[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to investigate the neurological integrity and physiological status of the auditory brainstem tracts and nuclei in children with chronic lead (Pb) exposure using non-invasive acoustic stapedius reflex (ASR) measurements of afferent and efferent-neuromuscular auditory function. Following audiological examinations, uncrossed (ipsilateral) and crossed (contralateral) brainstem ASR responses were evoked by pure tone (500, 1000, and 2000 Hz), and broadband noise (bandwidth: 125-4000 Hz) stimulus activators. The ASR threshold (ASRT), amplitude growth, and decay/fatigue were measured by conventional clinical middle ear immittance methods in a group of Andean children (age range: 2-18 years) with a history of chronic environmental Pb exposure from occupational Pb glazing. Blood lead (PbB) levels of the study group (n=117) ranged from 4.0 to 83.7 μg/dL with a mean PbB level of 33.5 μg/dL (SD: 23.6; median: 33.0: CDC III Classification). The PbB distribution data indicated that 77.8% (n=91) of the children had PbB levels greater than the CDC action line of 10 μg/dL. Repeatable, normal ASRTs were elicited for ipsilateral (mean: ≤90 dB HL) and contralateral (mean: ≤97 dB HL) stimulation for each acoustic activator. Spearman Rho correlation analysis indicated no significant association between PbB level and ipsilateral or contralateral ASRT for any of the stimulus activators. The ASR amplitude growth results showed typical growth functions with no Pb-associated aberrations. No statistical association was found between ASR decay/adaptation (ASRD) and PbB level for any of the stimulus activators. The results of stapedius muscle reflex testing using several stimulus activators showed no significant relationship between PbB level and the physiological integrity of the auditory brainstem mediated ASR responses in children with chronic Pb exposure and elevated PbB levels.
Journal of the neurological sciences 07/2011; 306(1-2):29-37. · 2.32 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The influence of the solitary avian middle ear muscle, the m. stapedius, on auditory sensitivity and sound transmission was investigated in the domestic chicken, Gallus gallus. Electrophysiological recordings of inner ear microphonic potentials (MP) were made in order to determine the effects of calibrated, mechanically induced stapedius muscle (SM) tension changes on sounds reaching the auditory receptor cells. The maximum MP responses recorded during the pre-tension measurements were on the order of 200 µ, V and were linear (on a log-log scale) over a range of 40–100 dB SPL. Tension levels of 50–400 mN in the SM caused a reduction of up to 20 dB in the MP at frequencies throughout the auditory spectrum. It is concluded that the SM of Aves serves to protect the inner ear receptor cells against overstimulation. In addition to attenuating the amplitude of the MP response, SM tension changes caused significant changes in the phase of the signals reaching the inner ear. The magnitude of attenuation in the ipsilateral MP response to 200–400 mN of tension was found to be similar to the interaural attenuation that occurs when sound is transmitted to the ipsilateral ear from the contralateral ear via the intracranial passageway. The similarity in MP amplitude changes resulting from SM tension and intracranial transmission suggests that the SM may be involved in interaural interaction and thereby may aid in sound localization.
[Show abstract][Hide abstract] ABSTRACT: The influence of the solitary avian middle ear muscle, the m. stapedius, on auditory sensitivity and sound transmission was investigated in the domestic chicken, Gallus gallus. Electrophysiological recordings of inner ear microphonic potentials (MP) were made in order to determine the effects of calibrated, mechanically induced stapedius muscle (SM) tension changes on sounds reaching the auditory receptor cells. The maximum MP responses recorded during the pre-tension measurements were on the order of 200 microV and were linear (on a log-log scale) over a range of 40-100 dB SPL. Tension levels of 50-400 mN in the SM caused a reduction of up to 20 dB in the MP at frequencies throughout the auditory spectrum. It is concluded that the SM of Aves serves to protect the inner ear receptor cells against overstimulation. In addition to attenuating the amplitude of the MP response, SM tension changes caused significant changes in the phase of the signals reaching the inner ear. The magnitude of attenuation in the ipsilateral MP response to 200-400 mN of tension was found to be similar to the interaural attenuation that occurs when sound is transmitted to the ipsilateral ear from the contralateral ear via the intracranial passageway. The similarity in MP amplitude changes resulting from SM tension and intracranial transmission suggests that the SM may be involved in interaural interaction and thereby may aid in sound localization.
[Show abstract][Hide abstract] ABSTRACT: The preservation of central neurophysiological function was assessed in a 32-year-old woman with hydranencephaly using brainstem auditory evoked responses (BAER), auditory middle latency responses (MLR), cortical auditory evoked responses (CER), strobe electroretinograms (ERG), strobe-flash visual evoked responses (VER) and median and tibial nerve somatosensory evoked responses (SER). The BAER to the right ear stimulation revealed wave peaks I through VII with normal thresholds, morphology and latencies, while the BAER in the left ear was abnormal. The auditory MLR and CER were absent. Grossly normal strobe ERGs were acquired bilaterally with peak waves at 20 and 50 ms. Strobe VERs were poorly defined and abnormal bilaterally. Left and right median nerve SER revealed significant conduction defects in the large fiber sensory system caudal to the thalamus, above the lower pontine level. Bilateral tibial nerve stimulation revealed normal knee popliteal fossa potentials, but distinct conduction defects in the large fiber sensory system rostral to the lower spinal cord. Brainstem electrophysiological measures revealed functional auditory afferent tracts and nuclei, in the absence of cortical influence, suggesting intact unilateral auditory function, which would support clinical observations of behavioral auditory responses in hydranencephaly.
Journal of the Neurological Sciences 01/2008; 263(1-2):198-207. · 2.24 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Hydranencephaly is a rare condition in which the cerebral hemispheres are absent at birth and are replaced by membranous sacs in a cerebrospinal fluid-filled cranium. Surviving hydranencephalic patients have a functional brainstem and possible remnants of the cerebral cortex. This case report examines hearing function and the integrity of the brainstem mediated stapedius muscle reflex (SMR) in an adult with hydranencephaly, using middle ear impedance change measures. The brainstem mediated ipsilateral and cross-brainstem contralateral SMRs were elicited in the right ear at normal threshold levels for noise bands of 0.25-1.0, 1.0-4.0, and 0.25-4.0 kHz (broadband), and at the sinusoidal frequencies of 0.5, 1.0, and 2.0 kHz. The ipsilateral and contralateral SMR decay rates were normal. The growth in the SMR amplitude in response to noise and pure tone stimuli from threshold to saturation over a 15-20 dB range was normal and showed essentially sigmoidal curves. The normal ipsilateral and crossed brainstem contralateral electrophysiological SMR in this hydranencephalic patient demonstrated the preservation of peripheral hearing reception and functional brainstem auditory afferent and efferent tracts and nuclei in the absence of corticofugal influence.
[Show abstract][Hide abstract] ABSTRACT: During the last decade, there have been numerous interesting findings regarding the roles of neurotrophins, nitric oxide, reactive oxygen species, glutamate receptors, and shock protein in the auditory system. These findings have provided a scientific basis for the development of techniques to protect the auditory system against trauma as well as for the treatment of peripheral hearing disorders. This review focuses on recent advances in experimental prevention and treatment of hearing impairment which are expected to be of clinical value in the near future. Viral vector and non-viral vector gene therapy and transplantation of stem cells are discussed as potential treatments of irreversible sensorineural inner ear damage.
Hearing Research 08/2002; 169(1-2):169-78. · 2.54 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: MRI with a T1 contrast agent was used to investigate the normal and noise-damaged cochlea. The time course and distribution of the in vivo uptake of the gadodiamide chelate bound paramagnetic Gd ion (GdDTPA-BMA) throughout the membranous labyrinth of normal and impulse noise-damaged guinea pig cochleae were measured by MRI at 4.7T. Simultaneous signal enhancement of the basal, medial and apical scala tympani (ST) and scala vestibuli (SV) was observed within 10 min following i.v. injection, reaching maximum levels at around 100 min. ANOVA and post hoc paired t-tests showed statistically significant differences in the levels and rates of Gd uptake-enhancement between the scalae. The ST revealed the most rapid and extensive enhancement throughout the period of active Gd uptake, while the SV showed comparatively slower and less enhancement, and the intact scala media (SM) indicated insignificant enhancement. The in vivo Gd penetration and enhancement of the membranous SM increased significantly in the noise-damaged cochlea, suggesting lesioning of the cochlear membranes.
[Show abstract][Hide abstract] ABSTRACT: High intensity acoustic noise is an undesirable side-effect in magnetic resonance imaging (MRI) that can cause discomfort and hearing loss in patients and may be an impediment in functional MRI (fMRI) studies of the auditory system. Experimental MRI systems with high magnetic field strengths may generate acoustic noise of higher sound pressure levels (SPLs) than conventional 1.0 and 1.5 T clinical systems. We measured the SPL and spectral content of the acoustic noise generated by the Bruker Biospect 47/40 4.7 T experimental MRI system during scanning sequences commonly used in animal testing. Each sequence generated acoustic noise of high SPL, rapid pulse rates, amplitude-modulated pulse envelopes and multi-peaked spectra. The rapid acquisition with enhancement sequence with a 0.25 mm slice thickness generated SPLs of up to 129 dB peak SPL and 130 dB (A). Fourier analysis of the spectral content of the acoustic noise generated by each MRI sequence showed a wide band of acoustic energy with spectral peaks from 0.2-5 kHz. The intense MRI acoustic impulse noise generated by the 4.7 T system may cause masking of stimuli used in fMRI of the auditory cortex, reduce the hearing acuity of experimental animals and present a risk for unprotected human ears.
[Show abstract][Hide abstract] ABSTRACT: This study investigated blood lead (PbB) and hemoglobin (HbB) levels in 88 children (42 females and 46 males; ages: 2-15 years; mean age: 7.2) with chronic Pb exposure, living in a highly Pb-contaminated Andean village at above 2800 meters. The mean PbB level for 88 venous blood samples was 43.2 microg/dl (SD: 25.1; range: 6.2 - 128.2 microg/dl) measured by ICP-MS, and 42.0 microg/dl (SD: 26.0; range: 5.0 - 130.0 microg/dl) by GFAAS analysis. The mean PbB level for the 42 females was 41.0 microg/dl and for 46 males, 45.0 microg/dl. Multiple regression analysis showed a significant gender by age interaction (R2 = 0.099; F = 4.173, p = 0.044), indicating a relationship between age and PbB level for males, but not for females. Simple regression analysis showed a statistically significant positive correlation between PbB levels and age for males (r = 0.416, p = 0.004), but not for females (r = -0.042, p = .793). The measured mean HbB level for the 88 children was 12.6 g/dl (12.5 g/dl for females and 12.8 g/dl for males) and lower than expected for children living in the Ecuadorian Andes. The mean altitude-corrected HbB level was 10.9 g/dl (10.8 g/dl for females and 11.1 g/dl for males). A significant inverse correlation between PbB and HbB levels was observed for the group of 88 children (r = -0.292, p = 0.006). Multiple regression analyses indicated no significant age and gender interaction (R2 = 0.014; F = 0.025, p = 0.876) for HbB levels. In conclusion, the results of this investigation indicate that the children in this Pb-contaminated, high altitude study area had chronic elevated PbB levels, which increased with age for males, and probable Pb-induced anemia.
[Show abstract][Hide abstract] ABSTRACT: Environmental lead (Pb) contamination was measured in samples of soil and locally grown food produce in a remote Ecuadorian village where Pb glazing of ceramics is the local cottage industry. The Pb concentration levels of local soil samples collected at varying distances from a cluster of backyard Pb baking kilns were 29,213 ppm (microg/g) at 0.001 km, 172 ppm at 0.005 km, 81 ppm at 0.01 km, 55 ppm at 1 km, 19 ppm at 2 km, and 1.4 ppm at 6 km, significantly higher than levels in control soil samples from non-Pb-glazing reference areas. Samples of locally grown food produce were also found to be Pb contaminated. Venous blood samples from 166 schoolchildren (ages 4 months to 15 years) in the study area and 56 children in the reference area showed mean blood lead levels of 40.0 microg/dl (SD: 24.5; range: 6.2. - 119.1 microg/dL) and 6.6 microg/dL (SD: 3.4; range: 1.9 - 18.1 microg/dL), respectively, which were significantly different (p = 0.0001). The Pb levels in milk from breastfeeding mothers ranged from 1.44 to 39 ng/g. Lead isotope ratios of the children's blood and of samples of village soil revealed a common Pb source or "fingerprint."
International journal of occupational and environmental health 01/2000; 6(3):169-76. · 1.18 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The membranous labyrinth of the guinea pig cochlea and retrocochlear neural structures were investigated by magnetic resonance imaging (MRI) using an experimental system with a field strength of 4.7T and a single turn surface coil 25 mm in diameter, or standard resonators of 34 or 70 mm in diameter and gradient field strengths of 950 mTm and 200 mTm. High-resolution 2-D and 3-D images of 0.3-1.0 mm slice thickness were acquired by a rapid acquisition with relaxation enhancement (RARE) sequence and a standard multi-echo technique. Structural and dimensional aspects of the cochlea were resolved in vitro and in vivo down to <50 microm, showing the scala vestibule, scala media, scala tympani, spiral ganglia and the cochlear (eighth) nerve. In vivo perfusions with the gadodiamide (GdDTPA-BMA) chelate-bound paramagnetic gadolinium ion resulted in dynamic temporal enhancement of the scala vestibule and scala tympani, but did not penetrate the scala media.
[Show abstract][Hide abstract] ABSTRACT: Blood lead (PbB) levels were investigated in chronically lead (Pb) exposed Andean children and adults living in a highly Pb contaminated area of Ecuador where Pb glazing of ceramics is prevalent. A comparative study was made of the PbB levels of Pb-glazing and non-Pb-glazing families living in close proximity, using three PbB analysis techniques. Fifty-one, 50-microl blood samples from children and adults were analyzed in the field by a finger-stick capillary screening technique using the portable ESA LeadCare Blood Lead Testing System (LCS). Venous blood samples of 2-4 ml were collected from the same 51 participants and analyzed in the laboratory by inductively coupled plasma mass spectrometry (ICP-MS) and by graphite furnace atomic absorption spectrometry (AAS). The median PbB levels for the Pb-glazing group as determined by the ICP-MS, AAS and LCS techniques were 37.2 microg/dl (range 11.6-101.0), 32.0 microg/dl (range 8.0-70.0 microg/dl) and 44.0 microg/dl (range 19.0-105.0), respectively. The median PbB levels for the non-Pb-glazing group were 9.2 microg/dl (range 5.0-21.7) with ICP-MS, 9.0 microg/dl (range 4.3-32.0) with AAS, and 11.3 microg/dl (range 7.3-21.1) with LCS. The differences in PbB levels between the Pb glazing and non-Pb glazing groups were statistically significant (p = < .0001) for each PbB analysis method. Correlations between paired samples were: LCS and ICP-MS: r = 0.913, LCS and AAS: r = 0.829, and ICP-MS and AAS: r = 0.905. The results suggest that neighboring Pb glazing and non-Pb glazing families have significantly different PbB levels, and that the portable LCS field technique may be useful for screening and periodic monitoring of relatively low and high PbB levels of persons in remote high altitude Andean areas.
[Show abstract][Hide abstract] ABSTRACT: Neuroauditory disorders and sensory-neural hearing loss have been suggested as possible etiologic factors in the neurodevelopmental learning disabilities attributed to lead (Pb) intoxication. However, studies relating hearing loss to Pb poisoning have presented disparate results, suggesting that auditory sensitivity may not be a reliable marker of Pb intoxication. Oto-acoustic emissions, sounds that can be recorded non-invasively from the ear canal and are preneural responses of the outer hair cells of the inner ear, have been found to be diminished in ears exposed to some toxic agents. In the current study, distortion product oto-acoustic emissions (DPOAEs) were obtained from 28 ears of 14 children and 10 ears of 5 adults living in a highly Pb-contaminated environment in remote villages in the Andes Mountains of Ecuador. Blood lead (PbB) levels for the children (ages: 5-14 years) ranged from 33.4 to 118.2 microg/dl (mean: 51.5; SD: 22.9 microg/dl), or 3-12 times higher than the U.S. Centers for Disease Control and Prevention's toxic level of 10 microg/dl. The PbB levels for the adults ranged from 19.2 to 55.7 microg/dl. Despite the high PbB levels, the children had normal hearing thresholds, and DPOAEs were present for the children at the following f2 frequencies: 1187, 1500, 1906, 2406, 3031, 3812, 4812 and 6031 Hz. Although there was a tendency for the children to have diminished DPOAEs, no consistent correlation of DPOAEs with PbB level was found. The adults had diminished DPOAEs that were consistent with their observed, probably noise-related hearing loss. Contrary to some reports in the literature, the current results show no unequivocal clinical or subclinical evidence that high PbB levels have a toxic effect on the cochlea.
[Show abstract][Hide abstract] ABSTRACT: Lead (Pb) intoxication in children has been associated with neurodevelopmental disabilities which may result in motor and cognitive impairment. We conducted blood lead (PbB) measurements, neurological examinations and cognitive tests on children living in Ecuadorian villages where Pb is used extensively in the glazing of ceramics. Group I consisted of 55 children with a mean PbB level of 48.0 microg/dl (SD: 26.4, range: 9.2-119.1 microg/dl) who received PbB tests and complete neurological examinations. An appreciable number of the children with elevated PbB levels were normal on specific components of the neurological examination. Among the children who showed neurological deficits, higher PbB levels were associated with abnormal tendon reflexes, finger tapping, visual pursuit, size discrimination, draw-a-person, and math calculation skills. Group II consisted of 41 children with a mean PbB level of 47.4 microg/dl (SD: 22.0, range: 6.6-84.7 microg/dl) who were administered Raven's Coloured Progressive Matrices (RCPM) non-verbal reasoning test. Performance on RCPM was abnormal in 22 (53.7%) of 41 children. Children with abnormal RCPM scores had higher PbB levels (t-test: P=0.030). There was a significant inverse correlation between RCPM scores and PbB levels for children ages 9 years and older (r=-0.618, P=0.011). Males had higher mean PbB levels as a function of age than females (t-test: P=0.037), and more males showed neurocognitive deficits. The results demonstrate a range of neurological responses in children with chronically elevated PbB levels from apparent exceptional neuro-physiological tolerance of PbB intoxication, to some fine motor and cognitive deficits.
Journal of the Neurological Sciences 10/1998; 160(1):47-53. · 2.24 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study investigated blood mercury (B-Hg) levels and the auditory neuro-sensory status of children and adults in the remote Andean settlement of Nambija, Ecuador where Hg is used in the extensive gold mining operations. The mean B-Hg level in 75 Nambija (Study Area) inhabitants (36 children and 39 adults) was 17.5 micrograms/L (SD = 11.0) vs 3.0 micrograms/L (SD = 1.6) in a second group of 34 subjects (15 children and 19 adults) in a non-gold mining area (Reference Area), the difference being statistically significant (p < 0.0001). Neuro-otological examinations revealed 34 subjects (45%) with complaints of headaches and/or memory loss, 3 cases of severe neurological impairment and 4 cases of middle ear pathology. Audiological tests on 40 persons in the Study Area (21 children and 19 adults) showed hearing thresholds ranging from normal to mildly abnormal at 2, 3, 4, 6 and 8 kHz for children, and normal to severely abnormal for adults. Correlation coefficients showed a significant relationship between B-Hg level and hearing level in children at 3 kHz in the right ear, and at no frequency for adults. Auditory brainstem evoked responses (ABR) on subjects in the Study Area showed a significant correlation between B-Hg and the I-III interpeak latency on the right side. The results indicated that the study population of the Nambija gold mining area had abnormally elevated B-Hg levels, and may be at neurological risk from exposure to methylmercury (MeHg) from the consumption of contaminated food and possibly from elemental Hg vapors inhaled during amalgam burning in the gold extraction process.
[Show abstract][Hide abstract] ABSTRACT: Lead (Pb) intoxication in children has been associated with encephalopathy, sensory and cognitive impairments. We investigated the prevalence and neuro-sensory effects of Pb exposure in children living in Andean villages of Ecuador with high Pb contamination from discarded automobile batteries used in the local ceramics glazing industry. Venous blood samples were collected from 107 children in the Pb glazing area and from 39 children living in a geographically distant area with no known Pb contamination and measured for blood lead (PbB) levels. Auditory brainstem responses (ABR) and audiological/otological tests were conducted on children in the Pb-Glazing Group. The median PbB level for children in the Pb-Glazing Group was 40.0 microg per dl (range: 6.2-128.2 microg per dl) and for the non Pb-Glazing Group 6.0 microg per dl (1.9-18.0 microg per dl). The differences in PbB levels for children in the study and control areas were statistically significant (t-test, P<0.0001). ABR tests on the Pb-Glazing Group indicated normal wave latencies and neural transmission times, and no statistical correlation between PbB level and interpeak latencies. Audiological tests showed normal cochlear function and no statistical relation between auditory thresholds and PbB level. Contrary to prevailing assumptions, elevated PbB levels in children do not invariably impair auditory brainstem neural transmission or sensory-neural cochlear function, both of which have been implicated as significant contributors to the neurodevelopmental disabilities associated with childhood plumbism.
Journal of the Neurological Sciences 12/1997; 152(1):85-92. · 2.24 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We investigated blood lead (B-Pb) and mercury (B-Hg) levels and auditory sensory-neural function in 62 Andean school children living in a Pb-contaminated area of Ecuador and 14 children in a neighboring gold mining area with no known Pb exposure. The median B-Pb level for 62 children in the Pb-exposed group was 52.6 micrograms/dl (range 9.9-110.0 micrograms/dl) compared with 6.4 micrograms/dl (range 3.9-12.0 micrograms/dl) for the children in the non-Pb exposed group; the differences were statistically significant (p < 0.001). Auditory thresholds for the Pb-exposed group were normal at the pure tone frequencies of 0.25-8 kHz over the entire range of B-Pb levels, Auditory brain stem response tests in seven children with high B-Pb levels showed normal absolute peak and interpeak latencies. The median B-Hg levels were 0.16 micrograms/dl (range 0.04-0.58 micrograms/dl) for children in the Pb-exposed group and 0.22 micrograms/dl (range 0.1-0.44 micrograms/dl) for children in the non-Pb exposed gold mining area, and showed no significant relationship to auditory function.
Environmental Health Perspectives 06/1997; 105(5):522-6. · 7.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The goal of the present study was to analyze the distribution of efferent 8th nerve synaptic endings in a surface preparation of the guinea pig cochlea using synaptophysin antibodies. Employing light and confocal microscopy synaptophysin immunoreactivity was found exclusively at the base of the outer hair cells (OHCs) and the inner hair cells (IHCs) axosomatic efferent synapses. Qualitative and quantitative differences were found between the OHCs and the IHCs immunoreactivity. Efferent nerve endings innervating IHCs were comparatively smaller, more numerous and densely packed. Efferent terminals demonstrated a longitudinal gradient for the IHCs and a longitudinal and radial gradient for the OHCs. Quantitative analysis of synaptophysin immunofluorescence demonstrated a higher percentage of efferent terminals innervating the IHCs and the OHCs in the mid and basal segments of the cochlea than in the apical regions. In addition, a radial gradient from the 1st to 3rd row of OHCs was evident. The results from the present study show that the analysis of synaptophysin immunoreactivity on cochlear surface preparations allows the efferent innervation to be determined throughout the entire cochlea. This technique allows for a rapid assessment of the normal cochlea as well as after cochlear insult.
[Show abstract][Hide abstract] ABSTRACT: Electromagnetically induced auditory perception was investigated in 18 deaf patients who were candidates for cochlear implants. In the extracranial magnetic stimulation (EMS) procedure, patients were stimulated with time-varying magnetic field brief pulses from a coil positioned at the i) auricle, ii) the mastoid, and iii) the temporal lobe area. EMS elicited auditory sensations in 26 ears (of 14 patients/subjects). The lowest threshold of auditory sensation (TAS) was found to be at the 20% EMS level, with a range of 20-50% of the maximum level (2.0 Tesla), and approximately equal sensitivity in each coil position. Eleven of the subjects hearing EMS-induced sound perceived changes in pitch while 6 heard "clicks" or clicks and tones. Spearman Rho correlation analysis showed a mild negative correlation between the EMS/TAS and the pre-implant FFA, best tone threshold (BTT), and direct promontorial electrical stimulation (ES) thresholds at 250 Hz and 500 Hz. No correlation was found between EMS or ES and performance on the pre-implant or post-implant psychacoustic tests (MAC VIII or 3-Digit speech tests) or the measurements of the thickness of cutaneous and osseous tissue from the stimulation sites at the mastoid and ear canal to the cochlear and 8th nerve. A fair positive correlation was found between the EMS/TAS and the post-implant (6 months) ES threshold when the electrodes allocated the 500 Hz frequency range were stimulated. A mild positive correlation between the pre-cochlear-implant promontorial electrical stimulation (ES) at 250 Hz and the four frequency tone average (FFA: 0.5, 1, 2, 4 kHz) was also found.(ABSTRACT TRUNCATED AT 250 WORDS)