MED-EL Elektromedizinische Geräte GmbH

The aim of this systematic review was to determine the rates of scalar dislocation (SD) after cochlear implant surgery with two types of electrode arrays (lateral wall, LW, and pre-formed, PF) from three manufacturers.

Literature databases were systematically searched for relevant articles covering three time periods between August 2014 and December 2023. Retrieved articles were evaluated for inclusion in further analysis. We performed a quantitative synthesis to estimate the overall rates of SD with each array type and manufacturer, and to test if these differences were significant.

66 publications covering 4,729 implantations were used for the systematic review. These implantations included 1,782 LW arrays and 2,737 PF arrays. The breakdown according to manufacturer was 903 arrays from MED-EL, 2,527 from Manufacturer A, 850 from Manufacturer B, and 449 where the manufacturer was unspecified. SD occurred in 923 cases overall (19.5%). The SD rates by array type were 8.1% for LW arrays and 25.0% for PF arrays. The SD rates by manufacturer were 6.4% for MED-EL arrays, 23.2% for Manufacturer A arrays, and 21.3% for Manufacturer B arrays. The SD rate was significantly lower for MED-EL LW arrays compared to Manufacturer A LW arrays (p = 0.001). Within manufacturers, the SD rate was significantly lower for LW arrays compared to PF arrays for both Manufacturer A and Manufacturer B devices (both p < 0.001).

Rates of SD vary by array type and manufacturer. LW arrays had the lowest rate. By manufacturer, MED-EL arrays had the lowest rate.

The Quality of Life in People with Hearing Loss Questionnaire (HL-QoL) measures quality of life (QoL) in individuals with hearing loss. The German version of the HL-QoL was validated in cochlear implant (CI) users.

Validation of the English version of the HL-QoL.

The HL-QoL was forward-backward translated. 97 participants were included in the HL-QoL validation. Item and scale analyses assessed the quality of individual items and of the questionnaire in its entirety.

Questionnaire validation results confirmed item difficulty and item discrimination, good test reliability and construct and discriminant validity. The mean total HL-QoL score was 103 points, which indicates a 'high' quality of life. 94% of participants reported at least a 'moderate' quality of life benefit. Participants tended to have a higher QoL when their hearing loss was fully addressed, i.e. biltaral CI users with bilateral hearing loss. QoL did not correlate with age, duration of CI use, sex, or gender.

The English version of the HL-QoL is a valid tool to assess how hearing loss and its treatment can impact an individual's quality of life. The mean total HL-QoL score suggests an overall high QoL benefit in this sample of CI users.

To compare Anatomy-Based Fitting (ABF) vs. Default Fitting (DF) in terms of music perception and music enjoyment in CI users.

CI users ≥ 18 years implanted with a Synchrony ST Flex28 (MEDEL) with at least 12 months of experience with either ABF or DF, with good speech tests outcomes (≥ 65% disyllables) were enrolled. Music tasks were assessed with "Discovery" level of Meludia online interactive music tool, which includes Rhythm (beat count), Spatialization (differentiating between lower and higher notes), Stable/unstable (perception of stability or instability), Melody (ascendant or descendant), and Density (presence of one or multiple simultaneous sounds). Each task consists of five levels of difficulty. Participants were allowed a maximum of 4 attempts to complete a level. The Music-Related Quality of Life (MuRQoL) and the Munich Music (MUMU) questionnaires evaluated music background.

Twenty CI users took part: 10 using ABF and 10 DF. There were no significant differences in age at implantation (53.2 ± 15.0 vs. 53.8 ± 14.5y), time since surgery (1.8 ± 0.5 vs. 2.4 ± 1.5y), or the percentage of disyllables in silence (68.0 ± 8.0 vs. 77.3 ± 11.5%) between groups. Regarding Meludia scores, differences were observed between both groups in Density: ABF had better mean scores when completing the level in only one attempt (8.7 ± 2.5 vs. 4.6 ± 3.1, p = 0.016) and required fewer restarts to complete the five levels (6.6 ± 1.6 vs. 9.3 ± 2.3; p = 0.009). Furthermore, the fifth level of Density was successfully completed by 60% of patients with ABF, while none of the patients with DF achieved this (p = 0.003). The scores obtained in MuRQoL were similar between ABF and DF groups. In a similar way, the MUMU showed no differences in terms of frequency and music importance.

ABF demonstrates specific advantages in certain musical tasks, specifically in processing multiple sounds simultaneously. Further studies are necessary to explore additional benefits of ABF in musical skills in CI users. NCT05319678.

Level 3.