This case report presents the successful use of multiple treatments of electroconvulsive therapy (ECT) in a patient with a cochlear implant (CI). A 60‐year‐old man with a left‐sided CI and bipolar disorder presented with severe depression. A total of 9 separate sessions of unilateral ECT was administered to the contralateral side of the existing CI. We collected subjective, clinical, and audiological assessment of the patient and the CI prior, during, and after ECT therapy. The patient tolerated ECT well and there were no complications. Unilateral ECT was performed contralateral to the CI without any harm to the patient or implant. Laryngoscope, 131:E1695–E1698, 2021

Objective We examined how sociodemographic and audiologic factors affect receptive and expressive language outcomes in children with cochlear implantation. Study Design Retrospective cohort study. Setting A hearing loss (HL) clinic at a tertiary center. Methods Sociodemographic variables, HL characteristics, age at implantation, and receptive language scores (Preschool Language Scale and the Clinical Evaluation of Language Fundamentals) were collected from patients with congenital HL who received their first implant by 4 years old after January 1, 2007. t Tests, linear regression, Mann‐Whitney, Cohen's d, and mediation analysis were used for descriptive statistics and hypothesis testing. Results Among 79 patients, 42 (53%) were females, 44 (56%) under‐represented minorities, and 56 (71%) had public insurance. At least 1 year after implantation, the median receptive language score was 69 (range 50‐117). Females (p = .005), having private insurance (p = .00001), having a Cochlear Implant Profile score below 4 (p = .0001), and receiving their implant at or before 12 months of age (p = .0009) were significantly associated with improved receptive language outcomes. Insurance type had a significant effect on receptive language outcomes, independent from age at first implantation (total effect: coef = −13.00, p = .02; direct effect: coef = −12.26, p = .03; indirect effect: coef = −0.75, p = .47). Sociodemographic variables had large effect sizes, with the Cochlear Implant Profile score having the largest effect size (d = 1.3). Conclusion Sociodemographic factors have a large impact on receptive language outcomes. Public insurance is associated with worse receptive language, not mediated by later age at implantation, suggesting that other factors primarily impact language outcomes in publicly insured children with cochlear implants.

Objective Vestibular dysfunction is a known risk of cochlear implantation (CI). However, the utility of the physical exam to screen CI candidates for vestibular dysfunction is not well‐studied. The objective of this study is to evaluate the preoperative role of the clinical head impulse test (cHIT) in subjects undergoing CI surgery evaluation. Study Design Setting, and Subjects We conducted a retrospective review of 64 adult CI candidacy cases between 2017 and 2020 at a tertiary health care center. Methods All patients underwent audiometric testing and evaluation by the senior author. Patients with an abnormal catch‐up saccade contralateral to their worse hearing ear during cHIT were referred for formal vestibular testing. Outcomes included clinical and formal vestibular results, operated ear with regard to audiometric and vestibular results, and postoperative vertigo. Results Among all CI candidates, 44% (n = 28) reported preoperative disequilibrium symptoms. Overall, 62% (n = 40) of the cHITs were normal, 33% (n = 21) were abnormal, and 5% (n = 3) were inconclusive. There was one patient who presented with a false positive cHIT. Among the patients who endorsed disequilibrium, 43% had a positive preoperative cHIT. Fourteen percent of the subjects (n = 9) without disequilibrium had an abnormal cHIT. In this cohort, bilateral vestibular impairment (71%) was more common than unilateral vestibular impairment (29%). In 3% of the cases (n = 2), surgical management was revisited or altered due to cHIT findings. Conclusion There is a high prevalence of vestibular hypofunction in the CI candidate population. Self‐reported assessments of vestibular function are often not congruent with cHIT results. Clinicians should consider incorporating cHITs as part of the preoperative physical exam to potentially avoid bilateral vestibular dysfunction in a minority of patients.