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Objectives: This is a cross-sectional study conducted on cochlear implant recipients, to monitor changes in recorded impedance telemetry and evoked compound action potentials (ECAP) measured during surgery versus the same measures at post implant follow-up visits. An additional aim was to correlate the recorded ECAP measures with the patient ' s postoperative performance and to evaluate the incidence of abnormal intra-operative cochlear implant telemetry measurements and their changes at device activation. Study design: The present study comprised 44 subjects -12 adults and 32 children of both genders -implanted at the Cochlear Implant Unit, Cairo University. ECAP thresholds and electrode impedance measures were collected intra-operatively, at initial stimulation, and at 9 -12 months post initial stimulation. Measurements were compared at the three intervals and ECAP measures were correlated to the patient ' s post-operative performance in the form of aided sound fi eld thresholds, speech detection and discrimination for adults and language assessment for children. Results: In the absence of electrical stimulation, there was an increase of impedance on all electrodes at the initial stimulation visit, which decreased at the 9 -12 months follow-up. Open circuit fi ndings were more prevalent than short circuits. Children had higher impedance values at post implant activation compared to adult patients. No correlation existed between ECAP thresholds and post-operative patient performance at the one-year evaluation. Conclusion: At the time of surgery, telemetry provides valuable information regarding the electrical output of the implant and the response of the auditory system to electrical stimulation; however, it is not a valuable predictor of post-operative performance.

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Background: Counselling, stress reduction and sound stimulation have been effective in the management of tinnitus. Aim of the work: It was to investigate the effectiveness of counselling and amplification and sound stimulation (Zen tones of fractal music) technology for hearing impaired patients suffering from tinnitus. Methods: This study included 40 hearing impaired subjects with tinnitus, divided into two groups: Both received counselling for 2 months then amplification for 4 months. The study group had their hearing aids with Zen program activated. Results: Post-counselling, none of the cases or controls showed improvement >20 points in the total tinnitus handicap inventory (THI) score. Only 20% of the study group and 15% of the controls showed improved tinnitus severity. Only one of the study group showed improvement in the tinnitus functional index (TFI) > 13 points. After hearing aids, 80% of the study group showed improvement in the tinnitus severity degree compared to 60% of the controls. And 20% improved ≥20 points in the total THI score, compared to none of the controls. Half of the study group improved in the TFI >13 points, compared to only 10% of the controls, and this was statistically significant. After 6 months, both groups showed comparable improvement in THI tinnitus severity degree: But 60% of the study group and only 15% of the controls improved ≥20 points in total THI score and this difference was statistically significant. And (85%) of the study group improved >13 points in total TFI score following both counselling and hearing aid fitting, compared to 50% of the controls, and this was statistically significant. Conclusion: Counselling alone had no significant effect on tinnitus improvement in the hearing-impaired patients. The combined approach of counselling and amplification resulted in remarkable improvement. And added music resulted in greater improvements, but was more effective when the loudness of the perceived tinnitus was weaker.

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