الفهرس 
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Abstract
SUMMARY
Cochlear implantation has proved to be a successful treatment for severely and profoundly deaf individuals. A cochlear implant (CI) enhances speech perception in quiet and noise. Improved speech perception has been due to ongoing development in CI electrode array design, new speech processing strategies, and by implanting patients with increasing amounts of residual hearing. However, not all patients benefit to the same degree. Research has shown that different factors may affect speech perception scores.
The current study was designed to analyze the influence of insertion depth and electrode length on the speech comprehension of Cochlear implanted patients after 3 and 6 months of device use.A total 20 cochlear implanted patients (13 females and 7 males; with a mean of 27.60 ±8.15 years old) were enrolled in the study between October 2018 to October 2020. The patients were recruited from three hospitals: Kasr El-Aini and Beni-Suef university hospitals. All patients were subjected to, recording of demographic data, full history taking, full clinical examination, otological evaluation, aided evaluation, speech test in quiet and noise and finally the Nijmegen Cochlear Implant Questionnaire (NCIQ).
Results showed that Aided-Thresholds at 0.5, 1, 2 and 4 kHz were significantly highest with decrease the number of active electrodes. Aided-Thresholds at 0.5 kHz showed positive moderate linear correlation with CI Duration at baseline assessment (12 Active Electrodes).
The speech recognition threshold (SRT) was significantly highest at 4 active electrodes as compared with 8 and 12 active electrodes with a statistically significant p-values <0.001 between 4 as compared with 8 and 12 active electrodes; however non-statistically significant difference was detected between 12 Vs. 8 active electrodes. Speech discrimination in quiet was significantly highest with increase the number of active electrodes. The initial SDS was set at 0 dB SNR; was significantly highest with increase the number of active electrodes. The initial SDS was set at (0 dB S/N) was significantly lowest among studied CI patients with hereditary causes of hearing loss; (p-value = 0.045). Testing in noise (+10 dB S/N) was significantly lowest at 4 active electrodes as compared with 8 and 12 active electrodes with a statistically significant p-values <0.001 between 4 as compared with 8 and 12 active electrodes; however non-statistically significant difference was detected between 12 Vs. 8 active electrodes (p-value= 0.171). Testing in noise (-10 dB S/N) was significantly lowest at 4 active electrodes as compared with 8 and 12 active electrodes with a statistically significant p-values <0.001 between 4 as compared with 8 and 12 active electrodes; however non-statistically significant difference was detected between 12 Vs. 8 active electrodes (p-value= 0.109). Nijmegen Cochlear Implant Questionnaire (NCIQ) total score was significantly lowest at 4 Active Electrodes as compared with 8 and 12 Active Electrodes with statistically significant p-values (0.003, 0.001 and 0.001) for a 12 Vs. 8 Electrodes, 12 Vs. 4 Electrodes and 8 Vs. 4.
In conclusion, improvements in cochlear implant electrode technology and a soft surgical technique have enabled acoustic hearing preservation following cochlear implant surgery in patients with hearing loss. from the current study results we can conclude that speech recognition generally increases as the insertion depth and number of electrodes activated increase. Our results support previous findings that cochlear implantation significantly improves QoL and hearing capacity.
No correlation was observed between the studied variables age at hearing loss, time, and duration of CI use for the QoL domains and subdomains of the NCIQ.