CI Atlas · Self-assessment
Self-assessment
All 1378 self-assessment questions from across the atlas, grouped by module and tagged by level (Foundation, Trainee, Clinician). Each set scores as you reveal answers; read every rationale, including the incorrect options. For applied vignettes, work the case library; for a measure-by-measure overview, see Compare.
Module 1 · Overview — a 200-year idea
Roughly how long separated Volta's first description of electrical hearing from the first deliberate stimulation of a human auditory nerve?
Which best characterises how the cochlear implant was received as it developed?
Module 2 · Volta & the first electrical hearing
What did Volta's ear experiment fundamentally demonstrate?
Why did roughly 150 years pass before the idea became a device?
Module 3 · Djourno & Eyriès — the 1957 first
What did Djourno and Eyriès achieve in 1957?
Which feature of their device survives in every modern implant?
Module 4 · William House & the single-channel implant
What was the principal limitation of the single-channel implant?
Why is William House's contribution historically pivotal despite the device's limits?
Module 5 · The single- vs multi-channel debate
Why does a multichannel implant outperform a single-channel one for speech?
What largely settled the single- vs multi-channel debate?
Module 6 · The American multichannel pioneers
What did Blair Simmons demonstrate at Stanford in the 1960s?
Which modern manufacturer descends from the UCSF (Michelson & Merzenich) lineage?
Module 7 · Graeme Clark & the Nucleus implant
What did Graeme Clark achieve in 1978?
Why did the Nucleus device become the global template for implantation?
Module 8 · The European devices — Chouard & MED-EL
Which major modern manufacturer grew from the Hochmairs' work in Vienna?
What is true of the French contribution to the cochlear implant?
Module 9 · The speech-coding breakthrough
What problem does continuous interleaved sampling (CIS) primarily address?
Why is CIS considered the most important single advance in implant performance?
Module 10 · FDA approval & the 1988 NIH consensus
Which FDA milestone was most significant for the developing brain?
What role did the NIH consensus statements play?
Module 11 · Widening the indications
Which best describes how cochlear-implant candidacy changed over time?
For a patient with good low-frequency hearing but a steep high-frequency loss, which expansion applies?
Module 12 · The implant goes global
What chiefly distinguishes the newest generation of cochlear-implant manufacturers (China, Korea, India) from the first?
Whose vision drove India's indigenous DRDO/SBMT cochlear implant?
Why is an affordable implant especially important for India specifically?
Module 13 · From milestone to mainstream
Who shared the 2013 Lasker Award for the modern cochlear implant?
What is the cochlear implant's principal unfinished challenge?
Module 1 · Overview — the hearing pathway
Which single feature of normal cochlear physiology is the one a cochlear implant most depends on, and exploits?
Where in the normal hearing chain does a cochlear implant intervene?
Module 2 · Sound & acoustics
On a pure tone, which physical property is the main correlate of pitch?
The decibel scale for sound level is logarithmic. Roughly what does every 20 dB represent?
What are the formants of a vowel?
Module 3 · Outer & middle ear
What is the dominant mechanism by which the middle ear matches the impedance of air to cochlear fluid?
A patient has a pure conductive hearing loss. What does this tell you about the cochlea and auditory nerve?
Which parts of the hearing pathway does a cochlear implant bypass?
Module 4 · Cochlear mechanics & tonotopy
A high-frequency tone produces its largest basilar-membrane vibration where?
Why does tonotopy make cochlear implantation possible even after the hair cells have died?
Why is low-pitch representation often imperfect with a cochlear implant?
Module 5 · Organ of Corti & hair cells
Which hair cells provide the great majority of the auditory nerve's afferent input?
What is the principal role of outer hair cells?
At which step does a cochlear implant substitute for the cochlea?
Module 6 · Mechanoelectrical transduction
What generates the endocochlear potential of about +80 mV?
What physically opens the hair cell's transduction channels?
Why does potassium flow INTO the hair cell through the transduction channel, depolarising it?
Module 7 · The cochlear amplifier
What is prestin?
Why is the basilar-membrane response to sound compressive in a healthy cochlea?
Loudness recruitment — a rapid growth of loudness once a sound becomes audible — is the hallmark of damage to which structure?
Module 8 · Otoacoustic emissions
Otoacoustic emissions are the audible by-product of which structure?
A distortion-product emission appears at 2f₁ − f₂. What does this demonstrate about the cochlea?
An otoacoustic emission is absent. What are the two broad explanations to keep in mind?
Module 9 · The auditory nerve
Which auditory-nerve fibres carry essentially the whole sound signal to the brain?
An auditory-nerve fibre's rate-level function saturates within ~20–40 dB, yet we hear across >100 dB. How does the nerve population span the range?
What is a fibre's characteristic frequency (CF)?
Module 10 · Coding of intensity & loudness
Besides each fibre firing faster, how else does the auditory nerve signal that a sound is louder?
Roughly how large is the usable dynamic range of normal hearing?
Why does a cochlear implant have a very narrow electrical dynamic range (small T–C window)?
Module 11 · Coding of frequency & pitch
What are the two codes the auditory system uses to represent frequency?
Above roughly what frequency does phase-locking fail, leaving only the place code?
Why do cochlear-implant recipients typically understand speech well but find music and pitch difficult?
Module 12 · Central auditory pathways
Which nucleus is the obligatory first relay where every auditory-nerve fibre terminates?
What happens to the cochlear frequency map (tonotopy) along the ascending pathway?
Why does age at implantation matter so much for congenitally deaf children?
Module 13 · Binaural hearing & localization
According to the duplex theory, which cue dominates localisation at LOW frequencies?
How does the lateral superior olive (LSO) compute interaural level difference?
Which binaural benefit is hardest for bilateral cochlear implants to restore, and why?
Module 1 · Overview — the plastic brain
What is the central claim of this chapter about how the auditory brain develops?
Monocular deprivation early in life leaves the deprived eye unable to drive the cortex, but the same deprivation in an adult does almost nothing. What principle does this illustrate?
Why does the principle that 'even a perfect sensory input cannot produce normal perception if the central pathway was not built' matter for cochlear implantation?
Module 2 · Critical & sensitive periods
What did Lorenz's work on imprinting in goslings establish?
What is the key difference between a 'critical period' and a 'sensitive period'?
An infant can discriminate the speech sounds of all languages at birth but, within the first year, tunes to only its native language. What does this illustrate?
Module 3 · Lessons from the visual system
After early monocular deprivation, why do the open eye's ocular-dominance columns expand while the deprived eye's shrink?
Why is binocular deprivation (both eyes closed) often LESS damaging to ocular-dominance columns than monocular deprivation (one eye closed)?
What is the key warning the deprivation experiments give for sensory prostheses such as cochlear implants?
Module 4 · Competition & the pluripotent cortex
What does the barrel-cortex experiment (damaging a single whisker in the newborn) demonstrate?
Rerouting retinal input to the auditory thalamus causes the auditory cortex to form a map of visual space. What principle does this establish?
How do pluripotency and competition together explain the risk of prolonged deafness?
Module 5 · The deaf brain — auditory deprivation
Why is the congenitally deaf white cat an especially informative model of the deaf brain?
What happens to the endbulb of Held in long-standing deafness, and why does it matter clinically?
Deafening a neonatal animal causes severe cochlear-nucleus changes, but the same procedure in an adult causes far less. What does this age-grading illustrate?
Module 6 · Cross-modal plasticity
What is cross-modal plasticity?
What evidence shows that cross-modal recruitment is functional rather than incidental?
Why is cross-modal plasticity described as a 'double edge' for cochlear implantation?
Module 7 · The sensitive period for hearing
Why was a biomarker like the cortical P1 needed to study the human auditory sensitive period?
What is the approximate human sensitive-period pattern revealed by P1 latency in implanted children?
Why does the auditory sensitive period matter so much for spoken language?
Module 8 · The implant as environmental input
From the brain's point of view, what is the cochlear implant's essential job?
What did stimulating congenitally deaf cats with cochlear implants show about the endbulb of Held?
In congenitally deaf cats implanted as kittens, how did the active auditory cortex change with duration of implant use?
Module 9 · Age at implantation & outcomes
In a child deaf from birth, how important is age at implantation relative to other factors?
Why does age at implantation matter far less for a postlingually deaf adult than for a prelingually deaf child?
Why does even minimal residual hearing tend to predict a better implant outcome?
Module 10 · Adult plasticity & rehabilitation
What does cortical reorganisation after digit amputation in an adult monkey demonstrate?
Why is the adult brain less plastic than the child's, and what is the trade-off?
How does adult plasticity explain why a newly activated adult implant user improves over months?
Module 11 · Binaural plasticity & bilateral CIs
Why must the binaural system receive balanced input from both ears during development?
Why does a long interval between a first and second implant reduce binaural benefit, especially in children?
What is the developmental rationale for bilateral (often simultaneous) implantation in children?
Module 12 · The paradox of plasticity
What is the 'paradox of plasticity'?
Why is the closing of a sensitive period best understood as adaptive rather than as a flaw?
If the whole chapter reduces to one idea, what is it?
Module 1 · Overview — deprivation & rescue
What is the central idea of this chapter relative to the brain-plasticity chapter?
Why does deafness affect structures as far up as the cortex?
Module 2 · The pathway in health
Which principle explains why deprived auditory structures decline?
Which are the three parts of the spiral-ganglion neuron, in order from the hair cell inward?
Module 3 · Hair-cell loss & deafferentation
Why does the spiral-ganglion neuron degenerate after hair-cell loss, even when the neuron was never directly injured?
Which part of the neuron degenerates first after deafferentation, and why does the timing matter clinically?
Module 4 · Spiral ganglion neuron degeneration
What largely determines how many spiral-ganglion neurons survive after deafness?
How tight is the link between spiral-ganglion survival and cochlear-implant outcome?
Module 5 · The nerve & the electrode
Why can two ears with the same total spiral-ganglion count perform differently with the same array?
How do objective measures (ECAP/NRT, eABR) relate to the neural substrate this module describes?
Module 6 · The cochlear nucleus & the endbulb
What is the endbulb of Held, and what happens to it in deafness?
Why is the developing brainstem especially vulnerable to deprivation?
Module 7 · Up the brainstem & midbrain
What does the superior olivary complex do, and what is its characteristic vulnerability?
What clinical practice does the binaural-circuit biology support?
Module 8 · The deprived auditory cortex
What two things does early deafness do to the auditory cortex?
Why is cross-modal takeover relevant to implant timing?
Module 9 · Stimulation as a trophic signal
What did chronic stimulation do to spiral-ganglion survival in deafened animals?
Which neurotrophins are part of how activity supports spiral-ganglion neurons?
Module 10 · What stimulation restores — and its limits
What did Ryugo et al. (2005) demonstrate about chronic implant stimulation?
What is the 'asymmetry of damage and repair' this module emphasises?
Module 11 · From bench to bedside
This chapter gives two independent biological reasons for early implantation. What are they?
Why do implant users often find localisation and speech-in-noise the hardest gains?
Module 12 · Protecting & rebuilding the substrate
What is the rationale for a neurotrophin-eluting electrode?
What is the single throughline of this whole chapter?
Module 1 · Overview — counting hearing loss
Why was hearing loss historically under-prioritised in global health, and what changed?
Which statement best captures why this atlas tells the epidemiology 'from India first'?
Module 2 · Measuring the burden — grades, prevalence & DALYs
What is the difference between prevalence and incidence?
A report states that 1.5 billion people have hearing loss but 430 million have disabling loss. How can both be right?
Module 3 · The burden of hearing loss in India
Roughly how many people in India are estimated to have significant auditory impairment, and what is most distinctive about this burden?
Why is access, rather than biology, often the limiting factor for Indian implant candidates?
Module 4 · Causes & risk factors in India
How does the Indian causal mix differ most from the typical high-income-country profile?
What is the main strategic implication of most of India's burden being preventable or treatable?
Module 5 · Chronic ear disease & preventable loss
What type of hearing loss does chronic suppurative otitis media typically cause, and what follows from that?
Why does the WHO treat a population CSOM prevalence of ≥4% as significant?
Module 6 · Noise-induced loss & ototoxicity
Using the NIOSH 85 dB/8 h limit and a 3-dB exchange rate, what is the safe exposure time at 94 dBA?
Why are noise and ototoxic drugs grouped together, and why do both matter especially in India?
Module 7 · Consanguinity & the genetics of deafness
How does consanguinity increase the risk of recessive deafness?
Which single gene is the commonest cause of non-syndromic recessive deafness, and what is notable about it in India?
Module 8 · Congenital & childhood hearing loss
Roughly what is the birth prevalence of permanent congenital hearing loss, and why does it matter so much?
Why can a child pass the newborn hearing screen and still be found deaf at age two?
Module 9 · Newborn & infant hearing screening
What do the 1–3–6 milestones of early hearing detection and intervention stand for?
Why do high-risk and NICU infants need automated ABR rather than OAE alone for screening?
Module 10 · The global picture & projections to 2050
Roughly how many people worldwide were living with hearing loss in 2019, and what is the 2050 projection?
What mainly drives the projected rise, and how is the burden distributed?
Module 11 · The cost — economic, educational & cognitive
According to the Lancet Commission, what is the relationship between hearing loss and dementia?
What is the WHO's estimate of the annual global cost of unaddressed hearing loss, and what is the key implication?
Module 12 · Prevention & the cochlear-implant access gap
Where do cochlear implants sit within the levels of prevention?
What is the principal limiting factor for cochlear implantation in India, and what follows for strategy?
Module 1 · Overview — genes, deafness & the implant
Roughly how common is congenital hearing loss, and how much is genetic?
What is this chapter's central organising idea linking genetics to implant outcome?
Module 2 · Syndromic & non-syndromic deafness
How does genetic hearing loss divide into syndromic and non-syndromic, and why does it matter?
What is an 'NSHL mimic', and why does it justify genetic testing?
Module 3 · Patterns of inheritance
Which inheritance pattern accounts for most non-syndromic genetic deafness, and what is its recurrence risk?
Which inheritance pattern should prompt you to avoid aminoglycosides in at-risk relatives?
Module 4 · GJB2 & the connexins
What does connexin-26 (GJB2) do in the cochlea, and how common is its mutation?
Why does GJB2-related deafness tend to give good cochlear-implant outcomes?
Module 5 · The deafness-gene landscape
What single feature of a deafness gene best organises its likely effect on cochlear-implant outcome?
Which set are membranous-labyrinth (favourable) genes?
Module 6 · Testing — from Sanger to next-generation
Why is Sanger sequencing ill-suited to diagnosing non-syndromic deafness comprehensively?
What does a targeted next-generation panel such as OtoSCOPE provide?
Module 7 · Genetic testing in the CI work-up
In the proposed paradigm, how is an apparently non-syndromic CI candidate tested?
What does a NEGATIVE comprehensive panel mean for a deaf CI candidate?
Module 8 · The spiral-ganglion hypothesis
State the spiral-ganglion hypothesis.
What is an important limitation of the hypothesis in practice?
Module 9 · Genotype-specific CI outcomes
Which genotype is associated with POOR cochlear-implant performance?
Why is TMPRSS3 described as giving 'variable' rather than uniformly poor outcomes?
Module 10 · Auditory neuropathy & OTOF
What defines auditory neuropathy spectrum disorder on testing?
Why do OTOF-related auditory neuropathy patients implant well?
Module 11 · Counselling, recurrence & ethics
What is a key concrete value of a confirmed genetic diagnosis for a family?
How should a genotype that predicts a poor implant outcome be used?
Module 12 · Gene therapy & the genomic future
Why did otoferlin (OTOF) become the first successful inner-ear gene-therapy target?
For most genetic deafness today, what remains the treatment?
Module 1 · Overview — why the cause matters
Why is the cause of sensorineural hearing loss prognostically useful even when the audiogram is identical between patients?
Which phrase best captures sensorineural hearing loss as framed in this chapter?
Module 2 · Where the lesion sits
At what point does a cochlear implant inject its signal into the auditory pathway?
Why can the single label 'sensorineural' hide two very different prospects for implantation?
Module 3 · Congenital & perinatal causes
Roughly how does congenital sensorineural hearing loss divide by cause?
Why are high-risk newborns (e.g. NICU graduates) screened with automated ABR rather than OAE alone?
Module 4 · Meningitis & cochlear ossification
Why is post-meningitic deafness treated as an otological emergency?
What does the degree of new bone formation after meningitis also signal about the neural substrate?
Module 5 · Congenital CMV & in-utero infections
What is the most distinctive feature of congenital CMV hearing loss for the clinician?
Why must congenital CMV be confirmed within the first two to three weeks of life (or from the newborn blood spot)?
Module 6 · Ototoxicity — drugs that damage the ear
What is the characteristic audiometric pattern of ototoxic damage, and why?
For the cochlear implant, why is ototoxic deafness relatively favourable — and what is the caveat?
Module 7 · Noise-induced hearing loss
What is the classic audiometric fingerprint of noise-induced hearing loss?
What does cochlear synaptopathy add to the understanding of noise damage?
Module 8 · Presbycusis — the ageing cochlea
In Schuknecht's scheme, which presbycusis subtype gives disproportionately poor word recognition?
Why does the neural subtype matter most for implant counselling?
Module 9 · Sudden & autoimmune hearing loss
How is sudden sensorineural hearing loss conventionally defined, and why does it matter?
What makes autoimmune (immune-mediated) inner-ear disease so important to recognise?
Module 10 · Ménière's & cochlear otosclerosis
Why does Ménière's disease complicate cochlear-implant candidacy assessment, and what is the silver lining?
What surgical complication is cochlear otosclerosis particularly associated with?
Module 11 · What the temporal bone reveals
What is the central implant-relevant finding from human temporal-bone studies of deafness?
What is the fundamental limit of temporal-bone evidence for the practising surgeon?
Module 12 · From cause to candidacy
What is the chapter's organising workflow from a diagnosis to a plan?
Two children are listed: stable GJB2 deafness and recent meningitis with early basal-turn ossification. Which is the more urgent, and why?
Module 1 · Why Electric Hearing Is Different
What does a cochlear implant fundamentally bypass?
Psychophysics in implant users is fundamentally a method of relating what to what?
Which is NOT one of the four core families of psychophysical measurement described?
Why does the perceptual chapter precede the coding and programming chapters?
A clinician setting threshold and comfort levels during programming is best described as doing what?
Module 2 · From Acoustic to Electric: What Is Lost in Translation
The cochlear amplifier is primarily attributed to which structures?
Compression at the basilar membrane chiefly affects which sounds?
Compared with acoustic firing, electrical activation of the nerve is best described as:
When outer hair cells are damaged, the basilar-membrane input-output function becomes:
The single organising idea of this module is that electric hearing is:
Module 3 · The Electric Dynamic Range: A Few Decibels to Work With
The behavioural dynamic range in electric hearing is typically about:
The quantity most relevant to reaching threshold for a biphasic pulse is:
As phase duration lengthens, the threshold current:
Chronaxie for auditory nerve fibres is on the order of:
Because the electric range is so narrow, the processor must:
Module 4 · Steep and Fast: How Loudness Grows with Electric Current
Approximately how wide is the usable dynamic range in electric hearing compared with normal acoustic hearing?
Why is the electric loudness-growth function so much steeper than the acoustic one?
Which mathematical form best captures the shallow near-threshold tail and rapid rise of electric loudness across the whole range?
As per-channel pulse rate is raised above about 100 pps, loudness generally:
When several electrodes are activated within one stimulation period, the per-channel current usually must be:
Module 5 · The Processor Must Do What the Cochlea No Longer Can
What provides instantaneous compression in a normal cochlea that the implant cannot inherit?
What is the role of automatic gain control in a cochlear implant processor?
The instantaneous acoustic-to-electric mapping within a channel is usually:
Lowering the loudness-growth Q value (more compression) tends to:
A patient hears well in quiet but loses speech in noise; a likely mapping cause is:
Module 6 · Just Detectable: What Sets the Electric Threshold
The strength-duration relationship in electric hearing describes how:
Inserting a short interphase gap between the two phases of a biphasic pulse tends to:
Why does raising pulse rate generally lower the threshold for a pulse train?
Compared with focused modes, monopolar stimulation typically yields:
Why must behavioural T-levels be measured with the same rate, phase duration and mode as the live program?
Module 7 · Reading the Envelope: Temporal Processing in Electric Hearing
Which feature of a sound does a cochlear implant primarily transmit in each channel?
The temporal modulation transfer function (TMTF) in implant users has what overall shape?
How does the just-detectable gap change as stimulus level increases?
Why does temporal acuity in implant users approach that of normal-hearing listeners?
Modulation-detection thresholds in implant users are clinically interesting because they tend to correlate with what?
Module 8 · Pitch from Timing: The 300-Hz Ceiling
Temporal (rate) pitch is created by changing what, while holding place constant?
Around what pulse rate does temporal pitch typically saturate in implant users?
Besides changing pulse rate, what else can produce temporal pitch?
Why is the ~300 Hz ceiling clinically important for voice and music?
Experiments on interpulse intervals suggest the auditory system extracts temporal pitch by reading what?
Module 9 · Pitch from Place: Tonotopy, Mismatch, and the Map
Stimulating a more basal electrode produces a percept that is:
Why does adding more electrodes not linearly increase the number of resolvable pitches?
A frequency-to-place mismatch most commonly arises from:
What does longitudinal evidence show can happen to mismatched pitch percepts over time?
Place pitch and rate pitch in an implant are best described as:
Module 10 · Blurred Frequencies: Spectral Resolution and Current Spread
Why is frequency resolution coarser in electric than in acoustic hearing?
Spectral-ripple discrimination measures a listener's ability to:
Across listener groups, spectral peak/ripple resolution is typically:
Spread of excitation can be measured objectively using:
Why does spectral smearing hurt speech in noise more than speech in quiet?
Module 11 · When Channels Talk to Each Other: Channel Interaction
Forward masking as a form of channel interaction occurs because:
A forward-masked spatial tuning curve that is broad rather than sharp indicates:
How does tripolar (or partial-tripolar) stimulation aim to reduce interaction?
Current steering differs from current focusing in that it:
Why has improved spatial selectivity from focusing not always improved speech in noise?
Module 12 · Twelve Wires, Eight Voices: The Number of Effective Channels
Roughly how many effective channels do typical CI users extract despite having 12-22 electrodes?
In a noise-band vocoder, the number of bands controls:
How many channels does sentence recognition in QUIET typically need to approach ceiling?
Why does speech in NOISE keep improving as channels are added beyond what quiet needs?
Which design or clinical move follows from the effective-channel ceiling?
Module 13 · Why Speech in Noise Is the Hardest Test
Why can an implant user score highly in quiet yet poorly in noise?
Which signal component do standard processors discard, and why does that hurt in noise?
What happens to the number of channels needed for good speech when noise is added?
Channel interaction degrades speech in noise mainly by:
Which psychophysical measures best predict a user's real-world speech-in-noise ability?
Module 14 · Why Music Is the Hardest Signal of All
Which musical attribute is best preserved in electric hearing?
What is the approximate ceiling above which rate pitch no longer rises in most implant users?
Why is place pitch a poor substitute for the missing rate pitch in music?
Why is timbre so degraded with an implant?
Which intervention most directly restores genuine fine-structure pitch for music?
Module 15 · Measuring Electric Hearing, and Using What You Find
What does a forward-masked spatial tuning curve measure?
Spectral-ripple discrimination is valued clinically because it is:
Poor modulation-detection thresholds in a region of the array most directly indicate a problem with:
Which programming lever best addresses broad tuning and poor spectral-ripple scores?
When psychophysics reveals a limit no electrode configuration can overcome, such as low-frequency pitch, the principled next step is to:
Module 1 · Overview — recreating hearing
What is the fundamental challenge of cochlear-implant sound coding?
Which simplification underlies most cochlear-implant coding?
Module 2 · What normal hearing does
Which auditory function does the cochlear implant recreate most poorly?
Why is speech in quiet largely a solved problem for cochlear implants?
Module 3 · The processor's signal path
What is the correct order of the sound processor's signal path?
Roughly the same signal-path backbone is used by which devices?
Module 4 · Filter banks & the place code
How does the implant recreate the cochlea's place code?
What is a frequency-to-place mismatch and why does it matter?
Module 5 · Envelope, fine structure & the vocoder
What does envelope extraction keep and discard?
What is the cochlear implant best modelled as, in signal-processing terms?
Module 6 · CIS — the breakthrough
What problem did continuous interleaved sampling (CIS) solve?
What is the enduring lesson of the CIS breakthrough?
Module 7 · Channel interaction & current spread
Why don't 22 electrodes provide 22 independent channels?
Roughly how many effective channels do implant users typically achieve, and where does it matter most?
Module 8 · Peak-picking — SPEAK & ACE
How does an n-of-m strategy such as ACE work?
Why does peak-picking help despite leaving some channels silent each cycle?
Module 9 · Fine structure & temporal coding
What does fine-structure coding (e.g. FSP) add, and where?
Why is fine-structure coding restricted to low (apical) frequencies?
Module 10 · Current focusing & virtual channels
What does current focusing (e.g. tripolar) achieve?
What is a 'virtual channel' created by current steering?
Module 11 · Front-end pre-processing
What does automatic gain control (AGC) do in the front end?
Why is the front end such a powerful lever for hearing in noise?
Module 12 · The future of sound coding
What is the most immediate (near-term) advance in cochlear-implant sound coding?
Why might optical (optogenetic/infrared) stimulation eventually break the channel ceiling?
Module 1 · Overview — the limits of amplification
What is this chapter's organising idea?
Why do many people with significant hearing loss reject hearing aids?
Module 2 · Beyond the audiogram
What does the pure-tone audiogram actually measure?
Which suprathreshold correlates does the audiogram fail to capture?
Module 3 · Audibility — what amplification does
What is the core job of amplification?
How good a predictor of aided speech recognition is audibility?
Module 4 · Recruitment & the narrowed dynamic range
How does sensorineural loss narrow the dynamic range?
Using Boothroyd's formula, roughly what usable dynamic range remains at a 90 dB loss?
Module 5 · Why recruitment happens
What mechanism produces loudness recruitment?
Why does electrical (implant) hearing show no recruitment?
Module 6 · Blurred frequency resolution
How does sensorineural loss degrade frequency resolution?
Why can't a hearing aid fix broadened frequency resolution?
Module 7 · Reduced temporal resolution
What happens to temporal processing in sensorineural loss?
Why does reduced temporal resolution hit hardest in noise?
Module 8 · Cochlear dead regions
What is a cochlear dead region?
What does amplifying into a dead region achieve, and how is it detected?
Module 9 · Audibility vs distortion
Why do audibility-based models (the Speech Intelligibility Index) break down in severe loss?
How can wide dynamic range compression, used to maximise audibility, backfire?
Module 10 · When a hearing aid has done all it can
What evidence best shows that a hearing aid has reached its limit?
What has happened to the candidacy 'crossover' line as implants have improved?
Module 11 · When the lesion changes the calculus
Why do hearing aids often fail in auditory neuropathy spectrum disorder (ANSD)?
When does even a cochlear implant have no target?
Module 12 · From hearing aid to implant
What is the fundamental difference that lets the implant succeed where the aid fails?
Which statement best reflects the modern status of the cochlear implant for severe-to-profound SNHL?
Module 1 · The test battery & cross-check
What is the cross-check principle?
Why does Wolfe recommend running the physiologic battery before behavioural testing?
Module 2 · Pure-tone audiometry & calibration
Why are insert earphones preferred for pure-tone audiometry?
Why must the RECD be measured individually in infants?
Module 3 · Masking — isolating the test ear
When is masking required for an air-conduction threshold?
What is the plateau (Hood) method?
Module 4 · Bone conduction & the air–bone gap
What does an air–bone gap with normal bone conduction indicate?
What is a spurious low-frequency air–bone gap?
Module 5 · Speech audiometry & rollover
What is the main role of the speech reception threshold (SRT)?
Why are recorded (not monitored-live-voice) speech materials mandatory?
Module 6 · Tympanometry & immittance
Which tympanogram type indicates middle-ear effusion?
Why must infants under ~6 months be tested with a 1000 Hz probe tone?
Module 7 · The acoustic reflex
Why is the acoustic reflex so sensitive to conductive loss?
What does a present reflex at a normal level imply about degree of loss?
Module 8 · Otoacoustic emissions
What do otoacoustic emissions tell you?
What does present OAE with an absent ABR indicate?
Module 9 · The auditory brainstem response
Which ABR wave persists nearest threshold and anchors threshold estimation?
What is the electrophysiologic hallmark of auditory neuropathy on click ABR?
Module 10 · ASSR, ECochG & cortical responses
What can ASSR do that tone-burst ABR cannot?
An enlarged ECochG SP/AP ratio supports which diagnosis?
Module 11 · Paediatric behavioural audiometry
What does behavioural observation audiometry (BOA) measure?
From roughly what developmental age can visual reinforcement audiometry (VRA) give true thresholds?
Module 12 · Paediatric speech perception
What is Erber's hierarchy of auditory skill?
What must be accounted for when scoring a closed-set speech test?
Module 13 · Speech-in-noise & valid testing
What does a speech-in-noise test report?
Why does multi-talker babble depress CI users' scores more than steady noise?
Module 14 · Real-ear measurement & verification
What does probe-microphone real-ear measurement verify?
Why must verification precede aided speech testing or a hearing-aid trial?
Module 15 · Loudness, tinnitus & non-organic loss
What does loudness recruitment do to the dynamic range?
Which finding suggests a non-organic component?
Module 16 · Self-report & functional outcomes
Why use self-report questionnaires alongside booth tests?
What is distinctive about the COSI?
Module 17 · Tele-audiology & the future
What is the main promise of tele-audiology?
What is the limiting factor for remote and automated testing?
Module 18 · Putting the battery together
Which fingerprint indicates a cochlear sensorineural loss?
What does the assembled battery hand to the candidacy decision?
Module 1 · Overview — will the implant beat the aid?
What is the central question of cochlear-implant candidacy?
Who makes the candidacy decision?
Module 2 · How the criteria evolved
How have cochlear-implant candidacy criteria changed since the early 1980s?
Beyond the numbers, what conceptual shift accompanied the loosening of criteria?
Module 3 · The audiological battery
Which test decides cochlear-implant candidacy?
Why are recorded (not live-voice) sentences used?
Module 4 · Audiometric criteria & level
Why does candidacy testing use conversational/soft presentation levels rather than loud ones?
What shapes exactly where the candidacy speech-score line sits?
Module 5 · Speech-in-noise & valid testing
Why is speech-in-noise testing part of cochlear-implant candidacy?
Why must the speech-in-noise protocol be fixed and applied identically to every candidate?
Module 6 · Regulation & reimbursement
What does the FDA actually regulate in cochlear implantation?
What is the real-world limit on off-label implantation?
Module 7 · Predicting the outcome
Which are the two strongest pre-operative predictors of implant speech outcome?
What does an intact 'auditory foundation' represent, and why does prediction remain humble?
Module 8 · The actuarial odds model
How does the actuarial model define candidacy?
Why can two ears with identical aided scores have different candidacy under this model?
Module 9 · Medical & otologic assessment
How does aetiology usually bear on candidacy?
Why is meningitis vaccination part of the implant work-up?
Module 10 · Imaging in the work-up
What do CT and MRI each contribute to the candidacy work-up?
Which imaging finding most often changes the candidacy decision (not just the surgery)?
Module 11 · Vestibular assessment
What is the main purpose of vestibular assessment at candidacy?
Why are several vestibular tests combined rather than relying on one?
Module 12 · Paediatric candidacy
How is candidacy assessed in an infant who cannot give behavioural responses?
Why is paediatric candidacy so time-pressured?
Module 13 · The expanding indications
Which of these is now an accepted expanded indication for cochlear implantation?
What is electric-acoustic (hybrid) stimulation, and whom does it suit?
Module 14 · Cognition, dementia & the elderly
Is advanced age a contraindication to cochlear implantation?
How does the hearing–cognition link bear on candidacy in an older adult with early cognitive decline?
Module 15 · Psychosocial assessment & expectations
Why is managing expectations part of candidacy?
What does the psychosocial assessment commonly find in adult candidates, and what is the trend after implantation?
Module 16 · Cost, funding & access
What does the large gap between eligible and implanted patients mainly reflect?
What is the 'most obvious candidate' rationing bias?
Module 17 · Counselling, ethics & consent
What does the cultural/Deaf-community dimension require of candidacy?
When does informed consent need extra evaluation in candidacy?
Module 18 · Which ear, one or both
Which ear is often favoured for implantation, and why?
What does a bimodal configuration provide?
Module 19 · Bilateral & bimodal candidacy
Why should bilateral implants be simultaneous or placed within a short interval?
What distinguishes a second implant from a bimodal (implant + contralateral aid) approach?
Module 20 · The team decision
How is the candidacy decision ultimately made?
Is 'do not implant' a legitimate outcome of candidacy assessment?
Module 1 · Our Philosophy: The Rational Checklist
In the MRI-predominant, selective-HRCT protocol, which candidates are screened with MRI?
Which finding or feature would prompt adding a selective HRCT?
Module 2 · Imaging as the surgical blueprint
What two jobs does preoperative imaging do?
Which findings are absolute imaging gates that redirect to an ABI?
Module 3 · HRCT technique & planes
Why does isotropic-voxel HRCT only need one acquisition?
Which plane is the temporal-bone 'axial' plane?
Module 4 · MRI sequences & the nerve view
What do heavily-T2 sequences (CISS/FIESTA) show?
What is the oblique-sagittal nerve view for?
Module 5 · Normal temporal-bone anatomy
By when has the cochlear duct coiled to its 2.5 turns?
Why learn malformations through embryology?
Module 6 · Cochleovestibular malformations
Which classification is the worldwide-accepted scheme?
How does a common cavity differ from cochlear aplasia with a dilated vestibule (CADV)?
Module 7 · Hypoplasia, IP & EVA in detail
What distinguishes cochlear hypoplasia from incomplete partition?
Which incomplete partition carries ~100% gusher risk and IAC-migration risk?
Module 8 · Cochlear nerve, IAC & the ABI boundary
Does a normal-sized IAC on CT prove a present cochlear nerve?
How do cochlear-nerve hypoplasia and aplasia differ for candidacy?
Module 9 · Ossification & fibrosis — patency
Why does MRI beat CT for early post-meningitic obstruction?
What is the right response to cochlear ossification?
Module 10 · The facial nerve
Why is CT mapping of the facial canal essential before CI surgery?
What does proximity of the apical turn and otospongiotic bone to the facial canal predict?
Module 11 · Middle ear, mastoid & vessels
What determines access in the transmastoid facial-recess approach?
Which vascular variant most demands recognition before a drill-out?
Module 12 · Measurements & electrode selection
What does a cochlear duct length <25 mm indicate?
When is a perimodiolar array appropriate?
Module 13 · Paediatric imaging & radiation safety
Why do children with profound loss need MRI, not CT alone?
Does the intracochlear electrode migrate as the child's skull grows?
Module 14 · Intra-operative imaging
When is intra-operative fluoroscopy most useful?
What does fluoroscopy allow in a common-cavity malformation?
Module 15 · Post-op electrode position
Which two complications does post-op imaging chiefly seek?
Why does plain-film projection geometry matter?
Module 16 · MRI compatibility of the implant
Are cochlear implants compatible with MRI?
Why can a recipient still have surveillance MRI for contralateral pathology?
Module 17 · Recent & emerging imaging
What makes cone-beam CT attractive for electrode imaging?
How do diffusion-tensor and functional imaging extend the work-up?
Module 18 · The structured report
Why is the preoperative imaging report side-specific and structured?
What must the report conclude with?
Module 1 · Anatomy of a Cochlear Implant System
What couples the external and internal parts of a cochlear implant?
Which is hardware rather than coding strategy?
Module 2 · From Sound to Nerve: The End-to-End Signal Path
Tonotopy in a CI means…
Which stage limits what the coding strategy can do?
Module 3 · The Transcutaneous Link and Telemetry
Back (reverse) telemetry returns…
Why does coil alignment over the magnet matter?
Module 4 · The Nucleus Family Tree: From CI22 to CI600
How many intracochlear contacts has every Nucleus generation carried?
In the Nucleus naming convention, what does the model number encode?
Module 5 · Choosing a Nucleus Array: Perimodiolar vs Lateral Wall
The Contour Advance is inserted with which technique to hug the modiolus?
Why does a short perimodiolar array reach the same angle as a longer lateral-wall one?
Module 6 · Advanced Bionics: 16 Current Sources and Current Steering
Advanced Bionics' defining hardware feature is…
HiRes Fidelity 120 current steering can create…
Module 7 · The HiFocus Array Family and Naida Processors
The HiFocus Mid-Scala array targets…
The early HiFocus Silastic positioner was withdrawn because…
Module 8 · The MED-EL Philosophy: Long, Flexible, Lateral-Wall
A MED-EL array has 24 contacts but how many stimulation channels?
MED-EL's design philosophy is…
Module 9 · SYNCHRONY, FSP and the SONNET/RONDO System
The SYNCHRONY implant eases MRI by…
Fine-structure strategies (FSP/FS4) add what to the apical channels?
Module 10 · The Electrode Array as a Frequency Ruler
Human cochlear duct length varies between people by as much as…
A shallow insertion typically produces…
Module 11 · Why 22 Electrodes Behave Like 8 Channels
A 22-electrode implant typically delivers how many effective channels?
The main cause of the effective-channel ceiling is…
Module 12 · The Three Array Families: Lateral-Wall, Perimodiolar, Mid-Scala
The three array families are defined by…
Perimodiolar proximity mainly buys…
Module 13 · Stimulation Modes: From Monopolar to Tripolar
Which mode is the most spatially selective?
Why are pulses charge-balanced and biphasic?
Module 14 · Dynamic Range and Electrode-to-Neuron Distance
The electrical dynamic range (T to C) is typically…
Bringing a contact closer to the neurons…
Module 15 · Materials, Reliability and MRI
The standard reliability metric for implants is…
Magnet demagnetisation in MRI depends mainly on…
Module 16 · Electric-Acoustic Stimulation and Hearing Preservation
Electric-acoustic stimulation is indicated when a patient has…
The major risk of EAS is…
Module 17 · Special Arrays for the Difficult Cochlea
In basal-turn ossification, the drill-out should not exceed about…
When no modiolus exists (common cavity, IP-I)…
Module 18 · The Wider World: Other Manufacturers and the Pioneers' Electrodes
What made the University of Utah Ineraid/Symbion device uniquely valuable for research?
Korea's TODOC array carries 32 contacts. Why does this not give roughly four times the resolution of an 8-channel map?
Module 20 · The Cochlear Implant of the Future and Choosing a Device
Why might optical/optogenetic stimulation surpass electrical?
The recurring lesson about array choice is…
Module 1 · The Lineage at a Glance: Why Coding Strategies Keep Changing
Which transition does Wilson date to the early 1990s as the central movement in CI coding history?
For the comparison of CA versus CIS outcomes, what does the high NU-6 correlation (r≈0.92) imply?
Module 2 · One Electrode, One Sound: The Single-Channel Era
What carrier did the 3M/House single-channel processor amplitude-modulate?
What was the band-pass filter range in the 3M/House processor?
Module 3 · Compressed Analog: The First Multichannel Waveform Strategy
What is the principal channel-interaction mechanism in simultaneous analog strategies like CA?
Which device/manufacturer is the classic exemplar of the Compressed Analog strategy?
Module 4 · Continuous Interleaved Sampling: The Pulse That Changed Everything
How does CIS eliminate the principal channel-interaction problem of Compressed Analog?
What does CIS deliberately discard within each frequency band?
Module 5 · Tracking the Voice: F0/F2 Formant Extraction
In the F0/F2 strategy, what does the estimated F2 frequency control?
How is F0 estimated in the F0/F2 strategy?
Module 6 · Adding F1: The F0/F1/F2 Processor
In F0/F1/F2, how is the electrode array divided between the two formants?
Why did F0/F1/F2 still struggle with consonant recognition?
Module 7 · Multipeak (MPEAK): Formants Plus High-Frequency Bands
What did MPEAK add to the F0/F1/F2 strategy?
What weakness of MPEAK most directly motivated the spectral-maxima approach?
Module 8 · SMSP: Letting the Spectrum Choose
What is the n-of-m configuration of the SMSP strategy?
What does SMSP deliberately NOT extract that MPEAK did?
Module 9 · The n-of-m Family: SPEAK and the Rise of Peak Picking
What distinguishes SPEAK from a fixed n-of-m strategy?
Why is SPEAK's per-channel stimulation rate so low (~250/s)?
Module 10 · ACE: Spectral Maxima Meet High Rate
What is the default stimulation rate for Nucleus cochlear implants using ACE?
How many electrodes does the Nucleus-24 have, and of what type?
Module 11 · Chasing Fine Structure: FSP, FS4 and the Temporal-Pitch Ceiling
To which channels does FS4 apply temporal fine-structure timing?
Approximately where does electric rate-pitch saturate for most CI users?
Module 12 · Virtual Channels: Current Steering and Current Focusing
How does current steering create virtual channels?
What does HiRes Fidelity 120 use to place excitation across its virtual locations?
Module 13 · The Present Commercial Landscape: Four Makers, Five Philosophies
What is distinctive about how Oticon Medical's Crystalis encodes stimulation magnitude?
How does PACE/MP3000 differ from standard ACE?
Module 14 · The Frontier: Deep Learning, Closed Loops and Light
What is the defining feature of end-to-end deep-learning sound coding?
Why is optical/optogenetic stimulation pursued as a future direction?
Module 1 · From Decision to Theatre: What Preparation Must Achieve
Pre-operative preparation for cochlear implantation has three core jobs. Which set correctly names them?
On the CIQOL-Expectations instrument, what proportion of candidates held pre-operative expectations exceeding their actual 12-month outcomes?
Module 2 · Fit for Surgery: The Medical and Anaesthetic Work-up
Pneumococcal vaccination is recommended for all cochlear implant candidates. What is the recommended minimum timing relative to surgery, and what is the magnitude of the risk it addresses?
Cochlear implant surgery is elective. A 3-year-old candidate arrives on the day of surgery with a fever and an active upper-respiratory tract infection. What is the appropriate course of action?
Module 3 · Vaccination and Meningitis Prophylaxis
By what factor was pneumococcal meningitis elevated in CI recipients in the CDC cohort?
Vaccine-naive adult CI candidate pneumococcal schedule?
Module 4 · The Multidisciplinary Sign-off and the Final Plan
At the pre-operative case conference, which factor most appropriately guides selection of the ear for unilateral cochlear implantation?
According to CDC/ACIP guidance, when should pneumococcal vaccination be completed relative to cochlear implant surgery?
Module 5 · Counselling and Shared Decision-Making
On the CIQOL-Expectations instrument, what proportion of cochlear implant candidates hold pre-operative expectations that exceed their actual 12-month post-implant outcomes?
When counselling the parents of a deaf child, which timing fact best conveys the urgency of an early decision?
Module 6 · Informed Consent: Risks, Benefits and Alternatives
During consent for cochlear implantation, a patient asks how likely it is that the operation will leave them with a permanently paralysed face. Based on reported frequencies, which figure best represents the risk of post-operative facial paralysis from intraoperative nerve injury?
A counsellor is explaining meningitis-related consent requirements. Which statement is correct?
Module 7 · Preparing the Family and the Home
A cochlear implant team is counselling the parents of a child before implantation. Regarding the relationship between pre-operative expectations and post-operative satisfaction, which statement is best supported by the evidence?
Two children with bilateral profound congenital deafness are implanted: one at 16 months and one at 40 months, both then receiving habilitation. Three years later, which outcome is most consistent with the evidence on timing of implantation?
Module 8 · What an Implant Can and Cannot Do
A post-lingually deafened adult asks what a cochlear implant will realistically give him. Which statement best reflects the honest baseline the team should convey?
Which finding best supports spending counselling time to lower a candidate's unrealistically high pre-operative expectations?
Module 9 · Why Outcomes Vary: The Predictors Behind Expectations
Which factor is the single most consistent NEGATIVE predictor of post-operative open-set speech recognition in post-lingually deafened adult cochlear implant recipients?
Regarding timing of paediatric implantation, the language-comprehension deficit at three years post-implant for children implanted before 18 months versus after 36 months is best described as:
Module 10 · Realistic Expectations by Group
Stem one?
Stem two?
Module 11 · Measuring Expectations and Psychological Readiness
On the CIQOL-Expectations instrument, what proportion of cochlear implant candidates hold pre-operative expectations that exceed their actual 12-month outcomes?
Which pre-operative factor most strongly predicts how well an adult recipient learns to use electric hearing, per the cited evidence?
Module 12 · Pre-habilitation and Patient Education
What to expect on switch-on day?
Which behaviour reflects effective pre-habilitation?
Module 13 · Bringing It Together: The Preparation Checklist
On a pre-operative cochlear implant checklist, why is reviewing the CT/MRI a mandatory gate even when the surgeon expects routine anatomy?
When setting expectations during pre-operative counselling, which statement best reflects the evidence the checklist should incorporate?
Module 1 · The Operation in Context: What Implant Surgery Must Achieve
What is the approximate insertion depth represented by full insertion of an array within the basal turn of the cochlea?
In the large multicentre survey of 2,751 implants, what were the reported major and minor complication rates?
Module 2 · Surgical Anatomy of the Temporal Bone
Which three structures form the borders of the facial recess triangle?
Which deep mastoid structure is the cardinal landmark identified before uncovering the short process of the incus?
Module 3 · Medical Fitness and Anaesthesia for Surgery
Why are long-acting neuromuscular blocking agents avoided during cochlear implant surgery?
Approximately what proportion of individuals with profound congenital hearing loss have Jervell and Lange-Nielsen syndrome, prompting routine ECG screening?
Module 4 · The Incision and the Receiver Bed
Why did the inverted-J post-auricular flap replace the original C-shaped flap?
To what thickness is the scalp over the receiver typically thinned, and why is over-thinning dangerous?
Module 5 · Mastoidectomy and the Facial Recess Approach
Which three structures bound the facial recess (posterior tympanotomy)?
What is the chief rationale for the suprameatal (Kronenberg) approach?
Module 6 · Surgical Approaches Compared: Recess, Suprameatal and Beyond
In the suprameatal approach, the facial nerve is kept out of harm primarily because:
Which is a recognised disadvantage of the suprameatal approach compared with the standard facial-recess approach?
Module 7 · Reaching the Scala Tympani: Round Window vs Cochleostomy
Through the facial recess, where does the round-window membrane lie relative to nearby landmarks?
Why has the round-window approach regained popularity over a promontory cochleostomy?
Module 8 · Atraumatic Electrode Insertion: The Soft-Surgery Principles
Which manoeuvre is specific to inserting a precurved perimodiolar array atraumatically?
Why is bone dust meticulously irrigated away before the scala tympani is opened in soft surgery?
Module 9 · Hearing-Preservation Surgery and EAS
What threshold change is conventionally used to define complete (functional) hearing preservation after implantation?
Why are EAS arrays kept short (e.g., the 10 mm Iowa Hybrid)?
Module 10 · Securing the Receiver-Stimulator
Why do many surgeons now omit the drilled bony well and tie-down holes in favour of a tight subperiosteal pocket?
How much redundant electrode lead is typically left in the mastoid of a young child, and why?
Module 11 · The Ossified Cochlea
Which intracochlear compartment is most commonly the first and worst affected by post-meningitic ossification, and why?
A radical drill-out for a totally ossified cochlea most endangers which structure, requiring it to be positively identified before drilling the basal-turn trough?
Module 12 · Malformed Cochleae and the CSF Gusher
On preoperative work-up of a malformed ear, which modality is most decisive for confirming the cochlear nerve is present?
Why is a perimodiolar electrode generally a poor choice in a common-cavity malformation?
Module 13 · Intraoperative Monitoring and Verification
Why are long-acting paralytic agents avoided during cochlear-implant surgery?
An intraoperative ECAP (NRT) is robust on all electrodes, yet the array tip has folded back on itself. What does this illustrate?
Module 14 · Revision and Reimplantation Surgery
What is the principal surgical advantage of the fibrous sheath found around a previously implanted electrode at revision?
Which statement about outcomes after cochlear reimplantation is best supported by the literature?
Module 15 · Minimally Invasive, Image-Guided and Robotic Surgery
In image-guided minimally invasive cochlear implantation, what is the minimum planned safety margin to the facial nerve for the drilled tunnel?
Which is the main proposed advantage of robotic over manual electrode insertion?
Module 16 · Postoperative Care and the Road to Switch-On
Why is cochlear implant activation typically delayed to about 3 to 4 weeks after surgery?
Which precaution is permanent for every cochlear implant recipient undergoing any future head and neck surgery?
Module 1 · The Watchful Operation: Why We Monitor and Preserve
Why can the surgeon not simply rely on watching and asking the patient during a cochlear implant?
Which pairing correctly matches the two guardianship goals of the watchful operation?
Electrocochleography during insertion principally serves which half of this chapter?
Module 2 · Guarding the Face: Intraoperative Facial-Nerve Monitoring
What is the principal real-time warning that the drill is irritating the facial nerve?
As the bone island over the facial nerve is drilled thinner, the stimulus-evoked EMG threshold typically does what?
Why is intraoperative facial-nerve monitoring considered effectively mandatory in CHARGE and malformed ears?
Module 3 · Is the Device Working? Intraoperative Impedance and Integrity
An abnormally low impedance on a cochlear implant channel classically indicates what?
Why are electrode impedances typically lowest at the time of surgery?
What distinct question does the integrity test answer that impedance telemetry does not?
Module 4 · Listening to the Nerve: Intraoperative ECAP/NRT
In approximately what proportion of recipients is an intraoperative ECAP recordable?
A flat or absent intraoperative ECAP is MOST associated with which conditions?
How should intraoperative ECAP thresholds be used for the first MAP?
Module 5 · Reflex and Brainstem: Intraoperative ESRT and eABR
Intraoperatively, how is the electrically-evoked stapedius reflex most simply detected?
What does the ESRT primarily help set during fitting?
Which waveform component is the key marker of the eABR?
Module 6 · Catching the Fold-Over: Intraoperative Imaging and Field Telemetry
On a transimpedance matrix heat-map, what is the signature of a tip fold-over?
Why is detecting a fold-over BEFORE wound closure so valuable?
Which intraoperative imaging tool best resolves whether the array sits in scala tympani versus scala vestibuli?
Module 7 · Where Is the Array? Verifying Electrode Position
Which scala is the intended target for a cochlear implant electrode array?
Compared with lateral-wall arrays, perimodiolar (pre-curved) arrays are associated with:
An abrupt reversal in the spread-of-excitation or transimpedance gradient along the array most specifically suggests:
Module 8 · Why Save the Hearing You Have
The principal speech benefit of electric-acoustic stimulation over full-electric stimulation is most evident in:
Preserving residual hearing is valuable even when no usable acoustic hearing remains because:
Expanded EAS/hybrid candidacy now includes patients who characteristically have:
Module 9 · How the Cochlea Gets Hurt: Mechanisms of Insertion Trauma
On the Eshraghi grading scale, the most severe (grade 4) intracochlear trauma includes:
Delayed (progressive) post-implant hearing loss is best explained by:
Pharmacological otoprotection (steroids, antioxidants, JNK inhibitors) is rationally aimed at which part of insertion trauma?
Module 10 · Soft Surgery: The Atraumatic Technique
Who is credited with the original description of cochlear-implant soft surgery?
Why is a drop of hyaluronic acid placed on the opened endosteum during soft surgery?
Which factor has the clearest technique-only evidence for improving residual-hearing preservation?
Module 11 · The Gentle Electrode: Atraumatic Array Design
Compared with lateral-wall arrays, perimodiolar arrays are associated with:
For hearing preservation, the conventional insertion-depth target is approximately:
The central design trade-off in atraumatic arrays is between:
Module 12 · Protecting the Cochlea with Drugs
The principal mechanism by which glucocorticoids protect the cochlea around CI surgery is:
Compared with systemic dosing, intratympanic/local steroid delivery offers:
Drug-eluting electrode arrays primarily aim to:
Module 13 · Listening as You Insert: Real-Time Electrocochleography
Which electrocochleographic component, generated mainly by outer hair cells and following the stimulus waveform, is the principal real-time signal watched during electrode insertion?
What advantage does recording ECochG directly through the implant's apical electrode have over an extracochlear (round-window) electrode?
What did the randomised controlled trial of ECochG-triggered intervention demonstrate?
Module 14 · Counting What Is Saved: Measuring Hearing Preservation
The HEARRING (Skarzynski) hearing-preservation classification expresses the result as a percentage referenced to what?
What distinguishes 'functional' from merely 'measurable' hearing preservation?
Why should hearing-preservation rates be reported at a later interval such as 6-12 months rather than only at activation?
Module 15 · What Preserved Hearing Buys, and Where This Is Going
Which auditory cues, poorly conveyed by electric stimulation, does the acoustic component of electric-acoustic stimulation help restore?
What is the 'bail-out' when a recipient loses preserved residual hearing after electric-acoustic stimulation?
How does robotic/motorised electrode insertion aim to improve hearing preservation?
Module 1 · What Programming Achieves
Why is the cochlear implant typically activated two to four weeks after surgery rather than on the day of surgery?
Which statement best captures the overarching goal of cochlear implant programming?
Module 2 · Anatomy of the MAP: Thresholds, Comfort and Dynamic Range
What does the electrical dynamic range of a cochlear implant channel represent?
Two biphasic pulses deliver identical charge but one has half the current amplitude. How does it differ?
Module 3 · The First Switch-On
An adult is distressed at switch-on because voices sound robotic and high-pitched. What is the correct interpretation?
Why are larger measurement step sizes (e.g., 5 units ascending) often used when setting T levels at the very first activation?
Module 4 · Setting Threshold (T) Levels
Why are T levels usually based on the recipient's ascending rather than descending responses?
In many modern Advanced Bionics and MED-EL programs, why has precise behavioural T measurement become less critical?
Module 5 · Setting Comfort Levels and Loudness Balancing
When balancing loudness across an electrode pair, which electrode's level is adjusted?
Which best describes the typical shape of the upper-stimulation (C/M) level profile relative to the T-level profile?
Module 6 · Frequency Allocation and the Filter Map
Why does a shallow lateral-wall insertion create a place-frequency mismatch with default allocations?
What happens to frequency allocation when an electrode is disabled in a contemporary system?
Module 7 · Strategy, Rate and Maxima in the Clinic
In an ACE program with a fixed total stimulation budget, what happens to the per-channel rate if maxima is reduced from 12 to 8?
What did the large Nucleus Freedom rate study (500 to 3500 pulses per second) most consistently show?
Module 8 · Front-End Processing: IDR, Sensitivity and Noise
Lowering microphone sensitivity on a cochlear implant processor primarily does what?
A typical medium setting of an adaptive channel-by-channel noise-reduction algorithm applies up to how much attenuation?
Module 9 · Programming the Young Child
Reliable psychophysical loudness balancing in children is typically not achievable until what age?
In the ECAP profile-shifting method for estimating map levels in a young child, what is shifted and by how much?
Module 10 · Objective Measures at the Fitting
An intracochlear contact reads 0.4 kilohms and shares an identical voltage with its neighbour when only one is stimulated. This indicates:
Why is ECAP threshold an imperfect predictor of behavioural T and C levels?
Module 11 · Troubleshooting the MAP
During an apex-to-base sweep, contact 12 sounds clearly lower in pitch than the more apical contact 14. The best management is to:
A recipient complains the implant sounds tinny and over-sharp. The most direct map adjustment is to:
Module 12 · The Poor Performer: A Systematic Work-up
In the systematic work-up of a poor performer, which should be checked FIRST?
A device passes in-vivo integrity testing yet the recipient has declining scores, pain at low levels and frequent failed reprogramming. This pattern best fits:
Module 13 · Bimodal and Bilateral Fitting
The principal acoustic advantage a contralateral hearing aid adds to a cochlear implant (bimodal listening) is:
For an adult with single-sided deafness, the unique benefit of a cochlear implant over a CROS or bone-conduction device is that it:
Module 14 · EAS and Special Maps
In MED-EL EAS fitting, the default crossover frequency is set to:
An electrode produces facial twitching rather than a clear sound. Before disabling it, a reasonable rescue step is to:
Module 15 · Longitudinal Care, Datalogging and Verification
Aided sound-field warbled-tone thresholds are used after implantation primarily to verify that the recipient:
Children's threshold (T) levels typically stabilise:
Module 1 · What We Mean by Outcomes
Why do open-set sentence scores typically exceed open-set word scores in the same cochlear implant recipient?
What is the main limitation of reporting cochlear implant outcomes as a single group mean?
Module 2 · The Outcome Test Battery
In the BKB-SIN test, how is the signal-to-noise ratio for 50% correct derived?
Why was HINT sentences in quiet replaced by AzBio in the contemporary outcome battery?
Module 3 · The Adult Learning Curve
By roughly what time point do most postlingually deafened adults reach a plateau in open-set speech perception?
The continued rise in adult speech scores over months of implant use, even without map changes, is best explained by:
Module 4 · The Variability Problem
In pooled multicentre analyses of postlingually deafened adult cochlear implant users, the standard preoperative demographic predictors together explain approximately what proportion of the variance in postoperative speech scores?
Which test condition is most likely to mask the true between-subject variability in adult outcomes?
Module 5 · Duration of Deafness and Age
In postlingually deafened adults, which preoperative variable is most consistently the single strongest negative predictor of open-set speech recognition?
Which metric has been found to predict spoken word recognition better than duration of deafness alone?
Module 6 · The Ear and the Nerve: Peripheral Predictors
Postmortem temporal-bone studies of former cochlear implant users found which relationship between counted spiral ganglion cell number and the word recognition scores those patients achieved in life?
Which electrode-position finding is most consistently associated with poorer open-set speech outcomes?
Module 7 · Cognition and the Listening Brain
Which cognitive measure has been identified as the strongest cognitive predictor of speech understanding one year after implantation in older adults?
Why does the same word-recognition score sometimes mask very different real-world experiences between two implant users?
Module 8 · Paediatric Outcomes: Language, Literacy and School
In the CDaCI study, children implanted before approximately which age tended to keep language scores within about one standard deviation of normal-hearing peers?
Which factor was associated with better reading achievement in adolescents with cochlear implants?
Module 9 · Speech and Language Development in Children
Children implanted at 8 to 24 months and tested around 5.5 years achieved roughly what average speech intelligibility, compared with those implanted at 25 to 36 months?
Which set of factors is repeatedly identified as shaping language outcome in children with cochlear implants, beyond the device itself?
Module 10 · Hearing in Noise and in Space
The speech-reception threshold in noise is defined as the signal-to-noise ratio at which a listener correctly identifies what proportion of the speech material?
Why does a single cochlear implant provide only limited spatial release from masking?
Module 11 · Music and the Human Voice
Which aspect of music is best preserved through a cochlear implant?
Why does voice-gender and talker identification remain difficult for many implant users?
Module 12 · Two Ears Are Better: Bilateral, Bimodal and SSD Outcomes
Approximately how much threshold improvement does binaural summation provide when the same sound reaches both ears?
What is the primary audiological goal of implanting the deaf ear in single-sided deafness?
Module 13 · Patient-Reported Outcomes
What are the three sections of the Speech, Spatial and Qualities of Hearing scale?
Which feature most distinguishes the CIQOL instruments from earlier hearing questionnaires applied to cochlear implant users?
Module 14 · Outcomes in Special Groups
Compared with adults under 65, elderly cochlear implant recipients most characteristically show:
In late-implanted prelingually deaf adults, which statement best reflects realistic outcomes?
Module 15 · Predicting and Benchmarking Outcomes
Approximately how much of the variance in adult cochlear implant speech outcomes did the large Blamey 2013 analysis attribute to the standard preoperative factors combined?
Which factor did the large Lazard model newly identify as significantly associated with better postimplant performance?
Module 1 · Why Rehabilitation Matters
Which two conditions must both be satisfied for an implanted child to develop spoken language?
How does the rehabilitation task of a post-lingually deafened adult differ from that of a congenitally deaf infant?
Module 2 · The Rehabilitation Team and Pathway
In the auditory-verbal approach to paediatric rehabilitation, who is the primary agent of change?
Which member is characteristically part of an ADULT cochlear implant team but not typically central to a paediatric one?
Module 3 · Plasticity and the Window of Opportunity
What does the latency of the P1 cortical auditory evoked potential index in implanted children?
Why does prolonged auditory deprivation before implantation reduce speech-understanding outcomes in congenitally deaf recipients?
Module 4 · The Principles of Auditory Training
In Erber's listening hierarchy, the ability to determine only whether a sound is present or absent corresponds to which level?
Which description best fits a synthetic (top-down) auditory-training approach?
Module 5 · Auditory-Verbal Therapy
In Auditory-Verbal Therapy, who is regarded as the primary agent of the child's listening and language development?
A practitioner certified to deliver auditory-verbal therapy holds which credential?
Module 6 · Family-Centred Early Intervention
Which factor is considered among the strongest MODIFIABLE predictors of a young implanted child's language outcome?
What is 'acoustic highlighting' as used by coached caregivers?
Module 7 · Developing Spoken Language in Children
Why is a child's post-implant language progress paced to 'listening age' rather than chronological age?
Which factor is most consistently associated with stronger spoken-language outcomes in implanted children?
Module 8 · Speech Production and Articulation
Why does speech production typically improve after cochlear implantation in a child who is profoundly deaf?
Which speech sounds are most often produced in error by implanted children, and why?
Module 9 · Adult Aural Rehabilitation
How does aural rehabilitation for a post-lingually deafened adult differ fundamentally from habilitation for a young deaf child?
Why are adults often under-served by formal rehabilitation, and what is the consequence?
Module 10 · Communication Strategies and Repair
An anticipatory communication strategy is best illustrated by which action?
Speechreading is described as complementary to the implant signal mainly because it supplies which cues that the electric signal conveys poorly?
Module 11 · Training for Noise and the Real World
When introducing background noise into listening training, the recommended starting level is one that:
How does a remote-microphone system primarily help an implant user understand a single talker in noise?
Module 12 · Music Rehabilitation
Why is rhythm the most accessible musical dimension for cochlear implant users?
Adding residual low-frequency acoustic hearing (via EAS or a contralateral hearing aid) most improves which aspect of music perception?
Module 13 · Technology and Telepractice in Rehabilitation
A controlled pilot comparing auditory-verbal therapy delivered by telepractice versus in person in toddlers found:
Which best describes the role of computer- and app-based auditory training in a rehabilitation plan?
Module 14 · School Transition and Educational Support
Why does a remote-microphone/FM system help a child with a cochlear implant in a noisy classroom when simply increasing processor volume does not?
Which statement about mainstream placement of an implanted child is most accurate?
Module 15 · Measuring Progress and Steering Therapy
What is the primary purpose of running the Ling six-sound test as a daily check?
Which tool is a structured parent-interview scale of everyday auditory behaviours scored on a hierarchy from device attachment to speech comprehension?
Module 1 · Beyond the Audiogram: Why Outcomes and Value Matter
What do 0.00 and 1.00 mean?
Why disease-specific over SF-36?
Module 2 · What Is Quality of Life, and How Do You Put a Number on It?
A patient is expected to live 20 more years at a constant health utility of 0.2. How many QALYs is that, and why?
Which best contrasts a generic preference-based instrument (HUI3, EQ-5D) with a disease-specific one (CIQOL) in CI evaluation?
Module 3 · The Generic Yardsticks: HUI3, EQ-5D and Utility
Which instrument is preferred for CI cost-utility analysis because it explicitly contains a hearing attribute?
Pooled across seven studies adults gain about +0.26 in HUI3 utility after CI, supporting a weighted-average cost-utility near which value?
Module 4 · Hearing Through the Patient's Ears: Disease-Specific Instruments
A clinician wants to measure the change in a patient's quality of life specifically attributable to a cochlear implant operation, using a single summary score from -100 to +100. Which instrument is designed for exactly this purpose?
On the Speech, Spatial and Qualities of Hearing scale (SSQ), how do cochlear implant users typically score relative to hearing-aid users, and on which dimension is the gap most pronounced?
Module 5 · Does It Help? Quality-of-Life Gains in Adults
Pooled across seven adult cochlear-implant studies, what is the approximate mean health-utility gain after implantation on a 0.00 (death) to 1.00 (perfect health) scale?
Why do generic preference-based instruments (HUI Mark III, EQ-5D, SF-6D) tend to UNDERESTIMATE cochlear-implant benefit compared with disease-specific tools like the NCIQ or CIQOL?
Module 6 · The Child and the Family: Quality of Life in Pediatric Implantation
When are parent-proxy quality-of-life reports for children with cochlear implants in CLOSEST agreement with the child's own self-report?
A UK national cohort comparing implanted and unimplanted deaf children found which difference in mainstream school attendance?
Module 7 · The Economist's Toolkit: QALYs, ICERs and Thresholds
A patient is expected to live 25 more years. Without an implant her utility is 0.45; with one it rises to 0.70 for life. Ignoring discounting and costs, how many QALYs does the implant gain her?
In a cost-utility analysis, what does the incremental cost-effectiveness ratio (ICER) represent?
Module 8 · Counting the Costs: A Lifetime of an Implant
In a lifetime cost-utility model, why is surgical morbidity usually represented as a temporary reduction in health utility rather than a line-item cash cost?
Adult unilateral implantation costs roughly $12,847 per QALY. Adding a second implant typically costs how much per additional QALY, and what does this imply?
Module 9 · Was It Worth It? Cost-Effectiveness in Adults
In the pooled adult cochlear-implant cost-utility literature, the most frequently cited weighted-average cost per QALY for unilateral implantation is approximately:
Why do generic preference-based instruments such as the HUI and EQ-5D tend to underestimate the benefit of cochlear implantation compared with disease-specific tools like the NCIQ or CIQOL?
Module 10 · The Strongest Case: Cost-Effectiveness in Children
S1?
S2?
Module 11 · The Second Ear and the Hard Cases
Why is the incremental cost-effectiveness ratio for the second cochlear implant typically much higher (~$50,000-$150,000+/QALY) than for the first (~$12,847/QALY)?
Which statement best reflects the economics captured in NICE Technology Appraisal TA166 and related analyses?
Module 12 · Value Beyond the Clinic: Education, Work and Society
Pooled cost-utility analyses of adult unilateral cochlear implantation report a weighted-average ICER of approximately which value, placing the implant within the customary $20,000-$50,000 per-QALY cost-effective range?
What does the incremental cost-effectiveness ratio (ICER) measure, and why is it the central comparison metric in cost-utility analysis?
Module 13 · Worth It for Whom? Access, Equity and the Global Picture
A cochlear-implant programme has a cost-utility ratio of $13,000 per QALY. In which country is it MOST likely to be classified as NOT cost-effective under the WHO-CHOICE 1-3x GDP-per-capita rule?
Roughly what fraction of the global moderate-to-profound hearing-loss burden lies in low- and middle-income countries, and what share of candidates there are actually implanted, the gap that drives the chapter's equity argument?
Module 1 · Who Are the Special Populations?
Which feature best characterises a special-population cochlear implant candidate?
Cochlear implant candidacy over the past decades is best described as:
Module 2 · Single-Sided Deafness and Asymmetric Loss
What is the principal advantage of a cochlear implant over a CROS or bone-conduction device in single-sided deafness?
Which variable most strongly predicts benefit and daily use after cochlear implantation for single-sided deafness?
Module 3 · Auditory Neuropathy Spectrum Disorder
Which test combination defines auditory neuropathy spectrum disorder?
Why does cochlear implantation often work well in OTOF-related auditory neuropathy?
Module 4 · Cochlear Nerve Deficiency
Which imaging finding best confirms the presence or absence of the cochlear nerve before implantation?
Why can some children with an apparently absent cochlear nerve still derive meaningful benefit from a cochlear implant?
Module 5 · Malformed Inner Ears: Candidacy and Expectations
Which single factor most strongly governs whether a malformed inner ear will benefit from an implant?
Which group of malformations tends to achieve the best speech-recognition outcomes after implantation?
Module 6 · Post-Meningitic Deafness and the Ossified Cochlea
Where does post-meningitic cochlear ossification typically begin?
Why can implantation still help an ossified post-meningitic cochlea even with a partial insertion?
Module 7 · Otosclerosis, Meniere's and the Diseased Ear
Why is facial nerve stimulation so much more common after cochlear implantation in far-advanced otosclerosis than in a normal cochlea?
What is the principal reason cochlear implantation is offered in end-stage Meniere's disease?
Module 8 · The Very Young Infant
What year did the FDA lower the approved age of cochlear implantation to nine months?
How do surgical and anaesthetic complication rates in infants under twelve months compare with older children?
Module 9 · The Older Adult and Cognition
What should principally determine whether an older adult is offered a cochlear implant?
How do speech and quality-of-life outcomes typically compare between older and younger cochlear implant recipients?
Module 10 · Children with Additional Disabilities
Approximately what proportion of children with severe-to-profound hearing loss are reported to have a significant additional disability?
In a deaf child whose spoken-language delay is roughly commensurate with a low non-verbal IQ, the most reasonable interpretation is that:
Module 11 · Syndromic Deafness
Why is early cochlear implantation argued for so strongly in Usher syndrome type 1?
Which inner-ear finding should the surgeon anticipate in Pendred syndrome / enlarged vestibular aqueduct?
Module 12 · Prelingual Adolescents and Adults
Why is fluent open-set speech understanding rarely achieved when a congenitally deaf adult is implanted late?
Which is the strongest favourable predictor of better outcome in a late-implanted prelingual candidate?
Module 13 · The Only-Hearing Ear and the Medically Complex Patient
Why has the historical refusal to implant a patient's only or better-hearing ear become largely outdated?
A 70-year-old on warfarin for atrial fibrillation is a strong cochlear implant candidate. What does the evidence support regarding her anticoagulation?
Module 14 · When the Cochlea or Nerve Cannot Be Used: ABI Candidates
Where is the auditory brainstem implant electrode array placed?
Why do non-tumour brainstem-implant recipients generally outperform NF2 recipients?
Module 15 · Special Populations in Low-Resource Settings
Approximately what fraction of people with disabling hearing loss live in low- and middle-income countries?
What feature most distinguishes India's ADIP scheme as an effective low-resource access model?
Module 1 · When the Cochlea Is Built Differently
Approximately what proportion of congenital sensorineural hearing loss shows a radiologically detectable inner-ear malformation?
Which structure is the true determinant of a cochlear implant versus an auditory brainstem implant in a malformed ear?
Which two intra-operative hazards are most characteristic of inner-ear malformations?
Module 2 · How the Inner Ear Is Made — and Mis-Made
From which embryonic structure does the membranous labyrinth of the inner ear arise?
By roughly which week of gestation has the cochlear duct completed its two-and-a-half turns?
Why are incomplete partitions among the mildest inner-ear malformations?
Module 3 · Naming the Malformations: Jackler, Sennaroğlu and Grover
What was the principal organising idea behind Jackler's 1987 classification?
Which incomplete-partition subtype is the classic Mondini deformity, typically with a deficient apical modiolus and frequent enlarged vestibular aqueduct?
What key structure do the original classical classifications fail to grade, despite its decisive role in candidacy?
Module 4 · The Empty Promontory: Michel Aplasia and the Rudimentary Otocyst
Michel aplasia results from developmental arrest at approximately which gestational time point?
How is a rudimentary otocyst best distinguished from a common cavity?
Why is a cochlear implant inappropriate in Michel aplasia and the rudimentary otocyst?
Module 5 · Too Little Cochlea: Aplasia and Hypoplasia
What single imaging feature most cleanly separates cochlear aplasia from Michel aplasia?
In cochlear hypoplasia, which two structures are the key variables predicting implant benefit?
Why is a full-length cochlear-implant array usually inappropriate in cochlear hypoplasia?
Module 6 · One Chamber for Everything: The Common Cavity
Why does a perimodiolar (modiolus-seeking) array make little sense in a common cavity?
What two intraoperative hazards are especially associated with common-cavity surgery?
How does a common cavity differ from cochlear aplasia with a dilated vestibule?
Module 7 · The Incomplete Partitions: IP-I, IP-II and IP-III
What structural deficiency defines the incomplete partitions as a group, separating them from cochlear hypoplasia?
Why are cochlear-implant outcomes in IP-II usually good?
Which IP type is associated with POU3F4 mutations and an almost universal CSF gusher?
Module 8 · The Enlarged Vestibular Aqueduct
Under the Cincinnati criteria, which measurement defines an enlarged vestibular aqueduct?
Which gene is most strongly associated with EVA and Pendred syndrome?
What fluid finding should the surgeon expect and counsel for in a typical EVA cochleostomy?
Module 9 · The Decider: The Cochlear Nerve and Its Bony Canal
On CT, what bony cochlear nerve canal width should prompt MRI to look for cochlear nerve deficiency?
In the parasagittal oblique view of the internal auditory canal, where does the cochlear nerve normally sit?
How does the device decision differ between cochlear nerve aplasia and hypoplasia?
Module 10 · Reading the Malformed Ear: CT and MRI
Which structure is best assessed on a parasagittal-oblique MRI reconstruction through the internal auditory canal?
A vestibular aqueduct is considered enlarged by the Valvassori-Clemis criterion when its midpoint width exceeds:
On CT, an absent modiolus with a wide communication between the internal auditory canal and the cochlear basal turn should prompt the surgeon to anticipate:
Module 11 · The Genes Behind the Shapes
Biallelic SLC26A4 mutations classically produce which combination?
A child with semicircular-canal aplasia and suspected cochlear-nerve deficiency should be tested for mutations in which gene?
Why do membranous malformations (e.g. SLC26A4-related) generally implant better than syndromic malformations with cochlear-nerve deficiency?
Module 12 · In the Operating Room: Gusher, Facial Nerve and the Difficult Insertion
A perilymph/CSF gusher at cochleostomy is most strongly predicted by which imaging finding?
Which precaution is mandatory in cochlear implantation of every malformed ear because of the displaced facial-nerve course in conditions such as CHARGE?
In a common-cavity malformation, the principal misplacement the surgeon must guard against is:
Module 13 · Choosing the Array, Setting Expectations: Electrodes and Outcomes
Why are perimodiolar arrays generally avoided in cochleae with a deficient modiolus?
Which finding is the single strongest negative predictor of cochlear implant outcome in a malformed ear?
Which malformations most often approach normal-anatomy open-set speech results after implantation?
Module 14 · A Prognosis-Oriented Algorithm for Decision-Making
What do the Jackler, Sennaroglu and Grover/SMS classifications omit that the author's algorithm explicitly routes on?
In the algorithm, which incomplete-partition type carries a 100% expected gusher rate?
A child with severe-to-profound SNHL has no useful cochlear lumen and an absent cochlear nerve. Which destination does the algorithm give?
Module 15 · From Diagnosis to Decision: Putting It All Together
Which branch point most decisively separates a cochlear-implant candidate from an ABI candidate?
A conductive malformed ear with a useful lumen and a normal cochlear aperture and nerve maps to which destination?
Which atlas chapters supply the inputs this decision pathway depends on?
Module 1 · Why Two Ears Are Better Than One
What is the primary everyday consequence of listening with only one ear once basic audibility has been restored?
Why can a unilateral implant user have excellent quiet-booth scores yet report exhaustion in real life?
Which of the following is NOT available to a single-eared listener?
Module 2 · The Cues the Brain Uses: ITD, ILD and Spatial Hearing
According to the duplex theory, which cue dominates the localization of low-frequency sounds?
Approximately what is the maximum interaural time difference for an adult human head?
Why do cochlear implants convey ITD poorly?
Module 3 · The Three Binaural Benefits: Head Shadow, Summation and Squelch
Which of the three binaural benefits is purely acoustic and obtained by nearly all bilateral implant users?
Which benefit is the smallest and least reliable in bilateral cochlear implant users, because it depends on interaural timing?
Approximately how large is the head-shadow benefit reported in bilateral implant users by Schleich et al. (2004)?
Module 4 · Finding the Sound: Localization With Two Devices
The dominant interaural cue used by bilateral cochlear implant users to localize sound is:
Going from one implant to two typically changes horizontal RMS localization error by approximately:
Front-back confusions persist in bilateral CI users mainly because:
Module 5 · Speech in Noise: The Real Payoff
The primary mechanism behind the bilateral speech-in-noise benefit when speech and noise are spatially separated is:
The speech reception threshold (SRT) in noise refers to:
Compared with a single lateral noise source, diffuse surrounding noise tends to:
Module 6 · Beyond the Booth: Real-World and Quality-of-Life Benefits
On the SSQ, the subscale where bilateral CI users most clearly outscore unilateral users is:
The 'effect-size paradox' of bilateral implantation refers to the observation that:
A practical advantage of the SSQ12 over the full SSQ is that it:
Module 7 · One Surgery or Two: Simultaneous vs Sequential Implantation
Which feature uniquely defines simultaneous bilateral implantation?
A commonly cited advantage of the sequential approach is that it:
Compared with children, adults considering a second implant:
Module 8 · Mind the Gap: The Inter-Implant Interval
In children, a longer interimplant interval is associated with:
The cortical 'aural preference' seen with prolonged unilateral implant use refers to:
Evidence on long-delayed second implants in older children shows that:
Module 9 · Two Ears for a Developing Brain: Bilateral CI in Children
A key reason bilateral implants matter more in children than in adults is that:
Which classroom-relevant benefit is most directly tied to having two implanted ears?
Current standard of care for a young deaf child with no useful residual hearing favours:
Module 10 · The Second Ear in Adults: Evidence and Candidacy
Which binaural advantage contributes the largest signal-to-noise improvement when speech and noise are spatially separated?
In the Dutch randomized controlled trial of bilateral versus unilateral implantation in adults, the most consistent objective benefit of two implants was:
Why is the second cochlear implant less cost-effective than the first in adults?
Module 11 · Best of Both Worlds: Bimodal Hearing (CI + Hearing Aid)
Bimodal hearing refers to:
What does the acoustic hearing-aid ear primarily contribute that the cochlear implant cannot provide well?
When is moving from bimodal hearing to a second cochlear implant most appropriate?
Module 12 · Making Two Different Ears Work Together: Bimodal Fitting
The primary goal of loudness balancing in bimodal fitting is to:
An advantage of using a coordinated hearing aid and implant from the same manufacturer is that:
If a well-fit, well-balanced bimodal configuration still performs worse than the implant alone and the residual ear has clearly declined, the appropriate next step is to:
Module 13 · The Missing Timing: Why Two Implants Aren't Two Normal Ears
Why do standard CIS/ACE coding strategies degrade interaural time-difference cues in bilateral CI users?
What is the main consequence of having independent (unlinked) automatic gain control in the two processors?
Which binaural ability is most preserved in typical bilateral CI users?
Module 14 · Choosing the Strategy: Bilateral, Bimodal or Wait
An adult CI user has good low-frequency residual hearing in the non-implanted ear. What is the reasonable first strategy?
Why does early bilateral implantation matter most in young children?
When is a second cochlear implant favoured over a bimodal trial in an adult?
Module 15 · Worth the Second Ear? Cost, Access and the Binaural Future
How does the cost-effectiveness of the second cochlear implant typically compare with the first?
Which near-term engineering change most directly improves binaural performance in current bilateral users?
Why is global access a central caveat to the 'binaural future'?
Module 1 · Why Implanting the Cochlea Touches Balance
Which vestibular end organ is closest to the cochlear-implant insertion path and most at risk?
By caloric testing, the approximate risk of SEVERE or profound vestibular loss in the implanted ear is:
Module 2 · Anatomy and Physiology of the Balance Organs
How many sensory organs does each vestibular labyrinth contain?
Why do current vestibular implants target the semicircular canals rather than the otoliths?
Module 3 · How Implant Surgery Injures the Labyrinth
In temporal-bone studies, which vestibular end organ is most frequently damaged after implantation?
Cadaveric insertion pressure transients have been recorded at levels up to approximately:
Module 4 · Who Already Has Vestibular Loss: Etiology and Baseline
Approximately what fraction of CI candidates have some degree of bilateral vestibular hypofunction on caloric testing?
In CHARGE association, the typical vestibular finding relevant to ear selection is:
Module 5 · Reading the Dizzy History and the Five-Minute Screen
A fall on the tandem head-shake Romberg is seen in roughly what proportion of patients with caloric-defined bilateral vestibular hypofunction?
Brief vertigo (<10 s) triggered by Valsalva or loud sound most suggests:
Module 6 · The Vestibular Audiogram I: Canal Tests Across Frequency
Which vestibular test probes the LOWEST stimulus frequency?
Compared with caloric testing, vHIT for detecting post-surgical vestibular change is generally:
Module 7 · The Vestibular Audiogram II: VEMP, Otoliths and Function Tests
Cervical VEMP assesses which end organ and reflex pathway?
Which is the most sensitive single marker of CI-induced vestibular injury?
Module 8 · The Dizzy Patient After Implantation
At the bedside, the presence of nystagmus under Frenzel lenses after CI indicates:
BPPV after cochlear implantation occurs in roughly what fraction of recipients in the first post-op year, and responds to:
Module 9 · Choosing the Ear: Vestibular Risk and Bilateral Implants
When vestibular function is asymmetric, the recommended ear to implant first is:
Simultaneous bilateral implantation is most defensible (from a vestibular standpoint) when:
Module 10 · Atraumatic Surgery: Preserving Hearing and Balance Together
Compared with antero-inferior cochleostomy, the round-window approach is associated with:
In a randomized trial, what intervention reduced post-CI dizziness?
Module 11 · The Child's Balance and Motor Development
After pediatric implantation, which test shows the largest deterioration, reflecting otolith vulnerability?
Children with reduced vestibular function were found to have what change in cochlear-implant device failure risk?
Module 12 · Falls and the Older Recipient
Compared with the general population, the prevalence of falls among hearing-loss audiology-clinic patients is approximately:
Why should vestibular suppressants be stopped after acute vertigo in an older recipient?
Module 13 · The Vestibular and Cochleovestibular Implant Frontier
A multichannel vestibular prosthesis primarily restores function by stimulating:
Which finding best demonstrates that combined hearing-and-vestibular preservation is feasible?
Module 1 · The Complication Landscape: Classifying What Can Go Wrong
In the classic functional taxonomy, what makes a cochlear implant complication major rather than minor?
Across large modern cochlear implant series, the major surgical complication rate is best described as:
Which trio represents three distinct axes used to classify implant complications?
Module 2 · The Wound and the Flap: Skin, Healing and Breakdown
Which under-flap fluid collection is sterile serous fluid rather than blood?
Why have modern minimal-access incisions reduced wound complications compared with the early large flaps?
At what point does flap breakdown almost always force device removal?
Module 3 · Infection and the Implant: From Pocket Infection to Biofilm
Why is a biofilm-associated implant infection so hard to clear with antibiotics alone?
Which organisms are the most common in cochlear implant soft-tissue and device infections?
What is the principal rationale for pneumococcal vaccination in cochlear implant recipients?
Module 4 · In the Operating Room: Intraoperative Complications
The facial recess (posterior tympanotomy) is bounded by the chorda tympani, the fossa incudis and which other structure?
Deliberate sacrifice of the chorda tympani during access most directly produces which symptom?
Why is intraoperative imaging (e.g. conebeam CT or plain radiography) valuable before closing the wound?
Module 5 · Wrong Place, Wrong Path: Electrode Misplacement and Migration
Compared with apical placement in scala tympani, an array that translocates into scala vestibuli is associated with:
Which array type is most prone to scalar translocation and tip fold-over?
A previously well-functioning recipient develops a gradual performance decline with new facial twitching and changed apical impedances months after surgery. The array is intact on telemetry. What should be suspected?
Module 6 · When the Device Fails: Hard and Soft Failure
What distinguishes a hard failure from a soft failure?
What does the cumulative survival percentage (CSP) describe?
Why was an international consensus group convened around cochlear implant reliability?
Module 7 · The Twitch: Facial-Nerve Stimulation
Why does far-advanced otosclerosis predispose to facial-nerve stimulation from a cochlear implant?
Which array characteristic is associated with a higher risk of aberrant facial-nerve stimulation?
What is the principal clinical cost of deactivating electrodes to abolish FNS?
Module 8 · Beyond Sound: Non-Auditory Percepts and Pain
Which finding most favours a biological cause over a device fault for a non-auditory percept?
What is the usual first reprogramming step for a culprit electrode evoking pain on stimulation?
Why is each electrode change balanced against speech outcome?
Module 9 · The Dizzy Recipient: Vestibular Symptoms After Implantation
Which statement best reflects the reported burden of dizziness after cochlear implantation?
Which mechanism is supported by the finding that round-window steroid application reduces post-CI dizziness?
Across the vestibular test battery after CI, which pattern is typical?
Module 10 · The Poor Performer: A Structured Workup
Which presentation most strongly suggests a device or electrode cause rather than a host/central one?
By consensus definition, a cochlear implant 'soft failure' is:
Which is the correct first step in a structured poor-performer workup?
Module 11 · Listening to the Device: Objective Measures in Troubleshooting
An abnormally LOW impedance on two adjacent contacts most likely indicates:
A normal manufacturer integrity test combined with abnormal in-vivo performance points toward:
Which objective measure most directly flags an electrode tip fold-over?
Module 12 · Seeing the Problem: Imaging the Implanted Ear
Which imaging modality is best for determining whether the array lies in scala tympani or scala vestibuli?
The main advantage of a plain cochlear-view radiograph over CT for routine position confirmation is:
Why is intraoperative imaging particularly valued with precurved slim modiolar arrays?
Module 13 · Going Back In: Revision and Reimplantation
What distinguishes a hard device failure from a soft failure?
Why is the fibrous sheath around the original electrode array surgically useful at reimplantation?
What is the most consistent single cause of reimplantation across published series?
Module 14 · Living With the Device: MRI, Magnets and External Hazards
Which feature of a cochlear implant is responsible for most MRI-related problems?
How does a self-aligning (diametric bipolar) magnet improve MRI safety?
What is a sensible everyday precaution against electrostatic discharge for a child with an implant?
Module 15 · Children, Prevention and Building a Safer Programme
Why are implanted children at higher risk of bacterial meningitis than their peers?
What must be allowed for when implanting a young child whose skull is still growing?
What is the cornerstone of meningitis prevention in cochlear implant recipients?
Module 1 · The Frontier: What Still Needs Solving
Average adult cochlear implant performance on sentences in quiet has, over the last three decades:
Why does adding electrodes beyond roughly eight independent channels usually fail to improve performance?
Which statement honestly describes what a cochlear implant does and does not do?
Module 2 · The Steady Hand: Robotics-Assisted Electrode Insertion
On the iotaSOFT system, the surgeon-selectable insertion speed range is approximately:
In the Paris RobOtol adult comparative study using straight arrays, scalar translocation with the robot versus the hand was roughly:
Which best describes the current role of robotic insertion tools like iotaSOFT and RobOtol?
Module 3 · A Keyhole to the Cochlea: Image-Guided and Minimally Invasive Surgery
The defining feature of minimally invasive / percutaneous cochlear implantation is:
In the Antwerp HEARO robotic series, the mean drilling error to the facial nerve was approximately:
What best summarises the current status of image-guided, robotic minimally invasive CI surgery?
Module 4 · The Pharmacological Electrode: Drug-Eluting and Bioactive Arrays
What is the chief advantage of a drug-eluting electrode array over a single peri-operative dose of intratympanic dexamethasone?
In human and animal studies, what bedside telemetry measure most clearly reflects the benefit of a steroid-eluting array?
Which agent is the proof-of-principle for an ANTI-APOPTOTIC (rather than purely anti-inflammatory) approach to protecting the cochlea after implantation?
Module 5 · More Contacts, Less Trauma: Next-Generation Arrays
Why are parylene and polyimide attractive substrates for next-generation thin-film cochlear arrays?
A research high-density micro-fabricated array can carry roughly how many contacts, and what extra capability have some such designs integrated?
For a recipient with usable low-frequency residual hearing, which array characteristic best supports hearing preservation?
Module 6 · Closing the Gap: The Electrode-Neuron Interface
Why does adding more monopolar contacts fail to keep increasing the number of independent channels?
What did an intraneural (penetrating) auditory-nerve array achieve in animal models, and what is its clinical status?
How does close-field electroporation aim to bridge the electrode-neuron gap from the neural side?
Module 7 · Nothing on the Outside: The Totally Implantable Implant
Which component is internal in a conventional cochlear implant but would additionally need to be internal in a totally implantable device?
In the 'invisible-but-chargeable' intermediate design, what is the external coil used for?
Which of the following best describes the current clinical status of totally implantable cochlear implants?
Module 8 · The Microphone Under the Skin and the Power to Run It
What is the primary disadvantage of a subcutaneous (under-skin) microphone for a totally implantable cochlear implant?
Energy harvesting from the cochlea's endocochlear potential is best described as:
Which power approach is already mature and used in current commercial cochlear implant processors?
Module 9 · A Smarter Processor: AI and Sound Processing
Compared with classic Wiener filtering, neural-network speech enhancement in cochlear implant users has been shown to:
An automatic scene classifier such as SCAN primarily:
Why do front-end SNR gains from AI processing not translate one-to-one into perceptual benefit?
Module 10 · Care at a Distance: Remote Programming and Self-Fitting
In studies of remote cochlear implant programming, hearing outcomes were generally found to be:
Self-fitting via remote-assistant fitting has the strongest evidence in which group?
A key value of processor data-logging between visits is that it:
Module 11 · Regrowing the Ear: Hair-Cell and Neural Regeneration
Which transcription factor's forced expression produced new hair cells and improved thresholds in deafened mammals, establishing proof-of-principle for regeneration?
Neurotrophins such as BDNF and NT-3 are being delivered to the cochlea primarily to:
What is the honest current status of inner-ear regeneration in humans?
Module 12 · A Genetic Cure: Gene Therapy Restoring Hearing
Why is OTOF (otoferlin) considered the ideal first target for hearing gene therapy?
Which statement about OTOF gene therapy and cochlear implantation is most accurate?
A correct, non-hyped summary of OTOF gene therapy's current status is that it is:
Module 13 · Hearing in Light: The Optical Cochlear Implant
What is the central physical reason an optical cochlear implant could deliver better spectral resolution than an electrical one?
Why does an optical cochlear implant inherently require gene therapy?
What is the correct current status of optogenetic hearing restoration?
Module 14 · The Self-Tuning Implant: Closed-Loop Fitting
Which objective measure does the implant itself record to estimate the auditory nerve's response without behavioural input?
What does anatomy-based fitting use to assign frequencies to electrodes?
What is the honest current status of a fully self-tuning, environment-aware closed-loop implant?
Module 15 · The Bionic Ear: Putting It Together
Which of these emerging cochlear-implant technologies is genuinely in clinical use today rather than preclinical?
Why is the staging of the 'bionic ear' described as uneven across causes of deafness?
What does the chapter identify as the dominant global unmet need in cochlear implantation?
Module 1 · Why Music Is the Implant's Hardest Sound
Which everyday sound do most cochlear implant recipients find hardest to perceive?
Speech remains intelligible through an implant largely because it depends on which cue?
Why does poor pitch information hurt music recognition more than speech recognition?
Module 2 · The Building Blocks: Pitch, Timbre and Rhythm
The perceptual correlate of a note's fundamental frequency, and the basis of melody, is:
Most melodic information in music lies in fundamentals in which range?
In normal hearing, what two mechanisms together encode pitch?
Module 3 · What the Implant Keeps and What It Throws Away
Which musical dimension survives envelope-based coding (CIS/ACE) best?
Although a CI array may have 12-22 electrodes, how many effectively independent channels do recipients typically behave as if they have?
Why does raising the stimulation pulse rate on a single electrode fail to keep raising perceived pitch?
Module 4 · The Hardest Part: Pitch and Melody
Why does electrically evoked temporal pitch fail to convey most musical melodies?
What is the main reason place-pitch is ambiguous in cochlear implant users?
Compared with normal hearing, the average just-noticeable frequency difference for CI users is approximately:
Module 5 · Which Instrument Is That? Timbre Perception
Which two acoustic features most determine an instrument's timbre?
Why do CI users find sustained string instruments especially hard to identify?
Compared with cochlear implant users, hearing-aid users with similar hearing loss typically:
Module 6 · Rhythm: The One That Survives
Why is rhythm the best-preserved dimension of music for cochlear implant users?
On which music task do CI users most closely match normal-hearing listeners?
What is the key limitation of relying on rhythm in CI music perception?
Module 7 · Many Notes at Once: Harmony and Polyphony
Why are chords and polyphonic textures especially hard to perceive through a cochlear implant?
Which type of music is generally MOST accessible to a cochlear implant user?
Separating a singer's melody from a backing band through an implant is best described as:
Module 8 · Putting a Number on It: Measuring Music Perception
What is the key conceptual difference between music PERCEPTION and APPRAISAL measures?
Which test is a clinically practical CI music battery with pitch-direction, melody, and timbre subtests?
A melodic-contour identification (MCI) task typically requires the listener to:
Module 9 · Can Better Coding Help? Strategies and Music
Why do standard envelope strategies (CIS, ACE, SPEAK) limit music perception?
What does current steering (virtual channels) aim to achieve?
Why are the real-world music gains from advanced coding strategies generally modest?
Module 10 · Out of Tune: Frequency-to-Place Mismatch
The Greenwood function describes:
Why does a shallow electrode array tend to make pitch sound shifted upward (sharp)?
Anatomy-based (place-based) frequency allocation works by:
Module 11 · Growing Up Musical: Children and the Implant
Compared with post-lingually deafened adults, early-implanted children with the same pitch limitation typically:
Which cue do paediatric CI users rely on most for recognising familiar songs?
The strongest predictor of sustained participation in music lessons among children with implants is:
Module 12 · Rescuing the Melody: Bimodal and Electric-Acoustic Hearing
Why does acoustic low-frequency hearing help music more than the implant's electric channels?
Compared with electric-only listening, electric-acoustic (hybrid) listening primarily improves:
Which patient is best positioned for the largest music benefit from acoustic hearing?
Module 13 · Training the Musical Ear: Rehabilitation
Which music skill tends to improve MOST with structured training in CI users?
A randomised crossover trial of online (home) music training found improvement in which outcomes?
The most consistent overall pattern from music rehabilitation studies is that:
Module 14 · Enjoyment, Identity and Quality of Life
The relationship between measured music-perception accuracy and self-reported music enjoyment in CI users is best described as:
Which type of music is generally rated MOST enjoyable by implant recipients?
Focus-group research found that music contributes to recipients' quality of life mainly through:
Module 15 · Toward a Musical Implant: The Future
Why does music expose the limits of cochlear implants more than speech does?
Which of the following is best classed as an INCREMENTAL, currently-available improvement for musical hearing?
What is the main theoretical attraction of optical (optogenetic) stimulation for music?
Module 1 · Beyond Hearing: The Implant's Other Two Jobs
Why does cochlear implantation affect tinnitus and balance and not hearing alone?
In what sense is the implant 'double-edged' for these extra symptoms?
For a typical hearing-ear candidate, how should tinnitus relief be framed?
Module 2 · The Ringing in Silence: Tinnitus in the Deafened Ear
According to the central-gain model, what produces tinnitus after hearing loss?
Roughly how common is tinnitus among people with severe-to-profound hearing loss?
Which tool best captures how much tinnitus disrupts a patient's life rather than just its loudness?
Module 3 · How the Implant Quietens the Ringing
Which mechanism most directly reverses the maladaptive central gain that caused the tinnitus?
What distinguishes residual inhibition from simple masking?
Why does it matter which mechanism dominates in a given patient?
Module 4 · What the Evidence Shows: Tinnitus Outcomes
In systematic reviews of recipients with preoperative tinnitus, which outcome is most common after cochlear implantation?
Which factor most undermines confidence that observed tinnitus improvement after implantation is a true treatment effect?
How should tinnitus benefit be framed when counselling a bilateral candidate?
Module 5 · The Clearest Case: Single-Sided Deafness and Tinnitus
Why is single-sided deafness considered the clearest setting for implant-mediated tinnitus relief?
Compared with a cochlear implant, what do CROS aids and bone-conduction devices do for the tinnitus of the dead ear?
In an SSD candidate whose dominant complaint is incapacitating tinnitus, how does tinnitus factor into the indication?
Module 6 · The Hard Cases: When Tinnitus Persists or Worsens
Which preoperative profile is associated with being among those more likely to feel worse off for tinnitus after implantation?
A recipient develops a new stimulation-related tinnitus percept after activation. What is the most appropriate first device-related step?
How should the predictability of tinnitus worsening after implantation be described to candidates?
Module 7 · Setting Expectations: Counselling and Managing Tinnitus
What is the most accurate single statement to give a candidate about the effect of cochlear implantation on tinnitus?
A recipient is still highly bothered by tinnitus three months after activation. What is the most appropriate next step?
Which intervention has the strongest guideline support as an adjunct to the implant for persistent bothersome tinnitus?
Module 8 · The Electrode and the Labyrinth: How Implantation Affects Balance
Why does cochlear implantation put vestibular function at risk?
Which finding is most characteristic of vestibular change after implantation?
Why is bilateral implantation a particular balance concern?
Module 9 · Checking the Balance System Around Surgery
Which combination of tests best documents both canal and otolith function before implantation?
When ears hear equally, which is generally the safer ear to implant on balance grounds?
A recipient reports dizziness only when the processor is switched on. What does this most suggest?
Module 10 · Restoring the Sixth Sense: Why a Vestibular Implant
Oscillopsia in bilateral vestibular hypofunction is best explained by:
Which is the most characteristic identifiable cause of acquired bilateral vestibular hypofunction?
The central idea behind the vestibular implant is borrowed directly from which established device?
Module 11 · Building a Vestibular Implant: The Device
In a vestibular implant, the component that detects head rotation is the:
Why must a vestibular implant deliver a tonic baseline pulse rate at rest?
The Geneva/Maastricht human vestibular implant work was notable for:
Module 12 · Encoding Head Movement: How It Stimulates
Why does a vestibular implant modulate around a tonic baseline rather than simply switching pulses on for rotation?
Current steering and precompensation in a vestibular implant are used mainly to:
Which statement most honestly describes current vestibular-implant fidelity?
Module 13 · Does It Work? Vestibular Implant Outcomes
What is the principal physiological gain that defines a working vestibular implant?
Why was placebo-mode (sham) testing important in the vestibular-implant trials?
Which best describes the current clinical status of vestibular implants?
Module 14 · Hearing and Balance Together: The Combined Cochleovestibular Implant
What anatomical fact creates the hearing trade-off of vestibular implantation?
Which patients are the most natural candidates for a single combined cochleovestibular device?
What did the van de Berg intralabyrinthine case report establish?
Module 15 · One Device, Three Senses: The Road Ahead
What is the unifying vision that closes this chapter?
Which improvement would most directly let multi-sensory implants stimulate cochlear, canal, and otolith targets selectively?
What equity caveat should temper enthusiasm for advanced multi-sensory implants?
Module 1 · When the Cochlear Implant Is the Wrong Answer
The air-bone gap on an audiogram primarily reflects a problem in which part of the auditory chain?
A cochlear implant is the wrong choice for which of these patients?
Which device class enters the auditory chain furthest along, beyond the cochlear nerve?
In single-sided deafness, what makes a cochlear implant uniquely able versus a bone-conduction device?
The chapter's organising principle for device selection is best summarised as:
Module 2 · Mapping the Implantable Hearing Landscape
Which route to the cochlea is used by an active middle-ear implant?
A passive transcutaneous bone device loses output compared to a percutaneous one mainly because:
In an active transcutaneous bone-conduction implant, what crosses the skin?
Which statement about the device-class map is correct?
Round-window coupling has extended which device class into conductive and mixed losses?
Module 3 · How Bone Conduction Works
Von Bekesy's cancellation experiment demonstrated that bone-conducted and air-conducted sound:
Below about 1 kHz, the dominant bone-conduction pathway is:
Why does bone conduction keep working when the outer and middle ear are diseased?
The often-quoted transcranial attenuation of about 10 dB is best described as:
For device coupling, the physics implies that the ideal interface to the skull is:
Module 4 · Through the Skin: Percutaneous Bone Conduction
What is the chief audiological advantage of a percutaneous over a transcutaneous bone-conduction system?
Which manufacturing and surgical condition most directly threatens osseointegration?
The Holgers classification grades what?
A standard percutaneous processor is most appropriate when the sensorineural component of the loss is:
Compared with magnet-coupled passive transcutaneous systems, percutaneous devices generally:
Module 5 · Across Intact Skin: Passive Transcutaneous Bone Conduction
In a passive transcutaneous system, where is the vibrating transducer located?
How does skin attenuation in a passive transcutaneous system vary with frequency?
Which is a recognised magnet-related complication of passive transcutaneous devices?
Regarding MRI, a passive transcutaneous system with a fixed internal magnet is typically:
Compared with a percutaneous abutment system, the main clinical trade-off of a passive transcutaneous system is:
Module 6 · Power Beneath the Skin: Active Transcutaneous Bone Conduction
What fundamentally distinguishes an active from a passive transcutaneous bone-conduction implant?
The Cochlear Osia drives bone using:
What is the main improvement of the Bonebridge BCI602 over the BCI601?
Why do active transcutaneous systems generally achieve higher output than passive ones?
Regarding MRI, the Osia piezoelectric transducer is advantageous because:
Module 7 · Anchoring Sound to Bone: Implanting Bone-Conduction Devices
Why is a percutaneous abutment acoustically more efficient than a transcutaneous bone-conduction device?
During Bonebridge (BCI) placement, what does 'lifting' the implant body achieve?
How does the Cochlear Osia minimise bone removal compared with the Bonebridge?
Which patients are at the highest risk of failed osseointegration and abutment extrusion?
What is the safest assumption about MRI compatibility across bone-conduction implants?
Module 8 · Driving the Ossicles: Active Middle-Ear Implants
What is the defining principle of an active middle-ear implant?
How does the floating mass transducer generate vibration?
Which component distinguishes a partially implantable from a fully implantable active middle-ear implant?
How does the Envoy Esteem avoid needing a separate implanted microphone?
What recurrent practical limitation pushes fully implantable middle-ear devices toward repeat surgery?
Module 9 · Where to Clip the Transducer: Coupling and Surgery for Middle-Ear Implants
Why does the coupling site largely determine which hearing losses an active middle-ear implant can treat?
Which coupling target is used when the ossicular chain is destroyed and cannot be used?
What is the purpose of the dedicated couplers (RW coupler, PORP/TORP couplers, clips)?
Why does a mixed loss generally demand more transducer output than a pure SNHL?
An implanted Soundbridge underperforms with stable bone-conduction thresholds and imaging showing transducer shift. The leading cause is:
Module 10 · When the Sound Cannot Get In: Conductive and Mixed Loss
Which audiometric measure best reflects the true health of the cochlea in a mixed loss?
A large air-bone gap with good bone thresholds is the signature of an ear best served by what?
Why is congenital aural atresia a textbook indication for a bone-conduction device?
As bone-conduction thresholds worsen in a mixed loss, the device choice tends to shift toward what?
In far-advanced otosclerosis where stapes surgery has failed and the loss is now mixed and severe, what is a reasonable rehabilitation option?
Module 11 · One Dead Ear, Three Different Answers
What is the fundamental difference between a CROS/bone-conduction device and a cochlear implant in single-sided deafness?
Which ability is recovered ONLY by restoring input to the deaf ear?
Why do CROS and bone-conduction devices generally fail to relieve single-sided tinnitus?
In randomised and pooled comparisons for SSD, which option ranks best for localization and spatial speech perception?
A patient who refuses ear surgery and wants a reversible trial is best counselled toward what, with what caveat?
Module 12 · Reading the Audiogram to Pick the Device
For bone-conduction and middle-ear devices in conductive/mixed loss, candidacy is read primarily off which axis of the audiogram?
What is the cochlear implant candidacy box, broadly speaking?
Why is a softband or test-rod trial so valuable before a bone-conduction implant?
Besides the audiogram, what can move a patient from one device class to another?
In single-sided deafness, the audiometric criterion that defines candidacy is best described as what?
Module 13 · Reading the Evidence: How Well Do Other Implantable Hearing Devices Work?
Functional gain is defined as:
Why can a device show a large functional gain yet still be a clinical failure?
In the randomised single-sided-deafness trial, which intervention improved sound localisation?
The dominant limitation of the outcome evidence for these devices is:
Compared with passive transcutaneous bone-conduction devices, active transcutaneous devices tend to perform better mainly:
Module 14 · Choosing the Right Device: A Decision Framework
The single most decisive audiometric number when sorting patients toward bypass-versus-implant strategies is:
In the decision pathway, implantable options are considered only when:
A chronically draining, anatomically disrupted ear most favours which option within the conductive/mixed branch?
When the cochlea is severely-to-profoundly sensorineurally impaired but the cochlear nerve is absent, the appropriate option is:
A patient who will need regular surveillance MRI scans should prompt the clinician to:
Module 15 · Children and the Horizon: Paediatric Use and the Future of Implantable Hearing
In a child with microtia and aural atresia and normal inner ears, the hearing loss is:
Why is a softband bone-conduction device used in infancy rather than waiting for surgery?
The classic anatomical prerequisite for a percutaneous bone-anchored surgical fixture is:
Bilateral bone-conduction fitting in a child with bilateral atresia is justified mainly because it:
A key future direction blurring the lines between device categories is:
Module 1 · When the Cochlea Won't Do: Why a Central Auditory Implant Exists
What does an auditory brainstem implant stimulate?
Why does a cochlear implant fail in a patient with an absent cochlear nerve?
Which condition classically destroys both cochlear nerves and is a leading ABI indication?
Which of these makes a cochlea unsuitable for a conventional cochlear implant?
Compared with most cochlear implant users, the typical NF2 ABI user can expect to gain:
Module 2 · The Cochlear Nucleus Target: A Crowded Corner of the Brainstem
Where does the ABI electrode paddle sit?
Which landmark flags the foramen of Luschka for the surgeon?
Why does a surface paddle engage the speech-relevant VCN poorly?
A throat tickle and cough on stimulating one ABI electrode most likely reflects current spread to which structures?
Why is ABI pitch order determined by patient ranking rather than by electrode number?
Module 3 · From One Electrode to Open-Set Speech: A History of the ABI
Who performed the first ABI and in what year?
For which group did the FDA approve the multichannel ABI in 2000?
What did the original single-channel ABI mainly provide?
Who led the European expansion of the ABI to non-tumour adults and children?
The finding that non-tumour ABI users outperform NF2 users suggests that:
Module 4 · Who Needs an Auditory Brainstem Implant?
What anatomical structure does an ABI stimulate?
Which feature most defines a patient who needs an ABI rather than a CI?
Why is NF2 the classic ABI indication?
What does the CI-first principle state?
Which investigation best demonstrates an absent cochlear nerve?
Module 5 · The ABI Device: A Cochlear Implant With a Different Electrode
What is the defining physical difference between an ABI and a cochlear implant?
Roughly how many active electrodes do contemporary surface ABI arrays carry?
What was the PABI designed to do?
What was the clinical result of the PABI trial?
Which manufacturer's ABI is the one cleared for use in the United States?
Module 6 · The ABI in NF2: Implanting a Distorted Brainstem
When is the ABI typically placed in an NF2 patient?
Why is the cochlear nucleus difficult to target in ABI surgery?
Which intraoperative test guides ABI electrode positioning?
Why do NF2 ABI users generally do worse than non-tumour users?
What is a realistic primary goal for most NF2 ABI users?
Module 7 · When the Tumour Is Not the Problem: The Non-Tumour ABI
Why do non-tumour ABI users generally outperform NF2 ABI users with the same device?
Which non-tumour aetiology tends to give the BEST ABI speech outcome?
An adult with bilateral cochlear ossification gets only non-auditory twitching and inconsistent detection from a cochlear implant. The ABI is best described here as:
Which risk must be discussed specifically because the non-tumour adult is operating purely to gain sound?
What is the single most useful predictor of likely ABI benefit a clinician can give a non-tumour candidate preoperatively?
Module 8 · Hearing for a Brain That Has Never Heard: The Paediatric ABI
Which child is a candidate for an ABI rather than a cochlear implant?
Why is early implantation emphasised in paediatric ABI?
What is the recommended age window for paediatric ABI in prelingually deaf children?
Why is operating on an infant under one year considered higher risk for ABI?
What makes programming a young ABI child especially challenging?
Module 9 · Finding the Lateral Recess: The ABI Operation
Through which structure is the ABI electrode paddle introduced to reach the cochlear nucleus?
A key advantage of the translabyrinthine approach over the retrosigmoid approach for ABI is:
How is optimal positioning of the ABI paddle confirmed intraoperatively?
Which set of landmarks is used to identify and bound the lateral recess?
Which is the MOST frequent surgical complication of the ABI operation, especially via the retrosigmoid approach?
Module 10 · Finding the Sweet Spot: Intraoperative Monitoring
Why is intraoperative guidance more critical for an ABI than for a cochlear implant?
Which feature characterises a well-placed ABI eABR?
Why is a vertex-to-neck montage with bipolar stimulation preferred for intraoperative eABR?
What does activation of a neighbouring cranial nerve at low stimulus current indicate?
Which safety concern specifically requires alerting the anaesthetist before ABI stimulation?
Module 11 · Activating and Programming the Electric Brainstem
Why is the first activation of an ABI performed in a monitored, resuscitation-ready setting?
What is done with an electrode that produces only a non-auditory sensation?
What does pitch ranking accomplish in ABI programming?
Why is ABI fitting generally slower and more individualised than cochlear-implant fitting?
What is realistic counselling for most NF2 ABI users about expected benefit?
Module 12 · The Non-Auditory Side-Effect Problem
Why are non-auditory side-effects so much more central to the ABI than to the cochlear implant?
Which of these is a recognised ABI non-auditory side-effect?
How do non-auditory side-effects most directly limit ABI performance?
Which programming adjustment can help reduce a non-auditory side-effect before an electrode is abandoned?
How does cochlear-implant facial-nerve stimulation contrast with the ABI side-effect problem?
Module 13 · What an ABI Can Deliver: Outcomes and Honest Expectations
Across large ABI series, roughly what proportion of recipients perceive useful auditory sensations from the device?
What is the single strongest predictor of whether an ABI user achieves open-set speech?
How does the time course of ABI benefit typically compare with a cochlear implant?
When ABI sound is added to lip-reading, the typical effect is:
Which group shows the widest variability in open-set outcomes and the greatest dependence on early implantation and habilitation?
Module 14 · Nerve If You Can, Nucleus If You Must: ABI versus CI
Where does a cochlear implant deliver stimulation compared with an auditory brainstem implant?
Why does a CI outperform an ABI when a functioning cochlear nerve exists?
Which is a standard indication for an ABI rather than a CI?
A child has bilateral cochlear nerve deficiency. The interface principle suggests:
The maxim summarising ABI-versus-CI candidacy is best stated as:
Module 15 · Higher Up the Pathway: The Auditory Midbrain Implant and the Frontier
What anatomical structure does the auditory midbrain implant (AMI) target?
Why is the inferior colliculus an attractive target for a penetrating array?
What was the main lesson from the penetrating ABI (PABI) trial?
In the first AMI clinical trial, how did the best patient's outcome compare?
Which factor is emphasised as essential to the future of central auditory prostheses alongside better arrays and placement?
Module 1 · The Implant and the Deaf World: Why This Chapter Exists
Why does a clinical cochlear-implant atlas include a chapter on ethics and Deaf culture?
The convention of writing 'Deaf' with a capital D refers to:
The contemporary mainstream Deaf-scholarship position on implanting children is best described as:
Why is 'device versus no device' a misleading way to frame the choice?
Many culturally Deaf people prefer identity-first language ('a Deaf person') because:
Module 2 · Deaf Culture and Identity: A Linguistic Minority, Not a Disability Group
What most centrally defines membership in a Deaf community?
The concept of 'Deaf gain' refers to:
Why can the word 'loss' land as an insult to some Deaf people?
Historically, why is there suspicion in the Deaf community toward technologies that center speech?
Which is a common misunderstanding hearing clinicians make?
Module 3 · Two Models of Deafness: Why the Models Clash, Not the Device
The medical (pathological) model locates the problem of deafness primarily in:
Under the social or cultural model, the more pressing question about a deaf child is:
How does each model tend to define 'success' after implantation?
Why is it said that the clash of models, not the device, drives much of the controversy?
The WHO biopsychosocial (ICF) framework is useful because it:
Module 4 · From Alarm to Dialogue: A History of the Controversy
What event most directly triggered the early Deaf-community alarm over cochlear implants?
The capital-D usage in 'Deaf' is generally meant to signal what?
How did the NAD's 2000 statement differ from its 1991 statement?
Which development most helped cool the controversy?
In its mature form, the controversy now centers mainly on what?
Module 5 · Deciding for a Child: The Core Ethical Tension
Why is there no neutral 'wait and see' option in pediatric implantation?
What is the central empirical claim behind the case for early implantation?
Which fact most strengthens the consent/identity objection?
Why is the 'just remove it later' reply to the irreversibility worry only partly reassuring?
What is the most defensible practical stance when both arguments hold force?
Module 6 · Best Interests and Real Consent: Deciding Well for a Deaf Child
Under the best-interests standard as applied in pediatrics, what is considered?
Why do most analysts place both implanting and declining within permissible parental choices?
Which element is essential for consent to be genuinely informed in this setting?
What does the literature repeatedly find about counseling practice?
What best characterizes shared decision-making in this context?
Module 7 · The Child's Right to an Open Future
What did Feinberg mean by a child's 'rights-in-trust'?
How did Dena Davis reframe the central tension for the deaf child?
Why does the open-future argument fail to settle the implant debate on its own?
What asymmetry favors the both-and (implant plus early sign) reading?
How do implant advocates typically apply the open-future argument?
Module 8 · Language Deprivation: The Danger Both Sides Fear
What causes language deprivation in a deaf child?
Roughly when is the sensitive period for first-language acquisition strongest?
Which downstream effects are associated with early language deprivation?
Why is an 'implant and hope, no sign' strategy considered risky?
How does recognizing language deprivation reframe the implant debate?
Module 9 · Bilingual-Bimodal: Sign and Spoken Together
What does 'bimodal' refer to in the bilingual-bimodal model?
What did studies of deaf children of deaf parents suggest about implant outcomes?
What did the large multisite cohort study report?
What is a key methodological criticism of the cautionary studies on sign exposure?
What is the unifying commitment across the contested evidence?
Module 10 · Is Deafness a Problem to Be Fixed? The Disability-Rights Critique
The social model of disability locates the central difficulty of deafness primarily in:
The expressivist objection claims that routinely eliminating a trait:
A common counter-argument to the expressivist objection is that:
Why does the disability-rights critique apply more weakly to a competent adult?
The 'open future' argument is invoked by BOTH sides in the paediatric debate because:
Module 11 · Who Gets to Hear? Equity, Access and Justice
Globally, most of the world's deaf children:
In the United States, paediatric implantation rates have historically been higher among:
A major reason funding a device alone does not guarantee equity is that:
Among qualifying adults in high-income countries, cochlear implant uptake is:
A Deaf-aware view of equity holds that a just system should also:
Module 12 · Choosing Hearing, Choosing Deafness: Genetics and Reproductive Ethics
A common, testable genetic cause of congenital deafness involves variants in:
Selection technologies (PGT, prenatal testing) are ethically distinctive because they:
The famous case most associated with selecting FOR deafness involved:
Surveys of hearing children of Deaf adults regarding selection technology generally found that most:
The three values most directly in tension in this debate are:
Module 13 · Counselling Families with Cultural Humility
Roughly what proportion of deaf children are born to hearing parents?
Cultural humility in this context is best described as:
What developmental priority should counselling separate from the device decision?
According to the scoping review, connecting hearing families with Deaf role models tends to:
Parents in qualitative studies frequently report that the most distressing aspect of post-diagnostic counselling is:
Module 14 · The Adult and Late-Deafened Experience
Why is the central ethical tension of the paediatric implant debate largely absent for competent adults?
Historically, implantation was first approved for:
A key difference between the late-deafened adult and the culturally Deaf adult is that:
Interview research on late-deafened adults after implantation found:
Respecting autonomy in the adult setting requires the clinician to:
Module 15 · Toward Common Ground
How has the dominant framing of the debate evolved?
Which point now attracts broad agreement across previously opposed camps?
Evidence on bilingual-bimodal approaches (implant plus sign) indicates they:
Which issue still genuinely divides the field?
The clinician's respectful synthesis is best summarised as:
Module 1 · Hearing in the Real World: Beyond the Test Booth
Why does an excellent quiet-booth score over-predict daily-life success for CI users?
Which feature of electric hearing most directly explains poor performance in noise?
Why should sentence recognition be tested in noise as well as in quiet?
Which sequence best describes this chapter's logic?
A recipient scores 95% in quiet but 30% at a +5 dB SNR group setting. The best interpretation is:
Module 2 · The Problem of Noise: Why a Crowd Is the Enemy
What does a +5 dB SNR mean?
Roughly how much more favourable an SNR do many CI users need versus normal-hearing listeners for the same understanding?
Energetic masking refers to:
Why is a single competing talker especially damaging for CI users?
The most direct way to overcome the CI SNR penalty in a hard environment is to:
Module 3 · Reverberation, Distance and the Tyranny of the Room
Why is reverberation particularly harmful to cochlear implant users?
By the inverse-square law, doubling the distance from a talker in a free field reduces the direct-sound level by about:
Critical distance is the distance at which:
Why can a recipient hear a partner across a small table yet lose a friend two seats away in a lively restaurant?
Which is the most reliable way to defeat both distance and reverberation at once?
Module 4 · The First Link: Where the Microphone Lives
Why is the processor microphone described as the first link in the real-world chain?
What is the acoustic advantage of placing a microphone at the entrance of the ear canal (the T-Mic concept)?
How does behind-the-ear microphone placement change incoming sound compared with a healthy ear?
What capability does a second microphone primarily unlock?
A recipient reports slowly worsening sound quality with an otherwise stable MAP. What should be suspected first?
Module 5 · Pointing the Ear: Directionality and Beamforming
How does a directional microphone improve the signal-to-noise ratio?
What distinguishes an adaptive beamformer from a fixed directional pattern?
In which situation does directionality provide the greatest benefit?
Why can sound-booth tests overestimate real-world directional benefit?
What is the main limitation of a strongly directional, always-on setting?
Module 6 · Cleaning the Signal: Noise Reduction and Scene Analysis
In what situation is single-channel noise reduction more useful than directionality?
How does SNR-based (Wiener-type) gain work within a frequency band?
What is the most reliable benefit of single-channel noise reduction?
How is wind noise typically detected and managed?
What does scene classification add to the processor?
Module 7 · Set and Forget: How the Processor Reads the Room
What is the main purpose of an automatic scene classifier in a sound processor?
Which acoustic feature most directly helps the classifier distinguish speech from steady noise?
Why does directional processing provide little benefit when speech and noise come from the same direction?
What does automatic sensitivity (autosensitivity-type) control typically do in a noisy room?
Which situation still commonly justifies a dedicated manual program rather than relying on automation?
Module 8 · Bring the Mic to the Talker: Remote and FM/DM Systems
Why is a remote microphone the most effective tool for hearing in noise and at distance?
What advantage do digital-modulation systems (e.g. Roger) have over older analogue FM?
Which connection method couples a remote-mic receiver to the processor via the telecoil?
Roughly how large can the SNR or SRT benefit of remote microphone systems be in challenging noise?
What is the most common fitting error that undermines remote-microphone benefit?
Module 9 · The Invisible Cable: Telecoils and Hearing Loops
How does a telecoil produce sound from a hearing loop?
What is the main acoustic advantage of listening through a hearing loop in a large reverberant venue?
What does an automatic telecoil (autocoil) feature do?
Why can the same loop sound stronger or weaker depending on head position?
How does telecoil/loop technology best relate to newer personal wireless streaming?
Module 10 · Cutting Out the Room: Bluetooth and Direct Audio Streaming
The main reason direct streaming improves listening over the processor microphone is that it:
MFi and ASHA are best described as:
Auracast (part of Bluetooth LE Audio) is significant for hearing access because it enables:
The LC3 codec used by LE Audio chiefly provides:
The streaming-to-microphone mixing ratio matters because:
Module 11 · The Ecosystem Around the Ear: Accessories, Apps and Telecare
Thinking of the processor as a hub is useful because:
Datalogging in a modern processor records:
Remote-care and remote-check workflows have been shown to:
For a bilateral user, an accessory should ideally:
A common cause of accessory problems found at follow-up is:
Module 12 · Beyond the Device: Assistive Listening and Real-World Accessibility
The three stacked layers that together produce real-world access are:
Alerting systems for deaf/hard-of-hearing users typically work by:
CART (Communication Access Real-time Translation) is best described as:
Under ADA-type legislation, assembly areas with a public-address system must:
Auracast broadcast audio is relevant to venue accessibility because it:
Module 13 · Beyond the Booth: Measuring Real-World Benefit
Why is a quiet-booth percent-correct score often inadequate for modern implant users?
What does an adaptive speech-in-noise procedure converge on?
Which test is specifically recommended for cochlear implant candidates and children when QuickSIN is too difficult?
What unique information does processor datalogging add to outcome assessment?
Which instrument was developed specifically to measure quality of life in cochlear implant users?
Module 14 · The Coached Listener: Counselling for Daily Listening
Why is setting realistic expectations considered a clinical intervention?
Which is an effective communication-repair strategy?
Which environmental change most directly improves lip-reading support in noise?
A remote microphone helps most because it primarily improves what?
How do counselling and auditory training relate?
Module 15 · The Listening Machine: The Future of Real-World Hearing
Where has the main frontier of real-world hearing progress shifted in recent years?
Why is deep-learning denoising especially valuable for implant users?
What does Auracast (Bluetooth LE Audio broadcast) enable for implant users?
What problem does own-voice processing address?
What is the realistic status of EEG attention-decoded, brain-steered hearing?
Module 2 · Impedance & electrode interface
Which stimulation mode normally gives the lowest impedance values and is the clinical default?
An abnormally LOW impedance on a contact most suggests:
Which objective measure can flag an electrode-array tip fold-over without imaging?
Module 3 · ECAP / Neural Response Telemetry
The N1 peak of the ECAP is generated by:
Forward-masking subtraction removes the stimulus artifact by exploiting:
Compared with the acoustic CAP, the ECAP is larger and earlier mainly because:
Module 4 · ECAP threshold & functions
The ECAP threshold is most correctly obtained by:
A steep amplitude growth function slope is generally interpreted as indicating:
A broad spread-of-excitation function indicates:
Module 5 · Electrical stapedius reflex
The electrical stapedius reflex is most useful for anchoring which part of the MAP?
Post-operatively, the electrical stapedius reflex is typically recorded with immittance equipment in the:
Why are intra-operative ESRTs generally higher and more variable than awake post-operative values?
Module 6 · Electrically-evoked ABR
Compared with the ECAP, the eABR primarily adds information about:
The most robust and clinically used peak of the eABR is:
In which scenario is the eABR most valuable?
Module 7 · Electrical cortical responses
The P1 cortical response in implanted children is used as a biomarker of:
Compared with the eABR, recording cortical responses (CAEPs) usually requires the patient to be:
The P1 evidence base contributed to which change in clinical practice?
Module 8 · Intraoperative ECochG
Intraoperative ECochG during CI surgery primarily aims to:
The workhorse signal monitored during insertion is the:
An abrupt ~30–40% drop in CM amplitude during insertion should prompt:
Module 9 · Objective measures → the MAP
Which objective measure best anchors the comfortable-level (C/M) ceiling of a MAP?
Why is the ECAP threshold better used as a profile than as an absolute value?
A MAP built purely on objective measures should be regarded as:
Module 10 · Troubleshooting & special cases
In suspected device soft failure, the most informative objective evidence is usually:
Loud-sound-triggered facial twitching after activation most likely represents:
In cochlear nerve deficiency, a present, replicable eABR supports:
Module 11 · Manufacturer systems compared
NRT, ART, and NRI are three manufacturers' names for systems that record:
Which is true about level values across manufacturers?
Cochlear's AutoNRT obtains ECAP thresholds primarily using:
Which statement about the cochlear-implant manufacturer landscape is correct?
Module 13 · Future directions, AI & emerging tech
AutoNRT, which finds ECAP thresholds automatically, is an early clinical example of:
Panoramic ECAP (PECAP) is being developed primarily to:
A multicentre trial supported which of these as non-inferior to in-person care?
Why will an optogenetic cochlear implant need a new objective-measures toolbox?