title: Programming peculiarities in two cochlear implant users with superficial siderosis of the central nervous system.
abstract: OBJECTIVE
  To report the audiological outcomes of cochlear implantation in two patients with severe to profound sensorineural hearing loss secondary to superficial siderosis of the CNS and discuss some programming peculiarities that were found in these cases.
  
  
  METHODS
  Retrospective review. Data concerning clinical presentation, diagnosis and audiological assessment pre- and post-implantation were collected of two patients with superficial siderosis of the CNS.
  
  
  RESULTS
  Both patients showed good hearing thresholds but variable speech perception outcomes. One patient did not achieve open-set speech recognition, but the other achieved 70% speech recognition in quiet. Electrical compound action potentials could not be elicited in either patient. Map parameters showed the need for increased charge. Electrode impedances showed high longitudinal variability.
  
  
  CONCLUSIONS
  The implants were fairly beneficial in restoring hearing and improving communication abilities although many reprogramming sessions have been required. The hurdle in programming was the need of frequent adjustments due to the physiologic variations in electrical discharges and neural conduction, besides the changes in the impedances. Patients diagnosed with superficial siderosis may achieve limited results in speech perception scores due to both cochlear and retrocochlear reasons. Careful counseling about the results must be given to the patients and their families before the cochlear implantation indication.
authors.affiliation: Department of Otolaryngology, Hospital das Clínicas, University of São Paulo School of Medicine, Av. Dr. Enéas de Carvalho Aguiar, 255, 6º andar/sala 6167, CEP, São Paulo, SP 05403-000, Brazil. alinebittencourt@hotmail.com
authors.forename: Aline Gomes
authors.initials: AG
authors.lastname: Bittencourt
authors.forename: Maria Valéria Schmidt
authors.initials: MV
authors.lastname: Goffi-Gomez
authors.forename: Mariana Hausen
authors.initials: MH
authors.lastname: Pinna
authors.forename: Ricardo Ferreira
authors.initials: RF
authors.lastname: Bento
authors.forename: Rubens
authors.initials: R
authors.lastname: de Brito
authors.forename: Robinson Koji
authors.initials: RK
authors.lastname: Tsuji
mesh_terms: D000328:Adult; D003054:Cochlear Implants; D018450:Disease Progression; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012806:Siderosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D013063:Speech Discrimination Tests / Q000379:methods*; D013067:Speech Perception