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Tang D, Tran Y, Lo C, Lee JN, Turner J, McAlpine D, McMahon C, Gopinath B. The Benefits of Cochlear Implantation for Adults: A Systematic Umbrella Review. Ear Hear 2024; 45:801-807. [PMID: 38233980 DOI: 10.1097/aud.0000000000001473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
OBJECTIVES The uptake of cochlear implants among adults who could benefit (based on pure-tone audiometry) in developed countries is estimated to be less than 10%. Concerns about potential surgical complications, fear of losing residual hearing, and limited awareness about the benefits of this intervention contribute to the low adoption rate. To enhance quality of life and improve the uptake of cochlear implants, it is essential to have a clear understanding of their benefits. DESIGN This umbrella review aims to summarize the major benefits of cochlear implant usage in adults, by synthesizing findings from published review articles. A comprehensive search of databases including MEDLINE, EMBASE, PsycINFO, and Google Scholar, was conducted. The search was limited to English-language review articles published between 1990 and 2022, focusing on cochlear implant outcomes in at least 5 adults (aged ≥18 years). Two independent reviewers screened titles, abstracts, and full-text articles, and conducted a quality assessment using the Joanna Briggs Checklist for Systematic Reviews and Research Syntheses. RESULTS Forty-two articles were included in this review. There were 15 systematic reviews with meta-analysis, 25 systematic reviews without meta-analysis, and 2 systematic scoping reviews. All 42 articles underwent quality assessment using the Joanna Briggs Institute Checklist for Systematic Reviews and Research Syntheses, of which 40% (n = 17) satisfied 9 out of 11 quality criteria. This umbrella review shows that cochlear implants are associated with improvements in speech perception and recognition as well as improved quality of life and cognition. These benefits are observed in a significant proportion of adults undergoing the procedure, highlighting its effectiveness as a viable intervention for individuals with severe to profound hearing loss. CONCLUSIONS The potential benefits of cochlear implantation appear to outweigh the risks and complications associated with the procedure. It is recommended that adults with severe to profound hearing loss in particular, engage in informed discussions with healthcare professionals to consider cochlear implantation as a viable treatment option.
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Affiliation(s)
- Diana Tang
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Yvonne Tran
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Charles Lo
- Department of Management, Australian College of Applied Professions, Sydney, New South Wales, Australia
| | - Jien Nien Lee
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Jessica Turner
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - David McAlpine
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Catherine McMahon
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Bamini Gopinath
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
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Wong D, Copson B, Gerard JM, Hill F, Leigh J, Dowell R. Cochlear implantation in advanced otosclerosis: utility of pre-operative radiological assessment in predicting intra-operative difficulty and final electrode position. J Laryngol Otol 2023; 137:1248-1255. [PMID: 37016895 DOI: 10.1017/s0022215123000609] [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: 04/06/2023]
Abstract
OBJECTIVE This study aimed to determine if pre-operative radiological scoring can reliably predict intra-operative difficulty and final cochlear electrode position in patients with advanced otosclerosis. METHOD A retrospective cohort study of advanced otosclerosis patients who underwent cochlear implantation (n = 48, 52 ears) was compared with a larger cohort of post-lingually deaf adult patients (n = 1414) with bilateral hearing loss and normal cochlear anatomy. Pre-operative imaging for advanced otosclerosis patients and final electrode position were scored and correlated with intra-operative difficulty and speech outcomes. RESULTS Advanced otosclerosis patients benefit significantly from cochlear implantation. Mean duration of deafness was longer in the advanced otosclerosis group (19.5 vs 14.3 years; p < 0.05). CONCLUSION Anatomical changes in advanced otosclerosis can result in increased difficulty of surgery. Evidence of pre-operative cochlear luminal changes was associated with intra-operative difficult insertion and final non-scala tympani position. Nearly all electrodes implanted in the advanced otosclerosis cohort were peri-modiolar. No reports of facial nerve stimulation were observed.
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Affiliation(s)
- D Wong
- Department of Otolaryngology, Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - B Copson
- Department of Radiology, St Vincent's Hospital, Melbourne, Australia
- Department of Surgery (Otolaryngology), University of Melbourne, Parkville, Australia
| | - J-M Gerard
- Department of Otolaryngology, Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - F Hill
- Department of Otolaryngology, Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - J Leigh
- Department of Otolaryngology, Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- Department of Audiology, University of Melbourne, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - R Dowell
- Department of Otolaryngology, Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- Department of Audiology, University of Melbourne, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia
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Silva VAR, Pauna HF, Lavinsky J, Guimarães GC, Abrahão NM, Massuda ET, Vianna MF, Ikino CMY, Santos VM, Polanski JF, Silva MNLD, Sampaio ALL, Zanini RVR, Lourençone LFM, Denaro MMDC, Calil DB, Chone CT, Castilho AM. Brazilian Society of Otology task force - Otosclerosis: evaluation and treatment. Braz J Otorhinolaryngol 2023; 89:101303. [PMID: 37647735 PMCID: PMC10474207 DOI: 10.1016/j.bjorl.2023.101303] [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] [Received: 07/21/2023] [Accepted: 08/06/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVES To review and provide evidence-based recommendations for the diagnosis and treatment of otosclerosis. METHODS Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on otosclerosis were eligible for inclusion. The American College of Physicians' guideline grading system and the American Thyroid Association's guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. RESULTS The topics were divided into 2 parts: 1) Diagnosis - audiologic and radiologic; 2) Treatment - hearing AIDS, pharmacological therapy, stapes surgery, and implantable devices - bone-anchored devices, active middle ear implants, and Cochlear Implants (CI). CONCLUSIONS The pathophysiology of otosclerosis has not yet been fully elucidated, but environmental factors and unidentified genes are likely to play a significant role in it. Women with otosclerosis are not at increased risk of worsening clinical condition due to the use of contraceptives or during pregnancy. Drug treatment has shown little benefit. If the patient does not want to undergo stapedotomy, the use of hearing aids is well indicated. Implantable systems should be indicated only in rare cases, and the CI should be indicated in cases of profound deafness.
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Affiliation(s)
- Vagner Antonio Rodrigues Silva
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas (FCM), Departamento de Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Henrique Furlan Pauna
- Hospital Universitário Cajuru, Departamento de Otorrinolaringologia, Curitiba, PR, Brazil
| | - Joel Lavinsky
- Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Ciências Morfológicas, Porto Alegre, RS, Brazil
| | - Guilherme Corrêa Guimarães
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas (FCM), Departamento de Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Nicolau Moreira Abrahão
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas (FCM), Departamento de Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Eduardo Tanaka Massuda
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Melissa Ferreira Vianna
- Irmandade Santa Casa de Misericordia de São Paulo, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Cláudio Márcio Yudi Ikino
- Universidade Federal de Santa Catarina, Departamento de Cirurgia e Hospital Universitário, Florianópolis, SC, Brazil
| | - Vanessa Mazanek Santos
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Curitiba, PR, Brazil
| | - José Fernando Polanski
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Curitiba, PR, Brazil; Faculdade Evangélica Mackensie do Paraná, Curitiba, PR, Brazil
| | | | - André Luiz Lopes Sampaio
- Universidade de Brasília (UnB), Faculdade de Medicina, Laboratório de Ensino e Pesquisa em Otorrinolaringologia, Brasília, DF, Brazil
| | | | - Luiz Fernando Manzoni Lourençone
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, SP, Brazil; Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, SP, Brazil
| | | | - Daniela Bortoloti Calil
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas (FCM), Departamento de Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Carlos Takahiro Chone
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas (FCM), Departamento de Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Arthur Menino Castilho
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas (FCM), Departamento de Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil.
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Ricci G, Ferlito S, Gambacorta V, Faralli M, De Luca P, Di Giovanni A, Di Stadio A. Treatment of Far-Advanced Otosclerosis: Stapedotomy Plus Hearing Aids to Maximize the Recovery of Auditory Function-A Retrospective Case Series. Healthcare (Basel) 2023; 11:676. [PMID: 36900680 PMCID: PMC10000942 DOI: 10.3390/healthcare11050676] [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: 11/08/2022] [Revised: 02/07/2023] [Accepted: 02/22/2023] [Indexed: 03/02/2023] Open
Abstract
Far-advanced otosclerosis (FAO) refers to severe otosclerosis with scarce auditory functions. The identification of the best method to correctly listen to sound and speech has a large impact on patients' quality of life. We retrospectively analyzed the auditory function of 15 patients affected by FAO who were treated with stapedectomy plus hearing aids independent of the severity of their auditory deficit before surgery. The combination of surgery and hearing aids allowed excellent recovery of the perception of pure tone sounds and speech. Four patients, because of poor auditory thresholds, needed a cochlear implant after stapedectomy. Despite being based on a small sample of patients, our results suggest that stapedotomy plus hearing aids could improve the auditory capacities of patients with FAO independent of their auditory thresholds at T0. The careful selection of patients is fundamental to obtain the best outcomes.
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Affiliation(s)
- Giampietro Ricci
- Otolaryngology Department, University of Perugia, 06129 Perugia, Italy
| | - Salvatore Ferlito
- Otolaryngology Department, San Giovannni-Addolorata Hospital, 00100 Rome, Italy
| | | | - Mario Faralli
- Otolaryngology Department, University of Perugia, 06129 Perugia, Italy
| | - Pietro De Luca
- Otolaryngology Department, San Giovannni-Addolorata Hospital, 00100 Rome, Italy
| | | | - Arianna Di Stadio
- GF Ingrassia Department, Otolaryngology, University of Catania, 95124 Catania, Italy
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Zucca M, Albera A, Albera R, Montuschi C, Della Gatta B, Canale A, Rainero I. Cochlear Implant Results in Older Adults with Post-Lingual Deafness: The Role of "Top-Down" Neurocognitive Mechanisms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1343. [PMID: 35162365 PMCID: PMC8834693 DOI: 10.3390/ijerph19031343] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 12/04/2022]
Abstract
To date, no clear specific cognitive predictors of speech perception outcome in older adult cochlear implant (CI) users have yet emerged. The aim of this prospective study was to increase knowledge on cognitive and clinical predictors of the audiological outcome in adult cochlear implant users. A total of 21 patients with post-lingual deafness, who were candidates for cochlear implantation, were recruited at the Department of Ear, Nose and Throat, University of Torino (Italy) and subjected to a pre-operatory neuropsychological assessment (T0) and an audiological examination after 12 months of implantation (T12). Patients who, at T12, had a 60 dB verbal recognition above 80%, were younger (z = -2.131, p = 0.033) and performed better in the Verbal Semantic Fluency Test at T0 (z = -1.941, p = 0.052) than subjects who had a 60 dB verbal recognition at T12 below 80%. The most significant predictors of the CI audiological outcome at T12 were age (β = -0.492, p = 0.024) and patients' TMT-A performance at baseline (β = -0.486, p = 0.035). We conclude that cognitive processing speed might be a good predictor of the level of speech understanding in older adult patients with CI after one year of implantation.
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Affiliation(s)
- Milena Zucca
- Department of Neuroscience, Aging Brain and Memory Clinic, University of Torino, 10126 Turin, Italy;
| | - Andrea Albera
- Department of Surgical Sciences, ENT Division, University of Torino, 10126 Turin, Italy; (A.A.); (R.A.); (B.D.G.); (A.C.)
| | - Roberto Albera
- Department of Surgical Sciences, ENT Division, University of Torino, 10126 Turin, Italy; (A.A.); (R.A.); (B.D.G.); (A.C.)
| | - Carla Montuschi
- Section of Otorhinolaryngology, Department of Surgery, Ospedale degli Infermi, 13875 Biella, Italy;
| | - Beatrice Della Gatta
- Department of Surgical Sciences, ENT Division, University of Torino, 10126 Turin, Italy; (A.A.); (R.A.); (B.D.G.); (A.C.)
| | - Andrea Canale
- Department of Surgical Sciences, ENT Division, University of Torino, 10126 Turin, Italy; (A.A.); (R.A.); (B.D.G.); (A.C.)
| | - Innocenzo Rainero
- Department of Neuroscience, Aging Brain and Memory Clinic, University of Torino, 10126 Turin, Italy;
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