ECAPs are a well-established method to get information about the CI's and nerve's function during and after surgery. After initial higher values NRTs decrease after 6months and remain stable in the following controls. Very young and older patients tend to have higher thresholds than middle-aged groups. Perimodiolar electrodes are significantly attached to lower values because there is a closer nerve-electrode interaction.

Objectives In clinical practice, characterization of speech comprehension for cochlear implant (CI) patients is typically administered by a set of suprathreshold measurements in quiet and in noise. This study investigates speech comprehension of the three most recent cochlear implant sound processors; CP810, CP910, and CP1000 (Cochlear Limited). To compare sound processor performance across generations and input dynamic range changes, the state‐of‐the art signal processing technologies available in each sound processor were enabled. Outcomes will be assessed across a range of stimulation intensities, and finally analyzed with respect to normal hearing listeners. Methods In a prospective study, 20 experienced postlingually deafened CI patients who received a Nucleus CI in the ENT department of the University Hospital of SH in Kiel were recruited. Speech comprehension was measured in quiet at 40, 50, and 65 dBSPL with monosyllabic words as well as by speech reception threshold for two‐digit numbers. In noise, speech reception thresholds were measured with the adaptive German matrix test with speech and noise in front. Results We found that high levels of open‐set speech comprehension are achieved at suprathreshold presentation levels in quiet. However, results at lower test levels have remained mostly unchanged for tested sound processors with default dynamic range. Expanding the lower limit of the acoustic input dynamic range yields better speech comprehension at lower presentation levels. In noise the application of ForwardFocus improves the speech reception. Overall, a continuous improvement for speech perception across three generations of CI sound processors was found. Conclusions Findings motivate further development of signal pre‐processing, an additional focus of clinical work on lower stimulation levels, and automation of ForwardFocus. Level of evidence 2.

No abstract

Background: Aim of study was the evaluation of hearing improvement, quality of life and surgical risks in geriatric patients receiving a cochlear implant.Material and methods: 78 postlingual deafened patients older than 60 years (yrs) implanted between 2007 and 2012. The cohort was divided into 60-69 yrs (G II, n=35) and >70 yrs (G III, n=43). Subjective improvement in different everyday surroundings was evaluated by APHAB questionnaire. Improvement in quality of life was assessed by a QoL questionnaire. Preoperative risk factors and perioperative complications were analyzed via retrospective chart review. All subjects were categorized preoperatively according to ASA-Criteria. Audiological improvement was tested by Freiburger speech test for mono-and bisyllables. Results were compared to a younger control group aged 40-59 yrs (G I, n=39) having received CI in comparable conditions. 117 patients were included.Results: According to APHAB questionnaire all groups had a significant increase in perception in everyday surroundings. An improvement in quality of life was reported in all groups. No increase in surgical complications in the older groups was recorded. Seniors at age 60-69 yrs. do not differ from a younger control. No difference in speech perception was shown for bisyllabic words in G I, II, and III (98%, 65dB). G III showed a lower perception for monosyllabic words (53%, 65dB) than G I (63%, 65dB) and G II (58%, 65dB). Conclusion:Geriatric patients over 70 yrs. significantly benefit from cochlear implantation, though outcome in speech perception is marginally inferior to younger patients.