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Kim H, Ha J, Gil ES, Jang JH, Park HY, Choung YH. Selection of the optimal first ear for sequential bilateral cochlear implantation in children. EAR, NOSE & THROAT JOURNAL 2024; 103:NP432-NP439. [PMID: 34898304 DOI: 10.1177/01455613211064012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES When there is a difference in hearing on both ears, where to perform the first cochlear implantation (CI) becomes an important issue. The purpose of the study was to evaluate which ear should be chosen for the first implantation in sequential bilateral CI with a long inter-implant period. METHODS The study population consisted of 34 severe-to-profound sensorineural hearing loss pediatrics with the inter-implant period of ≥3 years between the first CI (CI-1) and the second CI (CI-2) before the age of 19 (mean of inter-implant period: 7.1-year). The patients were classified into Group A (CI-1 was performed on the ear with better hearing), Group B (CI-1 on the ear with worse hearing), or Group C (symmetrical hearing in both ears). Speech intelligibility test results were compared between the groups. RESULTS The monosyllabic word scores of CI-1 were excellent in Groups A (91.7±7.9%) and B (92.5±3.6%) but slightly lower in Group C (85.7±14.9%) before the second implantation (P = .487). At 3 years after the second implantation, all groups demonstrated excellent scores in the bilateral CI condition (95.9±3.0% in Group A; 99.1±.8% in Group B; 97.5±2.9% in Group C, P = .600). However, when the patients were tested in using CI-2 only in Groups A and B after using bilateral CI for 3 years, the scores were inconsistent in Group A (79.6±23.9%; range: 22.2-94.4%), while those were higher and more constant in Group B (92.9±4.8%; 86.8-100.0%). CONCLUSIONS The first CI is strongly recommended to perform on a worse hearing ear if they had different hearing levels between ears. Even with the first CI on a worse hearing ear, its performance never deteriorates. In addition, if they receive the second CI several years later, it will be likely that the second one functions better.
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Affiliation(s)
- Hantai Kim
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea
- Department of Medical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea
| | - Jungho Ha
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea
- Department of Medical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea
| | - Eun Sol Gil
- Department of Medical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea
| | - Jeong Hun Jang
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Hun Yi Park
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Yun-Hoon Choung
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea
- Department of Medical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea
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Franchella S, Concheri S, Di Pasquale Fiasca VM, Brotto D, Sorrentino F, Ortolani C, Agostinelli A, Montino S, Gregori D, Lorenzoni G, Borghini C, Trevisi P, Marioni G, Zanoletti E. Bilateral simultaneous cochlear implants in children: Best timing of surgery and long-term auditory outcomes. Am J Otolaryngol 2024; 45:104124. [PMID: 38035465 DOI: 10.1016/j.amjoto.2023.104124] [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: 10/11/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023]
Abstract
PURPOSE Evaluate the hearing outcomes of bilateral deaf children implanted simultaneously and define the most appropriate timing for surgery. MATERIALS AND METHODS Audiological CI results were retrieved in both the short-term and long-term period and compared by stratifying the patients into different subcohorts according to their age at surgery. Additional data collected were age at implant activation, etiology and timing of onset of deafness, presence of psychomotor delay. RESULTS fifty-six bilaterally implanted children were included. The short-term outcomes differed significantly when comparing groups of different ages at implantation: younger patients achieved better aided pure tone audiometry results. Considering long-term follow-up, a significant correlation was identified between an early age at implantation and the hearing outcome at ages 2 to 5 years. Perceptive levels were better at 4 years of age in the younger group. No significant differences were found between children implanted at before 12 months and between 12 and 16 months of age. CONCLUSIONS The results of the analyzed follow-up data support the hypothesis that children implanted at before 24 months are expected to have better hearing performances. Nevertheless, these results are referred to a widely heterogeneous group of patients and the duration of auditory deprivation should be considered.
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Affiliation(s)
- Sebastiano Franchella
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Stefano Concheri
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | | | - Davide Brotto
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Flavia Sorrentino
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Caterina Ortolani
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Anna Agostinelli
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Silvia Montino
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, via Loredan, 18, 35121 Padova, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, via Loredan, 18, 35121 Padova, Italy
| | - Carlotta Borghini
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, via Loredan, 18, 35121 Padova, Italy
| | - Patrizia Trevisi
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Gino Marioni
- Phoniatrics and Audiology Unit, Department of Neuroscience, University of Padova, Treviso, Italy.
| | - Elisabetta Zanoletti
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
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Degirmenci Uzun E, Batuk MO, Sennaroglu G, Sennaroglu L. Factors affecting phoneme discrimination in children with sequential bilateral cochlear implants. Int J Audiol 2021; 61:329-335. [PMID: 34148495 DOI: 10.1080/14992027.2021.1915507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To investigate the effects of a number of variables on phoneme discrimination (PD) performance in children with sequential bilateral cochlear implants (SeqBiCIs) and compare PD performance between the 2 implantation sides and between children with bilateral cochlear implants (BiCIs) and their age-matched peers with normal hearing (NH). DESIGN All participants completed the Auditory Speech Sound Evaluation Phoneme Discrimination Test. STUDY SAMPLE The sample included 23 children with SeqBiCIs as the study group and 23 with NH as the control group. RESULTS A significant difference was found between the scores of the two groups under the CI1 and CI2 conditions (p = 0.001), CI1 and BiCI conditions (p = 0.002), and CI2 and BiCI conditions (p = 0.001). PD scores with CI1 significantly depend on age at CI1 and duration of bilateral use. PD scores with CI1 were significant predictors of PD performance with CI2. Duration of BiCI use was a significant predictor of PD scores with BiCI. CONCLUSIONS The age at CI1 and the duration of bilateral cochlear implant use were found to improve phoneme discrimination performance in children with a sequential bilateral cochlear implant. According to the success of the CI1, it is possible to predict the success of CI2 use.
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Affiliation(s)
- Erva Degirmenci Uzun
- Faculty of Health Sciences, Department of Audiology, Izmir Bakircay University, Izmir, Turkey
| | - Merve Ozbal Batuk
- Faculty of Healthy Sciences, Department of Audiology, Hacettepe University, Ankara, Turkey
| | - Gonca Sennaroglu
- Faculty of Healthy Sciences, Department of Audiology, Hacettepe University, Ankara, Turkey
| | - Levent Sennaroglu
- Faculty of Medicine, Department of Otolaryngology, Hacettepe University, Ankara, Turkey
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Dempsey M, Simões-Franklin C, Walshe P, Glynn F, Viani L. A retrospective review of parents' perceptions of the impact of bilateral cochlear implants on their child's quality of life. Cochlear Implants Int 2021; 22:303-310. [PMID: 34126866 DOI: 10.1080/14670100.2021.1935526] [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: 10/21/2022]
Abstract
OBJECTIVE To evaluate the impact of simultaneous and sequential bilateral cochlear implantation on deaf children's quality of life (QoL) and to investigate the impact of inter-implant time delay for the sequentially implanted children. METHODS All completed questionnaires of the Brief Assessment of Parental Perception (BAPP), which had been routinely filled out by parents at annual review, were analysed for children with at least 12 months of bilateral implant experience. The responses for the simultaneous implanted group were compared to those who received sequential implants. Within the sequential group, the impact of shorter (<7 years) and longer (>7 years) inter-implant delays on QoL were compared. RESULTS There were a total of 176 children in the sequential group and 97 in the simultaneous group. Results indicated that most children wore their devices regularly and significant improvements in QoL were reported for all children particularly in communication and learning. QoL scores were higher for the children with simultaneous implants, followed by children with a shorter time delay between implants. CONCLUSION Both simultaneous and sequential bilateral cochlear implants significantly improved the functioning and QoL of deaf children.
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Affiliation(s)
- Mairead Dempsey
- National Hearing Implant and Viani Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Cristina Simões-Franklin
- National Hearing Implant and Viani Research Centre, Beaumont Hospital, Dublin, Ireland.,Trinity Centre for Bioengineering and School of Medicine, Trinity College, The University of Dublin Ireland, Dublin, Ireland
| | - Peter Walshe
- National Hearing Implant and Viani Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Fergal Glynn
- National Hearing Implant and Viani Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Laura Viani
- National Hearing Implant and Viani Research Centre, Beaumont Hospital, Dublin, Ireland.,Trinity Centre for Bioengineering and School of Medicine, Trinity College, The University of Dublin Ireland, Dublin, Ireland.,Royal College of Surgeons Ireland, Dublin, Ireland
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Speech Perception Growth Patterns in Prelingual Deaf Children With Bilateral Sequential Cochlear Implantation. Otol Neurotol 2019; 40:e761-e768. [PMID: 31318784 DOI: 10.1097/mao.0000000000002303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate speech perception following the first (CI-1) and second (CI-2) cochlear implantation (CI) in children with sequential bilateral CI. STUDY DESIGN Retrospective. PATIENTS Seventy children with follow-up for 60 months post CI-1 and 36 months post CI-2. MAIN OUTCOME MEASURES Word recognition score (WRS) was the main outcome. WRSs were compared by age at CI operation (group A ≤ 3.5 yr, B 3.6-8.6, for CI-1; group I ≤ 3.5 yr, II 3.6-7.0, III 7.1-13, IV > 13, for CI-2). RESULTS For CI-1, the WRS of group A exceeded 80% at 24 months post procedure, earlier than group B (54 mo). Group A also had a shorter period of CI-1 use up to the WRS plateau than group B. CI-2 showed an initial burst of WRS growth much earlier than CI-1. This initial burst was most robust within 3 months in group II, but modest in group IV. The periods of CI-2 use (11-17 mo) up to the WRS plateau were much shorter than CI-1 (40-64 mo). Group I did not show the best WRS at 1 month post CI but later exceeded the other groups. CONCLUSION Children received an immediate benefit by a burst of WRS growth from CI-2 earlier than CI-1, even within 3 months, suggesting that CI-1 gets the auditory cortex ready to foster speech processing from CI-2. The CI-2 performance depends on age at CI-2 implantation and on CI-1 performance. Our current findings will be relevant for clinicians who are counselling parents on CI-2 surgery.
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Baron S, Blanchard M, Parodi M, Rouillon I, Loundon N. Sequential bilateral cochlear implants in children and adolescents: Outcomes and prognostic factors. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:69-73. [DOI: 10.1016/j.anorl.2018.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Surgical timing for bilateral simultaneous cochlear implants: When is best? Int J Pediatr Otorhinolaryngol 2018; 109:54-59. [PMID: 29728185 DOI: 10.1016/j.ijporl.2018.03.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 03/18/2018] [Accepted: 03/21/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Hearing loss is considered the most common congenital disease and the prevalence of neonatal deafness can be estimated between 1 and 2 cases per 1000 live births. Infant deafness must be diagnosed as early as possible and an effective therapeutic intervention needs to be carried out in order to avoid the serious consequences of hearing deprivation during the evolutionary period: alterations in the development of central auditory pathways and lack of language acquisition. The cochlear implant (CI) has proved to be the best instrument to solve the problem of auditory deprivation. In particular, the bilateral CI gives the patient access to binaural hearing which results in benefits in terms of sound localisation and discrimination. The optimal age of application of the CI is a widely discussed topic in the scientific community and the current guidelines indicate a period between 12 and 24 months of age, even though the supporters of the application before 12 months of age are nowadays increasing. MATERIALS AND METHODS The study is observational, retrospective, monocentric. 49 paediatric patients (<18 years) with simultaneous bilateral CIs were included. The audiometric threshold and speech tests were carried out during the follow-up 3, 6 and 12 months after the CIs activation and when the patient reached 2 years of age. RESULTS The statistical analysis showed that undergoing bilateral implantation surgery before 2 years of age allows a satisfactory audiometric performance, while there are no particular benefits in performing the surgery before 1 year of age. As far as the speech outcome is concerned, the statistical analysis didn't show significant correlation between the earlier age of implantation and better speech performance if the operation is carried out before 2.5 years of age. CONCLUSIONS The results of the study indicate that the optimal age to perform the simultaneous bilateral CIs surgery is between 12 and 24 months, without demonstrating any particular benefit in carrying out the procedure before 1 year of age. This may be clinically relevant in terms of avoiding the risks of diagnostic mistakes and reducing the related surgical risk in children under 1 year of age.
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Dhondt CMC, Swinnen FKR, Dhooge IJM. Bilateral cochlear implantation or bimodal listening in the paediatric population: Retrospective analysis of decisive criteria. Int J Pediatr Otorhinolaryngol 2018; 104:170-177. [PMID: 29287861 DOI: 10.1016/j.ijporl.2017.10.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/25/2017] [Accepted: 10/27/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION In children with bilateral severe to profound hearing loss, bilateral hearing can be achieved by either bimodal stimulation (CIHA) or bilateral cochlear implantation (BICI). The aim of this study was to analyse the audiologic test protocol that is currently applied to make decisions regarding the bilateral hearing modality in the paediatric population. METHODS Pre- and postoperative audiologic test results of 21 CIHA, 19 sequential BICI and 12 simultaneous BICI children were examined retrospectively. RESULTS Deciding between either simultaneous BICI or unilateral implantation was mainly based on the infant's preoperative Auditory Brainstem Response thresholds. Evolution from CIHA to sequential BICI was mainly based on the audiometric test results in the contralateral (hearing aid) ear after unilateral cochlear implantation. Preoperative audiometric thresholds in the hearing aid ear were significantly better in CIHA versus sequential BICI children (p < 0.001 and p = 0.001 in unaided and aided condition, respectively). Decisive values obtained in the hearing aid ear in favour of BICI were: An average hearing threshold measured at 0.5, 1, 2 and 4 kHz of at least 93 dB HL without, and at least 52 dB HL with hearing aid together with a 40% aided speech recognition score and a 70% aided score on the phoneme discrimination subtest of the Auditory Speech Sounds Evaluation test battery. CONCLUSIONS Although pure tone audiometry offers no information about bimodal benefit, it remains the most obvious audiometric evaluation in the decision process on the mode of bilateral stimulation in the paediatric population. A theoretical test protocol for adequate evaluation of bimodal benefit in the paediatric population is proposed.
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Affiliation(s)
- Cleo M C Dhondt
- Department of Ear Nose Throat, Ghent University, De Pintelaan 185 (1P1), B - 9000, Ghent, Belgium.
| | - Freya K R Swinnen
- Department of Otorhinolaryngology, Ghent University Hospital, De Pintelaan 185 (1P1), B - 9000, Ghent, Belgium.
| | - Ingeborg J M Dhooge
- Department of Ear Nose Throat, Ghent University, De Pintelaan 185 (1P1), B - 9000, Ghent, Belgium; Department of Otorhinolaryngology, Ghent University Hospital, De Pintelaan 185 (1P1), B - 9000, Ghent, Belgium.
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Bianchin G, Tribi L, Formigoni P, Russo C, Polizzi V. Sequential pediatric bilateral cochlear implantation: The effect of time interval between implants. Int J Pediatr Otorhinolaryngol 2017; 102:10-14. [PMID: 29106853 DOI: 10.1016/j.ijporl.2017.08.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 08/21/2017] [Accepted: 08/22/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine speech intelligibility in children subjected to sequential bilateral cochlear implants (CI) surgery and to assess the influence of the inter-stage interval duration. INTRODUCTION Binaural hearing recovery can have additional benefits, especially in speech and language development in patients with congenital profound sensorineural hearing loss; so recently there has been an increase in the number of children receiving bilateral CI. METHODS Twenty-seven children who underwent sequential bilateral cochlear implant (SBCI) with a short (1-3 yrs), medium (4-6 yrs) and long (7-12 yrs) range interval between both implantations, respectively, were evaluated. All patients underwent periodic speech perception test in quiet and noise after second implant activation in three conditions: with the first or second implant alone and with both implants. Results were examined according to the inter-stage interval. RESULTS Speech intelligibility in noise was significantly better under bilateral conditions than either ear alone, in all three groups. Small improvements were seen in quiet, especially in the third group (6-12 yrs). CONCLUSION Benefits of second implant in the early-implanted children and after a short inter-implant delay are more evident. However our study support that, even after a long period of deafness and despite a prolonged inter-stage interval, sequential bilateral cochlear implantation should be considered. LEVEL OF EVIDENCE Level 4.
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Affiliation(s)
- Giovanni Bianchin
- Department of Otolaryngology and Audiology, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy.
| | - Lorenzo Tribi
- Department of Otolaryngology and Audiology, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Patrizia Formigoni
- Department of Otolaryngology and Audiology, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Carmela Russo
- Department of Otolaryngology and Audiology, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Valeria Polizzi
- Department of Otolaryngology and Audiology, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
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Kraaijenga VJC, Ramakers GGJ, Smulders YE, van Zon A, Stegeman I, Smit AL, Stokroos RJ, Hendrice N, Free RH, Maat B, Frijns JHM, Briaire JJ, Mylanus EAM, Huinck WJ, Van Zanten GA, Grolman W. Objective and Subjective Measures of Simultaneous vs Sequential Bilateral Cochlear Implants in Adults: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg 2017; 143:881-890. [PMID: 28655036 DOI: 10.1001/jamaoto.2017.0745] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance To date, no randomized clinical trial on the comparison between simultaneous and sequential bilateral cochlear implants (BiCIs) has been performed. Objective To investigate the hearing capabilities and the self-reported benefits of simultaneous BiCIs compared with those of sequential BiCIs. Design, Setting, and Participants A multicenter randomized clinical trial was conducted between January 12, 2010, and September 2, 2012, at 5 tertiary referral centers among 40 participants eligible for BiCIs. Main inclusion criteria were postlingual severe to profound hearing loss, age 18 to 70 years, and a maximum duration of 10 years without hearing aid use in both ears. Data analysis was conducted from May 24 to June 12, 2016. Interventions The simultaneous BiCI group received 2 cochlear implants during 1 surgical procedure. The sequential BiCI group received 2 cochlear implants with an interval of 2 years between implants. Main Outcomes and Measures First, the results 1 year after receiving simultaneous BiCIs were compared with the results 1 year after receiving sequential BiCIs. Second, the results of 3 years of follow-up for both groups were compared separately. The primary outcome measure was speech intelligibility in noise from straight ahead. Secondary outcome measures were speech intelligibility in noise from spatially separated sources, speech intelligibility in silence, localization capabilities, and self-reported benefits assessed with various hearing and quality of life questionnaires. Results Nineteen participants were randomized to receive simultaneous BiCIs (11 women and 8 men; median age, 52 years [interquartile range, 36-63 years]), and another 19 participants were randomized to undergo sequential BiCIs (8 women and 11 men; median age, 54 years [interquartile range, 43-64 years]). Three patients did not receive a second cochlear implant and were unavailable for follow-up. Comparable results were found 1 year after simultaneous or sequential BiCIs for speech intelligibility in noise from straight ahead (difference, 0.9 dB [95% CI, -3.1 to 4.4 dB]) and all secondary outcome measures except for localization with a 30° angle between loudspeakers (difference, -10% [95% CI, -20.1% to 0.0%]). In the sequential BiCI group, all participants performed significantly better after the BiCIs on speech intelligibility in noise from spatially separated sources and on all localization tests, which was consistent with most of the participants' self-reported hearing capabilities. Speech intelligibility-in-noise results improved in the simultaneous BiCI group up to 3 years following the BiCIs. Conclusions and Relevance This study shows comparable objective and subjective hearing results 1 year after receiving simultaneous BiCIs and sequential BiCIs with an interval of 2 years between implants. It also shows a significant benefit of sequential BiCIs over a unilateral cochlear implant. Until 3 years after receiving simultaneous BiCIs, speech intelligibility in noise significantly improved compared with previous years. Trial Registration trialregister.nl Identifier: NTR1722.
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Affiliation(s)
- Véronique J C Kraaijenga
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Geerte G J Ramakers
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Yvette E Smulders
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Alice van Zon
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Adriana L Smit
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Robert J Stokroos
- Department of Otorhinolaryngology-Head and Neck Surgery, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Nadia Hendrice
- Department of Otorhinolaryngology-Head and Neck Surgery, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Rolien H Free
- Department of Otorhinolaryngology, University Medical Center Groningen, Groningen, the Netherlands.,Graduate School of Medical Sciences, Research School of Behavioural and Cognitive Neurosciences, University Medical Center Groningen, Groningen, the Netherlands
| | - Bert Maat
- Department of Otorhinolaryngology, University Medical Center Groningen, Groningen, the Netherlands.,Graduate School of Medical Sciences, Research School of Behavioural and Cognitive Neurosciences, University Medical Center Groningen, Groningen, the Netherlands
| | - Johan H M Frijns
- Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, the Netherlands
| | - Jeroen J Briaire
- Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, the Netherlands
| | - E A M Mylanus
- Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Wendy J Huinck
- Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Gijsbert A Van Zanten
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Wilko Grolman
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
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12
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Litovsky RY, Gordon K. Bilateral cochlear implants in children: Effects of auditory experience and deprivation on auditory perception. Hear Res 2016; 338:76-87. [PMID: 26828740 PMCID: PMC5647834 DOI: 10.1016/j.heares.2016.01.003] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 01/07/2016] [Accepted: 01/11/2016] [Indexed: 11/29/2022]
Abstract
Spatial hearing skills are essential for children as they grow, learn and play. These skills provide critical cues for determining the locations of sources in the environment, and enable segregation of important sounds, such as speech, from background maskers or interferers. Spatial hearing depends on availability of monaural cues and binaural cues. The latter result from integration of inputs arriving at the two ears from sounds that vary in location. The binaural system has exquisite mechanisms for capturing differences between the ears in both time of arrival and intensity. The major cues that are thus referred to as being vital for binaural hearing are: interaural differences in time (ITDs) and interaural differences in levels (ILDs). In children with normal hearing (NH), spatial hearing abilities are fairly well developed by age 4-5 years. In contrast, most children who are deaf and hear through cochlear implants (CIs) do not have an opportunity to experience normal, binaural acoustic hearing early in life. These children may function by having to utilize auditory cues that are degraded with regard to numerous stimulus features. In recent years there has been a notable increase in the number of children receiving bilateral CIs, and evidence suggests that while having two CIs helps them function better than when listening through a single CI, these children generally perform worse than their NH peers. This paper reviews some of the recent work on bilaterally implanted children. The focus is on measures of spatial hearing, including sound localization, release from masking for speech understanding in noise and binaural sensitivity using research processors. Data from behavioral and electrophysiological studies are included, with a focus on the recent work of the authors and their collaborators. The effects of auditory plasticity and deprivation on the emergence of binaural and spatial hearing are discussed along with evidence for reorganized processing from both behavioral and electrophysiological studies. The consequences of both unilateral and bilateral auditory deprivation during development suggest that the relevant set of issues is highly complex with regard to successes and the limitations experienced by children receiving bilateral cochlear implants. This article is part of a Special Issue entitled .
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Affiliation(s)
- Ruth Y Litovsky
- University of Wisconsin-Madison, 1500 Highland Ave, Madison, WI, 53705, United States.
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Mancini P, Giallini I, Prosperini L, D'alessandro HD, Guerzoni L, Murri A, Cuda D, Ruoppolo G, De Vincentiis M, Nicastri M. Level of emotion comprehension in children with mid to long term cochlear implant use: How basic and more complex emotion recognition relates to language and age at implantation. Int J Pediatr Otorhinolaryngol 2016; 87:219-32. [PMID: 27368475 DOI: 10.1016/j.ijporl.2016.06.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 06/09/2016] [Accepted: 06/10/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The current study was designed with three main aims: To document the level of emotional comprehension skills, from basic to more complex ones, reached by a wide sample of cochlear implant (CI) deaf children with at least 36 months of device use; To investigate subjective and audiological factors that can affect their emotional development; To identify, if present, a "critical age", in which early intervention might positively affect adequate emotional competence development. DESIGN This is an observational cohort study. Children with congenital severe/profound deafness were selected based on: aged by 4-11 years, minimum of 36 months of CI use, Italian as the primary language in the family; normal cognitive level and absence of associated disorders or socio-economic difficulties. Audiological characteristics and language development were assessed throughout standardized tests, to measure speech perception in quiet, lexical comprehension and production. The development of emotions' understanding was assessed using the Test of Emotion Comprehension (TEC) of Pons and Harris, a hierarchical developmental model, where emotion comprehension is organized in 3 Stages (external, mental and reflective). Statistical analysis was accomplished via the Spearman Rank Correlation Coefficient, to study the relationship between the personal and audiological characteristics; a multivariate linear regression analysis was carried out to find which variables were better associated with the standardized TEC values; a chi-squared test with Yate's continuity correction and Mann-Whitney U test were used to account for differences between continuous variables and proportions. RESULTS 72 children (40 females, 32 males) with a mean age of 8.1 years were included. At TEC score, 57 children showed normal range performances (79.17% of recipients) and 15 fell below average (20.83% of recipients). The 16.63% of older subjects (range of age 8-12 years) didn't master the Stage 3 (reflective), which is normally acquired by 8 years of age and failed 2 or all the 3 items of this component. Subjects implanted within 18 months of age had better emotion comprehension skills. TEC results were also positively correlated with an early diagnosis, a longer implant use, better auditory skills and higher scores on lexical and morphosintactic tests. On the contrary, it was negatively correlated with the presence of siblings and the order of birth. The gender, the side and the severity of deafness, type of implant and strategy were not correlated. CONCLUSIONS Early implanted children have more chance to develop adequate emotion comprehension, especially when the complex aspects are included, due to the very strong link between listening and language skills and emotional development. Furthermore, longer CI auditory experience along with early intervention allows an adequate communication development which positively influences the acquisition of such competencies.
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Affiliation(s)
- Patrizia Mancini
- Department of Sense Organs, University Sapienza of Rome, 00161 Rome, Italy.
| | - Ilaria Giallini
- Department of Sense Organs, University Sapienza of Rome, 00161 Rome, Italy.
| | - Luca Prosperini
- Department of Neurology and Psychiatry, University Sapienza of Rome, 00161 Rome, Italy.
| | | | - Letizia Guerzoni
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, 29121 Piacenza, Italy.
| | - Alessandra Murri
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, 29121 Piacenza, Italy.
| | - Domenico Cuda
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, 29121 Piacenza, Italy.
| | - Giovanni Ruoppolo
- Department of Sense Organs, University Sapienza of Rome, 00161 Rome, Italy.
| | | | - Maria Nicastri
- Department of Sense Organs, University Sapienza of Rome, 00161 Rome, Italy.
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