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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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Yıldırım Gökay N, Orhan E, Tutar V, Tutar H, Karamert R, Gündüz B. Adults With Cochlear Implants: Residual Hearing, Musical Perception, and Temporal Skills. Am J Audiol 2024; 33:379-385. [PMID: 38407075 DOI: 10.1044/2024_aja-23-00266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
PURPOSE The main purpose of the study is to investigate whether the presence of residual hearing before cochlear implantation has an effect on temporal pattern recognition skills and musical perception in adults. METHOD The study included adults with cochlear implants who were between the ages of 20 and 45 years. Adults with cochlear implants were divided into two groups: absent (n = 20) and available (n = 20) groups according to residual hearing before implantation. Frequency Pattern and Duration Pattern tests were applied to evaluate temporal pattern recognition, and the "Music-Related Quality of Life Questionnaire" was applied to evaluate musical perceptions. RESULTS There were no statistically significant differences between the groups in terms of cochlear-implanted hearing thresholds and speech recognition scores, musical perception, and musical activities, according to their residual hearing. On the other hand, the frequency and duration pattern recognition skills were statistically significantly better in adults with residual hearing. Also, statistically significant correlations were obtained in terms of temporal skills and musical perception subskills. CONCLUSIONS The presence of residual hearing before cochlear implantation may affect temporal auditory processing skills. It is concluded that the integration of cochlear implants may affect temporal processing skills in adults as well as quality of life. It is recommended that experts be aware of this issue and pay attention to residual hearing.
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Affiliation(s)
- Nuriye Yıldırım Gökay
- Faculty of Health Sciences, Department of Audiology, Gazi University, Ankara, Turkey
| | - Emre Orhan
- Faculty of Health Sciences, Department of Audiology, Gazi University, Ankara, Turkey
| | - Volkan Tutar
- Faculty of Health Sciences, Department of Audiology, Gazi University, Ankara, Turkey
| | - Hakan Tutar
- Faculty of Medicine, Department of Otorhinolaryngology, Gazi University, Ankara, Turkey
| | - Recep Karamert
- Faculty of Medicine, Department of Otorhinolaryngology, Gazi University, Ankara, Turkey
| | - Bülent Gündüz
- Faculty of Health Sciences, Department of Audiology, Gazi University, Ankara, Turkey
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MacKay CI, Kuthubutheen J, Campbell AJ. An overview of risk factors, management and prevention of cochlear implant infections. Curr Opin Infect Dis 2024; 37:220-225. [PMID: 38545833 DOI: 10.1097/qco.0000000000001011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
PURPOSE OF REVIEW With cochlear implantation becoming increasingly performed worldwide, an understanding of the risk factors, preventive measures, and management of cochlear implant (CI) infection remains important given the significant morbidity and cost it conveys. RECENT FINDINGS At the turn of the 21st century there was a decrease in rates of CI infection, particularly meningitis, following the discontinuation of positioner use for CI. However, in more recent years rates of CI infection have remained largely static. Recently, studies evaluating preventive measures such as pneumococcal vaccination, S. aureus decolonization and surgical antibiotic prophylaxis have emerged in the literature. SUMMARY Prompt recognition of CI infection and appropriate investigation and management are key, however at present treatment is largely informed by cohort and case-control studies and expert opinion. Preventive measures including pneumococcal vaccination, S. aureus decolonization and preoperative antibiotic prophylaxis play a role in reducing rates of CI infection. However, there remains a need for well designed clinical trials to provide higher level evidence to better guide preventive measures for, and management decisions of, CI infections in the future.
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Affiliation(s)
- Conor I MacKay
- Department of Infectious Diseases, Perth Children's Hospital
| | - Jafri Kuthubutheen
- Department of Otolaryngology Head and Neck Surgery, Perth Children's Hospital
- Division of Surgery, Medical School, University of Western, Australia
| | - Anita J Campbell
- Department of Infectious Diseases, Perth Children's Hospital
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands
- Division of Paediatrics, School of Medicine, University of Western Australia, Perth, Australia
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Magee LC, Dunn CC, Vovos R, Zeitler DM, Schwartz SR, Anne S. Cochlear Implantation Outcomes in Pediatric Unilateral Hearing Loss: Impact of Device Use and Direct Input. Otolaryngol Head Neck Surg 2024; 170:1449-1455. [PMID: 38314892 PMCID: PMC11058022 DOI: 10.1002/ohn.657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/27/2023] [Accepted: 01/06/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE To investigate the impact of daily cochlear implant (CI) use on speech perception outcomes among children with unilateral hearing loss (UHL). STUDY DESIGN Multi-institutional retrospective case series of pediatric patients with UHL who underwent CI between 2018 to 2022. SETTING Three tertiary children's hospitals. METHODS Demographics were obtained including duration of deafness and age at CI. Best consonant-nucleus-consonant (CNC) word scores and data logs describing hours of CI usage were assessed postimplantation. Use of direct audio input (DAI) during rehabilitation was recorded. RESULTS Twenty-seven children were included, with a mean age at CI of 7.8 years. Mean datalogging time was 7.8 ± 3.0 hours/day. 40.7% of children utilized daily DAI. The mean CNC score using the best score during the study period was 34.9%. There was no significant correlation between hours of CI usage and CNC score. There was a significant improvement in CNC score associated with whether the child used DAI during rehabilitation (CNC 50.91% [yes] vs 23.81% [no]), which remained significant when adjusting for age at CI, duration of deafness, and data log hours. CONCLUSION Unlike children with bilateral hearing loss and CI, children with UHL and CI demonstrate no significant correlation between hours of daily CI usage and CNC scores. However, children who used DAI during postoperative rehabilitation achieved significantly higher CNC scores than those who did not. This suggests that rehabilitation focused on isolated listening with the implanted ear maybe critical in optimizing outcomes with CI in UHL patients.
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Affiliation(s)
- Lacey C. Magee
- Head and Neck Institute, Cleveland Clinic Foundation: Cleveland Clinic, Cleveland, Ohio, USA
| | - Camille C. Dunn
- Department of Head and Neck Surgery–Otolaryngology, University of Iowa, Iowa City, Iowa, USA
| | - Rachel Vovos
- Head and Neck Institute, Cleveland Clinic Foundation: Cleveland Clinic, Cleveland, Ohio, USA
| | - Daniel M. Zeitler
- Department of Otolaryngology/Head and Neck Surgery, Section of Otology/Neurotology, Virginia Mason Medical Center, Seattle, Washington, USA
| | - Seth R. Schwartz
- Department of Otolaryngology/Head and Neck Surgery, Section of Otology/Neurotology, Virginia Mason Medical Center, Seattle, Washington, USA
| | - Samantha Anne
- Head and Neck Institute, Cleveland Clinic Foundation: Cleveland Clinic, Cleveland, Ohio, USA
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Inguscio BMS, Cartocci G, Sciaraffa N, Nicastri M, Giallini I, Aricò P, Greco A, Babiloni F, Mancini P. Two are better than one: Differences in cortical EEG patterns during auditory and visual verbal working memory processing between Unilateral and Bilateral Cochlear Implanted children. Hear Res 2024; 446:109007. [PMID: 38608331 DOI: 10.1016/j.heares.2024.109007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024]
Abstract
Despite the proven effectiveness of cochlear implant (CI) in the hearing restoration of deaf or hard-of-hearing (DHH) children, to date, extreme variability in verbal working memory (VWM) abilities is observed in both unilateral and bilateral CI user children (CIs). Although clinical experience has long observed deficits in this fundamental executive function in CIs, the cause to date is still unknown. Here, we have set out to investigate differences in brain functioning regarding the impact of monaural and binaural listening in CIs compared with normal hearing (NH) peers during a three-level difficulty n-back task undertaken in two sensory modalities (auditory and visual). The objective of this pioneering study was to identify electroencephalographic (EEG) marker pattern differences in visual and auditory VWM performances in CIs compared to NH peers and possible differences between unilateral cochlear implant (UCI) and bilateral cochlear implant (BCI) users. The main results revealed differences in theta and gamma EEG bands. Compared with hearing controls and BCIs, UCIs showed hypoactivation of theta in the frontal area during the most complex condition of the auditory task and a correlation of the same activation with VWM performance. Hypoactivation in theta was also observed, again for UCIs, in the left hemisphere when compared to BCIs and in the gamma band in UCIs compared to both BCIs and NHs. For the latter two, a correlation was found between left hemispheric gamma oscillation and performance in the audio task. These findings, discussed in the light of recent research, suggest that unilateral CI is deficient in supporting auditory VWM in DHH. At the same time, bilateral CI would allow the DHH child to approach the VWM benchmark for NH children. The present study suggests the possible effectiveness of EEG in supporting, through a targeted approach, the diagnosis and rehabilitation of VWM in DHH children.
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Affiliation(s)
- Bianca Maria Serena Inguscio
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, Rome 00161, Italy; BrainSigns Srl, Via Tirso, 14, Rome 00198, Italy.
| | - Giulia Cartocci
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, Rome 00161, Italy; BrainSigns Srl, Via Tirso, 14, Rome 00198, Italy
| | | | - Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome 00161, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome 00161, Italy
| | - Pietro Aricò
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, Rome 00161, Italy; BrainSigns Srl, Via Tirso, 14, Rome 00198, Italy; Department of Computer, Control, and Management Engineering "Antonio Ruberti", Sapienza University of Rome, Via Ariosto 125, Rome 00185, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome 00161, Italy
| | - Fabio Babiloni
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, Rome 00161, Italy; BrainSigns Srl, Via Tirso, 14, Rome 00198, Italy; Department of Computer Science, Hangzhou Dianzi University, Xiasha Higher Education Zone, Hangzhou 310018, China
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome 00161, Italy
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de Beer C, Bennett RJ, Eikelboom RH, le Roux T. Impact of paediatric cochlear implantation on family life: a conceptual framework informed by parents. Disabil Rehabil 2024:1-14. [PMID: 38606527 DOI: 10.1080/09638288.2024.2337094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/24/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE While the impact of paediatric cochlear implantation on parents and siblings are recognised, limited evidence exists regarding the effect of paediatric cochlear implantation on the entire family life (e.g., routine interactions, family activities). This study aimed to describe the impact of paediatric cochlear implantation on family life as perceived by parents, using concept mapping. MATERIALS AND METHODS Parents of paediatric cochlear implant (CI) recipients (n = 29) participated in this concept mapping study to generate, group, and rate statements regarding the impact of paediatric cochlear implantation on family life. RESULTS In total, 99 unique statements described the impact of paediatric cochlear implantation on family life. The concept map revealed six concepts, namely (i) Financial Outlay and Supports; (ii) Education and Therapy; (iii) Responsibilities and Sacrifices; (iv) Extended Family and Community; (v) Spouses and Siblings and (vi) Achievements and Enrichments. CONCLUSIONS This study highlights the multiple areas of family life affected by paediatric cochlear implantation. To improve patient-and-family-centered care, these factors must be considered during pre-operative and successive counselling of paediatric CI recipients and their families.
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Affiliation(s)
- Chané de Beer
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Rebecca J Bennett
- Ear Science Institute Australia, Subiaco, WA, Australia
- Curtin University, Perth, WA, Australia
- National Acoustic Laboratories, Macquarie University, Sydney, NSW, Australia
| | - Robert H Eikelboom
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Ear Science Institute Australia, Subiaco, WA, Australia
- Curtin University, Perth, WA, Australia
- Centre for Ear Sciences, University of Western Australia, Perth, WA, Australia
| | - Talita le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
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Fagniart S, Delvaux V, Harmegnies B, Huberlant A, Huet K, Piccaluga M, Watterman I, Charlier B. Nasal/Oral Vowel Perception in French-Speaking Children With Cochlear Implants and Children With Typical Hearing. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1243-1267. [PMID: 38457658 DOI: 10.1044/2024_jslhr-23-00274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
PURPOSE The present study investigates the perception of vowel nasality in French-speaking children with cochlear implants (CIs; CI group) and children with typical hearing (TH; TH group) aged 4-12 years. By investigating the vocalic nasality feature in French, the study aims to document more broadly the effects of the acoustic limitations of CI in processing segments characterized by acoustic cues that require optimal spectral resolution. The impact of various factors related to children's characteristics, such as chronological/auditory age, age of implantation, and exposure to cued speech, has been studied on performance, and the acoustic characteristics of the stimuli in perceptual tasks have also been investigated. METHOD Identification and discrimination tasks involving French nasal and oral vowels were administered to two groups of children: 13 children with CIs (CI group) and 25 children with TH (TH group) divided into three age groups (4-6 years, 7-9 years, and 10-12 years). French nasal vowels were paired with their oral phonological counterpart (phonological pairing) as well as to the closest oral vowel in terms of phonetic proximity (phonetic pairing). Post hoc acoustic analyses of the stimuli were linked to the performance in perception. RESULTS The results indicate an effect of the auditory status on the performance in the two tasks, with the CI group performing at a lower level than the TH group. However, the scores of the children in the CI group are well above chance level, exceeding 80%. The most common errors in identification were substitutions between nasal vowels and phonetically close oral vowels as well as confusions between the phoneme /u/ and other oral vowels. Phonetic pairs showed lower discrimination performance in the CI group with great variability in the results. Age effects were observed only in TH children for nasal vowel identification, whereas in children with CIs, a positive impact of cued speech practice and early implantation was found. Differential links between performance and acoustic characteristics were found within our groups, suggesting that in children with CIs, selective use of certain acoustic features, presumed to be better transmitted by the implant, leads to better perceptual performance. CONCLUSIONS The study's results reveal specific challenges in children with CIs when processing segments characterized by fine spectral resolution cues. However, the CI children in our study appear to effectively compensate for these difficulties by utilizing various acoustic cues assumed to be well transmitted by the implant, such as cues related to the temporal resolution of stimuli. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25328704.
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Affiliation(s)
- Sophie Fagniart
- Language Sciences and Metrology Unit, University of Mons, Belgium
- Research Institute for Language Science and Technology, University of Mons, Belgium
| | - Véronique Delvaux
- Language Sciences and Metrology Unit, University of Mons, Belgium
- Research Institute for Language Science and Technology, University of Mons, Belgium
- Université Libre de Bruxelles, Brussels, Belgium
- Fund for Scientific Research (F.R.S.-FNRS), Brussels, Belgium
| | - Bernard Harmegnies
- Research Institute for Language Science and Technology, University of Mons, Belgium
- Université Libre de Bruxelles, Brussels, Belgium
| | - Anne Huberlant
- Functional Rehabilitation Center "Comprendre et Parler," Brussels, Belgium
| | - Kathy Huet
- Language Sciences and Metrology Unit, University of Mons, Belgium
- Research Institute for Language Science and Technology, University of Mons, Belgium
| | - Myriam Piccaluga
- Language Sciences and Metrology Unit, University of Mons, Belgium
- Research Institute for Language Science and Technology, University of Mons, Belgium
| | - Isabelle Watterman
- Université Libre de Bruxelles, Brussels, Belgium
- Functional Rehabilitation Center "Comprendre et Parler," Brussels, Belgium
| | - Brigitte Charlier
- Université Libre de Bruxelles, Brussels, Belgium
- Functional Rehabilitation Center "Comprendre et Parler," Brussels, Belgium
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Yıldırım Gökay N, Demirtaş B, Özbal Batuk M, Yücel E, Sennaroğlu G. Auditory performance and language skills in children with auditory brainstem implants and cochlear implants. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08594-0. [PMID: 38573512 DOI: 10.1007/s00405-024-08594-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/01/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE This study aims to evaluate school-age language skills and auditory performance in different listening situations in children with cochlear implants and auditory brainstem implants. METHOD The study included 60 children between the ages of 5 and 9 years with cochlear implants (CI) and auditory brainstem implants (ABI). The volunteer children were divided into two groups: bimodal CI-ABI and bilateral CI users. Test of Language Development: Primary (TOLD-P:4), which assesses components of language such as phonology, morphology, syntax and semantics, was used to evaluate school-age language skills. Children's Auditory Performance Scale (CHAPS) was used to measure their listening performance in quiet, noisy, multi-stimulus environments and their auditory attention and memory skills in daily life. The correlations between language and auditory performance were analyzed and compared between the two groups. RESULTS Children with ABI showed poorer performance in school-age language skills and auditory performance in different listening environments (p < 0.05). Significant correlations were between school-age language skills and auditory performance (p < 0.05). CONCLUSION Improved auditory performance is crucial for the development of school-age language skills. To improve auditory performance in children with ABI in different listening environments, assistive listening devices, acoustic environmental arrangements, informative activities, etc., should be used.
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Affiliation(s)
- Nuriye Yıldırım Gökay
- Department of Audiology, Faculty of Healthy Science, Gazi University, Emek, 06900, Ankara, Turkey.
| | - Beyza Demirtaş
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Merve Özbal Batuk
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Esra Yücel
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Gonca Sennaroğlu
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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Yildirim Gökay N, Yücel E. Evaluation of language, attention, and memory skills in children with auditory brainstem implants. Eur Arch Otorhinolaryngol 2024; 281:1683-1692. [PMID: 37851114 DOI: 10.1007/s00405-023-08262-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/25/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE This study aimed to evaluate attention, memory, and language skills in children with auditory brainstem implants and cochlear implants. METHODS This study included 20 children with auditory brainstem implants (ABI) and 20 cochlear implanted (CI) children between the ages of 6 years and 8 years 11 months and their families. "Test of Language Development: Primary (TOLD-P:4)" was used to assess language skills, "STROOP Test, Visual-Aural Digit Span (VADS) test, and Cancellation Test" were used to evaluate attention and memory skills. In addition, the functional outcomes of hearing skills in daily life were scored by "Auditory Behavior in Everyday Life (ABEL) scale". The significance level was determined as 0.05. RESULTS Children with ABI showed lower language skills than children with CI in terms of TOLD-P:4 language test scores, STROOP sub-test completion times, and the VADS and Cancellation test scores (p < 0.05). In addition, statistically significant correlations were found between language, attention, memory skills, and auditory behavior scale. CONCLUSIONS This study is one of the limited numbers of studies investigating cognitive processes in children with ABI. Since attention and memory are correlated with language skills, it is recommended that the development of cognition should be considered in follow-up and intervention approaches of children with ABI and/or CI.
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Affiliation(s)
- Nuriye Yildirim Gökay
- Department of Audiology, Gazi University Faculty of Health Sciences, 06745, Ankara, Turkey.
| | - Esra Yücel
- Department of Audiology, Hacettepe University, Faculty of Health Sciences, Ankara, Turkey
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Nourski KV, Steinschneider M, Rhone AE, Berger JI, Dappen ER, Kawasaki H, Howard III MA. Intracranial electrophysiology of spectrally degraded speech in the human cortex. Front Hum Neurosci 2024; 17:1334742. [PMID: 38318272 PMCID: PMC10839784 DOI: 10.3389/fnhum.2023.1334742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/28/2023] [Indexed: 02/07/2024] Open
Abstract
Introduction Cochlear implants (CIs) are the treatment of choice for severe to profound hearing loss. Variability in CI outcomes remains despite advances in technology and is attributed in part to differences in cortical processing. Studying these differences in CI users is technically challenging. Spectrally degraded stimuli presented to normal-hearing individuals approximate input to the central auditory system in CI users. This study used intracranial electroencephalography (iEEG) to investigate cortical processing of spectrally degraded speech. Methods Participants were adult neurosurgical epilepsy patients. Stimuli were utterances /aba/ and /ada/, spectrally degraded using a noise vocoder (1-4 bands) or presented without vocoding. The stimuli were presented in a two-alternative forced choice task. Cortical activity was recorded using depth and subdural iEEG electrodes. Electrode coverage included auditory core in posteromedial Heschl's gyrus (HGPM), superior temporal gyrus (STG), ventral and dorsal auditory-related areas, and prefrontal and sensorimotor cortex. Analysis focused on high gamma (70-150 Hz) power augmentation and alpha (8-14 Hz) suppression. Results Chance task performance occurred with 1-2 spectral bands and was near-ceiling for clear stimuli. Performance was variable with 3-4 bands, permitting identification of good and poor performers. There was no relationship between task performance and participants demographic, audiometric, neuropsychological, or clinical profiles. Several response patterns were identified based on magnitude and differences between stimulus conditions. HGPM responded strongly to all stimuli. A preference for clear speech emerged within non-core auditory cortex. Good performers typically had strong responses to all stimuli along the dorsal stream, including posterior STG, supramarginal, and precentral gyrus; a minority of sites in STG and supramarginal gyrus had a preference for vocoded stimuli. In poor performers, responses were typically restricted to clear speech. Alpha suppression was more pronounced in good performers. In contrast, poor performers exhibited a greater involvement of posterior middle temporal gyrus when listening to clear speech. Discussion Responses to noise-vocoded speech provide insights into potential factors underlying CI outcome variability. The results emphasize differences in the balance of neural processing along the dorsal and ventral stream between good and poor performers, identify specific cortical regions that may have diagnostic and prognostic utility, and suggest potential targets for neuromodulation-based CI rehabilitation strategies.
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Affiliation(s)
- Kirill V. Nourski
- Department of Neurosurgery, The University of Iowa, Iowa City, IA, United States
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, United States
| | - Mitchell Steinschneider
- Department of Neurosurgery, The University of Iowa, Iowa City, IA, United States
- Departments of Neurology and Neuroscience, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Ariane E. Rhone
- Department of Neurosurgery, The University of Iowa, Iowa City, IA, United States
| | - Joel I. Berger
- Department of Neurosurgery, The University of Iowa, Iowa City, IA, United States
| | - Emily R. Dappen
- Department of Neurosurgery, The University of Iowa, Iowa City, IA, United States
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, United States
| | - Hiroto Kawasaki
- Department of Neurosurgery, The University of Iowa, Iowa City, IA, United States
| | - Matthew A. Howard III
- Department of Neurosurgery, The University of Iowa, Iowa City, IA, United States
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, United States
- Pappajohn Biomedical Institute, The University of Iowa, Iowa City, IA, United States
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İkiz Bozsoy M, Yücel E. Language, cognitive, and speech in noise perception abilities of children with cochlear ımplants: a comparative analysis by implantation period and bilateral versus unilateral cochlear implants. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08462-x. [PMID: 38244031 DOI: 10.1007/s00405-024-08462-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/08/2024] [Indexed: 01/22/2024]
Abstract
PURPOSE The purpose of this study was to compare the language, cognitive, and speech in noise (SiN) perception abilities of children with cochlear implants (CIs) to those of their peers with NH by grouping them according to their implantation period (12-18 months/19-24 months) and unilateral/bilateral CI use. METHODS The sample comprised 50 children with cochlear implants (CIs) and 20 children with normal hearing (NH), ages 6-9 years. Children's language, cognitive, and speech in noise (SiN) perception skills were assessed. RESULTS Children with CIs between 12 and 18 months and 19 and 24 months performed more poorly than children with NH on language, verbal memory (VM), verbal-short-term memory (V-STM), verbal working memory (V-WM), rapid naming, and speech in noise (SiN) perception abilities measures (p < 0.001). In addition, children with CIs between 19 and 24 months performed worse on rapid naming and V-WM tasks than children with CIs between 12 and 18 months (p < 0.017). Children with unilateral and bilateral CI performed more poorly than children with NH on language, VM, V-STM, V-WM, rapid naming, and SiN perception abilities assessments (p < 0.001). Additionally children with unilateral CI users performed poorly than children with bilateral CI users on SiN perception (p < 0.017). CONCLUSIONS In children with congenital hearing loss (CHL), cochlear implantation between 12 and 18 months or sequential bilateral implantation is not sufficient for these children to perform like their NH peers in language, cognitive, and SiN perception abilities. In addition, intervention approaches should focus not only on increasing language skills, but also on cognitive abilities.
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Affiliation(s)
- Merve İkiz Bozsoy
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, 06100, Ankara, Turkey.
| | - Esra Yücel
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, 06100, Ankara, Turkey
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Everhardt MK, Jung DE, Stiensma B, Lowie W, Başkent D, Sarampalis A. Foreign Language Acquisition in Adolescent Cochlear Implant Users. Ear Hear 2024; 45:174-185. [PMID: 37747307 PMCID: PMC10718217 DOI: 10.1097/aud.0000000000001410] [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: 10/14/2022] [Accepted: 06/20/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES This study explores to what degree adolescent cochlear implant (CI) users can learn a foreign language in a school setting similar to their normal-hearing (NH) peers despite the degraded auditory input. DESIGN A group of native Dutch adolescent CI users (age range 13 to 17 years) learning English as a foreign language at secondary school and a group of NH controls (age range 12 to 15 years) were assessed on their Dutch and English language skills using various language tasks that either relied on the processing of auditory information (i.e., listening task) or on the processing of orthographic information (i.e., reading and/or gap-fill task). The test battery also included various auditory and cognitive tasks to assess whether the auditory and cognitive functioning of the learners could explain the potential variation in language skills. RESULTS Results showed that adolescent CI users can learn English as a foreign language, as the English language skills of the CI users and their NH peers were comparable when assessed with reading or gap-fill tasks. However, the performance of the adolescent CI users was lower for English listening tasks. This discrepancy between task performance was not observed in their native language Dutch. The auditory tasks confirmed that the adolescent CI users had coarser temporal and spectral resolution than their NH peers, supporting the notion that the difference in foreign language listening skills may be due to a difference in auditory functioning. No differences in the cognitive functioning of the CI users and their NH peers were found that could explain the variation in the foreign language listening tasks. CONCLUSIONS In short, acquiring a foreign language with degraded auditory input appears to affect foreign language listening skills, yet does not appear to impact foreign language skills when assessed with tasks that rely on the processing of orthographic information. CI users could take advantage of orthographic information to facilitate foreign language acquisition and potentially support the development of listening-based foreign language skills.
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Affiliation(s)
- Marita K. Everhardt
- Center for Language and Cognition Groningen, University of Groningen, Netherlands
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
| | - Dorit Enja Jung
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
- Department of Psychology, University of Groningen, Netherlands
| | - Berrit Stiensma
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
| | - Wander Lowie
- Center for Language and Cognition Groningen, University of Groningen, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
| | - Deniz Başkent
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
- W.J. Kolff Institute for Biomedical Engineering and Materials Science, University Medical Center Groningen, University of Groningen, Netherlands
| | - Anastasios Sarampalis
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
- Department of Psychology, University of Groningen, Netherlands
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Zhang X, Xie J, Wu W, Cao L, Jiang Z, Li Z, Li Y. The mediation effect of mental resilience between stress and coping style among parents of children with cochlear implants: Cross-sectional study. J Pediatr Nurs 2024; 74:1-9. [PMID: 37979333 DOI: 10.1016/j.pedn.2023.10.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/20/2023]
Abstract
PURPOSE This study aimed to examine the relationship of stress, mental resilience, and coping style, and the mediation effect of mental resilience between stress and coping style among parents of children with cochlear implants. DESIGN AND METHODS A cross-sectional design was used. A total of 231 parents of children with cochlear implants were recruited from May 1, 2022, to February 28, 2023 at a comprehensive tertiary hospital and a cochlear implant rehabilitation center in China. Parenting Stress Index-Short Form (PSI-SF), the Connor-Davidson Resilience Scale (CD-RISC) and the Simplified Coping Style Questionnaire(SCSQ) were used to measure stress, mental resilience, and coping style respectively. RESULTS The mean score observed for PSI-SF, CD-RISC, active coping, and passive coping was 87.85 ± 24.59, 55.63 ± 16.11, 21.36 ± 6.73, and 9.05 ± 4.52, respectively. Mental resilience was a significant mediator explaining the effect of stress on active coping (β = -0.294; 95% bias-corrected bootstrap CI: -0.358 to -0.164). CONCLUSIONS Attention should be paid to the status of stress, mental resilience and coping style in parents of children with cochlear implants. Mental resilience mediated stress and coping style. PRACTICE IMPLICATIONS This study provides a theoretical basis for establishing an active coping care program for parents of children with cochlear implants. There is a need to identify strategies that can help increase the level of mental resilience of parents of children with cochlear implants and more subjective and objective social support should be provided to reduce their stress and to encourage active coping style.
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Affiliation(s)
- Xiaodan Zhang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiao Xie
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Otolaryngology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Weijing Wu
- Department of Otolaryngology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lifang Cao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zheyi Jiang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhu Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Al-Rawashdeh B, Zuriekat M, Alhanbali S, Alananbeh L, Rammaha D, Al-Zghoul M, Darweesh M, Sawalha A, Al-Bakri Q, Tawalbeh M, Abdul-Baqi K. Sensorineural hearing loss among children at risk: A 16-year audiological records review in a tertiary referral center. Int J Pediatr Otorhinolaryngol 2024; 176:111780. [PMID: 37988919 DOI: 10.1016/j.ijporl.2023.111780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/17/2023] [Accepted: 11/05/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES Hearing loss (HL) constitutes an increasing worldwide health problem. Neonatal hearing screening improved early detection and management to alleviate HL detriments on the person and society. Still, HL in childhood, beyond infancy, is under-investigated, especially in developing countries. This study aimed to explore the prevalence of HL in childhood amongst Jordanian children with HL risk factors and investigate the associated risk factors. METHODS Retrospective cross-sectional review of audiological records in a tertiary public and teaching hospital. The data of 1307 children aged 0-15 years who underwent audiological assessment from 2000 to 2016 were included. A review of diagnostic audiological and medical records was conducted to investigate the prevalence of sensorineural HL in high-risk (HR) children and the most contributing risk factors. RESULTS Descriptive statistical analysis showed that the prevalence of sensorineural HL was 29.2% in the study sample. The HL was bilateral in 95% and mild to moderate HL in 73%. The mean age at the diagnosis was around 4.5 years. The most common risk factors were parental concern about their child's hearing, ototoxic drug use, and developmental and speech delay. The Chi-squared test showed that parental concern and ototoxic drug use were associated with an increased probability of having HL. CONCLUSION The prevalence of HL amongst at-risk children in Jordan is relatively high, and the diagnosis is delayed. The results highlight the importance of implementing a hearing screening program in at-risk children. This needs to start from birth and include a serial follow-up to detect cases of delayed-onset HL.
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Affiliation(s)
- Baeth Al-Rawashdeh
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Margaret Zuriekat
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Sara Alhanbali
- Department of Hearing and Speech Sciences, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan.
| | - Lubna Alananbeh
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Doaa Rammaha
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Mohammad Al-Zghoul
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Mohammad Darweesh
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Amer Sawalha
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Qais Al-Bakri
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Mohamad Tawalbeh
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Khader Abdul-Baqi
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan; Department of Hearing and Speech Sciences, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan.
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Moura JE, Martins JH, Alves M, Oliveira G, Ramos D, Alves H, Caiado R, Teixeira A, Silva LF, Migueis J. Children then, adults now: long-term outcomes-performance at 15, 20, and 25 years of cochlear implant use. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1275808. [PMID: 38170021 PMCID: PMC10760633 DOI: 10.3389/fresc.2023.1275808] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/24/2023] [Indexed: 01/05/2024]
Abstract
Motivation Severe to profound sensorineural hearing loss interferes with a child's development at the cognitive, linguistic, academic, and social levels. Since the beginning of the pediatric auditory rehabilitation program through cochlear implantation in the Ear, Nose, and Throat (ENT) Service of the Coimbra Hospital and University Center (CHUC), Portugal, its mentors defended the early diagnosis of hearing loss followed by timely intervention, and this was considered the starting point to optimize (re)habilitation through this method. Three decades or so later, recently we conducted this study to evaluate the performance of patients implanted in the initial phase of the cochlear implantation program. Objectives The study aimed to evaluate the performance of individuals with severe to profound congenital hearing loss who underwent pediatric cochlear implantation and have used the cochlear implant for at least 25 years, to analyze the beneficial effect of early intervention in improving performance results. Methods The study sample is composed of 31 individuals with severe to profound congenital hearing loss and no other comorbidities, divided into two groups (Group 1: age at implantation was under 3 years; Group 2: age at implantation was over 3 years). All 31 subjects were evaluated at 15, 20, and 25 years of cochlear implant (CI) use with a comprehensive set of tests. In addition, data were collected regarding the academic level of each participant. The results of both groups were compared to find out if there is an effect of age at implantation on auditory performance, and if there is an improvement in the performance with CI over time (15, 20, and 25 years of use). Results The results show that there is a positive effect, with statistical significance, of early implantation on auditory performance, and telephone use. In both groups, there is an increase in performance over time, but it tends to stabilize after 20 years of CI use. Discussion and conclusion The results obtained in this work support the importance of early intervention in patients with severe to profound hearing loss who are cochlear implant users and show that CI is an effective and reliable method in the treatment of these patients, contributing to their improved socio-educational integration, and that the benefits last over time.
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Affiliation(s)
- João Elói Moura
- Cochlear Implants Reference Center, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Jorge Humberto Martins
- Department of Audiology, Center in Rehabilitation (CiR), School of Health, Polytechnic of Porto (ESS-P. Porto), Porto, Portugal
| | - Marisa Alves
- Cochlear Implants Reference Center, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Graça Oliveira
- Cochlear Implants Reference Center, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Daniela Ramos
- Cochlear Implants Reference Center, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Helena Alves
- Cochlear Implants Reference Center, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Ricardo Caiado
- Cochlear Implants Reference Center, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - António Teixeira
- Biomedical Informatics and Technologies (BIT), Institute of Electronics and Informatics Engineering of Aveiro (IEETA), Department of Electronics Telecommunications & Informatics, University of Aveiro, Aveiro, Portugal
| | - Luís Filipe Silva
- Cochlear Implants Reference Center, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Jorge Migueis
- Serviço de Otorrinolaringologia, ENT Service, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Levin M, Zaltz Y. Voice Discrimination in Quiet and in Background Noise by Simulated and Real Cochlear Implant Users. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:5169-5186. [PMID: 37992412 DOI: 10.1044/2023_jslhr-23-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
PURPOSE Cochlear implant (CI) users demonstrate poor voice discrimination (VD) in quiet conditions based on the speaker's fundamental frequency (fo) and formant frequencies (i.e., vocal-tract length [VTL]). Our purpose was to examine the effect of background noise at levels that allow good speech recognition thresholds (SRTs) on VD via acoustic CI simulations and CI hearing. METHOD Forty-eight normal-hearing (NH) listeners who listened via noise-excited (n = 20) or sinewave (n = 28) vocoders and 10 prelingually deaf CI users (i.e., whose hearing loss began before language acquisition) participated in the study. First, the signal-to-noise ratio (SNR) that yields 70.7% correct SRT was assessed using an adaptive sentence-in-noise test. Next, the CI simulation listeners performed 12 adaptive VDs: six in quiet conditions, two with each cue (fo, VTL, fo + VTL), and six amid speech-shaped noise. The CI participants performed six VDs: one with each cue, in quiet and amid noise. SNR at VD testing was 5 dB higher than the individual's SRT in noise (SRTn +5 dB). RESULTS Results showed the following: (a) Better VD was achieved via the noise-excited than the sinewave vocoder, with the noise-excited vocoder better mimicking CI VD; (b) background noise had a limited negative effect on VD, only for the CI simulation listeners; and (c) there was a significant association between SNR at testing and VTL VD only for the CI simulation listeners. CONCLUSIONS For NH listeners who listen to CI simulations, noise that allows good SRT can nevertheless impede VD, probably because VD depends more on bottom-up sensory processing. Conversely, for prelingually deaf CI users, noise that allows good SRT hardly affects VD, suggesting that they rely strongly on bottom-up processing for both VD and speech recognition.
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Affiliation(s)
- Michal Levin
- Department of Communication Disorders, The Stanley Steyer School of Health Professions, Faculty of Medicine, Tel Aviv University, Israel
| | - Yael Zaltz
- Department of Communication Disorders, The Stanley Steyer School of Health Professions, Faculty of Medicine, Tel Aviv University, Israel
- Sagol School of Neuroscience, Tel Aviv University, Israel
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Abstract
Neurological insults, such as congenital blindness, deafness, amputation, and stroke, often result in surprising and impressive behavioural changes. Cortical reorganisation, which refers to preserved brain tissue taking on a new functional role, is often invoked to account for these behavioural changes. Here, we revisit many of the classical animal and patient cortical remapping studies that spawned this notion of reorganisation. We highlight empirical, methodological, and conceptual problems that call this notion into doubt. We argue that appeal to the idea of reorganisation is attributable in part to the way that cortical maps are empirically derived. Specifically, cortical maps are often defined based on oversimplified assumptions of 'winner-takes-all', which in turn leads to an erroneous interpretation of what it means when these maps appear to change. Conceptually, remapping is interpreted as a circuit receiving novel input and processing it in a way unrelated to its original function. This implies that neurons are either pluripotent enough to change what they are tuned to or that a circuit can change what it computes. Instead of reorganisation, we argue that remapping is more likely to occur due to potentiation of pre-existing architecture that already has the requisite representational and computational capacity pre-injury. This architecture can be facilitated via Hebbian and homeostatic plasticity mechanisms. Crucially, our revised framework proposes that opportunities for functional change are constrained throughout the lifespan by the underlying structural 'blueprint'. At no period, including early in development, does the cortex offer structural opportunities for functional pluripotency. We conclude that reorganisation as a distinct form of cortical plasticity, ubiquitously evoked with words such as 'take-over'' and 'rewiring', does not exist.
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Affiliation(s)
- Tamar R Makin
- MRC Cognition and Brain Sciences Unit, University of CambridgeCambridgeUnited Kingdom
| | - John W Krakauer
- Department of Neuroscience, Johns Hopkins University School of MedicineBaltimoreUnited States
- Department of Neurology, Johns Hopkins University School of MedicineBaltimoreUnited States
- The Santa Fe InstituteSanta FeUnited States
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18
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Frånlund K, Lindehammar H, Mäki-Torkko E, Hergils L. Cortical auditory evoked potentials (P1 latency) in children with cochlear implants in relation to clinical language tests. Int J Audiol 2023:1-7. [PMID: 37933984 DOI: 10.1080/14992027.2023.2276048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
Abstract
Objective - To study the correlation between P1 latency and the results of clinical language tests (Reynell III and TROG-2), the latter were used as they are recommended for follow-up assessments of children with cochlear implants (Cis) by the Swedish National Quality Register for children with hearing impairment.Design - A clinical cohort study.Study sample - Cross-sectional and consecutive sampling of 49 children with CIs coming for clinical follow-up assessment from March 2017 - December 2019.Results - For all children tested, there was a significant negative correlation (Spearman's rho= -0.403, p = 0.011) between hearing age and P1 latency. A significant correlation between P1 latency and the Reynell III result (Spearman's rho = -0.810, p = 0.015) was found. In the TROG-2 group, there was no significant correlation between their P1 latency and their language test results (Spearman's rho -0.239, p = 0.196).Conclusion - This method seems to be feasible and easily accepted. The study was conducted in a heterogeneous group of children that we meet daily in our clinic. The results indicated that P1 latency has a negative correlation with language development among our youngest patients fitted with CIs and might be a clinical tool to assess the maturation of central auditory pathways.
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Affiliation(s)
- Karin Frånlund
- Department of Otorhinolaryngology, Linköping University Hospital, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Hans Lindehammar
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
| | - Elina Mäki-Torkko
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Audiological Research Center, Örebro University, Sweden
| | - Leif Hergils
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Yüksel M, Sarlik E, Çiprut A. Emotions and Psychological Mechanisms of Listening to Music in Cochlear Implant Recipients. Ear Hear 2023; 44:1451-1463. [PMID: 37280743 DOI: 10.1097/aud.0000000000001388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Music is a multidimensional phenomenon and is classified by its arousal properties, emotional quality, and structural characteristics. Although structural features of music (i.e., pitch, timbre, and tempo) and music emotion recognition in cochlear implant (CI) recipients are popular research topics, music-evoked emotions, and related psychological mechanisms that reflect both the individual and social context of music are largely ignored. Understanding the music-evoked emotions (the "what") and related mechanisms (the "why") can help professionals and CI recipients better comprehend the impact of music on CI recipients' daily lives. Therefore, the purpose of this study is to evaluate these aspects in CI recipients and compare their findings to those of normal hearing (NH) controls. DESIGN This study included 50 CI recipients with diverse auditory experiences who were prelingually deafened (deafened at or before 6 years of age)-early implanted (N = 21), prelingually deafened-late implanted (implanted at or after 12 years of age-N = 13), and postlingually deafened (N = 16) as well as 50 age-matched NH controls. All participants completed the same survey, which included 28 emotions and 10 mechanisms (Brainstem reflex, Rhythmic entrainment, Evaluative Conditioning, Contagion, Visual imagery, Episodic memory, Musical expectancy, Aesthetic judgment, Cognitive appraisal, and Lyrics). Data were presented in detail for CI groups and compared between CI groups and between CI and NH groups. RESULTS The principal component analysis showed five emotion factors that are explained by 63.4% of the total variance, including anxiety and anger, happiness and pride, sadness and pain, sympathy and tenderness, and serenity and satisfaction in the CI group. Positive emotions such as happiness, tranquility, love, joy, and trust ranked as most often experienced in all groups, whereas negative and complex emotions such as guilt, fear, anger, and anxiety ranked lowest. The CI group ranked lyrics and rhythmic entrainment highest in the emotion mechanism, and there was a statistically significant group difference in the episodic memory mechanism, in which the prelingually deafened, early implanted group scored the lowest. CONCLUSION Our findings indicate that music can evoke similar emotions in CI recipients with diverse auditory experiences as it does in NH individuals. However, prelingually deafened and early implanted individuals lack autobiographical memories associated with music, which affects the feelings evoked by music. In addition, the preference for rhythmic entrainment and lyrics as mechanisms of music-elicited emotions suggests that rehabilitation programs should pay particular attention to these cues.
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Affiliation(s)
- Mustafa Yüksel
- Ankara Medipol University School of Health Sciences, Department of Speech and Language Therapy, Ankara, Turkey
| | - Esra Sarlik
- Marmara University Institute of Health Sciences, Audiology and Speech Disorders Program, Istanbul, Turkey
| | - Ayça Çiprut
- Marmara University Faculty of Medicine, Department of Audiology, Istanbul, Turkey
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20
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Fan Y, Wang J, Zhao Y, Li R, Liu H, Labadie RF, Noble JH, Dawant BM. A Unified Deep-Learning-Based Framework for Cochlear Implant Electrode Array Localization. MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION : MICCAI ... INTERNATIONAL CONFERENCE ON MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION 2023; 14228:376-385. [PMID: 38559808 PMCID: PMC10976972 DOI: 10.1007/978-3-031-43996-4_36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Cochlear implants (CIs) are neuroprosthetics that can provide a sense of sound to people with severe-to-profound hearing loss. A CI contains an electrode array (EA) that is threaded into the cochlea during surgery. Recent studies have shown that hearing outcomes are correlated with EA placement. An image-guided cochlear implant programming technique is based on this correlation and utilizes the EA location with respect to the intracochlear anatomy to help audiologists adjust the CI settings to improve hearing. Automated methods to localize EA in postoperative CT images are of great interest for large-scale studies and for translation into the clinical workflow. In this work, we propose a unified deep-learning-based framework for automated EA localization. It consists of a multi-task network and a series of postprocessing algorithms to localize various types of EAs. The evaluation on a dataset with 27 cadaveric samples shows that its localization error is slightly smaller than the state-of-the-art method. Another evaluation on a large-scale clinical dataset containing 561 cases across two institutions demonstrates a significant improvement in robustness compared to the state-of-the-art method. This suggests that this technique could be integrated into the clinical workflow and provide audiologists with information that facilitates the programming of the implant leading to improved patient care.
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Affiliation(s)
- Yubo Fan
- Department of Computer Science, Vanderbilt University, Nashville, TN 37235, USA
| | - Jianing Wang
- Digital Technology and Innovation, Siemens Healthineers, Princeton, NJ 08540, USA
| | - Yiyuan Zhao
- Digital and Automation, Siemens Healthineers, Malvern, PA 19355, USA
| | - Rui Li
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN 37235, USA
| | - Han Liu
- Department of Computer Science, Vanderbilt University, Nashville, TN 37235, USA
| | - Robert F Labadie
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Jack H Noble
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN 37235, USA
| | - Benoit M Dawant
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN 37235, USA
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Wang X, Lin Z, Guo Y, Liu Y, Zhou X, Bai J, Liu H. Correlation between cortical auditory evoked potential and auditory speech performance in children with cochlear implants. Int J Pediatr Otorhinolaryngol 2023; 172:111687. [PMID: 37515869 DOI: 10.1016/j.ijporl.2023.111687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/13/2023] [Accepted: 07/20/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVES This study aimed to explore the correlation between the characteristics of cortical auditory evoked potential (CAEP) of children with cochlear implants (CIs) and auditory and speech rehabilitation performance by an objective evaluation technique and subjective auditory and speech skills measurements. METHODS All participants were recruited from Beijing Children's Hospital, Beijing, China. 19 children with CIs had their responses to the CAEP and MMN recorded. The LittlEARs® Auditory Questionnaire (LEAQ), Categories of Auditory Performance (CAP), Speech Intelligibility Rating Scale (SIR), Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS), and Meaningful Use of Speech Scale (MUSS) measures were taken to assess the children's speech and hearing abilities. RESULTS P1 and MMN of CAEP were negatively related to the duration of CI usage. The duration of CI usage and scores of auditory-verbal assessment questionnaires all showed significant relationships. Additionally, scores of these questionnaires were significantly inversely associated with the latency of P1 and MMN. CONCLUSION P1 and MMN could be used as objective methods to evaluate the effectiveness of hearing and speech rehabilitation in children with CIs. In particular to those who cannot give effectively feedback of auditory and verbal effects, these methods might have a certain guiding significance.
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Affiliation(s)
- Xuetong Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Zhihan Lin
- Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Ying Guo
- Royal National Ear, Nose, Throat & Eastman Dental Hospitals, London, 110686, UK.
| | - Yidi Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Xin Zhou
- Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Jie Bai
- Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Haihong Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China; Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Ministry of Education (MOE) Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
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Kobosko J, Jedrzejczak WW, Rostkowska J, Porembska DB, Fludra M, Skarżyński H. Satisfaction with life in a sample of prelingually deaf cochlear implant users with a good command of spoken Polish as the primary language. JOURNAL OF COMMUNICATION DISORDERS 2023; 105:106370. [PMID: 37683553 DOI: 10.1016/j.jcomdis.2023.106370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 08/18/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023]
Abstract
INTRODUCTION This study investigated the level of satisfaction with life (SWL) in a group of cochlear implant (CI) users who had been prelingually deaf but were orally educated. They had received one or two CIs (as a child, adolescent, or adult) and were highly competent Polish speakers. This study looked at three factors that may affect SWL - psychosocial, deafness/hearing and communication related, and sociodemographic. METHODS The participants were prelingually deaf CI users who had learned highly competent spoken Polish as their primary language. They had been educated in mainstream or integrated schools (not schools for the deaf), and had no other disability or severe illness. Measurements were done with 5 questionnaires: the Satisfaction With Life Scale (SWLS), the I-Others Questionnaire, the Patient Health Questionnaire (PHQ-9), the Deaf Identity Development Scale (DIDS), and the Nijmegen Cochlear Implant Questionnaire (NCIQ). RESULTS The SWL level of the group was similar to that of the standard Polish population. SWL was positively related to positive self-perception, acceptance of oneself as a deaf person, and to perceiving the benefits of having a CI (as measured by three NCIQ domains: self-esteem, activity limitations, and social interactions). On the other hand, negative self-perception, marginal deaf identity, and depressive symptoms were negatively related to SWL. There was no relationship between SWL and knowledge of sign language. Lower depressive symptoms and greater hearing loss were both significant predictors of SWL, although those who used two CIs generally had a lower SWL. CONCLUSIONS Prelingually deaf CI users with low SWL require psychological support in many spheres, including working through problems of deaf identity, self-acceptance, and depression. Additional research should involve diverse DHH CI users, including those with limited spoken Polish competency or sign language skills, as well as members of the Polish Deaf community.
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Affiliation(s)
- Joanna Kobosko
- Institute of Physiology and Pathology of Hearing, ul. M. Mochnackiego 10, 02-042 Warsaw, Poland; World Hearing Center, ul. Mokra 17, Kajetany 05-830 Nadarzyn, Poland; Maria Grzegorzewska University, ul. Szczęśliwicka 40, 02-353 Warsaw, Poland
| | - W Wiktor Jedrzejczak
- Institute of Physiology and Pathology of Hearing, ul. M. Mochnackiego 10, 02-042 Warsaw, Poland; World Hearing Center, ul. Mokra 17, Kajetany 05-830 Nadarzyn, Poland.
| | - Joanna Rostkowska
- Institute of Physiology and Pathology of Hearing, ul. M. Mochnackiego 10, 02-042 Warsaw, Poland; World Hearing Center, ul. Mokra 17, Kajetany 05-830 Nadarzyn, Poland
| | - D Beata Porembska
- Institute of Physiology and Pathology of Hearing, ul. M. Mochnackiego 10, 02-042 Warsaw, Poland; World Hearing Center, ul. Mokra 17, Kajetany 05-830 Nadarzyn, Poland; Maria Grzegorzewska University, ul. Szczęśliwicka 40, 02-353 Warsaw, Poland
| | - Małgorzata Fludra
- Institute of Physiology and Pathology of Hearing, ul. M. Mochnackiego 10, 02-042 Warsaw, Poland; World Hearing Center, ul. Mokra 17, Kajetany 05-830 Nadarzyn, Poland
| | - Henryk Skarżyński
- Institute of Physiology and Pathology of Hearing, ul. M. Mochnackiego 10, 02-042 Warsaw, Poland; World Hearing Center, ul. Mokra 17, Kajetany 05-830 Nadarzyn, Poland
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Braack KJ, Miles T, Amat F, Brown DJ, Atlas MD, Kuthubutheen J, Mulders WH, Prêle CM. Using x-ray micro computed tomography to quantify intracochlear fibrosis after cochlear implantation in a Guinea pig model. Heliyon 2023; 9:e19343. [PMID: 37662829 PMCID: PMC10474428 DOI: 10.1016/j.heliyon.2023.e19343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 08/07/2023] [Accepted: 08/18/2023] [Indexed: 09/05/2023] Open
Abstract
Cochlear implants (CIs) allow individuals with profound hearing loss to understand speech and perceive sounds. However, not all patients obtain the full benefits that CIs can provide and the cause of this disparity is not fully understood. One possible factor for the variability in outcomes after cochlear implantation, is the development of fibrotic scar tissue around the implanted electrode. It has been hypothesised that limiting the extent of fibrosis after implantation may improve overall CI function, and longevity of the device. Currently, histology is often used to quantify the extent of intracochlear tissue growth after implantation however this method is labour intensive, time-consuming, often involves significant user bias, and causes physical distortion of the fibrosis. Therefore, this study aimed to evaluate x-ray micro computed tomography (μCT) as a method to measure the amount and distribution of fibrosis in a guinea pig model of cochlear implantation. Adult guinea pigs were implanted with an inactive electrode, and cochleae harvested eight weeks later (n = 7) and analysed using μCT, to quantify the extent of tissue reaction, followed by histological analysis to confirm that the tissue was indeed fibrotic. Cochleae harvested from an additional six animals following implantation were analysed by μCT, before and after contrast staining with osmium tetroxide (OsO4), to enhance the visualisation of soft tissues within the cochlea, including the tissue reaction. Independent analysis by two observers showed that the quantification method was robust and provided additional information on the distribution of the response within the cochlea. Histological analysis revealed that μCT visualised dense collagenous material and new bone formation but did not capture loose, areolar fibrotic tissue. Treatment with OsO4 significantly enhanced the visible tissue reaction detected using μCT. Overall, μCT is an alternative and reliable method that can be used to quantify the extent of the CI-induced intracochlear tissue response and will be a useful tool for the in vivo assessment of novel anti-fibrotic treatments.
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Affiliation(s)
- Kady J. Braack
- School of Human Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - Tylah Miles
- Institute for Respiratory Health, University of Western Australia, Nedlands, WA 6009, Australia
| | - Farah Amat
- School of Human Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - Daniel J. Brown
- Curtin Medical School, Curtin University, Bentley, WA 6102, Australia
| | - Marcus D. Atlas
- Curtin Medical School, Curtin University, Bentley, WA 6102, Australia
- Medical School, University of Western Australia, Crawley, WA 6009, Australia
- Ear Science Institute Australia, Subiaco, WA 6008, Australia
| | - Jafri Kuthubutheen
- Medical School, University of Western Australia, Crawley, WA 6009, Australia
- Department of Otolaryngology Head and Neck Surgery, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia
| | | | - Cecilia M. Prêle
- Institute for Respiratory Health, University of Western Australia, Nedlands, WA 6009, Australia
- Ear Science Institute Australia, Subiaco, WA 6008, Australia
- School of Medical, Molecular and Forensic Sciences, Murdoch University, Murdoch, WA 6150, Australia
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Cejas I, Barker DH, Petruzzello E, Sarangoulis CM, Quittner AL. Cochlear Implantation and Educational and Quality-of-Life Outcomes in Adolescence. JAMA Otolaryngol Head Neck Surg 2023; 149:708-715. [PMID: 37382935 PMCID: PMC10311426 DOI: 10.1001/jamaoto.2023.1327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/25/2023] [Indexed: 06/30/2023]
Abstract
Importance Cochlear implants (CIs) have been shown to be effective in improving auditory skills and speech and language development. However, less is known about the long-term outcomes of CIs on educational functioning or quality of life. Objective To evaluate long-term educational outcomes and quality of life in adolescents over 13 years postimplantation. Design, Setting, and Participants This longitudinal cohort study included 188 children with bilateral severe to profound hearing loss with CIs from the Childhood Development After Cochlear Implantation (CDaCI) study from hospital-based CI programs; a cohort of 340 children with severe to profound hearing loss without CIs from a nationally representative survey (National Longitudinal Transition Study-2; NLTS-2), and results from the literature of comparable children without CIs. Exposure(s) Cochlear implantation (early and late). Main Outcomes and Measures Adolescent performance on measures of academic achievement (Woodcock Johnson), language (Comprehensive Assessment of Spoken Language), and quality of life (Pediatric Quality of Life Inventory, Youth Quality of Life Instrument-Deaf and Hard of Hearing). Results The CDaCI cohort included 188 children, 136 of whom completed the wave 3 postimplantation follow-up visits (77 [55%] female) with CIs; mean [SD] age was 11.47 [1.27] years. The NLTS-2 cohort included 340 children (50% female) with severe to profound hearing loss without CIs. Children with CIs had better academic performance compared with children without CIs with similar levels of hearing loss. The largest benefits were seen for children who received implants early (prior to age 18 months), who performed at or above age and gender norms for language and academic achievement. Similarly, adolescents with CIs reported better quality of life on the Pediatric Quality of Life Inventory compared with children without CIs. On a condition-specific measure (Youth Quality of Life Instrument-Deaf and Hard of Hearing), children who received implants early scored higher across all 3 domains than comparisons without CIs. Conclusions and Relevance To our knowledge, this is the first study to evaluate long-term educational outcomes and quality of life in adolescents using CIs. This longitudinal cohort study showed better outcomes of CIs in terms of language, academic performance, and quality of life. While the greatest benefits were observed for children who received implants before age 18 months, benefits were also noted for children who received implants later, providing evidence that children with severe to profound hearing loss with CIs can achieve at or above expected levels compared with hearing peers.
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Affiliation(s)
- Ivette Cejas
- Department of Otolaryngology, University of Miami, Miami, Florida
| | - David H. Barker
- Department of Psychiatry, Rhode Island Hospital, Providence
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Esteban Petruzzello
- Department of Economics, Miami Herbert Business School, Coral Gables, Florida
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Patel R, Hoare DJ, Willis KR, Tabraiz S, Bateman PK, Thornton SK. Characterisation of the treatment provided for children with unilateral hearing loss. Front Pediatr 2023; 11:1197713. [PMID: 37559951 PMCID: PMC10407268 DOI: 10.3389/fped.2023.1197713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/16/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Children with permanent unilateral hearing loss (UHL) are an understudied population, with limited data to inform the guidelines on clinical management. There is a funding gap in healthcare provision for the children with UHL in the United Kingdom, where genetic screening, support services, and devices are not consistently provided or fully funded in all areas. They are a disparate population with regard to aetiology and their degree of hearing loss, and hence their device choice and use. Despite having one "good ear", some children with UHL can have similar outcomes, socially, behaviourally, and academically, to children with bilateral hearing loss, highlighting the importance of understanding this population. In this longitudinal cohort study, we aimed to characterise the management of the children with UHL and the gaps in the support services that are provided for the children in Nottingham, United Kingdom. METHODS A cohort study was conducted collecting longitudinal data over 17 years (2002-2019) for 63 children with permanent congenital confirmed UHL in a large tertiary regional referral centre for hearing loss in Nottingham, United Kingdom. The cases of UHL include permanent congenital, conductive, mixed, or sensorineural hearing loss, and the degree of hearing loss ranges from mild to profound. The data were taken from their diagnostic auditory brainstem responses and their two most recent hearing assessments. Descriptors were recorded of the devices trialled and used and the diagnoses including aetiology of UHL, age of first fit, degree of hearing loss, when and which type of device was used, why a device was not used, the support services provided, concerns raised, and who raised them. RESULTS Most children (45/63; 71%) trialled a device, and the remaining 18 children had no device trial on record. Most children (20/45; 44%) trialled a bone-conduction device, followed by contralateral routing of signal aid (15/45; 33%) and conventional hearing aids (9/45; 20%). Most children (36/45; 80%) who had a device indicated that they wore their device "all day" or every day in school. Few children (8/45; 18%) reported that they wore their device rarely, and the reasons for this included bullying (3/8), feedback from the device (2/8), and discomfort from the device (2/8). Only one child reported that the device was not helping with their hearing. The age that the children were first fitted with their hearing device varied a median of 2.5 years for hearing aids and bone-conduction devices and 7 years for a contralateral routing of signal aid. The length of time that the children had the device also varied widely (median of 26 months, range 3-135 months); the children had their bone-conduction hearing aid for the longest period of time (median of 32.5 months). There was a significant trend where more recent device fittings were happening for children at a younger age. Fifty-one children were referred by the paediatric audiologist to a support service, 72.5% (37/51) were subsequently followed up by the referred service with no issue, whilst the remaining 27.5% (14/51) encountered an issue leading to an unsuccessful provision of support. Overall, most children (65%, 41/63) had no reported concerns, and 28.5% (18/63) of the children went on to have a documented concern at some point during their audiological care: five with hearing aid difficulties, five with speech issues, four with no improvement in hearing, three facing self-image or bullying issues, and one case of a child struggling to interact socially with friends. Three of these children had not trialled a device. We documented every concern reported from the parents, clinicians, teachers of the deaf, and from the children themselves. Where concerns were raised, more than half (58.6%, 10/18) were by schools and teachers, the remaining four concerns were raised by the family, and further four concerns were raised by the children themselves. CONCLUSION To discover what management will most benefit which children with permanent UHL, we first must characterise their treatment, their concerns, and the support services available for them. Despite the children with UHL being a highly disparate population-in terms of their aetiology, their device use, the degree of hearing loss, and the age at which they trial a device-the majority report they use their device mostly in school. In lieu of available data and in consideration of the devices that are available to them, it could be useful to support families and clinicians in understanding the devices which are most used and where they are used. Considering the reasons for cessation of regular device use counselling and support services would be vital to support the children with UHL.
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Affiliation(s)
- Roshni Patel
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, The University of Nottingham, Nottingham, United Kingdom
| | - Derek J. Hoare
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, The University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Karen R. Willis
- Children’s Audiology, Ropewalk House, Nottingham, United Kingdom
| | - Shammas Tabraiz
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, The University of Nottingham, Nottingham, United Kingdom
| | - Paul K. Bateman
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, The University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Sally K. Thornton
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, The University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
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Melo RS, Lemos A, Delgado A, Raposo MCF, Ferraz KM, Belian RB. Use of Virtual Reality-Based Games to Improve Balance and Gait of Children and Adolescents with Sensorineural Hearing Loss: A Systematic Review and Meta-Analysis. SENSORS (BASEL, SWITZERLAND) 2023; 23:6601. [PMID: 37514897 PMCID: PMC10385194 DOI: 10.3390/s23146601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Children and adolescents with sensorineural hearing loss (SNHL) often experience motor skill disturbances, particularly in balance and gait, due to potential vestibular dysfunctions resulting from inner ear damage. Consequently, several studies have proposed the use of virtual reality-based games as a technological resource for therapeutic purposes, aiming to improve the balance and gait of this population. OBJECTIVE The objective of this systematic review is to evaluate the quality of evidence derived from randomized or quasi-randomized controlled trials that employed virtual reality-based games to enhance the balance and/or gait of children and adolescents with SNHL. METHODS A comprehensive search was conducted across nine databases, encompassing articles published in any language until 1 July 2023. The following inclusion criteria were applied: randomized or quasi-randomized controlled trials involving volunteers from both groups with a clinical diagnosis of bilateral SNHL, aged 6-19 years, devoid of physical, cognitive, or neurological deficits other than vestibular dysfunction, and utilizing virtual reality-based games as an intervention to improve balance and/or gait outcomes. RESULTS Initially, a total of 5984 articles were identified through the searches. Following the removal of duplicates and screening of titles and abstracts, eight studies remained for full reading, out of which three trials met the eligibility criteria for this systematic review. The included trials exhibited a very low quality of evidence concerning the balance outcome, and none of the trials evaluated gait. The meta-analysis did not reveal significant differences in balance improvement between the use of traditional balance exercises and virtual reality-based games for adolescents with SNHL (effect size: -0.48; [CI: -1.54 to 0.57]; p = 0.37; I2 = 0%). CONCLUSION Virtual reality-based games show promise as a potential technology to be included among the therapeutic options for rehabilitating the balance of children and adolescents with SNHL. However, given the methodological limitations of the trials and the overall low quality of evidence currently available on this topic, caution should be exercised when interpreting the results of the trials analyzed in this systematic review.
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Affiliation(s)
- Renato S Melo
- Post-Graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
- Laboratory of Informatics in Health, Laboratório de Imunopatologia Keizo Asami (LIKA), Recife 50670-901, PE, Brazil
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
- Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
| | - Andrea Lemos
- Post-Graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
| | - Alexandre Delgado
- Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife 50070-550, PE, Brazil
| | | | - Karla Mônica Ferraz
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
- Laboratory of Pediatric Studies (LEPed), Universidade Federal de Pernambuco (UFPE), Recife 50740-560, PE, Brazil
| | - Rosalie Barreto Belian
- Post-Graduate Program on Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
- Laboratory of Informatics in Health, Laboratório de Imunopatologia Keizo Asami (LIKA), Recife 50670-901, PE, Brazil
- Department of Medicine, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
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Joo HA, Lee DK, Lee YJ, Alrehaili BM, AlMutawah AA, Kang WS, Ahn JH, Chung JW, Park HJ. Anatomical Features of Children With Mondini Dysplasia: Influence on Cochlear Implantation Performance. Otol Neurotol 2023; 44:e379-e386. [PMID: 37231535 DOI: 10.1097/mao.0000000000003911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To analyze the long-term auditory performance after cochlear implantation (CI) and identify anatomical features of Mondini dysplasia associated with post-CI outcomes. STUDY DESIGN Retrospective study. SETTING Tertiary care academic center. PATIENTS We enrolled 49 ears with Mondini dysplasia who underwent CI with more than 7 years of follow-up and age at CI- and sex-matched control group with radiologically normal inner ears. MAIN OUTCOMES AND MEASURES The development of auditory skills after CI was evaluated using word recognition scores (WRSs). The anatomical features were measured based on temporal bone computed tomography and magnetic resonance imaging, involving the width of the bony cochlear nerve canal (BCNC), cochlear basal turn, enlarged vestibular aqueduct, cochlear height, and diameter of the cochlear nerve (CN). RESULTS CI in ears with Mondini dysplasia showed comparable benefits and improvement of auditory performance to controls during the 7 years of follow-up. In Mondini dysplasia, four (8.2%) ears showed narrow BCNC (<1.4 mm) with poorer WRS (58 ± 17%) than those with normal-sized BCNC, which had WRS (79 ± 10%) comparable to that of the control group (77 ± 14%). In Mondini dysplasia, the maximum ( r = 0.513, p < 0.001) and minimum ( r = 0.328, p = 0.021) CN diameters had positive correlations with post-CI WRS. The maximum CN diameter ( β = 48.347, p < 0.001) and BCNC width ( β = 12.411, p = 0.041) were significant factors that influence the post-CI WRS in multiple regression analysis. CONCLUSIONS Preoperative anatomical evaluation, especially BCNC status and CN integrity, may serve as predictive markers for post-CI performance.
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Affiliation(s)
- Hye Ah Joo
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Kyu Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Ji Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bassim Mallith Alrehaili
- Otolaryngology-Head and Neck Surgery, Ohud Hospital, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia
| | - Abdullah Ali AlMutawah
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Seok Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joong Ho Ahn
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Woo Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong Ju Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Nicastri M, Lo Castro F, Giallini I, Inguscio BMS, Mariani L, Portanova G, Ruoppolo G, Orlando MP, Dincer D'Alessandro H, Mancini P. Vocal singing skills by cochlear implanted children without formal musical training: Familiar versus unfamiliar songs. Int J Pediatr Otorhinolaryngol 2023; 170:111605. [PMID: 37245390 DOI: 10.1016/j.ijporl.2023.111605] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/03/2023] [Accepted: 05/21/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVES Vocal singing skills in pediatric CI users are not much known due to the limited number of studies. The principal aim of the present study was to evaluate vocal singing skills in Italian pediatric CI users. A further aim was to investigate factors that may significantly influence their performance. METHODS The participants were twenty-two implanted children and twenty-two hearing peers. Their vocal singing skills for familiar ("Happy Birthday to You") and unfamiliar songs ("Baton Twirler" from Pam Pam 2- Tribute to Gordon) were evaluated in relation to their music perception (the Gordon test). Acoustic analysis was performed using Praat and MATLAB software. Nonparametric statistical tests and principal component analysis (PCA) were used to analyze the data. RESULTS Hearing children outperformed implanted peers in both music perception and vocal singing tasks (all measures regarding intonation, vocal range, melody, and memory for the familiar song versus measures regarding intonation and overall melody production for the unfamiliar song). Music perception and vocal singing performances revealed strong correlations. For the familiar and unfamiliar songs, age-appropriate vocal singing was observed in 27.3% versus 45.4% of children, all implanted within 24 months of age. Age at implantation and duration of CI experience were moderately correlated with the total score obtained from the Gordon test. CONCLUSION Implanted children show limited vocal singing skills in comparison to their hearing peers. However, some children implanted within 24 months of age seem to achieve vocal singing skills as good as their hearing peers. Future research could be useful to better understand the role of brain plasticity to implement specific training programs for both music perception and vocal singing.
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Affiliation(s)
- Maria Nicastri
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Fabio Lo Castro
- CNR-INM-Section of Acoustics and Sensors "O.M.ca Corbino", 00133, Rome, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University, Rome, Italy
| | | | - Laura Mariani
- Department of Sense Organs, Sapienza University, Rome, Italy
| | | | | | | | - Hilal Dincer D'Alessandro
- Istanbul University-Cerrahpasa, Faculty of Health Sciences, Department of Audiology, Istanbul, Turkey.
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Park LR, Gagnon EB, Dillon MT. Factors that influence outcomes and device use for pediatric cochlear implant recipients with unilateral hearing loss. Front Hum Neurosci 2023; 17:1141065. [PMID: 37250696 PMCID: PMC10213360 DOI: 10.3389/fnhum.2023.1141065] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Candidacy criteria for cochlear implantation in the United States has expanded to include children with single-sided deafness (SSD) who are at least 5 years of age. Pediatric cochlear implant (CI) users with SSD experience improved speech recognition with increased daily device use. There are few studies that report the hearing hour percentage (HHP) or the incidence of non-use for pediatric CI recipients with SSD. The aim of this study was to investigate factors that impact outcomes in children with SSD who use CIs. A secondary aim was to identify factors that impact daily device use in this population. Methods A clinical database query revealed 97 pediatric CI recipients with SSD who underwent implantation between 2014 and 2022 and had records of datalogs. The clinical test battery included speech recognition assessment for CNC words with the CI-alone and BKB-SIN with the CI plus the normal-hearing ear (combined condition). The target and masker for the BKB-SIN were presented in collocated and spatially separated conditions to evaluate spatial release from masking (SRM). Linear mixed-effects models evaluated the influence of time since activation, duration of deafness, HHP, and age at activation on performance (CNC and SRM). A separate linear mixed-effects model evaluated the main effects of age at testing, time since activation, duration of deafness, and onset of deafness (stable, progressive, or sudden) on HHP. Results Longer time since activation, shorter duration of deafness, and higher HHP were significantly correlated with better CNC word scores. Younger age at device activation was not found to be a significant predictor of CNC outcomes. There was a significant relationship between HHP and SRM, with children who had higher HHP experiencing greater SRM. There was a significant negative correlation between time since activation and age at test with HHP. Children with sudden hearing loss had a higher HHP than children with progressive and congenital hearing losses. Conclusion The present data presented here do not support a cut-off age or duration of deafness for pediatric cochlear implantation in cases of SSD. Instead, they expand on our understanding of the benefits of CI use in this population by reviewing the factors that influence outcomes in this growing patient population. Higher HHP, or greater percentage of time spent each day using bilateral input, was associated with better outcomes in the CI-alone and in the combined condition. Younger children and those within the first months of use had higher HHP. Clinicians should discuss these factors and how they may influence CI outcomes with potential candidates with SSD and their families. Ongoing work is investigating the long-term outcomes in this patient population, including whether increasing HHP after a period of limited CI use results in improved outcomes.
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Bruce I, Schaefer S, Kluk K, Nichani J, Odriscoll M, Rajai A, Sladen M. 'Real-life' benefit of hearing preservation cochlear implantation in the paediatric population: a single-site case-control study. BMJ Open 2023; 13:e067248. [PMID: 37156582 PMCID: PMC10173958 DOI: 10.1136/bmjopen-2022-067248] [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] [Indexed: 05/10/2023] Open
Abstract
INTRODUCTION Cochlear implantation with hearing preservation (HPCI) has allowed a cochlear implant (CI) electrode to be implanted while trying to preserve residual acoustic low-frequency hearing. The concept arises from the importance of this low-frequency information and the limitations of a CI in several auditory domains. The combination of electrical hearing with either preserved acoustic hearing or amplified 'natural' hearing has the potential to address these issues and enable children with HPCI to closely follow normal auditory development.The aim of this study is to evaluate the 'real-life' benefit of preserved acoustic low-frequency hearing in children with a CI, understand the benefits of preserved natural hearing in complex listening situations and so enable parents and children to make an informed choice about implantation. Ultimately, helping to ensure the maximum number of children benefit from this life-changing intervention. METHODS AND ANALYSIS Nineteen ears in children and young people aged 6-17 years old with 'successful' HPCI will be subjected to a test battery consisting of: (1) spatial release from masking; (2) complex pitch direction discrimination; (3) melodic identification; (4) perception of prosodic features in speech and (5) threshold equalising noise test. Subjects will be tested in the electro-acoustic stimulation (EAS)/electro-natural stimulation (ENS) and the electric-only (ES) condition, thereby acting as their own control group. Standard demographic and hearing health information will be collected. In the absence of comparable published data to power the study, sample size was determined on pragmatic grounds. Tests are exploratory and for hypothesis-generating purposes. Therefore, the standard criterion of p<0.05 will be used. ETHICS AND DISSEMINATION This study has been approved by the Health Research Authority and NHS Research Ethics Committee (REC) within the UK (22/EM/0017). Industry funding was secured via a competitive researcher-led grant application process. Trial results will be subject to publication according to the definition of the outcome presented in this protocol.
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Affiliation(s)
- Iain Bruce
- Paediatric ENT Department, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | | | | | - Jaya Nichani
- Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Azita Rajai
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Mark Sladen
- Manchester University NHS Foundation Trust, Manchester, UK
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Skrbic R, Bugarski-Ignjatovic V, Komazec Z, Veselinovic M. Verbal, Figural, and Arithmetic Fluency of Children with Cochlear Implants. Behav Sci (Basel) 2023; 13:bs13050349. [PMID: 37232588 DOI: 10.3390/bs13050349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/27/2023] Open
Abstract
Cochlear implantation gives children with prelingual severe hearing loss and deafness the opportunity to develop their hearing abilities, speech, language, cognitive abilities and academic skills with adequate rehabilitation. The aim of the research was to analyze verbal, figural and arithmetic fluency and their interrelationship in children with a cochlear implant (CI) and children with normal hearing (NH). A total of 46 children with CI and 110 children with NH, aged 9 to 16, participated in the research. Verbal fluency was assessed using phonemic and semantic fluency, and non-verbal fluency using figural fluency. Arithmetic fluency was assessed using simple arithmetic tasks within the number range up to 100. The results showed that children with CI achieved poorer results in phonemic fluency (z = -4.92; p < 0.001), semantic fluency (z = -3.89; p < 0.001), figural fluency (z = -3.07; p = 0.002), and arithmetic fluency (z = -4.27; p < 0.001). In both groups, a positive correlation was obtained between the measured modalities and types of fluency. In the group of children with CI, a sex difference was obtained on the phonemic fluency test, in favor of girls. The age of children with CI was correlated with arithmetic fluency. Verbal, figural and arithmetic fluency of children with CI speak in favor of the importance of early auditory and language experiences.
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Affiliation(s)
- Renata Skrbic
- Faculty of Medicine, University of Novi Sad, 21 137 Novi Sad, Serbia
| | - Vojislava Bugarski-Ignjatovic
- Faculty of Medicine, University of Novi Sad, 21 137 Novi Sad, Serbia
- Clinic for Neurology, University Clinical Center of Vojvodina, 21 137 Novi Sad, Serbia
| | - Zoran Komazec
- Faculty of Medicine, University of Novi Sad, 21 137 Novi Sad, Serbia
- Clinic for Otorhinolaryngology and Head and Neck Surgery, University Clinical Center of Vojvodina, 21 137 Novi Sad, Serbia
| | - Mila Veselinovic
- Faculty of Medicine, University of Novi Sad, 21 137 Novi Sad, Serbia
- Clinic for Otorhinolaryngology and Head and Neck Surgery, University Clinical Center of Vojvodina, 21 137 Novi Sad, Serbia
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Virzob CRB, Poenaru M, Morar R, Horhat ID, Balica NC, Prathipati R, Moleriu RD, Toma AO, Juganaru I, Bloanca V, Chicin GN, Fericean RM, Domuta EM, Iurciuc M, Iurciuc S. Efficacy of Bilateral Cochlear Implantation in Pediatric and Adult Patients with Profound Sensorineural Hearing Loss: A Retrospective Analysis in a Developing European Country. J Clin Med 2023; 12:jcm12082948. [PMID: 37109284 PMCID: PMC10144087 DOI: 10.3390/jcm12082948] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
This retrospective study aimed to evaluate the outcomes of bilateral cochlear implantation in patients with severe-to-profound sensorineural hearing loss at the Timisoara Municipal Emergency Clinical Hospital ENT Clinic. The study involved 77 participants, divided into four groups based on their hearing loss characteristics and implantation history. Assessments were conducted pre- and post-implantation, focusing on speech perception, speech production, and reading achievement. Standard surgical procedures were performed, and participants were provided with a comprehensive rehabilitation program involving auditory training and communication therapy. The variables considered for analysis included demographic factors, implantation period, and quality of life assessment, with no statistically significant differences pre-implantation between the four study groups. Results revealed significant improvements in speech perception, speech production, and reading achievement after cochlear implantation. In adult patients, speech perception scores increased from 21.3% to 73.4% for WIPI and from 22.7% to 68.4% for HINT after 12 months of rehabilitation. Speech production scores improved from 33.5% to 76.8% and reading achievement scores increased from 76.2 to 106.3. Moreover, there was a significant improvement in patients' quality of life following cochlear implantation, with mean scores increasing from 2.0 to 4.2. Although it is known that bilateral cochlear implantation significantly improves speech perception, speech production, reading achievement, and quality of life in patients with severe-to-profound sensorineural hearing loss, this is the first study of its kind from Romania. Further research is warranted to optimize patient selection and rehabilitation strategies to maximize outcomes and determine better policies towards funding and access of cochlear implants for a wider range of patients in need.
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Affiliation(s)
- Claudia Raluca Balasa Virzob
- Department of Ear-Nose-Throat, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Marioara Poenaru
- Department of Ear-Nose-Throat, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Raluca Morar
- Department of Ear-Nose-Throat, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Ioana Delia Horhat
- Department of Ear-Nose-Throat, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Nicolae Constantin Balica
- Department of Ear-Nose-Throat, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Reshmanth Prathipati
- Santiram Medical College and General Hospital, Faculty of Genenral Medicine, Nandyala 518001, Andhra Pradesh, India
| | - Radu Dumitru Moleriu
- Mathematics Department, Faculty of Mathematics and Computer Science, West University Timisoara, 4th Vasile Parvan, 300223 Timisoara, Romania
| | - Ana-Olivia Toma
- Discipline of Dermatology, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Iulius Juganaru
- Department of Pediatrics, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Vlad Bloanca
- Department of Plastic Surgery, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Gratiana Nicoleta Chicin
- Faculty of General Medicine, "Vasile Goldis" Western University of Arad, Bulevardul Revolutiei 94, 310025 Arad, Romania
- National Institute of Public Health, Strada Doctor Leonte Anastasievici 1-3, 050463 Bucuresti, Romania
| | - Roxana Manuela Fericean
- Doctoral School, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Eugenia Maria Domuta
- Surgery Department, Faculty of Medicine and Pharmacy, University of Oradea, Piata 1 Decembrie 10, 410073 Oradea, Romania
| | - Mircea Iurciuc
- Department of Cardiology, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Research Center of the Institute of Cardiovascular Diseases Timisoara, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Stela Iurciuc
- Department of Cardiology, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Research Center of the Institute of Cardiovascular Diseases Timisoara, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Interobserver variability of cochlear duct measurements in pediatric cochlear implant candidates. Eur Arch Otorhinolaryngol 2023; 280:1647-1651. [PMID: 36074160 PMCID: PMC9988785 DOI: 10.1007/s00405-022-07639-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/31/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The objective of the study was to evaluate the proposed cochlear duct length estimation based on the cochlear 'A value'. Furthermore, we assessed the interobserver variability between radiology and otolaryngology attending physicians and otolaryngology trainees. METHODS Thirteen pediatric cochlear implant candidates were retrospectively analyzed by three otolaryngology physicians (attending physician, second year, and fourth year trainees) and a radiology attending. The cochlear duct length was calculated based on the formula of Grover et al. The differences in acquired measurements between observers were compared using the Wilcoxon matched signed-rank test. RESULTS The differences in measurements between the attending otolaryngologist and radiologist were not statistically different, while several significant differences were observed with regard to measurements of attending doctors compared to both residents. In particular, a significant difference between the second year otolaryngology resident and otolaryngology and radiology attending was observed for one side (right ear p = 0.034 and p = 0.012, respectively). Moreover, the fourth year resident calculated significantly different cochlear duct measurements when compared to the attending otolaryngologist (left ear p = 0.014) and radiologist (right ear p = 0.047). Interestingly, differently experienced otolaryngology residents provided significantly different measurements for both ears. CONCLUSIONS Based on these results, cochlear duct length measurement according to the proposed method may be a reliable and cost-effective method. Indeed, otolaryngology training may be sufficient to provide measurements comparable to radiologists. On the other hand, additional efforts should be invested during otolaryngology training in terms of the evaluation of radiological imaging which may increase the capabilities of otolaryngology residents in this regard.
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Diego KA, Hardonk SC. Deaf Identity Under Pressure: Experiences of Deaf Persons in Iceland. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2023; 28:235-245. [PMID: 36641598 PMCID: PMC10039646 DOI: 10.1093/deafed/enac049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/04/2022] [Accepted: 11/12/2022] [Indexed: 06/17/2023]
Abstract
Over the past decades, changes in technology and policy have made developing and maintaining identity and community increasingly challenging for Deaf individuals. This is particularly obvious in Iceland, where the Deaf community is threatened in its existence. This paper reports on an empirical study that explores how Deaf individuals experience developing and maintaining a positive identity in various areas, including family life, working life, and social life. The study approaches deaf identities as multifaceted and dynamic, and particular emphasis is placed on the role of social interactions in identity-related processes. Qualitative interviews were conducted among members of the Icelandic Deaf community and analyzed using a phenomenological approach. The results indicate that social interactions within the Deaf community are a key factor in developing and maintaining Deaf identity. However, decreasing numbers in the Deaf community make its members explore other opportunities, and they experience being Deaf in Iceland as an insecure identity.
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Affiliation(s)
- Kristinn Arnar Diego
- Centre for Disability Studies, School for Social Sciences, University of Iceland
| | - Stefan C Hardonk
- Correspondence should be addressed to Stefan C. Hardonk, 00 354 5255317. E-mail:
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Pluta A, Krysztofiak M, Zgoda M, Wysocka J, Golec K, Gajos K, Dołyk T, Wolak T, Haman M. Theory of Mind and Parental Mental-State Talk in Children with CIs. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2023:enad004. [PMID: 36951492 PMCID: PMC10376925 DOI: 10.1093/deafed/enad004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Previous studies have suggested that parents may support the development of theory of mind (ToM) in their child by talking about mental states (mental state talk; MST). However, MST has not been sufficiently explored in deaf children with cochlear implants (CIs). This study investigated ToM and availability of parental MST in deaf children with CIs (n = 39, Mage = 62.92, SD = 15.23) in comparison with their peers with typical hearing (TH; n = 52, Mage = 52.48, SD = 1.07). MST was measured during shared storybook reading. Parents' narratives were coded for cognitive, emotional, literal, and non-mental references. ToM was measured with a parental questionnaire. Children with CIs had lower ToM scores than their peers with TH, and their parents used more literal references during shared storybook reading. There were no significant differences in the frequencies of cognitive and emotional references between groups. Parental emotional references contributed positively to children's ToM scores when controlling for the child's age and receptive grammar only in the CI group. These results indicated some distinctive features in parents of deaf children with CIs' MST and highlighted the role of MST in the development of ToM abilities in this group.
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Affiliation(s)
- Agnieszka Pluta
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
- Bioimaging Research Center, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | | | - Małgorzata Zgoda
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Joanna Wysocka
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Karolina Golec
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | | | - Tadeusz Dołyk
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Tomasz Wolak
- Bioimaging Research Center, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Maciej Haman
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
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Alkhamra R, Alkhamra H. Assessing school readiness in children with cochlear implants using an Arabic language-based test. SPEECH, LANGUAGE AND HEARING 2023. [DOI: 10.1080/2050571x.2023.2178760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- Rana Alkhamra
- Department of Hearing and Speech Sciences, University of Jordan, Amman, Jordan
| | - Hatem Alkhamra
- Department of Special Education, University of Jordan, Amman, Jordan
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Zaidman-Zait A, Curle D, Jamieson JR. Health-related quality of life among mothers of children with cochlear implants with and without developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 133:104397. [PMID: 36586392 DOI: 10.1016/j.ridd.2022.104397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/09/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Cochlear implants (CIs) are widely used among children with severe to profound hearing loss. Raising a child with a CI presents unique challenges to the family, especially when the child has a developmental disability (CI-DD). AIMS This study aimed to elucidate the relations between the functioning of children with CIs, their mothers' coping resources (i.e., social support and family-centered care), and maternal health-related quality of life (HRQoL). Also, it examined whether the presence of a DD in addition to the child's deafness moderated these relations. METHODS AND PROCEDURES A sample of 100 mothers of children with CIs (54 in the CI-DD group) completed questionnaires regarding perceived social support, family-centered care, and HRQoL. OUTCOMES AND RESULTS Mothers of deaf children with CIs and DD experienced lower levels of family functioning and HRQoL across all dimensions compared to mothers of deaf children with CIs without DD. In addition, social support was positively related to HRQoL only among mothers of children in the CI-DD group, indicating the protective role of social support. CONCLUSIONS AND IMPLICATIONS Social support is an important coping resource, and psychosocial support is needed for mothers of children with CIs, especially for mothers whose children also have a DD.
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Affiliation(s)
- Anat Zaidman-Zait
- Tel Aviv University, Israel; University of British Columbia, Canada.
| | - Deirdre Curle
- Washington Center for Deaf and Hard of Hearing Youth, USA.
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Meinhardt G, Sharrer C, Perez N, Downes A, Davidowitz T, Schuh M, Robinson L, Lustig LR, Bush M. Reporting of Sociodemographic Data in Cochlear Implant Clinical Trials: A Systematic Review. Otol Neurotol 2023; 44:99-106. [PMID: 36624584 PMCID: PMC9835009 DOI: 10.1097/mao.0000000000003766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The purpose of this study was to systematically evaluate the literature on the frequency of reporting of sociodemographic data (gender, race, ethnicity, education status, health insurance status, geographic location of residence, and socioeconomic status) among interventional clinical trials involving cochlear implant patients. DATABASES REVIEWED A systematic search was performed in PubMed, Cochrane Database of Systematic Reviews, Web of Science, and SCOPUS to identify peer reviewed research. METHODS A systematic review was performed, which included original prospective clinical trial research studies involving cochlear implantation and/or interventional trials involving cochlear implant patients. Collected data included funding type, level of evidence, race reporting, ethnicity reporting, socioeconomic status reporting, education level reporting, type of insurance, geographic location, and gender of patients. RESULTS A total of 644 articles were included for review. Gender was the most reported sociodemographic factor (70% of included studies). Reporting of other data among included studies was low: educational level (6%), socioeconomic status (2%), race (1%), ethnicity (1%), insurance status (0.3%), and geography (1%). The odds of reporting gender (odds ratio [OR] = 1.51), education (OR = 1.81), and geography (OR = 2.72) increased with each subsequent publication date decade; however, this trend was not seen for reporting of race, ethnicity, socioeconomic status, or insurance. The reporting of gender was less likely to be reported in studies with the pediatric participants (OR = 0.62), level II evidence (OR = 0.14), and device programming interventional studies (OR = 0.26). CONCLUSION Reporting of sociodemographic data, other than gender, is low among prospective clinical trials involving cochlear implant patients. The lack of reporting of this key data may limit research rigor and generalizability. Clinical researchers are advised to prospectively collect these data to promote equity in cochlear implant research and clinical care.
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Affiliation(s)
| | | | - Nicole Perez
- College of Medicine, University of Kentucky, Lexington, KY
| | - Alexandra Downes
- Department of Otolaryngology-Head and Neck Surgery, Vagelos College of Physicians and Surgeons, Columbia University New York, NY
| | - Tess Davidowitz
- Department of Otolaryngology-Head and Neck Surgery, Vagelos College of Physicians and Surgeons, Columbia University New York, NY
| | - Marissa Schuh
- Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, KY
| | | | - Lawrence R Lustig
- Department of Otolaryngology-Head and Neck Surgery, Vagelos College of Physicians and Surgeons, Columbia University New York, NY
| | - Matthew Bush
- Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, KY
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Liao EN, Yaramala N, Coulthurst S, Merrill K, Ho M, Kramer K, Chan DK. Impact of Sociodemographic Disparities on Language Outcomes After Cochlear Implantation in a Diverse Pediatric Cohort. Otolaryngol Head Neck Surg 2023; 168:1185-1196. [PMID: 36939528 DOI: 10.1002/ohn.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/09/2022] [Accepted: 10/08/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE We examined how sociodemographic and audiologic factors affect receptive and expressive language outcomes in children with cochlear implantation. STUDY DESIGN Retrospective cohort study. SETTING A hearing loss (HL) clinic at a tertiary center. METHODS Sociodemographic variables, HL characteristics, age at implantation, and receptive language scores (Preschool Language Scale and the Clinical Evaluation of Language Fundamentals) were collected from patients with congenital HL who received their first implant by 4 years old after January 1, 2007. t Tests, linear regression, Mann-Whitney, Cohen's d, and mediation analysis were used for descriptive statistics and hypothesis testing. RESULTS Among 79 patients, 42 (53%) were females, 44 (56%) under-represented minorities, and 56 (71%) had public insurance. At least 1 year after implantation, the median receptive language score was 69 (range 50-117). Females (p = .005), having private insurance (p = .00001), having a Cochlear Implant Profile score below 4 (p = .0001), and receiving their implant at or before 12 months of age (p = .0009) were significantly associated with improved receptive language outcomes. Insurance type had a significant effect on receptive language outcomes, independent from age at first implantation (total effect: coef = -13.00, p = .02; direct effect: coef = -12.26, p = .03; indirect effect: coef = -0.75, p = .47). Sociodemographic variables had large effect sizes, with the Cochlear Implant Profile score having the largest effect size (d = 1.3). CONCLUSION Sociodemographic factors have a large impact on receptive language outcomes. Public insurance is associated with worse receptive language, not mediated by later age at implantation, suggesting that other factors primarily impact language outcomes in publicly insured children with cochlear implants.
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Affiliation(s)
- Elizabeth N Liao
- Department of Otolaryngology-Head & Neck Surgery, University of California, San Francisco, California, USA
| | - Naveen Yaramala
- Department of Otolaryngology-Head & Neck Surgery, University of California, San Francisco, California, USA
| | - Sarah Coulthurst
- Department of Audiology, San Francisco Benioff Children's Hospital, University of California, Oakland, California, USA
| | - Kris Merrill
- Department of Otolaryngology-Head & Neck Surgery, University of California, San Francisco, California, USA
| | - Melissa Ho
- Department of Audiology, University of California, San Francisco, California, USA
| | - Kurt Kramer
- Department of Audiology, University of California, San Francisco, California, USA
| | - Dylan K Chan
- Department of Otolaryngology-Head & Neck Surgery, University of California, San Francisco, California, USA
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Bordeynik-Cohen M, Sperber M, Ebbers L, Messika-Gold N, Krohs C, Koffler-Brill T, Noy Y, Elkon R, Nothwang HG, Avraham KB. Shared and organ-specific gene-expression programs during the development of the cochlea and the superior olivary complex. RNA Biol 2023; 20:629-640. [PMID: 37602850 PMCID: PMC10443965 DOI: 10.1080/15476286.2023.2247628] [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] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/22/2023] Open
Abstract
The peripheral and central auditory subsystems together form a complex sensory network that allows an organism to hear. The genetic programs of the two subsystems must therefore be tightly coordinated during development. Yet, their interactions and common expression pathways have never been systematically explored. MicroRNAs (miRNAs) are short non-coding RNAs that regulate gene expression and are essential for normal development of the auditory system. We performed mRNA and small-RNA sequencing of organs from both auditory subsystems at three critical developmental timepoints (E16, P0, P16) to obtain a comprehensive and unbiased insight of their expression profiles. Our analysis reveals common and organ-specific expression patterns for differentially regulated mRNAs and miRNAs, which could be clustered with a particular selection of functions such as inner ear development, Wnt signalling, K+ transport, and axon guidance, based on gene ontology. Bioinformatics detected enrichment of predicted targets of specific miRNAs in the clusters and predicted regulatory interactions by monitoring opposite trends of expression of miRNAs and their targets. This approach identified six miRNAs as strong regulatory candidates for both subsystems. Among them was miR-96, an established critical factor for proper development in both subsystems, demonstrating the strength of our approach. We suggest that other miRNAs identified by this analysis are also common effectors of proper hearing acquirement. This first combined comprehensive analysis of the developmental program of the peripheral and central auditory systems provides important data and bioinformatics insights into the shared genetic program of the two sensory subsystems and their regulation by miRNAs.
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Affiliation(s)
- Mor Bordeynik-Cohen
- Laboratory of Neural and Sensory Genomics, Department of Human Molecular Genetics & Biochemistry, Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Michal Sperber
- Department of Human Molecular Genetics & Biochemistry, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lena Ebbers
- Neurogenetics group and Cluster of Excellence Hearing4All, School of Medicine and Health Sciences and Research Center for Neurosensory Science, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Naama Messika-Gold
- Department of Human Molecular Genetics & Biochemistry, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Constanze Krohs
- Neurogenetics group and Cluster of Excellence Hearing4All, School of Medicine and Health Sciences and Research Center for Neurosensory Science, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Tal Koffler-Brill
- Laboratory of Neural and Sensory Genomics, Department of Human Molecular Genetics & Biochemistry, Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Yael Noy
- Laboratory of Neural and Sensory Genomics, Department of Human Molecular Genetics & Biochemistry, Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Ran Elkon
- Department of Human Molecular Genetics & Biochemistry, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hans Gerd Nothwang
- Neurogenetics group and Cluster of Excellence Hearing4All, School of Medicine and Health Sciences and Research Center for Neurosensory Science, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Karen B. Avraham
- Laboratory of Neural and Sensory Genomics, Department of Human Molecular Genetics & Biochemistry, Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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41
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Noij KS, Huang EY, Walsh J, Creighton FX, Galaiya D, Bowditch SP, Stewart CM, Jenks CM. Trends in Timing and Provision of Pediatric Cochlear Implant Care During COVID‐19. OTO Open 2023; 7:e37. [PMID: 36998553 PMCID: PMC10046719 DOI: 10.1002/oto2.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/28/2023] [Indexed: 02/25/2023] Open
Abstract
Objectives To identify trends in timing of pediatric cochlear implant (CI) care during COVID-19. Study Design Retrospective cohort. Setting Tertiary care center. Methods Patients under 18 years of age who underwent CI between 1/1/2016 and 2/29/2020 were included in the pre-COVID-19 group, and patients implanted between 3/1/2020 and 12/31/2021 comprised the COVID-19 group. Revision and sequential surgeries were excluded. Time intervals between care milestones including severe-to-profound hearing loss diagnosis, initial CI candidacy evaluation, and surgery were compared among groups, as were the number and type of postoperative visits. Results A total of 98 patients met criteria; 70 were implanted pre-COVID-19 and 28 during COVID-19. A significant increase in the interval between CI candidacy evaluation and surgery was seen among patients with prelingual deafness during COVID-19 compared with pre-COVID-19 (µ = 47.3 weeks, 95% confidence interval [CI]: 34.8-59.9 vs µ = 20.5 weeks, 95% CI: 13.1-27.9; p < .001). Patients in the COVID-19 group attended fewer in-person rehabilitation visits in the 12 months after surgery (µ = 14.9 visits, 95% CI: 9.7-20.1 vs µ = 20.9, 95% CI: 18.1-23.7; p = .04). Average age at implantation in the COVID-19 group was 5.7 years (95% CI: 4.0-7.5) versus 3.7 years in the pre-COVID-19 group (95% CI: 2.9-4.6; p = .05). The time interval between hearing loss confirmation and CI surgery was on average 99.7 weeks for patients implanted during COVID-19 (95% CI: 48.8-150) versus 54.2 weeks for patients implanted pre-COVID (95% CI: 39.6-68.8), which was not a statistically significant difference (p = .1). Conclusion During the COVID-19 pandemic patients with prelingual deafness experienced delays in care relative to patients implanted before the pandemic.
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Affiliation(s)
- Kimberley S. Noij
- Department of Otolaryngology–Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - Emily Y. Huang
- Department of Otolaryngology–Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - Jonathan Walsh
- Department of Otolaryngology–Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - Francis X. Creighton
- Department of Otolaryngology–Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - Deepa Galaiya
- Department of Otolaryngology–Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - Stephen P. Bowditch
- Department of Otolaryngology–Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - C. Matthew Stewart
- Department of Otolaryngology–Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - Carolyn M. Jenks
- Department of Otolaryngology–Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA
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Huber M, Lee HJ, Langereis M, Vermeulen A. Editorial: Quality of life in young cochlear implant recipients: Are there controlling factors and regional differences? Front Psychol 2022; 13:1109242. [PMID: 36591102 PMCID: PMC9798845 DOI: 10.3389/fpsyg.2022.1109242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Maria Huber
- Department of Otorhinolaryngology, Paracelsus Medical University, Salzburg, Austria,*Correspondence: Maria Huber ✉
| | - Hyo-Jeong Lee
- Department of Otolaryngology, Hallym University Medical Center, Chuncheon, South Korea
| | - Margreet Langereis
- Research Department, Pento Speech and Hearing Centres, Nijmegen, Netherlands
| | - Anneke Vermeulen
- Research Department, Pento Speech and Hearing Centres, Nijmegen, Netherlands
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Shi X, Wu S, Liang D. Lexical Access in Preschool Mandarin-Speaking Children With Cochlear Implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:4761-4773. [PMID: 36417769 DOI: 10.1044/2022_jslhr-21-00671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE Children with cochlear implants (CIs) have less experience accessing spoken language. Mandarin Chinese uses pitch information to contrast word meaning, and the signal that the CI devices provide is degraded. Thus, Mandarin-speaking children with CIs may face more challenges in the development of language skills. This study examines preschool Mandarin-speaking children's performance in lexical access. We hypothesized that children with CIs and their peers with normal hearing (NH) have comparable naming ability, but they process phonological or semantic information differently. METHOD Twenty children with CIs and 20 age-matched children with NH were tested. The cross-modal visual-auditory picture-word interference paradigm was applied. The distractor was either phonologically related (mao55 cat -mao51 hat), semantically related (mao55 cat -shu214 mouse) or unrelated (mao55 cat -zhi214 paper) to the target, and it was aurally presented at four different points in time relative to the picture. Accuracy was compared between the two groups to tap into the children's naming abilities, and reaction time was analyzed to examine the effects of phonological and semantic information. RESULTS No group difference in accuracy was found. The phonologically related distractors led to significantly higher accuracy scores and shorter reaction times, whereas the semantically related distractors did not. Unlike the NH group, the CI group did not respond significantly faster or slower in phonologically related condition when the distractor and picture occurred simultaneously. Finally, the CI group made overall quicker responses than the NH group. CONCLUSIONS Children with CIs are as successful as children with NH in word retrieval and production, and the two groups both show phonological priming effect and lack semantic effect. However, children with CIs do not process phonological information as early as their NH peers, and they may be more tasks directed and hence make quicker responses.
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Affiliation(s)
- Xinyuan Shi
- School of Chinese Language and Literature, Nanjing Normal University, Jiangsu, China
| | - Shanshan Wu
- School of Chinese Language and Literature, Nanjing Normal University, Jiangsu, China
| | - Dandan Liang
- School of Chinese Language and Literature, Nanjing Normal University, Jiangsu, China
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44
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Cesur S, Topcu MT, Kalcıoğlu MT. Psychosocial Impact of the COVID-19 Pandemic on Children With Cochlear Implants and Their Parents/Family Members. Am J Audiol 2022; 31:1232-1246. [DOI: 10.1044/2022_aja-22-00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose:
The purpose of this study was to describe hearing health care and education experiences of children with cochlear implants (CIs) during the COVID-19 pandemic and the potential psychosocial effects of the pandemic on these children and their parents/family members.
Method:
The study used a cross-sectional survey design. The study sample comprised two groups, namely, parents/family members of children with CIs (study group,
n
= 70,
M
age
= 44.6 ± 12.4 years) and parents/family members of children with normal hearing (control group,
n
= 58,
M
age
= 43.8 ± 11.5 years). Parents/family members completed the Perceived Stress Scale (PSS), the Coronavirus Anxiety Scale (CAS), and the Family Perspective Profile form, as well as the Demographic Information form.
Results:
The PSS scores of the study group were higher than those of the control group (
p
= .001). However, there was no statistically significant difference between groups in the CAS scores (
p
= .896). According to the Family Perspective Profile form, almost half of the parents/family members of children with CIs reported that their children experienced difficulties in education and hearing health care services during the pandemic and showed some changes in their attitudes and behaviors.
Conclusions:
During the pandemic, the stress levels of parents/family members of children with CIs were higher than parents/family members of children with normal hearing. In addition to the challenges posed by the pandemic, the difficulties that parents/family members of children with CIs experience in meeting their children's additional needs related to accessing education and hearing health care services may have contributed to increased stress levels.
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Affiliation(s)
- Sıdıka Cesur
- Department of Audiology, Faculty of Health Sciences, Istanbul Medeniyet University, Turkey
| | - Merve Torun Topcu
- Department of Audiology, Faculty of Health Sciences, Istanbul Medeniyet University, Turkey
| | - Mahmut Tayyar Kalcıoğlu
- Department of Otorhinolaryngology–Head and Neck Surgery, Faculty of Medicine, Istanbul Medeniyet University, Turkey
- Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
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45
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Huber M. Cochlear implant-specific risks should be considered, when assessing the quality of life of children and adolescents with hearing loss and cochlear implants–not just cochlear implant-specific benefits–Perspective. Front Neurosci 2022; 16:985230. [DOI: 10.3389/fnins.2022.985230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 10/14/2022] [Indexed: 11/10/2022] Open
Abstract
Cochlear implants (CIs) are electronic medical devices that enable hearing in cases where traditional hearing aids are of minimal or no use. Quality of life (QoL) studies of children and adolescents with a CI have so far focused on the CI-specific benefits. However, the CI-specific risks listed by the U.S. Food and Drug Administration have not yet been considered. From this list, medical and device-related complications, lifelong dependency on the implanted device, and neurosecurity risks (CI technology is an interface technology) may be particularly relevant for young CI users. Medical and device-related complications can cause physical discomfort (e.g., fever, pain), as well as functioning problems (e.g., in speech discrimination, social behavior, and mood). In the worst case, reimplantation is required. Clinical experience shows that these complications are perceived as a burden for young CI users. Furthermore, many young patients are worried about possible complications. Additionally, CIs can be at least a temporary burden when children, typically at the age of 8–9 years, realize that they need the CI for life, or when they become peer victims because of their CI. Concerning neurosecurity risks, it is still unknown how young CI recipients perceive them. In summary, CI-specific risks can be perceived as a burden by young CI users that impairs their QoL. Therefore, they should not be ignored. There is an urgent need for studies on this topic, which would not only be important for professionals and parents, but also for the design of CI-specific QoL instruments.
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Glaubitz C, Liebscher T, Hoppe U. Children with cochlear implant and additional disabilities benefit from consistent device use. Int J Pediatr Otorhinolaryngol 2022; 162:111301. [PMID: 36096038 DOI: 10.1016/j.ijporl.2022.111301] [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: 03/29/2022] [Revised: 08/08/2022] [Accepted: 08/27/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Although the prevalence of additional disabilities (AD) in children with a cochlear implant (CI) is high, children with such disabilities are often excluded from clinical studies, or their specific characteristics are only partially included. The literature shows that several factors need to be considered in evaluating auditory and language development in CI children with AD, including demographic variables as well as the severity and type of disability. Current findings on device use in children show correlations with auditory and language outcome, but little is known about device use specifically in children with AD. The purpose of this study was to determine the auditory and language outcome of CI children with AD and to analyse their datalogging-based daily device use, both 1 year and 2 years after implantation. In addition, any potential correlations between outcome and device use were to be identified. METHODS A cohort of 32 CI children with 5 different types of AD were included in this retrospective analysis. The children's auditory and language outcome was assessed by the parental questionnaires LittlEARS and ELFRA and by the professional observation tool CAP (Categories of Auditory Performance) 1 and 2 years after implantation. Longitudinal device use was analysed by using the CI system-integrated data-logging; daily duration of CI use, number of coil disconnections and exposure to different listening scenes were recorded. RESULTS Overall, the cohort's auditory and language performance showed significant progress over time, while reduced abilities became more obvious after 2 years of CI experience. The mean daily duration of CI use increased significantly from 7.8 ± 2.8 to 8.2 ± 2.7 h after 2 years. High numbers of daily coil disconnections were detected, with a significant mean decrease from 83.4 ± 73.1 to 66.3 ± 54.6 whereas the percentage exposure to different listening environments was widely stable over time. Significant rank correlations were identified between outcomes measured by ELFRA and CAP with daily duration of CI use, numbers of coil disconnections and percentage of exposure to speech-characterised listening scenes. CONCLUSION The auditory and language outcome in CI children with AD is variable, but it progresses over time. Children benefit from a consistent daily device use as well as from a high exposure to speech-characterised environments. Device use should be monitored constantly, with particular focus on daily duration of CI use and, in particular, on the number of coil disconnections if children have a severe motor impairment. Objective data-logging is an important addition to outcome assessment by testing, observations and parental questionnaires. Although assessment in children with AD is a major challenge for professionals, comprehensive assessment is needed to improve cochlear implant services with special adaption to children with AD, and this should include audiological, development-related and psychosocial information. A unified system to classify types of disabilities could help to improve procedures for analysing different outcomes.
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Affiliation(s)
- Cynthia Glaubitz
- Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, ENT-clinic, Department of Audiology and Cochlear Implant Centre, Waldstr.1, 91054, Erlangen, Germany.
| | - Tim Liebscher
- Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, ENT-clinic, Department of Audiology and Cochlear Implant Centre, Waldstr.1, 91054, Erlangen, Germany
| | - Ulrich Hoppe
- Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, ENT-clinic, Department of Audiology and Cochlear Implant Centre, Waldstr.1, 91054, Erlangen, Germany
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Inguscio BMS, Cartocci G, Sciaraffa N, Nicastri M, Giallini I, Greco A, Babiloni F, Mancini P. Gamma-Band Modulation in Parietal Area as the Electroencephalographic Signature for Performance in Auditory-Verbal Working Memory: An Exploratory Pilot Study in Hearing and Unilateral Cochlear Implant Children. Brain Sci 2022; 12:1291. [PMID: 36291225 PMCID: PMC9599211 DOI: 10.3390/brainsci12101291] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 07/30/2023] Open
Abstract
This pilot study investigates the neurophysiological patterns of visual and auditory verbal working memory (VWM) in unilateral cochlear implant users (UCIs). We compared the task-related electroencephalogram (EEG) power spectral density of 7- to 13-year-old UCIs (n = 7) with a hearing control group (HC, n = 10) during the execution of a three-level n-back task with auditory and visual verbal (letters) stimuli. Performances improved as memory load decreased regardless of sensory modality (SM) and group factors. Theta EEG activation over the frontal area was proportionally influenced by task level; the left hemisphere (LH) showed greater activation in the gamma band, suggesting lateralization of VWM function regardless of SM. However, HCs showed stronger activation patterns in the LH than UCIs regardless of SM and in the parietal area (PA) during the most challenging audio condition. Linear regressions for gamma activation in the PA suggest the presence of a pattern-supporting auditory VWM only in HCs. Our findings seem to recognize gamma activation in the PA as the signature of effective auditory VWM. These results, although preliminary, highlight this EEG pattern as a possible cause of the variability found in VWM outcomes in deaf children, opening up new possibilities for interdisciplinary research and rehabilitation intervention.
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Affiliation(s)
- Bianca Maria Serena Inguscio
- Department of Sense Organs, Sapienza University of Rome, Viale dell’Università 31, 00161 Rome, Italy
- BrainSigns Srl, Lungotevere Michelangelo, 9, 00192 Rome, Italy
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell’Università 30, 00161 Rome, Italy
| | - Giulia Cartocci
- BrainSigns Srl, Lungotevere Michelangelo, 9, 00192 Rome, Italy
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, 00161 Rome, Italy
| | | | - Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Viale dell’Università 31, 00161 Rome, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University of Rome, Viale dell’Università 31, 00161 Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale dell’Università 31, 00161 Rome, Italy
| | - Fabio Babiloni
- BrainSigns Srl, Lungotevere Michelangelo, 9, 00192 Rome, Italy
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, 00161 Rome, Italy
- Department of Computer Science, Hangzhou Dianzi University, Xiasha Higher Education Zone, Hangzhou 310018, China
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale dell’Università 31, 00161 Rome, Italy
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Culbertson SR, Dillon MT, Richter ME, Brown KD, Anderson MR, Hancock SL, Park LR. Younger Age at Cochlear Implant Activation Results in Improved Auditory Skill Development for Children With Congenital Deafness. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3539-3547. [PMID: 36001854 PMCID: PMC9913281 DOI: 10.1044/2022_jslhr-22-00039] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/27/2022] [Accepted: 06/04/2022] [Indexed: 06/01/2023]
Abstract
PURPOSE The U.S. Food and Drug Administration indications for cochlear implantation in children is currently 9 months of age and older for children with bilateral profound sensorineural hearing loss (SNHL). Studies have shown that earlier activation of a cochlear implant (CI) can lead to better spoken language outcomes. As auditory skills are a precursor to the development of spoken language, this study was developed to investigate the influence of age at CI activation on auditory skill acquisition in young children. A secondary aim was to describe the auditory skills of children implanted prior to 9 months of age as compared to children with older ages of activation. METHOD Functional Listening Index (FLI) scores obtained during routine clinical visits were reviewed for 78 pediatric CI recipients with congenital bilateral profound hearing loss who were activated before 2 years of age. A linear mixed-effects model assessed the effect of age at CI activation on cumulative FLI scores over time. RESULTS There was a significant interaction between age at activation and chronological age at the time of evaluation, indicating that children with earlier access to sound achieved a greater number of auditory skills than those with later CI activations when measured at the same chronological age. Children activated before the age of 9 months approximated scores expected of children with typical hearing, whereas children activated between 9 and 24 months of age did not. CONCLUSIONS Younger age at CI activation is associated with increased auditory skills over time. Children who undergo cochlear implantation and CI activation before 9 months achieve more auditory skills by 4 years of age than children who are activated at later ages. These data suggest that reducing the approved age at cochlear implantation for children with congenital bilateral profound SNHL may support optimal auditory skill acquisition.
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Affiliation(s)
- Shannon R. Culbertson
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill
| | - Margaret T. Dillon
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Margaret E. Richter
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Kevin D. Brown
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Melissa R. Anderson
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Sandra L. Hancock
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Lisa R. Park
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
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49
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Yang Y, Gao J, Du H, Geng L, Li A, Zhao N, Xu Y, Liu X, Qian X, Gao X. Influence of cochlear implants on hearing-related quality of life: results from Chinese children with cochlear implants entering mainstream education. Int J Pediatr Otorhinolaryngol 2022; 160:111228. [PMID: 35932564 DOI: 10.1016/j.ijporl.2022.111228] [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: 04/13/2022] [Revised: 06/09/2022] [Accepted: 06/29/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to 1) assess the hearing-related Quality of Life (QoL) of children with cochlear implants (CIs) in China and 2) investigate the impact of CI in children and of the socio-demographic backgrounds of their guardians on the hearing-related QoL of children with CIs in the Chinese mainstream education system. METHODS This study used the Mandarin Children with Cochlear Implants: Parental Perspectives questionnaire (MPP), which assessed the communication capability, auditory perception, self-independence, level of happiness with family, social interaction, academic performance, outcome assessment for CI, and level of family support in children with CIs. Both univariate and multiple linear regression analyses were performed to identify the relationship of CI in children and the socio-demographic backgrounds of their guardians with hearing-related QoL in children with CI. RESULT A total of 124 responses were collected, and they indicated satisfaction and improvement across all aspects of the MPP Questionnaire. Statistical analysis revealed that an earlier age of cochlear implantation (≤3 years old) could improve the communication capabilities, self-independence, social interaction performance, and academic performance of children with CIs. In addition, children with CI from the urban regions demonstrated better social interaction performance than that by those from the rural regions of China. CONCLUSION CIs can improve hearing-related QoL in children with pre-lingual or congenital hearing loss entering the mainstream education system in China. This study showed that early age of cochlear implantation was critical for successful long-term auditory development and academic achievement in children with CIs in China. Therefore, healthcare professionals and educators in China should advocate for CI for children with severe congenital or pre-lingual hearing loss.
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Affiliation(s)
- Ye Yang
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), No.321 Zhongshan Road, Nanjing, 210008, China; Research Institute of Otolaryngology, No.321 Zhongshan Road, Nanjing, 210008, China
| | - Junyan Gao
- Department of Technical Counseling, Jiangsu Children's Rehabilitation Research Center, Nanjing, 210008, China
| | - Haoliang Du
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), No.321 Zhongshan Road, Nanjing, 210008, China; Research Institute of Otolaryngology, No.321 Zhongshan Road, Nanjing, 210008, China
| | - Liguo Geng
- Department of Medical Information, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Ao Li
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), No.321 Zhongshan Road, Nanjing, 210008, China; Research Institute of Otolaryngology, No.321 Zhongshan Road, Nanjing, 210008, China
| | - Ning Zhao
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), No.321 Zhongshan Road, Nanjing, 210008, China; Research Institute of Otolaryngology, No.321 Zhongshan Road, Nanjing, 210008, China
| | - Yuqin Xu
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), No.321 Zhongshan Road, Nanjing, 210008, China; Research Institute of Otolaryngology, No.321 Zhongshan Road, Nanjing, 210008, China
| | - Xueyao Liu
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), No.321 Zhongshan Road, Nanjing, 210008, China; Research Institute of Otolaryngology, No.321 Zhongshan Road, Nanjing, 210008, China
| | - Xiaoyun Qian
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), No.321 Zhongshan Road, Nanjing, 210008, China; Research Institute of Otolaryngology, No.321 Zhongshan Road, Nanjing, 210008, China
| | - Xia Gao
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), No.321 Zhongshan Road, Nanjing, 210008, China; Research Institute of Otolaryngology, No.321 Zhongshan Road, Nanjing, 210008, China.
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Wolf BJ, Kusch K, Hunniford V, Vona B, Kühler R, Keppeler D, Strenzke N, Moser T. Is there an unmet medical need for improved hearing restoration? EMBO Mol Med 2022; 14:e15798. [PMID: 35833443 PMCID: PMC9358394 DOI: 10.15252/emmm.202215798] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/12/2022] [Accepted: 06/02/2022] [Indexed: 12/26/2022] Open
Abstract
Hearing impairment, the most prevalent sensory deficit, affects more than 466 million people worldwide (WHO). We presently lack causative treatment for the most common form, sensorineural hearing impairment; hearing aids and cochlear implants (CI) remain the only means of hearing restoration. We engaged with CI users to learn about their expectations and their willingness to collaborate with health care professionals on establishing novel therapies. We summarize upcoming CI innovations, gene therapies, and regenerative approaches and evaluate the chances for clinical translation of these novel strategies. We conclude that there remains an unmet medical need for improving hearing restoration and that we are likely to witness the clinical translation of gene therapy and major CI innovations within this decade.
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Affiliation(s)
- Bettina Julia Wolf
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany.,Auditory Neuroscience and Optogenetics Laboratory, German Primate Center, Göttingen, Germany.,Auditory Neuroscience & Synaptic Nanophysiology Group, Max-Planck-Institute for Multidisciplinary Sciences, Göttingen, Germany.,Cluster of Excellence "Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells" (MBExC), University of Göttingen, Göttingen, Germany
| | - Kathrin Kusch
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany.,Functional Auditory Genomics Group, Auditory Neuroscience and Optogenetics Laboratory, German Primate Center, Göttingen, Germany
| | - Victoria Hunniford
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany.,Sensory and Motor Neuroscience PhD Program, Göttingen Graduate Center for Neurosciences, Biophysics, and Molecular Biosciences, Göttingen, Germany
| | - Barbara Vona
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany.,Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Robert Kühler
- Department of Otolaryngology, University Medical Center Göttingen, Göttingen, Germany
| | - Daniel Keppeler
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany.,Auditory Neuroscience & Synaptic Nanophysiology Group, Max-Planck-Institute for Multidisciplinary Sciences, Göttingen, Germany
| | - Nicola Strenzke
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany.,Department of Otolaryngology, University Medical Center Göttingen, Göttingen, Germany.,Collaborative Research Center 889, University of Göttingen, Göttingen, Germany
| | - Tobias Moser
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany.,Auditory Neuroscience and Optogenetics Laboratory, German Primate Center, Göttingen, Germany.,Auditory Neuroscience & Synaptic Nanophysiology Group, Max-Planck-Institute for Multidisciplinary Sciences, Göttingen, Germany.,Cluster of Excellence "Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells" (MBExC), University of Göttingen, Göttingen, Germany.,Collaborative Research Center 889, University of Göttingen, Göttingen, Germany
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