Twenty years of experience in revision cochlear implant surgery: signs that indicate the need for revision surgery to audiologists.

OBJECTIVE: To report device failures, audiological signs and other reasons for revision cochlear implant surgery, and discuss indications for revision surgery. METHODS: Revision procedures between November 1997 and August 2017 were retrospectively analysed. Over 20 years, 2181 cochlear implant operations were performed, and 114 patients underwent 127 revision operations. RESULTS: The revision rate was 4.67 per cent. The full insertion rate for revision cochlear implant surgery was 88.2 per cent. The most frequent reasons for revision surgery were: device failure (59 per cent), wound breakdown (9.4 per cent) and electrode malposition (8.7 per cent). The device failure rate was: 2.78 per cent for Advanced Bionics, 1.82 per cent for Cochlear and 5.25 per cent for Med-El systems. The number of active electrodes was significantly increased only for Med-El devices after revision surgery. The most common complaints among 61 patients were: gradually decreased auditory performance, sudden internal device shutdown and headaches. CONCLUSION: The most common reason for revision surgery was device failure. Patients should be evaluated for device failure in cases of: no hearing despite appropriate follow up, side effects such as facial nerve stimulation, and rejection of speech processor use in paediatrics. After revision surgery, most patients have successful outcomes.

Relationship between aided cortical auditory evoked responses and aided behavioral thresholds.

OBJECTIVES: The present study aimed to determine the relationship between aided cortical auditory evoked potentials and aided behavioral thresholds. Secondary aims of the study were to investigate the relationship between age and Cortical Auditory Evoked Potentials latencies, and to analyze the relationship between the /m/, /g/ and /t/ stimuli. METHOD: Therefore, 20 subjects (4-8 years old) who diagnosed with moderate to severe hearing loss were included in the study. Behavioral pure-tone audiometry was performed using supra-aural earphones. After verification of the settings of hearing aid settings, aided behavioral thresholds were determined in the free field. Aided CAEPs were recorded using the HEARLab system in a sound-treated room. The /m/, /g/, and /t/ speech stimuli were applied with durations of 30, 20, and 30 ms respectively. RESULTS: A strong correlation was found between aided cortical auditory evoked responses at the level of 55 dB SPL and aided behavioral thresholds in the free field(r=0.86). We showed that the CAEP latencies were not correlated with the age (/m/ stimulus [r=-0.051; p=0.830], /g/ stimulus [r=-0.053; p=0.825], and /t/ stimulus [r=0.121; p=0,610]). The mean latency of the /m/ stimulus at 55 dB SPL intensity was longer than those of the /g/ and /t/ stimuli. CONCLUSION: The results of the present study demonstrated that the use of the cortical auditory evoked potentials is clinically useful for measuring the hearing aid benefit. The CAEP can predict the aided behavioral thresholds in children with moderate hearing loss.

Grain-Boundary Engineering for Aging and Slow-Crack-Growth Resistant Zirconia.

Ceramic materials are prone to slow crack growth, resulting in strength degradation over time. Although yttria-stabilized zirconia (Y-TZP) ceramics have higher crack resistance than other dental ceramics, their aging susceptibility threatens their long-term performance in aqueous environments such as the oral cavity. Unfortunately, increasing the aging resistance of Y-TZP ceramics normally reduces their crack resistance. Our recently conducted systematic study of doping 3Y-TZP with various trivalent cations revealed that lanthanum oxide (La2O3) and aluminum oxide (Al2O3) have the most potent effect to retard the aging kinetics of 3Y-TZP. In this study, the crack-propagation behavior of La2O3 and Al2O3 co-doped 3Y-TZP ceramics was investigated by double-torsion methods. The grain boundaries were examined using scanning transmission electron microscopy and energy-dispersive spectroscopy (STEM-EDS). Correlating these analytic data with hydrothermal aging studies using different doping systems, a strategy to strongly bind the segregated dopant cations with the oxygen vacancies at the zirconia-grain boundary was found to improve effectively the aging resistance of Y-TZP ceramics without affecting the resistance to crack propagation.

{110}-Layered B-cation ordering in the anion-deficient perovskite Pb2.4Ba2.6Fe2Sc2TiO13 with the crystallographic shear structure.

A novel anion-deficient perovskite-based compound, Pb(2.4)Ba(2.6)Fe(2)Sc(2)TiO(13), was synthesized via the citrate-based route. This compound is an n = 5 member of the AnBnO(3n-2) homologous series with unit-cell parameters related to the perovskite subcell a(p)≈ 4.0 Å as a(p)√2 ×a(p)× 5a(p)√2. The crystal structure of Pb(2.4)Ba(2.6)Fe(2)Sc(2)TiO(13) consists of quasi-2D perovskite blocks with a thickness of three octahedral layers separated by the 1/2[110](1[combining macron]01)(p) crystallographic shear (CS) planes, which are parallel to the {110} plane of the perovskite subcell. The CS planes transform the corner-sharing octahedra into chains of edge-sharing distorted tetragonal pyramids. Using a combination of neutron powder diffraction, (57)Fe Mössbauer spectroscopy and atomic resolution electron energy-loss spectroscopy we demonstrate that the B-cations in Pb(2.4)Ba(2.6)Fe(2)Sc(2)TiO(13) are ordered along the {110} perovskite layers with Fe(3+) in distorted tetragonal pyramids along the CS planes, Ti(4+) preferentially in the central octahedra of the perovskite blocks and Sc(3+) in the outer octahedra of the perovskite blocks. Magnetic susceptibility and Mössbauer spectroscopy indicate a broadened magnetic transition around T(N)∼ 45 K and the onset of local magnetic fields at low temperatures. The magnetic order is probably reminiscent of that in other AnBnO(3n-2) homologues, where G-type AFM order within the perovskite blocks has been observed.

Structural and magnetic phase transitions in the A(n)B(n)O(3n-2) anion-deficient perovskites Pb2Ba2BiFe5O13 and Pb(1.5)Ba(2.5)Bi2Fe6O16.

Novel anion-deficient perovskite-based ferrites Pb2Ba2BiFe5O13 and Pb(1.5)Ba(2.5)Bi2Fe6O16 were synthesized by solid-state reaction in air. Pb2Ba2BiFe5O13 and Pb(1.5)Ba(2.5)Bi2Fe6O16 belong to the perovskite-based A(n)B(n)O(3n-2) homologous series with n = 5 and 6, respectively, with a unit cell related to the perovskite subcell a(p) as a(p)√2 × a(p) × na(p)√2. Their structures are derived from the perovskite one by slicing it with 1/2[110]p(101)p crystallographic shear (CS) planes. The CS operation results in (101)p-shaped perovskite blocks with a thickness of (n - 2) FeO6 octahedra connected to each other through double chains of edge-sharing FeO5 distorted tetragonal pyramids which can adopt two distinct mirror-related configurations. Ordering of chains with a different configuration provides an extra level of structure complexity. Above T ≈ 750 K for Pb2Ba2BiFe5O13 and T ≈ 400 K for Pb(1.5)Ba(2.5)Bi2Fe6O16 the chains have a disordered arrangement. On cooling, a second-order structural phase transition to the ordered state occurs in both compounds. Symmetry changes upon phase transition are analyzed using a combination of superspace crystallography and group theory approach. Correlations between the chain ordering pattern and octahedral tilting in the perovskite blocks are discussed. Pb2Ba2BiFe5O13 and Pb(1.5)Ba(2.5)Bi2Fe6O16 undergo a transition into an antiferromagnetically (AFM) ordered state, which is characterized by a G-type AFM ordering of the Fe magnetic moments within the perovskite blocks. The AFM perovskite blocks are stacked along the CS planes producing alternating FM and AFM-aligned Fe-Fe pairs. In spite of the apparent frustration of the magnetic coupling between the perovskite blocks, all n = 4, 5, 6 A(n)Fe(n)O(3n-2) (A = Pb, Bi, Ba) feature robust antiferromagnetism with similar Néel temperatures of 623-632 K.