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Wu SS, Dunn-Johnson C, Zeitler DM, Schwartz S, Sutliff S, Appachi S, Jamis C, Petter K, Vovos R, Goldberg D, Anne S. Auditory Outcomes Following Cochlear Implantation in Children with Unilateral Hearing Loss. Otol Neurotol 2024; 45:513-520. [PMID: 38511263 PMCID: PMC11087191 DOI: 10.1097/mao.0000000000004169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
OBJECTIVE Unilateral hearing loss (UHL) in children is associated with speech and language delays. Cochlear implantation (CI) is currently the only rehabilitative option that restores binaural hearing. This study aims to describe auditory outcomes in children who underwent CI for UHL and to determine the association between duration of hearing loss and auditory outcomes. STUDY DESIGN Retrospective case series. SETTING Three tertiary-level, academic institutions. PATIENTS Children <18 years with UHL who underwent CI between 2018 and 2021. INTERVENTION Cochlear implantation. MAIN OUTCOME MEASURES Speech perception and Speech, Spatial and Qualities of Hearing Scale (SSQ) were assessed postimplantation. Scores >50% on speech perception and SSQ scores >8 points were considered satisfactory. Associations between duration of UHL and implantation age and outcomes were assessed using Spearman's rank correlation. RESULTS Of the 38 children included, mean age at CI was 7.9 ± 3.2 years and mean UHL duration was 5.0 ± 2.8 years. Mean datalogging was 8.1 ± 3.1 hours/day. Mean auditory testing scores were SSQ, 7.9 ± 1.2; BABY BIO, 68.1 ± 30.2%; CNC, 38.4 ± 28.4%; WIPI, 52.5 ± 23.1%. Scores >50% on CNC testing were achieved by 40% of patients. SSQ scores >8 points were reported by 78% (7/9) of patients. There were no significant correlations between UHL duration and auditory outcomes. CONCLUSION Overall, children with UHL who undergo CI can achieve satisfactory speech perception scores and SSQ scores. There were no associations between duration of hearing loss and age at implantation with auditory outcomes. Multiple variables may impact auditory outcomes, including motivation, family support, access to technology, and consistent isolated auditory training postactivation and should be taken into consideration in addition to age at implantation and duration of UHL in determination of CI candidacy.
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Affiliation(s)
- Shannon S. Wu
- Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - Camille Dunn-Johnson
- Department of Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Daniel M. Zeitler
- Department of Otolaryngology, Virginia Mason Medical Center, Seattle, Washington
| | - Seth Schwartz
- Department of Otolaryngology, Virginia Mason Medical Center, Seattle, Washington
| | - Suzanne Sutliff
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Swathi Appachi
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Carmen Jamis
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Karen Petter
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Rachel Vovos
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Donald Goldberg
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Samantha Anne
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
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Garcia-Matte RJ, O'Neil LM, Chase C, Leeming P, Clack R, Rodrigues S, Kuthubutheen J. Long-Term Cochlear Implant Sound Processor Usage in Children with Single-Sided Deafness. Otol Neurotol 2024; 45:392-397. [PMID: 38478407 DOI: 10.1097/mao.0000000000004156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
OBJECTIVE To assess cochlear implant (CI) sound processor usage over time in children with single-sided deafness (SSD) and identify factors influencing device use. STUDY DESIGN Retrospective, chart review study. SETTING Pediatric tertiary referral center. PATIENTS Children with SSD who received CI between 2014 and 2020. OUTCOME MEASURE Primary outcome was average daily CI sound processor usage over follow-up. RESULTS Fifteen children with SSD who underwent CI surgery were categorized based on age of diagnosis and surgery timing. Over an average of 4.3-year follow-up, patients averaged 4.6 hours/day of CI usage. Declining usage trends were noted over time, with the first 2 years postactivation showing higher rates. No significant usage differences emerged based on age, surgery timing, or hearing loss etiology. CONCLUSIONS Long-term usage decline necessitates further research into barriers and enablers for continued CI use in pediatric SSD cases.
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Affiliation(s)
| | - Luke M O'Neil
- Department of Otolaryngology, Perth Children's Hospital
| | - Carl Chase
- Department of Otolaryngology, Perth Children's Hospital
| | - Pia Leeming
- Department of Otolaryngology, Perth Children's Hospital
| | - Rachel Clack
- Department of Otolaryngology, Perth Children's Hospital
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Guerzoni L, Falzone C, Ghiselli S, Fabrizi E, Cuda D. Pediatric version of speech, spatial and qualities of hearing scale (SSQ) in cochlear implanted children. Int J Pediatr Otorhinolaryngol 2024; 179:111917. [PMID: 38484425 DOI: 10.1016/j.ijporl.2024.111917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/19/2024] [Accepted: 03/08/2024] [Indexed: 04/14/2024]
Affiliation(s)
- L Guerzoni
- Department of Otorhinolaryngology "Guglielmo da Saliceto" Hospital, Via Cantone del Cristo 40, 29121, Piacenza, Italy.
| | - C Falzone
- Department of Otorhinolaryngology "Guglielmo da Saliceto" Hospital, Via Cantone del Cristo 40, 29121, Piacenza, Italy
| | - S Ghiselli
- Department of Otorhinolaryngology "Guglielmo da Saliceto" Hospital, Via Cantone del Cristo 40, 29121, Piacenza, Italy
| | - E Fabrizi
- Department of Economics and Social Sciences, Università Cattolica del S. Cuore, Via Emilia Parmense 84, 29122, Piacenza, Italy
| | - D Cuda
- Department of Otorhinolaryngology "Guglielmo da Saliceto" Hospital, Via Cantone del Cristo 40, 29121, Piacenza, Italy; Department of Medicine and Surgery, University Hospital of Parma, Italy
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Arndt S, Findeis L, Wesarg T, Aschendorff A, Speck I, Ketterer MC, Rauch AK. Long-Term Outcome of Cochlear Implantation in Children With Congenital, Perilingual, and Postlingual Single-Sided Deafness. Ear Hear 2024; 45:316-328. [PMID: 37726884 DOI: 10.1097/aud.0000000000001426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
OBJECTIVES We investigated the long-term outcomes of children with single-sided deafness (SSD) after cochlear implant (CI) surgery, during and after rehabilitation, and compared the results of children with congenital, perilingual, and postlingual SSD. We evaluated the impact of SSD at age at onset and duration of deafness on their performance. DESIGN Thirty-six children with SSD treated with CI participated in the study: 20 had congenital, seven perilingual (defined: >0 to 4 years), and nine had postlingual deafness (defined as >4 years of age). Their outcome with CI were measured on both subjective and objective scales: duration of device use, speech intelligibility in noise and in quiet, bilateral hearing and localization ability, quality of life and hearing, presence and loudness of tinnitus, and hearing ability of the better hearing ear. RESULTS After a mean follow-up time of 4.75 years, 32 of the 36 children used their CI on a regular basis. The remaining four children were nonusers. These children had congenital SSD and were older than three years at the time of CI surgery. Overall, for congenital/perilingual and postlingual SSD, speech intelligibility in noise and the Speech, Spatial and Qualities of Hearing Scale (SSQ) speech subscore were significantly improved, as were their subjective and objective localization ability and hearing-related quality of life. Children with postlingual SSD benefited from the CI with regard to speech intelligibility, SSQ speech/spatial/total score, and localization error, and children with congenital SSD showed better results with a short duration of deafness of less than 3 years compared with those with a longer deafness period. CONCLUSIONS Cochlear implantation is a successful treatment for children with congenital/perilingual or postlingual SSD. Results largely differed with respect to the onset and duration of deafness, and better outcomes were achieved by children with postlingual SSD and with a short duration of deafness. Our data also confirmed that children with congenital SSD should be implanted with a CI within three years of age.
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Affiliation(s)
- Susan Arndt
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
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Colasacco CJ, Morgan S, Bornstein R, Drugge E, Stidham KR. Cochlear Implantation in Children With a Long Average Duration of Single Sided Deafness. Ann Otol Rhinol Laryngol 2024; 133:345-350. [PMID: 38047440 DOI: 10.1177/00034894231216288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
OBJECTIVES Previous research has shown the positive effects of cochlear implantation in children with a short duration of single sided deafness (SSD). This case series assessed the impact of cochlear implantation in a cohort of children with a longer average duration of SSD. METHODS A retrospective chart review of 6 children who received a cochlear implant for SSD. The mean age at time of cochlear implantation was 14.7 years old (median = 15.5, interquartile range (IQR) = 2.5) and mean duration of hearing loss before cochlear implantation was 10.8 years (median = 11.5, IQR = 5.3). Pre- and post-operative audiometric data for aided speech perception testing, sentence recognition in quiet, sentence recognition in noise, and word recognition scores were analyzed. RESULTS When compared to preoperative hearing aid scores a 24% significant increase in median word score and a 64% significant increase in median sentence recognition score in quiet was observed at 12 months post-op. CONCLUSION Cochlear implantation in children with a longer duration of SSD can provide benefit to speech recognition. LAY SUMMARY This retrospective case series of children with prolonged single sided deafness demonstrated an improvement in word and sentence recognition within 12 months of receiving a cochlear implant.
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Affiliation(s)
| | - Samantha Morgan
- Department of Otolaryngology, Westchester Medical Center, Valhalla, NY, USA
- Westchester Institute for Human Development, Valhalla, NY, USA
| | - Rivka Bornstein
- Department of Otolaryngology, Westchester Medical Center, Valhalla, NY, USA
- Westchester Institute for Human Development, Valhalla, NY, USA
| | | | - Katrina R Stidham
- Department of Otolaryngology, Westchester Medical Center, Valhalla, NY, USA
- Westchester Institute for Human Development, Valhalla, NY, USA
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Hicks KB, Park LR, Brown KD, Dillon MT. Long-Term Perceived Benefit of Pediatric Cochlear Implant Users with Unilateral Hearing Loss. Laryngoscope 2024; 134:919-925. [PMID: 37466238 DOI: 10.1002/lary.30896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE To assess the perceived benefit of cochlear implant (CI) use for children with unilateral hearing loss (UHL) and evaluate whether perceived abilities are associated with performance on measures of speech recognition and spatial hearing. METHOD Nineteen children with moderate-to-profound UHL underwent cochlear implantation. The Speech Spatial and Qualities of Hearing Questionnaire modified for children (SSQ-C) were completed by parental proxy pre-operatively and at 3, 6, 9, 12, 18, and 24 months post-activation. Linear mixed models evaluated perceived benefits over the study period. Pearson correlations assessed the association between subjective report and performance on measures of word recognition with the CI alone and spatial hearing (speech recognition in spatially-separated noise and sound source localization) in the combined condition (CI plus contralateral ear). RESULTS For the SSQ-C, parents reported significant improvements with CI use as compared to pre-operative perceptions (p < 0.001); improved perceptions were either maintained or continued to improve over the 2-year post-activation period. Perceived benefit did not significantly correlate with word recognition with the CI alone or spatial hearing outcomes in the combined condition. CONCLUSION Families of children with UHL observed benefits of CI use early after cochlear implantation that was maintained with long-term device use. Responses to subjective measures may broaden our understanding of the experiences of pediatric CI users with UHL in addition to outcomes on typical measures of CI performance. LEVEL OF EVIDENCE 3 Laryngoscope, 134:919-925, 2024.
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Affiliation(s)
- Kayla B Hicks
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lisa R Park
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kevin D Brown
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Margaret T Dillon
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Spitzer ER, Attlassy Y, Roland JT, Waltzman SB. Early cochlear implantation for children with single sided deafness. Int J Pediatr Otorhinolaryngol 2024; 177:111857. [PMID: 38244481 DOI: 10.1016/j.ijporl.2024.111857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/27/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVES Single-sided deafness (SSD) can have consequences for a child's language, educational, and social development. A cochlear implant (CI) is the only device which can restore true binaural hearing, yet they are only approved for children with (SSD) over the age of five in the United States. Reports on speech perception outcomes for children implanted at a younger age are limited. The present study aims to examine the effects of age at implantation, duration of deafness, hearing loss etiology, and presence of additional disabilities on device usage and speech perception outcomes. METHODS A retrospective chart review was used to examine demographics and speech perception outcomes for 18 children implanted at age five or younger. RESULTS Speech perception results were highly variable, with some children deriving significant benefit and others demonstrating no sound awareness through the implant alone. Age at implantation and duration of deafness did not have a clear impact on outcomes. Device usage was low in many children, often those with anatomical abnormalities such as a hypoplastic cochlear nerve. There are challenges to assessing speech perception in young children with SSD, leading to a lack of standardized outcome measures. CONCLUSIONS Early CI for children with SSD may improve speech perception, but benefit is not guaranteed. Candidacy evaluation should consider both medical and audiological factors, in addition to the degree of family support and realistic expectations. Caution is especially warranted in children with significant anatomical anomalies.
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Affiliation(s)
- Emily R Spitzer
- New York University Grossman School of Medicine, Department of Otolaryngology-Head and Neck Surgery, New York, NY, USA.
| | - Younes Attlassy
- New York University Grossman School of Medicine, New York, NY, USA
| | - J Thomas Roland
- New York University Grossman School of Medicine, Department of Otolaryngology-Head and Neck Surgery, New York, NY, USA
| | - Susan B Waltzman
- New York University Grossman School of Medicine, Department of Otolaryngology-Head and Neck Surgery, New York, NY, USA
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8
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Santopietro G, Fancello V, Fancello G, Bianchini C, Pelucchi S, Ciorba A. Cochlear Implantation in Children Affected by Single-Sided Deafness: A Comprehensive Review. Audiol Res 2024; 14:77-85. [PMID: 38247563 PMCID: PMC10801602 DOI: 10.3390/audiolres14010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/17/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Children with single-sided deafness (SSD) may experience delays in language and speech development. Reduced speech discrimination and poor sound localization abilities in young SSD patients may result in greater cognitive efforts required to focus and process auditory information, as well as increased listening-related fatigue. Consequently, these children can have a higher risk of academic failure and are often in need of extra help at school. Recently, cochlear implants (CIs) have been introduced as a rehabilitative option for these children, but their effectiveness is still a topic of debate. A literature review was performed according to PRISMA guidelines, searching the Medline database from inception to October 2023. The research identified nine papers that met the inclusion criteria. Data extracted from the selected studies included 311 children affected by SSD and cochlear implants. The reported audiological outcomes were further analyzed. Overall, a high level of satisfaction was described by parents of children with SSD and CI, and those who received a CI under the age of 3 presented better results. However, a proportion of patients did not use the device daily. Our review highlights the possible, and still controversial, role of CI for the hearing rehabilitation of children with unilateral deafness, underlining the need for further research in this field. To date, careful and comprehensive counseling with the child and the family is necessary before considering this option.
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Affiliation(s)
- Giuseppe Santopietro
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44121 Ferrara, Italy
| | - Virginia Fancello
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44121 Ferrara, Italy
| | - Giuseppe Fancello
- Department of Otorhinolaryngology, Careggi University Hospital, 50134 Florence, Italy
| | - Chiara Bianchini
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44121 Ferrara, Italy
| | - Stefano Pelucchi
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44121 Ferrara, Italy
| | - Andrea Ciorba
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44121 Ferrara, Italy
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Patro A, Holder JT, Brown CL, DeFreese A, Virgin F, Perkins EL. Cochlear Implantation in Very Young Children With Single-Sided Deafness. Otolaryngol Head Neck Surg 2023; 169:1615-1623. [PMID: 37232481 DOI: 10.1002/ohn.375] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/17/2023] [Accepted: 04/29/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Cochlear implants (CIs) for single-sided deafness (SSD) have only been approved for patients 5 years and older despite data supporting that younger children can also benefit from implantation. This study describes our institution's experience with CI for SSD in children 5 years and younger. STUDY DESIGN Case series with chart review. SETTING Tertiary referral center. METHODS A case series with chart review identified 19 patients up to age 5 years who underwent CI for SSD between 2014 and 2022. Baseline characteristics, perioperative complications, device usage, and speech outcomes were collected. RESULTS The median age at CI was 2.8 (range, 1.0-5.4) years, with 15 (79%) patients being below age 5 at implantation. Etiologies of hearing loss were idiopathic (n = 8), cytomegalovirus (n = 4), enlarged vestibular aqueduct (n = 3), hypoplastic cochlear nerve (n = 3), and meningitis (n = 1). The median preoperative pure-tone average was 90 (range, 75-120) and 20 (range, 5-35) dB eHL in the poor and better hearing ears, respectively. No patients had postoperative complications. Twelve patients achieved consistent device use (average, 9 h/d). Three of the seven who were not consistent users had hypoplastic cochlear nerves and/or developmental delays. The three patients with available preoperative and postoperative speech testing showed significant benefits, and five patients with available postoperative testing demonstrated speech recognition in the implanted ear when isolated from the better ear. CONCLUSION CI can safely be performed in younger children with SSD. Patients and families accept early implantation, as evidenced by consistent device use, and derive notable benefits in speech recognition. Candidacy can be broadened to include SSD patients under age five years, particularly individuals without hypoplastic cochlear nerves or developmental delay.
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Affiliation(s)
- Ankita Patro
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jourdan T Holder
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christine L Brown
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Andrea DeFreese
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Frank Virgin
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Elizabeth L Perkins
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Gundacker G, Trales DE, Stefanescu HE. Quality of Life and Audiological Benefits in Pediatric Cochlear Implant Users in Romania: Systematic Review and Cohort Study. J Pers Med 2023; 13:1610. [PMID: 38003925 PMCID: PMC10672230 DOI: 10.3390/jpm13111610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
Profound sensorineural hearing loss (SNHL) can be successfully treated with a cochlear implant (CI), and treatment is usually accompanied by increased quality of life (QoL). Therefore, the aim of this study was to investigate generic and health-related QoL, as well as the level of audiological outcomes, of CI users, in addition to whether Qol can be restored to the extent of those with normal hearing. Furthermore, different implantation timepoints were compared (early vs. late), and a possible correlation between health and generic QoL questionnaires was investigated. The outcomes from 93 pediatric CI users from Romania were analyzed in the study. Two QoL questionnaires (SSQ12, AQoL-6D), as well as the HSM sentence test and Soundfield measurements, were assessed. The outcomes revealed that the CI users were able to achieve the same QoL as their age- and-gender matched peers with normal hearing, and hearing was restored with good speech comprehension. No significant difference between early- and late-implanted children was detected, although a tendency of a better Word Recognition Score (+10%) in the early-implanted group was discovered. A moderate and significant correlation between the generic and health-related Qol questionnaire was observed. Audiological examinations are still the standard practice by which to measure the benefit of any hearing intervention; nonetheless, generic and health-related QoL should be assessed in order to provide a full picture of a successful and patient-satisfactory cochlear implant procedure.
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Affiliation(s)
- Gina Gundacker
- Life Science Department, University of Applied Sciences Technikum Vienna, 1200 Vienna, Austria
| | - Delia Emilia Trales
- Department of Otolaryngology, Victor Babeș Medical and Pharmaceutical University, 300041 Timișoara, Romania; (D.E.T.); (H.E.S.)
| | - Horatiu Eugen Stefanescu
- Department of Otolaryngology, Victor Babeș Medical and Pharmaceutical University, 300041 Timișoara, Romania; (D.E.T.); (H.E.S.)
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Lazzerini F, Bruschini L, Fiacchini G, Canzi P, Berrettini S, Forli F. The Role of Bone-Anchored Hearing Devices and Remote Microphones in Children with Congenital Unilateral Hearing Loss. Brain Sci 2023; 13:1379. [PMID: 37891748 PMCID: PMC10605185 DOI: 10.3390/brainsci13101379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/16/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
Congenital unilateral hearing loss (UHL) represents a contemporary audiologic challenge. Children with UHL can struggle with understanding speech in noise, localizing sounds, developing language, and maintaining academic performance, leading to low self-esteem, anxiety, and decreased social support. Two specific conditions related to UHL in children are single-sided deafness (SSD) and unilateral auris atresia (UAA). This was a retrospective observational study on a group of children with UHL. The Simplified Italian Matrix Sentence Test was used for the assessment of speech reception threshold (SRT) in different conditions: speech and noise from the front (S0N0), speech at 45° from the side of the better ear and noise at 45° from the opposite side (SbNw), and vice versa (SwNb). Each test was conducted unaided, with a bone-anchored hearing device (BAHD), and with a remote microphone (RM) system. The use of a BAHD and RM led to an improvement in SRT in S0N0 and SwNb conditions. The SSD subgroup demonstrated significant benefits with both devices in SwNb, and the UAA subgroup from the use of BAHD in S0N0. In conclusion, the study underscores the potential benefits of both devices in enhancing speech perception for UHL children, providing insights into effective intervention strategies for these challenging cases.
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Affiliation(s)
- Francesco Lazzerini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, 56126 Pisa, Italy; (L.B.); (G.F.); (S.B.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Luca Bruschini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, 56126 Pisa, Italy; (L.B.); (G.F.); (S.B.)
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
| | - Giacomo Fiacchini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, 56126 Pisa, Italy; (L.B.); (G.F.); (S.B.)
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
| | - Pietro Canzi
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Stefano Berrettini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, 56126 Pisa, Italy; (L.B.); (G.F.); (S.B.)
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
- Clinical Science, Intervention and Technology, Karolinska Institute, 17177 Stockholm, Sweden
| | - Francesca Forli
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, 56126 Pisa, Italy; (L.B.); (G.F.); (S.B.)
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
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Park LR, Dillon MT, Buss E, Brown KD. Two-Year Outcomes of Cochlear Implant Use for Children With Unilateral Hearing Loss: Benefits and Comparison to Children With Normal Hearing. Ear Hear 2023; 44:955-968. [PMID: 36879386 PMCID: PMC10426784 DOI: 10.1097/aud.0000000000001353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 01/24/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVES Children with severe-to-profound unilateral hearing loss, including cases of single-sided deafness (SSD), lack access to binaural cues that support spatial hearing, such as recognizing speech in complex multisource environments and sound source localization. Listening in a monaural condition negatively impacts communication, learning, and quality of life for children with SSD. Cochlear implant (CI) use may restore binaural hearing abilities and improve outcomes as compared to alternative treatments or no treatment. This study investigated performance over 24 months of CI use in young children with SSD as compared to the better hearing ear alone and to children with bilateral normal hearing (NH). DESIGN Eighteen children with SSD who received a CI between the ages of 3.5 and 6.5 years as part of a prospective clinical trial completed assessments of word recognition in quiet, masked sentence recognition, and sound source localization at regular intervals out to 24-month postactivation. Eighteen peers with bilateral NH, matched by age at the group level, completed the same test battery. Performance at 24-month postactivation for the SSD group was compared to the performance of the NH group. RESULTS Children with SSD have significantly poorer speech recognition in quiet, masked sentence recognition, and localization both with and without the use of the CI than their peers with NH. The SSD group experienced significant benefits with the CI+NH versus the NH ear alone on measures of isolated word recognition, masked sentence recognition, and localization. These benefits were realized within the first 3 months of use and were maintained through the 24-month postactivation interval. CONCLUSIONS Young children with SSD who use a CI experience significant isolated word recognition and bilateral spatial hearing benefits, although their performance remains poorer than their peers with NH.
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Affiliation(s)
- Lisa R. Park
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Margaret T. Dillon
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Emily Buss
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Kevin D. Brown
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina, USA
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Calvino M, Sánchez-Cuadrado I, Gavilán J, Lassaletta L. Long-Term Non-Users of Transcutaneous Auditory Implants: Thirty Years of Experience at a Single Institution. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6201. [PMID: 37444049 PMCID: PMC10341118 DOI: 10.3390/ijerph20136201] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023]
Abstract
Background: Although it is a recognized phenomenon, there is little published in the literature on the discontinuation of auditory implant use. Aim: To evaluate the incidence of device non-use of transcutaneous auditory implants. Patients and Methods: This is a retrospective study of all living individuals (children and adults) implanted at the La Paz Hospital (Madrid, Spain) between 1992-2015, with a follow-up examination endpoint of December 2022. 356 device recipients were included: 316 with cochlear implants (CI), 22 with middle-ear implants (Vibrant Soundbridge, VSB), and 18 with bone conduction implants (Bonebridge, BB). Results: Nine CI recipients (2.8%) were identified as non-users (mean follow-up 15.1 ± 5.4 years). The reasons for non-use were implant failure and reimplantation rejection, lack of benefit, non-attendance of rehabilitation sessions, loss of the audio processor, and cognitive and linguistic difficulties. None of them experienced any surgical complications. Six VSB recipients (27.3%) were device non-users (mean follow-up 11.4 ± 2.1 years). All of them experienced device failure or surgical complications. To date, none of the BB recipients is a non-user (mean follow-up 8.6 ± 1.1 years). Conclusion: The rates of non-use of transcutaneous auditory implants vary widely between different types of implants. Given the small proportion of non-users, information on what are the predictive factors could not be determined. The reasons for non-use should be carefully documented and used to guide careful patient selection to reduce the risk of non-use in future candidates.
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Affiliation(s)
- Miryam Calvino
- Department of Otolaryngology, Hospital Universitario La Paz, IdiPAZ Research Institute, 28046 Madrid, Spain
- Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, CIBERER-U761, 28029 Madrid, Spain
| | - Isabel Sánchez-Cuadrado
- Department of Otolaryngology, Hospital Universitario La Paz, IdiPAZ Research Institute, 28046 Madrid, Spain
| | - Javier Gavilán
- Department of Otolaryngology, Hospital Universitario La Paz, IdiPAZ Research Institute, 28046 Madrid, Spain
| | - Luis Lassaletta
- Department of Otolaryngology, Hospital Universitario La Paz, IdiPAZ Research Institute, 28046 Madrid, Spain
- Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, CIBERER-U761, 28029 Madrid, Spain
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Park LR, Gagnon EB, Dillon MT. Factors that influence outcomes and device use for pediatric cochlear implant recipients with unilateral hearing loss. Front Hum Neurosci 2023; 17:1141065. [PMID: 37250696 PMCID: PMC10213360 DOI: 10.3389/fnhum.2023.1141065] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Candidacy criteria for cochlear implantation in the United States has expanded to include children with single-sided deafness (SSD) who are at least 5 years of age. Pediatric cochlear implant (CI) users with SSD experience improved speech recognition with increased daily device use. There are few studies that report the hearing hour percentage (HHP) or the incidence of non-use for pediatric CI recipients with SSD. The aim of this study was to investigate factors that impact outcomes in children with SSD who use CIs. A secondary aim was to identify factors that impact daily device use in this population. Methods A clinical database query revealed 97 pediatric CI recipients with SSD who underwent implantation between 2014 and 2022 and had records of datalogs. The clinical test battery included speech recognition assessment for CNC words with the CI-alone and BKB-SIN with the CI plus the normal-hearing ear (combined condition). The target and masker for the BKB-SIN were presented in collocated and spatially separated conditions to evaluate spatial release from masking (SRM). Linear mixed-effects models evaluated the influence of time since activation, duration of deafness, HHP, and age at activation on performance (CNC and SRM). A separate linear mixed-effects model evaluated the main effects of age at testing, time since activation, duration of deafness, and onset of deafness (stable, progressive, or sudden) on HHP. Results Longer time since activation, shorter duration of deafness, and higher HHP were significantly correlated with better CNC word scores. Younger age at device activation was not found to be a significant predictor of CNC outcomes. There was a significant relationship between HHP and SRM, with children who had higher HHP experiencing greater SRM. There was a significant negative correlation between time since activation and age at test with HHP. Children with sudden hearing loss had a higher HHP than children with progressive and congenital hearing losses. Conclusion The present data presented here do not support a cut-off age or duration of deafness for pediatric cochlear implantation in cases of SSD. Instead, they expand on our understanding of the benefits of CI use in this population by reviewing the factors that influence outcomes in this growing patient population. Higher HHP, or greater percentage of time spent each day using bilateral input, was associated with better outcomes in the CI-alone and in the combined condition. Younger children and those within the first months of use had higher HHP. Clinicians should discuss these factors and how they may influence CI outcomes with potential candidates with SSD and their families. Ongoing work is investigating the long-term outcomes in this patient population, including whether increasing HHP after a period of limited CI use results in improved outcomes.
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Zeitler DM, Dunn C, Schwartz SR, McCoy JL, Jamis C, Chi DH, Goldberg DM, Anne S. Health-Related Quality of Life in Children With Unilateral Sensorineural Hearing Loss Following Cochlear Implantation. Otolaryngol Head Neck Surg 2023; 168:1511-1520. [PMID: 36934432 DOI: 10.1002/ohn.165] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/16/2022] [Accepted: 09/04/2022] [Indexed: 03/20/2023]
Abstract
OBJECTIVE Evaluate health-related quality of life (HR-QOL) benefits with cochlear implantation (CI) in children with unilateral sensorineural hearing loss (USNHL) versus bilateral sensorineural hearing loss (BSNHL). STUDY DESIGN A cross-sectional survey of parents of children who underwent CI for USNHL and BSNHL. SETTING Tertiary care academic centers. METHODS The "Children with cochlear implants: parental perspectives" survey was administered. Parents rated responses on a 5-point Likert scale. Scores greater than 3.0 were considered favorable. Responses were recorded within 8 domains and groups were compared with respect to domain scores. Analysis of covariance models was used to compare groups while adjusting for age at implantation and duration of implant use. RESULTS There were 31 patients with USNHL and 27 patients with BSNHL. The average age of implantation in BSNHL patients was 1.9 and 6.7 years for USNHL. Parents of all children answered favorably in all domains. When adjusted for age at implantation and duration of implant use, parents of BSNHL children responded significantly more favorably only in 2 domains. When comparing patients with older age or prolonged duration of hearing loss in the USNHL cohort, there were favorable responses in all domains with no significant differences between groups. CONCLUSION There are HR-QOL benefits of CI in USNHL children; less pronounced favorable results were noted only in 2 domains when compared to BSNHL children. Benefits were noted with CI in USNHL children at an older age at implantation or prolonged duration of hearing loss. Therefore, these factors should not be absolute contraindications for CI in USNHL.
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Affiliation(s)
| | | | | | - Jennifer L McCoy
- Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - David H Chi
- Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Gordon KA, Alemu R, Papsin BC, Negandhi J, Cushing SL. Effects of Age at Implantation on Outcomes of Cochlear Implantation in Children with Short Durations of Single-Sided Deafness. Otol Neurotol 2023; 44:233-240. [PMID: 36728258 PMCID: PMC9924958 DOI: 10.1097/mao.0000000000003811] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Children with single-sided deafness (SSD) show reduced language and academic development and report hearing challenges. We aim to improve outcomes in children with SSD by providing bilateral hearing through cochlear implantation of the deaf ear with minimal delay. STUDY DESIGN Prospective cohort study of 57 children with SSD provided with cochlear implant (CI) between May 13, 2013, and June 25, 2021. SETTING Tertiary children's hospital. PARTICIPANTS Children with early onset (n = 40) or later onset of SSD (n = 17) received CIs at ages 2.47 ± 1.58 years (early onset group) and 11.67 ± 3.91 years (late onset group) (mean ± SD). Duration of unilateral deafness was limited (mean ± SD = 1.93 ± 1.56 yr). INTERVENTION Cochlear implantation of the deaf ear. MAIN OUTCOMES/MEASURES Evaluations of device use (data logging) and hearing (speech perception, effects of spatial release from masking on speech detection, localization of stationary and moving sound, self-reported hearing questionnaires). RESULTS Results indicated that daily device use is variable (mean ± SD = 5.60 ± 2.97, range = 0.0-14.7 h/d) with particular challenges during extended COVID-19 lockdowns, including school closures (daily use reduced by mean 1.73 h). Speech perception with the CI alone improved (mean ± SD = 65.7 ± 26.4 RAU) but, in the late onset group, remained poorer than in the normal hearing ear. Measures of spatial release from masking also showed asymmetric hearing in the late onset group ( t13 = 5.14, p = 0.001). Localization of both stationary and moving sound was poor (mean ± SD error = 34.6° ± 16.7°) but slightly improved on the deaf side with CI use ( F1,36 = 3.95, p = 0.05). Decreased sound localization significantly correlated with poorer self-reported hearing. CONCLUSIONS AND RELEVANCE Benefits of CI in children with limited durations of SSD may be more restricted for older children/adolescents. Spatial hearing challenges remain. Efforts to increase CI acceptance and consistent use are needed.
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Affiliation(s)
- Karen A. Gordon
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children
- Department of Communication Disorders, The Hospital for Sick Children
| | - Robel Alemu
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children
| | - Blake C. Papsin
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children
- Department of Otolaryngology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jaina Negandhi
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children
| | - Sharon L. Cushing
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children
- Department of Otolaryngology, The Hospital for Sick Children, Toronto, ON, Canada
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A new tool for the assessment of speech understanding and spatial hearing difficulties in children: the Kid-SSQ questionnaire. Eur Arch Otorhinolaryngol 2023:10.1007/s00405-023-07846-9. [PMID: 36763152 DOI: 10.1007/s00405-023-07846-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/17/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE To develop and validate a new questionnaire, the Kid-SSQ, for the rapid screening of hearing abilities in children with hearing impairment, aged 7-17 years. METHODS The questionnaire was constructed from two existing, validated versions of the 'Speech, Spatial and Qualities of Hearing' - (SSQ) questionnaire (pediatric form and adult short-form). The 12 selected items included auditory aspects from three subscales: speech perception, spatial hearing, and qualities of hearing. This new short form was then validated in 154 children with cochlear implants (100 bilaterally, and 54 unilaterally implanted children). Construct validity was assessed by testing relationships between Kid-SSQ scores and objective clinical parameters (e.g., age at test, pure-tone audiometry-PTA threshold, speech reception threshold-SRT, duration of binaural experience). RESULTS Completion time was acceptable for use with children (less than 10 min) and the non-response rate was less than 1%. Good internal consistency was obtained (Cronbach's α = 0.78), with a stable internal structure corresponding to the 3 intended subscales. External validity showed the specificity of each subscale: speech subscale scores were significantly predicted (r = 0.32, p < 0.001) by both 2 kHz PTA threshold (β = 0.33, p < 0.001) and SRT (β = - 0.23, p < 0.001). Children with more binaural experience showed significantly higher scores on the spatial subscale than children with less binaural experience (F(1,98) = 5.1, p < 0.03) and the qualities of hearing subscale scores significantly depended on both age and SRT (r = 0.32, p < 0.001). CONCLUSIONS The Kid-SSQ questionnaire is a robust and clinically useful questionnaire for self-assessment of difficulties in various auditory domains.
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Rader T, Waleka OJ, Strieth S, Eichhorn KWG, Bohnert A, Koutsimpelas D, Matthias C, Ernst BP. Hearing rehabilitation for unilateral deafness using a cochlear implant: the influence of the subjective duration of deafness on speech intelligibility. Eur Arch Otorhinolaryngol 2023; 280:651-659. [PMID: 35792917 PMCID: PMC9849293 DOI: 10.1007/s00405-022-07531-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/27/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND For patients with single sided deafness (SSD) or severe asymmetric sensorineural hearing loss (ASHL), cochlear implantation remains the only solution to restore bilateral hearing capacity. Prognostically, the duration of hearing loss in terms of audiological outcome is not yet clear. Therefore, the aim of this study was to retrospectively investigate the influence of subjective deafness duration on postoperative speech perception after cochlear implantation for SSD as well as its impact on quality of life. MATERIALS AND METHODS The present study included a total of 36 adults aged 50.2 ± 15.5 years who underwent CI for SSD/ASHL at our clinic between 2010 and 2015. Patients were audiometrically assessed at 3 and 12-36 months postoperatively. Test results were correlated with self-reported duration of deafness. Quality of life was assessed by questionnaire. RESULTS Mean duration of deafness was 193.9 ± 185.7 months. The side-separated hearing threshold showed an averaged target range between 30 and 40 dB HL. Freiburg monosyllable test increased from 0% pre-operatively to 20% after 3 months (p = 0.001) and to 50% after 12-36 months (p = 0.002). There was a significant correlation between audiometric outcome and subjective deafness duration at 12-36 months postoperatively (r = - 0.564; p = 0.02) with a cutoff for open-set monosyllable recognition at a duration of deafness of greater than 408 months. Quality of life was significantly improved by CI. CONCLUSIONS CI implantation in unilaterally deafened patients provides objective and subjective benefits. Duration of deafness is unlikely to be an independent negative predictive factor and thus should not generally be considered as contraindication.
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Affiliation(s)
- Tobias Rader
- Division of Audiology, Department of Otorhinolaryngology, Ludwig-Maximilians-University Medical Center, Munich, Germany. .,Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany. .,LMU Klinikum, Klinik für Hals-Nasen-Ohrenheilkunde, Abteilung Audiologie, Marchioninistr. 15, 81377, Munich, Germany.
| | - Oliver Julian Waleka
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany
| | - Sebastian Strieth
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany.,Department of Otorhinolaryngology, University Medical Center Bonn (UKB), Bonn, Germany
| | | | - Andrea Bohnert
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany
| | | | - Christoph Matthias
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany
| | - Benjamin Philipp Ernst
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany.,Department of Otorhinolaryngology, University Medical Center Bonn (UKB), Bonn, Germany
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Batthyany C, Schut AR, van der Schroeff M, Vroegop J. Translation and validation of the speech, spatial, and qualities of hearing scale (SSQ) and the hearing environments and reflection on quality of life (HEAR-QL) questionnaire for children and adolescents in Dutch. Int J Audiol 2023; 62:129-137. [PMID: 35085481 DOI: 10.1080/14992027.2021.2020914] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To date, no hearing-specific self-report tool is available in Dutch to give insight into how deficits in auditory skills are experienced by a child in daily life or to examine the impact of hearing loss on children's quality of life. Therefore, we aimed to translate and validate the Speech, Spatial, and Qualities of Hearing Scale (SSQ) and the Hearing Environments and Reflection on Quality of Life (HEAR-QL) Questionnaire for children and adolescents into Dutch. DESIGN Translation of the questionnaires into Dutch was conducted by means of the forward-backward procedure. Participants were invited to complete the questionnaires digitally. We examined discriminant validity, internal consistency, and test-retest reliability. STUDY SAMPLE A total of 121 subjects between 7 and 18 years old were included, of which 54 normal hearing and 67 bilaterally hearing-impaired subjects. Hearing-impaired subjects were fitted with hearing aids, bone conductive devices and/or cochlear implants. RESULTS All questionnaires were shown to significantly discriminate between the normal hearing and the hearing-impaired group. Satisfying internal consistency and good test-retest reliability were found. CONCLUSIONS The Dutch SSQ and HEAR-QL questionnaires for children and adolescents appear to be valid and reliable self-report tools for management and follow-up of those with hearing loss.
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Affiliation(s)
- Christina Batthyany
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Anne-Rose Schut
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Marc van der Schroeff
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Jantien Vroegop
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands
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Impact of unilateral hearing loss in early development. Curr Opin Otolaryngol Head Neck Surg 2022; 30:344-350. [PMID: 36004776 DOI: 10.1097/moo.0000000000000848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an update on current literature as it relates to the impact of unilateral hearing loss for the pediatric population. RECENT FINDINGS Current studies further corroborate past research findings which reveal the potential consequences of unilateral hearing loss on spatial hearing, language, and neurocognitive functioning. Deficits among children with unilateral hearing loss may parallel those seen in children with bilateral hearing loss, further challenging historic views that hearing in one ear in childhood is sufficient for normal development. The potential deficiencies seen in children with unilateral hearing loss can be subtler than those seen with bilateral hearing loss, but may nonetheless also impact school performance, patient fatigue, parental stress, and quality of life. Early interventions within a sensitive period of development of the central auditory system may circumvent potential barriers in cognitive, academic, and psychosocial development. SUMMARY This review synthesizes the latest research on the impact of unilateral hearing loss in childhood and the role for possible interventions. The summarized information may serve to support the development of new guidelines for the evaluation and treatment of children with unilateral hearing loss.
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Cochlear implantation for paediatric and adult cases of unilateral and asymmetric hearing loss. Curr Opin Otolaryngol Head Neck Surg 2022; 30:303-308. [PMID: 36004791 DOI: 10.1097/moo.0000000000000838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Children and adults with unilateral or asymmetric hearing loss (UHL/AHL) have poorer spatial hearing (e.g. speech understanding in complex maskers and localization) and quality of life compared with peers with normal hearing bilaterally. Patients with UHL/AHL experience limited benefits with contralateral-routing technologies (e.g. bone conduction, CROS hearing aid systems). Cochlear implantation allows for stimulation of the auditory pathway for the poorer hearing ear. The present study reviews the recent literature on outcomes of cochlear implant use for recipients with UHL/AHL. RECENT FINDINGS Recent research corroborates previous investigations of the significant benefits on measures of spatial hearing, tinnitus severity and quality of life for adult cochlear implant recipients. These benefits are also observed in pediatric cochlear implant recipients, with an association of better outcomes with younger ages at implantation for congenital cases and shorter durations of UHL/AHL for acquired cases. In addition, randomized trials demonstrate better outcomes with cochlear implant use versus contralateral-routing technologies. SUMMARY Cochlear implantation supports better spatial hearing and quality of life in children and adults with UHL/AHL as compared to alternative listening conditions. Current research supports the expansion of candidacy criteria and insurance coverage for cochlear implantation for patients with UHL/AHL to improve their binaural hearing.
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Longitudinal auditory data of children with prelingual single-sided deafness managed with early cochlear implantation. Sci Rep 2022; 12:9376. [PMID: 35672363 PMCID: PMC9174487 DOI: 10.1038/s41598-022-13247-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 05/23/2022] [Indexed: 11/09/2022] Open
Abstract
Individuals with single-sided deafness (SSD) have no access to binaural hearing, which limits their ability to localize sounds and understand speech in noisy environments. In addition, children with prelingual SSD are at risk for neurocognitive and academic difficulties. Early cochlear implantation may lead to improved hearing outcomes by restoring bilateral hearing. However, its longitudinal impact on the development of children with SSD remains unclear. In the current study, a group of young children with prelingual SSD received a cochlear implant at an early age. From the age of four, the children’s spatial hearing skills could be assessed using a spatial speech perception in noise test and a sound localization test. The results are compared to those of two control groups: children with SSD without a cochlear implant and children with bilateral normal hearing. Overall, the implanted group exhibited improved speech perception in noise abilities and better sound localization skills, compared to their non-implanted peers. On average, the children wore their device approximately nine hours a day. Given the large contribution of maturation to the development of spatial hearing skills, further follow-up is important to understand the long-term benefit of a cochlear implant for children with prelingual SSD.
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An Adaptation and Validation Study of the Speech, Spatial, and Qualities of Hearing Scale (SSQ) in Italian Normal-Hearing Children. Audiol Res 2022; 12:297-306. [PMID: 35735364 PMCID: PMC9220328 DOI: 10.3390/audiolres12030031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/11/2022] [Accepted: 05/25/2022] [Indexed: 11/25/2022] Open
Abstract
This study aimed to translate and adapt the English version of the Speech, Spatial, and Qualities of Hearing Scale (SSQ) for children and for parents into the Italian language; validate SSQ for hearing children and their parents; and evaluate the discriminant validity of the instrument. A group of 102 normal-hearing Italian children, aged between 9 and 16 years, and their parents were included in this study. A group of 31 parents of normal-hearing Italian children aged between 6 and 8 years was also included. A group of 57 hearing-impaired Italian children aged between 9 and 16 years, and their parents were also included, as well as a group of 30 parents of hearing-impaired Italian children aged between 6 and 8 years. Cronbach’s alpha in the SSQ for parents was 0.92; it was 0.95 in the SSQ for children. Guttmann’s split-half coefficient in SSQ for children for both λ4 and λ6 was 0.98; in SSQ for parents in λ4 was 0.96 and λ6 was 0.95. These data provide evidence for the discriminant validity of the SSQ scale (p-value < 0.001). Italian SSQ scales for children and for parents are now available.
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American Cochlear Implant Alliance Task Force Guidelines for Clinical Assessment and Management of Cochlear Implantation in Children With Single-Sided Deafness. Ear Hear 2022; 43:255-267. [PMID: 35213890 PMCID: PMC8862768 DOI: 10.1097/aud.0000000000001204] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Park LR, Gagnon EB, Brown KD. The Limitations of FDA Criteria: Inconsistencies with Clinical Practice, Findings, and Adult Criteria as a Barrier to Pediatric Implantation. Semin Hear 2021; 42:373-380. [PMID: 34912165 PMCID: PMC8660172 DOI: 10.1055/s-0041-1739370] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Children require greater access to sound than adults as they are learning to communicate using hearing and spoken language. Yet when it comes to cochlear implant candidacy, currently approved Food and Drug Administration (FDA) criteria for adults are much less restrictive than those for children, allowing for greater levels of residual hearing and aided speech recognition in adults. Cochlear implant guidelines for children have changed very little in the 30 years since cochlear implants have been approved for pediatrics, and this lack of change has proven to be a barrier to implantation. Using evidence-based practice, centers have been providing off-label implantation for children who fall outside of current FDA criteria, including children with more residual hearing, children with single-side deafness younger than 5 years, and infants with bilateral profound loss younger than 9 months. The purpose of this article is to outline how these restrictions impede access to implants for children and describe the evidence supporting cochlear implantation in children who fall outside of current criteria.
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Affiliation(s)
- Lisa R Park
- Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill, Durham, North Carolina
| | - Erika B Gagnon
- Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill, Durham, North Carolina
| | - Kevin D Brown
- Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill, Durham, North Carolina
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Arras T, Boudewyns A, Dhooge I, Offeciers E, Philips B, Desloovere C, Wouters J, van Wieringen A. Assessment of Receptive and Expressive Language Skills Among Young Children With Prelingual Single-Sided Deafness Managed With Early Cochlear Implantation. JAMA Netw Open 2021; 4:e2122591. [PMID: 34432009 PMCID: PMC8387851 DOI: 10.1001/jamanetworkopen.2021.22591] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
IMPORTANCE Pediatric single-sided deafness (SSD) can seriously affect development, causing impaired spatial hearing skills, speech-language delays, and academic underachievement. Early cochlear implantation likely improves hearing-related outcomes, but its association with language development remains unclear. OBJECTIVE To investigate whether early cochlear implantation is associated with language outcomes for children with prelingual SSD. DESIGN, SETTING, AND PARTICIPANTS The Cochlear Implant for Children and One Deaf Ear study was initiated in 2015 and recruited participants at 4 academic hospitals in Flanders, Belgium, through 2019. This cohort study included 3 groups of children aged 2 to 5 years: children with SSD and a cochlear implant, children with SSD without a cochlear implant, and a control group with normal hearing. Language and hearing skills were assessed 1 to 2 times per year until the age of 10 years. Study completion rates were high (82%). Data analysis was performed from October to December 2020. EXPOSURE Unilateral cochlear implant. MAIN OUTCOMES AND MEASURES Longitudinal vocabulary, grammar, and receptive language scores. The implanted group was hypothesized to outperform the nonimplanted group on all language tests. RESULTS During the recruitment period, 47 children with prelingual SSD without additional disabilities were identified at the participating hospitals. Fifteen of the 34 children with an intact auditory nerve received a cochlear implant (44%, convenience sample). Sixteen of the remaining children were enrolled in the SSD control group (50%). Data from 61 children (mean [SD] age at the time of enrollment, 2.08 [1.34] years; 26 girls [42%]) were included in the analysis: 15 children with SSD and a cochlear implant, 16 children with SSD without a cochlear implant, and 30 children with normal hearing. Children with SSD and a cochlear implant performed in line with their peers with normal hearing with regard to grammar. In contrast, children with SSD without a cochlear implant had worse grammar scores than the group with implants (-0.76; 95% CI, -0.31 to -1.21; P = .004) and the group with normal hearing (-0.53; 95% CI, -0.91 to -0.15; P = .02). The 3 groups had similar vocabulary and receptive language abilities. CONCLUSIONS AND RELEVANCE These findings suggest that early cochlear implantation is associated with normal grammar development in young children with prelingual SSD. Although further follow-up will reveal the long-term outcomes of the cochlear implant for other skills, the current results will help clinicians and policy makers identify the best treatment option for these children.
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Affiliation(s)
- Tine Arras
- Department of Neurosciences, Experimental Otorhinolaryngology, KU Leuven, Leuven, Belgium
| | - An Boudewyns
- University Department of Otorhinolaryngology, Antwerp University Hospital, Antwerp University, Edegem, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Wilrijk, Belgium
| | - Ingeborg Dhooge
- Department of Otorhinolaryngology, Ghent University, Ghent, Belgium
| | - Erwin Offeciers
- European Institute for Otorhinolaryngology, Head and Neck Surgery, Sint-Augustinus Hospital Antwerp, Wilrijk, Belgium
| | | | - Christian Desloovere
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Jan Wouters
- Department of Neurosciences, Experimental Otorhinolaryngology, KU Leuven, Leuven, Belgium
| | - Astrid van Wieringen
- Department of Neurosciences, Experimental Otorhinolaryngology, KU Leuven, Leuven, Belgium
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Hempel JM, Epp A, Volgger V. [Hearing rehabilitation with the Vibrant Soundbridge in patients with congenital middle ear malformation]. HNO 2021:10.1007/s00106-021-01004-5. [PMID: 33599810 DOI: 10.1007/s00106-021-01004-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Congenital aural atresia, which is usually unilateral, causes hearing loss and aesthetic impairment. Besides tympanoplasty with/without canalplasty and bone conduction devices, active middle ear implants are also available for functional rehabilitation. OBJECTIVE This article aims to present a contemporary review on the treatment possibilities for middle ear malformations, with a focus on audiological rehabilitation with the Vibrant Soundbridge. MATERIALS AND METHODS A selective literature search for treatment possibilities was performed in PubMed up to October 2020, and personal clinical experiences are reported. RESULTS The Vibrant Soundbridge, which is approved for children ≥ 5 years, is suitable for treatment of middle ear malformations with a Jahrsdoerfer score ≥ 5. Although implantation of a Vibrant Soundbridge is surgically more demanding than implantation of a bone conduction device, the method is safe, delivers good auditory results (superior to bone conduction devices in terms of speech understanding and spatial hearing), does not involve intensive postsurgical care, and rarely requires revision surgery. The Vibrant Soundbridge can be coupled to (remnants of) the ossicular chain or the round window. CONCLUSION The Vibrant Soundbridge is an appropriate treatment method in patients with middle ear malformations who have suitable anatomical preconditions.
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Affiliation(s)
- J M Hempel
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, LMU Klinikum Großhadern, Marchioninistr. 15, 81377, München, Deutschland.
| | - A Epp
- Kinderklinik, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - V Volgger
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, LMU Klinikum Großhadern, Marchioninistr. 15, 81377, München, Deutschland
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