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Jaiswal AS, Kumar R, Kumar R, Kairo AK, Raveendran S, Sagar P. Cochlear Implantation in Adults with Post-lingual Hearing Loss: Clinico-Demographical Study and Outcomes in the Current Times. Indian J Otolaryngol Head Neck Surg 2023; 75:548-551. [PMID: 37200896 PMCID: PMC10016170 DOI: 10.1007/s12070-022-03467-6] [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: 09/24/2022] [Accepted: 12/31/2022] [Indexed: 03/17/2023] Open
Abstract
To describe clinico-demographical profile for post-lingual hearing loss in the adults undergoing cochlear implantation and their outcomes. A retrospective chart review was conducted including adult patients (> 18 years) with bilateral post-lingual severe to profound hearing loss who underwent cochlear implantation in a tertiary care hospital of north India. The clinico-demographical details were collected and the outcomes of the procedure were assessed in terms of speech intelligibility scores, usage and satisfaction scores. Twenty-one patients were included with a mean age of 38.6 years with 15 males and 6 females. The major cause of deafness was infections followed by ototoxicity. The complication rate was 4.8%. Preoperative SDS was not recordable in any of the patients. The mean postoperative SDS was 74%, with no issue of device malfunction in a mean follow-up of 44 months. Cochlear implantation is a safe surgery with good outcomes in post-lingually deafened adults with the major cause for deafness being infections.
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Affiliation(s)
- Avinash Shekhar Jaiswal
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Rajeev Kumar
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Rakesh Kumar
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Arvind Kumar Kairo
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Sarath Raveendran
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Prem Sagar
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
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Sorrentino F, Gheller F, Lunardi G, Brotto D, Trevisi P, Martini A, Marioni G, Bovo R. Cochlear implantation in adults with auditory deprivation: What do we know about it? Am J Otolaryngol 2020; 41:102366. [PMID: 31837837 DOI: 10.1016/j.amjoto.2019.102366] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 12/02/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION In the ENT community, auditory deprivation is frequently considered as a negative prognostic factor for a good hearing outcome of cochlear implantation (CI), even if a growing literature suggests that this is not completely true. The purpose of this study is to evaluate the results of CI in patients with hearing deprivation, to compare them to results from non-deprived patients and then estimate how time of deprivation impacts on CI outcome and how a bilateral deprivation can affect the outcome compared to a unilateral deprivation. METHODS Seventy-eight adults with severe to profound post-verbal hearing loss, with and without auditory deprivation history, received CI; audiological results obtained at 3-6-12-24 months follow up post CI were analyzed. RESULTS No differences were founded between patients with unilateral deprivation and patients with no deprivation. Patients with bilateral deprivation seem to have a worse hearing outcome compared to that of those patients with unilateral deprivation or no deprivation at all. Long time deprivation (>15 years) seems to have a negative influence on the hearing outcome but results with CI remain excellent. CONCLUSIONS Auditory deprivation should not be considered a contraindication to CI. The duration of auditory deprivation in the implanted ear seems to be a negative prognostic factor only for ears deprived from more of 15 years.
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Affiliation(s)
- Flavia Sorrentino
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy.
| | - Flavia Gheller
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Giuseppe Lunardi
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Davide Brotto
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Patrizia Trevisi
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Alessandro Martini
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Gino Marioni
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Roberto Bovo
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
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Fuller C, Başkent D, Free R. Early Deafened, Late Implanted Cochlear Implant Users Appreciate Music More Than and Identify Music as Well as Postlingual Users. Front Neurosci 2019; 13:1050. [PMID: 31680802 PMCID: PMC6798179 DOI: 10.3389/fnins.2019.01050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/19/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Typical cochlear implant (CI) users, namely postlingually deafened and implanted, report to not enjoy listening to music, and find it difficult to perceive music. Another group of CI users, the early-deafened (during language acquisition) and late-implanted (after a long period of auditory deprivation; EDLI), report a higher music appreciation, but is this related to a better music perception? Materials and Methods: Sixteen EDLI and fifteen postlingually deafened (control group) CI users participated in the study. The inclusion criteria for EDLI were: severe or profound hearing loss onset before the age of 6 years, implantation after the age of 16 years, and CI experience more than 1 year. Subjectively, music perception and appreciation was evaluated using the Dutch Musical Background Questionnaire. Behaviorally, music perception was measured with melodic contour identification (MCI), using two instruments (piano and organ), each tested with and without a masking contour. Semitone distance between successive tones of the target varied from 1 to 3 semitones. Results: Subjectively, the EDLI group reported to appreciate music more than postlingually deafened CI users. Behaviorally, while clinical phoneme recognition test score on average was lower in the EDLI group, melodic contour identification did not significantly differ between the two groups. There was, however, an effect of instrument and masker for both groups; the piano was the best-recognized instrument, and for both instruments, the masker with non-overlapping pitch was best recognized. Discussion: EDLI group reported higher appreciation of music than postlingual control group, even though behaviorally measured music perception did not differ significantly between the two groups. Both surprising findings since EDLI CI users would be expected to have lower outcomes based on the early deafness onset, long duration of auditory deprivation, and on average lower clinical speech scores. Perhaps, the music perception difficulty comes from similar electric hearing limitations in both groups. The higher subjective appreciation in EDLI might be due to the lack of a musical memory, with no ability to compare music heard via the CI to acoustic music perception. Overall, our findings support a benefit from implantation for a positive music experience in EDLI CI users.
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Affiliation(s)
- Christina Fuller
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Research School of Behavioral and Cognitive Neurosciences, Graduate School of Medical Sciences, University of Groningen, Groningen, Netherlands.,Department of Otorhinolaryngology, Treant Zorggroep, Emmen, Netherlands
| | - Deniz Başkent
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Research School of Behavioral and Cognitive Neurosciences, Graduate School of Medical Sciences, University of Groningen, Groningen, Netherlands
| | - Rolien Free
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Research School of Behavioral and Cognitive Neurosciences, Graduate School of Medical Sciences, University of Groningen, Groningen, Netherlands
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Kirchner GJ, Ghazaryan H, Lieber AM, Sunkerneni AR, McKinnon BJ. Cost-effectiveness of Preoperative Staphylococcus aureus Screening and Decolonization in Cochlear Implantation. OTO Open 2019; 3:2473974X19866391. [PMID: 31428733 PMCID: PMC6684140 DOI: 10.1177/2473974x19866391] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/09/2019] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Infection following cochlear implantation is medically and economically devastating. The cost-effectiveness (CE) of colonization screening and decolonization for infection prophylaxis in cochlear implantation has not been examined. STUDY DESIGN An analytic observational study of data collected from purchasing records and the literature. METHODS Costs of Staphylococcus aureus colonization screening and decolonization were acquired from purchasing records and the literature. Infection rates after cochlear implantation and average total costs for evaluation and treatment were obtained from a review of the literature. A break-even analysis was performed to determine the required absolute risk reduction (ARR) in infection rate to make colonization screening or decolonization CE. RESULTS Nasal screening ($144.07) is CE if the initial infection rate (1.7%) had an ARR of 0.60%. Decolonization with 2% intranasal mupirocin ointment ($5.09) was CE (ARR, 0.02%). A combined decolonization technique (2% intranasal mupirocin ointment, chlorhexidine wipes, chlorhexidine shower, and prophylactic vancomycin: $37.57) was CE (ARR, 0.16%). Varying infection rate as high as 15% demonstrated that CE did not change by maintaining an ARR of 0.16%. CE of the most expensive decolonization protocol was enhanced as the cost of infection treatment increased, with an ARR of 0.03% at $125,000. CONCLUSIONS Prophylactic S aureus decolonization techniques can be CE for preventing infection following cochlear implantation. Decolonization with mupirocin is economically justified if it prevents at least 1 infection out of 5000 implants. S aureus colonization screening needed high reductions in infection rate to be CE.
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Affiliation(s)
- Gregory J. Kirchner
- Department of Otolaryngology–Head and Neck Surgery, College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA
| | - Hovhannes Ghazaryan
- Department of Otolaryngology–Head and Neck Surgery, College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA
| | - Alexander M. Lieber
- Department of Otolaryngology–Head and Neck Surgery, College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA
| | - Anisha Reddy Sunkerneni
- Department of Otolaryngology–Head and Neck Surgery, College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA
| | - Brian J. McKinnon
- Department of Otolaryngology–Head and Neck Surgery, College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA
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Cohen SM, Svirsky MA. Duration of unilateral auditory deprivation is associated with reduced speech perception after cochlear implantation: A single-sided deafness study. Cochlear Implants Int 2018; 20:51-56. [PMID: 30486762 DOI: 10.1080/14670100.2018.1550469] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Examine the relationship between duration of unilateral deafness and speech perception outcomes after cochlear implantation in adults with single-sided deafness. METHODS A systematic review of PubMed articles containing individual speech perception and duration of deafness data from single-sided deaf adults. Studies were selected for detailed review and duration of deafness and speech perception outcomes were extracted, with speech scores reported as percent correct. A linear regression as a function of study and length of deafness was performed. RESULTS A statistically significant negative effect of duration of unilateral deafness on speech perception was found, but there was substantial uncertainty regarding the strength of the effect. DISCUSSION Existing data make it difficult to either support or reject a hard 5- or 10-year unilateral auditory deprivation limit on cochlear implant (CI) candidacy for patients with single-sided deafness. This is because the totality of available data are consistent with a very small effect, perhaps negligible in practical terms, and just as consistent with a very large effect. Regardless of effect size, the present results have important basic implications. They suggest that unilateral sound deprivation may have a deleterious effect on auditory processing even though more central parts of the auditory system have continued to receive input from a contralateral normal ear. CONCLUSIONS Speech perception scores in SSD patients are negatively correlated with duration of deafness, but the limited amount of data from cochlear implant users with long-term single-sided deafness leads to substantial uncertainly, which in turn precludes any strong clinical recommendations. Further study of SSD CI users with long-term deafness will be necessary to generate evidence-based guidelines for implantation criteria in this population.
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Affiliation(s)
- Samuel M Cohen
- a Department of Otolaryngology , New York University School of Medicine , New York , NY , USA
| | - Mario A Svirsky
- a Department of Otolaryngology , New York University School of Medicine , New York , NY , USA
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Cochlear Implantation in Postlingual Adult Patients With Long-Term Auditory Deprivation. Otol Neurotol 2017; 38:e248-e252. [DOI: 10.1097/mao.0000000000001257] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Boisvert I, McMahon CM, Dowell RC, Lyxell B. Long-term asymmetric hearing affects cochlear implantation outcomes differently in adults with pre- and postlingual hearing loss. PLoS One 2015; 10:e0129167. [PMID: 26043227 PMCID: PMC4456415 DOI: 10.1371/journal.pone.0129167] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 05/05/2015] [Indexed: 02/01/2023] Open
Abstract
In many countries, a single cochlear implant is offered as a treatment for a bilateral hearing loss. In cases where there is asymmetry in the amount of sound deprivation between the ears, there is a dilemma in choosing which ear should be implanted. In many clinics, the choice of ear has been guided by an assumption that the reorganisation of the auditory pathways caused by longer duration of deafness in one ear is associated with poorer implantation outcomes for that ear. This assumption, however, is mainly derived from studies of early childhood deafness. This study compared outcomes following implantation of the better or poorer ear in cases of long-term hearing asymmetries. Audiological records of 146 adults with bilateral hearing loss using a single hearing aid were reviewed. The unaided ear had 15 to 72 years of unaided severe to profound hearing loss before unilateral cochlear implantation. 98 received the implant in their long-term sound-deprived ear. A multiple regression analysis was conducted to assess the relative contribution of potential predictors to speech recognition performance after implantation. Duration of bilateral significant hearing loss and the presence of a prelingual hearing loss explained the majority of variance in speech recognition performance following cochlear implantation. For participants with postlingual hearing loss, similar outcomes were obtained by implanting either ear. With prelingual hearing loss, poorer outcomes were obtained when implanting the long-term sound-deprived ear, but the duration of the sound deprivation in the implanted ear did not reliably predict outcomes. Contrary to an apparent clinical consensus, duration of sound deprivation in one ear has limited value in predicting speech recognition outcomes of cochlear implantation in that ear. Outcomes of cochlear implantation are more closely related to the period of time for which the brain is deprived of auditory stimulation from both ears.
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Affiliation(s)
- Isabelle Boisvert
- Department Linguistics, Macquarie University, Sydney, New South Wales, Australia
- HEARing Cooperative Research Centre, Melbourne, Victoria, Australia
- SCIC Cochlear Implant Program - An RIDBC service, Sydney, New South Wales, Australia
- Linnaeus Centre HEAD, The Swedish Institute for Disability Research, Linköping, Sweden
- * E-mail:
| | - Catherine M. McMahon
- Department Linguistics, Macquarie University, Sydney, New South Wales, Australia
- HEARing Cooperative Research Centre, Melbourne, Victoria, Australia
| | - Richard C. Dowell
- HEARing Cooperative Research Centre, Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Victoria, Australia
- Audiology, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Björn Lyxell
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Linnaeus Centre HEAD, The Swedish Institute for Disability Research, Linköping, Sweden
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Choice of Ear for Cochlear Implantation in Adults With Monaural Sound-Deprivation and Unilateral Hearing Aid. Otol Neurotol 2012; 33:572-9. [DOI: 10.1097/mao.0b013e3182544cdb] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Relative importance of monaural sound deprivation and bilateral significant hearing loss in predicting cochlear implantation outcomes. Ear Hear 2012; 32:758-66. [PMID: 21750463 DOI: 10.1097/aud.0b013e3182234c45] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Making evidence-based recommendations to prospective unilateral cochlear implant recipients on the potential benefits of implanting one or the other ear is challenging for cochlear implant teams. This particularly occurs in cases where a hearing aid has only been used in one ear for many years (referred to here as the "hearing ear"), and the contralateral ear has, in essence, been sound-deprived. In such cases, research to date is inconclusive, and little anecdotal evidence exists to inform the debate and support best clinical practice. DESIGN Retrospective data on speech recognition outcomes of 16 adult participants who received a cochlear implant in an ear deprived of sound for a minimum of 15 yr were analyzed. All subjects were implanted through the Quebec Cochlear Implant Program and were provided with personalized intensive rehabilitation services. Data obtained from clinical records included demographic data and speech recognition scores measured after implantation with the sentences of a multimedia auditory test battery in the auditory-only condition. Speech recognition outcomes were compared with the duration of auditory deprivation in the implanted ear, bilateral significant hearing loss, and auditory stimulation before bilateral significant hearing loss. RESULTS Using nonparametric correlation analyses, a strong negative correlation was demonstrated between speech recognition scores and the duration of bilateral significant hearing loss and with the duration of auditory stimulation before bilateral significant hearing loss. No significant correlation with the duration of auditory deprivation or with the duration of prior auditory stimulation in the implanted ear was found. CONCLUSIONS These findings suggest that functional outcomes of cochlear implantation for unilateral sound deprivation may be more strongly influenced by central processes than peripheral effects stemming from the deprivation per se. This indicates the relevance of considering the client's history of binaural hearing rather than the hearing in each ear individually when discussing possible outcomes with a cochlear implant.
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Lee JH. Cochlear implantation in the elderly. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2011. [DOI: 10.5124/jkma.2011.54.9.925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jun Ho Lee
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea
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