide implanted with a MEDEL COMBI 40/40+. Analysis of LiP data showed a significant increase after 1 month of CI use compared to preoperative scores (p < 0.01). No initial decrease was observed with this test. Analysis of MTP data revealed a significant improvement of word recognition after 6 months (p < 0.01), with a significant temporary decrease after initial fitting (p < 0.01). With both tests, children’s auditory skills improved up to 2 years. Amount of improvement was negatively correlated with age at implantation.

Objective: To create and validate a Spanish sentence test for evaluation of speech understanding of Spanish-speaking listeners with hearing loss or cochlear implants (CI). Study Design: Two thousand sentences were recorded from two male and two female speakers. The average intelligibility of each sentence was estimated as the mean score achieved by five listeners presented with a five-channel cochlear implant simulation. The mean scores of each sentence were used to construct 42 lists of 20 sentences with similar mean scores. List equivalency was then validated by presenting all lists to 10 CI users and in a 2-list comparison in a clinical setting to 38 CI patients. Setting: Tertiary referral center. Patients: Normal-hearing listeners (n = 5), CI users in a research study (n = 10), and CI patients (n = 38) in routine clinical follow-up. Intervention: Multiple sentence lists from a newly minted speech perception test. Main Outcome Measures: List intelligibility and equivalence across sentence lists. Results: Forty-two lists of sentences were equivalent when all lists were presented in random order to 10 adult CI recipients. The variability of scores observed on lists presented to the same listener in the same condition was captured using a binomial distribution model based on a 40-item list for 38 adult implant recipients. Conclusion: The Spanish AzBio Sentence Test includes 42 lists of 20 sentences. These sentences are roughly equivalent in terms of overall difficulty and confidence limits have been provided to assess the significance of variability in list scores observed within or across conditions. These materials will be of benefit when assessing native Spanish speakers in both research and clinical settings.

Introduction: Defensins are small anti-microbial peptides produced by epithelial cells. These peptides have a broad range of actions against microorganisms, including Gram-positive and Gram-negative bacteria.Human defensins are classifi ed into two subfamilies, the α-, and β- defensins, which differ in their distribution of disulphide bonds between the six conserved cysteine residues. Defensins are found in salivaand others compartments of the body. Human β defensins 2 (hBD2), beta defensins 4 (hBD4) and alpha defensins 4 (hNP4) in saliva may contributes to vulnerability or resistance to caries. This study aimed to determine a possible correlation between caries and levels of defensins measuring the expression in gingival tissue and concentrations in saliva samples.Methods: Oral examinations were performed on 100 adults of both genders (18-30 years old), and unstimulated whole saliva was collected for immunoassays of the three peptides and for the salivary pH, buffercapacity, protein, and peroxidase activity. mRNA levels of defensins in gingival sample were assessed by semi-quantitative RT-PCR technique.Results: The median salivary levels of hBD2 and hBD4 were 1.88 μg/ml and 0.86 μg/ml respectively for the caries-free group (n=44) and 7.26 μ/ml (hBD2) and 4.25 μg/ml (hBD4) for all subjects with evidenceof caries (n=56). There was no difference in the levels of hNP4, salivary pH, and proteins between groups, however the peroxidase activity and buffer capacity (interval 6.0-5.0) were reduced in caries group. Transcriptional levels of hBD2 and hBD4 did correlate with caries experience, the mRNA expression of hBD2 and hBD4 were signifi cantly higher in patients with caries than in patients with no-caries (p < 0.01).Conclusion: We conclude that high salivary levels and expression of beta defensins, low peroxidase activity and buffer capacity may represent a biological response of oral tissue to caries. Our observation couldlead to new ways to prevent caries and a new tool for caries risk assessment.

No abstract