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Cochlear implants provide a treatment option for adults with severe to profound sensorineural hearing loss (SNHL). However, their long-term impact on mental health were understudied. This study explored the long-term effect of cochlear implants on the incidence of psychiatric disorders in adults with bilateral severe to profound SNHL, and examined the subgroup differences in these outcomes. Data for this cohort study were analyzed on January 12, 2024, from the TriNetX electronic records database. Adults with bilateral severe to profound SNHL who received a cochlear implant were compared with matched peers who did not. The primary outcome was the combined incidence of anxiety, depression, and insomnia, within one to three-years after baseline. Each psychiatric disorder was examined separately as a secondary outcome. This study included 8,964 adults in each group. The cochlear implant group demonstrated a significant lower risk of psychiatric disorders compared to the non-implanted group. Reductions were also observed for depression, insomnia, and anxiety, with effects consistent across the follow-up period and subgroups. Cochlear implantation was associated with a lower long-term incidence of psychiatric disorders among adults with bilateral severe to profound SNHL.

To explore how families support and adapt to their child's language development following cochlear implantation in Saudi Arabia. Although international research has explored these factors, fewer qualitative studies have examined how family dynamics, parental self-efficacy, and perceptions of professional services intersect in shaping parents' interpretations of their children's linguistic outcomes in the Saudi context. Eighteen parents (10 mothers and 8 fathers) of children with cochlear implants aged 2-12 years in Riyadh participated in semi-structured Arabic interviews. The parents' ages ranged from 27 to 45 years, and their educational backgrounds varied from high school to postgraduate degrees. Transcripts were analyzed thematically following Braun and Clarke's six-phase framework. Four themes emerged family support and engagement, parental self-efficacy and language strategies, perceptions of professional services, and early intervention. Parents emphasized consistent home practice, sibling involvement, and culturally appropriate communication routines but reported challenges related to limited access and coordination of services. Findings highlight the need for family-centered, culturally responsive rehabilitation programs that strengthen parental confidence and ensure timely intervention to optimize language outcomes for children with cochlear implants.

To identify barriers that audiologists face in adopting telemedicine in adult cochlear implant care, and to determine what is needed to overcome these barriers. Prospective mixed-methods anonymous online survey of cochlear implant audiologists working with adults in the United Kingdom. Thirty-one complete responses were received in August - September 2024. Eighty-seven percent (27) had used remote care tools in their care of adults with cochlear implants. Twenty-nine percent (9) had never used remote care tools or used them rarely; no respondents used them daily. Sixty-eight percent of respondents reported frequent technical issues with remote care tools. Respondents were split equally when asked if remote care is less effective than in-person care, but 81% felt that the gold standard of clinical care is in-person care. Barriers to remote care could be overcome by improvements and enhancements to the cochlear implant manufacturers' tools, and easier and fuller integration into patient pathways and systems. The main barriers to audiologists using remote care were frequent technical problems and the perception that the gold standard of clinical care was in-person care. When telemedicine offers a seamless, accessible, person-centred care experience, perceptions about the gold standard of care may change.

This study aims to investigate the language and listening development of children with cochlear implants (CI) in the Gulf Cooperation Council (GCC) region over 24 months. It seeks to identify factors influencing progress and the impact of challenges on CI outcomes, focusing on children without additional disabilities. The project design is explorative, with a descriptive, longitudinal, ambispective analysis conducted across six hospitals in four GCC countries. Qualified speech and language therapists evaluated children diagnosed with prelingual severe to profound bilateral sensorineural hearing loss who received CIs between 2018 and 2024. The Integrated Scales of Development (ISD) assessed progress in six developmental domains at five intervals (T0-T4). Data also included demographics, prior hearing aid use, and parental education. The results indicated significant improvements across all six developmental domains over the 24-month period, with median scores increasing consistently. Statistical analysis revealed a strong linear trend in development (P = 0.000). Children who received CIs earlier showed better outcomes, whereas prior hearing aid use did not significantly affect results. Parental education levels had no impact on developmental outcomes. The study underscores the importance of early cochlear implantation and ongoing auditory-focused intervention for enhancing listening and spoken language skills in children with CIs in the GCC. Despite significant progress, children did not fully match their hearing peers within the 24-month timeframe, suggesting the need for extended support.

To investigate the safety of magnetic resonance imaging (MRI) of cochlear implants under nonimplanted external conditions and to evaluate the potential effects of the MRI environment on their functionality. Twelve qualified volunteers were recruited for the study, and the CS-30A cochlear implant, manufactured by Zhejiang Nurotron Biotechnology Co., Ltd., was securely positioned at the standard surgical implantation site on the head using a silicone swim cap. The implant site was marked to facilitate precise displacement measurements. MRI scans were performed under static magnetic fields of 1.5 and 3.0 T. Volunteers were systematically surveyed for pain, thermal burns, and electrical sensations. Implant displacement, magnet dislodgement or flipping, and overall device functionality, including measurements of electrode impedance, maximum stimulation amplitude, pulse width, and magnet demagnetization, were comprehensively assessed. The volunteers successfully completed MRI examinations under 1.5 and 3.0 T static magnetic fields without experiencing any abnormalities. After the 3.0 T MRI scan, no pain or electrical stimulation was reported, although two volunteers experienced mild warming. Similarly, after the 1.5 T MRI scan, no pain or electrical stimulation occurred, but one volunteer noted mild warming. Pre - and post-scan comparisons showed that the implant was not displaced. Electrode impedance remained within the standard range (1-20 kΩ), averaging 6.87 ± 2.45 kΩ, with no significant group differences (p > 0.05). Evaluations of implant functionality and magnet performance across monopolar 1, monopolar 2, monopolar 1 + 2 (MP1 + 2), and common ground parameters revealed no significant alterations before and after the scans (p > 0.05). This study provides important evidence supporting the clinical safety of cochlear implants under MRI conditions, ensuring their compatibility and functionality for patients requiring MRI scans. In non-implanted volunteers with the CS-30A externally affixed at the anatomical site, MRI at both 1.5 and 3.0 T produced no reports of pain, electrical-like sensations, or thermal burns. Pre- and post-scan position assessments confirmed the absence of displacement, and comprehensive functional and magnet performance testing demonstrated stable operation throughout. These device-specific findings, obtained under the tested MRI parameters, provide preliminary but important evidence supporting the compatibility of the CS-30A with MRI.

Cochlear implant (CI) pathways are well established in the general population, but data on pediatric and young adult cancer survivors are limited. This study evaluated the feasibility and safety of cochlear implantation in this population, described demographic and clinical characteristics, examined timelines to hearing rehabilitation, and reported short-term outcomes and complications. Retrospective case-control study on patients aged 0-22 years with cancer-related hearing loss and matched peers who underwent CI between December 2010 and January 2023. Eight oncologic patients and 20 controls (37 implantations) were analyzed. All had bilateral progressive hearing loss. Except for three oncologic patients, all used bilateral hearing aids before implantation. The time from meeting candidacy criteria to CI was significantly longer in cases than controls (2.8 vs. 0.5 years; p = 0.004). Although most cases qualified for bilateral implants, only two received them. Five of eight oncologic patients demonstrated excellent CI use with good speech recognition. Pediatric and young adult oncology patients with limited benefit from hearing aids may be good candidates for cochlear implantation. Multidisciplinary care is essential to guide timely, evidence-based implantation in this population. HighlightsCochlear implantation is safe and feasible in pediatric and young adult cancer survivors.This study presents the largest known case series of cochlear implantation in this population, demonstrating that the procedure is both technically safe and clinically beneficial for children and young adults with cancer-related hearing loss. Delayed rehabilitation and inconsistent hearing aid use are common in this populationMany patients experienced long delays, from the onset of hearing loss to cochlear implantation, and showed inconsistent preoperative hearing aid use, which may negatively impact long-term auditory and language outcomes. A multidisciplinary, individualized approach is critical for optimizing outcomesGiven the complexity of cancer treatment effects on the auditory system and developing brain, early and coordinated multidisciplinary care is essential to identify suitable candidates and determine optimal timing for cochlear implantation.

We had two sets of objectives. First, to assess the effects of an online music program on the expressive vocabulary of children with cochlear implants (CIs) and on maternal stress. Second, to explore associations between children's vocabulary, maternal stress, and the quality of children's acoustic environment, measured as daily exposure to speech in quiet. Sixteen children with CIs (M&#x2009;=&#x2009;17.63 months, SD&#x2009;=&#x2009;6.39) and their mothers participated weekly in a 12-week online music program (CI-T), and 16 children with CIs (M&#x2009;=&#x2009;18.46 months, SD&#x2009;=&#x2009;6.02) and their mothers served as controls (CI-C). The program started three months after CI activation. Both groups were assessed at three (T1), six (T2), and twelve (T3) months after CI activation. We collected measures of children's vocabulary (using the MacArthur-Bates Cognitive Development Inventories; MB-CDI), maternal stress (using the Parenting Stress Index; PSI), and children's daily exposure to speech in quiet (from the datalogging of children's devices). Friedman non-parametric tests examined within-group differences in children's vocabulary and in mothers' stress across time points. Spearman correlations (both groups combined) explored associations between changes in vocabulary, maternal stress, and the datalogging at T1, T2, and T3. The CI-T group showed significant vocabulary gains between T1 and T2, and between T2 and T3 [&#x3c7;&#xb2;(2)&#x2009;=&#x2009;20.5, p&#x2009;<&#x2009;.001]. The CI-C group significantly improved only between T2 and T3 [&#x3c7;&#xb2;(2)&#x2009;=&#x2009;19.60, p&#x2009;<&#x2009;.001]. Maternal stress decreased significantly in the CI-T group between T1 and T2 [&#x3c7;&#xb2;(2)&#x2009;=&#x2009;8.22, p&#x2009;=&#x2009;.02], but not in the CI-C group (all ps&#x2009;>&#x2009;.05). In both groups, we found significant associations between increases in children's expressive vocabulary and maternal stress (e.g. between children's vocabulary increases between T1 and T2, and mothers' scores on the 'Parent-Child Dysfunctional Interaction' subscale at T1; r&#x2009;=&#x2009;-.40, p&#x2009;=&#x2009;.03); between increases in children's expressive vocabulary and daily exposure to speech in quiet (e.g. between children's vocabulary increases between T1 and T2 and the datalogging 'Speech' scene at T2; r&#x2009;=&#x2009;.47, p&#x2009;=&#x2009;.03); and between maternal stress and daily exposure to speech in quiet (e.g. between mothers' scores on the 'Parent Distress' subscale at T2 and the datalogging 'Speech' scene at T2; r&#x2009;=&#x2009;-.56, p&#x2009;=&#x2009;.01). Online music-based interventions could benefit children with CIs and their mothers, alongside longer exposure to speech in quiet.

Normally hearing humans can localize sound sources quite accurately, with minimum audible angles as small as 1&#xb0;. To achieve this, these auditory pathways combine information from multiple acoustic cues, including interaural time and interaural level differences (ITDs and ILDs). Patients relying on cochlear implants (CIs) to hear the world do not match normal performance. These deficits are most pronounced in patients with little or no hearing experience early in life, and they appear to result from impaired sensitivity to ITDs, but not to ILDs. However, little is known about how ITD and ILD sensitivities develop and interact in an early deafened auditory system shortly after CI implantation. neonatally deafened rats with bilateral CIs are fitted, and, providing informative ITDs and ILDs from stimulation onset, trained them to lateralize CI stimuli. These animals are exquisitely sensitive to both ILDs and ITDs of CI stimulus pulses, and combined information from both cues in a weighted sum. Importantly, ITDs are weighted heavily in the CI rats, such that only very modest ITDs pointing in one direction can confound quite large ILDs pointing in the opposite direction. This underlines the importance of informative ITDs for maximizing the potential for spatial hearing with CI devices.

Early cochlear implantation during the critical period of neuroplasticity leads to better auditory and language outcomes but presents unique anesthetic challenges in infants. This study retrospectively examined anesthesia-related events throughout the full diagnostic and surgical process over a 10-year period, focusing on pediatic population undervent cochlear implantation - especially under the age of 18 month. Data from 175 children under age 3 were analized who received cochlear implants between 2014 and 2024. Anesthesia-related events during audiological tests (BERA/ASSR), imaging (CT/MRI), and surgery were recorded. Collected variables were demographics, comorbidities, ASA and Mallampati scores, anesthetic techniques, procedure durations, complications, and ICU admissions. A subgroup analysis was conducted for patients implanted before 18 months. Of the 175 patients, 35 (20.2%) received implants before 18 months and 8 (4.6%) before 12 months. Anesthesia-related complications occurred in 14 cases (8.1%) in the study population, with laryngospasm during extubation being the most frequent (n&#x2009;=&#x2009;8); all resolved without reintubation. Difficult intubation was noted in 3 patients, mainly those with craniofacial anomalies. Four children required postoperative ICU care. No complications were observed during diagnostic procedures. No significant association was found between complication rates and age, ASA status, or Mallampati score. Cochlear implantation, even in infants under one year, is safe with appropriate anesthesia and experienced teams. Complications were rare and manageable. Recognizing anesthesia risks helps optimize care and reassure parents, supporting timely intervention within the neuroplastic window.

To present a case series of patients with Chudley - McCullough syndrome (CMS) and provide audiometric outcomes pre - and post - cochlear implantation. A retrospective case series was written based on six patients with CMS and hearing loss. Patients were treated in a tertiary-care medical center for their hearing loss with hearing aid fitting and cochlear implantation. Audiometric outcomes pre- and post-cochlear implantation were analyzed. Three out of six patients were diagnosed with auditory neuropathy spectrum disorder (ANSD), one patient was suspected of ANSD, and in two patients, the presence of ANSD could neither be confirmed nor excluded. All patients were fitted with hearing aids, and all had limited benefit. In most cases, hearing deteriorated rapidly and eventually, all patients received a cochlear implant (CI), unilateral or bilateral. In general, aided thresholds with CIs were satisfactory. However, speech recognition varied widely between patients and was, on average, worse compared to patients with sensorineural hearing loss without CMS. CMS was often diagnosed relatively late during childhood, and sometimes hearing loss was the first apparent symptom. Hearing loss was found to be progressive, often not detected shortly after birth and often complicated by ANSD. Cochlear implantation emerged as the optimal treatment, demonstrating superiority over hearing aid rehabilitation to improve hearing performance. Auditory and speech-language development outcomes remained poorer than in children with CI and without CMS. Based on these results, we advocate considering cochlear implantation early for children who have CMS and hearing loss.

Langerhans cell histiocytosis (LCH) is a rare disorder that may involve the temporal bone and, in rare cases, result in sensorineural hearing loss. This report highlights the importance of close radiological surveillance and timely cochlear implantation in the setting of progressive otic capsule ossification. A 21-year-old male presented with a five-year history of progressive bilateral hearing loss, tinnitus, vertigo and imbalance. Following multidisciplinary team (MDT) discussion, cochlear implantation was deferred until completion of chemotherapy. Repeat CT imaging demonstrated progressive cochlear ossification involving the otic capsules. A repeat discussion followed, which led to an expedited cochlear implantation. The left side was implanted first due to lesser ossification, achieving full electrode insertion. Sequential implantation of the contralateral ear was performed four months later. However, insertion was limited due to advanced ossification. The second implantation was technically more challenging, with only partial electrode insertion possible due to advanced ossification. We advocate for close surveillance in the case of LCH to monitor for signs of otic capsule ossification. This case demonstrates that cochlear ossification in LCH may progress rapidly, narrowing the window for optimal implantation. Early cochlear implantation should be strongly considered in such cases.

Dementia is a major global health problem with increasing prevalence. Hearing loss has been identified as the most modifiable risk factor for dementia. The Age-Related Cognition and Hearing (ARCH) study is a 3-year prospective, controlled, observational comparative cohort study comparing cochlear implants (Implants) and hearing aids (HAs) for reducing cognitive decline associated with age-related hearing loss (ARHL), based on patient-reported real-world outcomes of auditory function, cognitive performance, listening environment, social interaction and psychosocial well-being. Upon its completion in 2029, the ARCH study is expected to yield significant evidence regarding the comparative effects of two primary hearing interventions-Implants and HAs, to delay and ameliorate cognitive decline associated with ARHL. 210 older adults are divided into six study subgroups (N=35) with: (1) moderate to profound hearing loss or age-typical normal hearing, (2) use of Implants or HAs and (3) mild cognitive impairment (MCI) or normal cognition. Listeners in the HA groups have hearing loss that is consistent with Implant candidacy and qualification through Centers for Medicare & Medicaid Services in the USA. The primary study outcome is a 3-year change in real-time patient-reported outcomes collected while participants are in their natural listening environments using ecological momentary assessment (EMA) methodologies. Secondary outcomes include lab-based audiometric and neuropsychological testing, and patient-reported outcomes of social isolation, loneliness, depression, anxiety and quality of life.Cross-sectional analyses will use factor analysis to reduce EMA items into domains, followed by regression and mixed-effects models to test group differences and identify specific EMA items driving those effects. Machine-learning approaches will complement these models by predicting outcomes, identifying key variables and uncovering data-driven patterns. Longitudinal mixed-effects models will assess how EMA factor scores and cognition change over time and whether real-world EMA experiences mediate cognitive trajectories. Additional analyses will compare real-time EMA responses with retrospective patient-reported outcome measures and laboratory-based cognitive and auditory assessments, with sample size adjusted for up to 10% attrition. All study procedures follow institutional review board requirements and the Declaration of Helsinki at the University of Iowa (IRB# 202403385), with informed consent processes tailored to ensure understanding among participants with MCI. Study findings will be disseminated through a multi-tiered strategy aimed at maximising scientific, clinical and public health impact. Peer-reviewed manuscripts will be submitted to leading journals in audiology, geriatrics, cognitive ageing and public health, with interim and final results presented at national and international conferences and professional society meetings.

Cochlear implants (CIs) have made it possible to significantly improve hearing in people with profound hearing loss. Although, cochlear implants are considered a safe procedure, this minimally invasive surgery has an overall complication rate of 12.5%. With Gusher (cerebrospinal fluid outflow) considered a common intraoperative complication of cochlear implants. In this retrospective study, clinical files of patients with severe to profound sensorineural hearing loss who had undergone cochlear implantation were retrospectively reviewed. We calculated the incidence and risk factors of gusher and management options used . Statistical analysis included non-parametric tests and multivariate ordinal logistic regression to explore predictors of CSF leak intensity. 1050 patients with profound hearing loss who underwent CI, 21 of whom had an intraoperative cerebrospinal fluid (CSF) leak, i.e. 2%, with a mean age of 3.5 years, and a sex ratio of 0.62, i.e. 62% female and 38% male. 43% of patients with gusher had structural abnormalities on their CT scan. Dilatation of the vestibule and vestibular aqueduct, as well as Mondini dysplasia, were the most common anomalies in Gusher patients. Younger implantation age was the only factor associated with higher CSF leak intensity in univariate analysis, but no independent predictors were identified in multivariate analysis. Advancements in surgical techniques, radiological assessments, and technological innovation have significantly reduced cochlear implant&#x2013;related complications, leading to a decreased risk of cerebrospinal fluid leakage incidents.

Incomplete Partition type II (IP-II), or Mondini dysplasia, accounts for half of congenital cochlear malformations and results in profound sensorineural hearing loss. Cochlear implantation restores hearing in patients with IP-II however low numbers mean reporting of auditory performance outcomes is limited. Here we review English language articles between 2010 and 2025 reporting hearing outcomes following cochlear implantation in individuals IP-II. Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR) and parental reports of cochlear implantation in 731 individuals, across 20 studies, with a follow-up of 1-3 years, met the inclusion criteria. Findings suggest that auditory perception and speech develop more slowly in people with IP-II compared to controls but there was no difference between groups by 1-2 years post-implantation. Most patients with IP-II have better hearing with a cochlear implant than before. However, there is limited evidence that this is comparable to those with normal middle ear anatomy. Findings were typically derived from questionnaires with small cohorts and short follow-up. Patient counselling for people IP-II should identify that prediction of hearing outcomes is uncertain. Informed prognostication of timing of surgery and hearing outcomes after cochlear implantation in IP-II needs further study with long-term follow-up including surgical and hearing outcome measures.

Background/Objectives: Cochlear implants (CIs) and other implantable hearing devices are crucial to treat hearing loss. The aim of this study was to analyze the temporal trends of implantation for hearing devices in Italy between 2001 and 2023, with stratification by age. Methods: This population-based study explored Hospital Discharge Records and used codes from the International Classification of Diseases, 9th revision-Clinical Modification (ICD9-CM) to identify cochlear and non-cochlear implants. Patients were partitioned into six age classes: <1, 1-2, 3-17, 18-65, 66-80, and >80; and time series for counts and incidence rates (IRs) per 1,000,000 inhabitants with confidence intervals (CI95%) were explored overall and by age class. Trends were assessed by incidence rate ratio and Cox-Stuart test with a significance threshold for p-values at 0.05. Results: 22,850 (83.6%) records for cochlear and 4476 (16.4%) for non-cochlear implants were extracted. Cochlear implants volume shifted from 537 procedures in 2001 to 1595 in 2023 (p < 0.01), while IR increased (p < 0.01) from 9.4 (CI95%: 9.7, 10.3) in 2001 to 27 (CI95%: 25.7, 28.4) in 2023. The volumes of implanted CIs increased in children and adults. Volumes for non-cochlear implants increased between 2001 and 2010, from 62 to 254, and remained stable afterwards. IR shifted from 1.1 (CI95%: 0.8, 1.4) in 2001 to 4.1 (CI95%: 3.6, 4.7) in 2023. Conclusions: Those trends highlight the importance of monitoring efficacy and safety of hearing devices, and the establishment of the Italian Implantable Hearing Device Registry at the Italian National Institute of Health is a first step in such a direction.

Meni&#xe8;re's disease is a&#xa0;chronic inner ear disorder characterized by recurrent vertigo attacks, tinnitus, and fluctuating hearing loss, which may progress to severe sensorineural hearing impairment in a&#xa0;subset of patients. Since 2015, international consensus criteria distinguish between definite and probable disease. Current therapeutic strategies follow a&#xa0;stepwise approach, ranging from non-ablative to ablative interventions. Cochlear implantation (CI) has emerged as an effective option for auditory rehabilitation and has also shown beneficial effects on vertigo and tinnitus. Combined strategies with endolymphatic sac surgery are discussed, while labyrinthectomy with simultaneous CI represents a&#xa0;highly effective yet irreversible intervention. Particular challenges arise in bilateral cases, where radiological endotyping (e.g., hypoplastic vestibular aqueduct type) may improve future treatment planning. Evidence demonstrates that CI is feasible after ablative procedures as well as in unilateral Meni&#xe8;re's disease with hearing preservation, resulting in significant improvements in quality of life. Systematic reviews confirm the safety and efficacy of CI, establishing its central role in the management of advanced disease stages. Early developments of vestibulocochlear implants (VCI) additionally open perspectives for combined auditory and vestibular rehabilitation, although clinical application remains experimental. Der Morbus&#xa0;Meni&#xe8;re ist eine chronische Innenohrerkrankung mit rezidivierenden Schwindelattacken, Tinnitus und H&#xf6;rverlust, die bei einem Teil der Patienten zu hochgradiger Schallempfindungsschwerh&#xf6;rigkeit f&#xfc;hrt. Die Diagnostik erfolgt seit 2015 anhand international konsentierter Kriterien, welche zwischen definitivem und wahrscheinlichem Morbus Meni&#xe8;re unterscheiden. Therapeutisch wird ein stufenweises Vorgehen empfohlen, das von nicht-ablativen bis hin zu ablativen Verfahren reicht. Cochleaimplantate (CI) haben sich als effektive Option zur H&#xf6;rrehabilitation etabliert und zeigen zudem g&#xfc;nstige Effekte auf Schwindel- und Tinnitussymptomatik. Kombinationsstrategien mit Saccuschirurgie werden diskutiert, w&#xe4;hrend die Labyrinthektomie mit simultaner CI-Implantation eine hochwirksame, jedoch irreversible Ma&#xdf;nahme darstellt. Besondere Herausforderungen bestehen bei bilateralen Verl&#xe4;ufen, bei denen radiologische Endotypisierungen (z.&#x202f;B. hypoplastischer Typus des vestibul&#xe4;ren Aqu&#xe4;dukts) k&#xfc;nftig die Therapieplanung pr&#xe4;zisieren k&#xf6;nnten. Studien belegen, dass die CI-Versorgung sowohl nach ablativen Eingriffen als auch bei einseitigem Morbus&#xa0;Meni&#xe8;re mit Erhalt von Restgeh&#xf6;r m&#xf6;glich ist und zu einer signifikanten Verbesserung der Lebensqualit&#xe4;t f&#xfc;hrt. Systematische &#xdc;bersichten best&#xe4;tigen die hohe Wirksamkeit und Sicherheit der CI-Therapie, wodurch sie eine zentrale Rolle in der Versorgung fortgeschrittener Erkrankungsverl&#xe4;ufe einnimmt. Erste Ans&#xe4;tze zur Entwicklung vestibulocochle&#xe4;rer Implantate (VCI) er&#xf6;ffnen zudem die Perspektive einer kombinierten auditiven und vestibul&#xe4;ren Rehabilitation, befinden sich jedoch noch im experimentellen Stadium.

Background: Meniere's Disease (MD) may present as a complication in the hearing outcomes of patients with hearing loss who are treated with either hearing aids or cochlear implants (CI).Objective: This case study aims to highlight the course of treatment for MED as well as being inflicted by MD, which was discovered after transferring care from a private practice to an academic medical center for treatment of internal failure of her left device, as indicated by manufacturer recall.Case Presentation: This patient is a long-time user of bilateral cochlear implants who has experienced multiple fluctuations in performance, most notably in her dominant right CI. Pressure changes in patients with middle ear dysfunction (MED) may impact the programming levels.Results: The patient has shown significant improvement following substantial programming changes in her right CI. She has become more aware of Meniere's attacks and is utilizing available self-adjustment of current parameters. In doing so, she is able to improve her hearing status regardless of the presence of Meniere's attacks through programming changes.

Cochlear implantation among adults remains disproportionately low compared with paediatric populations. This systematic review identified and synthesised the patient-related barriers that limit access to and uptake of cochlear implantation in adults. A systematic search of English-language literature was performed from January 1st, 1990, to November 21st, 2025, using PubMed, MEDLINE, CINAHL, EMBASE and PsycINFO databases. Twenty-eight studies met the inclusion criteria, and findings were synthesised descriptively. This systematic review was registered with PROSPERO (Registration number: CRD42024540401). Ninety-five patient-related barriers were identified and grouped into four overarching themes: (1) uncertainties, fears, and beliefs, (2) knowledge and professional guidance, (3) system and organisational factors, and (4) psychosocial and practical support. Common barriers included fear of surgery and residual hearing loss, limited professional guidance, perceived financial burden, fragmented funding systems, and inadequate psychosocial support. Adult cochlear implantation is limited by multifactorial barriers spanning psychological, informational, systemic, and social domains. Addressing these challenges requires coordinated strategies, including improved CI-specific education for healthcare professionals, clearer communication of funding options, standardised adult hearing screening programs, and integration of telehealth to reduce logistical burdens. Targeted interventions addressing fear, misinformation, and psychosocial support are essential to improve timely access and uptake of cochlear implantation.