The programming of CIs is essential for good performance. However, no Good Clinical Practice guidelines exist. This paper reports on the results of an inventory of the current practice worldwide. A questionnaire was distributed to 47 CI centers. They follow 47600 recipients in 17 countries and 5 continents. The results were discussed during a debate. Sixty-two percent of the results were verified through individual interviews during the following months. Most centers (72%) participated in a cross-sectional study logging 5 consecutive fitting sessions in 5 different recipients. Data indicate that general practice starts with a single switch-on session, followed by three monthly sessions, three quarterly sessions, and then annual sessions, all containing one hour of programming and testing. The main focus lies on setting maximum and, to a lesser extent, minimum current levels per electrode. These levels are often determined on a few electrodes and then extrapolated. They are mainly based on subjective loudness perception by the CI user and, to a lesser extent, on pure tone and speech audiometry. Objective measures play a small role as indication of the global MAP profile. Other MAP parameters are rarely modified. Measurable targets are only defined for pure tone audiometry. Huge variation exists between centers on all aspects of the fitting practice.

The main aim of this study was to assess the clinical effect of steroids (dexamethasone and prednisone) on hearing preservation in patients who underwent cochlear implantation with different cochlear implant systems (Oticon^®, Advanced Bionics^®, Med-El^®). 147 adult patients met the inclusion criteria and were enrolled to the study and divided into three groups depending on the brand of cochlear implant they received and participated in all follow-up visits regularly. They were also randomly divided into three subgroups depending on the steroid administration regime: (1) intravenous dexamethasone (0.1 mg/kg body weight twice a day for three days); (2) combined intravenous and oral steroids (dexamethasone 0.1 mg/kg body weight twice a day plus prednisone 1 mg/kg weight once a day); and (3) no steroids (control group). The results were measured by pure tone audiometry (PTA) at three time points: (i) before implantation, (ii) at processor activation, and (iii) 12 months after activation. A hearing preservation (HP) figure was also calculated by comparing the preoperative results and the results after 12 months. Further measures collected were electrode impedance and hearing threshold in the non-operated ear. The highest HP measures (partial and complete) were obtained in the subgroups who were given steroids. Of the 102 patients given steroids, HP was partial or complete in 63 of them (62%). In comparison, partial or complete HP was achieved in only 15 patients out of 45 (33%) who were not given steroids. There were differences between the three cochlear implant groups, with the Med-El and Advanced Bionics groups performing better than the Oticon group (45% and 43% of the former two groups achieved partial or complete HP compared to 20% in the latter). Hearing thresholds in the non-operated ear were stable over 12 months. Generally, impedance was slightly lower in the 12 month follow-up in comparison with the activation period, with the exception of the Oticon group. (4) Conclusions: Pharmacological treatment with steroids in patients undergoing cochlear implantation helps to preserve residual hearing.

Aim: To gauge the prevalence of hearing loss in school children in Bishkek, Kyrgyzstan, and refer pupils with positive results for further diagnostic testing.Background: According to WHO data, hearing disorders are common in school-age children. Screening for hearing loss is an important preventative tool, helping to avoid further complications. Expenditure that supports early child development can reduce future outlay on health care and social services; it can eliminate disability problems, education deficits, and social maladaptation in later adult life.Methods: Pure-tone air-conduction hearing thresholds were obtained at 0.5–8 kHz. The results of the hearing screening examination were regarded as positive if pure-tone thresholds were higher than 20 dB HL in one or both ears at one or more of the test frequencies. Data were also obtained from follow-up visits of children who failed the initial screening.Findings: This study included 452 children aged 7–13 years old. Based on audiograms, screening showed that 123 (27.2%) of the children had hearing impairment. The study has important implications for clinical practice and health policy. There is a need for systematic monitoring of hearing status among children of this age, and parents and educators need to be made aware of the significance of hearing loss.

OBJECTIVES: The intracochlear electrocochleography (ECoG) could be recorded directly from the cochlear implant (CI) electrode in CI recipients with residual hearing. The primary objective of this study is to identify the most sensitive frequency to record cochlear microphonics (CM) in CI users with a wide degree of hearing abilities and deep electrode insertion. The secondary objective is to identify the optimum location within the cochlea to record intracochlear potentials. MATERIALS and METHODS: CMs were recorded from the CI electrodes in eight females and eight males implanted with CIs Pulsar, Concerto, or Sonata, Med-El Corp. RESULTS: Among the tone pips of various frequencies, 1k or 500 Hz were the most sensitive for CI users. The most sensitive place in the cochlea to record the CM potentials depended on the tone frequency used. The deeper into the cochlea the mean maximum CM peak-to-peak amplitude was measured, the lower the stimulating tone frequency was. CONCLUSION: The most optimal recording parameters identified for intracochlear CM recording can be useful for intraoperative and postoperative monitoring of cochlear health in CI users with residual hearing. Cite this article as: Lorens A, Walkowiak A, Polak M, Kowalczuk A, Furmanek M, Skarzynski H, et al. Cochlear Microphonics in Hearing Preservation Cochlear Implantees. J Int Adv Otol 2019; 15(3): 345-51.