Search results for: children with cochlear implants

Authors: Elnaz Dabiri, Somayeh Hamidnezhad

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Background and Objective: This study aims at investigating the effect of whole word method on Mean Length of Utterance (MLU) of 3 to 6 years old children with cochlear implants having normal IQ. Materials and Methods: In this quasi-experimental and interventional study, 20 children with cochlear implants, aged between 3and 6 years, and normal IQ were selected from Tabriz cochlear implants center using convenience sampling. Afterward, they were randomly bifurcated. The first group was educated by whole-word reading method along with traditional methods and the second group by traditional methods. Both groups had three sessions of 45-minutes each, every week continuously for a period of 3 months. Pre-test and post-test language abilities of both groups were assessed using the TOLD test. Results: Both groups before training have the same age, IQ, and MLU, but after training the first group shows a considerable improvement in MLU in comparison with the second group. Conclusions: Reading training by the whole word method have more effect on MLU of children with cochlear implants in comparison of the traditional method.

Keywords: cochlear implants, reading training, traditional methods, language therapy, whole word method, Mean Length of Utterance (MLU)

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Authors: Amirreza Razzaghipour, Mahdi Khalili

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References from the World Health Organization and the Center for Disease Control for deceleration the spread of the Novel COVID-19, comprises social estrangement, frequent handwashing, and covering your mouth when around others. As hearing healthcare specialists, the influence of existenceinvoluntary to boundary social interactions on persons with hearing impairment was significant for us to understand. We found ourselves delaying cochlear implant (CI) surgeries. All children, and chiefly those with hearing loss, are susceptible to reductions in spoken communication. Hearing plans, such as cochlear implants, provide children with hearing loss access to spoken communication and provision language development. when provided early and used consistently, these supplies help children with hearing loss to engage in spoken connections. Cochlear implant (CI) is a standard medical-surgical treatment for bilateral severe to profound hearing loss with no advantage with the hearing aid. Hearing is one of the most important senses in humans. Pediatric hearing loss establishes one of the most important public health challenges. Children with hearing loss are recognized early and habilitated via hearing aids or with cochlear implants (CIs). Suitable care and maintenance as well as continuous auditory verbal therapy (AVT) are also essential in reaching for the successful attainment of language acquisition. Children with hearing loss posture important challenges to their parents, particularly when there is limited admission to their hearing care providers. The disruption in the routine of their hearing and therapy follow-up services has had substantial effects on the children as well as their parents.

Keywords: healthcare, covid-19, cochlear implants, spoken communication, hearing loss

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Authors: Hesham Kozou

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Sensorineural hearing loss (SNHL) poses a significant challenge due to limited access to the inner ear for therapies. Emerging treatments such as regenerative, genetic, and pharmacotherapies offer hope for addressing this condition. This study aims to highlight the potential of cochlear implants and emerging therapies in managing sensorineural hearing loss by improving access to the inner ear. The study is conducted through a review of relevant literature and research articles in the field of cochlear implants and emerging therapies for hearing loss. It outlines how advancements in cochlear implant technologies, electrodes, and surgical techniques can facilitate the delivery of therapies to the inner ear, potentially revolutionizing the treatment of sensorineural hearing loss. The study underscores the potential of cochlear implants and emerging therapies in revolutionizing the treatment landscape for sensorineural hearing loss, emphasizing the feasibility of curing this condition by leveraging technological advancements.

Keywords: therapies for hearing loss management, future of CI as a cochlear delivery channel, regenerative, genetic and pharmacotherapeutic management of hearing loss

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Authors: Tamer Mesallam, Medhat Yousef, Ayna Almasaad

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BACKGROUND: Cochlear implantation (CI) in children with additional disabilities can be a fundamental and supportive intervention. Although, there may be some positive impacts of CI on children with multiple disabilities such as better outcomes of communication skills, development, and quality of life, the families of those children complain from the post-implant habilitation efforts that considered as a burden. OBJECTIVE: To investigate the outcomes of CI children with different co-disabilities through using the Meaningful Auditory Integration Scale (MAIS) and the Meaningful Use of Speech Scale (MUSS) as outcome measurement tools. METHODS: The study sample comprised 25 hearing-impaired children with co-disability who received cochlear implantation. Age and gender-matched control group of 25 cochlear-implanted children without any other disability has been also included. The participants' auditory skills and speech outcomes were assessed using MAIS and MUSS tests. RESULTS: There was a statistically significant difference in the different outcomes measure between the two groups. However, the outcomes of some multiple disabilities subgroups were comparable to the control group. Around 40% of the participants with co-disabilities experienced advancement in their methods of communication from behavior to oral mode. CONCLUSION: Cochlear-implanted children with multiple disabilities showed variable degrees of auditory and speech outcomes. The degree of benefits depends on the type of the co-disability. Long-term follow-up is recommended for those children.

Keywords: children with disabilities, Cochlear implants, hearing impairment, language development

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Authors: Sachin, Shantanu Arya, Gunjan Mehta, Md. Shamim Ansari

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The cross-modal influence of visual information on speech perception can be illustrated by the McGurk effect which is an illusion of hearing of syllable /ta/ when a listener listens one syllable, e.g.: /pa/ while watching a synchronized video recording of syllable, /ka/. The McGurk effect is an excellent tool to investigate multisensory integration in speech perception in both normal hearing and hearing impaired populations. As the visual cue is unaffected by noise, individuals with hearing impairment rely more than normal listeners on the visual cues.However, when non congruent visual and auditory cues are processed together, audiovisual interaction seems to occur differently in normal and persons with hearing impairment. Therefore, this study aims to observe the audiovisual interaction in speech perception in Cochlear Implant users compares the same with normal hearing children. Auditory stimuli was routed through calibrated Clinical audiometer in sound field condition, and visual stimuli were presented on laptop screen placed at a distance of 1m at 0 degree azimuth. Out of 4 presentations, if 3 responses were a fusion, then McGurk effect was considered to be present. The congruent audiovisual stimuli /pa/ /pa/ and /ka/ /ka/ were perceived correctly as ‘‘pa’’ and ‘‘ka,’’ respectively by both the groups. For the non- congruent stimuli /da/ /pa/, 23 children out of 35 with normal hearing and 9 children out of 35 with cochlear implant had a fusion of sounds i.e. McGurk effect was present. For the non-congruent stimulus /pa/ /ka/, 25 children out of 35 with normal hearing and 8 children out of 35 with cochlear implant had fusion of sounds.The children who used cochlear implants for less than three years did not exhibit fusion of sound i.e. McGurk effect was absent in this group of children. To conclude, the results demonstrate that consistent fusion of visual with auditory information for speech perception is shaped by experience with bimodal spoken language during early life. When auditory experience with speech is mediated by cochlear implant, the likelihood of acquiring bimodal fusion is increased and it greatly depends on the age of implantation. All the above results strongly support the need for screening children for hearing capabilities and providing cochlear implants and aural rehabilitation as early as possible.

Keywords: cochlear implant, congruent stimuli, mcgurk effect, non-congruent stimuli

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Authors: Munish Saroch, Amit Saini

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Introduction: Many children with congenital malformation of inner ear have undergone cochlear implant (CI) surgery. The results for cochlear implant surgery in these children are very encouraging and provide a ray of hope for these patients. Objective: The main objective of this presentation is to prove that even in Mondini’s deformity Minimal incision cochlear implantation improves cosmesis, reduces post-operative infection and earliest switch on of device. Methods: We report a case of two-year-old child suffering from Mondini’s deformity who underwent CI with minimal incision cochlear implantation (MICI). MICI has been developed with the aims of reducing the impact of surgery on the patient without any preoperative shaving of hairs. Results: Patient after surgery with MICI showed better looking postauricular scar, low post-operative morbidity in comparison to conventional wider access approach and hence earliest switch on of device (1st post operative day). Conclusion: We are of opinion that MICI is safe and successful in Mondini’s deformity.

Keywords: CI, Cochlear Implant, MICI, Minimal Incision Cochlear Implantation, HL, Hearing Loss, HRCT, High Resolution Computer Tomography, MRI, Magnetic resonance imaging, SCI, Standard cochlear implantation

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Authors: Deepthy Ann Joy, N. Sreedevi

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Hearing impairment (HI) at an early age, identified before the onset of language development can reduce the negative effect on speech and language development of children. Early rehabilitation is very important in the improvement of speech production in children with HI. Other than conventional hearing aids, Cochlear Implants are being used in the rehabilitation of children with HI. However, delay in acquisition of speech and language milestones persist in children with Cochlear Implant (CI). Delay in speech milestones are reflected through speech sound errors. These errors reflect the temporal and spectral characteristics of speech. Hence, acoustical analysis of the speech sounds will provide a better representation of speech production skills in children with CI. The present study aimed at investigating the acoustic characteristics of vowels in Malayalam speaking children with a cochlear implant. The participants of the study consisted of 20 Malayalam speaking children in the age range of four and seven years. The experimental group consisted of 10 children with CI, and the control group consisted of 10 typically developing children. Acoustic analysis was carried out for 5 short (/a/, /i/, /u/, /e/, /o/) and 5 long vowels (/a:/, /i:/, /u:/, /e:/, /o:/) in word-initial position. The responses were recorded and analyzed for acoustic parameters such as Vowel duration, Ratio of the duration of a short and long vowel, Formant frequencies (F₁ and F₂) and Formant Centralization Ratio (FCR) computed using the formula (F₂u+F₂a+F₁i+F₁u)/(F₂i+F₁a). Findings of the present study indicated that the values for vowel duration were higher in experimental group compared to the control group for all the vowels except for /u/. Ratio of duration of short and long vowel was also found to be higher in experimental group compared to control group except for /i/. Further F₁ for all vowels was found to be higher in experimental group with variability noticed in F₂ values. FCR was found be higher in experimental group, indicating vowel centralization. Further, the results of independent t-test revealed no significant difference across the parameters in both the groups. It was found that the spectral and temporal measures in children with CI moved towards normal range. The result emphasizes the significance of early rehabilitation in children with hearing impairment. The role of rehabilitation related aspects are also discussed in detail which can be clinically incorporated for the betterment of speech therapeutic services in children with CI.

Keywords: acoustics, cochlear implant, Malayalam, vowels

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Authors: Lei Hou, Xinli Du, Nikolaos Boulgouris

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A cochlear implant, referred to as a CI, is a small electronic device that can provide direct electrical stimulation to the auditory nerve. During cochlear implant surgery, atraumatic electrode array insertion is considered to be a crucial step. However, during implantation, the mechanical behaviour of an electrode array inside the cochlea is not known. The behaviour of an electrode array inside of the cochlea is hardly identified by regular methods. In this study, a CI electrode array capacitive sensor system is proposed. It is able to automatically determine the array state as a result of the capacitance variations. Instead of applying sensors to the electrode array, the capacitance information from the electrodes will be gathered and analysed. Results reveal that this sensing method is capable of recognising different states when fed into a pre-shaped model.

Keywords: cochlear implant, electrode, hearing preservation, insertion force, capacitive sensing

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Authors: Yunhe Chen, Xinyun Liu, Qian Wang, Jianan Li

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Background Cochlear implants (CIs) are currently the primary effective treatment for severe or profound sensorineural hearing loss. As China's population ages and the number of young children rises, the demand for MRI for CI patients is expected to increase. Methods Reviewed MRI cases of 25 CI patients between 2015 and 2024, assessed imaging auditory outcomes and adverse reactions. Use the adverse event record sheet and accompanying medication sheet to record follow-up measures. Results Most CI patients undergoing MRI may face risks such as artifacts, pain, redness, swelling, tissue damage, bleeding, and magnet displacement or demagnetization. Twenty-five CI patients in our hospital were reviewed. Seven patient underwent 3.0 T MR, the others underwent 1.5 T MR. The manufacturers are 18 cases in Austria, 5 cases in Australia and 2 cases in Nurotron. Among them, one patient with bilateral CI underwent 1.5 T MR examination after head pressure bandaging, and the left magnet was displaced (CI24RE Series, Australia). This patient underwent surgical replacement of the magnet under general anesthesia. Six days after the operation, the patient's feedback indicated that the performance of the cochlear implant was consistent with the previous results following the reactivation of the external device. Based on the experience of our hospital, we proposed the feasible management scheme of MRI examination procedure for CI patients. This plan should include a module for confirming MRI imaging parameters, informed consent, educational materials for patients, and other safety measures to ensure that patients receive imaging results safely and effectively, implify clinical. Conclusion As indications for both MRI and cochlear implantation expand，the number of MRI studies recommended for patients with cochlear implants will also increase. The process and management scheme proposed in this study can help to obtain imaging results safely and effectively, and reduce clinical stress.

Keywords: cochlear implantation, MRI, magnet, displacement

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Authors: Yung-Shan Lu, Chia-Fone Lee, Shang-Hsuan Li, Chien-Hao Liu

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Recently, various bioelectronic devices have been developed for neurologic disease treatments via electro-stimulations such as cochlear implants and retinal prosthesis. Since the electric signal needs electrodes to be transmitted to an organism, electrodes play an important role of stimulations. The materials of stimulation electrodes affect the efficiency of the delivered currents. The higher the efficiency of the electrodes, the lower the threshold current can be used to stimulate the organism which minimizes the potential damages to the adjacent tissues. In this study, we proposed a biocompatible composite electrode composed of high-charge-capacity iridium oxide (IrOₓ) film for a bone-guide extra-cochlear implant. IrOₓ was exploited to decrease the threshold current due to its high capacitance and low impedance. The IrOₓ electrode was fabricated via microelectromechanical systems (MEMS) photolithography and examined with in-vivo tests with guinea pigs. Based on the measured responses of brain waves to sound, the results demonstrated that IrOₓ electrodes have a lower threshold current compared with the Platinum (Pt) electrodes. The research results are expected to be beneficial for implantable and biocompatible electrodes for electrical stimulations.

Keywords: cochlear implants, electrode, electrical stimulation, iridium oxide

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Authors: Alimohamad Asghari, Ahmad Daneshi, Mohammad Farhadi, Arash Bayat, Mohammad Ajalloueyan, Marjan Mirsalehi, Mohsen Rajati, Seyed Basir Hashemi, Nader Saki, Ali Omidvari

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Evidence suggests that Cochlear Implantation (CI) is a beneficial approach for auditory and speech skills improvement in children with severe to profound hearing loss. However, it remains controversial if implantation in children <12 months is safe and effective compared to older children. The present study aimed to determine whether children's ages affect surgical complications and auditory and speech development. The current multicenter study enrolled 86 children who underwent CI surgery at <12 months of age (group A) and 362 children who underwent implantation between 12 and 24 months of age (group B). The Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores were determined pre-impanation, and "one-year" and "two-year" post-implantation. Four complications (overall rate: 4.65%; three minor) occurred in group A and 12 complications (overall rate: 4.41%; nine minor) occurred in group B. We found no statistically significant difference in the complication rates between the groups (p>0.05). The mean SIR and CAP scores improved over time following CI activation in both groups. However, we did not find significant differences in CAP and SIR scores between the groups across different time points. Cochlear implantation is a safe and efficient procedure in children younger than 12 months, providing substantial auditory and speech benefits comparable to children undergoing implantation at 12 to 24 months of age. Furthermore, surgical complications in younger children are similar to those of children undergoing the CI at an older age.

Keywords: cochlear implant, Infant, complications, outcome

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Authors: Areti Okalidou, Paul D. Hatzigiannakoglou, Aikaterini Vatou, George Kyriafinis

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Young children are nowadays adept at using technology. Hence, computer-based auditory training programs (CBATPs) have become increasingly popular in aural rehabilitation for children with hearing loss and/or with cochlear implants (CI). Yet, their clinical utility for prognostic, diagnostic, and monitoring purposes has not been explored. The purposes of the study were: a) to develop an updated version of the auditory rehabilitation tool for Greek-speaking children with cochlear implants, b) to develop a database for behavioral responses, and c) to compare accuracy rates and reaction times in children differing in hearing status and other medical and demographic characteristics, in order to assess the tool’s clinical utility in prognosis, diagnosis, and progress monitoring. The updated version of the auditory rehabilitation tool was developed on a tablet, retaining the User-Centered Design approach and the elements of the Virtual Reality (VR) serious game. The visual stimuli were farm animals acting in simple game scenarios designed to trigger children’s responses to animal sounds, names, and relevant sentences. Based on an extended version of Erber’s auditory development model, the VR game consisted of six stages, i.e., sound detection, sound discrimination, word discrimination, identification, comprehension of words in a carrier phrase, and comprehension of sentences. A familiarization stage (learning) was set prior to the game. Children’s tactile responses were recorded as correct, false, or impulsive, following a child-dependent set up of a valid delay time after stimulus offset for valid responses. Reaction times were also recorded, and the database was in Εxcel format. The tablet version of the auditory rehabilitation tool was piloted in 22 preschool children with Νormal Ηearing (ΝΗ), which led to improvements. The study took place in clinical settings or at children’s homes. Fifteen children with CI, aged 5;7-12;3 years with post-implantation 0;11-5;1 years used the auditory rehabilitation tool. Eight children with CI were monolingual, two were bilingual and five had additional disabilities. The control groups consisted of 13 children with ΝΗ, aged 2;6-9;11 years. A comparison of both accuracy rates, as percent correct, and reaction times (in sec) was made at each stage, across hearing status, age, and also, within the CI group, based on presence of additional disability and bilingualism. Both monolingual Greek-speaking children with CI with no additional disabilities and hearing peers showed high accuracy rates at all stages, with performances falling above the 3rd quartile. However, children with normal hearing scored higher than the children with CI, especially in the detection and word discrimination tasks. The reaction time differences between the two groups decreased in language-based tasks. Results for children with CI with additional disability or bilingualism varied. Finally, older children scored higher than younger ones in both groups (CI, NH), but larger differences occurred in children with CI. The interactions between familiarization of the software, age, hearing status and demographic characteristics are discussed. Overall, the VR game is a promising tool for tracking the development of auditory skills, as it provides multi-level longitudinal empirical data. Acknowledgment: This work is part of a project that has received funding from the Research Committee of the University of Macedonia under the Basic Research 2020-21 funding programme.

Keywords: VR serious games, auditory rehabilitation, auditory training, children with cochlear implants

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Authors: Paris Binos

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The present work investigates developmental aspects of the duration of isolated vowels in infants with normal hearing compared to those who received cochlear implants (CIs) before two years of age. Infants with normal hearing produced shorter vowel duration since this find related with more mature production abilities. First isolated vowels are transparent during the protophonic stage as evidence of an increased motor and linguistic control. Vowel duration is a crucial factor for the transition of prelexical speech to normal adult speech. Despite current knowledge of data for infants with normal hearing more research is needed to unravel productions skills in early implanted children. Thus, isolated vowel productions by two congenitally hearing-impaired Greek infants (implantation ages 1:4-1:11; post-implant ages 0:6-1:3) were recorded and sampled for six months after implantation with a Nucleus-24. The results compared with the productions of three normal hearing infants (chronological ages 0:8-1:1). Vegetative data and vocalizations masked by external noise or sounds were excluded. Participants had no other disabilities and had unknown deafness etiology. Prior to implantation the infants had an average unaided hearing loss of 95-110 dB HL while the post-implantation PTA decreased to 10-38 dB HL. The current research offers a methodology for the processing of the prelinguistic productions based on a combination of acoustical and auditory analyses. Based on the current methodological framework, duration measured through spectrograms based on wideband analysis, from the voicing onset to the end of the vowel. The end marked by two co-occurring events: 1) The onset of aperiodicity with a rapid change in amplitude in the waveform and 2) a loss in formant’s energy. Cut-off levels of significance were set at 0.05 for all tests. Bonferroni post hoc tests indicated that difference was significant between the mean duration of vowels of infants wearing CIs and their normal hearing peers. Thus, the mean vowel duration of CIs measured longer compared to the normal hearing peers (0.000). The current longitudinal findings contribute to the existing data for the performance of children wearing CIs at a very young age and enrich also the data of the Greek language. The above described weakness for CI’s performance is a challenge for future work in speech processing and CI’s processing strategies.

Keywords: cochlear implant, duration, spectrogram, vowel

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Authors: Amina Sultan, Mohamed Ghonim, Eman Oweida, Aya Abdelaziz

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Objective: To assess the diagnostic reliability of multi-detector CT in pre and post-operative evaluation of cochlear implant candidates. Material and Methods: The study includes 40 patients (18 males and 22 females); mean age 5.6 years. They were classified into two groups: Group A (20 patients): cochlear implant device was Nucleus-22 and Group B (20 patients): the device was MED-EL. Cochlear length (CL) and cochlear height (CH) were measured pre-operatively by 128-multidetector CT. Electrode length (EL) and insertion depth angle (α) were measured post-operatively by MDCT. Results: For Group A mean CL was 9.1 mm ± 0.4 SD; mean CH was 4.1 ± 0.3 SD; mean EL was 18 ± 2.7 SD; mean α angle was 299.05 ± 37 SD. Significant statistical correlation (P < 0.05) was found between preoperative CL and post-operative EL (r²=0.6); as well as EL and α angle (r²=0.7). Group B's mean CL was 9.1 mm ± 0.3 SD; mean CH was 4.1 ± 0.4 SD; mean EL was 27 ± 2.1 SD; mean α angle was 287.6 ± 41.7 SD. Significant statistical correlation was found between CL and EL (r²= 0.6) and α angle (r²=0.5). Also, a strong correlation was found between EL and α angle (r²=0.8). Significant statistical difference was detected between the two devices as regards to the electrode length. Conclusion: Multidetector CT is a reliable tool for preoperative planning and post-operative evaluation of the outcomes of cochlear implant operations. Cochlear length is a valuable prognostic parameter for prediction of the depth of electrode array insertion which can influence criteria of device selection.

Keywords: angle of insertion (α angle), cochlear implant (CI), cochlear length (CL), Multidetector Computed Tomography (MDCT)

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Authors: Jianan Li, Lusen Shi, Haiqiao Du, Wei Chen, Qian Wang, Shuoshuo Kang, Shiming Yang

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Background: Follow-up of cochlear implant effectiveness is mainly focused on 3 years postoperatively, and studies with more than 5 years of observation are rare, especially for local Chinese brands. Objectives: Nurotron (Chinese domestic cochlear implant brand) CI recipients who participated in the clinical trial in 2009 were followed-up for 10 years prospectively, providing data to guide doctors and patients. Material and Methods: From December 2009 to April 2010, 57 subjects underwent Nurotron Venus CI surgery at multiple centers and were continued to be followed up and assessed at 1, 2, 3, 4, 5, and 10 years after switching on. Results: All recipients were successfully implanted with CIs with no difficulty in subsequent use, with one reported case of re-implantation 9 years after implantation. The aided hearing thresholds were significantly improved one month after switching on (p<0.0001) and remained stable afterward for 10 years. Speech recognition scores were significantly higher than pre-operative results (p<0.05) and continued to improve till 3 years after switching on. At 10 years of post-operation, most subjects had improved QOL scores in most sub-items. Conclusions and Significance: Nurotron Venus CI System provides long-term, stable results in hearing speech assistance capabilities and can improve the quality of life of CI recipients.

Keywords: cochlear implantation, hearing loss, post lingual, follow up

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Authors: Rajesh Bansal, Amit Raj Sharma, Vakil Singh

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The success and predictability of titanium implants for long durations are well established and there has been a tremendous increase in the popularity of implants among patients as well as clinicians over the last four decades. However, sometimes complications arise, which lead to the loss of the implant as well as the prosthesis. Fracture of dental implants is rare; however, at times, implants or abutment screws fracture and lead to many problems for the clinician and the patient. Possible causes of implant fracture include improper design, overload, fatigue and corrosion. Six retrieved fractured dental implants, with varying diameters and designs, were collected from time to time to examine by scanning electron microscope (SEM) to characterize fracture behavior and assess the mechanism of fracture. In this investigation, it was observed that fracture of the five dental implants occurred due to fatigue crack initiation and propagation from the thread roots.

Keywords: titanium, dental, implant, fracture, failure

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Authors: Yusuf Bulale, Mark Prince, Geoff Tansley, Peter Brett

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Cochlear Implantation (CI) which became a routine procedure for the last decades is an electronic device that provides a sense of sound for patients who are severely and profoundly deaf. Today, cochlear implantation technology uses electrode array (EA) implanted manually into the cochlea. The optimal success of this implantation depends on the electrode technology and deep insertion techniques. However, this manual insertion procedure may cause mechanical trauma which can lead to a severe destruction of the delicate intracochlear structure. Accordingly, future improvement of the cochlear electrode implant insertion needs reduction of the excessive force application during the cochlear implantation which causes tissue damage and trauma. This study is examined tool-tissue interaction of large prototype scale digit embedded with distributive tactile sensor based upon cochlear electrode and large prototype scale cochlea phantom for simulating the human cochlear which could lead to small-scale digit requirements. The digit, distributive tactile sensors embedded with silicon-substrate was inserted into the cochlea phantom to measure any digit/phantom interaction and position of the digit in order to minimize tissue and trauma damage during the electrode cochlear insertion. The digit has provided tactile information from the digit-phantom insertion interaction such as contact status, tip penetration, obstacles, relative shape and location, contact orientation and multiple contacts. The tests demonstrated that even devices of such a relative simple design with low cost have a potential to improve cochlear implant surgery and other lumen mapping applications by providing tactile sensory feedback information and thus controlling the insertion through sensing and control of the tip of the implant during the insertion. In that approach, the surgeon could minimize the tissue damage and potential damage to the delicate structures within the cochlear caused by current manual electrode insertion of the cochlear implantation. This approach also can be applied to other minimally invasive surgery applications as well as diagnosis and path navigation procedures.

Keywords: cochlear electrode insertion, distributive tactile sensory feedback information, flexible digit, minimally invasive surgery, tool/tissue interaction

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Authors: Boxiang Zhuang

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This study analyzes the clinical manifestations, hearing rehabilitation methods and outcomes of a complex case of neurofibromatosis type II (NF2). Methods: The clinical manifestations, medical history, clinical data, surgical methods and postoperative hearing rehabilitation outcomes of an NF2 patient were analyzed to determine the hearing reconstruction method and postoperative effect for a special type of NF2 acoustic neuroma. Results: The patient had bilateral acoustic neuromas with profound sensorineural hearing loss in both ears. Peripheral blood genetic testing did not reveal pathogenic gene mutations, suggesting mosaicism. The patient had an intracochlear schwannoma in the right ear and severely impaired vision in both eyes. Cochlear implantation with tumor retention was performed in the right ear. After 2 months of family-based auditory and speech rehabilitation, the Categories of Auditory Performance (CAP) score improved from 0 to 5. Conclusion: NF2 has complex clinical manifestations and poor prognosis. For NF2 patients with intracochlear tumors, cochlear implantation with tumor retention can be used to reconstruct hearing.

Keywords: NF2, intracochlear schwannoma, hearing reconstruction, cochlear implantation

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Authors: Asha Manoharan, Sooraj A. O, Anju K. G

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Enlarged vestibular aqueduct (EVA) refers to the presence of congenital sensorineural hearing loss with an enlarged vestibular aqueduct. The Audiological symptoms of EVA are fluctuating and progressive in nature and the diagnosis of EVAS can be confirmed only with radiological evaluation. Hence it is difficult to differentiate EVA from conditions like Meniere’s disease, semi-circular dehiscence, etc based on audiological findings alone. EVA in adults is easy to identify due to distinct vestibular symptoms. In children, EVA can remain either unidentified or misdiagnosed until the vestibular symptoms are evident. Motor developmental delay, especially the ones involving a change of body alignment, has been reported in the pediatric population with EVA. So, it should be made mandatory to recommend radiological evaluation in young children with fluctuating hearing loss reporting with motor developmental delay. This single case study of a baby with Enlarged Vestibular Aqueduct (EVA) primarily aimed to address the following: a) Challenges while diagnosing young patients with EVA and fluctuating hearing loss, b) Importance of radiological evaluation in audiological diagnosis in the pediatric population, c) Need for regular monitoring of hearing, hearing aid performance, and cochlear implant mapping closely for potential fluctuations in such populations, d) Importance of reviewing developmental, language milestones in very young children with fluctuating hearing loss.

Keywords: enlarged vestibular aqueduct (EVA), motor delay, radiological evaluation, fluctuating hearing loss, cochlear implant

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Authors: M. Benlebna, B. Serier, B. Bachir Bouiadjra, S. Khalkhal

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This study focuses on the mechanical behavior of a dental prosthesis subjected to dynamic loads chewing. It covers a three-dimensional analysis by the finite element method, the level of distribution of equivalent stresses induced in the bone between the implants (depending on the number of implants). The studied structure, consisting of a braced, implant and mandibular bone is subjected to dynamic loading of variable amplitude in three directions corrono-apical, mesial-distal and bucco-lingual. These efforts simulate those of mastication. We show that compared to the implantation of a single implant, implantology using two implants promotes the weakening of the bones. This weakness is all the more likely that the implants are located in close proximity to one another.

Keywords: stress, bone, dental implant, distribution, stress levels, dynamic, effort, interaction, prosthesis

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Authors: Naira Ghambaryan, Gagik Hakobyan

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Purpose:The study was to evaluate the survival rate of short implants (5-6 mm) functionalized with UV radiation placed in the posterior segments of the atrophied maxilla. Materials and Methods:The study included 47 patients with unilateral/bilateral missing teeth and vertical atrophy of the posterior maxillary area. A total of 64 short UV-functionalized implants and 62 standard implants over 10 mm in length were placed in patients. The clinical indices included the following parameters: ISQБ MBL, OHIP-G scale. Results: For short implants, the median ISQ at placement was 62.2 for primary stability, and the median ISQ at 5 months was 69.6 ISQ. For standart implant, the mean ISQ at placement was 64.3 ISQ, and ISQ after 5 months was 71.6 ISQ. Аfter 6 months mean MBL short implants 0.87 mm, after 1 year, 1.13 mm, after 5 year was 1.48 mm. Аfter 6 months, mean MBL standard implants 0.84 mm, after 1 year, 1.24 mm, after 5 year was 1.58 mm. Mean OHIP-G scores -patients satisfaction with the implant at 4.8 ± 0.3, satisfaction with the operation 4.6 ± 0.4; satisfaction with prosthetics 4.7 ± 0.5. Cumulative 5-year short implants rates was 96.7%, standard implants was 97.4%, and prosthesis cumulative survival rate was 97.2%. Conclusions: Short implants with ultraviolet functionalization for prosthetic rehabilitation of the posterior resorbed maxilla region is a reliable, reasonable alternative to sinus lift, demonstrating fewer complications, satisfactory survival of a 5-year follow-up period, and reducing the number of additional surgical interventions and postoperative complications.

Keywords: short implant, ultraviolet functionalization, atrophic posterior maxilla, prosthodontic rehabilitation

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Authors: Karima Chergui, Hichem Amrani, Hammoudi Mazouz, Fatiha Mezaache

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Cemented femoral resurfacings have experienced a revival for younger and more active patients. Future developments have shown that the uncemented version eliminates failures related to cementing implants. A three-dimensional finite element method (FEM) simulation was carried out in order to exploit a new resurfacing prothesis design named MARMEL, proposed by a recent study with Co–Cr–Mo material, for comparing a hip uncemented resurfacing with a novel carbon fiber/polyamide 12 (CF/PA12) composite to other hip resurfacing implants with various bio materials. From FE analysis, the von Mises stress range for the Composite hip resurfacing was much lower than that in the other hip resurfacing implants used in this comparison. These outcomes showed that the biomimetic hip resurfacing had the potential to reduce stress shielding and prevent from bone fracture compared to conventional hip resurfacing implants.

Keywords: biomechanics, carbon–fibre polyamide 12, finite element analysis, hip resurfacing

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Authors: Betsy S. Thomas, Manjeet Marpara, K. M. Bhat

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Introduction: After the initial enthusiasm and interest in hydroxyapatite products subsided due to dissolution of the coating and failure at the coating interface, this was a unique attempt to create a next generation of dental implant. Materials and Methods: The adhesion property of AW and HA coatings at various temperature by pulsed laser deposition was assessed on titanium plates. Moreover, AW/HA coated implants implanted in the femur of the rabbits was evaluated at various intervals. Results: Decohesion load was more for AW in scratch test and more bone formation around AW coated implants on histological evaluation. Discussion: AW coating by pulsed laser deposition was more adherent to the titanium surface and led to faster bone formation than HA. Conclusion: This experiment opined that AW coated by pulsed laser deposition seems to be a promising method in achieving bioactive coatings on titanium implants.

Keywords: surface coating, dental implants, osseo integration, biotechnology

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Authors: Akbar Darouie, Mamak Joulaie

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In regard of phonological skills development importance and its influence on other aspects of language, this study has been performed. Determination of some phonological indexes in children with hearing impairment and comparison with hearing children was the objective. A sample of convenience was selected from a rehabilitation center and a kindergarten in Karaj, Iran. Participants consisted of 12 hearing impaired and 12 hearing children (age range: 5 years and 6 months to 6 years and 6 months old). Hearing impaired children suffered from severe to profound hearing loss while three of them were cochlear implanted and the others were wearing hearing aids. Conversational speech of these children was recorded and 50 first utterances were selected to analyze. Percentage of consonant correct (PCC) and vowel correct (PVC), initial and final consonant omission error, cluster consonant omission error and syllabic structure variety were compared in two groups. Data were analyzed with t test (version 16th SPSS). Comparison between PCC and PVC averages in two groups showed a significant difference (P< 0/01). There was a significant difference about final consonant emission error (P<0/001) and initial consonant emission error (P<0/01) too. Also, the differences between two groups on cluster consonant omission were significant (P<0/001). Therefore, some changes were seen in syllabic structures in children with hearing impairment compared to typical group. This study demonstrates some phonological differences in Farsi language between two groups of children. Therefore, it seems, in clinical practices we must notice this issue.

Keywords: hearing impairment, phonology, vowel, consonant

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Authors: Dr., Suchita Daokar

Abstract:

Background: Successful orthodontic treatment has always relied on anchorage. The stability of the implants depends on bone quantity, mini-implant design, and placement conditions. Out of the various methods of gaining stability, Platelet concentrations are gaining popularity for various reasons. PRF is a minimally invasive method, and there are various studies that has shown its role in enhancing the stability of general implants. However, there is no literature found regarding the effect of PRF in enhancing the stability of the orthodontic implant. Therefore, this study aimed to evaluate and assess the efficacy of PRF on the stability of the orthodontic implant. Methods: The study comprised of 9 subjects aged above 18 years of age. The split mouth technique was used; Group A (where implants were coated before insertion) and group B (implant were normally inserted). The stability of the implant was measured using resonance frequency analysis at insertion (T0), 24 hours (T1), 2 weeks (T2), at 4 weeks (T3), at 6 weeks (T4), and 8 weeks (T5) after insertion. Result: Statistically significant findings were found when group A was compared to group B using ANOVA test (p<0.05). The stability of the implant of group A at each time interval was greater than group B. The implant stability was high at T0 and reduces at T2, and increasing through T3 to T5. The stability was highest at T5. Conclusion: A chairside, minimally invasive procedure ofPRF coating on implants have shown promising results in improving the stability of orthodontic implants and providing scope for future studies.

Keywords: Orthodontic implants, stablity, resonance Frequency Analysis, pre

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Authors: R. Janyaphadungpong, A. Pimkhaokham

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This prospective clinical study determined the insertion torque (IT) value and monitored the changes in implant stability quotient (ISQ) values during the 12 weeks healing period from implant placement without bone graft (control group) and with bone graft using the guided bone regeneration (GBR) technique (study group). The relationship between the IT and ISQ values of the implants was also assessed. The control and study groups each consisted of 6 patients with 8 implants per group. The ASTRA TECH Implant System™ EV 4.2 mm in diameter was placed in the posterior mandibular region. In the control group, implants were placed in bone without bone graft, whereas in the study group implants were placed simultaneously with the GBR technique at favorable bone defect. IT (Ncm) of each implant was recorded when fully inserted. ISQ values were obtained from the Osstell® ISQ at the time of implant placement, and at 2, 4, 8, and 12 weeks. No difference in IT was found between groups (P = 0.320). The ISQ values in the control group were significantly higher than in the study group at the time of implant placement and at 4 weeks. There was no significant association between IT and ISQ values either at baseline or after the 12 weeks. At 12 weeks of healing, the control and study groups displayed different trends. Mean ISQ values for the control group decreased over the first 2 weeks and then started to increase. ISQ value increases were statistically significant at 8 weeks and later, whereas mean ISQ values in the study group decreased over the first 4 weeks and then started to increase, with statistical significance after 12 weeks. At 12 weeks, all implants achieved osseointegration with mean ISQ values over the threshold value (ISQ>70). These results indicated that implants, in which guided bone regeneration technique was performed during implant placement for treating favorable bone defects, were as predictable as implants placed without bone graft. However, loading in implants placed with the GBR technique for correcting favorable bone defects should be performed after 12 weeks of healing to ensure implant stability and osseointegration.

Keywords: dental implant, favorable bone defect, guided bone regeneration technique, implant stability

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Authors: Fathi Kallel, Ahmed Ben Hamida, Christian Berger-Vachon

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In this paper, a Speech Enhancement Algorithm based on Multi-Band Spectral Subtraction (MBSS) principle is evaluated for Bilateral Cochlear Implant (BCI) users. Specifically, dual-channel noise power spectral estimation algorithm using Power Spectral Densities (PSD) and Cross Power Spectral Densities (CPSD) of the observed signals is studied. The enhanced speech signal is obtained using Dual-Channel Multi-Band Spectral Subtraction ‘DC-MBSS’ algorithm. For performance evaluation, objective speech assessment test relying on Perceptual Evaluation of Speech Quality (PESQ) score is performed to fix the optimal number of frequency bands needed in DC-MBSS algorithm. In order to evaluate the speech intelligibility, subjective listening tests are assessed with 3 deafened BCI patients. Experimental results obtained using French Lafon database corrupted by an additive babble noise at different Signal-to-Noise Ratios (SNR) showed that DC-MBSS algorithm improves speech understanding for single and multiple interfering noise sources.

Keywords: speech enhancement, spectral substracion, noise estimation, cochlear impalnt

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Authors: Mai Ashraf Talaat

Abstract:

Objectives: The aim of this review article is to assess the success of dental implants in breast cancer patients receiving bisphosphonate therapy and to evaluate the risk of developing bisphosphonate-related osteonecrosis of the jaw following dental implant surgery. Materials and Methods: A thorough search was conducted, with no time or language restriction, using: PubMed, PubMed Central, Web of Science, and ResearchGate electronic databases. Medical Subject Headings (MeSH) terms such as “bisphosphonate”, “dental implant”, “bisphosphonate-related osteonecrosis of the jaw (BRONJ)”, “osteonecrosis”, “breast cancer, MRONJ”, and their related entry terms were used. Eligibility criteria included studies and clinical trials that evaluated the impact of bisphosphonates on dental implants. Conclusion: Breast cancer patients undergoing bisphosphonate therapy may receive dental implants. However, the risk of developing BRONJ and implant failure is high. Risk factors such as the type of BP received, the route of administration, and the length of treatment prior to surgery should be considered. More randomized controlled trials with long-term follow-ups are needed to draw more evidence-based conclusions.

Keywords: dental implants, breast cancer, bisphosphonates, osteonecrosis, bisphosphonate-related osteonecrosis of the jaw

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Authors: L. Parisi

Abstract:

In this research work, neural networks were applied to classify two types of hip joint implants based on the relative hip joint implant side speed and three components of each ground reaction force. The condition of walking gait at normal velocity was used and carried out with each of the two hip joint implants assessed. Ground reaction forces’ kinetic temporal changes were considered in the first approach followed but discarded in the second one. Ground reaction force components were obtained from eighteen patients under such gait condition, half of which had a hip implant type I-II, whilst the other half had the hip implant, defined as type III by Orthoload®. After pre-processing raw gait kinetic data and selecting the time frames needed for the analysis, the ground reaction force components were used to train a MLP neural network, which learnt to distinguish the two hip joint implants in the abovementioned condition. Further to training, unknown hip implant side and ground reaction force components were presented to the neural networks, which assigned those features into the right class with a reasonably high accuracy for the hip implant type I-II and the type III. The results suggest that neural networks could be successfully applied in the performance assessment of hip joint implants.

Keywords: kinemic gait data, neural networks, hip joint implant, hip arthroplasty, rehabilitation engineering

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Authors: Kang Shuo-Shuo, Li Jian-Nan, Yang Shiming

Abstract:

Purpose: The three-dimensional anatomical structure of the facial nerve recess and its relationship were measured by high-resolution temporal bone CT to provide imaging reference for cochlear implant operation. Materials and Methods: By analyzing the high-resolution CT of 160 cases (320 pleural ears) of the temporal bone, the following parameters were measured at the axial window niche level: 1. The distance between the facial nerve and chordae tympani nerve d1; 2. Distance between the facial nerve and circular window niche d2; 3. The relative Angle between the facial nerve and the circular window niche a; 4. Distance between the middle point of the face recess and the circular window niche d3; 5. The relative angle between the middle point of the face recess and the circular window niche b. Factors that might influence the anatomy of the facial recess were recorded, including the patient's sex, age, and anatomical variation (e.g., vestibular duct dilation, mastoid gas type, mothoid sinus advancement, jugular bulbar elevation, etc.), and the correlation between these factors and the measured facial recess parameters was analyzed. Result: The mean value of face-drum distance d1 is (3.92 ± 0.26) mm, the mean value of face-niche distance d2 is (5.95 ± 0.62) mm, the mean value of face-niche Angle a is (94.61 ± 9.04) °, and the mean value of fossa - niche distance d3 is (6.46 ± 0.63) mm. The average fossa-niche Angle b was (113.47 ± 7.83) °. Gender, age, and anterior sigmoid sinus were the three factors affecting the width of the opposite recess d1, the Angle of the opposite nerve relative to the circular window niche a, and the Angle of the facial recess relative to the circular window niche b. Conclusion: High-resolution temporal bone CT before cochlear implantation can show the important anatomical relationship of the facial nerve recess, and the measurement results have clinical reference value for the operation of cochlear implantation.

Keywords: cochlear implantation, recess of facial nerve, temporal bone CT, three-dimensional measurement

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