Hearing Rehabilitation Flashcards
What assists in electrical stimulation by CI?
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.
In the cochlea, high pitches are delivered to the ___ region, and low pitches are delivered to the ___ region.
In the cochlea, high pitches are delivered to the basal region, and low pitches are delivered to the apical region.
In CI, the tonotopic organization of the cochlea is emulated by:
—> 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).
50% of all nonsyndromic SNHL cases are due to a mutation in a single gene that encodes ____.
Connexin 26 (Cx26), a gap junction protein on c13.
Preoperative high-resolution ___ scans should be performed on all CI candidates.
CT scan w/o contrast
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
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
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
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
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
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
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 _____
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
When congenital or acquired narrow IACs are identified on preop CT scan, _____ innervation may be lacking, and cochlear implantation is contraindicated.
When congenital or acquired narrow IACs are identified on preop CT scan, primary afferent innervation may be lacking, and cochlear implantation is contraindicated.
A wide vestibular aqueduct is an important preop consideration for CI, b/c it is associated w/an abnormal communication between the ___ and the ___.
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.
A wide vestibular aqueduct (abnormal communication btwn. CSF space and cochlea) is often associated w/a _____.
“Perilymph (CSF) gusher”
(and sealing of the cochleostomy w/pericranium or fascia is important to avoid meningitis following acute suppurative OM).
Hypoplastic cohleae are associated w/shorter length and can have _____, despite IAC.
small or absent cochlear nerves
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
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
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
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
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
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
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
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
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) _____
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
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.
60 dB sound-pressure level
Auditory-only sentence lists, called _____, evaluate a patient’s ability to understand sentence material in quiet or in the presence of background noise.
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.
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.
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.
When sentences are presented in noise during a HINT, the signal-to-noise ratio used is ____.
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).
CI patients demonstrate improvement in the ___ frequency range.
High frequency.
Speech Recognition Threshold (SRT) specifies:
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)
Speech Detection Threshold (SDT) specifies:
- 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.
The Word Recognition Score is the:
of words correctly repeated,
expressed as a % of Correct (discrimination score) or Incorrect (discrimination loss).
Word-recognition score should range between ___ and ___ in the ear to be implanted.
10% and 60%.
Referral criteria for CI evaluation:
1) _____
2) unaided word discrimination <70%
3) patient frustration w/HAs
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
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
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
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) _____
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
__ and __ are the major factors known to contribute to CI outcomes
Age and Duration of Deafness are the major factors known to contribute to CI outcomesAge and Duration of deafness.
CI in patients with advanced otosclerosis is a surgical option, however patients are at increaced risk for aberrant ___.
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).
