Bimodal benefits in Mandarin-speaking cochlear implant users with contralateral residual acoustic hearing.

OBJECTIVE: The present study aimed to measure bimodal benefits and probe their underlying mechanisms in Mandarin-speaking cochlear implant (CI) subjects who had contralateral residual acoustic hearing. DESIGN: The subjects recognised words or phonemes from the Mandarin Lexical Neighborhood Test in noise at a 10-dB signal-to-noise ratio (SNR) with acoustic stimulation, electric stimulation or the combined bimodal stimulation. STUDY SAMPLE: Thirteen Mandarin-speaking subjects wore a CI in one ear and had residual acoustic hearing in the contralateral ear. Six of the subjects (5.2-13.0 years) had pre-lingual onset of severe hearing loss, and seven of them (8.6-45.8 years) had post-lingual onset of severe hearing loss. RESULTS: Both groups of subjects produced a significant bimodal benefit in word recognition in noise. Consonants and tones accounted for the bimodal benefit. The bimodal integration efficiency was negatively correlated with the duration of deafness in the implanted ear for vowel recognition but positively correlated with CI or bimodal experience for consonant recognition. CONCLUSIONS: The present results support preservation of residual acoustic hearing, early cochlear implantation and continuous use of bimodal hearing for subjects who have significant residual hearing in the non-implanted ear.

Reduced acoustic and electric integration in concurrent-vowel recognition.

The present study used concurrent-vowel recognition to measure integration efficiency of combined acoustic and electric stimulation in eight actual cochlear-implant subjects who had normal or residual low-frequency acoustic hearing contralaterally. Although these subjects could recognize single vowels (>90% correct) with either electric or combined stimulation, their performance degraded significantly in concurrent-vowel recognition. Compared with previous simulation results using normal-hearing subjects, the present subjects produced similar performance with acoustic or electric stimulation alone, but significantly lower performance with combined stimulation. A probabilistic model found reduced integration efficiency between acoustic and electric stimulation in the present subjects. The integration efficiency was negatively correlated with residual acoustic hearing in the non-implanted ear and duration of deafness in the implanted ear. The present result suggests a central origin of the integration deficit and that this integration be evaluated and considered in future management of hearing impairment and design of auditory prostheses.

Cellulitis-like cutaneous metastasis of uterine cervical carcinoma.

Metastasis to the skin from cervical carcinoma is relatively uncommon. Herein we present a 41-year-old woman with a history of cervical carcinoma with severe facial erythematous swelling and telangiectasia. She was initially treated for cellulitis without improvement. A skin biopsy specimen revealed widespread intravascular tumor emboli in the dermis and subcutis, resembling the so-called inflammatory carcinoma of the breast. As this is an unusual clinical presentation for the metastasis of cervical carcinoma, this case is reported.