Speech perception outcomes with an<unk>  are generally poorer than those reported in cochlear implant multichannel CI users. Most patients are able to detect the presence of environmental sounds and speech. Speech understanding gradually improves during the first three years after activation, and most patients experience better speech understanding using a combination of lip-reading and the<unk> , as opposed to lip-reading alone. However, most patients are unable to understand speech using only their<unk> . There are two reasons that could explain the difference in outcomes between cochlear implants and<unk> s. Firstly, non-auditory side-effects, such as vertigo, limit the overall number of electrodes that can deliver useful frequency information. Electrodes found to cause one of these side-effects are deactivated, resulting in fewer signals reaching the brain. In addition, the<unk>  is unable to offer the same tonotopic range as the cochlea. With a cochlear implant, the electrodes positioned in the basal end of the cochlea elicit a higher pitch sensation than those positioned in the apical end. In contrast, the tonotopic map within the cochlear nucleus runs parallel and obliquely through the nucleus and the<unk>  positioned on the surface does not stimulate neural structures in such a clear, tonotopically ordered way. This makes it harder to achieve optimal results during fitting. Patients without NF2 tend to experience better speech outcomes with an<unk>  than those with NF2. A study by Colletti found that a significant number of patients without NF2 were able to understand speech with an<unk> , including effortless telephone use. It is believed that the tumours caused by the NF2 damage specialised cells in the cochlear nucleus important for speech perception. There is some evidence to suggest that<unk>  can help to reduce the effect of tinnitus and improve quality of life. Better language outcomes are also expected with younger children implanted before the age of 2. Because of the wide range of possible outcomes, it is crucial that patients and/or their parents are counselled effectively about what they can realistically expect from an<unk> . Parents are advised about additional communication modalities available, such as the use of sign language, as the ultimate goal is to facilitate language with the child.
Auditory brainstem implant
Vibroacoustic therapy
Totally implantable cochlear implant
Audio therapy
Direct acoustic cochlear implant
Bone-anchored hearing aid
Cochlear implant
Middle ear implant