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Hearing Disorders: HELP
Articles by Christoph Arnoldner
Based on 20 articles published since 2010
(Why 20 articles?)
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Between 2010 and 2020, C. Arnoldner wrote the following 20 articles about Hearing Disorders.
 
+ Citations + Abstracts
1 Review Expanded selection criteria in adult cochlear implantation. 2013

Arnoldner, Christoph / Lin, Vincent Y W. · ·Cochlear Implants Int · Pubmed #24533755.

ABSTRACT: Cochlear implantation has become the standard procedure for restoring substantial hearing in the profoundly deaf. The excellent performance of most of the CI recipients coupled with the rapid evolution of implant technology lead to a distinct expansion in selection criteria for CI. These changes in candidacy primarily include patients with (1) moderate preoperative speech recognition with hearing aids, (2) significant residual hearing, (3) single-sided deafness, and (4) geriatric patients. Many of these patients' conditions were regarded as a clear contraindication to CI only a few years ago. In this article an overview of the current and new aspects of candidacy for cochlear implantation is provided.

2 Clinical Trial First Results With a New, Pressure-free, Adhesive Bone Conduction Hearing Aid. 2018

Dahm, Valerie / Baumgartner, Wolf-Dieter / Liepins, Rudolfs / Arnoldner, Christoph / Riss, Dominik. ·Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria. ·Otol Neurotol · Pubmed #29889785.

ABSTRACT: OBJECTIVES: The aim of this study was to evaluate the hearing benefit, advantages, and disadvantages in a series of patients using a new, nonimplantable, pressure-free, adhesive bone conduction hearing aid. METHODS: Twelve patients were included in the study at the ear, nose, and throat department of the Medical University of Vienna. All patients suffered from conductive hearing loss for at least 3 months. A sound field audiometry, Freiburg monosyllables word test and Oldenburg sentence test were carried out. Additionally, sound quality (SSQ12) and quality of life (AQoL-8D) were assessed using questionnaires. RESULTS: Analysis revealed an average aided threshold of 30.8 dB HL (±7.1 SD) and an unaided threshold of 45.1 dB HL (±7.0 SD), resulting in a statistically significant (p < 0.001) average functional gain. Additionally, participants experienced about 30% gain in word recognition scores at 65 dB sound pressure level, speech reception threshold in quiet was 56.8 dB (±6.1) and improved to 44.5 dB (±6.4) in the aided condition. Both, the SSQ12 and the AQoL-8D showed a statistically significant improvement when comparing the scores at the beginning of the study to the answers after 2 weeks of device usage (SSQ12 (p < 0.002) and AQoL-8D (p = 0.002)). Neither skin irritations nor pain were reported during the study period. CONCLUSION: In conclusion, this new, adhesive bone conduction hearing aid has a high patient satisfaction rate while causing no skin irritation or pain.

3 Article Long-Term Outcome of Hearing Rehabilitation With An Active Middle Ear Implant. 2019

Brkic, Faris F / Riss, Dominik / Auinger, Alice / Zoerner, Barbara / Arnoldner, Christoph / Baumgartner, Wolf-Dieter / Gstoettner, Wolfgang / Vyskocil, Erich. ·Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria. ·Laryngoscope · Pubmed #30284273.

ABSTRACT: OBJECTIVE: To assess the audiological and long-term medical and technical follow-up outcomes of an active middle ear implant. METHODS: This was a retrospective medical chart analysis of all patients provided with an active middle ear implant in a tertiary academic medical referral center between September 1, 1998, and July 31, 2015. Main outcome measures were medical and technical complications, revisions, reimplantations, explantations, coupling approaches, mean time of use, pre- and postoperative hearing thresholds, functional hearing gain across frequencies (250-4,000 Hz), and Freiburg monosyllablic word test at 65 dB. RESULTS: One hundred and three patients were identified. Fifteen were implanted bilaterally (n = 118 Vibrant Soundbridge devices [MED-EL, Innsbruck, Austria]). Seventy-seven devices were implanted for sensorineural and 41 for mixed and conductive hearing loss. Patients used the implant for 6.7 years (range 0.7 months-17.9 years) on average. Ninety-one patients (77.12%) were using the device at the end of the observation period. An overall complication rate of 16.1% was observed. The revision and explantation rates were higher for devices implanted between 2004 and 2006. The device failure rate was 3.4%. Audiological evaluation showed significant hearing gains for both hearing loss patient groups. CONCLUSION: This long-term follow-up reveals the reliability of the active middle ear implant in a single center. Overall complication rate and device failure rate are acceptable. The complication rate was higher during implementation of alternative coupling approaches. The audiological benefit was satisfactory in patients with all hearing loss types. The majority of implanted patients used the implant at the end of the observation period. LEVEL OF EVIDENCE: 4 Laryngoscope, 129:477-481, 2019.

4 Article Single Sided Deaf Cochlear Implant Users in the Difficult Listening Situation: Speech Perception and Subjective Benefit. 2018

Prejban, David A / Hamzavi, Jafar-Sasan / Arnoldner, Christoph / Liepins, Rudolfs / Honeder, Clemens / Kaider, Alexandra / Gstöttner, Wolfgang / Baumgartner, Wolf-Dieter / Riss, Dominik. ·Department of Otolaryngology-Head and Neck Surgery. · Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria. ·Otol Neurotol · Pubmed #30199498.

ABSTRACT: OBJECTIVES: Patients with single-sided deafness (SSD) have great difficulties in listening situations which rely on binaural auditory processing. The purpose of this study was to examine to which extent a cochlear implant (CI) can improve speech perception outcomes in various noisy listening environments. Additionally, the ability to use interaural level differences for sound localization and subjective benefit with the CI were assessed. METHODS: Ten single-sided deaf patients with CI were tested in different loudspeaker configurations with and without the CI. A multi-source noise field (MSNF) with uncorrelated noise from four different directions was used in addition to a setup with the signal from the CI side and noise from the normal-hearing side (SCINNH, azimuth of ±45 degrees). Ten normal-hearing subjects were used as a control for the setup. Speech understanding was measured by an adaptive sentence test (Oldenburg Sentence Test, OLSA) in stationary speech shaped noise and temporally modulated noise to assess the benefit in each listening situation. Sensitivity to interaural level differences was measured in a lateralization experiment. Furthermore, patients completed the Bern Benefit in Single-Sided Deafness (BBSS) questionnaire to assess subjective benefit with the CI. RESULTS: An overall average benefit in speech reception threshold (SRT) of 1.6 dB (±0.6 dB standard error of the mean [SEM]) was observed in the binaural listening condition (with CI) in all conditions. In the MSNF setup thresholds improved by 0.4 dB (±0.5 dB SEM) and in the SCINNH configuration by 2.7 dB (±0.7 dB SEM). The choice of masking noise effect also had a significant effect on the SRT outcome. The lateralization performance of the SSD users was on a par with the normal hearing group. BBSS scores reflect the overall benefit with the CI apparent in the speech test results. CONCLUSION: Patients with single-sided deafness do benefit from a CI in difficult listening environments and are able to localize sound based on interaural level differences. Considering these outcomes, cochlear implantation represents a promising treatment option for patients with single-sided deafness.

5 Article Evaluation of Sustained-Release Steroid Hydrogels in a Guinea Pig Model for Noise-Induced Hearing Loss. 2018

Zhu, Chengjing / Gausterer, Julia Clara / Schöpper, Hanna / Nieratschker, Michael / Saidov, Nodir / Ahmadi, Navid / Honeder, Clemens / Gabor, Franz / Arnoldner, Christoph. ·Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria. · Department of Pharmaceutical Technology and Biopharmaceutics, University of Vienna, Vienna, Austria. · Department of Pathobiology, Institute of Anatomy, Histology and Embryology, University of Veterinary Medicine Vienna, Vienna, Austria. ·Audiol Neurootol · Pubmed #30092561.

ABSTRACT: The otoprotective effects of thermoreversible poloxamer 407 hydrogels containing dexamethasone or triamcinolone acetonide were evaluated in an animal model of noise-induced hearing loss. Seven days after noise exposure, hearing threshold shifts at 16 kHz were significantly reduced in the 6% dexamethasone group (p < 0.05). Even though no significant differences in hair cell counts were found, histological analysis revealed a significantly higher spiral ganglion cell density in the first turn of the cochlea in this group (p < 0.05). No otoprotective effects were observed after the application of the triamcinolone acetonide hydrogels. As the findings of this study indicate potential otoprotective effects of sustained topical dexamethasone delivery in the setting of noise-induced hearing loss, this strategy merits further evaluation.

6 Article Fixed and adaptive beamforming improves speech perception in noise in cochlear implant recipients equipped with the MED-EL SONNET audio processor. 2018

Honeder, Clemens / Liepins, Rudolfs / Arnoldner, Christoph / Šinkovec, Hana / Kaider, Alexandra / Vyskocil, Erich / Riss, Dominik. ·Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria. · Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria. ·PLoS One · Pubmed #29304186.

ABSTRACT: OBJECTIVE: To determine the impact of the fixed and adaptive beamforming technology of the new MED-EL SONNET cochlear implant audio processor on speech perception in noise. METHODS: The study cohort comprises 18 postlingually deafened adult cochlear implant recipients with at least six months of experience. Speech reception thresholds were measured with the Oldenburg Sentence Test in continuous, speech-shaped noise. Target sentences were presented in front of the listener, with noise sources placed at -135° and 135°, respectively. Outcome measures were the differences in speech reception threshold using omnidirectional, fixed and adaptive beamformer microphone settings. RESULTS: The use of directional microphones significantly improved speech reception thresholds: fixed beamformer vs. omnidirectional: 4.3 dB (95%-CI [3.1; 5.5]), p<0.0001; adaptive beamformer vs. omnidirectional: 6.1 dB (95%-CI [4.9; 7.3]), p<0.0001; and adaptive beamformer vs. fixed beamformer: 1.8 dB (95%-CI [0.7; 3.0]), p = 0.001. CONCLUSION: This study confirms the previously reported improvements in speech perception in noise of the fixed beamformer microphone setting and is the first to report significant improvements in speech perception in noise when applying the adaptive beamformer microphone settings of the SONNET audio processor. Cochlear implant users may be able to benefit from improved hearing performance especially in difficult listening situations.

7 Article The Role of Preoperative Steroids for Hearing Preservation Cochlear Implantation: Results of a Randomized Controlled Trial. 2017

Kuthubutheen, Jafri / Joglekar, Samidha / Smith, Leah / Friesen, Lendra / Smilsky, Kari / Millman, Tara / Ng, Amy / Shipp, David / Coates, Harvey / Arnoldner, Christoph / Nedzelski, Julian / Chen, Joseph / Lin, Vincent. ·Department of Otolaryngology - Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada. ·Audiol Neurootol · Pubmed #29332068.

ABSTRACT: OBJECTIVES: To determine whether preoperative steroids can improve hearing outcomes in cochlear implantation (CI). METHODS: This is a randomized controlled trial involving 30 postlingual deaf CI patients. Subjects had preoperative thresholds of better than or equal to 80 dB at 125 and 250 Hz, and better than or equal to 90 dB at 500 and 1,000 Hz. The subjects were randomized to a control group, an oral steroid group (receiving 1 mg/kg/day of prednisolone for 6 days prior to surgery), or a transtympanic steroid group (receiving a single dose of 0.5 mL of 10 mg/mL dexamethasone at 24 h prior to surgery). RESULTS: The subjects receiving transtympanic steroids had a significant decrease in the pure tone average over 3 months compared to the control and oral steroid group, which persisted over 12 months (p < 0.05). CONCLUSION: A single dose of preoperative transtympanic steroids prior to CI appears to have a beneficial effect, at least in the short term, with minimal effects seen in the longer term.

8 Article Masking release with changing fundamental frequency: Electric acoustic stimulation resembles normal hearing subjects. 2017

Auinger, Alice Barbara / Riss, Dominik / Liepins, Rudolfs / Rader, Tobias / Keck, Tilman / Keintzel, Thomas / Kaider, Alexandra / Baumgartner, Wolf-Dieter / Gstoettner, Wolfgang / Arnoldner, Christoph. ·Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. · Audiological Acoustics, Department of Otorhinolaryngology, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany. · Department of Otorhinolaryngology, Krankenhaus der Elisabethinen, Elisabethinergasse 14, 8020, Graz, Austria. · Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, Grieskirchner Straße 42, 4600, Wels, Austria. · Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria. · Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. Electronic address: christoph.arnoldner@meduniwien.ac.at. ·Hear Res · Pubmed #28527538.

ABSTRACT: It has been shown that patients with electric acoustic stimulation (EAS) perform better in noisy environments than patients with a cochlear implant (CI). One reason for this could be the preserved access to acoustic low-frequency cues including the fundamental frequency (F0). Therefore, our primary aim was to investigate whether users of EAS experience a release from masking with increasing F0 difference between target talker and masking talker. The study comprised 29 patients and consisted of three groups of subjects: EAS users, CI users and normal-hearing listeners (NH). All CI and EAS users were implanted with a MED-EL cochlear implant and had at least 12 months of experience with the implant. Speech perception was assessed with the Oldenburg sentence test (OlSa) using one sentence from the test corpus as speech masker. The F0 in this masking sentence was shifted upwards by 4, 8, or 12 semitones. For each of these masker conditions the speech reception threshold (SRT) was assessed by adaptively varying the masker level while presenting the target sentences at a fixed level. A statistically significant improvement in speech perception was found for increasing difference in F0 between target sentence and masker sentence in EAS users (p = 0.038) and in NH listeners (p = 0.003). In CI users (classic CI or EAS users with electrical stimulation only) speech perception was independent from differences in F0 between target and masker. A release from masking with increasing difference in F0 between target and masking speech was only observed in listeners and configurations in which the low-frequency region was presented acoustically. Thus, the speech information contained in the low frequencies seems to be crucial for allowing listeners to separate multiple sources. By combining acoustic and electric information, EAS users even manage tasks as complicated as segregating the audio streams from multiple talkers. Preserving the natural code, like fine-structure cues in the low-frequency region, seems to be crucial to provide CI users with the best benefit.

9 Article Dura and sinus compression with a transcutaneous bone conduction device - hearing outcomes and safety in 38 patients. 2017

Vyskocil, E / Riss, D / Arnoldner, C / Hamzavi, J S / Liepins, R / Kaider, A / Honeder, C / Fumicz, J / Gstoettner, W / Baumgartner, W D. ·Department of Otorhinolaryngology, Medical University of Vienna, Wien, Austria. · Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Wien, Austria. ·Clin Otolaryngol · Pubmed #27860393.

ABSTRACT: -- No abstract --

10 Article Effects of sustained release dexamethasone hydrogels in hearing preservation cochlear implantation. 2016

Honeder, Clemens / Zhu, Chengjing / Schöpper, Hanna / Gausterer, Julia Clara / Walter, Manuel / Landegger, Lukas David / Saidov, Nodir / Riss, Dominik / Plasenzotti, Roberto / Gabor, Franz / Arnoldner, Christoph. ·Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria. · Department of Pathobiology, Institute of Anatomy, Histology and Embryology, University of Veterinary Medicine Vienna, Vienna, Austria. · Department of Pharmaceutical Technology and Biopharmaceutics, University of Vienna, Vienna, Austria. · Department of Biomedical Research, Medical University of Vienna, Vienna, Austria. · Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria. Electronic address: christoph.arnoldner@meduniwien.ac.at. ·Hear Res · Pubmed #27519654.

ABSTRACT: It has been shown that glucocorticoids reduce the hearing threshold shifts associated with cochlear implantation. Previous studies evaluated the administration of glucocorticoids immediately before surgery or the repeated pre- or perioperative systemic application of glucocorticoids. The aim of this study was to evaluate the effects of a sustained release dexamethasone hydrogel in hearing preservation cochlear implantation. To address this issue, a guinea pig model of cochlear implantation was used. 30 normal hearing pigmented guinea pigs were randomized into a group receiving a single dose of a dexamethasone/poloxamer407 hydrogel one day prior to surgery, a second group receiving the hydrogel seven days prior to surgery and a control group. A silicone cochlear implant electrode designed for the use in guinea pigs was inserted to a depth of 5 mm through a cochleostomy. Compound action potentials of the auditory nerve (frequency range 0.5-32 kHz) were measured preoperatively, directly postoperatively and on postoperative days 3, 7, 14, 21 and 28. Following the last audiometry, temporal bones were harvested and histologically evaluated. Dexamethasone hydrogel application one day prior to surgery resulted in significantly reduced hearing threshold shifts at low, middle and high frequencies measured at postoperative day 28 (p < 0.05). Application of the hydrogel seven days prior to surgery did not show such an effect. Dexamethasone application one day prior to surgery resulted in increased outer hair cell counts in the cochlear apex and in reduced spiral ganglion cell counts in the basal and middle turn of the cochlea, a finding that was associated with a higher rate of electrode translocation in this group. In this study, we were able to demonstrate functional benefits of a single preoperative intratympanic application of a sustained release dexamethasone hydrogel in a guinea pig model of cochlear implantation.

11 Article Effects of Stimulation Rate With the FS4 and HDCIS Coding Strategies in Cochlear Implant Recipients. 2016

Riss, Dominik / Hamzavi, Jafar-Sasan / Blineder, Michaela / Flak, Stefan / Baumgartner, Wolf-Dieter / Kaider, Alexandra / Arnoldner, Christoph. ·*Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria †Center for Medical Statistics, Informatics and Intelligent Systems, Section of Clinical Biometrics, Medical University of Vienna, Vienna, Austria. ·Otol Neurotol · Pubmed #27295444.

ABSTRACT: OBJECTIVE: The aim of the present study was to evaluate the effect of stimulation rate on speech perception and sound quality for the fine structure strategy FS4 and the envelope-based strategy high definition continuous interleaved sampling (HDCIS). STUDY DESIGN: Randomized crossover trial with four conditions. SETTING: Tertiary referral. PATIENTS: Twenty-six postlingually deafened adult cochlear implant (CI) recipients were included. INTERVENTION: All subjects were equipped with four coding strategies: FS4 with high rate on the envelope channels (on average 1376 pps/ch), FS4 low rate (750 pps/ch), and HDCIS with the same high and low rates. A "flat-charge map" was used for all four strategies. Only the loudness was balanced between programs. All tests were performed acutely in a double blind manner and a randomized sequence. MAIN OUTCOME MEASURES: Monosyllables in quiet and subjective sound quality. RESULTS: Mean monosyllables scores at 65 dB in quiet were 25.5% correct with HDCIS low rate, 27.2% correct with HDCIS high rate, 25.2% with FS4 low rate, and 33.1% with FS4 high rate. Performance with high stimulation rates was significantly higher than with the low rate settings. Subjective sound quality measured with visual analogue scales showed that for naturalness of speech, the improvement with a high rate version was only evident with the FS4 strategy. In both FS4 and HDCIS, higher stimulation rates elicited a higher pitch and were perceived as less dull than lower rates. CONCLUSION: A high rate of stimulation resulted in better speech recognition in both strategies and a favorable subjective sound quality for FS4 in all tested settings.

12 Article Indication criteria and outcomes with the Bonebridge transcutaneous bone-conduction implant. 2014

Riss, Dominik / Arnoldner, Christoph / Baumgartner, Wolf-Dieter / Blineder, Michaela / Flak, Stefan / Bachner, Anna / Gstoettner, Wolfgang / Hamzavi, Jafar-Sasan. ·From the Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria. ·Laryngoscope · Pubmed #25142577.

ABSTRACT: OBJECTIVES/HYPOTHESIS: The aim of this study was to evaluate functional hearing gain, speech understanding, and preoperative bone-conduction thresholds with the bone-conduction implant Bonebridge. STUDY DESIGN: Retrospective study at a tertiary referral center. METHODS: Twenty-four consecutive Bonebridge patients were identified. Nine patients suffered from combined hearing loss (HL), 12 from atresia of the external auditory canal and three from single-sided deafness. One patient was lost to follow-up. Twenty-three patients were therefore analyzed. RESULTS: The overall average functional hearing gain of all patients (n = 23) was 28.8 dB (±16.1 standard deviation [SD]). Monosyllabic word scores at 65 dB sound pressure level in quiet increased statistically significantly from 4.6 (±7.4 SD) percentage points to 53.7 (±23.0 SD) percentage points. Evaluation of preoperative bone-conduction thresholds revealed three patients with thresholds higher than 45 dB HL in the high frequencies starting at 2 kHz. These three patients had a very limited benefit of their bone-conduction implants. CONCLUSIONS: The Bonebridge bone-conduction implant provides satisfactory results concerning functional gain and speech perception if preoperative bone conduction lies within 45 dB HL. LEVEL OF EVIDENCE: 4.

13 Article FS4, FS4-p, and FSP: a 4-month crossover study of 3 fine structure sound-coding strategies. 2014

Riss, Dominik / Hamzavi, Jafar-Sasan / Blineder, Michaela / Honeder, Clemens / Ehrenreich, Isabella / Kaider, Alexandra / Baumgartner, Wolf-Dieter / Gstoettner, Wolfgang / Arnoldner, Christoph. ·1Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria; and 2Section of Clinical Biometrics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria. ·Ear Hear · Pubmed #25127325.

ABSTRACT: OBJECTIVES: The aim of the present study was to compare two novel fine structure strategies "FS4" and "FS4-p" with the established fine structure processing (FSP) strategy. FS4 provides fine structure information on the apical four-electrode channels. With FS4-p, these electrodes may be stimulated in a parallel manner. The authors evaluated speech perception, sound quality, and subjective preference. DESIGN: A longitudinal crossover study was done on postlingually deafened adults (N = 33) who were using FSP as their default strategy. Each participant was fitted with FS4, FS4-p, and FSP, for 4 months in a randomized and blinded order. After each run, an Adaptive Sentence test in noise (Oldenburger Sentence Test [OLSA]) and a Monosyllable test in quiet (Freiburger Monosyllables) were performed, and subjective sound quality was determined with a Visual Analogue Scale. At the end of the study the preferred strategy was noted. RESULTS: Scores of the OLSA did not reveal any significant differences among the three strategies, but the Freiburger test showed a statistically significant effect (p = 0.03) with slightly worse scores for FS4 (49.7%) compared with FSP (54.3%). Performance of FS4-p (51.8%) was comparable with the other strategies. Both audiometric tests depicted a high variability among subjects. The number of best-performing strategies for each participant individually was as follows: (a) for the OLSA: FSP, N = 10.5; FS4, N = 10.5; and FS4-p, N = 12; and (b) for the Freiburger test: FSP, N = 14; FS4, N = 9; and FS4-p, N = 10. A moderate agreement was found in the best-performing strategies of the Speech tests within the participants. For sound quality, speech in quiet, classical, and pop music were assessed. No significant effects of strategy were found for speech in quiet and classical music, but auditory impression of pop music was rated as more natural in FSP compared with FS4 (p = 0.04). It is interesting that at the end of the study, a majority of the participants favored the new coding strategies over their previous default FSP (FSP, N = 13; FS4, N = 13; FS4-p, N = 7). CONCLUSIONS: In summary, FS4 and FS4-p offer new and further options in audio processor fitting, with similar levels of speech understanding in noise as FSP. This is an interesting result, given that the strategies' presentation of temporal fine structure differs from FSP. At the end of the study, 20 of 33 subjects chose either FS4 or FS4-p over their previous default strategy FSP.

14 Article Quality of life in cochlear implantees: comparing utility values obtained through the Medical Outcome Study Short-Form Survey-6D and the Health Utility Index Mark 3. 2014

Arnoldner, Christoph / Lin, Vincent Y / Bresler, Richard / Kaider, Alexandra / Kuthubutheen, Jafri / Shipp, David / Chen, Joseph M. ·Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. ·Laryngoscope · Pubmed #24536018.

ABSTRACT: OBJECTIVES/HYPOTHESIS: To evaluate the changes in health-related quality of life in unilateral adult cochlear implant patients using the Medical Outcome Study Short-Form Survey-36 (SF-36) and the Health Utility Index Mark 3 (HUI-3). To do so, a health utility index was obtained by converting the SF-36 to the Medical Outcome Study Short-Form Survey-6D (SF-6D) to permit comparison with HUI-3 scores in the context of health preference as measured by quality-adjusted life years. STUDY DESIGN: Prospective cohort study. METHODS: Eighty-one postlingually deaf adult patients undergoing cochlear implantation completed the SF-36 and HUI-3 preoperatively and at a median of 1.4 years (range, 11 months-5 years) after cochlear implantation. RESULTS: The SF-36 improvement was statistically significant in two domains. The SF-36 data were converted to SF-6D. Preoperatively, the mean SF-6D utility score was 0.575 ± 0.056. One year postoperatively this score increased to 0.590 ± 0.064. The improvement of 0.015 ± 0.082 was not statistically significant (P = .1118). Of the HUI-3 attributes, two showed improvement between preoperative and postoperative evaluations. The overall HUI-3 score increased from 0.464 ± 0.207 preoperatively to 0.611 ± 0.190 postoperatively. The gain of 0.146 ± 0.19 was statistically significant (P < .0001). The intraclass correlation coefficient between the SF-6D and HUI-3 showed a very small correlation, both pre- and postoperatively. CONCLUSIONS: Against the backdrop of diminishing resources for healthcare, cost-effective analysis is fast becoming an important tool. There remains a strong need for health-related quality-of-life instruments that can truly reflect the benefit of cochlear implantation, in which utility estimates are fundamentally important. The SF-36 scores, when converted to SF-6D, do not correlate well with HUI-3 scores in a cohort of adult cochlear implant recipients. The HUI-3 remains the most appropriate tool for this patient group. LEVEL OF EVIDENCE: 4

15 Article Cochlear implantation in patients with advanced Ménière's disease. 2014

Mick, Paul / Amoodi, Hosam / Arnoldner, Christoph / Shipp, David / Friesen, Lendra / Lin, Vincent / Nedzelski, Julian / Chen, Joseph. ·*Harvard School of Public Health, Boston, Massachusetts, U.S.A.; and †Department of Otolaryngology - Head & Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. ·Otol Neurotol · Pubmed #24366468.

ABSTRACT: BACKGROUND/OBJECTIVES: Ménière's disease (MD) that results in bilateral severe to profound sensorineural hearing loss is a rare indication for cochlear implantation; only a few studies exist documenting performance in these patients. The primary objective was to compare the difference in preoperative to 12-month postoperative speech perception scores among subjects with MD and controls. Groupwise comparisons of secondary postoperative outcomes (Tinnitus Handicap Inventory [THI] scores, 36-Item Short Form [SF-36] scores, and postoperative dizziness) were also performed. METHODS: A retrospective cohort study was conducted. Subjects with MD and controls matched by age, device manufacturer and model, preoperative sentence score, and sentence test used for preimplantation and postimplantation performance assessments were identified from 1,130 patients in the prospectively maintained cochlear implant database at our center. Speech perception, THI, and SF-36 scores and demographic variables were obtained from the database. Vestibular outcomes were obtained by retrospective chart review. Statistical comparisons were performed to compare preoperative to postoperative change between groups. RESULTS: Twenty patients with MD were identified. At 1 year after CI, improvements in sentence and word understanding did not differ in magnitude from the controls. Tinnitus was reduced significantly in patients with MD, whereas there was a trend for improvement in the controls. Quality of life as measured by the SF-36 improved in both groups. Patients with MD had significant improvements in 1 domain compared with 5 domains for the controls. Subjects with MD had significantly more chronic dizziness in the postoperative period than did controls. CONCLUSIONS: Patients with MD who have bilateral severe to profound sensorineural hearing loss benefit significantly from CI. Ongoing dizziness in some patients with MD may result in quality of life improvements that are slightly less than seen for the average adult patient with CI. Larger studies are needed to corroborate the results.

16 Article Vibroplasty in mixed and conductive hearing loss: comparison of different coupling methods. 2014

Vyskocil, Erich / Riss, Dominik / Honeder, Clemens / Arnoldner, Christoph / Hamzavi, Jafar-Sasan / Baumgartner, Wolf-Dieter / Flak, Stefan / Gstoettner, Wolfgang. ·Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria. ·Laryngoscope · Pubmed #24338550.

ABSTRACT: OBJECTIVES/HYPOTHESIS: To evaluate modified coupling techniques of the Vibrant Soundbridge system in patients with mixed and conductive hearing loss and to compare it with conventional vibroplasty. STUDY DESIGN: Retrospective study. METHODS: Two different groups were evaluated: 1) nine cases of conventional incus vibroplasty in comparison with 2) nine patients with modified coupling of the floating mass transducer. In the modified coupling approach, the vibrant floating mass transducer was attached to 1) the stapes/oval window, 2) the round window, or 3) the drilled promontory bone (promontory fenestration window). In three patients, an additional ossiculoplasty was performed. Preoperative and postoperative aided and unaided pure-tone and free-field audiometry and Freiburg monosyllabic word test were used to assess hearing outcome. RESULTS: Functional hearing gain obtained in patients with mixed and conductive hearing loss who underwent modified coupling was 39 dB. Patients with pure sensorineural hearing loss who received conventional incus coupling showed a functional hearing gain of 25 dB. Average functional gain was 41 dB in the oval window group, 45 dB in the round window group, and 30 dB in the promontory fenestration window group. Word recognition test revealed an average improvement of 51% and 21% in the modified and in the conventional approach, respectively. CONCLUSIONS: Modified vibroplasty is a safe and effective treatment for patients with conductive and mixed hearing loss. Coupling the floating mass transducer to the promontory bone (promontory fenestration window) is a viable option in chronically disabled ears if oval and round window coupling is not possible. LEVEL OF EVIDENCE: 4.

17 Article Residual hearing preservation using the suprameatal approach for cochlear implantation. 2011

Arnoldner, Christoph / Gstoettner, Wolfgang / Riss, Dominik / Wagenblast, Jens / Honeder, Clemens / Blineder, Michaela / Hamzavi, Jafar-Sasan / Jappel, Alexandra / Baumgartner, Wolf-Dieter. ·Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria. christoph.arnoldner@meduniwien.ac.at ·Wien Klin Wochenschr · Pubmed #21858425.

ABSTRACT: OBJECTIVE: Cochlear implantation of patients with high-frequency hearing loss and residual low-frequency hearing has become a new treatment standard within the last years. The objective of this study was to evaluate the rate of hearing preservation in cochlear implantation for electric-acoustic stimulation using the suprameatal approach. METHODS: Five patients (mean age 48.2 years) who were supplied with Med El (Combi 40+, Pulsar) cochlear implants and various different electrodes (Custom made, Flex soft, Flex EAS) were evaluated for residual hearing preservation after a mean follow-up time of 35.6 months (range 24 to 77 months). RESULTS: Three patients showed partial hearing preservation, whereas 2 patients experienced a complete loss of residual hearing. CONCLUSION: Although hearing preservation rates in this series of patients operated on using the suprameatal approach were inferior as compared with a series using the standard mastoidectomy approach, this study shows that it is in fact possible to preserve residual hearing using a non-mastoidectomy surgical technique for cochlear implantation. Nevertheless, more experience is necessary to answer the question whether this technique can be thoroughly recommended in cochlear implantation for electric-acoustic stimulation.

18 Article Envelope versus fine structure speech coding strategy: a crossover study. 2011

Riss, Dominik / Hamzavi, Jafar-Sasan / Selberherr, Andreas / Kaider, Alexandra / Blineder, Michaela / Starlinger, Veronika / Gstoettner, Wolfgang / Arnoldner, Christoph. ·Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria. ·Otol Neurotol · Pubmed #21817932.

ABSTRACT: OBJECTIVE: The transmission of fine structure information to cochlear implant users is an expanding area of research. Previous studies comparing the fine structure processing (FSP) speech coding strategy to the envelope-based continuous interleaved sampling (CIS) strategy indicated improved speech perception when using the fine structure strategy. Those investigations were performed with an extended frequency spectrum in the low frequencies together with the fine structure strategy. The current study addresses the question whether these improvements are due to the presentation of fine structure per se or rather the extended frequency spectrum. Hence, this cross over study compares the two strategies using an identical frequency spectrum. STUDY DESIGN: Randomized crossover study. PATIENTS: 31 patients were randomly assigned to two groups. INTERVENTIONS: One group was fitted with a CIS map for 4 weeks, tested and subsequently fitted with a FSP map for 4 weeks. The other group followed the same pattern in reverse. MAIN OUTCOME MEASURES: Test material consisted of sentence tests in noise, monosyllables in quiet and melody recognition. RESULTS: No statistical significance was noted between the different speech coding strategies at an identical frequency spectrum. CONCLUSION: This study shows that there is no difference in speech perception with FSP compared to CIS at an extended frequency spectrum. Therefore, the extended frequency spectrum in the low frequencies might explain a benefit of FSP observed in previous studies.

19 Article Effects of fine structure and extended low frequencies in pediatric cochlear implant recipients. 2011

Riss, Dominik / Hamzavi, Jafar-Sasan / Katzinger, Michaela / Baumgartner, Wolf-Dieter / Kaider, Alexandra / Gstoettner, Wolfgang / Arnoldner, Christoph. ·Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. dominik.riss@meduniwien.ac.at ·Int J Pediatr Otorhinolaryngol · Pubmed #21324531.

ABSTRACT: OBJECTIVE: In recent years, new speech coding strategies have been developed with the aim of improving the transmission of temporal fine structure to cochlear implant recipients. This study reports on the implementation of one such strategy (fine structure processing, FSP) in children. METHODS: This was a prospective study investigating the upgrade to a new speech processor. The upgrade used a repeated measures design with an alternating order of conditions (A-B-A-B design). Twelve pre- and perilingually deaf children with MED-EL C40+ cochlear implants were enrolled in the study. Patients were upgraded from their Tempo+ speech processor, which used continuous interleaved sampling (CIS) in combination with a frequency spectrum of 200-8500 Hz, to an Opus speech processor, which used FSP with an extended frequency spectrum of 70-8500 Hz. The primary means of testing was an HSM (Hochmair, Schulz and Moser) sentence test at 65 and 80 dB in quiet. In addition, the "Mainzer Kindersprachtest" (Mainz audiometric speech test for children) was applied at 65 and 70 dB. RESULTS: When the new FSP speech processor was used together with the extended low frequency range, HSM sentence tests at 65 and 80 dB resulted in scores indicating statistically significant improvements of 7.1 and 9.9 percentage points, respectively. Scores in the "Mainzer Kindersprachtest" at 65 and 70 dB indicated statistically significant improvements of 9.3 and 6.1 percentage points, respectively. CONCLUSIONS: The present study clearly shows that children benefit from the fine structure speech coding strategy in combination with an extended frequency spectrum in the low frequencies, as is offered by the Opus speech processors. This should be taken into consideration when fitting pre- and perilingually deaf children implanted almost a decade previously.

20 Article Cochlear osteoneogenesis after meningitis in cochlear implant patients: a retrospective analysis. 2010

Durisin, Martin / Bartling, Soenke / Arnoldner, Christoph / Ende, Melanie / Prokein, Jana / Lesinski-Schiedat, Anke / Lanfermann, Heinrich / Lenarz, Thomas / Stöver, Timo. ·Department of Otorhinolaryngology, Medical University of Hannover, Hannover, Germany. Durisin.Martin@MH-Hannover.De ·Otol Neurotol · Pubmed #20812396.

ABSTRACT: STUDY DESIGN: Retrospective clinical study. SETTING: Academic tertiary referral center at the Medical University of Hannover. PATIENTS: Computed tomographic findings of 126 patients (95 children and 31 adults) profoundly deafened by meningitis during a period of 20 years were evaluated. Children were defined as up to 12 years old at the onset of meningitis. No patients showed any relevant bilateral auditory brainstem response thresholds at the time of admission to our clinic. INTERVENTIONS: Patient histories, surgical findings, and imaging results were analyzed by experienced surgeons/neuroradiologists. RESULTS: Of 95 children, 30 (32%) displayed symptoms of labyrinthitis ossificans, whereas 11 (36%) of 31 adults showed changes of the bony structure of the cochlea. High-resolution computed tomography (HRCT) evaluation indicated that the ossification was detected more frequently if there was a larger time interval between onset of meningitis and high-resolution computed tomographic scan. Bilateral ossification at various stages was observed in 67% of children and 55% of adults with obliteration. In the comparison of cochlear ossification found in computed tomographic scans and intraoperative obliteration, HRCT showed a specificity of 73% and a sensitivity of 88%. The intraoperative evaluation revealed various stages of cochlear obliteration in 44% of children and 39% of adults. CONCLUSION: In our study, the earliest onset of labyrinthitis ossificans was found in high-resolution computed tomographic scans as early as 4 weeks after the onset of meningitis. In most cases, ossification occurred bilaterally with predominantly asymmetric involvement of both ears. The rate of osteoneogenesis increases significantly over time after meningitis. This leads to the conclusion that cochlear ossification can start very early and increase over time with unpredictable speed. Cochlear ossification typically develops bilaterally. From these results, we conclude that cochlear implantation should be performed bilaterally as soon as possible after meningitis and deafness have been diagnosed. HRCT offers good specificity but only limited sensitivity. Preoperative diagnostics should include magnetic resonance imaging to optimize preparation for cochlear implantation.