The effects of age of cochlear implantation on speech perception outcomes in prelingually deaf children

Acoustic and Aerodynamic Analyses of the Voice of Prelingually Deaf Young Men After Cochlear Implantation

OBJECTIVE

The purpose of this study was to characterize the acoustic and aerodynamics of the voice of young men with prelingual deafness after cochlear implantation (CI) to provide a theoretical basis for their rehabilitation after CI.

METHODS

The CI group included 17 young men with prelingual deafness who implanted cochlear at 18-24 years old. The control group included 17 normally hearing young men at the same age. The 10-item Voice Handicap Index, acoustic parameters, and aerodynamic parameters were evaluated.

RESULTS

For the acoustic parameters, the F0, SDF0, and Jitter of the CI group were higher than those of the Control group, and these differences were statistically significant. Additionally, The difference in mean shimmer and mean NHR values between the CI group and the Control group was not statistically significant For the aerodynamic parameters, the subglottal pressure and aerodynamic power of the CI group were significantly higher than those of the Control group, whereas the MPT was significantly shorter.

DISCUSSION

Due to excessive stress on the laryngeal muscle and limited pneumo-phono-articulatory coordination, the young men in the CI group had a thin voice and poor voice control and muscle coordination, and they exhibited excessive laryngeal resistance. We propose that after CI, in addition to regular hearing and speech rehabilitation, voice training is also extremely important for prelingually deaf young men.

DTI study on rehabilitation of the congenital deafness auditory pathway and speech center by cochlear implantation

PURPOSE

To explore the correlation between hearing and speech recovery levels after cochlear implantation and examined the preoperative microstructure of auditory pathways and speech centre using DTI.

METHODS

(1) Fifty-two SNHL children between 0 and 6 years and 19 age and gender matched normal hearing subjects had received 3.0 T-MRI examination of the brain.FA, axial diffusion coefficient (λ_‖), radial diffusion coefficient (λ_⊥), and MD values in the lateral lemniscus, inferior colliculus, medial geniculate bodies, auditory radiations, Brodmann areas 41, 42, 22, 44, 45, and 39 were all measured bilaterally. (2) CAP and SIR scores were assessed in fourty-six cochlear implantation children at 6 months post-implant. Correlations among deaf children ages, FA value of bilateral inferior colliculus FA values, BA22, BA44, and postoperative CAP, and SIR scores were analyzed using multiple linear regression.

RESULTS

The preoperative standard partial regression age coefficient of deaf children (|bi'| = 0.404) was slightly greater than that of the inferior colliculus (|bi'| = 0.377) FA value.

CONCLUSION

Preoperative children ages and inferior colliculus FA values were important factors influencing postoperative CAP score. Inferior colliculus FA value is a vital influencing factor in rehabilitation after cochlear implantation.

Cochlear Implantation and Social-Emotional Functioning of Children with Hearing Loss

This study examined the contribution of cochlear implants (CIs) to the social-emotional functioning of children who are deaf or hard of hearing (dhh). Sixty-three parents of children who are dhh participated in the study. Thirty children were CI users and 32 used hearing aids (HAs). They completed the Strengths and Difficulties Questionnaire and a background questionnaire. Parents of children with CIs reported lower levels of hyperactivity/inattention and higher levels of pro-social behavior compared to parents of children with HAs. Additionally, older age when hearing loss was detected was related to more pro-social behavior, and age at implantation among CI users was negatively correlated with children's hyperactivity/inattention and conduct problems. These findings add to the existing knowledge about the many benefits of CIs for individuals with hearing loss and emphasize the possible impact of early implantation to children's social-emotional functioning.

Parental mode of communication is essential for speech and language outcomes in cochlear implanted children

CONCLUSION

The present study demonstrates a very strong effect of the parental communication mode on the auditory capabilities and speech/language outcome for cochlear implanted children. The children exposed to spoken language had higher odds of scoring high in all tests applied and the findings suggest a very clear benefit of spoken language communication with a cochlear implanted child.

OBJECTIVES

The aim of the study was to identify factors associated with speech and language outcomes for cochlear implanted children and also to estimate the effect-related odds ratio for each factor in relation to the children's speech and language performances.

METHODS

Data relate to 155 prelingually deafened children with cochlear implant (CI). A test battery consisting of six different speech and language tests/assessments was used. Seven different factors were considered, i.e. hearing age, implantation age, gender, educational placement, ear of implantation, CI center, and communication mode. Logistic regression models and proportional odds models were used to analyze the relationship between the considered factors and test responses.

RESULTS

The communication mode at home proved essential to speech and language outcome, as children exposed to spoken language had markedly better odds of performing well in all tests, compared with children exposed to a mixture of spoken language and sign support, or sign language.

What can be expected from a late cochlear implantation?

OBJECTIVE

Verify if late cochlear implantation allows pre-lingual deafs to convert from visual to oral communication mode only.

METHOD

Thirteen pre-lingual profoundly deaf patients implanted the ages of 8 and 22 years were included in the study. Before cochlear implantation, none of the patients used the oral language. Six patients used cued speech and seven used the sign language to communicate. Evaluations were made with measures of hearing thresholds, phoneme identification, categories of auditory performance and rating of the intelligibility of speech before and after implantation. Changes in principal mode of communication (i.e. oral, cued speech or sign language) were also monitored.

RESULTS

The former users of cued speech benefited significantly more from cochlear implantation than the sign language users for phoneme identification and categories of auditory performance, although all had similar hearing thresholds before and after cochlear implantation. After a mean implant use of 4.5 years, four out of six cued speech users converted to exclusive use of the oral language, while only one out of seven former users of the sign language converted to the use of the oral language.

DISCUSSION

It is possible for pre-lingual or congenital deafs to convert totally from a visual to an oral communication mode even in case of late cochlear implantation. Previous awareness of the structure of the oral language, even without hearing (e.g. via cued speech) influences positively the outcome of delayed implantations. We recommend the adoption of oral communication with the cued speech code in cases where a late cochlear implantation is envisioned.

Cochlear implant surgery at 12 months of age or younger

OBJECTIVES

Early presentation of congenitally deaf children for cochlear implantation is leading to surgery in younger candidates. The safety of cochlear implantation in children aged 12 months and younger is reviewed with radiologic assessment of mastoid bone anatomy and surgical outcome data.

STUDY DESIGN

Analysis of case records and temporal bone computed tomography (CT) scans with description of surgical technique in infants.

METHODS

Chart analysis of children aged 12 months or younger at cochlear implantation. Mastoid bone anatomy was compared with older children (mean age 2 years) using CT scans.

RESULTS

Twenty-five infants received implants at 7 to 12 months of age because of meningitis (n = 4) or early detection of deafness (n = 21). Mastoid marrow content on CT scan was significantly greater in this age group (P < .001 Mann-Whitney rank sum test), but pneumatization was always adequate for safe identification of surgical landmarks. The smaller size of the mastoid bone was not restrictive. An extended postauricular approach was used in the first 11 cases and a 2.5 cm hair-line incision in the remainder. Ligature tie-down of the device was completed in all cases. No complications occurred. All are full-time implant users, except one with other neurologic sequelae of preoperative meningitis.

CONCLUSIONS

In our experience, cochlear implant surgery is safe in children aged 7 to 12 months with appropriate anesthetic and postoperative support. The small incision technique is particularly suited to this age group. Ligature fixation of the device is considered advisable because of the increased risk of displacement from frequent falls when learning to walk.

[Hypoacusis-deafness related to perinatal adverse conditions. According to the register available in a specialized unit of Ciudad de Mexico. Analysis according to birth weight]

OBJECTIVE

To analyse perinatal adverse conditions related with birth weight in 160 children with hearing impairment-deafness (prelingual sensorineural hearing loss) according to medical data of a specialized medical unit in Mexico City.

RESULTS

The average age of children was 4 years old +/- 1.7; 61% were male. 47.5% of the cases had a birthweight between 1,500 and 2,900 g. 90 cases (56%) had an abnormal delivery and 68 (42.5%) were first pregnancy cases. A high number of cases had delayed breathing, cyanosis, jaundice or respiratory failure. 104 cases (65%) had deafness and 56 (35%) presented. hearing loss. Only 11% of the children had a birth-weight under 1,500 g. 58% of all cases had a birth weight lower than 3,000 g.

CONCLUSION

The quality of medical assistance provided during the perinatal period has a very important role in origin of hearing impairment--deafness in this group of children. It is important to increase our knowledge about the perinatal adverse conditions in order to establish preventive programs.