\documentclass[10pt]{article}

\usepackage{fullpage}
\usepackage{setspace}
\usepackage{parskip}
\usepackage{titlesec}
\usepackage[section]{placeins}
\usepackage{xcolor}
\usepackage{breakcites}
\usepackage{lineno}
\usepackage{hyphenat}





\PassOptionsToPackage{hyphens}{url}
\usepackage[colorlinks = true,
            linkcolor = blue,
            urlcolor  = blue,
            citecolor = blue,
            anchorcolor = blue]{hyperref}
\usepackage{etoolbox}
\makeatletter
\patchcmd\@combinedblfloats{\box\@outputbox}{\unvbox\@outputbox}{}{%
  \errmessage{\noexpand\@combinedblfloats could not be patched}%
}%
\makeatother


\usepackage{natbib}




\renewenvironment{abstract}
  {{\bfseries\noindent{\abstractname}\par\nobreak}\footnotesize}
  {\bigskip}

\titlespacing{\section}{0pt}{*3}{*1}
\titlespacing{\subsection}{0pt}{*2}{*0.5}
\titlespacing{\subsubsection}{0pt}{*1.5}{0pt}


\usepackage{authblk}


\usepackage{graphicx}
\usepackage[space]{grffile}
\usepackage{latexsym}
\usepackage{textcomp}
\usepackage{longtable}
\usepackage{tabulary}
\usepackage{booktabs,array,multirow}
\usepackage{amsfonts,amsmath,amssymb}
\providecommand\citet{\cite}
\providecommand\citep{\cite}
\providecommand\citealt{\cite}
% You can conditionalize code for latexml or normal latex using this.
\newif\iflatexml\latexmlfalse
\providecommand{\tightlist}{\setlength{\itemsep}{0pt}\setlength{\parskip}{0pt}}%

\AtBeginDocument{\DeclareGraphicsExtensions{.pdf,.PDF,.eps,.EPS,.png,.PNG,.tif,.TIF,.jpg,.JPG,.jpeg,.JPEG}}

\usepackage[utf8]{inputenc}
\usepackage[english]{babel}



\usepackage{float}








\begin{document}

\title{Cochlear Implant evolving indications: our outcomes in adult patients.}



\author[1]{Andrea Achena}%
\author[2]{Serena Sechi}%
\author[2]{Andrea Pili}%
\author[2]{Maria  Locci}%
\author[2]{Giuseppe Turnu}%
\author[3]{Francesco Achena}%
\affil[1]{Niguarda Hospital}%
\affil[2]{CTO Hospital District}%
\affil[3]{CTO Hospital}%


\vspace{-1em}



  
  \date{May 18, 2024}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup





\selectlanguage{english}
\begin{abstract}
Objective: The eligibility criteria for cochlear implant (CI) are
constantly changing. The aim of the current study was to show our
department's cochlear implant indications and to evaluate the
longitudinal performance outcomes for patients with different types and
degrees of sensorineural hearing loss, treated with CI. Methods: Between
2007--2019, 73 cochlear implantations were performed. Current CI
indications allow us to categorize patients based on the type and degree
of hearing loss. These can be grouped as follows: 1) Bilateral symmetric
sensorineural hearing loss (SHL); 2) Bilateral profound hearing loss for
high frequencies while maintaining low frequencies (EAS); 3) Asymmetric
hearing loss (AHL); 4) Single-sided deafness (SSD) with intensive
tinnitus in the deaf ear. For each group we evaluated the pre and
post-operative pure tone audiometry and speech perception test in
silence and with background noise. The patients also completed the
speech, spatial and qualities of Hearing questionnaire (SSQ). Results:
The four subgroups achieved significant benefits after CI, both in terms
of speech performance and SSQ. Conclusions: According to literature, our
data confirm that CI is an effective treatment for patients with
different types of hearing loss. Key Points: 1) The eligibility criteria
for cochlear implantation have regularly changed following the
continuous progress in technology. 2) Schematically we divided our
patients in 4 subgroups: 1) SHL; 2) EAS; 3) AHL; 4) SSD with intensive
tinnitus in the deaf ear. 3) The criteria for AHL and SSD are in line
with definitions suggested by Vincent et al. 4) Asymmetric hearing loss
(AHL) and single-sided deafness (SSD) were traditionally treated with a
contralateral routing of a signal hearing aid (CROS-HA) or a bone
conduction device (BCD), even though CI is the only device capable of
restoring bilateral stimulation to the auditory system and decreasing
severity and incidence of tinnitus. 5) By treating patients with AHL or
SSD and associated tinnitus, we saw that CI could not only improve
hearing, but also drastically reduce tinnitus in most of the patients.%
\end{abstract}%



\sloppy


\textbf{Hosted file}

\verb`-Cochlear Implant evolving indications.doc`  available at \url{https://authorea.com/users/726850/articles/709065-cochlear-implant-evolving-indications-our-outcomes-in-adult-patients}

\textbf{Hosted file}

\verb`Andrea Achena TABLES.odt`  available at \url{https://authorea.com/users/726850/articles/709065-cochlear-implant-evolving-indications-our-outcomes-in-adult-patients}

\selectlanguage{english}
\FloatBarrier
\end{document}

