Linguistic Assessment Tools for the Digisonic® Dual Electric-Acoustic Speech Processor

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Figure 2: Verbotonal training allows a child to hear her own voice using a microphone and headphones and to feel speech through the soundboard on her wrist.Neuroplasticity allows patients' brains to restructure themselves when the optimal frequency response (OFR) with hearing devices and regular auditory therapy are provided. But are we doing enough to facilitate this restructuring? Verbotonal rehabilitation, an auditory-based strategy that maximizes listening skills of those with hearing impairment and other communications disorders, simultaneously allows the development of intelligible spoken language through binaural listening. The verbotonal system includes diagnostic therapy, habilitation, rehabilitation, speech disorders, and foreign languages. First introduced in 1967 at the University of Tennessee, Knoxville, the method quickly expanded worldwide due to positive clinical outcomes, but clinicians still may not be taking advantage of some tools to improve word understanding for patients using hearing aids and cochlear implants. THE VIBROTACTILE PHASE What's the difference between the infant, child, and adult brain? Under age 5, a child can learn to speak two languages fluently. After puberty, a teenager has an adult brain, and it's difficult for him to learn a second language. Vibrotactile learning is optimal below age 2, which is why it is best to place hearing aids and cochlear implants in children under 5. Hearing specialists must adapt their strategy to infant, child, and adult brains. All infants learn from vibrotactile and proprioceptive input; the fetus feels and hears his mother's body and speech rhythms. After birth, the infant first feels and then hears through wide bandwidths of 2 Hz to 20,000 Hz. Verbotonal always begins with this wideband amplification regardless of the patient's age. At birth, vibrotactile and proprioceptive senses are more dominant than auditory senses, which strengthen as the child's brain develops. Verbotonal rehabilitation takes advantage of the early dominant vibrotactile sense with body movements to develop sound awareness using a VTU speech vibrator with a common bone vibrator. (Figure 1.) The vibrator responds from 2 Hz to 1000 Hz, and is attached to the infant's wrist or to a speech board. Using a speech vibrator, speech board, and headphone during therapy, a child can feel and hear his parent's voice and via a special microphone, a child can hear his own voice. (Figure 2.)Figure 1: Verbotonal rehabilitation takes advantage of the early dominant vibrotactile sense with body movements to develop sound awareness using a VTU speech vibrator with a common bone vibrator.Early vibrotactile input will establish sound awareness, and prepare the child's brain to accept speech through hearing aids, cochlear implants, or both. Most infants go through a preimplant evaluation stage where hearing aids are fitted bilaterally. With effective training, some infants can continue with hearing aids while others will need binaural cochlear implants as soon as possible. Developing a successful training program, however, takes careful planning. SPEECH, RHYTHM, INTONATION Hearing aids and cochlear implants should be adjusted to include low speech frequencies so the patient can hear the octave changes when a speaker's words have an emotional pitch. Changing vocal pitch adds meaning to speech, and is essential to word understanding. Verbotonal therapy sets hearing aids and cochlear implants to include speech frequencies below 300 Hz with a speech vibrator. A cochlear implant electrode at 188 Hz or lower is set to stimulate the client's neural reserve in the cochlea. Seven perceptual parameters are used for error analysis and correction. (Table 1.) Begin with speech modifications and move on to body movements. These corrections may be difficult at first, but because the hearing specialist has normal speech patterns, he can effectively correct errors. Infants and children may have balance and coordination problems so vestibular function should be assessed when possible. Reporting optimal octaves for each of the 40 phonemes is a helpful tool for analyzing perceptual errors, such as why a patient with a certain audiometric pattern makes a particular mistake. Optimal octaves also provide a foundation for the tonality perceptual continuum.Table 1: Body movements and speech modifications based on the parameters.OPTIMAL FREQUENCY RESPONSE The optimal frequency response changes with brain maturation and the progress patients make with therapy. Some clients may always need the speech vibrator while others will progress with only auditory input. The verbotonal clinician uses the VLU by changing the center frequency, bandwidth, and slopes to 0, 6, 12, 18, 20, or 60 dB/octave. Once the client's brain is trained under the OFR with the verbotonal system, the OFR is shifted toward an optimal hearing aid setting. As Robert Martin, PhD, noted in his March Hearing Journal column, patients will often comment during training, “If I could only hear like this with my hearing aids.” (See FastLinks.) With digital hearing aids and cochlear implants, gain needs to be adjusted independently in each of the 10 to 15 frequency bands to create the optimal frequency response. The slope toward low frequencies is an important adjustment for the wide flat frequency and bimodal (discontinuous) responses on the VTU and the hearing aid response. In 1972, Guberina constructed eight nonsense syllables as logatomes: /bru-bru, mu-mu, bu-bu, vo-vo, la-la, ke-ke, shi-shi, and si-si/. Asp developed a shortened three logatome test —/mu-mu, la-la, si-si/ — to evaluate detection and perception through VTU, hearing aids, and cochlear implants. Most often it is used without amplification in distance evaluation. Can the client repeat si-si correctly without using amplification or visual cues? If not, he has a high-frequency hearing loss. This is an effective screening tool for the tonality perceptual continuum. TONALITY PERCEPTUAL CONTINUUM The tonality perceptual continuum (TPC) is based on filtered optimal-octaves and the spectral pitch (tonality) of each phoneme. The TPC ranges from low to mid to high tonality. Verbotonal uses a phoneme, logatome, and word or sentence that is homogenous in tonality. For instance, /i/, /si-si/, cease, and “she is my sister” are all homogenous and in high tonality. At the low end of the tonality continuum are /u/, /mu-mu/, moon, and “mama blew a bubble.” Remember, the tonality continuum represents the frequencies on the cochlear continuum. If an error occurs in a lower tonality than the target tonality, change the optimum frequency response by adding high frequencies, reducing low frequencies, or both. Use the continuum for correcting errors. Phoneme and logatome testing are preferred because they minimize client guessing. The phoneme /i/ minimizes guessing but a word or a sentence includes guessing. Because the word level is important, we've included a list of homogenous tonality words in five categories: low, low-mid, mid, mid-high, and high. (Table 2.) These test words can be presented inside or outside the sound booth. Note that adding more gain in the high-frequency region may not always be the solution when a patient makes an error. With digital technology, the OFR can be used by altering the gain in individual frequency bands until good results are obtained. The prescribed frequency response is a starting point; the client's preference is key.Table 2: Homogenous tonality words.Conversational speaker-to-listener distance is three feet; the speech level is 65 dB SPL (50 dB HL) at the listener's ear. At two inches, the speech level is 95 dB SPL (80 dB HL). Use this as a reference. The hearing specialist must keep his normal speaking loudness at different distances to be effective. This takes discipline and training. Outside the booth, doubling the distance between the clinician and the client's ear reduces the speech signal by 6 dB; half the distance increases it 6 dB. With a tape line on the floor, increase the distance gradually until the client misses a word, then decrease the distance until the client correctly repeats it. This will help the client manage louder or softer speech and distances. Closer distances increase loudness and reduce the effect of noise and reverberation. MAKING UP FOR LOST TIME Placing hearing aids or cochlear implants at age 1 means the infant missed a whole year not hearing. How do we make up for lost time? Will he always be behind? Verbotonal uses intensive vibrotactile, proprioceptive, and body movement training to treat the infant because he needs to hear and feel speech all the time. Some hearing specialists use aided pure-tone thresholds within 20 dB HL to indicate normal hearing, but it's not that simple. Current thinking holds that normal cochlear implant thresholds mean normal hearing. That is, once the implant is programmed, the client will hear like normal hearing people. If this were true, the hearing specialist's job would be easy. Ironically, cochlear implants have created a need for effective habilitation or rehabilitation. Diagnostic therapy involves evaluation for implant candidacy, examination of speech recognition through hearing aids, preimplant counseling, initial programming of the implants, counseling, and the client repeating words, sentences, and paragraphs. As an option, verbotonal treatment includes perceptual parameters, tonality error analysis, and correction with a speech vibrator to feel and hear speech. OVERCOMING OBSTACLES Implementing verbotonal therapy is not without financial obstacles. Medicare and private insurers offer low reimbursement for aural rehabilitation and cochlear implant programming. Habilitation and rehabilitation therapy should already be included in the initial or follow-up hearing aid or cochlear implant visit. While using the verbotonal system will add 30 to 40 minutes to the visit, the patient will be satisfied with the new optimum frequency response, and will refer others to your clinic. The initial financial setback will provide an opportunity for increased earnings if the practitioner improves his client's word understanding. Remember, the best form of advertisement is good hearing aid or cochlear implant results. The Hearing Journal article, “Retraining the brain when hearing aids aren't enough,” noted that digital hearing aid technology has advanced, but the technology itself has not been able to resolve all the communication problems of the hearing impaired. (See FastLinks.) Whether the hearing specialist uses advanced hearing aid technology or cochlear implants, these devices are only a remediation tool for the defective peripheral hearing organ to send information to the brain. Unless we as hearing health care providers modify our thinking to change the way we practice, we are not doing enough to serve our clients. FastLinks • Read Dr. Robert Martin's Nuts and Bolts column on word understanding at http://bit.ly/WordUnderstanding. • Read “Retraining the brain when hearing aids aren't enough” at http://bit.ly/HJRetraining. • Comment about this article by writing to [email protected]. • Follow us on Twitter at twitter.com/hearingjournal.

Introduction: Cochlear implantation allows auditory stimulation in individuals with bilateral profound hearing loss with limited benefits from conventional hearing aids. This device facilitates language development in children with profound sensorineural congenital hearing loss. The language development of children who use cochlear implants has differences when compared with that of normal-hearing children. This study investigated the linguistic performance of children who use cochlear implant over time and the influence of age at implantation on the results. Materials and methods: Study on the spoken language development in children with profound sensorineural congenital hearing loss implanted between 19 to 60 months of age in Centro Hospitalar de Coimbra. The evaluation instrument was a Portuguese Language Development Test (Teste de Avaliacao da Linguagem na Crianca). The participants were divided into 4 groups, based on age at implantation: before 25 months, from 25 to 36 months, from 37 to 48 months and after 48 months of age. Results: A comparison was made between the results of the four implanted children groups, as well as with normative data available for the test used. The implanted group that showed the best final results and the evolution curve most similar to that of the normative data was the group implanted before 25 months of age. No statistically significant differences were found between the studied groups. Conclusion: The collected data indicates a positive effect of early implantation on language development. The obtained results are in agreement with the literature. New studies should include more individuals and the evaluation of other aspects of child development.

Introduction: Cochlear implants have proved their clinical efficacy and have overcome a routine treatment for profound sensorineural impairment. More than thirty years pass since the first cochlear implant was used. These years, and the increasing number of implanted devices, have shown however some limitations and technical failures. These electronic device failures are unpredictable and sometimes difficult to diagnose. Description of two cases: The authors present two cases to illustrate failures of the intracochlear device. Both cases required a cochlear reimplantation surgery. Discussion and conclusion: There are multiple causes for intracochlear device’s failure. Management of implant failures, including revision surgeries, is becoming an increasingly important part of cochlear implant program activity.

The aim of the study was to investigate the link between temporal fine structure (TFS) processing, pitch, and speech perception performance in adult cochlear implant (CI) recipients, including bimodal listeners who may benefit better low-frequency (LF) temporal coding in the contralateral ear. The study participants were 43 adult CI recipients (23 unilateral, 6 bilateral, and 14 bimodal listeners). Two new LF pitch perception tests-harmonic intonation (HI) and disharmonic intonation (DI)-were used to evaluate TFS sensitivity. HI and DI were designed to estimate a difference limen for discrimination of tone changes based on harmonic or inharmonic pitch glides. Speech perception was assessed using the newly developed Italian Sentence Test with Adaptive Randomized Roving level (STARR) test where sentences relevant to everyday contexts were presented at low, medium, and high levels in a fluctuating background noise to estimate a speech reception threshold (SRT). Although TFS and STARR performances in the majority of CI recipients were much poorer than those of hearing people reported in the literature, a considerable intersubject variability was observed. For CI listeners, median just noticeable differences were 27.0 and 147.0 Hz for HI and DI, respectively. HI outcomes were significantly better than those for DI. Median STARR score was 14.8 dB. Better performers with speech reception thresholds less than 20 dB had a median score of 8.6 dB. A significant effect of age was observed for both HI/DI tests, suggesting that TFS sensitivity tended to worsen with increasing age. CI pure-tone thresholds and duration of profound deafness were significantly correlated with STARR performance. Bimodal users showed significantly better TFS and STARR performance for bimodal listening than for their CI-only condition. Median bimodal gains were 33.0 Hz for the HI test and 95.0 Hz for the DI test. DI outcomes in bimodal users revealed a significant correlation with unaided hearing thresholds for octave frequencies lower than 1000 Hz. Median STARR scores were 17.3 versus 8.1 dB for CI only and bimodal listening, respectively. STARR performance was significantly correlated with HI findings for CI listeners and with those of DI for bimodal listeners. LF pitch perception was found to be abnormal in the majority of adult CI recipients, confirming poor TFS processing of CIs. Similarly, the STARR findings reflected a common performance deterioration with the HI/DI tests, suggesting the cause probably being a lack of access to TFS information. Contralateral hearing aid users obtained a remarkable bimodal benefit for all tests. Such results highlighted the importance of TFS cues for challenging speech perception and the relevance to everyday listening conditions. HI/DI and STARR tests show promise for gaining insights into how TFS and speech perception are being limited and may guide the customization of CI program parameters and support the fine tuning of bimodal listening.

Purpose: Electric acoustic stimulation (EAS) relies on the preservation of low-frequency hearing and adequate amplification of these frequencies. EAS has been achieved by fitting the cochlear implant (CI) speech processor together with an ipsilateral in-the-ear hearing aid. This study will evaluate the outcomes when CI/EAS users upgrade to a new combination of hearing aid and speech processor in 1 device (DUET™). Method: Nine EAS patients participated in this study. Before switchover and after 2 and 8 months of DUET device use, they were assessed using monosyllables and sentences in quiet and in noise. Additionally, a questionnaire, the Abbreviated Profile for Hearing Aid Benefit (APHAB), was used to evaluate subjective impressions. Results: All subjects performed equally well, or even better, after switchover. This was also demonstrated over time. The participants with EAS before switchover performed equally afterwards, while those who used CI only did markedly better with the new device, especially in noisy conditions. Slight preference for the new system was also demonstrated with the APHAB. Conclusion: All subjects showed benefit in noise; CI-only users before switchover particularly benefited from the new hearing system. Those who applied EAS before switchover performed equally well. The DUET allows individuals better access to EAS.

In modern cochlear implants, the electrode array has a small volume, is less stiff, and is positioned to prevent traumatic contact with the fine structure of the cochlea. With these improvements, the electrode array causes less trauma, and preservation of residual inner ear function is possible. Newly developed speech coding strategies are based on the psychology of hearing. The fine structure of speech is reproduced by mimicking the temporal excitatory patterns of inner hair cells. The role of the virtual channel is to excite the spiral ganglion neurons located between two electrode contacts by controlling the current spread from two neighboring electrodes. The psychoacoustic masking model is also utilized in channel selection. This model considers the physiological masking effect and reduces the number of stimulated channels without deteriorating the speech understanding. Due to the development of atraumatic electrode arrays, residual hearing at low frequencies can be preserved after cochlear implantation. The remaining hearing can be utilized to transmit low-frequency sounds, and the spiral ganglion neurons in the basal turn, which transmit high-frequency sounds, can be electrically stimulated (electric acoustic stimulation). Bilateral cochlear implantation is also a new trend. The use of two implants improves sound source localization and speech understanding in noisy environments.

Cochlear Implants Present and Future

To investigate the music perception skills of adult cochlear implant (CI) users in comparison with hearing aid (HA) users who have similar levels of hearing impairment. It was hypothesized that the HA users would perform better than the CI recipients on tests involving pitch, instrument, and melody perception, but similarly for rhythm perception. Fifteen users of the Nucleus CI system and 15 HA users participated in a series of music perception tests. All subjects were postlingually deafened adults, with the HA subjects being required to meet the current audiological criteria for CI candidacy. A music test battery was designed for the study incorporating four major tasks: (1) discrimination of 38 pairs of rhythms; (2) pitch ranking of one-octave, half-octave, and quarter-octave intervals; (3) instrument recognition incorporating three subtests, each with 12 different instruments or ensembles; and (4) recognition of 10 familiar melodies. Stimuli were presented via direct audio input at comfortable presentation levels. The test battery was administered to each subject on two separate occasions, approximately 4 mo apart. The results from the rhythm test were 93% correct for the CI group and 94% correct for the HA group; these scores were not significantly different. For the pitch test, there was a significant difference between the HA group and the CI group (p < 0.001), with higher mean scores recorded by the HA group for all three interval sizes. The CI subject group was unable to rank pitches a quarter-octave apart, only scoring at chance level for this interval size. In the instrument recognition test, although there was no significant difference between the mean scores of the two groups, both groups obtained significantly higher scores for the subtest incorporating single instrument stimuli than those incorporating multiple instrumentations (p < 0.001). In the melody test, there was a significant difference between the implantees' mean score of 52% correct and the HA group's mean of 91% (p < 0.001). As hypothesized, results from the two groups were almost identical for the rhythm test, with the HA group performing significantly better than the CI group on the pitch and melody tests. However, there was no difference between the groups in their ability to identify musical instruments or ensembles. The results of this study indicate that HA users with similar levels of hearing loss perform at least equal to, if not better than, CI users on these music perception tests. However, despite the differences between scores obtained by the CI and HA subject groups, both these subject groups were largely unable to achieve accurate or effective music perception, regardless of the device they used.

小児人工内耳装用者におけるＦＭ補聴システムの活用状況

<b>Purpose: </b>There is a well-established relationship between hearing loss and psychological symptoms. To ensure audiological rehabilitation is provided appropriately for older adults with comorbid psychological symptoms, a greater understanding of their preferences and experiences is needed. This study sought to understand experiences of hearing loss and audiological rehabilitation from the perspective of older adults with comorbid psychological symptoms (e.g., depression, anxiety, psychosis).<b>Design: </b>A qualitative study using in-depth semistructured interviews was conducted with older adults who had attended audiological rehabilitation within the last year and scored above established cutoffs on measures of depression, anxiety, and psychosis. A thematic analysis generated themes that related to participants’ experiences of hearing loss and audiological rehabilitation.<b>Results:</b> Participants included 14 older adults (eight men and six women) with an average age of 70.5 years (<i>SD</i> = 4.45, range: 64–80) who received hearing aids or a cochlear implant. Three major themes emerged from the analysis of participant interviews. “The cumulative impact of hearing loss and psychological symptoms” theme describes the two-way, additive relationship between hearing ability and psychological symptoms. “The experience of loss throughout hearing loss and audiological rehabilitation” captures subjective losses, the impact they have, and how participants cope with them. In contrast, “The experience of gain throughout hearing loss and audiological rehabilitation” describes the participants’ reported gains, their related impacts, and coping strategies.<b>Conclusions: </b>The experiences of participants revealed that the presence of comorbid psychological symptoms can influence the experience of hearing loss and audiological rehabilitation. These findings have implications for how audiological rehabilitation is provided to ensure optimal outcomes for adults with hearing loss and comorbid psychological symptoms.<br><b>Supplemental Material S1. </b>Sampling matrix containing number of participants fulfilling criteria (gender, age, hearing device, psychological symptoms) to obtain maximum variation sampling.<br><b>Supplemental Material S2.</b> Interview topic guide containing initial and follow-up open-ended questions.<br>Laird, E. C., Bennett, R. J., Barr, C. M., &amp; Bryant, C. A. (2020). Experiences of hearing loss and audiological rehabilitation for older adults with comorbid psychological symptoms: A qualitative study. <i>American Journal of Audiology.</i> Advance online publication. https://doi.org/10.1044/2020_AJA-19-00123

Disability is a profoundly relational category, always already created as a distinction from cultural ideas of normality, shaped by social conditions that exclude full participation in society of those considered atypical Faye Ginsburg, Rayna Rapp, Disability worlds, 2013. This article explores how the temporal needs of intervention for deaf people defines therapies inside the clinical spaces, and appears as an essential and political element inside the controversy between associations and institutions deafness related. Inside the clinical/therapeutic process of enabling language for deaf, the “time” – divided by the contradiction “fast”/“slow” – appears as characteristic element as well as useful tool to investigate health system linked to deafness. In a biomedical fieldwork defined by the balance of power between social actors – associations, family, deaf people, audiologists, otorhinolaryngologists, speech therapists – the “time” and “mandate” practical-operational of clinical professionals tend to manage the production of health and disease. From this context, my contribution refers to an ethnographic case that I followed with health and education professionals to structuring an Italian Sign Language educational path, after the “failure” of biomedical approach based on multiple operations for inserting a Cochlear Implant.

Background: Breast cancer represents the most common type of neoplasm in women around the world. Breast reconstruction following mastectomy has become a demanding procedure in the treatment of patients suffering from breast cancer. Their major role is to improve the quality of life of women, leading to better aesthetic outcomes. Based on each type of reconstruction, the complications following surgery and the duration of hospital stay, the financial implications slightly vary. Methods: Our study included 168 female patients who underwent immediate or delayed breast reconstruction after mastectomy. We assessed the clinical management of each of these cases and we evaluated the average final cost of the treatment after the reconstruction, focusing on the reconstructive method used, the complications that occurred and the number of days of hospitalization. Results: The total cost of care in breast reconstruction surgery depends on the type of reconstructive procedure used, which consequently affects the duration of hospitalization of the patients. The expenses also depend on the materials that are used: the type of implant/expander or the use of ADM. Costs were higher in patients who underwent breast reconstruction using a latissimus dorsi flap associated with an implant, in comparison to reconstruction using a free flap. Conclusions: Breast reconstruction represents a crucial process in the management of women who underwent mastectomies following cancer and presumes variable financial resources, depending on the chosen reconstructive method.

Purpose:Cochlear implant (CI) recipients demonstrate variable speech recognition when listening with a CI-alone or electric-acoustic stimulation (EAS) device, which may be due in part to electric frequency-to-place mismatches created by the default mapping procedures. Performance may be improved if the filter frequencies are aligned with the cochlear place frequencies, known as place-based mapping. Performance with default maps versus an experimental place-based map was compared for participants with normal hearing when listening to CI-alone or EAS simulations to observe potential outcomes prior to initiating an investigation with CI recipients.Method:A noise vocoder simulated CI-alone and EAS devices, mapped with default or place-based procedures. The simulations were based on an actual 24-mm electrode array recipient, whose insertion angles for each electrode contact were used to estimate the respective cochlear place frequency. The default maps used the filter frequencies assigned by the clinical software. The filter frequencies for the place-based maps aligned with the cochlear place frequencies for individual contacts in the low- to mid-frequency cochlear region. For the EAS simulations, low-frequency acoustic information was filtered to simulate aided low-frequency audibility. Performance was evaluated for the AzBio sentences presented in a 10-talker masker at +5 dB signal-to-noise ratio (SNR), +10 dB SNR, and asymptote.Results:Performance was better with the place-based maps as compared with the default maps for both CI-alone and EAS simulations. For instance, median performance at +10 dB SNR for the CI-alone simulation was 57% correct for the place-based map and 20% for the default map. For the EAS simulation, those values were 59% and 37% correct. Adding acoustic low-frequency information resulted in a similar benefit for both maps.Conclusions:Reducing frequency-to-place mismatches, such as with the experimental place-based mapping procedure, produces a greater benefit in speech recognition than maximizing bandwidth for CI-alone and EAS simulations. Ongoing work is evaluating the initial and long-term performance benefits in CI-alone and EAS users.Supplemental Material:https://doi.org/10.23641/asha.19529053

Minimally traumatic surgical techniques and advances in cochlear implant (CI) electrode array designs have allowed acoustic hearing present in a CI candidate prior to surgery to be preserved postoperatively. As a result, these patients benefit from combined electric-acoustic stimulation (EAS) postoperatively. However, 30% to 40% of EAS CI users experience a partial loss of hearing up to 30 dB after surgery. This additional hearing loss is generally not severe enough to preclude use of acoustic amplification; however, it can still impact EAS benefits. The use of electrocochleography (ECoG) measures of peripheral hair cell and neural auditory function have shed insight into the pathophysiology of postimplant loss of residual acoustic hearing. The present study aims to assess the long-term stability of ECoG measures and to establish ECoG as an objective method of monitoring residual hearing over the course of EAS CI use. We hypothesize that repeated measures of ECoG should remain stable over time for EAS CI users with stable postoperative hearing preservation. We also hypothesize that changes in behavioral audiometry for EAS CI users with loss of residual hearing should also be reflected in changes in ECoG measures. A pool of 40 subjects implanted under hearing preservation protocol was included in the study. Subjects were seen at postoperative visits for behavioral audiometry and ECoG recordings. Test sessions occurred 0.5, 1, 3, 6, 12 months, and annually after 12 months postoperatively. Changes in pure-tone behavioral audiometric thresholds relative to baseline were used to classify subjects into two groups: one group with stable acoustic hearing and another group with loss of acoustic hearing. At each test session, ECoG amplitude growth functions for several low-frequency stimuli were obtained. The threshold, slope, and suprathreshold amplitude at a fixed stimulation level was obtained from each growth function at each time point. Longitudinal linear mixed effects models were used to study trends in ECoG thresholds, slopes, and amplitudes for subjects with stable hearing and subjects with hearing loss. Preoperative, behavioral audiometry indicated that subjects had an average low-frequency pure-tone average (125 to 500 Hz) of 40.88 ± 13.12 dB HL. Postoperatively, results showed that ECoG thresholds and amplitudes were stable in EAS CI users with preserved residual hearing. ECoG thresholds increased (worsened) while ECoG amplitudes decreased (worsened) for those with delayed hearing loss. The slope did not distinguish between EAS CI users with stable hearing and subjects with delayed loss of hearing. These results provide a new application of postoperative ECoG as an objective tool to monitor residual hearing and understand the pathophysiology of delayed hearing loss. While our measures were conducted with custom-designed in-house equipment, CI companies are also designing and implementing hardware and software adaptations to conduct ECoG recordings. Thus, postoperative ECoG recordings can potentially be integrated into clinical practice.