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Wesarg T, Wiebe K, Galindo Guerreros JC, Arndt S, Aschendorff A, Voß B. Speech Understanding and Subjective Listening Effort in Noise With Different OTEs and Sound Processing Technologies. Otol Neurotol 2024; 45:e91-e101. [PMID: 38206063 DOI: 10.1097/mao.0000000000004091] [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: 01/12/2024]
Abstract
OBJECTIVE To determine speech reception thresholds (SRTs) in noise and subjective listening effort (LE) in cochlear implant (CI) recipients for application of three sound processing (SP) technologies with two off-the-ear (OTE) CI sound processors, a fixed moderately directional microphone (Standard), an adaptive directional microphone (Beam), and the spatial noise-reduction setting ForwardFocus, with the Kanso 2 (OTE2), and Beam with the Kanso (OTE1). STUDY DESIGN Prospective repeated measures, within-subject design. SETTING Single tertiary-referral center. PATIENTS Twenty CI recipients with bilateral severe-to-profound sensorineural hearing loss. MAIN OUTCOME MEASURES SRTs were assessed in two spatial configurations with frontal speech and noise from 90-180-270 degrees (S0N90-180-270) or from the CI side (S0NCI). SRTs were obtained for sentences of the Oldenburg sentence test presented in International Collegium of Rehabilitative Audiology (ICRA) noise ICRA5-250. LE for speech understanding in noise was evaluated in S0N90-180-270 and assessed in effort scale categorical units (ESCUs) by using Adaptive Categorical Listening Effort Scaling (ACALES). LEs at 5-dB signal-to-noise ratio (SNR) were calculated from fitted psychometric curves. RESULTS With OTE2 in S0N90-180-270, SRT with ForwardFocus (-4.28 dB SNR) was better than with Beam (-3.13 dB SNR) and Standard (0.43 dB SNR). ForwardFocus showed lower LE5dB (2.61 ESCU) compared with Beam (4.60 ESCU) and Standard (5.32 ESCU). In a comparison of both OTEs in S0N90-180-270 regarding best-performing SP technology, ForwardFocus with OTE2 yielded a better SRT and better LE5dB than Beam with OTE1 (SRT: -1.70 dB SNR; LE5dB: 4.00 ESCU). With OTE2 in S0NCI, SRT was improved with ForwardFocus (-2.78 dB SNR) compared with Beam (-1.23 dB SNR) and Standard (1.83 dB SNR). CONCLUSION With respect to SP technology and OTE, CI recipients experience best SRT and lowest LE in S0N90-180-270 when using ForwardFocus with OTE2. ACALES is feasible for assessing subjective LE in CI recipients.
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Affiliation(s)
- Thomas Wesarg
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Ledesma ALL, Evangelista KDS, de Alexandria DML, Sales JDS, Caldas FF, Bahmad F. Satisfaction and quality of life in cochlear implant users with long sensory deprivation. Codas 2023; 35:e20210021. [PMID: 37466501 PMCID: PMC10446750 DOI: 10.1590/2317-1782/20232021021en] [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: 05/19/2021] [Accepted: 08/17/2022] [Indexed: 07/20/2023] Open
Abstract
PURPOSE The aim of the study was to verify the level of satisfaction of CI users with long periods of hearing deprivation, highlighting the positive and negative aspects of the use of the device and their quality of life. METHODS This is a analytical research, of the type observational cross-sectional study. The study was performed with 24 patients from a private Institute of Otorhinolaryngology. Three surveys were applied: Satisfaction with Amplification in Daily Life (SADL), International Outcome Inventory - Cochlear Implant (IOI - CI) to assess cochlear implant satisfaction and WHOQOL- bref to assess the quality of life. The results in the pre and post lingual groups were compared. RESULTS The highest degree of satisfaction was reported with regard to personal image, positive effects, and how the users feel about their CI. The lowest degree of satisfaction was reported regarding the cost-benefit of the CI and the competitive noise. In the WHOQOL-bref assessment, the highest scores were found in physical, psychological and social relations domains. When comparing the results of the surveys, the pre and post-lingual groups showed no difference in relation to the achieved scores. CONCLUSION The participants had a high level of satisfaction with the use of cochlear implants. The longer the sensory deprivation time, the greater the degree of satisfaction with the device. The use of the CI electronic device reflects on the individual's quality of life.
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Affiliation(s)
| | | | | | - Jéssica da Silva Sales
- Faculdade de Fonoaudiologia, Centro Universitário Planalto do Distrito Federal – UNIPLAN - Brasília (DF), Brasil.
| | - Fernanda Ferreira Caldas
- Programa de Pós-graduação em Ciências da Saúde, Universidade de Brasília – UnB - Brasília (DF), Brasil.
| | - Fayez Bahmad
- Programa de Pós-graduação em Ciências da Saúde, Universidade de Brasília – UnB - Brasília (DF), Brasil.
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Candidacy for Cochlear Implantation in Prelingual Profoundly Deaf Adult Patients. J Clin Med 2022; 11:jcm11071874. [PMID: 35407482 PMCID: PMC8999851 DOI: 10.3390/jcm11071874] [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: 02/09/2022] [Revised: 03/14/2022] [Accepted: 03/21/2022] [Indexed: 12/04/2022] Open
Abstract
Cochlear implantation is usually not recommended for prelingual profoundly deaf adults, although some of these patients might benefit from it. This study aims to define the candidates for cochlear implantation in this population. This retrospective study reviewed 34 prelingual profoundly deaf patients who had received a cochlear implant at 32 ± 1.7 years old (16−55), with at least 1 year of follow-up. Speech perception and quality of life were assessed before and 3, 6, and 12 months after cochlear implantation, then every year thereafter. According to the word speech intelligibility in quiet (WSI) 1 year after implantation, two groups were identified: good performer (GP) with WSI ≥ 50% (n = 15), and poor performer (PP) with WSI ≤ 40% (n = 19). At the 1 year mark, mean WSI improved by 28 ± 4.6% (−20−100) (p < 0.0001). In GP, the intelligibility for words and sentences, communication and quality of life scales improved. In PP, the communication scale improved, but not auditory performance or quality of life. GP and PP differed pre-operatively in speech production, communication abilities, and WSI in best-aided conditions. In prelingual profoundly deaf adults, a dramatic auditory performance benefit could be expected after cochlear implantation if the patients have some degree of speech intelligibility in aided conditions and have developed oral communication and speech production.
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Klopp-Dutote N, Lefranc M, Strunski V, Page C. Minimally invasive fully ROBOT-assisted cochlear implantation in humans: Preliminary results in five consecutive patients. Clin Otolaryngol 2021; 46:1326-1330. [PMID: 34310841 DOI: 10.1111/coa.13840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/25/2021] [Accepted: 07/17/2021] [Indexed: 11/27/2022]
Affiliation(s)
| | - Michel Lefranc
- Neurosurgery Department, Amiens University Hospital, Amiens, France
| | - Vladimir Strunski
- ENT and Head & Neck Surgery Department, Amiens University Hospital, Amiens, France
| | - Cyril Page
- ENT and Head & Neck Surgery Department, Amiens University Hospital, Amiens, France
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Henkin Y, Shapira Y, Yaar Soffer Y. Current demographic and auditory profiles of adult cochlear implant candidates and factors affecting uptake. Int J Audiol 2021; 61:483-489. [PMID: 34191666 DOI: 10.1080/14992027.2021.1941327] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Despite growth of CI and widening of implantation criteria, penetration rates remain low and the clinical profile of adult CI candidates has not substantially changed. This study evaluated the demographic and auditory profiles of current adult CI candidates and identified factors affecting CI uptake. DESIGN Preoperative data from patients who underwent CI candidacy evaluation between 2016-2018 were retrospectively reviewed. Data included demographics, medical reports, audiological results, and reasons for not pursuing implantation. Comparisons between candidates who pursued implantation and those who did not were performed. STUDY SAMPLE Ninety-five candidates (54 females), average age 52 years. RESULTS Most candidates exhibited post-lingual bilateral hearing loss with mean unaided PTA4 of 105dBHL and monosyllabic word score of 26%. Forty-nine candidates were implanted, and the main reason for not pursuing CI was candidates' reluctance. Candidates that pursued CI were mostly younger females with poorer unaided PTA4. Age was the only significant predictor of CI uptake. CONCLUSIONS While current candidates demonstrated greater demographic diversity and better speech perception compared to previous findings, unaided thresholds are still within the profound range. Our findings indicate that eligible candidates face barriers to the utilisation of CI, some of which are modifiable by means of updated candidacy protocols.
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Affiliation(s)
- Yael Henkin
- Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer, Israel.,Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Yisgav Shapira
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Yifat Yaar Soffer
- Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer, Israel.,Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
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Duchêne J, Ribadeau Dumas A, Bonnard D, Sagardoy T, Franco-Vidal V. Musical Ear Syndrome: Prevalence and characteristics in cochlear implant bearers. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:153-157. [PMID: 33257264 DOI: 10.1016/j.anorl.2020.11.005] [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: 10/22/2022]
Abstract
INTRODUCTION Musical Ear Syndrome (MES) is an uncommon phenomenon described as the perception of auditory musical sensations not corresponding to any external stimulus. It seems to be more frequent in case of profound hearing loss. Our objective was to evaluate prevalence, characteristics and risk factors in a population of cochlear implant patients. METHODS A retrospective study was conducted in cochlear implant patients, who were adult (>18 years) in 2020 and underwent cochlear implantation between 1993 and 2019. We analyzed the presence and characteristics of MES. RESULTS 118 of the 358 patients (33%) perceived or had perceived auditory musical sensations: 71 (19.8%) before, 100 (28%) after, and 53 (14.8%) both before and after implantation. The musical auditory sensations were usually short and well-tolerated, resembling instrumental music, and occurring several times a day. Thirteen patients (11%) considered them intolerable. Fatigue was a triggering factor in 40 patients (33.9%). Personal and medical characteristics, type of implantation, make of implant, etiology and tinnitus did not emerge as risk factors. On the other hand, MES+ patients were significatively younger (56±17.4 years versus 61.9±17.9 years; P=0.0009). Despite the phenomenon, patients were satisfied with implant functioning and subjective auditory performance was not affected. CONCLUSION Prevalence of Musical Ear Syndrome was high in cochlear implant patients, and especially in younger subjects. It is essential to improve knowledge of this phenomenon.
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Affiliation(s)
- J Duchêne
- Département d'Otorhinolaryngologie, de Chirurgie Cervico-Faciale et d'ORL Pédiatrique, Centre Hospitalier Universitaire Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France.
| | - A Ribadeau Dumas
- Département d'Otorhinolaryngologie, de Chirurgie Cervico-Faciale et d'ORL Pédiatrique, Centre Hospitalier Universitaire Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France
| | - D Bonnard
- Département d'Otorhinolaryngologie, de Chirurgie Cervico-Faciale et d'ORL Pédiatrique, Centre Hospitalier Universitaire Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France
| | - T Sagardoy
- Département d'Otorhinolaryngologie, de Chirurgie Cervico-Faciale et d'ORL Pédiatrique, Centre Hospitalier Universitaire Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France
| | - V Franco-Vidal
- Département d'Otorhinolaryngologie, de Chirurgie Cervico-Faciale et d'ORL Pédiatrique, Centre Hospitalier Universitaire Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France
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Voultsos P, Oliva A, Grassi S, Palmiero D, Spagnolo AG. Are errors in otorhinolaryngology always a sign of medical malpractice? Review of the literature and new perspectives in the SARS-CoV-2 (COVID-19) era. ACTA ACUST UNITED AC 2020; 40:157-163. [PMID: 32519993 PMCID: PMC7416369 DOI: 10.14639/0392-100x-n0674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 05/05/2020] [Indexed: 01/16/2023]
Abstract
In medical practice, during certain procedures that usually are not regarded highly demanding, some skill-based errors, that might not be considered as medical malpractice, may occur. In fact, such errors can be caused by factors beyond the physician’s control.A review of Greek case law regarding medical malpractice in otorhinolaryngology was performed to identify cases of lawsuits that concerned medical errors during routine procedures. The analysis of the cases showed that some medical errors may cause serious complications, even if deviation from the standard of medical care is minimal. Thus, in some cases it may be difficult to make a distinction between preventable and unpreventable complications. Certain medical errors from routine medical procedures might be considered unpreventable and, therefore, classified as almost no-fault errors. A brief commentary regarding opportunities to further improve the medical liability system after the SARS-CoV-2 emergency is also given.
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Affiliation(s)
- Polychronis Voultsos
- Department of Medical Ethics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Antonio Oliva
- Department of Healthcare Surveillance and Bioethics, Catholic University of the Sacred Heart, Rome, Italy
| | - Simone Grassi
- Department of Healthcare Surveillance and Bioethics, Catholic University of the Sacred Heart, Rome, Italy
| | - Debora Palmiero
- Department of Healthcare Surveillance and Bioethics, Catholic University of the Sacred Heart, Rome, Italy
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Mudry A. Mechanical ear and "blue book" in 1973. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:439-440. [PMID: 32499149 DOI: 10.1016/j.anorl.2020.01.023] [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: 01/09/2020] [Accepted: 01/09/2020] [Indexed: 10/24/2022]
Abstract
Cochlear implant has progressively become an essential treatment for profound hearing loss. The aim of this historical note is to briefly review the very beginnings of this technique, in 1973, with the production of a painting entitled "Mechanical ear" and the first international congress on cochlear implants. In a way, these two events marked the beginning of an antagonism that played a very important role in the development and especially the acceptance of cochlear implants in the multicultural society of the late twentieth century.
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Affiliation(s)
- A Mudry
- Department of Otolaryngology, Head & Neck Surgery, Stanford University School of Medicine, avenue de la Gare 6, CH-1003 Lausanne, Switzerland.
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