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Song B, Hwang K, Koh SM, Moon IJ, Cho YS. Clinical Portrait of Cochlear Implantation in Patients With CHARGE Syndrome. Otolaryngol Head Neck Surg 2024; 171:560-570. [PMID: 38738912 DOI: 10.1002/ohn.808] [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: 12/14/2023] [Revised: 02/28/2024] [Accepted: 03/07/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE To examine the clinical characteristics and auditory performance of patients with CHARGE syndrome following cochlear implantation (CI), as well as the prognostic factors affecting auditory outcomes. STUDY DESIGN Retrospective cohort. SETTING Tertiary academic center. METHODS A retrospective chart review was performed in patients with CHARGE syndrome who underwent CI from 2007 to 2022. The category of auditory performance (CAP) score was used to assess the CI outcomes, and factors that may affect the speech outcomes were also evaluated. RESULTS In 14 children with CHARGE syndrome, 22 CIs were performed, 6 unilaterally and 8 bilaterally. The mean age at CI was 25.9 months (range: 10-62). All patients had ear abnormalities and developmental delays, and cochlear nerve deficiency (CND) was present in all ears. At the last follow-up (mean: 49.6 months), the mean CAP score improved significantly compared to the preoperative measure (from 0.36 ± 0.81 to 3.21 ± 1.70, P = .001), with 6 patients (42.9%) achieving a CAP score of 4 points or higher. However, between the unilateral and bilateral CI groups, the final CAP score or change in CAP score was similar. Factors including age, coloboma, and CND did not significantly affect speech outcomes (all P > .05). CONCLUSION Even though CHARGE syndrome features challenging anomalies, CI can be conducted safely and can offer effective contribution to significant speech improvement. Patients with CHARGE syndrome should be given the opportunity to undergo CI to maximize their audiological progress.
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Affiliation(s)
- Bokhyun Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyuhyeon Hwang
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Min Koh
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Il Joon Moon
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Sang Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kocabay AP, Batuk MO, Sennaroglu G, Sennaroglu L. Speech Perception and Sound Localization Skills in Inner Ear Malformations: Children With Incomplete Partition Type-II. Otolaryngol Head Neck Surg 2023. [PMID: 36939548 DOI: 10.1002/ohn.244] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/24/2022] [Accepted: 12/10/2022] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The present study aimed to evaluate binaural auditory skills in bimodal and bilateral pediatric cochlear implant (CI) users with incomplete partition type-II (IP-II) and to reveal the effect of IP-II on performance by comparing the results to pediatric CI users with normal cochlear morphology. STUDY DESIGN Cross-sectional study. SETTING Tertiary referral center. METHODS Forty-one CI users (mean age 8.8 ± 1.9) were grouped as bimodal (BIM-IP) and bilateral (BIL-IP) users with IP-II; bimodal (BIM-N) and bilateral (BIL-N) users with normal cochlear anatomy. Speech perception in noise and sound localization skills were compared under 2 conditions; binaural (bilateral or bimodal) and monaural (first CI alone). RESULTS BIM-IP and BIL-IP showed no performance difference in binaural tasks. The BIM-N group showed remarkably poor performance in comparison to the groups of BIL-IP (p = .007), BIM-IP (p < .001), and BIL-N (p = .004) in terms of speech-in-noise skills. In sound localization abilities, similar significant differences were found between the group of BIM-N and the groups of BIL-IP (p = .001), BIM-IP (p < .001), and BIL-N (p = .004). All groups showed statistically significant improvements in binaural condition on both tasks (p < .05). CONCLUSION We revealed that bilateral and bimodal pediatric CI users with IP-II benefitted from implantation as much as bilateral users with normal anatomy. Differences in residual hearing between groups may explain the poor performance of bimodal users with normal cochlear morphology. To the best of our knowledge, it is the first study to unveil binaural performance characteristics in children diagnosed with a specific inner ear malformation subgroup.
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Affiliation(s)
| | | | | | - Levent Sennaroglu
- Department of Otorhinolaryngology, Hacettepe University, Ankara, Turkey
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Quantifying the Influence of Factors on the Accuracy of Speech Perception in Mandarin-Speaking Cochlear Implant Patients. J Clin Med 2023; 12:jcm12030821. [PMID: 36769470 PMCID: PMC9917954 DOI: 10.3390/jcm12030821] [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: 12/26/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
Rehabilitation of hearing perception in cochlear implant (CI) patients is a challenging process. A comprehensive analysis of the characteristics of hearing rehabilitation in Mandarin-speaking CI patients was conducted. We measured the aided hearing threshold (AHT) and the speech perception accuracy (SPA) and collected clinical data. A total of 49 CI patients were included. Significant linear relationships existed between the AHT and SPA. The SPA increased by about 5-7% when the AHT decreased by 5 dB. An apparent individual difference in the SPA was observed under the same AHT, which in some patients was lower than the reference value fitted by the regression model. The timing of both of cochlear implantation and rehabilitation training was found to lead to significant improvement in SPA. The SPA increases by 2.1-3.6% per year of cochlear implantation and 0.7-1.5% per year of rehabilitation training. The time of auditory deprivation can significantly reduce the SPA by about 1.0-1.6% per year. The SPA was still poor in some CI patients when the hearing compensation seemed satisfying. Early cochlear implantation and post-operative rehabilitation are essential for recovery of the patient's SPA if the indications for cochlear implantation are met.
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Shah S, Walters R, Langlie J, Davies C, Finberg A, Tuset MP, Ebode D, Mittal R, Eshraghi AA. Systematic review of cochlear implantation in patients with inner ear malformations. PLoS One 2022; 17:e0275543. [PMID: 36269710 PMCID: PMC9586398 DOI: 10.1371/journal.pone.0275543] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/19/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To evaluate the outcomes of cochlear implantation in patients with severe to profound sensorineural hearing loss due to inner ear malformations (IEMs) when compared to patients without IEMs. We discussed audiological outcomes such as open-set testing, closed-set testing, CAP score, and SIR score as well as postoperative outcomes such as cerebrospinal fluid gusher and incomplete insertion rate associated with cochlear implantation in individuals with IEMs. DATA SOURCES PubMed, Science Direct, Web of Science, Scopus, and EMBASE databases. REVIEW METHODS After screening a total of 222 studies, twelve eligible original articles were included in the review to analyze the speech and hearing outcomes of implanted patients with IEMs. Five reviewers independently screened, selected, and extracted data. The "Tool to Assess Risk of Bias in Cohort Studies" published by the CLARITY group was used to perform quality assessment on eligible studies. Systematic review registration number: CRD42021237489. RESULTS IEMs are more likely to be associated with abnormal position of the facial nerve, raising the risk of intraoperative complications. These patients may benefit from cochlear implantation, but audiological outcomes may also be less favorable than in individuals without IEMs. Furthermore, due to the risk of cerebrospinal fluid gusher, incomplete insertion of electrodes, and postoperative facial nerve stimulation, surgeons can employ precautionary measures such as preoperative imaging and proper counseling. Postoperative imaging is suggested to be beneficial in ensuring proper electrode placement. CONCLUSIONS Cochlear implants (CIs) have the potential to provide auditory rehabilitation to individuals with IEMs. Precise classification of the malformation, preoperative imaging and anatomical mapping, appropriate electrode selection, intra-operative techniques, and postoperative imaging are recommended in this population.
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Affiliation(s)
- Sunny Shah
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
| | - Rameen Walters
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
| | - Jake Langlie
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Camron Davies
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
| | - Ariel Finberg
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Maria-Pia Tuset
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Dario Ebode
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Rahul Mittal
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Adrien A. Eshraghi
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- Department of Biomedical Engineering, University of Miami, Coral Gables, Florida, United States of America
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- * E-mail:
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Degirmenci Uzun E, Batuk MO, D'Alessandro HD, Sennaroglu G. Auditory perception in pediatric cochlear implant users with cochlear nerve hypoplasia. Int J Pediatr Otorhinolaryngol 2022; 160:111248. [PMID: 35870254 DOI: 10.1016/j.ijporl.2022.111248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 07/10/2022] [Accepted: 07/14/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The objectives of this study were to assess auditory perception and speech intelligibility outcomes in children with cochlear nerve (CN) hypoplasia who received cochlear implants (CIs) using Categories of Auditory Performance II (CAP II) and Speech Intelligibility Rating (SIR) scales. METHODS In total, 40 children who received CI and who were aged between 3 and 18 years were included in this study. The study group included 20 children with CN hypoplasia at least one ear, while the control group included 20 children with normal cochleas and cochlear nerve structures. All children in the study and control groups who participated were evaluated using the CAP II and the SIR scale. Demographic data were collected. RESULTS Significant differences were found between the study and control groups' CAP II and SIR scores (p < 0.001). It was found that CAP II scores were positively correlated with SIR scores in the study (r = 0.743, p < 0.001) and control (r = 0.601, p < 0.001) groups. In the study group, significant negative correlations were found between SIR scores and age at implantation (r = -0.674, p = 0.004) and between CAP II scores and age at implantation (r = 0.751, p = 0.003). In the control group, a significant negative correlation was found between age at implantation and CAP II scores (r = -0.805, p = 0.001). Similarly, a significant negative correlation was found between age at implantation and SIR scores (r = -0.702, p = 0.007). CONCLUSION Even for children with severe inner ear malformation and CN hypoplasia, CI is an effective treatment modality for auditory perception and speech production. However, it should be noted that CN hypoplasia affects auditory performance negatively in children with CI.
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Affiliation(s)
- Erva Degirmenci Uzun
- Department of Audiology, Faculty of Health Science, Izmir Bakircay University, Izmir, Turkey.
| | - Merve Ozbal Batuk
- Department of Audiology, Faculty of Health Science, Hacettepe University, Ankara, Turkey
| | | | - Gonca Sennaroglu
- Department of Audiology, Faculty of Health Science, Hacettepe University, Ankara, Turkey
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Hearing-related quality of life assessment of pediatric cochlear implant users with inner ear malformations. Int J Pediatr Otorhinolaryngol 2022; 160:111243. [PMID: 35853403 DOI: 10.1016/j.ijporl.2022.111243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To assess the quality of life (QoL) in child and adolescent cochlear implant users with inner ear malformations (IEM) and to compare their outcomes to their cochlear implant using peers with normal inner ear structures. METHODS The present sample consisted of 100 children (45 with IEM, 55 without IEM) and 100 adolescents (46 with IEM, 54 without IEM). The following QoL questionnaires were used to assess the hearing-related QoL: The Hearing Environments and Reflection on Quality of Life 26 (HEAR-QL-26 for children between 7 and 12 years of age) and HEAR-QL-28 (for adolescents between 13 and 18 years of age). Both questionnaires were based on a 5-points Likert scale from 0 to 4, with higher scores indicating a better perception of QoL. The scores were converted to percentage values (never = 100, almost never = 75, sometimes = 50, often = 25, almost always = 0). RESULTS For the patients with IEM, mean scores from the HEAR-QL-26 and HEAR-QL-28 were 50.4 (SD = 18.9) and 54.5 (SD = 19.6), respectively. For the patients without IEM, mean scores from the HEAR-QL-26 and HEAR-QL-28 were 72.7 (SD = 18.0) and 65.0 (SD = 19.1), respectively. For both child and adolescent subgroups, statistically significant differences were observed between QoL scores from patients with and without IEM (p < 0.001). There were no statistically significant effects of the malformation type on the QoL findings (p ≥ 0.05). CONCLUSION Child and adolescent cochlear implant users with IEM had significantly lower scores on validated HEAR-QL versions in comparison to their implanted peers without IEM.
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Kocabay AP, Cinar BC, Batuk MO, Yarali M, Sennaroglu G. Pediatric cochlear implant fitting parameters in inner ear malformation: Is it same with normal cochlea? Int J Pediatr Otorhinolaryngol 2022; 155:111084. [PMID: 35217268 DOI: 10.1016/j.ijporl.2022.111084] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/15/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim was to evaluate the cochlear implant (CI) mapping parameters of CI users with inner ear malformation (IEM) and to reveal the changes in parameters over time. METHODS In total, 118 CI users were included with 127 ears (68-IEM; 59-normal cochlear anatomy) in present retrospective study. The impedance measurements, thresholds levels-THR, most comfortable levels- MCL, pulse width-PW and rate values were analyzed in both IEM and control group at the initial activation, 6th,12th and 24th months postoperatively. RESULTS There were statistically significant differences in impedance measurements in several time points. And also, there was a remarkable difference in THR & MCL and PW values between IEM and control groups in all time points (p < 0.05). THR & MCL levels and PW values increased significantly between all time periods in both groups (p < 0,008) and values of parameters in IEM-group were higher than those of control group. When comparing rates, statistically significant difference was observed only at the initial activation in both within (p < 0.001) and between groups (p = 0.03). CONCLUSION Pediatric CI users with IEM need individual changes in fitting parameters. More frequent map sessions should be planned as they require more PW, THR and MCL increase over time. The increase rate differs between IEM subgroups depending on the deviation of malformation from the normal cochlear anatomy. This study is the first to in its attempt to reveal the mapping characteristics and long-term changes in pediatric CI users with different IEM subgroups.
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Affiliation(s)
| | | | | | - Mehmet Yarali
- Hacettepe University, Department of Audiology, Ankara, Turkey
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Nishio SY, Moteki H, Miyagawa M, Yamasoba T, Kashio A, Iwasaki S, Takahashi M, Naito Y, Fujiwara K, Sugaya A, Takahashi H, Kitaoka K, Usami SI. Etiology of hearing loss affects auditory skill development and vocabulary development in pediatric cochlear implantation cases. Acta Otolaryngol 2022; 142:308-315. [PMID: 35481391 DOI: 10.1080/00016489.2022.2065027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Cochlear implantation (CI) is an effective treatment for severe-to-profound hearing loss patients and is currently used as the standard therapeutic option worldwide. However, the outcomes of CI vary among patients. AIMS/OBJECTIVES This study aimed to clarify the clinical features for each etiological group as well as the effects of etiology on CI outcomes. MATERIALS AND METHODS We collected clinical information for 308 pediatric cochlear implant cases, including the etiology, hearing thresholds, age at CI, early auditory skill development, total development, monosyllable perception, speech intelligibility and vocabulary development in school age, and compared them for each etiology group. RESULTS Among the 308 CI children registered for this survey, the most common etiology of hearing loss was genetic causes. The genetic etiology group showed the most favorable development after CI followed by the unknown etiology group, syndromic hearing loss group, congenital CMV infection group, inner ear malformation group, and cochlear nerve deficiency group. CONCLUSIONS AND SIGNIFICANCE Our results clearly indicated that the etiology of HL affects not only early auditory skill development, but also vocabulary development in school age. The results of the present study will aid in more appropriate CI outcome assessment and in more appropriate intervention or habilitation programs.
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Affiliation(s)
- Shin-ya Nishio
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Nagano, Matsumoto, Japan
| | - Hideaki Moteki
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Nagano, Matsumoto, Japan
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Nagano, Matsumoto, Japan
| | - Maiko Miyagawa
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Nagano, Matsumoto, Japan
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Nagano, Matsumoto, Japan
| | - Tatsuya Yamasoba
- Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Akinori Kashio
- Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Satoshi Iwasaki
- Department of Otolaryngology, International University of Health and Welfare, Mita Hospital, Minato-ku, Tokyo, Japan
| | - Masahiro Takahashi
- Department of Otolaryngology, International University of Health and Welfare, Mita Hospital, Minato-ku, Tokyo, Japan
| | - Yasushi Naito
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe-City, Hyogo, Japan
| | - Keizo Fujiwara
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe-City, Hyogo, Japan
| | - Akiko Sugaya
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmacy, Okayama, Japan
| | - Haruo Takahashi
- Department of Otolaryngology, Nagasaki University Faculty of Medicine, Nagasaki-shi, Nagasaki, Japan
| | - Kyoko Kitaoka
- Department of Otolaryngology, Nagasaki University Faculty of Medicine, Nagasaki-shi, Nagasaki, Japan
| | - Shin-ichi Usami
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Nagano, Matsumoto, Japan
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Othman IA, Abdullah A, See GB, Umat C, Tyler RS. Auditory Performance in Early Implanted Children with Cochleovestibular Malformation and Cochlear Nerve Deficiency. J Int Adv Otol 2020; 16:297-302. [PMID: 33136006 DOI: 10.5152/iao.2020.8563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES This study aimed to report the auditory performance in children with cochleovestibular malformation (CVM)/cochlear nerve deficiency (CND) who were implanted early at the Universiti Kebangsaan Malaysia Medical Centre, using Categorical Auditory Performance (CAP)-II score and Speech Intelligibility Rating (SIR) scales, and to compare the outcome of their matched counterparts. MATERIALS AND METHODS A total of 14 children with CVM/CND with unilateral cochlear implant (CI) implanted before the age of 4 years old were matched and compared with 14 children with normal inner ear structures. Their improvement in auditory performance was evaluated twice using CAP-II score and SIR scales at 6-month intervals, with the baseline evaluation done at least 6 months after implantation. RESULTS The average age of implantation was 31±8 and 33±7 months for the control group and the case (CVM/CND) group, respectively. Overall, there were no significant differences in outcome when comparing the entire cohort of case subjects and their matched control subjects in this study. However, the improvement in CAP-II scores and SIR scales among the case subjects in between the first and second evaluations was statistically significant (p=0.040 and p=0.034, respectively). With longer duration of CI usage, children with CVM/CND showed significant speech perception outcome evident by their SIR scales (p=0.011). CONCLUSION Children with radiographically malformed inner ear structures who were implanted before the age of 4 years have comparable performance to their matched counterparts, evident by their similar improvement of CAP-II scores and SIR scales over time. Hence, this group of children benefited from cochlear implantation.
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Affiliation(s)
- Iylia Ajmal Othman
- Department of Otorhinolaryngology Head and Neck Surgery, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia;Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Asma Abdullah
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Goh Bee See
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Cila Umat
- Centre for Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Richard S Tyler
- Department of Otolaryngology Head and Neck Surgery, Department of Communication Sciences and Disorders, The University of Iowa, Iowa City, USA
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Na G, Lee JM, Lee HJ, Jeong Y, Jung J, Choi JY. Effect of Cochlear Implantation on Hearing Fluctuation in Patients with Biallelic SLC26A4 Variants. Audiol Neurootol 2020; 26:111-120. [PMID: 32877901 DOI: 10.1159/000508858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 05/21/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Fluctuating hearing loss is a distinctive feature caused by SLC26A4 variants. We investigated whether cochlear implantation had protective or deleterious effect on hearing fluctuation in patients with biallelic SLC26A4 variants. METHODS Patients with biallelic SLC26A4 variants (N = 16; age = 10.24 ± 9.20 years) who had unilateral cochlear implantation and consecutive postsurgical, bilateral pure-tone audiograms more than 3 times were selected. We retrospectively reviewed the patients' medical records from 2008 to 2019 obtained from a tertiary medical center and used the auditory threshold change (Shift) over time as a marker of hearing fluctuation. Fluctuation events were counted, and the Shift of the implanted and contralateral ears was compared using logistic regression with a generalized estimating equation and linear mixed model. A total of 178 values were included. RESULTS The odds of fluctuating hearing frequency were 11.185-fold higher in the unimplanted ears than in the implanted ears postoperatively (p = 0.001). The extent of fluctuation at 250 and 500 Hz was also significantly lower in the implanted ears than in the unimplanted ears after adjusting for every other effect (p = 0.003 and p < 0.001, respectively). Notably, higher residual hearing was rather associated with lesser fluctuation in frequency and the extent of fluctuation at 500 Hz, indicating residual hearing function is not the positive predictor for hearing fluctuation. CONCLUSION In patients with biallelic SLC26A4 variants, cochlear implantation may reduce the frequency and extent of hearing fluctuations.
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Affiliation(s)
- Gina Na
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeon Mi Lee
- Department of Otorhinolaryngology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Hyun Jin Lee
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yeonsu Jeong
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jinsei Jung
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea,
| | - Jae Young Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
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Amin N, Sethukumar P, Pai I, Rajput K, Nash R. Systematic review of cochlear implantation in CHARGE syndrome. Cochlear Implants Int 2019; 20:266-280. [DOI: 10.1080/14670100.2019.1634857] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Nikul Amin
- Department of Paediatric Otolaryngology, Great Ormond Street Hospital, London, UK
| | - Priya Sethukumar
- Department of Paediatric Otolaryngology, Great Ormond Street Hospital, London, UK
| | - Irumee Pai
- Hearing Implant Team, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Kaukab Rajput
- Cochlear Implant Department, Great Ormond Street Hospital, London, UK
| | - Robert Nash
- Department of Paediatric Otolaryngology, Great Ormond Street Hospital, London, UK
- Cochlear Implant Department, Great Ormond Street Hospital, London, UK
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12
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Demir B, Cesur S, Sahin A, Binnetoglu A, Ciprut A, Batman C. Outcomes of cochlear implantation in children with inner ear malformations. Eur Arch Otorhinolaryngol 2019; 276:2397-2403. [PMID: 31111254 DOI: 10.1007/s00405-019-05475-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 05/14/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the surgical experience and auditory functions and progress of speech development of cochlear implantation in malformed ears. MATERIALS AND METHODS Between November 1995 and July 2017, thirty-seven patients (26 females and 11 males; mean age: 138.275 ± 96.24 months) with diverse anomalies of the inner ear were retrospectively examined for surgical and audiological results. Speech Intelligibility Rating (SIR), Categories of Auditory Perception (CAP), Pure Tone Average (PTA), Speech Intelligibility Rating (SRT), and Word Discrimination Score (WDS) were the audiological tests used to evaluate the efficacy of CI in the malformed inner ears. RESULTS CSF gusher was experienced by six patients (three with LVA (large vestibular aqueduct), one with IP (incomplete partition) I, and two with both IP II Mondini malformations and LVA). Two patients had transient facial paresis after surgery. All patients fully recovered within 6 months. The postoperative PTA, SRT, and WDS test results showed significant differences between progressive and congenital sensorineural hearing loss (p values < 0.05 for all). On the other hand, the postoperative CAP and SIR test results revealed no significant differences between the two groups. According to etiology, the PTA and SRT values were significantly lower in common cavity patients than the LVA patients (p values < 0.01); no significant differences were found among the other etiological groups. CONCLUSIONS Cochlear implantation is safe in children with inner ear malformations. However, the success rate is low compared to patients with normal anatomy in terms of audiological results; the most successful group of patients with inner ear malformation is large vestibular aqueduct.
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Affiliation(s)
- Berat Demir
- Department of Otorhinolaryngology-Head and Neck Surgery, Pendik Training and Research Hospital, Marmara University Medical Faculty, Mimar Sinan Caddesi No. 41, Fevzi Cakmak Mahallesi, Ust Kaynarca-Pendik, 34899, Istanbul, Turkey.
| | - Sıdıka Cesur
- Department of Audiology, Marmara University Pendik Training and Research Hospital, Mimar Sinan Caddesi No. 41, Fevzi Cakmak Mahallesi, Ust Kaynarca-Pendik, 34899, Istanbul, Turkey
| | - Akın Sahin
- Department of Otorhinolaryngology-Head and Neck Surgery, Pendik Training and Research Hospital, Marmara University Medical Faculty, Mimar Sinan Caddesi No. 41, Fevzi Cakmak Mahallesi, Ust Kaynarca-Pendik, 34899, Istanbul, Turkey
| | - Adem Binnetoglu
- St. Elizabeth'S Medical Center, 736 Cambridge St, Brighton, MA, 02135, USA
| | - Ayca Ciprut
- Department of Audiology, Marmara University Pendik Training and Research Hospital, Mimar Sinan Caddesi No. 41, Fevzi Cakmak Mahallesi, Ust Kaynarca-Pendik, 34899, Istanbul, Turkey
| | - Caglar Batman
- Department of Otorhinolaryngology-Head and Neck Surgery, Pendik Training and Research Hospital, Marmara University Medical Faculty, Mimar Sinan Caddesi No. 41, Fevzi Cakmak Mahallesi, Ust Kaynarca-Pendik, 34899, Istanbul, Turkey
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Fisher LM, Martinez AS, Richmond FJ, Krieger MD, Wilkinson EP, Eisenberg LS. Assessing the Benefit-Risk Profile for Pediatric Implantable Auditory Prostheses. Ther Innov Regul Sci 2018; 52:669-679. [PMID: 29714549 PMCID: PMC5943182 DOI: 10.1177/2168479017741111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 09/25/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND/AIMS Children with congenital cochleovestibular abnormalities associated with profound hearing loss have few treatment options if cochlear implantation does not yield benefit. An alternative is the auditory brainstem implant (ABI). Regulatory authority device approvals currently include a structured benefit-risk assessment. Such an assessment, for regulatory purposes or to guide clinical decision making, has not been published, to our knowledge, for the ABI and may lead to the design of a research program that incorporates regulatory authority, family, and professional input. METHODS Much structured benefit-risk research has been conducted in the context of drug trials; here we apply this approach to device studies. A qualitative framework organized benefit (speech recognition, parent self-report measures) and risk (surgery- and device-related) information to guide the selection of candidates thought to have potential benefit from ABI. RESULTS Children with cochleovestibular anatomical abnormalities are challenging for appropriate assessment of candidacy for a cochlear implant or an ABI. While the research is still preliminary, children with an ABI appear to slowly obtain benefit over time. A team of professionals, including audiological, occupational, and educational therapy, affords maximum opportunity for benefit. CONCLUSIONS Pediatric patients who have abnormal anatomy and are candidates for an implantable auditory prosthetic require an individualized, multisystems review. The qualitative benefit-risk assessment used here to characterize the condition, the medical need, potential benefits, risks, and risk management strategies has revealed the complex factors involved. After implantation, continued team support for the family during extensive postimplant therapy is needed to develop maximum auditory skill benefit.
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Affiliation(s)
- Laurel M. Fisher
- Rick and Tina Caruso Department of Otolaryngology – Head and Neck Surgery, Keck School of Medicine of University of Southern California, 1540 Alcazar Street, Suite 204, Los Angeles, CA 90033
| | - Amy S. Martinez
- Rick and Tina Caruso Department of Otolaryngology – Head and Neck Surgery, Keck School of Medicine of University of Southern California, 1540 Alcazar Street, Suite 204, Los Angeles, CA 90033
| | - Frances J. Richmond
- USC School of Pharmacy, Department of Regulatory Science, Keck School of Medicine of University of Southern California, 1540 Alcazar Street, CHP 140 Los Angeles, CA 90033
| | - Mark D. Krieger
- Billy and Audrey L. Wilder Endowed Chair in Neurosurgery, Professor of Clinical Neurological Surgery, USC Keck School of Medicine, 4650 Sunset Blvd, Los Angeles, CA 90027
| | - Eric P. Wilkinson
- Huntington Medical Research Institute, 99 N. El Molino Ave, Pasadena, CA 91101
| | - Laurie S. Eisenberg
- Rick and Tina Caruso Department of Otolaryngology – Head and Neck Surgery, Keck School of Medicine of University of Southern California, 1540 Alcazar Street, Suite 204, Los Angeles, CA 90033
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Celik M, Karatas E, Kanlikama M. Outcomes of cochlear implantation in children with and without inner ear malformations. Pak J Med Sci 2018; 34:380-384. [PMID: 29805412 PMCID: PMC5954383 DOI: 10.12669/pjms.342.14066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To evaluate the auditory functions and progress of speech development in children with and without cochlear anomalies who underwent cochlear implantation due to prelingual profound sensorineural hearing loss (SNHL). Methods: This study was conducted at Gaziantep University Faculty of Medicine Ear-Nose-Throat Department, between October 2006 and December 2007. A total of 69 children (aged 6 to 24 months) diagnosed with profound SNHL were included. Patients were divided into two groups with respect to the presence of inner ear anomalies: Group-1 consisted of 41 children without inner ear anomaly, whereas Group-2 was composed of 28 patients with inner ear anomalies. The auditory performance was assessed using Listening Progress Profile Test (LPPT) and Monosyllabic Trochee Polysyllabic Test (MTP), the subsections of Evaluation of Auditory Responses to Speech (EARS) test battery. Results: Preoperative LPPT scores were 5 (12%) in both groups. Mean LPPT values after fitting in Group-1 and Group-2 on 1st, 3rd and 6th months were 18.5 (44.1%) and 19 (45.6%); 27 (64.2%) and 28 (67.3%); 31 (75%) and 34 (83%), respectively. Postoperatively, MTP scores in Group-1 and Group-2 were 7.5 (62%) and 7.7 (64%) for 3-words set; 10.4 (58%) and 10.6 (59%) for 6-words set; 14.3 (60%) and 14 (59%) for 12-words set, respectively. The rate of stimulation for electrodes was 1345 q/u (quick/unit) in Group-1 and 1310 q/u in Group-2. No statistically significant difference was detected between groups for variables under investigation. Conclusion: Cochlear implantation is an effective treatment in children with prelingual profound SNHL. Auditory performance and advancement of speech are similar for children with and without inner ear anomalies.
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Affiliation(s)
- Mustafa Celik
- Mustafa Celik, Department of Otorhinolaryngology, Harran University Medical Faculty, Sanlıurfa, Turkey
| | - Erkan Karatas
- Erkan Karatas, Department of Otorhinolaryngology, Inonu University Medical Faculty, Malatya, Turkey
| | - Muzaffer Kanlikama
- Muzaffer Kanlikama, Department of Otorhinolaryngology, Gaziantep University Medical Faculty, Gaziantep, Turkey
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Melo AS, Martins J, Silva J, Quadros J, Paiva A. Cochlear implantation in children with anomalous cochleovestibular anatomy. Auris Nasus Larynx 2017; 44:509-516. [DOI: 10.1016/j.anl.2017.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 01/11/2017] [Accepted: 02/03/2017] [Indexed: 11/15/2022]
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Kant AR, Banik AA. The Use of Lexical Neighborhood Test (LNT) in the Assessment of Speech Recognition Performance of Cochlear Implantees with Normal and Malformed Cochlea. Indian J Otolaryngol Head Neck Surg 2017; 69:338-344. [PMID: 28929065 DOI: 10.1007/s12070-017-1142-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 04/27/2017] [Indexed: 11/29/2022] Open
Abstract
The present study aims to use the model-based test Lexical Neighborhood Test (LNT), to assess speech recognition performance in early and late implanted hearing impaired children with normal and malformed cochlea. The LNT was administered to 46 children with congenital (prelingual) bilateral severe-profound sensorineural hearing loss, using Nucleus 24 cochlear implant. The children were grouped into Group 1-(early implantees with normal cochlea-EI); n = 15, 31/2-61/2 years of age; mean age at implantation-3½ years. Group 2-(late implantees with normal cochlea-LI); n = 15, 6-12 years of age; mean age at implantation-5 years. Group 3-(early implantees with malformed cochlea-EIMC); n = 9; 4.9-10.6 years of age; mean age at implantation-3.10 years. Group 4-(late implantees with malformed cochlea-LIMC); n = 7; 7-12.6 years of age; mean age at implantation-6.3 years. The following were the malformations: dysplastic cochlea, common cavity, Mondini's, incomplete partition-1 and 2 (IP-1 and 2), enlarged IAC. The children were instructed to repeat the words on hearing them. Means of the word and phoneme scores were computed. The LNT can also be used to assess speech recognition performance of hearing impaired children with malformed cochlea. When both easy and hard lists of LNT are considered, although, late implantees (with or without normal cochlea), have achieved higher word scores than early implantees, the differences are not statistically significant. Using LNT for assessing speech recognition enables a quantitative as well as descriptive report of phonological processes used by the children.
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Affiliation(s)
- Anjali R Kant
- Department of Speech and Language Pathology, Ali Yavar Jung National Institute of Speech and Hearing Disabilities (Divyangjan) (AYJNISHDD), Mumbai, Maharashtra India
| | - Arun A Banik
- Material Development Department, Ali Yavar Jung National Institute of Speech and Hearing Disabilities (Divyangjan) (AYJNISHDD), Mumbai, Maharashtra India
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Sun JQ, Sun JW, Hou XY. Cochlear implantation in Mondini's deformity: could the straight electrode array with length of 31 mm be fully inserted? Acta Otolaryngol 2017; 137:712-715. [PMID: 28498076 DOI: 10.1080/00016489.2017.1280849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CONCLUSIONS The straight electrode array with length of 31 mm can be fully inserted using round window insertion in cochlear implantation with Mondini's deformity. It is a safe and effective process, but also a challenging task of the full implantation in children with Mondini's deformity. OBJECTIVE The aim of this study is to discuss whether the straight electrode array with a length of 31 mm could be fully inserted in cochlear implantation with Mondini's deformity. METHODS A chart review of 30 patients undergoing cochlear implantation with Mondini's deformity using the electrode array with length of 31 mm was undertaken from January 2012 and December 2015 in Anhui Provincial Hospital. RESULTS Full insertion of the straight electrode array with length of 31 mm were performed successfully in all patients with Mondini's deformity using round window insertion. Resistance was not encountered while introducing the electrodes. Ten of 30 patients had cerebrospinal fluid drainage during cochlear implantation. Cerebrospinal fluid drainage was controlled with small pieces of temporalis fascia packing round window in all patients. Intra-operative neural response telemetry was performed in all patients, and results were good. The result of X-ray showed proper placement of the cochlear implant electrode array. During surgery, no patients had experienced any immediate or delayed post-operative complications such as wound infection, intracranial complication, extrusion, or migration of the implant during an average follow-up period of 6-36 months.
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Affiliation(s)
- Jia-Qiang Sun
- Department of Otolaryngology-Head and Neck Surgery, Anhui provincial hospital, Hefei, Anhui Province, PR China
| | - Jing-Wu Sun
- Department of Otolaryngology-Head and Neck Surgery, Anhui provincial hospital, Hefei, Anhui Province, PR China
| | - Xiao-Yan Hou
- Department of Otolaryngology-Head and Neck Surgery, Anhui provincial hospital, Hefei, Anhui Province, PR China
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Farhood Z, Nguyen SA, Miller SC, Holcomb MA, Meyer TA, Rizk AHG. Cochlear Implantation in Inner Ear Malformations: Systematic Review of Speech Perception Outcomes and Intraoperative Findings. Otolaryngol Head Neck Surg 2017; 156:783-793. [DOI: 10.1177/0194599817696502] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective (1) To analyze reported speech perception outcomes in patients with inner ear malformations who undergo cochlear implantation, (2) to review the surgical complications and findings, and (3) to compare the 2 classification systems of Jackler and Sennaroglu. Data Sources PubMed, Scopus (including Embase), Medline, and CINAHL Plus. Review Methods Fifty-nine articles were included that contained speech perception and/or intraoperative data. Cases were differentiated depending on whether the Jackler or Sennaroglu malformation classification was used. A meta-analysis of proportions examined incidences of complete insertion, gusher, and facial nerve aberrancy. For speech perception data, weighted means and standard deviations were calculated for all malformations for short-, medium-, and long-term follow-up. Speech tests were grouped into 3 categories—closed-set words, open-set words, and open-set sentences—and then compared through a comparison-of-means t test. Results Complete insertion was seen in 81.8% of all inner ear malformations (95% CI: 72.6-89.5); gusher was reported in 39.1% of cases (95% CI: 30.3-48.2); and facial nerve anomalies were encountered in 34.4% (95% CI: 20.1-50.3). Significant improvements in average performance were seen for closed- and open-set tests across all malformation types at 12 months postoperatively. Conclusions Cochlear implantation outcomes are favorable for those with inner ear malformations from a surgical and speech outcome standpoint. Accurate classification of anatomic malformations, as well as standardization of postimplantation speech outcomes, is necessary to improve understanding of the impact of implantation in this difficult patient population.
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Affiliation(s)
- Zachary Farhood
- Department of Otolaryngology–Head and Neck Surgery, Saint Louis University, St Louis, Missouri, USA
| | - Shaun A. Nguyen
- Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Stephen C. Miller
- Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Meredith A. Holcomb
- Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Ted A. Meyer
- Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - and Habib G. Rizk
- Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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Phan J, Houston DM, Ruffin C, Ting J, Holt RF. Factors Affecting Speech Discrimination in Children with Cochlear Implants: Evidence from Early-Implanted Infants. J Am Acad Audiol 2016; 27:480-488. [PMID: 27310406 PMCID: PMC5675533 DOI: 10.3766/jaaa.15088] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND To learn words and acquire language, children must be able to discriminate and correctly perceive phonemes. Although there has been much research on the general language outcomes of children with cochlear implants (CIs), little is known about the development of speech perception with regard to specific speech processes, such as speech discrimination. PURPOSE The purpose of this study was to investigate the development of speech discrimination in infants with CIs and identify factors that might correlate with speech discrimination skills. RESEARCH DESIGN Using a Hybrid Visual Habituation procedure, we tested infants with CIs on their ability to discriminate the vowel contrast /i/-/u/. We also gathered demographic and audiological information about each infant. STUDY SAMPLE Children who had received CIs before 2 yr of age served as participants. We tested the children at two post cochlear implantation intervals: 2-4 weeks post CI stimulation (N = 17) and 6-9 mo post CI stimulation (N = 10). DATA COLLECTION AND ANALYSIS The infants' mean looking times during the novel versus old trials of the experiment were measured. A linear regression model was used to evaluate the relationship between the normalized looking time difference and the following variables: chronological age, age at CI stimulation, gender, communication mode, and best unaided pure-tone average. RESULTS We found that the best unaided pure-tone average predicted speech discrimination at the early interval. In contrast to some previous speech perception studies that included children implanted before 3 yr of age, age at CI stimulation did not predict speech discrimination performance. CONCLUSIONS The results suggest that residual acoustic hearing before implantation might facilitate speech discrimination during the early period post cochlear implantation; with more hearing experience, communication mode might have a greater influence on the ability to discriminate speech. This and other studies on age at cochlear implantation suggest that earlier implantation might not have as large an effect on speech perception as it does on other language skills.
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Affiliation(s)
- Jennifer Phan
- DeVault Otologic Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Derek M. Houston
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH
| | - Chad Ruffin
- DeVault Otologic Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Jonathan Ting
- DeVault Otologic Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Rachael Frush Holt
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH
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le Roux T, Vinck B, Butler I, Cass N, Louw L, Nauta L, Schlesinger D, Soer M, Tshifularo M, Swanepoel DW. Predictors of pediatric cochlear implantation outcomes in South Africa. Int J Pediatr Otorhinolaryngol 2016; 84:61-70. [PMID: 27063755 DOI: 10.1016/j.ijporl.2016.02.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 01/27/2016] [Accepted: 02/25/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify and describe predictors of pediatric cochlear implantation outcomes in a South African population. METHODS A retrospective study of 301 pediatric cochlear implant (CI) recipients from five CI programs was conducted and cross-sectional outcome data were added at the time of data collection. Twenty potential prognostic factors were identified from the retrospective dataset, including demographical, CI, risk and family factors. Multiple regression analyses were performed to identify predictor variables that influence outcomes in terms of auditory performance (CAP scores), speech production (SIR scores), communication mode and educational placement. RESULTS Although implanted children within this sample did not have equal opportunity to access a second implant, bilateral implantation was strongly predictive of better auditory performance and speech production scores, an oral mode of communication and mainstream education. NICU admittance/prematurity were associated with poorer auditory performance and speech production scores, together with a higher probability for non-oral communication and non-mainstream education. The presence of one or more additional developmental condition was predictive of poorer outcomes in terms of speech production and educational placement, while a delay between diagnosis and implantation of more than one year was also related to non-mainstream education. Ethnicities other than Caucasian were predictive of poorer auditory performance scores and a lower probability for mainstream education. CONCLUSION An extensive range of prognostic indicators were identified for pediatric CI outcomes in South Africa. These predictive factors of better and poorer outcomes should guide pediatric CI services to promote optimal outcomes and assist professionals in providing evidence-based informational counseling.
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Affiliation(s)
- Talita le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.
| | - Bart Vinck
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa; Speech-Language Audiology Department, Ghent University, Belgium
| | - Iain Butler
- Department of Otorhinolaryngology, University of the Free State, Bloemfontein, South Africa
| | | | - Liebie Louw
- Department of Statistics, University of Pretoria, South Africa
| | - Leone Nauta
- Johannesburg Cochlear Implant Program, South Africa
| | - Dani Schlesinger
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Soweto, South Africa
| | - Maggi Soer
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - Mashudu Tshifularo
- Department of Otorhinolaryngology, Steve Biko Academic Hospital, University of Pretoria, South Africa
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa; Ear Sciences Centre, School of Surgery, University of Western Australia, Nedlands, Australia; Ear Science Institute Australia, Subiaco, Australia
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Kamogashira T, Akamatsu Y, Kashio A, Ogata E, Karino S, Kakigi A, Iwasaki S, Yamasoba T. Development of auditory skills after cochlear implantation in children with inner ear malformations. Acta Otolaryngol 2015; 136:78-82. [PMID: 26399885 DOI: 10.3109/00016489.2015.1087047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS CI improves hearing thresholds and auditory skills in children with most types of inner ear malformations. However, the development of sound detection skills is not as good as it is in children without inner ear malformations. OBJECTIVES To investigate the influence of inner ear malformations on development of auditory skills after cochlear implantation (CI). METHODS Records of 20 children with inner ear malformations who underwent cochlear implantation before 4 years of age and followed up for more than 2 years were retrospectively reviewed. Hearing thresholds, the Meaningful Auditory Integration Scale (MAIS), and Meaningful Use of Speech Scale (MUSS) scores before and after CI were analyzed and compared with 20 age-matched deaf children who underwent CI. RESULTS The children with inner ear malformations showed significant improvements in hearing thresholds and the MAIS and MUSS scores 1 year after CI (p < 0.01). However, their development of the MAIS scores was significantly delayed compared to children without inner ear malformations (p < 0.05), while there was no significant difference in development of the MUSS scores between them. Significant improvements in hearing thresholds and the MAIS and MUSS scores were observed in cochlear hypoplasia and incomplete partition (p < 0.05).
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Affiliation(s)
- Teru Kamogashira
- a Department of Otolaryngology , University of Tokyo , Tokyo , Japan
| | - Yusuke Akamatsu
- a Department of Otolaryngology , University of Tokyo , Tokyo , Japan
| | - Akinori Kashio
- a Department of Otolaryngology , University of Tokyo , Tokyo , Japan
| | - Erika Ogata
- a Department of Otolaryngology , University of Tokyo , Tokyo , Japan
| | - Shotaro Karino
- a Department of Otolaryngology , University of Tokyo , Tokyo , Japan
| | - Akinobu Kakigi
- a Department of Otolaryngology , University of Tokyo , Tokyo , Japan
| | - Shinichi Iwasaki
- a Department of Otolaryngology , University of Tokyo , Tokyo , Japan
| | - Tatsuya Yamasoba
- a Department of Otolaryngology , University of Tokyo , Tokyo , Japan
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Cochlear implantation in patients with inner ear bone malformations with posterior labyrinth involvement: an exploratory study. Eur Arch Otorhinolaryngol 2015; 273:893-8. [DOI: 10.1007/s00405-015-3652-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 05/07/2015] [Indexed: 11/28/2022]
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Effectiveness of cochlear implant in inner ear bone malformations with anterior labyrinth involvement. Int J Pediatr Otorhinolaryngol 2015; 79:369-73. [PMID: 25613931 DOI: 10.1016/j.ijporl.2014.12.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 12/17/2014] [Accepted: 12/22/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To study electrical stimulation, auditory functionality, and language development in patients with inner ear malformations involving the anterior labyrinth who underwent cochlear implantation. STUDY DESIGN Retrospective case review. SETTING Reference hospital for cochlear implantation. PATIENTS Review of 14 cases of severe hearing loss with major (common cavity deformity and cochlear hypoplasia) or minor (e.g., incomplete partition and basal turn aplasia) malformations. INTERVENTIONS After cochlear implantation, data were gathered on the threshold (THR) and maximum comfort level (MCL) of the electrical stimulation and the number of functioning electrodes. Auditory responses to speech (EARS protocol) subtests were used to evaluate auditory functionality and language acquisition at 6, 12, and 24 months post-implantation. Tests used were: LIP profile, MTP (3, 6 and 12 words), OLD (open set test) and CLD (close set test). Results were compared with findings in a control group of 28 cochlear implantation patients without these malformations and with congenital hearing loss. RESULTS The mean THR was 11.02μC in patients with malformations versus 3.5μC in those without, a significant difference. The THR also significantly differed between groups with major and minor malformations. Fewer functioning electrodes were used in patients with malformations. Auditory functionality scores were best in controls than in patients with malformations, who scored ≤50%, finding the lowest scores in those with major malformations. CONCLUSION Patients with inner ear malformations undergoing cochlear implantation require greater stimuli to obtain an auditory response and have worse auditory functionality outcomes; these differences are greater in those with major versus minor malformations Nevertheless, cochlear implantation appears to be beneficial for all patients with these malformations to a greater or lesser extent.
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Rachovitsas D, Psillas G, Triaridis S, Vital V, Constantinidis J. Outcome of cochlear implantation in children with cochlear malformation [corrected]. Eur Arch Otorhinolaryngol 2014; 271:2845. [PMID: 24756618 DOI: 10.1007/s00405-014-3059-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Accepted: 04/07/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Dimitrios Rachovitsas
- First Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, 1, Stilponos Kyriakidi St, 546 36, Thessaloniki, Greece
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Black J, Hickson L, Black B, Khan A. Paediatric cochlear implantation: Adverse prognostic factors and trends from a review of 174 cases. Cochlear Implants Int 2013; 15:62-77. [DOI: 10.1179/1754762813y.0000000045] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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