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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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Burkhardt V, Hassepaß F, Offergeld C. [Medical examination: Preparation for ENT specialisation : Part 68]. HNO 2023; 71:744-749. [PMID: 37847377 DOI: 10.1007/s00106-023-01373-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2023] [Indexed: 10/18/2023]
Affiliation(s)
- Valentin Burkhardt
- Klinik für Hals- Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland.
| | - Frederike Hassepaß
- Klinik für Hals- Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Christian Offergeld
- Klinik für Hals- Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
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Ullah MN, Cevallos A, Shen S, Carver C, Dunham R, Marsiglia D, Yeagle J, Della Santina CC, Bowditch S, Sun DQ. Cochlear implantation in unilateral hearing loss: impact of short- to medium-term auditory deprivation. Front Neurosci 2023; 17:1247269. [PMID: 37877013 PMCID: PMC10591100 DOI: 10.3389/fnins.2023.1247269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023] Open
Abstract
Introduction Single sided deafness (SSD) results in profound cortical reorganization that presents clinically with a significant impact on sound localization and speech comprehension. Cochlear implantation (CI) has been approved for two manufacturers' devices in the United States to restore bilateral function in SSD patients with up to 10 years of auditory deprivation. However, there is great variability in auditory performance and it remains unclear how auditory deprivation affects CI benefits within this 10-year window. This prospective study explores how measured auditory performance relates to real-world experience and device use in a cohort of SSD-CI subjects who have between 0 and 10 years of auditory deprivation. Methods Subjects were assessed before implantation and 3-, 6-, and 12-months post-CI activation via Consonant-Nucleus-Consonant (CNC) word recognition and Arizona Biomedical Institute (AzBio) sentence recognition in varying spatial speech and noise presentations that simulate head shadow, squelch, and summation effects (S0N0, SSSDNNH, SNHNSSD; 0 = front, SSD = impacted ear, NH = normal hearing ear). Patient-centered assessments were performed using Tinnitus Handicap Inventory (THI), Spatial Hearing Questionnaire (SHQ), and Health Utility Index Mark 3 (HUI3). Device use data was acquired from manufacturer software. Further subgroup analysis was performed on data stratified by <5 years and 5-10 years duration of deafness. Results In the SSD ear, median (IQR) CNC word scores pre-implant and at 3-, 6-, and 12-months post-implant were 0% (0-0%), 24% (8-44%), 28% (4-44%), and 18% (7-33%), respectively. At 6 months post-activation, AzBio scores in S0N0 and SSSDNNH configurations (n = 25) demonstrated statistically significant increases in performance by 5% (p = 0.03) and 20% (p = 0.005), respectively. The median HUI3 score was 0.56 pre-implant, lower than scores for common conditions such as anxiety (0.68) and diabetes (0.77), and comparable to stroke (0.58). Scores improved to 0.83 (0.71-0.91) by 3 months post-activation. These audiologic and subjective benefits were observed even in patients with longer durations of deafness. Discussion By merging CI-associated changes in objective and patient-centered measures of auditory function, our findings implicate central mechanisms of auditory compensation and adaptation critical in auditory performance after SSD-CI and quantify the extent to which they affect the real-world experience reported by individuals.
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Affiliation(s)
- Mohammed N. Ullah
- Johns Hopkins Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Ashley Cevallos
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Sarek Shen
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Courtney Carver
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Rachel Dunham
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Dawn Marsiglia
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Jennifer Yeagle
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Charles C. Della Santina
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Steve Bowditch
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Daniel Q. Sun
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
- Department of Otolaryngology – Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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4
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Rahne T, Wagner TM, Kopsch AC, Plontke SK, Wagner L. Influence of Age on Speech Recognition in Noise and Hearing Effort in Listeners with Age-Related Hearing Loss. J Clin Med 2023; 12:6133. [PMID: 37834776 PMCID: PMC10573265 DOI: 10.3390/jcm12196133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/20/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
The aim of this study was to measure how age affects the speech recognition threshold (SRT50) of the Oldenburg Sentence Test (OLSA) and the listening effort at the corresponding signal-to-noise ratio (SNRcut). The study also investigated the effect of the spatial configuration of sound sources and noise signals on SRT50 and SNRcut. To achieve this goal, the study used olnoise and icra5 noise presented from one or more spatial locations from the front and back. Ninety-nine participants with age-related hearing loss in the 18-80 years age range, specifically in the 18-30, 31-40, 41-50, 51-60, 61-70, and 71-80 age groups, participated in this study. Speech recognition and listening effort in noise were measured and compared between the different age groups, different spatial sound configurations and noise signals. Speech recognition in noise decreased with age and became significant from the age group of 50-51. The decrease in SRT50 with age was greater for icra5 noise than for olnoise. For all age groups, SRT50 and SNRcut were better for icra5 noise than for olnoise. The measured age-related reference data for SRT50 and SNRcut can be used in further studies in listeners with age-related hearing loss and hearing aid or implant users.
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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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Daher GS, Kocharyan A, Dillon MT, Carlson ML. Cochlear Implantation Outcomes in Adults With Single-Sided Deafness: A Systematic Review and Meta-analysis. Otol Neurotol 2023; 44:297-309. [PMID: 36791341 DOI: 10.1097/mao.0000000000003833] [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: 02/17/2023]
Abstract
OBJECTIVE To assess spatial hearing, tinnitus, and quality-of-life outcomes in adults with single-sided deafness (SSD) who underwent cochlear implantation. DATABASES REVIEWED PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus databases were searched from January 2008 to September 2021 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS Studies reporting spatial hearing, tinnitus, and quality-of-life outcomes in adult cochlear implant (CI) recipients (≥18 yr old) with SSD were evaluated. Study characteristics, demographic data, spatial hearing (speech recognition in noise, sound source localization), tinnitus (severity, loudness), and quality-of-life outcomes were collected. RESULTS From an initial search of 1,147 articles, 36 studies that evaluated CI use in 796 unique adults with SSD (51.3 ± 12.4 yr of age at time of implantation) were included. The mean duration of deafness was 6.2 ± 9.6 years. There was evidence of improvement for speech recognition in noise using different target-to-masker spatial configurations, with the largest benefit observed for target-to-masker configurations assessing head shadow (mean, 1.87-6.2 dB signal-to-noise ratio). Sound source localization, quantified as root-mean-squared error, improved with CI use (mean difference [MD], -25.3 degrees; 95% confidence interval [95% CI], -35.9 to -14.6 degrees; p < 0.001). Also, CI users reported a significant reduction in tinnitus severity as measured with the Tinnitus Handicap Inventory (MD, -29.97; 95% CI, -43.9 to -16.1; p < 0.001) and an improvement in spatial hearing abilities as measured with the Spatial, Speech, and Qualities of Hearing questionnaire (MD, 2.3; 95% CI, 1.7 to 2.8; p < 0.001). CONCLUSIONS Cochlear implantation and CI use consistently offer improvements in speech recognition in noise, sound source localization, tinnitus, and perceived quality of life in adults with SSD.
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Affiliation(s)
- Ghazal S Daher
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Armine Kocharyan
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Margaret T Dillon
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
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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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8
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Távora-Vieira D, Wedekind A. Single-Sided Deafness: Emotional and Social Handicap, Impact on Health Status and Quality of Life, Functional Hearing, and the Effects of Cochlear Implantation. Otol Neurotol 2022; 43:1116-1124. [PMID: 36351222 DOI: 10.1097/mao.0000000000003725] [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: 11/10/2022]
Abstract
OBJECTIVE To evaluate the functional and subjective outcomes in individuals with single-sided deafness (SSD) treated with a cochlear implant (CI). METHODS Eighty-one adult CI users with SSD participated in this study. Functional assessments consisted of speech in noise testing and localization. Subjective assessments consisted of the Speech Spatial Quality of Hearing Scale, the Tinnitus Reaction Questionnaire, the Abbreviated Profile of Hearing Aid Benefit questionnaire, the Hearing Handicap Inventory for Adults questionnaire, and the Glasgow Health Status Inventory and the Glasgow Benefit Inventory questionnaires. RESULTS SSD has remarkable consequences on quality of life (QoL) and imposes a substantial emotional and social handicap on the individuals. Self-reported QoL improved after CI with tinnitus intrusion significantly reduced as early as 3 months post-CI. A significant improvement was seen in all speech understanding in noise configurations. Localization ability significantly improved with CI on. CONCLUSION Our findings demonstrate that SSD reduces social and psychological QoL and imposes a remarkable level of handicap as per general and specific self-assessments tool. CI provided a significant improvement in function including speech understanding in noise and localization ability, as well as improved QoL and reduced tinnitus significantly in both the early and long terms.
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9
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American Cochlear Implant Alliance Task Force Guidelines for Clinical Assessment and Management of Adult Cochlear Implantation for Single-Sided Deafness. Ear Hear 2022; 43:1605-1619. [PMID: 35994570 PMCID: PMC9592177 DOI: 10.1097/aud.0000000000001260] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The indications for cochlear implantation have expanded to include individuals with profound sensorineural hearing loss in the impaired ear and normal hearing (NH) in the contralateral ear, known as single-sided deafness (SSD). There are additional considerations for the clinical assessment and management of adult cochlear implant candidates and recipients with SSD as compared to conventional cochlear implant candidates with bilateral moderate to profound sensorineural hearing loss. The present report reviews the current evidence relevant to the assessment and management of adults with SSD. A systematic review was also conducted on published studies that investigated outcomes of cochlear implant use on measures of speech recognition in quiet and noise, sound source localization, tinnitus perception, and quality of life for this patient population. Expert consensus and systematic review of the current literature were combined to provide guidance for the clinical assessment and management of adults with SSD.
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10
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Achena A, Achena F, Dragonetti AG, Sechi S, Pili AW, Locci MC, Turnu G, Maniaci A, Ferlito S. Cochlear Implant Evolving Indications: Our Outcomes in Adult Patients. Audiol Res 2022; 12:414-422. [PMID: 36004950 PMCID: PMC9404933 DOI: 10.3390/audiolres12040042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The eligibility criteria for cochlear implantation are constantly evolving, following the continuous progress in technology, knowledge about cochlear implant (CI) fitting, and the possibility to preserve residual hearing. Appropriate attention should be given to asymmetric hearing loss (AHL) and single-side deafness (SSD) subjects. This study aimed to analyze cochlear implant indications and evaluate the longitudinal performance outcomes for patients with different kinds and degrees of sensorineural hearing loss. Methods: A total of 69 adult hearing loss CI recipients were included and divided into four subgroups according to our CI indication criteria. We performed objective and subjective measures, including speech perception analysis in silence and with background noise, comparing the outcomes obtained in the four groups. Results: After cochlear implant surgery, concerning the preimplantation daily listening condition, a significantly improved speech perception score in silence and noise was found in all four groups (p < 0.05 for all). Conclusion: CI could represent an efficient solution for patients with AHL and SSD classes.
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Affiliation(s)
- Andrea Achena
- U.O.C di Otorinolaringoiatria ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy, (A.A.)
| | - Francesco Achena
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Alberto Giulio Dragonetti
- U.O.C di Otorinolaringoiatria ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy, (A.A.)
| | - Serena Sechi
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Andrea Walter Pili
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Maria Cristina Locci
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Giuseppe Turnu
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Antonino Maniaci
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia; 95123 Catania, Italy
| | - Salvatore Ferlito
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia; 95123 Catania, Italy
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Weglage A, Müller V, Layer N, Abdel-Latif KHA, Lang-Roth R, Walger M, Sandmann P. Side-of-Implantation Effect on Functional Asymmetry in the Auditory Cortex of Single-Sided Deaf Cochlear-Implant Users. Brain Topogr 2022; 35:431-452. [PMID: 35668310 PMCID: PMC9334411 DOI: 10.1007/s10548-022-00902-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 05/10/2022] [Indexed: 11/25/2022]
Abstract
Cochlear implants (CIs) allow to restore the hearing function in profoundly deaf individuals. Due to the degradation of the stimulus by CI signal processing, implanted individuals with single-sided deafness (SSD) have the specific challenge that the input highly differs between their ears. The present study compared normal-hearing (NH) listeners (N = 10) and left- and right-ear implanted SSD CI users (N = 10 left, N = 9 right), to evaluate cortical speech processing between CI- and NH-ears and to explore for side-of-implantation effects. The participants performed a two-deviant oddball task, separately with the left and the right ear. Auditory event-related potentials (ERPs) in response to syllables were compared between proficient and non-proficient CI users, as well as between CI and NH ears. The effect of the side of implantation was analysed on the sensor and the source level. CI proficiency could be distinguished based on the ERP amplitudes of the N1 and the P3b. Moreover, syllable processing via the CI ear, when compared to the NH ear, resulted in attenuated and delayed ERPs. In addition, the left-ear implanted SSD CI users revealed an enhanced functional asymmetry in the auditory cortex than right-ear implanted SSD CI users, regardless of whether the syllables were perceived via the CI or the NH ear. Our findings reveal that speech-discrimination proficiency in SSD CI users can be assessed by N1 and P3b ERPs. The results contribute to a better understanding of the rehabilitation success in SSD CI users by showing that cortical speech processing in SSD CI users is affected by CI-related stimulus degradation and experience-related functional changes in the auditory cortex.
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Affiliation(s)
- Anna Weglage
- Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, University of Cologne, Cologne, Germany.
| | - Verena Müller
- Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, University of Cologne, Cologne, Germany
| | - Natalie Layer
- Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, University of Cologne, Cologne, Germany
| | - Khaled H A Abdel-Latif
- Jean-Uhrmacher-Institute for Clinical ENT Research, University of Cologne, Cologne, Germany
| | - Ruth Lang-Roth
- Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, University of Cologne, Cologne, Germany
| | - Martin Walger
- Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, University of Cologne, Cologne, Germany.,Jean-Uhrmacher-Institute for Clinical ENT Research, University of Cologne, Cologne, Germany
| | - Pascale Sandmann
- Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, University of Cologne, Cologne, Germany
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12
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Neural activity of the auditory cortex predicts speech recognition of patients with asymmetric hearing loss after cochlear implantation. Sci Rep 2022; 12:8068. [PMID: 35577877 PMCID: PMC9110403 DOI: 10.1038/s41598-022-12139-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/05/2022] [Indexed: 11/25/2022] Open
Abstract
Patients with asymmetric hearing loss show an asymmetry of glucose metabolism of the primary auditory cortex (PAC). We investigated whether this asymmetry could serve as an objective predictor for speech recognition with CI. Nine patients underwent 18FDG PET prior to CI surgery. Average normalized 18FDG uptake of 25% of voxels with highest uptake was calculated for the PAC employing a probabilistic atlas and cerebellar cortex as reference. Differences in glucose metabolism of the PAC were assessed by an asymmetry index (AI-PAC). We tested the correlation between outcome of CI surgery (6 months post implantation), AI-PAC and clinical predictors. Pre-operative AI-PAC showed a positive correlation with speech recognition with CI (significant for sentences and numbers; trend for monosyllabic words). With a pre-operative AI-PAC ≥ 4.2%, patients reached good CI outcome in sentence recognition of 59–90% and number recognition of 90–100% and less favorable CI outcome in monosyllabic word recognition of 25–45%. Age at symptom onset was significantly associated with all measures of speech recognition, while deafness duration was only associated with sentence recognition. AI-PAC allows for a reliable and quantitative pre-operative prediction of early improvement in speech recognition after CI. 18FDG PET may be a valuable addition to the objective pre-operative assessment of CI candidates. Further studies in larger cohorts and with longer follow-up times are needed.
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Gordon KA, Papsin BC, Papaioannou V, Cushing SL. The Importance of Access to Bilateral Hearing through Cochlear Implants in Children. Semin Hear 2021; 42:381-388. [PMID: 34912166 PMCID: PMC8660169 DOI: 10.1055/s-0041-1739371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Children with hearing loss require early access to sound in both ears to support their development. In this article, we describe barriers to providing bilateral hearing and developmental consequences of delays during early sensitive periods. Barriers include late identification of hearing loss in one or both ears and delayed access to intervention with hearing devices such as cochlear implants. Effects of delayed bilateral input on the auditory pathways and brain are discussed as well as behavioral effects on speech perception and other developmental outcomes including language and academics. Evidence for these effects has supported an evolution in cochlear implant candidacy in children that was started with unilateral implantation in children with profound deafness bilaterally to bilateral implantation to implantation of children with asymmetric hearing loss including children with single-side deafness. Opportunities to enhance the developmental benefits of bilateral hearing in children with hearing loss are also discussed including efforts to improve binaural/spatial hearing and consideration of concurrent vestibular deficits which are common in children with hearing loss.
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Affiliation(s)
- Karen A Gordon
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Canada.,Department of Communication Disorders, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Blake C Papsin
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Vicky Papaioannou
- Department of Communication Disorders, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Sharon L Cushing
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada
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Peters JPM, van Heteren JAA, Wendrich AW, van Zanten GA, Grolman W, Stokroos RJ, Smit AL. Short-term outcomes of cochlear implantation for single-sided deafness compared to bone conduction devices and contralateral routing of sound hearing aids-Results of a Randomised controlled trial (CINGLE-trial). PLoS One 2021; 16:e0257447. [PMID: 34644322 PMCID: PMC8513831 DOI: 10.1371/journal.pone.0257447] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 08/22/2021] [Indexed: 02/06/2023] Open
Abstract
Single-sided deafness (SSD) leads to difficulties with speech perception in noise, sound localisation, and sometimes tinnitus. Current treatments (Contralateral Routing of Sound hearing aids (CROS) and Bone Conduction Devices (BCD)) do not sufficiently overcome these problems. Cochlear implants (CIs) may help. Our aim was to evaluate these treatments in a Randomised Controlled Trial (RCT). Adult SSD patients were randomised using a web-based randomisation tool into one of three groups: CI; trial period of ‘first BCD, then CROS’; trial period of ‘first CROS, then BCD’. After these trial periods, patients opted for BCD, CROS, or No treatment. The primary outcome was speech perception in noise (directed from the front (S0N0)). Secondary outcomes were speech perception in noise with speech directed to the poor ear and noise to the better ear (SpeNbe) and vice versa (SbeNpe), sound localisation, tinnitus burden, and disease-specific quality of life (QoL). We described results at baseline (unaided situation) and 3 and 6 months after device activation. 120 patients were randomised. Seven patients did not receive the allocated intervention. The number of patients per group after allocation was: CI (n = 28), BCD (n = 25), CROS (n = 34), and No treatment (n = 26). In S0N0, the CI group performed significantly better when compared to baseline, and when compared to the other groups. In SpeNbe, there was an advantage for all treatment groups compared to baseline. However, in SbeNpe, BCD and CROS groups performed worse compared to baseline, whereas the CI group improved. Only in the CI group sound localisation improved and tinnitus burden decreased. In general, all treatment groups improved on disease-specific QoL compared to baseline. This RCT demonstrates that cochlear implantation for SSD leads to improved speech perception in noise, sound localisation, tinnitus burden, and QoL after 3 and 6 months of follow-up. For most outcome measures, CI outperformed BCD and CROS. Trial registration: Netherlands Trial Register (www.trialregister.nl): NTR4580, CINGLE-trial.
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Affiliation(s)
- Jeroen P. M. Peters
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jan A. A. van Heteren
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anne W. Wendrich
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gijsbert A. van Zanten
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Robert J. Stokroos
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Adriana L. Smit
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- * E-mail:
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Lailach S, Neudert M, Zahnert T. [Update cochlear-implantation: indications and surgical aspects]. Laryngorhinootologie 2021; 100:652-672. [PMID: 34320675 DOI: 10.1055/a-1491-3426] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In childhood, inadequately rehabilitated hearing loss leads to impaired language acquisition and social, mental and emotional development. In adults, social withdrawal due to limited communication skills is often a consequence of unsatisfactory hearing rehabilitation. Therefore, in patients with profound hearing loss, the indication for cochlear implantation should be considered. Technical advances in cochlear implant development, as well as in microsurgical techniques and the rehabilitation process, have led to an expansion of indications in recent years. Adequate hearing rehabilitation is associated not only with an improvement in hearing function and speech understanding, but also with an increase in quality of life at all ages. In patients with unilateral profound hearing loss, cochlear implantation leads to an improvement of speech understanding and localization ability as well as to a reduction of the head shadow effect and tinnitus. The indication process, surgical treatment and the subsequent rehabilitation process require interprofessional cooperation in specialized centers.
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