Hearing Rehabilitation

Question 1

What assists in electrical stimulation by CI?

Answer 1

For the majority of causes of deafness, the auditory hair cells are lost or dysfunctional.

The bipolar spiral ganglion neurons and their primary afferent dendrites remain intact and available for direct stimulation.

Question 2

In the cochlea, high pitches are delivered to the ___ region, and low pitches are delivered to the ___ region.

Answer 2

In the cochlea, high pitches are delivered to the basal region, and low pitches are delivered to the apical region.

Question 3

In CI, the tonotopic organization of the cochlea is emulated by:

Answer 3

—> orienting electrodes toward the modiolus (central axis) w/in the scala tympani and assigning frequencies to specific electrodes, so that electrical stimulation corresponding to highest pitches are delivered to the basal region of the cochlea, and those of lowest pitch to the apical region.

(Electrical impulses bypass dysfunctional hair cells and directly depolarize the primary afferent neurons).

Question 4

50% of all nonsyndromic SNHL cases are due to a mutation in a single gene that encodes ____.

Answer 4

Connexin 26 (Cx26), a gap junction protein on c13.

Question 5

Preoperative high-resolution ___ scans should be performed on all CI candidates.

Answer 5

CT scan w/o contrast

Question 6

On CT scan when evaluating for CI candidacy it is important to look for:
1) intact ____
2) normalcy of the cochlea
3) primary or secondary bone diseases that affect the cochlea
4) presence of a wide vestibular aqueduct

Answer 6

On CT scan when evaluating for CI candidacy it is important to look for:
1) intact IACs
2) normalcy of the cochlea
3) primary or secondary bone diseases that affect the cochlea
4) presence of a wide vestibular aqueduct

Question 7

On CT scan when evaluating for CI candidacy it is important to look for:
1) intact IACs
2) normalcy of the _____
3) primary or secondary bone diseases that affect the cochlea
4) presence of a wide vestibular aqueduct

Answer 7

On CT scan when evaluating for CI candidacy it is important to look for:
1) intact IACs
2) normalcy of the cochlea
3) primary or secondary bone diseases that affect the cochlea
4) presence of a wide vestibular aqueduct

Question 8

On CT scan when evaluating for CI candidacy it is important to look for:
1) intact IACs
2) normalcy of the cochlea
3) primary or secondary ___ diseases that affect the cochlea
4) presence of a wide vestibular aqueduct

Answer 8

On CT scan when evaluating for CI candidacy it is important to look for:
1) intact IACs
2) normalcy of the cochlea
3) primary or secondary bone diseases that affect the cochlea
4) presence of a wide vestibular aqueduct

Question 9

On CT scan when evaluating for CI candidacy it is important to look for:
1) intact IACs
2) normalcy of the cochlea
3) primary or secondary bone diseases that affect the cochlea
4) presence of a _____

Answer 9

On CT scan when evaluating for CI candidacy it is important to look for:
1) intact IACs
2) normalcy of the cochlea
3) primary or secondary bone diseases that affect the cochlea
4) presence of a wide vestibular aqueduct

Question 10

When congenital or acquired narrow IACs are identified on preop CT scan, _____ innervation may be lacking, and cochlear implantation is contraindicated.

Answer 10

When congenital or acquired narrow IACs are identified on preop CT scan, primary afferent innervation may be lacking, and cochlear implantation is contraindicated.

Question 11

A wide vestibular aqueduct is an important preop consideration for CI, b/c it is associated w/an abnormal communication between the ___ and the ___.

Answer 11

A wide vestibular aqueduct is an important preop consideration for CI, b/c it is associated w/an abnormal communication between the CSF space and the cochlea.

Question 12

A wide vestibular aqueduct (abnormal communication btwn. CSF space and cochlea) is often associated w/a _____.

Answer 12

“Perilymph (CSF) gusher”

(and sealing of the cochleostomy w/pericranium or fascia is important to avoid meningitis following acute suppurative OM).

Question 13

Hypoplastic cohleae are associated w/shorter length and can have _____, despite IAC.

Answer 13

small or absent cochlear nerves

Question 14

Guidelines for adult CI implantation:

1) _____
2) trial of HA amplification
3) aided scores on open-set sentence testes of <50%
4) no evidence of central auditory lesions or lack of an auditory n.
5) no contraindications for CI surgery

Answer 14

Guidelines for adult CI implantation:

1) severe or prof HL w/PTA of 60dB or > hearing level
2) trial of HA amplification
3) aided scores on open-set sentence testes of <50%
4) no evidence of central auditory lesions or lack of an auditory n.
5) no contraindications for CI surgery

Question 15

Guidelines for adult CI implantation:

1) severe or prof HL w/PTA of 60dB or > hearing level
2) _____
3) aided scores on open-set sentence testes of <50%
4) no evidence of central auditory lesions or lack of an auditory n.
5) no contraindications for CI surgery

Answer 15

Guidelines for adult CI implantation:

1) severe or prof HL w/PTA of 60dB or > hearing level
2) trial of HA amplification
3) aided scores on open-set sentence testes of <50%
4) no evidence of central auditory lesions or lack of an auditory n.
5) no contraindications for CI surgery

Question 16

Guidelines for adult CI implantation:

1) severe or prof HL w/PTA of 60dB or > hearing level
2) trial of HA amplification
3) _____
4) no evidence of central auditory lesions or lack of an auditory n.
5) no contraindications for CI surgery

Answer 16

Guidelines for adult CI implantation:

1) severe or prof HL w/PTA of 60dB or > hearing level
2) trial of HA amplification
3) aided scores on open-set sentence tests of <50%
4) no evidence of central auditory lesions or lack of an auditory n.
5) no contraindications for CI surgery

Question 17

Guidelines for adult CI implantation:

1) severe or prof HL w/PTA of 60dB or > hearing level
2) trial of HA amplification
3) aided scores on open-set sentence testes of <50%
4) _____
5) no contraindications for CI surgery

Answer 17

Guidelines for adult CI implantation:

1) severe or prof HL w/PTA of 60dB or > hearing level
2) trial of HA amplification
3) aided scores on open-set sentence testes of <50%
4) no evidence of central auditory lesions or lack of an auditory n.
5) no contraindications for CI surgery

Question 18

Guidelines for adult CI implantation:

1) severe or prof HL w/PTA of 60dB or > hearing level
2) trial of HA amplification
3) aided scores on open-set sentence testes of <50%
4) no evidence of central auditory lesions or lack of an auditory n.
5) _____

Answer 18

Guidelines for adult CI implantation:

1) severe or prof HL w/PTA of 60dB or > hearing level
2) trial of HA amplification
3) aided scores on open-set sentence testes of <50%
4) no evidence of central auditory lesions or lack of an auditory n.
5) no contraindications for CI surgery

Question 19

Speech-perception measures are conducted at a presentation level of ___dB SPL and include open-set recorded presentations of words and sentences in quiet, and in noise.

Answer 19

60 dB sound-pressure level

Question 20

Auditory-only sentence lists, called _____, evaluate a patient’s ability to understand sentence material in quiet or in the presence of background noise.

Answer 20

Auditory-only sentence lists, Hearing in Noise Test (HINT), evaluate a patient’s ability to understand sentence material in quiet or in the presence of background noise.

Question 21

Auditory-only sentence lists, Hearing in Noise Test (HINT), evaluate a patient’s ability to understand ___ in quiet or in the presence of background noise.

Answer 21

Auditory-only sentence lists, Hearing in Noise Test (HINT), evaluate a patient’s ability to understand sentence material in quiet or in the presence of background noise.

Question 22

When sentences are presented in noise during a HINT, the signal-to-noise ratio used is ____.

Answer 22

10dB (less of a difference in dB, is consistent with a harder test. So if a patient is doing poorer with an easier test, makes the patient a better candidate for CI).

Question 23

CI patients demonstrate improvement in the ___ frequency range.

Answer 23

High frequency.

Question 24

Speech Recognition Threshold (SRT) specifies:

Answer 24

Speech Recognition Threshold (SRT) specifies:

• the minimal hearing level at which a patient correctly “recognizes” or “identifies” 50% of speech material (often 2-word syllables)

Question 25

Speech Detection Threshold (SDT) specifies:

Answer 25

• the minimal hearing level at which a patient correctly “detects” or “notices the presence of speech material (often 2-word syllables) vs. absence of the speech material, 50% of the time.

Question 26

The Word Recognition Score is the:

Answer 26

of words correctly repeated,

expressed as a % of Correct (discrimination score) or Incorrect (discrimination loss).

Question 27

Word-recognition score should range between ___ and ___ in the ear to be implanted.

Answer 27

10% and 60%.

Question 28

Referral criteria for CI evaluation:

1) _____
2) unaided word discrimination <70%
3) patient frustration w/HAs

Answer 28

Referral criteria for CI evaluation:

1) unaided thresholds of 70 dB HL or poorer at 1000 Hz and above in the better ear
2) unaided word discrimination <70%
3) patient frustration w/HAs

Question 29

Referral criteria for CI evaluation:

1) unaided thresholds of 70 dB HL or poorer at 1000 Hz and above in the better ear
2) _____
3) patient frustration w/HAs

Answer 29

Referral criteria for CI evaluation:

1) unaided thresholds of 70 dB HL or poorer at 1000 Hz and above in the better ear
2) unaided word discrimination <70%
3) patient frustration w/HAs

Question 30

Referral criteria for CI evaluation:

1) unaided thresholds of 70 dB HL or poorer at 1000 Hz and above in the better ear
2) unaided word discrimination <70%
3) _____

Answer 30

Referral criteria for CI evaluation:

1) unaided thresholds of 70 dB HL or poorer at 1000 Hz and above in the better ear
2) unaided word discrimination <70%
3) patient frustration w/HAs

Question 31

__ and __ are the major factors known to contribute to CI outcomes

Answer 31

Age and Duration of Deafness are the major factors known to contribute to CI outcomesAge and Duration of deafness.

Question 32

CI in patients with advanced otosclerosis is a surgical option, however patients are at increaced risk for aberrant ___.

Answer 32

CI in patients with advanced otosclerosis is a seurgical option, however patients are at increaced risk for aberrant facial nerve stimulation.

(increased conductivity in the soft, remodeled bone of early otosclerosis can increase the incidence of FNS, and the use of fluoride can cause maturation of the otosclerosis and reduce FNS).