Objectives: The objectives of the current study were to validate the LittlEARS^® Early Speech Production Questionnaire (LEESPQ) in Romanian and to evaluate the psychometric properties of the Romanian version of the questionnaire for Romanian children with normal hearing. The LEESPQ was created and tested for the assessment of preverbal and early verbal skills (0–18 months) in children with normal hearing. Methods: The English version of the LittlEARS^® Early Speech Production Questionnaire (LEESPQ) was adapted into Romanian language using a translation/back-translation procedure and validation of the content before applying the questionnaire. The Romanian version was applied to the parents of 232 children with normal hearing, aged between 0 and 18 months. The questionnaire was statistically analyzed to assess its reliability, internal consistency, predictive accuracy, and the influence of gender on children’s scores. Results: Statistical analyses confirmed the LEESPQ’s reliability (α = 0.876) and high predictive accuracy (λ = 0.951). Age correlated strongly with total scores (ρ = 0.67; p < 0.001), supporting the age-dependent progression of speech production milestones. Gender did not significantly affect the scores. Normative curves and minimum expected scores were established for each age group. Conclusions: This study confirmed that the Romanian version of the LEESPQ is a reliable, valid, language-independent instrument, useful in the assessment of language development in children with normal hearing, aged up to 18 months.

Introduction Cochlear implants are a modern approach for the treatment of multiple cases of profound sensorineural hearing loss. Factors such as the ethiology of hearing loss and the potential for achieving good postoperative outcomes are considered in cochlear implantation. Additionally, surgical strategies, protocols, the experience of the surgeon and audiologist, and the presence of postoperative issues and risks that may require revision surgery should also be taken into account. The surgeon specialized in cochlear implantation must inform the patient and his relatives not only about the surgical technique but also about possible complications. The literature shows different rates of complications evaluated both in adults and in children. An evaluation of adverse events in order to prevent complications can be made if the definition of medical complications and mistakes is strictly approached based on the CLAVIEN-DINDO classification system. The rate of complications can be compared with existing literature. Studies demonstrate the need for preoperative vaccination for pneumococcus, which can prevent complications, especially in patients with inner ear malformations who present an increased postoperative risk Relevant Sections This review is structured around the collection of specialized literature from PubMed, organized into subchapters related to intraoperative complications such as Gusher syndrome, foreign body reaction, endocochlear inflammation phenomena, issues related to electrode positioning and associated complications, vestibular phenomena related to cochlear implantation, as well as late complications related to the surgical wound and cochlear implant extrusion. The important sections in this review are: Inner Ear Malformations and Gusher Syndrome: Intraoperative Complication Risks, Electrode Insertion and Positioning Issues, Intracochlear Inflammation, Foreign Body Reaction, and Intracochlear Fibrosis: Phenomena That Can Occur with Cochlear Implantation, Vestibular Disorders, Tardive Postoperative Complications: Wound Injuries and Cochlear Implant Extrusion and Otitis Media and Cholesteatoma as Complications of Cochlear Implantation Conclusions: Postoperative complications, although considered quite rare. The surgical limits and long-term evolution of cochlear implants cannot be concretely established, despite the fact that this intervention is considered safe in the medium and long term. Future directions Given that cochlear implants represent the most modern surgical technique for auditory rehabilitation in adults and children, with massive implications for quality of life, there is a tendency to extend surgical indications in the future, and especially to inform doctors in related specialties about the benefits of this medical device. Surgeons must be knowledgeable about cochlear implantation methods, as well as the methods for managing complications that can arise immediately postoperatively, as well as in the medium and long term.

Background/Objectives: Real-time intraoperative navigation systems such as SmartNav (Cochlear Ltd., Sydney, Australia) provide objective feedback on electrode array insertion during cochlear implantation, yet it remains unclear whether the parameters they record vary across the device- and patient-level factors a surgeon selects between. This study compared intraoperative insertion dynamics and electrophysiological parameters across electrode array design (CI622 slim-straight versus CI632 slim-modiolar), surgical approach (round window versus cochleostomy), and patient age (children versus adults). Methods: Twenty-nine consecutive implantations in 26 patients (three children implanted bilaterally) performed with SmartNav monitoring were analysed. Insertion angle, insertion speed, total insertion time, the number of contacts (of 22) with in-range impedance, and the number of contacts (of 22) with a measurable neural response telemetry (NRT) response were extracted from device logs and operative records; insertion kinetics were available for 22 of 29 implantations. Distributions were non-normal, so comparisons used the Mann–Whitney U test with rank-biserial effect sizes, Fisher’s exact test, Kruskal–Wallis test, and Spearman correlation. Exploratory multivariable regression, Brown–Forsythe variance testing, bootstrap effect sizes, and outlier-inclusive and one-ear-per-patient sensitivity analyses were additionally applied; no correction for multiple comparisons was made. Results: The CI632 array was advanced faster per electrode than the CI622 (median 0.33 versus 0.56 s/electrode; n = 5 versus 16; p = 0.015; rank-biserial r = −0.75; bootstrap 95% CI −1.00 to −0.38), but the difference was not significant when one implausible outlying value was retained (p = 0.113). Impedance and NRT status were modestly correlated (ρ = 0.388, p = 0.037, uncorrected) and unchanged after adjustment for age band (partial ρ = 0.389), but were not significant in the one-ear-per-patient analysis. The study was unable to detect a difference between age groups or between surgical approaches (five cochleostomies versus 24 round window insertions) in any parameter, and impedance status varied minimally across all strata. Conclusions: Within the limits of a small, unbalanced cohort, SmartNav-derived parameters did not differ detectably across patient age or surgical approach. The data suggest that electrode array design is associated with per-electrode insertion pacing, an observation that depends on a single excluded data point and requires confirmation. The impedance–NRT association is exploratory, is consistent with a chance finding once multiplicity is considered, and should not yet be regarded as an intraoperative integrity signal. No clinical outcome was linked to the intraoperative parameters, so no inference about the clinical superiority of either array or approach can be drawn.

Background and Objectives: Outcomes after cochlear implantation are usually judged using audiological measures, although recipients' everyday benefit also depends on psychological and social functioning. This study characterized post-implant quality of life (QoL) across six patient-reported domains and explored factors associated with social integration. Methods: Fifty consecutive cochlear implant recipients completed a 35-item questionnaire covering speech perception, psychological self-esteem, media and music, environmental sound, listening effort, and social integration. Negatively framed items were reverse-scored, and domain scores were transformed to a 0-100 scale. Internal consistency, subgroup comparisons, inter-domain correlations, and multivariable regression were evaluated. Results: Mean overall QoL was 65.3 (95% CI, 60.5-69.7). Media and music received the highest mean score (77.9), whereas listening effort was lowest (56.6). The full questionnaire showed excellent internal consistency (Cronbach's alpha = 0.956). QoL scores did not differ significantly by sex, age group, time since implantation, surgical approach, or SMART NAV use, although several subgroup analyses were underpowered. Psychological self-esteem showed the strongest correlation with social integration (rho = 0.56, p < 0.001) and remained the only significant independent correlate in multivariable analysis (B = 0.456, 95% CI, 0.117-0.795; p = 0.010; R2 = 0.428). Conclusions: In this cohort, post-implant QoL varied across functional domains, with listening effort remaining a relative challenge. Social integration was more closely associated with psychological self-esteem than with individual auditory domains. These findings are exploratory and require confirmation in larger longitudinal studies with pre-implant measurements.

Background and Objectives: Outcomes after cochlear implantation are usually judged using audiological measures, although recipients’ everyday benefit also depends on psychological and social functioning. This study characterized post-implant quality of life (QoL) across six patient-reported domains in cochlear implant recipients followed at a tertiary center in Romania and explored factors associated with social integration. Methods: In this cross-sectional study, 50 consecutive cochlear implant recipients (24 children and adolescents, 26 adults) completed a validated 35-item Romanian-language questionnaire covering speech perception, psychological self-esteem, media and music, environmental sound, listening effort, and social integration, with parent-proxy completion for the youngest children. Domain scores were transformed to a 0–100 scale. Subgroup comparisons used rank-based tests, and associations with social integration were examined with Spearman correlations and an exploratory multivariable regression. Results: The median overall QoL score was 67.1 (interquartile range, 53.6–77.9). Media and music scored highest (median 85.7) and listening effort lowest (median 56.2); psychological self-esteem had a median of 66.7 (interquartile range, 50.0–79.2). QoL scores did not differ significantly by sex, age group, time since implantation, surgical approach, or SMART NAV use, although several subgroup analyses were underpowered. Psychological self-esteem showed the strongest correlation with social integration (rho = 0.56, p < 0.001) and was the only predictor with p < 0.05 in the exploratory multivariable model (B = 0.456, 95% CI, 0.117–0.795; p = 0.010; R² = 0.428). Conclusions: In this cohort, post-implant QoL varied across functional domains, with listening effort remaining a relative challenge. Social integration was more closely associated with psychological self-esteem than with individual auditory domains. These findings are exploratory and require confirmation in larger longitudinal studies with pre-implant measurements.

Background and Objectives: The Cochlear implant is the first approved cranial nerve stimulator that works by directly stimulating the cochlear nerve. Various attempts have been made to evaluate the dimensions of the cochlea related to cochlear implantation. The preoperative computed tomographic examination is essential not only in assessing the anatomical aspect of the cochlea, but also in determining its dimensions to choose an appropriate electrode and obtain the best possible audiological performance. Materials and Methods: In the present paper, we aimed to carry out an observational study regarding the role of cochlear measurements in the preoperative evaluation of patients proposed for cochlear implants. The purpose of the study was to measure the cochlea and establish the existence of a correlation between the size of the cochlea and the age and gender of the patients. Results: From the group of 35 examined patients, 54% (n = 19) were male and 46% (n = 16) were female. The average length of the cochlea in the age group 0–4 years is 7.82 mm in the left ear and 7.86 mm in the right ear; in the age group 4–7 years, it is 7.82 mm and 7.94 mm, respectively; for the age group 7–14 years, the dimensions increase to 8.48 mm and 8.77 mm, respectively; and after 14 years, these dimensions reach 9.12 mm and 9.18 mm, respectively. Comparative measurements of the length of the cochlea by age groups show an increase in length with the patient’s age, but this increase does not exceed 1.5 mm for both the right and left ears. The measurements of the width of the cochlea, by age group, start from 6.84 mm in the left ear and 6.81 mm in the right ear at 0–4 years, 6.94 mm and 6.97 mm, respectively, in the group 4–7 years, 7.71 mm and 7.55 mm at 7–14 years, and reaching 8.19 mm and 8.12 mm at the age of 14 years and over. Conclusions: From the study carried out, it can be concluded that the evaluation of the dimensions of the cochlea is important for cochlear implantation. The size variables, although small, are still an element to be considered in correlation with the age of the patient and the implanted ear. This increase is statistically insignificant, but it still exists, even if, from a theoretical point of view, it is considered that the dimensions of the cochlea remain constant.