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[Cochlear implant treatment of patients with single-sided deafness or asymmetric hearing loss. German version]. HNO 2019; 65:586-598. [PMID: 27995277 DOI: 10.1007/s00106-016-0294-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The rehabilitation of patients with single-sided deafness (SSD) or asymmetric hearing loss can be achieved with conventional (bilateral) contralateral routing of signals ((Bi)CROS) hearing aids ((Bi)CROS-HA, (Bi)CROS), bone-anchored hearing systems (BAHS) or cochlear implants (CI). To date, only small case series have been published on treatment outcomes in SSD patients after CI surgery and there are only a few comparative studies evaluating rehabilitation outcomes. OBJECTIVE The aim of this study was to provide evidence of successful treatment of SSD and asymmetric hearing loss with a CI compared to the untreated monaural hearing condition and the BAHS and (Bi)CROS treatment options in a large number of patients. MATERIALS AND METHODS In a single-centre study, 45 patients with SSD and 40 patients with asymmetric hearing loss were treated with a CI after careful evaluation for CI candidacy. Monaural speech comprehension in noise and localisation ability were examined with (Bi)CROS-HA and BAHS devices (on a test rod) both preoperatively and at 12 months after CI switch-on. At the same intervals, subjective evaluation of hearing ability was conducted using the Speech, Spatial and Qualities of Hearing Scale (SSQ). RESULTS This report presents the first evidence of successful binaural rehabilitation with CI in a relatively large patient cohort and the advantages over (Bi)CROS and BAHS in smaller subgroups, thus confirming the indication for CI treatment. Moreover, patients with long-term acquired deafness (>10 years) show a benefit from the CI comparable to that observed in patients with shorter-term deafness.
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Häußler SM, Köpke V, Knopke S, Gräbel S, Olze H. Multifactorial positive influence of cochlear implantation on patients with single‐sided deafness. Laryngoscope 2019; 130:500-506. [DOI: 10.1002/lary.28007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/02/2019] [Accepted: 03/28/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Sophia M. Häußler
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
| | - Vanessa Köpke
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
| | - Steffen Knopke
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
| | - Stefan Gräbel
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
| | - Heidi Olze
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
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Liu YW, Cheng X, Chen B, Peng K, Ishiyama A, Fu QJ. Effect of Tinnitus and Duration of Deafness on Sound Localization and Speech Recognition in Noise in Patients With Single-Sided Deafness. Trends Hear 2019; 22:2331216518813802. [PMID: 30509148 PMCID: PMC6291880 DOI: 10.1177/2331216518813802] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patients with single-sided deafness (SSD) often experience poor sound localization, reduced speech understanding in noise, reduced quality of life, and tinnitus. The present study aims to evaluate effects of tinnitus and duration of deafness on sound localization and speech recognition in noise by SSD subjects. Sound localization and speech recognition in noise were measured in 26 SSD and 10 normal-hearing (NH) subjects. Speech was always presented directly in front of the listener. Noise was presented to the deaf ear, in front of the listener, or to the better hearing ear. Tinnitus severity was measured using visual analog scale and Tinnitus Handicap Inventory. Relative to NH subjects, SSD subjects had significant deficits in sound localization and speech recognition in all listening conditions (p < .001). For SSD subjects, speech recognition in noise was correlated with mean hearing thresholds in the better hearing ear (p < .001) but not in the deaf ear. SSD subjects with tinnitus performed poorer in sound localization and speech recognition in noise than those without tinnitus. Shorter duration of deafness was associated with greater tinnitus and sound localization difficulty. Tinnitus visual analog scale and Tinnitus Handicap Inventory were highly correlated; the degree of tinnitus was negatively correlated with sound localization and speech recognition in noise. Those experiencing noticeable tinnitus may benefit more from cochlear implantation than those without; subjective tinnitus reduction may be correlated with improved sound localization and speech recognition in noise. Subjects with longer duration of deafness demonstrated better sound localization, suggesting long-term compensation for loss of binaural cues.
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Affiliation(s)
- Yang-Wenyi Liu
- 1 Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.,2 NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Xiaoting Cheng
- 1 Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.,2 NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Bing Chen
- 1 Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.,2 NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Kevin Peng
- 3 House Clinic, Los Angeles, CA, USA.,4 Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Akira Ishiyama
- 4 Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Qian-Jie Fu
- 4 Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Cortical auditory evoked responses in cochlear implant users with early-onset single-sided deafness: indicators of the development of bilateral auditory pathways. Neuroreport 2019; 29:408-416. [PMID: 29489587 DOI: 10.1097/wnr.0000000000000984] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cochlear implantation (CI) for early-onset single-sided deafness (SSD) provides a unique insight into the development and cortical reorganization of binaural pathways. This case series aimed to investigate the impact of duration of deafness on CI outcomes as measured by cortical evoked auditory potentials (CAEPs). Four adults with early-onset SSD were studied after CI. The adults had a duration of deafness of 22, 24, 42, and 38 years before implantation. CAEPs and speech perception in noise were used to investigate binaural cortical pathways and function. Our four patients lost their hearing at the ages of 3, 6, 5, and 6 (S1, S2, S3, and S4, respectively). CAEPs were present bilaterally in S2, S3, and S4. S1's, who had the least experience with a CI, cortical responses at 1 month after CI activation showed cortical responses from the CI ipsilateral pathway, but no responses from the CI contralateral pathway. At 3 and 6 months, S1 showed significant cortical responses from the CI contralateral pathway for two speech tokens. An improvement in speech perception in noise testing was observed in all four participants. This case series indicates that long duration of deafness for early-onset SSD is not a contraindication for CI and may not impact the long-term outcomes in this population. The electrical stimulation from the CI integrates with the normal-hearing ear to produce bilateral cortical projections and functional improvement in speech perception in noise. These early data provide surprisingly positive results and call for larger scale research to be carried out.
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Results in Adult Cochlear Implant Recipients With Varied Asymmetric Hearing: A Prospective Longitudinal Study of Speech Recognition, Localization, and Participant Report. Ear Hear 2019; 39:845-862. [PMID: 29373326 DOI: 10.1097/aud.0000000000000548] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Asymmetric hearing with severe to profound hearing loss (SPHL) in one ear and better hearing in the other requires increased listening effort and is detrimental for understanding speech in noise and sound localization. Although a cochlear implant (CI) is the only treatment that can restore hearing to an ear with SPHL, current candidacy criteria often disallows this option for patients with asymmetric hearing. The present study aimed to evaluate longitudinal performance outcomes in a relatively large group of adults with asymmetric hearing who received a CI in the poor ear. DESIGN Forty-seven adults with postlingual hearing loss participated. Test materials included objective and subjective measures meant to elucidate communication challenges encountered by those with asymmetric hearing. Test intervals included preimplant and 6 and 12 months postimplant. Preimplant testing was completed in participants' everyday listening condition: bilateral hearing aids (HAs) n = 9, better ear HA n = 29, and no HA n = 9; postimplant, each ear was tested separately and in the bimodal condition. RESULTS Group mean longitudinal results in the bimodal condition postimplant compared with the preimplant everyday listening condition indicated significantly improved sentence scores at soft levels and in noise, improved localization, and higher ratings of communication function by 6 months postimplant. Group mean, 6-month postimplant results were significantly better in the bimodal condition compared with either ear alone. Audibility and speech recognition for the poor ear alone improved significantly with a CI compared with preimplant. Most participants had clinically meaningful benefit on most measures. Contributory factors reported for traditional CI candidates also impacted results for this population. In general, older participants had poorer bimodal speech recognition in noise and localization abilities than younger participants. Participants with early SPHL onset had better bimodal localization than those with later SPHL onset, and participants with longer SPHL duration had poorer CI alone speech understanding in noise but not in quiet. Better ear pure-tone average (PTA) correlated with all speech recognition measures in the bimodal condition. To understand the impact of better ear hearing on bimodal performance, participants were grouped by better ear PTA: group 1 PTA ≤40 dB HL (n = 19), group 2 PTA = 41 to 55 dB HL (n = 14), and group 3 PTA = 56 to 70 dB HL (n = 14). All groups showed bimodal benefit on speech recognition measures in quiet and in noise; however, only group 3 obtained benefit when noise was toward the CI ear. All groups showed improved localization and ratings of perceived communication. CONCLUSIONS Receiving a CI for the poor ear was an effective treatment for this population. Improved audibility and speech recognition were evident by 6 months postimplant. Improvements in sound localization and self-reports of communication benefit were significant and not related to better ear hearing. Participants with more hearing in the better ear (group 1) showed less bimodal benefit but greater bimodal performance for speech recognition than groups 2 and 3. Test batteries for this population should include quality of life measures, sound localization, and adaptive speech recognition measures with spatially separated noise to capture the hearing loss deficits and treatment benefits reported by this patient population.
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Zeitler DM, Sladen DP, DeJong MD, Torres JH, Dorman MF, Carlson ML. Cochlear implantation for single-sided deafness in children and adolescents. Int J Pediatr Otorhinolaryngol 2019; 118:128-133. [PMID: 30623849 DOI: 10.1016/j.ijporl.2018.12.037] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/28/2018] [Accepted: 12/30/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate outcomes in pediatric and adolescent patients with single-sided deafness (SSD) undergoing cochlear implantation. METHODS A retrospective cohort design at two tertiary level academic cochlear implant centers. The subjects included nine children ages 1.5 to 15 years-old with single-sided deafness (SSD) who had undergone cochlear implantation in the affected ear. Objective outcome measures included were speech reception testing in quiet and noise, bimodal speech reception threshold testing in noise, tinnitus suppression, and device usage. RESULTS Nine pediatric and adolescent patients with SSD were implanted between 2011 and 2017. The median age at implantation was 8.9 years (range, 1.5-15.1) and the children had a median duration of deafness 2.9 years (range, 0.8-9.5). There was variability in testing measures due to patient age. Median pre-operative aided word recognition scores on the affected side were <30% regardless of the testing paradigm used. Six patients had pre-operative word testing (4 CNC, median score 25%; 2 MLNT, 8% and 17%). Four patients had pre-operative sentence testing (3 AzBio, median score 44%; 1 HINT-C, 57%). Median post-implantation follow-up interval was 12.3 months (range, 3-27.6 months). Six subjects had post-operative word recognition testing (CNC median, 70%; MLNT 50%, 92%) with a median improvement of 45.5% points. Five subjects had post-operative sentence testing (AzBio, median 82%; HINT, median 76%), with a median improvement of 40.5% points. Eight patients are full time users of their device. Tinnitus and bimodal speech reception thresholds in noise were improved. CONCLUSION Pediatric subjects with SSD benefit substantially from cochlear implantation. Objective speech outcome measures are improved in both quiet and noise, and bimodal speech reception thresholds in noise are greatly improved. There is a low rate of device non-use.
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Affiliation(s)
- Daniel M Zeitler
- Listen for Life Center, Department of Otolaryngology-Head and Neck Surgery, Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA, 98101, USA.
| | - Douglas P Sladen
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Melissa D DeJong
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Jennifer H Torres
- Denver Ear Associates, 401 W. Hampden Place #240, Englewood, CO, 80110, USA
| | - Michael F Dorman
- Department of Speech and Hearing Science, Arizona State University, PO Box 870102, Tempe, AZ, 85287, USA
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
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Marx M, Costa N, Lepage B, Taoui S, Molinier L, Deguine O, Fraysse B. Cochlear implantation as a treatment for single-sided deafness and asymmetric hearing loss: a randomized controlled evaluation of cost-utility. BMC EAR, NOSE, AND THROAT DISORDERS 2019; 19:1. [PMID: 30766449 PMCID: PMC6362575 DOI: 10.1186/s12901-019-0066-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/09/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Single-sided deafness (SSD) and asymmetric hearing loss (AHL) have recently been proposed as a new indication for cochlear implantation. There is still no recommended treatment for these hearing deficits, and most options considered rely on the transfer of sound from the poor ear to the better ear, using Contralateral Routing of the Signal (CROS) hearing aids or bone conduction (BC) devices. In contrast, cochlear implantation allows the poor ear to be stimulated and binaural hearing abilities to be partially restored. Indeed, most recently published studies have reported an improvement in the spatial localisation of an incoming sound and better speech recognition in noisy environments after cochlear implantation in SSD/AHL subjects. It also provides consistent relief of tinnitus when associated. These encouraging hearing outcomes raise the question of the cost-utility of this expensive treatment in an extended indication. METHODS The final endpoint of this national multicentre study is to determine the incremental cost-utility ratio (ICUR) of cochlear implantation in comparison to the current standard of care in France through simple observation, using a randomised controlled trial. Firstly, the study comprises a prospective and descriptive part, where 150 SSD/AHL subjects try CROS hearing aids and a BC device for three weeks each. Secondly, the choice is made between CROS hearing aids, BC implanted device and cochlear implantation. Hearing outcomes and quality of life measurements are described after 6 months for the subjects who chose CROS, BC or declined any option. The subjects who opt for cochlear implantation are randomised between one group where the cochlear implant is inserted without delay and one group of simple initial observation. Hearing outcomes and quality of life measurements are compared after 6 months. DISCUSSION The present study was designed to assess the efficiency of cochlear implantation in SSD/AHL. A favourable cost-utility ratio in this extended indication would strengthen the promising clinical results and justify a reimbursement by the health insurance. The efficiency of other options (CROS, BC) will also be described. TRIAL REGISTRATION This research has been registered in ClinicalTrials.gov (http://www.clinicaltrials.gov/), the 29th July 2014 under the n°NCT02204618.
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Affiliation(s)
- Mathieu Marx
- Service d’Oto–Rhino–Laryngologie, d’Oto-Neurologie et d’ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
- Université de Toulouse, CerCo UMR 5549 CNRS, Université Paul Sabatier, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
| | - Nadège Costa
- Health Economic Unit, Centre Hospitalier Universitaire de Toulouse, Hôtel-Dieu Saint-Jacques, 2, rue viguerie, 31059 Toulouse Cedex 9, France
- Unité Inserm UMR 1027, Faculté de Médecine, National Institute for Health and Medical Research (Inserm), 37 allées Jules Guesde, 31073 Toulouse, France
| | - Benoit Lepage
- Department of Epidemiology, USMR, 37 allées Jules Guesde, 31073 Toulouse, France
| | - Soumia Taoui
- Service d’Oto–Rhino–Laryngologie, d’Oto-Neurologie et d’ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
| | - Laurent Molinier
- Health Economic Unit, Centre Hospitalier Universitaire de Toulouse, Hôtel-Dieu Saint-Jacques, 2, rue viguerie, 31059 Toulouse Cedex 9, France
- Unité Inserm UMR 1027, Faculté de Médecine, National Institute for Health and Medical Research (Inserm), 37 allées Jules Guesde, 31073 Toulouse, France
| | - Olivier Deguine
- Service d’Oto–Rhino–Laryngologie, d’Oto-Neurologie et d’ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
- Université de Toulouse, CerCo UMR 5549 CNRS, Université Paul Sabatier, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
| | - Bernard Fraysse
- Service d’Oto–Rhino–Laryngologie, d’Oto-Neurologie et d’ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
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Front- and rear-facing horizontal sound localization results in adults with unilateral hearing loss and normal hearing. Hear Res 2019; 372:3-9. [DOI: 10.1016/j.heares.2018.03.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/18/2018] [Accepted: 03/15/2018] [Indexed: 11/20/2022]
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van Wieringen A, Boudewyns A, Sangen A, Wouters J, Desloovere C. Unilateral congenital hearing loss in children: Challenges and potentials. Hear Res 2019; 372:29-41. [PMID: 29395617 DOI: 10.1016/j.heares.2018.01.010] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/17/2017] [Accepted: 01/21/2018] [Indexed: 11/16/2022]
Abstract
The estimated incidence of sensorineural hearing impairment (>40 dB HL) at birth is 1.86 per 1000 newborns in developed countries and 30-40% of these are unilateral. Profound sensorineural unilateral hearing impairment or single sided deafness (SSD) can be treated with a cochlear implant. However, this treatment is costly and invasive and unnecessary in the eyes of many. Very young children with SSD often do not exhibit language and cognitive delays and it is hard to imagine that neurocognitive skills will present difficulties with one good ear. In the current paper we review the most recent evidence on the consequences of unilateral hearing impairment for auditory and neurocognitive factors. While data of both adults and children are discussed, we focus on developmental factors, congenital deafness and a window of opportunity for intervention. We discuss which etiologies qualify for a cochlear implant and present our multi-center prospective study on cochlear implants in infants with one deaf ear. The large, state-of-the art body of research allows for evidence-based decisions regarding management of unilateral hearing loss in children.
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Affiliation(s)
- Astrid van Wieringen
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium.
| | - An Boudewyns
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, 2650 Edegem, Belgium
| | - Anouk Sangen
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium
| | - Jan Wouters
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium
| | - Christian Desloovere
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium; University Hospital Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium
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Entwisle LK, Warren SE, Messersmith JJ. Cochlear Implantation for Children and Adults with Severe-to-Profound Hearing Loss. Semin Hear 2018; 39:390-404. [PMID: 30374210 DOI: 10.1055/s-0038-1670705] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Cochlear implants (CIs) have proven to be a useful treatment option for individuals with severe-to-profound hearing loss by providing improved access to one's surrounding auditory environment. CIs differ from traditional acoustic amplification by providing information to the auditory system via electrical stimulation. Both postlingually deafened adults and prelingually deafened children can benefit from a CI; however, outcomes with a CI can vary. Numerous factors can impact performance outcomes with a CI. It is important for the audiologist to understand what factors might play a role and impact performance outcomes with a CI so that they can effectively counsel the recipient and their family, as well as establish appropriate and realistic expectations with a CI. This review article will discuss the CI candidacy process, CI programming and postoperative follow-up care, as well as considerations across the lifespan that may affect performance outcomes with a CI.
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Affiliation(s)
- Lavin K Entwisle
- Department of Communication Sciences and Disorders, University of South Dakota, Vermillion, South Dakota.,Department of Otolaryngology, New York University School of Medicine, New York, New York
| | - Sarah E Warren
- School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee
| | - Jessica J Messersmith
- Department of Communication Sciences and Disorders, University of South Dakota, Vermillion, South Dakota
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Yu F, Li H, Zhou X, Tang X, Galvin III JJ, Fu QJ, Yuan W. Effects of Training on Lateralization for Simulations of Cochlear Implants and Single-Sided Deafness. Front Hum Neurosci 2018; 12:287. [PMID: 30065641 PMCID: PMC6056606 DOI: 10.3389/fnhum.2018.00287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/27/2018] [Indexed: 11/13/2022] Open
Abstract
While cochlear implantation has benefitted many patients with single-sided deafness (SSD), there is great variability in cochlear implant (CI) outcomes and binaural performance remains poorer than that of normal-hearing (NH) listeners. Differences in sound quality across ears-temporal fine structure (TFS) information with acoustic hearing vs. coarse spectro-temporal envelope information with electric hearing-may limit integration of acoustic and electric patterns. Binaural performance may also be limited by inter-aural mismatch between the acoustic input frequency and the place of stimulation in the cochlea. SSD CI patients must learn to accommodate these differences between acoustic and electric stimulation to maximize binaural performance. It is possible that training may increase and/or accelerate accommodation and further improve binaural performance. In this study, we evaluated lateralization training in NH subjects listening to broad simulations of SSD CI signal processing. A 16-channel vocoder was used to simulate the coarse spectro-temporal cues available with electric hearing; the degree of inter-aural mismatch was varied by adjusting the simulated insertion depth (SID) to be 25 mm (SID25), 22 mm (SID22) and 19 mm (SID19) from the base of the cochlea. Lateralization was measured using headphones and head-related transfer functions (HRTFs). Baseline lateralization was measured for unprocessed speech (UN) delivered to the left ear to simulate SSD and for binaural performance with the acoustic ear combined with the 16-channel vocoders (UN+SID25, UN+SID22 and UN+SID19). After completing baseline measurements, subjects completed six lateralization training exercises with the UN+SID22 condition, after which performance was re-measured for all baseline conditions. Post-training performance was significantly better than baseline for all conditions (p < 0.05 in all cases), with no significant difference in training benefits among conditions. Given that there was no significant difference between the SSD and the SSD CI conditions before or after training, the results suggest that NH listeners were unable to integrate TFS and coarse spectro-temporal cues across ears for lateralization, and that inter-aural mismatch played a secondary role at best. While lateralization training may benefit SSD CI patients, the training may largely improve spectral analysis with the acoustic ear alone, rather than improve integration of acoustic and electric hearing.
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Affiliation(s)
- Fei Yu
- Department of Otolaryngology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Hai Li
- Department of Otolaryngology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Xiaoqing Zhou
- Department of Otolaryngology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - XiaoLin Tang
- Department of Otolaryngology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | | | - Qian-Jie Fu
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Wei Yuan
- Department of Otolaryngology, Southwest Hospital, Third Military Medical University, Chongqing, China
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Prospective Evaluation of Patients Undergoing Translabyrinthine Excision of Vestibular Schwannoma with Concurrent Cochlear Implantation. Otol Neurotol 2018; 38:1512-1516. [PMID: 29099442 DOI: 10.1097/mao.0000000000001570] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Translabyrinthine (TL) vestibular schwannoma (VS) resection may be accomplished with preservation of the cochlear nerve, permitting successful, concurrent cochlear implantation. In this single institution, Food and Drug Administration-approved feasibility study, we wished to determine the success and outcomes of concurrent cochlear implantation at the time of TL resection of VS. STUDY DESIGN Prospective cohort. SETTING Tertiary referral center. PATIENTS Patients with small VS less than 1.5 cm in size. INTERVENTION Concurrent TL VS resection and cochlear implantation. MAIN OUTCOME MEASURE Sound localization and speech understanding. RESULTS All cochlear nerves were anatomically preserved. Five out of seven patients had auditory precepts at the time of activation. At 1 month following surgery, AzBio scores (0 dB SNR, with sound front, noise to normal ear) were improved by an average of 10% with implant on, persisting to 6 months out from surgery. Localization 1 month after surgery was markedly improved with root mean square 78 degrees ±13 in the "implant off" condition and 41 ± 9 degrees in the "implant on" condition. Average tinnitus severity was reduced in subjects and speech and spatial hearing was improved on speech, spatial and qualities of hearing scale (SSQ). CONCLUSIONS These data demonstrate preservation of electrical hearing in TL VS surgery is consistently possible, and although speech outcomes do not achieve the same levels seen with other etiologies of hearing loss, excellent improvement in sound localization, improved speech understanding, and substantial reductions in tinnitus are achieved.
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Gifford RH, Loiselle L, Natale S, Sheffield SW, Sunderhaus LW, S. Dietrich M, Dorman MF. Speech Understanding in Noise for Adults With Cochlear Implants: Effects of Hearing Configuration, Source Location Certainty, and Head Movement. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1306-1321. [PMID: 29800361 PMCID: PMC6195075 DOI: 10.1044/2018_jslhr-h-16-0444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 07/27/2017] [Accepted: 02/04/2018] [Indexed: 05/11/2023]
Abstract
Purpose The primary purpose of this study was to assess speech understanding in quiet and in diffuse noise for adult cochlear implant (CI) recipients utilizing bimodal hearing or bilateral CIs. Our primary hypothesis was that bilateral CI recipients would demonstrate less effect of source azimuth in the bilateral CI condition due to symmetric interaural head shadow. Method Sentence recognition was assessed for adult bilateral (n = 25) CI users and bimodal listeners (n = 12) in three conditions: (1) source location certainty regarding fixed target azimuth, (2) source location uncertainty regarding roving target azimuth, and (3) Condition 2 repeated, allowing listeners to turn their heads, as needed. Results (a) Bilateral CI users exhibited relatively similar performance regardless of source azimuth in the bilateral CI condition; (b) bimodal listeners exhibited higher performance for speech directed to the better hearing ear even in the bimodal condition; (c) the unilateral, better ear condition yielded higher performance for speech presented to the better ear versus speech to the front or to the poorer ear; (d) source location certainty did not affect speech understanding performance; and (e) head turns did not improve performance. The results confirmed our hypothesis that bilateral CI users exhibited less effect of source azimuth than bimodal listeners. That is, they exhibited similar performance for speech recognition irrespective of source azimuth, whereas bimodal listeners exhibited significantly poorer performance with speech originating from the poorer hearing ear (typically the nonimplanted ear). Conclusions Bilateral CI users overcame ear and source location effects observed for the bimodal listeners. Bilateral CI users have access to head shadow on both sides, whereas bimodal listeners generally have interaural asymmetry in both speech understanding and audible bandwidth limiting the head shadow benefit obtained from the poorer ear (generally the nonimplanted ear). In summary, we found that, in conditions with source location uncertainty and increased ecological validity, bilateral CI performance was superior to bimodal listening.
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Affiliation(s)
| | - Louise Loiselle
- Arizona State University, Tempe, AZ
- MED-EL Corporation, Durham, NC
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Perkins E, Rooth M, Dillon M, Brown K. Simultaneous labyrinthectomy and cochlear implantation in unilateral meniere's disease. Laryngoscope Investig Otolaryngol 2018; 3:225-230. [PMID: 30062139 PMCID: PMC6057226 DOI: 10.1002/lio2.163] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 03/30/2018] [Indexed: 11/10/2022] Open
Abstract
Objective In a single‐institution, FDA‐approved IDE study, subjects with unilateral Meniere's disease and intractable vertigo underwent concurrent labyrinthectomy and cochlear implantation to determine speech perception, localization, and quality of life outcomes. Methods Three subjects with unilateral Meniere's disease with normal or near‐normal hearing in the contralateral ear underwent simultaneous labyrinthectomy and cochlear implantation. Sound localization, speech perception in noise and quiet, tinnitus handicap index, and quality of life measures were evaluated at 1, 3, and 6 months after implant activation. Results Sound localization testing demonstrated immediate benefit postimplantation with the cochlear implant (CI). RMS error with CI on was 22 degrees (±2) and with CI off was 63 (±15) at 6 months. Mean CI alone scores were 22% (±20) at 1 month and improved to 43% (±20) and 49% (±11) at the 3‐ and 6‐month intervals, respectively. AzBio sentences in babble (0 dB SNR) scores presented in the most challenging listening condition (S0NContra) were 28% (±20) at 1 month, 38% (±18) at 3 months, and 45% (±24) at 6 months. Tinnitus Handicap Inventory (THI) significantly improved from an average preoperative score of 42 (±26) to 0 at 6 months. Quality of life measures improved overall over the postimplantation follow‐up intervals. Conclusions Subjects with unilateral Meniere's Disease who underwent simultaneous labyrinthectomy and cochlear implantation experienced improvements in sound localization, speech understanding, tinnitus severity, and quality of life with device use. There was a trend for better performance over the postoperative intervals. Level of Evidence 2b.
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Affiliation(s)
- Elizabeth Perkins
- Department of Otolaryngology-Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A
| | - Meredith Rooth
- Department of Otolaryngology-Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A
| | - Margaret Dillon
- Department of Otolaryngology-Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A
| | - Kevin Brown
- Department of Otolaryngology-Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A
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Abstract
BACKGROUND Cochlear implants (CIs) can improve speech-in-noise performance for listeners with unilateral sensorineural deafness. But these benefits are modest and in most cases are limited to head-shadow advantages, with little evidence of binaural squelch. HYPOTHESIS The goal of the investigation was to determine whether CI listeners with normal hearing or moderate hearing loss in the contralateral ear would receive a larger head-shadow benefit for target speech and noise originating from opposite sides of the head, and whether listeners would experience binaural squelch in the free field in a test involving interfering talkers. METHODS Eleven CI listeners performed a speech-identification task in the presence of interfering noise or speech. Six listeners had single-sided deafness (normal or near-normal audiometric thresholds in the acoustic ear) and five had asymmetric hearing loss (hearing loss in the acoustic ear treated with a hearing aid). Listeners were tested with the acoustic ear only and bilaterally with the CI turned on. One set of conditions examined head-shadow effects with target speech and masking noise presented from azimuths of 0 or ±108 degrees. A second set of conditions examined binaural squelch, with target speech presented from the front and interfering talkers symmetrically placed on both sides. RESULTS On average, the largest head-shadow benefit (5 dB) occurred when the target and masking noise were presented on opposite sides of the head. Listeners also showed an average of 2 dB of squelch, but only when the target speech was masked by interfering talkers of the same sex as the target. CONCLUSIONS CIs provide listeners with unilateral deafness important benefits for speech perception in complex spatial environments, including a larger head-shadow benefit when speech and noise originate on opposite sides of the head, and an improved ability to perceptually organize an auditory scene with multiple competing voices.The views expressed in this abstract are those of the authors and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or US Government.
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Firszt JB, Reeder RM, Holden LK. Unilateral Hearing Loss: Understanding Speech Recognition and Localization Variability-Implications for Cochlear Implant Candidacy. Ear Hear 2018; 38:159-173. [PMID: 28067750 PMCID: PMC5321788 DOI: 10.1097/aud.0000000000000380] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES At a minimum, unilateral hearing loss (UHL) impairs sound localization ability and understanding speech in noisy environments, particularly if the loss is severe to profound. Accompanying the numerous negative consequences of UHL is considerable unexplained individual variability in the magnitude of its effects. Identification of covariables that affect outcome and contribute to variability in UHLs could augment counseling, treatment options, and rehabilitation. Cochlear implantation as a treatment for UHL is on the rise yet little is known about factors that could impact performance or whether there is a group at risk for poor cochlear implant outcomes when hearing is near-normal in one ear. The overall goal of our research is to investigate the range and source of variability in speech recognition in noise and localization among individuals with severe to profound UHL and thereby help determine factors relevant to decisions regarding cochlear implantation in this population. DESIGN The present study evaluated adults with severe to profound UHL and adults with bilateral normal hearing. Measures included adaptive sentence understanding in diffuse restaurant noise, localization, roving-source speech recognition (words from 1 of 15 speakers in a 140° arc), and an adaptive speech-reception threshold psychoacoustic task with varied noise types and noise-source locations. There were three age-sex-matched groups: UHL (severe to profound hearing loss in one ear and normal hearing in the contralateral ear), normal hearing listening bilaterally, and normal hearing listening unilaterally. RESULTS Although the normal-hearing-bilateral group scored significantly better and had less performance variability than UHLs on all measures, some UHL participants scored within the range of the normal-hearing-bilateral group on all measures. The normal-hearing participants listening unilaterally had better monosyllabic word understanding than UHLs for words presented on the blocked/deaf side but not the open/hearing side. In contrast, UHLs localized better than the normal-hearing unilateral listeners for stimuli on the open/hearing side but not the blocked/deaf side. This suggests that UHLs had learned strategies for improved localization on the side of the intact ear. The UHL and unilateral normal-hearing participant groups were not significantly different for speech in noise measures. UHL participants with childhood rather than recent hearing loss onset localized significantly better; however, these two groups did not differ for speech recognition in noise. Age at onset in UHL adults appears to affect localization ability differently than understanding speech in noise. Hearing thresholds were significantly correlated with speech recognition for UHL participants but not the other two groups. CONCLUSIONS Auditory abilities of UHLs varied widely and could be explained only in part by hearing threshold levels. Age at onset and length of hearing loss influenced performance on some, but not all measures. Results support the need for a revised and diverse set of clinical measures, including sound localization, understanding speech in varied environments, and careful consideration of functional abilities as individuals with severe to profound UHL are being considered potential cochlear implant candidates.
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Affiliation(s)
- Jill B Firszt
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
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Távora-Vieira D, Wedekind A, Marino R, Purdy SC, Rajan GP. Using aided cortical assessment as an objective tool to evaluate cochlear implant fitting in users with single-sided deafness. PLoS One 2018; 13:e0193081. [PMID: 29470548 PMCID: PMC5823436 DOI: 10.1371/journal.pone.0193081] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 01/22/2018] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To assess the use of cortical auditory evoked potentials (CAEPs) to verify, and if necessary, optimize the cochlear implant (CI) fitting of adult CI users with postlingual single-sided deafness (SSD). METHODS Sound field cortical responses to the speech tokens /m/, /g/, /t/, and /s/ were recorded from input to the CI while the normal hearing ear was masked. Responses were evaluated by visual inspection and classified as presence or absence of the CAEPs components P1, N1, P2. In case of an absence fitting was adjusted accordingly. After fitting, subjects were asked to use their new setting for 2-3 weeks for acclimatization purposes and then return for retesting. At retesting, new CAEP recordings were performed to objectively ensure that the new fitting maps effectively activated the auditory cortex. RESULTS In 14/19 subjects, as per visual inspection, clear CAEPs were recorded by each speech token and were, therefore, not refit. In the other 5 subjects, CAEPs could not be evoked for at least one speech token. The fitting maps in these subjects were adjusted until clear CAEPs were evoked for all 4 speech tokens. CONCLUSIONS CAEP can be used to quickly and objectively verify the suitability of CI fitting in experienced adult CI users with SSD. If used in the early post-implantation stage, this method could help CI users derive greater benefit for CI use and, therefore, be more committed to auditory training.
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Affiliation(s)
- Dayse Távora-Vieira
- Otolaryngology, Head & Neck Surgery, School of Surgery, University of Western Australia, Perth, Australia
- Fiona Stanley Hospital, Perth, Australia
| | - Andre Wedekind
- Otolaryngology, Head & Neck Surgery, School of Surgery, University of Western Australia, Perth, Australia
| | - Roberta Marino
- Otolaryngology, Head & Neck Surgery, School of Surgery, University of Western Australia, Perth, Australia
- Fiona Stanley Hospital, Perth, Australia
| | - Suzanne C. Purdy
- School of Physhology, Faculty of Science, University of Auckland, Auckland, New Zealand
- Eisdell Moore Centre, Hearing and Balance Research, Auckland, New Zealand
| | - Gunesh P. Rajan
- Otolaryngology, Head & Neck Surgery, School of Surgery, University of Western Australia, Perth, Australia
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Abd El-Ghaffar NM, El-Gharib AM, Kolkaila EA, Elmahallawy TH. Speech-evoked auditory brainstem response with ipsilateral noise in adults with unilateral hearing loss. Acta Otolaryngol 2018; 138:145-152. [PMID: 29022419 DOI: 10.1080/00016489.2017.1380311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Subjects with unilateral hearing loss (UHL) report difficulties in speech understanding in noise. Speech-evoked auditory brainstem response (S-ABR) provides cues for temporal and spectral encoding of speech in the brainstem. S-ABR recording in noise increases its sensitivity in evaluating the auditory processing and related disorders. OBJECTIVES Study speech encoding at the level of brainstem when the auditory system relies on one ear and to study the effect of noise on this encoding. SUBJECTS AND METHOD This study included two groups: control group consisted of 15 adults with normal hearing sensitivity and study group consisted of 30 adults with UHL. The study group was further subdivided into two subgroups: study subgroup A (SG A) consisted of 15 adults with right functioning ears and study subgroup B (SG B) consisted of 15 adults with left functioning ears. S-ABR in quiet and with ipsilateral noise was recorded in both the groups using complex ABR advanced auditory research module. RESULTS In UHL, there was a statistically significant delay in the S-ABR onset and offset in noise compared to quiet. Moreover, quiet-noise (+5 SNR) correlation was significantly low compared to NH. Furthermore, pitch representation (F0 amplitude) was significantly degraded with noise. In addition, there was a statistically significant noise-induced phase shift in the transition region of speech syllable in these subjects. CONCLUSION In monaural processing, pitch representation (F0 amplitude) and cross-phaseogram were the main affected domains. Speech phonemes of transient origin can be confused in subjects with UHL.
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Affiliation(s)
| | | | - Enaas A. Kolkaila
- Audiology Unit ENT Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Benefits to Speech Perception in Noise From the Binaural Integration of Electric and Acoustic Signals in Simulated Unilateral Deafness. Ear Hear 2018; 37:248-59. [PMID: 27116049 PMCID: PMC4847646 DOI: 10.1097/aud.0000000000000252] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study used vocoder simulations with normal-hearing (NH) listeners to (1) measure their ability to integrate speech information from an NH ear and a simulated cochlear implant (CI), and (2) investigate whether binaural integration is disrupted by a mismatch in the delivery of spectral information between the ears arising from a misalignment in the mapping of frequency to place. DESIGN Eight NH volunteers participated in the study and listened to sentences embedded in background noise via headphones. Stimuli presented to the left ear were unprocessed. Stimuli presented to the right ear (referred to as the CI-simulation ear) were processed using an eight-channel noise vocoder with one of the three processing strategies. An Ideal strategy simulated a frequency-to-place map across all channels that matched the delivery of spectral information between the ears. A Realistic strategy created a misalignment in the mapping of frequency to place in the CI-simulation ear where the size of the mismatch between the ears varied across channels. Finally, a Shifted strategy imposed a similar degree of misalignment in all channels, resulting in consistent mismatch between the ears across frequency. The ability to report key words in sentences was assessed under monaural and binaural listening conditions and at signal to noise ratios (SNRs) established by estimating speech-reception thresholds in each ear alone. The SNRs ensured that the monaural performance of the left ear never exceeded that of the CI-simulation ear. The advantages of binaural integration were calculated by comparing binaural performance with monaural performance using the CI-simulation ear alone. Thus, these advantages reflected the additional use of the experimentally constrained left ear and were not attributable to better-ear listening. RESULTS Binaural performance was as accurate as, or more accurate than, monaural performance with the CI-simulation ear alone. When both ears supported a similar level of monaural performance (50%), binaural integration advantages were found regardless of whether a mismatch was simulated or not. When the CI-simulation ear supported a superior level of monaural performance (71%), evidence of binaural integration was absent when a mismatch was simulated using both the Realistic and the Ideal processing strategies. This absence of integration could not be accounted for by ceiling effects or by changes in SNR. CONCLUSIONS If generalizable to unilaterally deaf CI users, the results of the current simulation study would suggest that benefits to speech perception in noise can be obtained by integrating information from an implanted ear and an NH ear. A mismatch in the delivery of spectral information between the ears due to a misalignment in the mapping of frequency to place may disrupt binaural integration in situations where both ears cannot support a similar level of monaural speech understanding. Previous studies that have measured the speech perception of unilaterally deaf individuals after CI but with nonindividualized frequency-to-electrode allocations may therefore have underestimated the potential benefits of providing binaural hearing. However, it remains unclear whether the size and nature of the potential incremental benefits from individualized allocations are sufficient to justify the time and resources required to derive them based on cochlear imaging or pitch-matching tasks.
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Dillon MT, Buss E, Rooth MA, King ER, Deres EJ, Buchman CA, Pillsbury HC, Brown KD. Effect of Cochlear Implantation on Quality of Life in Adults with Unilateral Hearing Loss. Audiol Neurootol 2018; 22:259-271. [DOI: 10.1159/000484079] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 10/10/2017] [Indexed: 11/19/2022] Open
Abstract
Objective: Patients with moderate-to-profound sensorineural hearing loss in 1 ear and normal hearing in the contralateral ear, known as unilateral hearing loss (UHL) or single-sided deafness (SSD), may experience improved quality of life with the use of a cochlear implant (CI) in the affected ear. Quality of life assessment before and after implantation may reveal changes to aspects of hearing beyond those explicitly evaluated with behavioral measures. Methods: The present report completed 2 experiments investigating quality of life outcomes in CI recipients with UHL. The first experiment assessed quality of life during the 1st year of device use with 3 questionnaires: the Speech, Spatial, and Qualities of Hearing Scale (SSQ), the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the Tinnitus Handicap Inventory. Twenty subjects were evaluated preoperatively and 1, 3, 6, 9, and 12 months post-activation. Quality of life results were compared over the study period using traditional scoring methods and the SSQ pragmatic subscales. Subscales specific to localization and speech perception in noise were compared to behavioral measures at the preoperative and 12-month intervals. The 2nd experiment evaluated quality of life preoperatively and at the 12-month interval for CI recipients with UHL and CI recipients with bilateral hearing loss, including conventional CI users and those listening with electric-acoustic stimulation (EAS). The 3 cohorts differed in CI candidacy criteria, including the amount of residual hearing in the contralateral ear. Results: For subjects with moderate-to-profound UHL, receipt of a CI significantly improved quality of life, with benefits noted as early as 1 month after initial activation. The UHL cohort reported less perceived difficulty at the pre- and postoperative intervals than the conventional CI and EAS cohorts, which may be due to the presence of the normal-hearing ear. Each group experienced a significant benefit in quality of life on the APHAB with CI use. Conclusions: Cochlear implantation in cases of substantial UHL may offer significant improvements in quality of life. Quality of life measures revealed a reduction in perceived tinnitus severity and subjective improvements in speech perception in noise, spatial hearing, and listening effort. While self-report of difficulties were lower for the UHL cohort than the conventional CI and EAS cohorts, subjects in all 3 groups reported an improvement in quality of life with CI use.
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Arts RAGJ, George ELJ, Janssen MAML, Griessner A, Zierhofer C, Stokroos RJ. The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training. Int J Audiol 2017; 57:426-439. [DOI: 10.1080/14992027.2017.1408964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Remo A. G. J. Arts
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, The Netherlands,
| | - Erwin L. J. George
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, The Netherlands,
| | - Miranda A. M. L. Janssen
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, The Netherlands,
- Department of Methodology and Statistics, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands, and
| | - Andreas Griessner
- Institute of Mechatronics, University of Innsbruck, Innsbruck, Austria
| | - Clemens Zierhofer
- Institute of Mechatronics, University of Innsbruck, Innsbruck, Austria
| | - Robert J. Stokroos
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, The Netherlands,
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Aschendorff A, Arndt S, Laszig R, Wesarg T, Hassepaß F, Beck R. [Treatment and auditory rehabilitation of intralabyrinthine schwannoma by means of cochlear implants - German Version]. HNO 2017; 65:321-327. [PMID: 27573449 DOI: 10.1007/s00106-016-0216-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND To date, the therapy of intralabyrinthine schwannoma consists mainly of a wait-and-see approach, completely ignoring auditory rehabilitation. Only a few single-case reports are as yet available on treatment with cochlear implants (CI). AIM OF THE STUDY This study aimed to assess the results of auditory rehabilitation after treatment with CI in a series of cases. MATERIALS AND METHODS The demographic findings, symptoms, and results of surgical therapy in 8 patients were evaluated in a retrospective analysis. RESULTS Prior to surgery, all patients presented with profound hearing loss and tinnitus. Episodic dizziness was reported by 3 patients. Among the patients, 4 had an intracochlear and 3 an intravestibular schwannoma, and a transmodiolar schwannoma was found in 1 patient. A total of 6 patients underwent treatment with CI. The results of auditory rehabilitation are favorable with open-set speech comprehension. DISCUSSION CI treatment following resection of an intralabyrinthine schwannoma is a promising option for auditory rehabilitation, even in single-sided deafness. This is a new treatment concept in contrast to the wait-and-scan policy. Expectant management appears justified only if the patient still has usable hearing.
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Affiliation(s)
- A Aschendorff
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Implant Centrum Freiburg, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
| | - S Arndt
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Implant Centrum Freiburg, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - R Laszig
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Implant Centrum Freiburg, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - T Wesarg
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Implant Centrum Freiburg, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - F Hassepaß
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Implant Centrum Freiburg, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - R Beck
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Implant Centrum Freiburg, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
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Functional Result After Cochlear Implantation in Children and Adults With Single-sided Deafness. Otol Neurotol 2017; 37:e332-40. [PMID: 27631656 DOI: 10.1097/mao.0000000000000971] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients with single-sided deafness (SSD) suffer from reduced binaural hearing (i.e., sound localization and speech in noise discrimination). Cochlear implantation has recently been introduced for patients with SSD, as an alternative to hearing devices that employ contralateral routing of the signal. Application to children has also been started. METHODS We retrospectively analyze a case series of 4 children and 17 adults with SSD, treated with cochlear implantation. The outcome of adult patients was compared with a control group of 27 patients with bilateral profound hearing loss using a cochlear implant. RESULTS During 12 months, the mean speech recognition score increased from 30 to 41% for monosyllabic words in adults, and from 58 to 89% for multisyllabic numbers. The cochlear implant (CI) improved hearing in noise in all SSD patients, as was demonstrated by a significant improvement of the speech reception threshold in different speech and noise configurations. Sound localization-correlated angle detection error improved with CI use at every time point. The maximum word recognition score for monosyllabic words in quiet correlated with the logarithm of the duration of deafness; improvement of the speech reception threshold and RMS angle detection error by the CI did not. CONCLUSION All SSD patients benefitted from the CI in different hearing situations. Patients with SSD for a long period can improve after cochlear implantation.
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Cañete OM, Purdy SC, Neeff M, Brown CRS, Thorne PR. Cortical auditory evoked potential (CAEP) and behavioural measures of auditory function in a child with a single-sided deafness. Cochlear Implants Int 2017; 18:335-346. [DOI: 10.1080/14670100.2017.1373499] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Oscar M. Cañete
- Speech Science, School of Psychology, The University of Auckland, New Zealand
- Eisdell Moore Centre for Research in Hearing and Balance, Auckland, New Zealand
| | - Suzanne C. Purdy
- Speech Science, School of Psychology, The University of Auckland, New Zealand
- Eisdell Moore Centre for Research in Hearing and Balance, Auckland, New Zealand
| | - Michel Neeff
- Starship Children’s Hospital, Auckland, New Zealand
| | | | - Peter R. Thorne
- Section of Audiology, The University of Auckland, New Zealand
- Eisdell Moore Centre for Research in Hearing and Balance, Auckland, New Zealand
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Cochlear Implantation in Cases of Unilateral Hearing Loss: Initial Localization Abilities. Ear Hear 2017; 38:611-619. [DOI: 10.1097/aud.0000000000000430] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Greaver L, Eskridge H, Teagle HFB. Considerations for Pediatric Cochlear Implant Recipients With Unilateral or Asymmetric Hearing Loss: Assessment, Device Fitting, and Habilitation. Am J Audiol 2017; 26:91-98. [PMID: 28291986 DOI: 10.1044/2016_aja-16-0051] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 09/16/2016] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this clinical report is to present case studies of children who are nontraditional candidates for cochlear implantation because they have significant residual hearing in 1 ear and to describe outcomes and considerations for their audiological management and habilitation. METHOD Case information is presented for 5 children with profound hearing loss in 1 ear and normal or mild-to-moderate hearing loss in the opposite ear and who have undergone unilateral cochlear implantation. Pre- and postoperative assessments were performed per typical clinic routines with modifications described. Postimplant habilitation was customized for each recipient using a combination of traditional methods, newer technologies, and commercial materials. RESULTS The 5 children included in this report are consistent users of their cochlear implants and demonstrate speech recognition in the implanted ear when isolated from the better hearing ear. CONCLUSIONS Candidacy criteria for cochlear implantation are evolving. Children with single-sided deafness or asymmetric hearing loss who have traditionally not been considered candidates for cochlear implantation should be evaluated on a case-by-case basis. Audiological management of these recipients is not vastly different compared with children who are traditional cochlear implant recipients. Assessment and habilitation techniques must be modified to isolate the implanted ear to obtain accurate results and to provide meaningful therapeutic intervention.
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Finke M, Strauß-Schier A, Kludt E, Büchner A, Illg A. Speech intelligibility and subjective benefit in single-sided deaf adults after cochlear implantation. Hear Res 2017; 348:112-119. [DOI: 10.1016/j.heares.2017.03.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 02/21/2017] [Accepted: 03/01/2017] [Indexed: 12/18/2022]
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Patient benefit from Cochlear implantation in single-sided deafness: a 1-year follow-up. Eur Arch Otorhinolaryngol 2017; 274:2405-2409. [DOI: 10.1007/s00405-017-4511-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 02/15/2017] [Indexed: 11/25/2022]
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80
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Cochlear implant treatment of patients with single-sided deafness or asymmetric hearing loss. HNO 2017; 65:98-108. [DOI: 10.1007/s00106-016-0297-5] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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81
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Evaluation of Long-Term Cochlear Implant Use in Subjects With Acquired Unilateral Profound Hearing Loss: Focus on Binaural Auditory Outcomes. Ear Hear 2017; 38:117-125. [DOI: 10.1097/aud.0000000000000359] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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82
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Finke M, Sandmann P, Bönitz H, Kral A, Büchner A. Consequences of Stimulus Type on Higher-Order Processing in Single-Sided Deaf Cochlear Implant Users. Audiol Neurootol 2016; 21:305-315. [DOI: 10.1159/000452123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 09/20/2016] [Indexed: 11/19/2022] Open
Abstract
Single-sided deaf subjects with a cochlear implant (CI) provide the unique opportunity to compare central auditory processing of the electrical input (CI ear) and the acoustic input (normal-hearing, NH, ear) within the same individual. In these individuals, sensory processing differs between their two ears, while cognitive abilities are the same irrespectively of the sensory input. To better understand perceptual-cognitive factors modulating speech intelligibility with a CI, this electroencephalography study examined the central-auditory processing of words, the cognitive abilities, and the speech intelligibility in 10 postlingually single-sided deaf CI users. We found lower hit rates and prolonged response times for word classification during an oddball task for the CI ear when compared with the NH ear. Also, event-related potentials reflecting sensory (N1) and higher-order processing (N2/N4) were prolonged for word classification (targets versus nontargets) with the CI ear compared with the NH ear. Our results suggest that speech processing via the CI ear and the NH ear differs both at sensory (N1) and cognitive (N2/N4) processing stages, thereby affecting the behavioral performance for speech discrimination. These results provide objective evidence for cognition to be a key factor for speech perception under adverse listening conditions, such as the degraded speech signal provided from the CI.
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83
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Sladen DP, Carlson ML, Dowling BP, Olund AP, Teece K, DeJong MD, Breneman A, Peterson A, Beatty CW, Neff BA, Driscoll CL. Early outcomes after cochlear implantation for adults and children with unilateral hearing loss. Laryngoscope 2016; 127:1683-1688. [PMID: 27730647 DOI: 10.1002/lary.26337] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/12/2016] [Accepted: 08/25/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study was designed to examine speech recognition and self-perceived health-related quality of life (HRQoL) received from cochlear implantation among a cohort of adults and children with a short duration of unilateral hearing loss greater than 6 months, but less than 2 years. STUDY DESIGN Single-subject repeated measures prospective study. METHODS This study assessed changes in speech recognition and self-perceived quality of life by prospectively analyzing data at the preoperative evaluation and at the 3-month and 6-month postactivation intervals. Measurement tools included Medical Outcomes Study Questionnaire Short Form 36, Nijmegen Cochlear Implant Questionnaire, Speech Spatial and Qualities of Hearing-Comparative, and speech recognition measures in quiet and in noise. RESULTS Results indicated significant improvement in speech recognition, both in quiet and noise. Quality-of-life measures showed a significant increase in self-perceived benefit with disease-specific instruments, but remained constant with a generic HRQoL instrument. CONCLUSIONS Cochlear implantation was a successful intervention for improved hearing in quiet and noise, and a self-perceived benefit for this group of adults and children with a short duration of unilateral hearing loss. LEVEL OF EVIDENCE 4 Laryngoscope, 127:1683-1688, 2017.
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Affiliation(s)
- Douglas P Sladen
- Department of Otorhinolaryngology, Division of Audiology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Matthew L Carlson
- Department of Otorhinolaryngology, Division of Audiology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Brittany P Dowling
- Department of Otorhinolaryngology, Division of Audiology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Amy P Olund
- Department of Otorhinolaryngology, Division of Audiology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Kathryn Teece
- Department of Otorhinolaryngology, Division of Audiology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Melissa D DeJong
- Department of Otorhinolaryngology, Division of Audiology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Alyce Breneman
- Department of Otorhinolaryngology, Division of Audiology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Ann Peterson
- Department of Otorhinolaryngology, Division of Audiology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Charles W Beatty
- Department of Otorhinolaryngology, Division of Audiology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Brian A Neff
- Department of Otorhinolaryngology, Division of Audiology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Colin L Driscoll
- Department of Otorhinolaryngology, Division of Audiology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
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Thomas Roland J, Buchman C, Eisenberg L, Henderson L, He S, Firszt J, Francis H, Dunn C, Sladen D, Arndt S, May B, Zeitler D, Niparko JK, Emmett S, Tucci D, Chen J, McConkey Robbins A, Schwefler E, Geers A, Lederberg A, Hayes H, Hughes M, Bierer J, Schafer E, Sorkin D, Kozma-Spytek L, Childress T. Proceedings of the Annual Symposium of the American Cochlear Implant Alliance. Cochlear Implants Int 2016; 17:211-237. [PMID: 27635521 PMCID: PMC5062039 DOI: 10.1080/14670100.2016.1225348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
| | | | | | | | - Shuman He
- e Boys Town National Research Hospital (previously University of North Carolina)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Michelle Hughes
- e Boys Town National Research Hospital (previously University of North Carolina)
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85
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Aschendorff A, Arndt S, Laszig R, Wesarg T, Hassepaß F, Beck R. Treatment and auditory rehabilitation of intralabyrinthine schwannoma by means of cochlear implants. HNO 2016; 65:46-51. [DOI: 10.1007/s00106-016-0217-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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86
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Krishnan LA, Van Hyfte S. Management of unilateral hearing loss. Int J Pediatr Otorhinolaryngol 2016; 88:63-73. [PMID: 27497389 DOI: 10.1016/j.ijporl.2016.06.048] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE A representative sample of literature regarding unilateral hearing loss (UHL) was reviewed to provide evidence of the effects of UHL and the intervention options available for children with UHL. Considerations during the assessment and management of children with UHL are illustrated using case illustrations. METHOD Research articles published from 2013 to 2015 were searched in the PubMed database using the keywords "unilateral hearing loss". Articles from 1950 to 2013 were included from a previous literature review on minimal hearing loss [1]. A retrospective review of charts of 14 children with UHL was also conducted. RESULTS The evidence indicates that children with UHL are more likely to have structural anomalies of the inner ear; may face challenges in six different domains, and have six intervention options available. Evidence also indicates that although some children appear to exhibit no delays or difficulties, others have significant challenges, some of which continue into adulthood. CONCLUSIONS Children with UHL have to be treated on a case-by-case basis. Parent education regarding UHL, its effects, and all available management options is critical so they can make informed decisions. Close monitoring and good communication between professionals in different domains is crucial in order to minimize the potential negative effects of UHL.
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Affiliation(s)
- Lata A Krishnan
- Purdue University, West Lafayette, Department of Speech, Language, and Hearing Sciences, Purdue University, 715 Clinic Drive, West Lafayette, IN 47907, USA.
| | - Shannon Van Hyfte
- Purdue University, West Lafayette, Department of Speech, Language, and Hearing Sciences, Purdue University, 715 Clinic Drive, West Lafayette, IN 47907, USA
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87
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Zhou X, Li H, Galvin JJ, Fu QJ, Yuan W. Effects of insertion depth on spatial speech perception in noise for simulations of cochlear implants and single-sided deafness. Int J Audiol 2016; 56:S41-S48. [PMID: 27367147 DOI: 10.1080/14992027.2016.1197426] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study evaluated the effects of insertion depth on spatial speech perception in noise for simulations of cochlear implants (CI) and single-sided deafness (SSD). DESIGN Mandarin speech recognition thresholds were adaptively measured in five listening conditions and four spatial configurations. The original signal was delivered to the left ear. The right ear received either no input, one of three CI simulations in which the insertion depth was varied, or the original signal. Speech and noise were presented at either front, left, or right. STUDY SAMPLE Ten Mandarin-speaking NH listeners with pure-tone thresholds less than 20 dB HL. RESULTS Relative to no input in the right ear, the CI simulations provided significant improvements in head shadow benefit for all insertion depths, as well as better spatial release of masking (SRM) for the deepest simulated insertion. There were no significant improvements in summation or squelch for any of the CI simulations. CONCLUSIONS The benefits of cochlear implantation were largely limited to head shadow, with some benefit for SRM. The greatest benefits were observed for the deepest simulated CI insertion, suggesting that reducing mismatch between acoustic and electric hearing may increase the benefit of cochlear implantation.
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Affiliation(s)
- Xiaoqing Zhou
- a Department of Otolaryngology , Southwest Hospital, Third Military Medical University , Gao Tan Yan Street, Shaping Ba District , Chongqing , 400038 , China and
| | - Huajun Li
- a Department of Otolaryngology , Southwest Hospital, Third Military Medical University , Gao Tan Yan Street, Shaping Ba District , Chongqing , 400038 , China and
| | - John J Galvin
- b Department of Head and Neck Surgery , David Geffen School of Medicine, University of California Los Angeles , Los Angeles , CA 90095 , USA
| | - Qian-Jie Fu
- b Department of Head and Neck Surgery , David Geffen School of Medicine, University of California Los Angeles , Los Angeles , CA 90095 , USA
| | - Wei Yuan
- a Department of Otolaryngology , Southwest Hospital, Third Military Medical University , Gao Tan Yan Street, Shaping Ba District , Chongqing , 400038 , China and
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88
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Sladen DP, Frisch CD, Carlson ML, Driscoll CL, Torres JH, Zeitler DM. Cochlear implantation for single-sided deafness: A multicenter study. Laryngoscope 2016; 127:223-228. [DOI: 10.1002/lary.26102] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/15/2016] [Accepted: 04/26/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Douglas P. Sladen
- Department of Otolaryngology-Head and Neck Surgery; Mayo Clinic; Rochester Minnesota U.S.A
| | - Christopher D. Frisch
- Department of Otolaryngology-Head and Neck Surgery; Mayo Clinic; Rochester Minnesota U.S.A
| | - Matthew L. Carlson
- Department of Otolaryngology-Head and Neck Surgery; Mayo Clinic; Rochester Minnesota U.S.A
| | - Colin L.W. Driscoll
- Department of Otolaryngology-Head and Neck Surgery; Mayo Clinic; Rochester Minnesota U.S.A
| | | | - Daniel M. Zeitler
- Department of Otolaryngology-Head and Neck Surgery; Virginia Mason Medical Center; Seattle Washington U.S.A
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89
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Távora-Vieira D, Rajan G. Cochlear implantation in children with congenital unilateral deafness: Mid-term follow-up outcomes. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133 Suppl 1:S12-4. [DOI: 10.1016/j.anorl.2016.04.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 02/01/2016] [Accepted: 04/28/2016] [Indexed: 11/26/2022]
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90
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Sound Source Localization and Speech Understanding in Complex Listening Environments by Single-sided Deaf Listeners After Cochlear Implantation. Otol Neurotol 2016; 36:1467-71. [PMID: 26375967 DOI: 10.1097/mao.0000000000000841] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess improvements in sound source localization and speech understanding in complex listening environments after unilateral cochlear implantation for single-sided deafness (SSD). STUDY DESIGN Nonrandomized, open, prospective case series. SETTING Tertiary referral center. PATIENTS Nine subjects with a unilateral cochlear implant (CI) for SSD (SSD-CI) were tested. Reference groups for the task of sound source localization included young (n = 45) and older (n = 12) normal-hearing (NH) subjects and 27 bilateral CI (BCI) subjects. INTERVENTION Unilateral cochlear implantation. MAIN OUTCOME MEASURES Sound source localization was tested with 13 loudspeakers in a 180 arc in front of the subject. Speech understanding was tested with the subject seated in an 8-loudspeaker sound system arrayed in a 360-degree pattern. Directionally appropriate noise, originally recorded in a restaurant, was played from each loudspeaker. Speech understanding in noise was tested using the Azbio sentence test and sound source localization quantified using root mean square error. RESULTS All CI subjects showed poorer-than-normal sound source localization. SSD-CI subjects showed a bimodal distribution of scores: six subjects had scores near the mean of those obtained by BCI subjects, whereas three had scores just outside the 95th percentile of NH listeners. Speech understanding improved significantly in the restaurant environment when the signal was presented to the side of the CI. CONCLUSION Cochlear implantation for SSD can offer improved speech understanding in complex listening environments and improved sound source localization in both children and adults. On tasks of sound source localization, SSD-CI patients typically perform as well as BCI patients and, in some cases, achieve scores at the upper boundary of normal performance.
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91
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Hoth S, Rösli-Khabas M, Herisanu I, Plinkert PK, Praetorius M. Cochlear implantation in recipients with single-sided deafness: Audiological performance. Cochlear Implants Int 2016; 17:190-199. [DOI: 10.1080/14670100.2016.1176778] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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92
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Távora-Vieira D, Marino R, Acharya A, Rajan GP. Cochlear implantation in adults with unilateral deafness: A review of the assessment/evaluation protocols. Cochlear Implants Int 2016; 17:184-189. [PMID: 27142479 DOI: 10.1080/14670100.2016.1176303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Cochlear implantation is becoming widely used outside the tertiary research centers for treatment of unilateral deafness (UD). No consensus exists, however, on the most suitable assessment/evaluation protocols for this group of adult patients. This paper aims to review the assessment and evaluation protocols used by various research groups and to propose a protocol for the use in the clinical setting. METHODS The PubMed, Embase, and Cochrane Library databases were searched with the keywords 'cochlear', 'implant', 'single-sided', 'deafness', 'adults', 'unilateral', and 'deafness'. The words were either used individually, combined in pairs, or in groups of 5. All articles reporting on prospective studies, retrospective studies, or case studies were included. RESULTS Sixteen published studies met the inclusion criteria. Measures of hearing performance, tinnitus, subjective quality of hearing, and quality of life varied greatly among studies. DISCUSSION Adaptive speech in noise testing, localization, tinnitus measurement questionnaires, and self-rated hearing improvement are widely used among the research groups. These tools in conjunction assess and evaluate the main issues associated with UD. CONCLUSION The test battery most commonly used to assess and evaluate adult cochlea implant users with UD consists of (a) a subjective self-rating of hearing performance, (b) localization testing, and
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Affiliation(s)
- Dayse Távora-Vieira
- a Otolaryngology, Head & Neck Surgery-School of Surgery , University of Western Australia , Perth, Australia, Fiona Stanley Hospital, Perth , Australia
| | - Roberta Marino
- a Otolaryngology, Head & Neck Surgery-School of Surgery , University of Western Australia , Perth, Australia, Fiona Stanley Hospital, Perth , Australia
| | - Aanand Acharya
- a Otolaryngology, Head & Neck Surgery-School of Surgery , University of Western Australia , Perth, Australia, Fiona Stanley Hospital, Perth , Australia
| | - Gunesh P Rajan
- a Otolaryngology, Head & Neck Surgery-School of Surgery , University of Western Australia , Perth, Australia, Fiona Stanley Hospital, Perth , Australia
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93
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Chang JL, Pross SE, Findlay AM, Mizuiri D, Henderson-Sabes J, Garrett C, Nagarajan SS, Cheung SW. Spatial plasticity of the auditory cortex in single-sided deafness. Laryngoscope 2016; 126:2785-2791. [DOI: 10.1002/lary.25961] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Jolie L. Chang
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco; San Francisco California U.S.A
| | - Seth E. Pross
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco; San Francisco California U.S.A
| | - Anne M. Findlay
- Department of Radiology and Biomedical Imaging; University of California, San Francisco; San Francisco California U.S.A
| | - Danielle Mizuiri
- Department of Radiology and Biomedical Imaging; University of California, San Francisco; San Francisco California U.S.A
| | - Jennifer Henderson-Sabes
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco; San Francisco California U.S.A
| | - Coleman Garrett
- Department of Radiology and Biomedical Imaging; University of California, San Francisco; San Francisco California U.S.A
| | - Srikantan S. Nagarajan
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco; San Francisco California U.S.A
- Department of Radiology and Biomedical Imaging; University of California, San Francisco; San Francisco California U.S.A
| | - Steven W. Cheung
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco; San Francisco California U.S.A
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94
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Mertens G, Desmet J, De Bodt M, Van de Heyning P. Prospective case-controlled sound localisation study after cochlear implantation in adults with single-sided deafness and ipsilateral tinnitus. Clin Otolaryngol 2016; 41:511-8. [DOI: 10.1111/coa.12555] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2015] [Indexed: 12/01/2022]
Affiliation(s)
- G. Mertens
- University Department of Otorhinolaryngology; Head and Neck Surgery; Antwerp University Hospital; Edegem Antwerp Belgium
- Antwerp University; Antwerp Belgium
| | - J. Desmet
- University Department of Otorhinolaryngology; Head and Neck Surgery; Antwerp University Hospital; Edegem Antwerp Belgium
- Antwerp University; Antwerp Belgium
| | - M. De Bodt
- University Department of Otorhinolaryngology; Head and Neck Surgery; Antwerp University Hospital; Edegem Antwerp Belgium
- Antwerp University; Antwerp Belgium
| | - P. Van de Heyning
- University Department of Otorhinolaryngology; Head and Neck Surgery; Antwerp University Hospital; Edegem Antwerp Belgium
- Antwerp University; Antwerp Belgium
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95
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Sharma A, Glick H, Campbell J, Torres J, Dorman M, Zeitler DM. Cortical Plasticity and Reorganization in Pediatric Single-sided Deafness Pre- and Postcochlear Implantation: A Case Study. Otol Neurotol 2016; 37:e26-34. [PMID: 26756152 PMCID: PMC6530986 DOI: 10.1097/mao.0000000000000904] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS The purpose of this study was to examine changes in cortical development and neuroplasticity in a child with single-sided deafness (SSD) before and after cochlear implantation (CI). BACKGROUND The extent to which sensory pathways reorganize in childhood SSD is not well understood and there is currently little evidence demonstrating the efficacy of CI in children with SSD. METHODS High-density 128-channel electroencephalography (EEG) was used to collect cortical auditory evoked potentials (CAEP), cortical visual evoked potentials (CVEP), and cortical somatosensory evoked potentials (CSSEP) in a child with SSD, pre-CI and at subsequent sessions until approximately 3 years post-CI in her right ear which occurred at age 9.86 years. Behavioral correlates of speech perception and sound localization were also measured. RESULTS Pre-CI, high-density EEG showed evidence of delayed auditory cortical response morphology, auditory cortical development strongly contralateral (to the normal hearing ear), evidence of increased cognitive load, and cross-modal reorganization by the visual and somatosensory modalities. The post-CI developmental trajectory provided clear evidence of age-appropriate development of auditory cortical responses, and decreased cross-modal reorganization, consistent with improved speech perception and sound localization. CONCLUSION Post-CI, the child demonstrated age-appropriate auditory cortical development and improved speech perception and sound localization suggestive of significant benefits from cochlear implantation. Reversal of somatosensory recruitment was clearly apparent, and only a residual amount of visual cross-modal plasticity remained postimplantation. Overall, our results suggest that CI in pediatric SSD patients may benefit from a highly plastic cortex in childhood.
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Affiliation(s)
- Anu Sharma
- Department of Speech, Language, and Hearing Science and Institute of Cognitive Science, University of Colorado, 2501 Kittredge Loop Road 409 UCB, Boulder, Colorado, 80309
| | - Hannah Glick
- Department of Speech, Language, and Hearing Science and Institute of Cognitive Science, University of Colorado, 2501 Kittredge Loop Road 409 UCB, Boulder, Colorado, 80309
| | - Julia Campbell
- Department of Speech, Language, and Hearing Science and Institute of Cognitive Science, University of Colorado, 2501 Kittredge Loop Road 409 UCB, Boulder, Colorado, 80309
| | - Jennifer Torres
- Denver Ear Associates, 401 W Hampden Pl, Englewood, CO 80110
| | - Michael Dorman
- Department of Speech and Hearing Science, Arizona State University, 975 South Myrtle Avenue, P.O. Box 870102, Tempe, Arizona 85287
| | - Daniel M. Zeitler
- Virginia Mason Medical Center, 1201 Terry Ave., Mailstop X10-ON, Seattle, WA 98101
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96
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Hassepass F, Arndt S, Aschendorff A, Laszig R, Wesarg T. Cochlear implantation for hearing rehabilitation in single-sided deafness after translabyrinthine vestibular schwannoma surgery. Eur Arch Otorhinolaryngol 2015; 273:2373-83. [DOI: 10.1007/s00405-015-3801-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/15/2015] [Indexed: 11/28/2022]
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97
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Investigating long-term effects of cochlear implantation in single-sided deafness: a best practice model for longitudinal assessment of spatial hearing abilities and tinnitus handicap. Otol Neurotol 2015; 35:1525-32. [PMID: 25158615 DOI: 10.1097/mao.0000000000000437] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To evaluate methods for measuring long-term benefits of cochlear implantation in a patient with single-sided deafness (SSD) with respect to spatial hearing and to document improved quality of life because of reduced tinnitus. PATIENT A single adult male with profound right-sided sensorineural hearing loss and normal hearing in the left ear who underwent right-sided cochlear implantation. METHODS The subject was evaluated at 6, 9, 12, and 18 months after implantation on speech intelligibility with specific target-masker configurations, sound localization accuracy, audiologic performance, and tinnitus handicap. Testing conditions involved the acoustic (NH) ear only, the cochlear implant (CI) ear (acoustic ear plugged), and the bilateral condition (CI+NH). Measures of spatial hearing included speech intelligibility improvement because of spatial release from masking (SRM) and sound localization. In addition, traditional measures known as "head shadow," "binaural squelch," and "binaural summation" were evaluated. RESULTS The best indicator for improved speech intelligibility was SRM, in which both ears are activated, but the relative locations of target and masker(s) are manipulated. Measures that compare performance with a single ear to performance using bilateral auditory input indicated evidence of the ability to integrate inputs across the ears, possibly reflecting early binaural processing, with 12 months of bilateral input. Sound localization accuracy improved with addition of the implant, and a large improvement with respect to tinnitus handicap was observed. CONCLUSION Cochlear implantation resulted in improved sound localization accuracy when compared with performance using only the NH ear, and reduced tinnitus handicap was observed with use of the implant. The use of SRM addresses some of the current limitations of traditional measures of spatial and binaural hearing, as spatial cues related to target and maskers are manipulated, rather than the ear(s) tested. Sound testing methods and calculations described here are therefore recommended for assessing performance of a larger sample size of individuals with SSD who receive a CI.
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98
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The Prevalence of Cochlear Obliteration After Labyrinthectomy Using Magnetic Resonance Imaging and the Implications for Cochlear Implantation. Otol Neurotol 2015; 36:1328-30. [DOI: 10.1097/mao.0000000000000803] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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99
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Cochlear implantation for patients with single-sided deafness or asymmetrical hearing loss: a systematic review of the evidence. Otol Neurotol 2015; 36:209-19. [PMID: 25502451 DOI: 10.1097/mao.0000000000000681] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE A systematic review of the literature to evaluate the clinical outcome of cochlear implantation for patients with single-sided deafness (SSD) or asymmetrical hearing loss (AHL). DATA SOURCES We searched the PubMed, Embase, Cochrane Library, and CINAHL databases from their inception up to December 10, 2013 for SSD or AHL and cochlear implantation or their synonyms. STUDY SELECTION In total, 781 articles were retrieved, of which 15 satisfied the eligibility criteria. Our outcomes of interest were speech perception in noise, sound localization, quality of life (QoL), and tinnitus. DATA EXTRACTION Critical appraisal showed that six studies reported on less than five patients or that they carried a low directness of evidence or a high risk of bias. Therefore, we extracted the data of nine studies (n = 112). Patient numbers, age, duration of deafness, classification of deafness, pure tone audiometry, follow-up duration, and outcome measurements were extracted from all nine articles. DATA SYNTHESIS Because of large heterogeneity between studies, we were not able to pool data in a meta-analysis. We therefore summarized the results of the studies specified per outcome. CONCLUSION There are no high-level-of-evidence studies concerning cochlear implantation in patients with SSD or AHL. Current literature suggests important benefits of cochlear implantation regarding sound localization, QoL, and tinnitus. Varying results were reported for speech perception in noise, possibly caused by the large clinical heterogeneity between studies. Larger and high-quality studies are certainly warranted.
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The impact of cochlear implantation on speech understanding, subjective hearing performance, and tinnitus perception in patients with unilateral severe to profound hearing loss. Otol Neurotol 2015; 36:430-6. [PMID: 25594387 DOI: 10.1097/mao.0000000000000707] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to determine the impact of cochlear implantation on speech understanding in noise, subjective perception of hearing, and tinnitus perception of adult patients with unilateral severe to profound hearing loss and to investigate whether duration of deafness and age at implantation would influence the outcomes. In addition, this article describes the auditory training protocol used for unilaterally deaf patients. DESIGN This is a prospective study of subjects undergoing cochlear implantation for unilateral deafness with or without associated tinnitus. METHODS Speech perception in noise was tested using the Bamford-Kowal-Bench speech-in-noise test presented at 65 dB SPL. The Speech, Spatial, and Qualities of Hearing Scale and the Abbreviated Profile of Hearing Aid Benefit were used to evaluate the subjective perception of hearing with a cochlear implant and quality of life. Tinnitus disturbance was measured using the Tinnitus Reaction Questionnaire. Data were collected before cochlear implantation and 3, 6, 12, and 24 months after implantation. RESULTS Twenty-eight postlingual unilaterally deaf adults with or without tinnitus were implanted. There was a significant improvement in speech perception in noise across time in all spatial configurations. There was an overall significant improvement on the subjective perception of hearing and quality of life. Tinnitus disturbance reduced significantly across time. Age at implantation and duration of deafness did not influence the outcomes significantly. CONCLUSION Cochlear implantation provided significant improvement in speech understanding in challenging situations, subjective perception of hearing performance, and quality of life. Cochlear implantation also resulted in reduced tinnitus disturbance. Age at implantation and duration of deafness did not seem to influence the outcomes.
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