Telephone use and understanding in patients with cochlear implants.

We conducted a mail survey ofpatients who had received cochlear implants to ascertain their ability to communicate on the telephone. Of 86 patients who responded, 38 (44%) did not use the telephone at all, 36 (42%) were able to use the telephone without assistance (independent users), and 12 (14%) were able to use the telephone with some type of assistance. Factors associated with independent use were male sex, older age at the onset of hearing loss, longer duration of hearing loss, successful use of hearing aids prior to cochlear implantation, implantation with a MED-EL Combi 40+ device, and a shorter duration of implant use. But regardless of circumstances, our findings suggest that many cochlear implant patients can use the telephone during daily activity without the need for assistive devices or relay services.

Childhood otitis media and electrically elicited stapedius reflexes in adult cochlear implantees.

BACKGROUND: Electric stapedius reflex thresholds are helpful in programming cochlear implants, but only approximately two-thirds of patients have identifiable reflexes. HYPOTHESIS: Childhood otitis media correlates with absent stapedius reflexes or with high electric stimulation needed to elicit a reflex in cochlear implantees. STUDY POPULATION: Twenty-five adults with acquired hearing loss who underwent implantation with the MED-EL COMBI 40+ standard electrode array. STUDY PARAMETERS: The extent of temporal bone pneumatization, an indicator of childhood otitis media, was measured from preoperative computed tomographic images. Clinical units (in microamperes) needed to elicit a contralateral stapedius reflex, or maximum stimulation tried, were recorded. RESULTS: No definite association of pneumatization volume with intensity of stimulation was observed. The null hypothesis of no association cannot be rejected. CONCLUSION: Childhood otitis media does not seem to explain absent electric stapedius reflexes and the wide range of clinical units needed for maximum comfortable loudness level. Remaining potential explanations probably include the wide range of cochlear neurons that can be electrically stimulated, and that the maximum tolerable stimulation is too low to elicit a stapedius reflex.