Does bimodal hearing increase self-assessed abilities and hearing outcomes when compared to unilateral cochlear implantation?

Contralateral hearing aid use in adult cochlear implant recipients: retrospective analysis of auditory outcomes

OBJECTIVE

To investigate retrospectively the frequency of usage of bimodal stimulation among cochlear implant (CI) users, as well its clinical benefit relative to unilateral use.

DESIGN

All subjects had been monitored with the clinical Minimal Outcome Measurements test battery.

STUDY SAMPLES

103 adults with bilateral postlingual profound sensorineural hearing loss and unilateral CI use were extracted from the local database. These were divided into two groups: those who only used a CI and those who used bimodal stimulation.

RESULTS

The preoperative contralateral residual hearing in the bimodal group was significantly better than that of the CI-only group. In both groups, speech perception in quiet and in noise improved after CI, with no significant difference between postoperative unimodal conditions. For the bimodal group, an additional significant improvement was found for the bimodal condition compared to the unimodal.

CONCLUSION

Given the observed auditory benefit of bimodal stimulation in comparison to unimodal stimulation and given the finding that degree of residual hearing is not correlated with bimodal benefits, it is recommended to encourage CI recipients to continue contralateral HA use after CI. As a result of expanding CI criteria worldwide, the population of bimodal users is expected to grow in the near future.

Long-Term Non-Users of Transcutaneous Auditory Implants: Thirty Years of Experience at a Single Institution

Background: Although it is a recognized phenomenon, there is little published in the literature on the discontinuation of auditory implant use. Aim: To evaluate the incidence of device non-use of transcutaneous auditory implants. Patients and Methods: This is a retrospective study of all living individuals (children and adults) implanted at the La Paz Hospital (Madrid, Spain) between 1992-2015, with a follow-up examination endpoint of December 2022. 356 device recipients were included: 316 with cochlear implants (CI), 22 with middle-ear implants (Vibrant Soundbridge, VSB), and 18 with bone conduction implants (Bonebridge, BB). Results: Nine CI recipients (2.8%) were identified as non-users (mean follow-up 15.1 ± 5.4 years). The reasons for non-use were implant failure and reimplantation rejection, lack of benefit, non-attendance of rehabilitation sessions, loss of the audio processor, and cognitive and linguistic difficulties. None of them experienced any surgical complications. Six VSB recipients (27.3%) were device non-users (mean follow-up 11.4 ± 2.1 years). All of them experienced device failure or surgical complications. To date, none of the BB recipients is a non-user (mean follow-up 8.6 ± 1.1 years). Conclusion: The rates of non-use of transcutaneous auditory implants vary widely between different types of implants. Given the small proportion of non-users, information on what are the predictive factors could not be determined. The reasons for non-use should be carefully documented and used to guide careful patient selection to reduce the risk of non-use in future candidates.

Improved performance with automatic sound management 3 in the MED-EL SONNET 2 cochlear implant audio processor

Objectives

The SONNET 2 audio processor features ambient noise reduction (ANR), transient-noise reduction (TNR), and adaptive intelligence (AI). The primary aim of this study was to evaluate if using these features improves speech perception in noise, subjective listening effort, and sound quality.

Design

In this prospective longitudinal study, twenty adult SONNET users were fitted with the SONNET 2 audio processor, configured either as a default SONNET (no ANR/TNR/AI), with mild ANR/TNR, with strong ANR/TNR, with mild AI, and with strong AI. Speech perception in noise was assessed in speech and stationary noise from the front (S0N0); speech, stationary noise, and transient noise from the front (S0N0T0); and speech from the front in spatially-distributed stationary noise (S0N±45N±135). Listening effort, subjective sound quality, and device/setup preference were assessed.

Results

In the S0N0 setup, speech perception in noise was significantly better with the SONNET 2 when using ANR/TNR in the mild setup than with the SONNET or the SONNET 2 in the default SONNET configuration. In the S0N±45N±135 setup, speech understanding was significantly better in all four SONNET 2 configurations than with the SONNET or the SONNET 2 in the default SONNET configuration (a 1.26–2.55 dB SRT80 benefit). Subjects tolerated consistently lower signal-to-noise values with the SONNET 2 configurations using ANR/TNR than with the default SONNET configuration in all listening effort categories. All SONNET 2 configurations using ANR/TNR were preferred and better rated in speech in stationary and/or transient noise compared to the default SONNET configuration. Sound quality and pleasantness were better in those SONNET 2 configurations. Subjects strongly preferred the SONNET 2 configurations over the SONNET configuration.

Conclusions

The new front-end features implemented in the SONNET 2 audio processor objectively improve speech perception in noise. Subjects preferred the SONNET 2, over the SONNET, in the presence of stationary and transient noise.

Performance and self-perceived hearing impairment after cochlear implantation in Menière's disease

OBJECTIVE

Evaluation of the self-perceived hearing impairment and performance after cochlear implantation in patients with definite Menière's disease (MD).

PATIENTS AND METHODS

Seventeen unilaterally or bilaterally profoundly hearing-impaired patients suffering from MD who received a cochlear implantat (CI) were eligible for inclusion in this study. Their self-perceived hearing impairment using the short Speech Spatial and Qualities of Hearing Scale (SSQ12) as well as their performance in speech perception (German language Freiburger mono- and multisyllable test, Oldenburger sentence test) were compared with a best-matched control group of non-MD patients up to 24 months of follow-up.

RESULTS

MD patients improved significantly in perception of monosyllables presented at 65 dBSPL, from preoperatively best aided 18.2% [2.4, 34.0] to 51.7% [39.4, 63.9] 1 year after cochlear implantation (mean [95% confidence interval]). Their performance approached the matched controls with 63.2% [55.7, 70.8]. Monosyllables presented at a lower intensity of 55 dBSPL revealed a significant underperformance of the MD patients (21.1% [12.6, 29.6]) in contrast to the non-MD controls (39.1% [30.9, 47.4]) 12 months post-CI. Self-assessed hearing disability was significantly more pronounced in MD patients with a mean total SSQ12 score of 3.6 [2.4, 4.9] in comparison to 6.1 [5.4, 6.8] of the matched non-MD controls after 12 months of cochlear implantation.

CONCLUSION

Cochlear implantation substantially improves hearing capabilities in profoundly hearing-impaired patients with MD, but they tend to underperform in comparison to non-MD patients at least at lower sound pressure levels. This is likely one reason for the poorer self-assessed hearing function of cochlear implanted MD patients.

LEVEL OF EVIDENCE

3, retrospective, nonrandomized follow-up study.

Effect of cochlear implantation on cognitive decline and quality of life in younger and older adults with severe-to-profound hearing loss

Purpose

(a) To measure the change in cognition, the improvement of speech perception, and the subjective benefit in people under and over 60 years following cochlear implantation. (b) To assess the relationship between cognition, demographic, audiometric, and subjective outcomes in both age groups.

Methods

28 cochlear implant (CI) users were assigned to the < 60y group and 35 to the ≥ 60y group. Cognition was measured using the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing impaired individuals (RBANS-H); subjective benefit was measured using the Nijmegen Cochlear Implant Questionnaire (NCIQ); the Glasgow Benefit Inventory (GBI); the Hearing Implant Sound Quality Index (HISQUI₁₉); Speech, Spatial and Qualities of Hearing Scale (SSQ₁₂); and the Hospital Anxiety and Depression Scale (HADS).

Results

Prior to surgery: the RBANS-H total score positively correlated with the domains “Advanced sound”, “Self-esteem”, and “Social functioning” of NCIQ, and negatively with HADS scores. 12 months post-implantation: the RBANS-H total score increased in the < 60y (p = 0.038) and in the ≥ 60y group (p < 0.001); speech perception and subjective outcomes also improved; RBANS-H total score positively correlated with “Self-esteem” domain in NCIQ. Age and the RBANS-H total score correlated negatively in the ≥ 60y group (p = 0.026).

Conclusions

After implantation, both age groups demonstrated improved cognition, speech perception and quality of life. Their depression scores decreased. Age was inversely associated with cognition.