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Shahabaddin L, Al-Jaaf S, Emin A. Intraoperative Difficulties and Postoperative Complications Associated With Cochlear Implantations: A Study From Erbil City. Cureus 2024; 16:e52106. [PMID: 38213935 PMCID: PMC10783599 DOI: 10.7759/cureus.52106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 01/13/2024] Open
Abstract
Background and objective Cochlear implants are highly effective for the treatment of severe to profound hearing loss. Cochlear implant surgery is a safe surgical procedure; however, due to many modifications over the years, it has been associated with certain minor and major complications. This study aimed to examine the intraoperative difficulties and postoperative complications in patients who received cochlear implants in Erbil City. Methods We conducted a retrospective descriptive study regarding complications of cochlear implants involving patients who received unilateral or bilateral cochlear Implants at the Rizgary Teaching Hospital and a private hospital in Erbil City from January 2013 to July 2022. Their medical records were analyzed, and data on demographics, intraoperative difficulties, and postoperative complications were gathered. Results A total of 160 patients with cochlear implants (87 male, 54.4%; 73 female, 45.6%) were included in the study. The mean age of the patients at the time of operation was 6.76 ± 8.02 years (range: 1-53 years); 150 of these patients were children and 10 were adults (18 years and above). Intraoperative difficulties occurred in five patients (3.1%). The overall rate of complication was 10%, 7.5% of which was minor (the most common being wound infection) and 2.5% major (the most frequent being device extrusion). Conclusions Cochlear implant surgery is a safe procedure performed to treat profoundly deaf patients. It is associated with a low rate of complications, most of which can be successfully managed with conservative measures or minimal intervention.
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Affiliation(s)
- Lana Shahabaddin
- Otolaryngology - Head and Neck Surgery, Hawler Medical University, Erbil, IRQ
| | - Said Al-Jaaf
- Otolaryngology, Hawler Medical University, Erbil, IRQ
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Awad DR, Tang AJ, Venskytis EJ, Levy R, Kitsko DJ, Shaffer AD, Chi DH. Socioeconomic status and pediatric cochlear implant usage during COVID-19. Int J Pediatr Otorhinolaryngol 2024; 176:111800. [PMID: 38007839 DOI: 10.1016/j.ijporl.2023.111800] [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: 08/14/2023] [Revised: 10/28/2023] [Accepted: 11/19/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVE COVID-19 (COVID) delayed access to speech and hearing services. The objective of this study was to identify interactions between socioeconomic status (SES) and cochlear implant (CI) usage during COVID. METHODS Consecutive pediatric patients (age 0-17) with CI and audiology visits between 2019 and 2022 at a tertiary care children's hospital were reviewed. Age, sex, race, insurance type, and proxy measures for SES using zip code were recorded. Hours spent with CI on and in different listening environments were compared between pre-COVID (1/1/2019-12/31/2019), COVID (4/1/2020-3/31/2021), and most recent (6/1/2021-5/31/2022) time periods. RESULTS Most patients were male (32/59, 54 % ears of 48 patients) and White, non-Hispanic (45/59, 76 %). Median age at implant was 2.0 years (range:0.6-12.2). There were no significant differences in hours spent with CI on during COVID compared with pre-COVID. However, children spent more time listening to louder noises (70-79 dB and ≥80 dB) recently compared with during COVID (p = 0.01 and 0.006, respectively). During COVID, children living in areas with greater educational attainment showed smaller reductions in total hours with CI on (β = 0.1, p = 0.02) and hours listening to speech in noise (β = 0.03, p = 0.005) compared with pre-COVID. In the most recent time period, children of minority race (β = -3.94 p = 0.008) and those who were older at implant (β = -0.630, p = 0.02) were more likely to experience reductions in total hours with CI on compared with during COVID. CONCLUSION Interventions which mitigate barriers of implant use and promote rich listening home-environments for at risk populations should be implemented during challenging future social and environmental conditions.
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Affiliation(s)
- Daniel R Awad
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Anthony J Tang
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Emily J Venskytis
- Department of Audiology and Speech-Language Pathology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Rena Levy
- Department of Audiology and Speech-Language Pathology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Dennis J Kitsko
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Amber D Shaffer
- Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - David H Chi
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
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Transtympanic Visualization of Cochlear Implant Placement With Optical Coherence Tomography: A Pilot Study. Otol Neurotol 2022; 43:e824-e828. [PMID: 35970156 DOI: 10.1097/mao.0000000000003635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to evaluate the ability of transtympanic middle ear optical coherence tomography (ME-OCT) to assess placement of cochlear implants (CIs) in situ. PATIENT A 72-year-old man with bilateral progressive heredodegenerative sensorineural hearing loss due to work-related noise exposure received a CI with a slim modiolar electrode for his right ear 3 months before his scheduled checkup. INTERVENTION A custom-built swept source ME-OCT system (λo = 1550 nm, ∆λ = 40 nm) designed for transtympanic middle ear imaging was used to capture a series of two- and three-dimensional images of the patient's CI in situ. Separately, transtympanic OCT two-dimensional video imaging and three-dimensional imaging were used to visualize insertion and removal of a CI with a slim modiolar electrode in a human cadaveric temporal bone through a posterior tympanotomy. MAIN OUTCOME MEASURE Images and video were analyzed qualitatively to determine the visibility of implant features under ME-OCT imaging and quantitatively to determine insertion depth of the CI. RESULTS After implantation, the CI electrode could be readily visualized in the round window niche under transtympanic ME-OCT in both the patient and the temporal bone. In both cases, characteristic design features of the slim modiolar electrode allowed us to quantify the insertion depth from our images. CONCLUSIONS ME-OCT could potentially be used in a clinic as a noninvasive, nonionizing means to confirm implant placement. This study shows that features of the CI electrode visible under ME-OCT can be used to quantify insertion depth in the postoperative ear.
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Madahana MC, Khoza-Shangase K, Moroe N, Mayombo D, Nyandoro O, Ekoru J. A proposed artificial intelligence-based real-time speech-to-text to sign language translator for South African official languages for the COVID-19 era and beyond: In pursuit of solutions for the hearing impaired. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2022; 69:e1-e11. [PMID: 36073078 PMCID: PMC9452925 DOI: 10.4102/sajcd.v69i2.915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/15/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background The emergence of the coronavirus disease 2019 (COVID-19) pandemic has resulted in communication being heightened as one of the critical aspects in the implementation of interventions. Delays in the relaying of vital information by policymakers have the potential to be detrimental, especially for the hearing impaired. Objectives This study aims to conduct a scoping review on the application of artificial intelligence (AI) for real-time speech-to-text to sign language translation and consequently propose an AI-based real-time translation solution for South African languages from speech-to-text to sign language. Methods Electronic bibliographic databases including ScienceDirect, PubMed, Scopus, MEDLINE and ProQuest were searched to identify peer-reviewed publications published in English between 2019 and 2021 that provided evidence on AI-based real-time speech-to-text to sign language translation as a solution for the hearing impaired. This review was done as a precursor to the proposed real-time South African translator. Results The review revealed a dearth of evidence on the adoption and/or maximisation of AI and machine learning (ML) as possible solutions for the hearing impaired. There is a clear lag in clinical utilisation and investigation of these technological advances, particularly in the African continent. Conclusion Assistive technology that caters specifically for the South African community is essential to ensuring a two-way communication between individuals who can hear clearly and individuals with hearing impairments, thus the proposed solution presented in this article.
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Affiliation(s)
- Milka C Madahana
- School of Electrical and Information Engineering, University of the Witwatersrand, Johannesburg.
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Cejas I, Mitchell CM, Barker DH, Sarangoulis C, Eisenberg LS, Quittner AL. Parenting Stress, Self-Efficacy, and Involvement: Effects on Spoken Language Ability Three Years After Cochlear Implantation. Otol Neurotol 2021; 42:S11-S18. [PMID: 34766939 PMCID: PMC8597911 DOI: 10.1097/mao.0000000000003374] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study evaluated associations among parenting stress, self-efficacy, and involvement in relation to spoken language outcomes in young children 3 years following cochlear implantation. STUDY DESIGN Cross-sectional. SETTING Six university tertiary medical centers. PATIENTS One hundred sixty-four young children with bilateral, severe-to-profound sensorineural hearing loss who had 3 years of experience with a CI; children with substantial cognitive impairments were excluded from the study. MAIN OUTCOME MEASURESS Family Stress Scale (FSS), Scale of Parental Involvement and Self-Efficacy (SPISE), Oral and Written Language Scales (OWLS). RESULTS Correlations were of moderate strength between FSS scores and SPISE scores (Parental Self-Efficacy, r = -0.45, p < 0.01, Parental Involvement r = -0.32, p < 0.01). As hypothesized, parents reporting higher levels of stress reported lower perceptions of self-efficacy and involvement. In addition, results showed that family stress had a direct, negative effect on spoken language (-4.43 [95% confidence interval: -6.97; -1.89]). After controlling for maternal education and activation age, parental self-efficacy mediated the negative effect between family stress and spoken language (indirect effect = -1.91 [3.45; -0.69]; proportion mediated = 0.43). No mediating effects were found for parental involvement. CONCLUSIONS These findings highlight the need for parenting interventions that focus on reducing stressors and increasing parents' perceptions of self-efficacy in families of children using cochlear implants. Integration of mental health screening and tailored parenting interventions in CI clinics may increase parental self-efficacy and involvement, with measurable benefits in the child's use of spoken language.
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Affiliation(s)
- Ivette Cejas
- Department of Otolaryngology, University of Miami Ear Institute, Miami, FL
| | - Christine M. Mitchell
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - David H. Barker
- Department of Psychiatry and Human Behavior, The Alpert Medical School of Brown University, Providence, RI
- Department of Psychiatry, Rhode Island Hospital, Providence, RI
| | | | - Laurie S. Eisenberg
- Caruso Department of Otolaryngology, Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Quality of Life-CI: Development of an Early Childhood Parent-Proxy and Adolescent Version. Ear Hear 2021; 42:1072-1083. [PMID: 33974778 PMCID: PMC8855668 DOI: 10.1097/aud.0000000000001004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Severe to profound hearing loss is associated with communication, social, and behavioral difficulties that have been linked to worse health-related quality of life (HRQoL) compared to individuals with normal hearing. HRQoL has been identified as an important health outcome that measures functional ability, particularly for chronic conditions and disabilities. The current study developed the QoL-cochlear implant (CI) for early childhood and adolescents using the recommended Food and Drug Administration and European Medicines Agency guidelines on patient-reported outcomes. DESIGN Three phases of instrument development were conducted for both the early childhood (0 to 5 years old; parent proxy) and adolescent/young adult (13 to 22 years old) versions of the QoL-CI. Phase 1 included the development of our conceptual framework, which informed the discussion guides for stakeholder focus groups (e.g., audiologists, physicians, and therapists) at CI clinics in Miami and Philadelphia (n = 39). Open-ended interviews with parents (N = 18 for early childhood; N = 6 for adolescent/young adult version) and adolescents/young adults using CIs (n = 17) were then completed at both sites during phase 2. All interviews were transcribed and coded to identify common themes, which were then used to draft items for the QoL-CI. Both versions of the QoL-CI were developed using Qualtrics to allow for quick, easy electronic administration of the instruments on a tablet device. Last, phase 3 included cognitive testing in a new sample (N = 19 early childhood, N = 19 adolescent) to ensure that the draft instruments were clear, comprehensive, and easy to use. RESULTS Participant responses obtained via the open-ended interviews yielded an early childhood and adolescent version of the QoL-CI that was reportedly easy to complete and comprehensive. The final QoL-CI Early Childhood instrument yielded 35 questions across eight functional domains (environmental sounds, communication, social functioning, behavior, CI device management and routines, school, CI benefits, and early intervention). Similarly, the final QoL-CI adolescent/young adult version consisted of 46 items across eight domains (noisy environments, communication, CI usage and management, advocacy, social functioning, emotional functioning, acceptance, and independence). CONCLUSIONS The QoL-CI is a condition-specific QoL instrument that can be used for children ages birth through 22 years. These instruments capture the "whole" child by not only focusing on communication and auditory skills but also academic, social and emotional functioning. Once validated, these CI-specific measures will enable providers to track long-term outcomes and evaluate the efficacy of new interventions to improve overall CI use and QoL for pediatric and young adult users.
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Bruno R, Freni F, Portelli D, Alberti G, Gazia F, Meduri A, Galletti F, Galletti B. Frequency-lowering processing to improve speech-in-noise intelligibility in patients with age-related hearing loss. Eur Arch Otorhinolaryngol 2020; 278:3697-3706. [PMID: 33083865 DOI: 10.1007/s00405-020-06431-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Modern hearing aids use various signal-processing strategies to improve speech intelligibility. In this manuscript, we studied the linear frequency transposition (LFT), a frequency-lowering algorithm, in patients with age-related hearing loss. Frequency-lowering algorithms transpose high-frequency sounds to a lower-frequency band. The study aimed to assess whether LFT could be used as a tool to improve speech intelligibility in patients with a better high-frequency preservation. METHODS The study population consisted of 77 patients (age average 74.8 ± 12.4) wearing hearing aids with an open or tulip coupling system with age-related hearing loss. The unaided air conduction pure tone average (PTA) at 500, 1000, 2000 Hz was 43.5 ± 14.3 dB; the unaided word recognition score (WRS) average was 53.7 ± 12.5%. We compared WRS in all patients with the hearing aid turned on, in "quiet" and using a "pink" and "babble" masking noise. Three hearing aid settings were tested in each acoustic conditions: no transposition (NT), high transposition (HT), and low transposition (LT). "High" and "low" refer to the "start frequency"; all sounds above the start frequency are transposed in a lower-frequency band. When the start frequency was suggested by the fitting software, we called the condition "high transposition"; when the start frequency was set at the lowest possible value provided by the fitting software, we called the condition "low transposition". The quality of the voice was also assessed asking the patient to give a score from 1 to 10, where 10 was the maximum listening comfort [quality of voice score (QVS)]. RESULTS Collected data were compared for each condition (NT, HT, LT, in quiet, pink noise and babble noise) and no statistically significant differences were found in WRS and QVS (quiet WRS p = 0.07, pink noise WRS p = 0.18, babble noise WRS p = 0.11, QVS p = 0.91). We selected 33 patients with a better WRS in babble noise using transposition (high and low). In this group, the age was significantly lower than patients who did not use transposition (p = 0.01). CONCLUSION Linear frequency transposition is not useful to improve speech-in-noise intelligibility in patients with age-related hearing loss. Despite that no statistically significant differences were found, younger people could get advantages from the LFT when babble noise disturbs the listening of speech. The use of FL algorithm as a way to improve speech intelligibility in noisy environments should be always considered.
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Affiliation(s)
- Rocco Bruno
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Francesco Freni
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Daniele Portelli
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Giuseppe Alberti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Francesco Gazia
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy.
| | - Alessandro Meduri
- Department of Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Unit of Ophthalmology, University of Messina, Messina, Italy
| | - Francesco Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Bruno Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
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Thorpe RK, Smith RJH. Future directions for screening and treatment in congenital hearing loss. PRECISION CLINICAL MEDICINE 2020; 3:175-186. [PMID: 33209510 PMCID: PMC7653508 DOI: 10.1093/pcmedi/pbaa025] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/06/2020] [Accepted: 07/12/2020] [Indexed: 02/06/2023] Open
Abstract
Hearing loss is the most common neurosensory deficit. It results from a variety of heritable and acquired causes and is linked to multiple deleterious effects on a child's development that can be ameliorated by prompt identification and individualized therapies. Diagnosing hearing loss in newborns is challenging, especially in mild or progressive cases, and its management requires a multidisciplinary team of healthcare providers comprising audiologists, pediatricians, otolaryngologists, and genetic counselors. While physiologic newborn hearing screening has resulted in earlier diagnosis of hearing loss than ever before, a growing body of knowledge supports the concurrent implementation of genetic and cytomegalovirus testing to offset the limitations inherent to a singular screening modality. In this review, we discuss the contemporary role of screening for hearing loss in newborns as well as future directions in its diagnosis and treatment.
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Affiliation(s)
- Ryan K Thorpe
- Molecular Otolaryngology and Renal Research Laboratories, Carver College of Medicine, University of Iowa, 375 Newton Rd, Iowa City, IA 52242, USA
- Department of Otolaryngology – Head and Neck Surgery, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242, USA
| | - Richard J H Smith
- Molecular Otolaryngology and Renal Research Laboratories, Carver College of Medicine, University of Iowa, 375 Newton Rd, Iowa City, IA 52242, USA
- Department of Otolaryngology – Head and Neck Surgery, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242, USA
- The Interdisciplinary Graduate Program in Genetics, University of Iowa, 375 Newton Rd, Iowa City, IA 52242, USA
- Iowa Institute of Human Genetics, University of Iowa, 375 Newton Rd, Iowa City, IA 52242, USA
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