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Mertens G, Andries E, Clement C, Cochet E, Hofkens-Van den Brandt A, Jacquemin L, Joossen I, Vermeersch H, Lammers MJW, Van Rompaey V, Vanderveken O. Contralateral hearing aid use in adult cochlear implant recipients: retrospective analysis of auditory outcomes. Int J Audiol 2024; 63:543-550. [PMID: 37229750 DOI: 10.1080/14992027.2023.2209697] [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: 09/10/2022] [Revised: 04/22/2023] [Accepted: 04/25/2023] [Indexed: 05/27/2023]
Abstract
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.
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Affiliation(s)
- Griet Mertens
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Ellen Andries
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Charis Clement
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Ellen Cochet
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Anouk Hofkens-Van den Brandt
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Laure Jacquemin
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Iris Joossen
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Hanne Vermeersch
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Marc Jan-Willem Lammers
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Olivier Vanderveken
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Nishiyama Y, Minami S, Ijuin R, Kuroki T, Tendo A, Kusui Y, Wakabayashi S, Kaga K. The error patterns of phonemes in children with prelingual hearing loss: A comparison between hearing aid and cochlear implant users. Auris Nasus Larynx 2024; 51:537-541. [PMID: 38537556 DOI: 10.1016/j.anl.2024.01.001] [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: 07/08/2023] [Revised: 11/19/2023] [Accepted: 01/12/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE To reveal differences in error pattern of phonemes and articulation between children using cochlear implants (CIs) and those using hearing aids (HAs) due to prelingual hearing disorder and help the education of children with prelingual hearing loss. METHOD Children with prelingual hearing loss who were receiving auditory-verbal preschool education at an auditory center for hearing-impaired children (Fujimidai Auditory Center, Tokyo, Japan) from 2010 to 2020 were analyzed retrospectively. All participants underwent pure tone audiometry and monosyllabic intelligibility tests. The error answers were categorized into five patterns which was characterized by the substitution, addition, omission, failure, and no response according to consonant errors. In addition, the consonant errors classified into the manner of articulation and the differences of error patterns were analyzed between the HA and the CI group descriptively. RESULTS A total of 43 children with bilateral HAs and 46 children with bimodal CIs or bilateral CIs were enrolled. No significant between-group differences in median phoneme intelligibility were found. The most common error pattern was substitution in both HA and CI groups. The error number of addition pattern in the HA group was smaller than in the CI group. In both groups, the most common errors of articulation were flap errors, and the most common error patterns were flaps to nasals, nasals to nasals, plosives to plosives. In the HA group, plosives and nasals tended not to be recognized and in the CI group plosives were prone to be added to vowels. CONCLUSIONS There were some different error patterns of articulation and consonant substitution between groups. Clarifying differences of phoneme that are difficult to hear and tend to be misheard would help for creating an effective approach to auditory training for children with hearing loss.
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Affiliation(s)
- Yuri Nishiyama
- Department of Otolaryngology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Shujiro Minami
- Department of Otolaryngology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
| | - Ryoko Ijuin
- Fujimidai Auditory Center for Hearing-Impaired Children, Tokyo, Japan
| | - Tomoko Kuroki
- Fujimidai Auditory Center for Hearing-Impaired Children, Tokyo, Japan
| | - Ayako Tendo
- Fujimidai Auditory Center for Hearing-Impaired Children, Tokyo, Japan
| | - Yuko Kusui
- Fujimidai Auditory Center for Hearing-Impaired Children, Tokyo, Japan
| | | | - Kimitaka Kaga
- National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
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Giallini I, Inguscio BMS, Nicastri M, Portanova G, Ciofalo A, Pace A, Greco A, D’Alessandro HD, Mancini P. Neuropsychological Functions and Audiological Findings in Elderly Cochlear Implant Users: The Role of Attention in Postoperative Performance. Audiol Res 2023; 13:236-253. [PMID: 37102772 PMCID: PMC10136178 DOI: 10.3390/audiolres13020022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
Objectives: The present study aimed to investigate in a group of elderly CI users working memory and attention, conventionally considered as predictors of better CI performance and to try to disentangle the effects of these cognitive domains on speech perception, finding potential markers of cognitive decline related to audiometric findings. Methods Thirty postlingually deafened CI users aged >60 underwent an audiological evaluation followed by a cognitive assessment of attention and verbal working memory. A correlation analysis was performed to evaluate the associations between cognitive variables while a simple regression investigated the relationships between cognitive and audiological variables. Comparative analysis was performed to compare variables on the basis of subjects’ attention performance. Results: Attention was found to play a significant role in sound field and speech perception. Univariate analysis found a significant difference between poor and high attention performers, while regression analysis showed that attention significantly predicted recognition of words presented at Signal/Noise +10. Further, the high attention performers showed significantly higher scores than low attentional performers for all working memory tasks. Conclusion: Overall findings confirmed that a better cognitive performance may positively contribute to better speech perception outcomes, especially in complex listening situations. WM may play a crucial role in storage and processing of auditory-verbal stimuli and a robust attention may lead to better performance for speech perception in noise. Implementation of cognitive training in auditory rehabilitation of CI users should be investigated in order to improve cognitive and audiological performance in elderly CI users.
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Mancini P, Nicastri M, Giallini I, Odabaşi Y, Greco A, Dincer D'Alessandro H, Portanova G, Mariani L. Long-term speech perception and morphosyntactic outcomes in adolescents and young adults implanted in childhood. Int J Pediatr Otorhinolaryngol 2023; 167:111514. [PMID: 36947998 DOI: 10.1016/j.ijporl.2023.111514] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Long-term assessments of children with cochlear implants (CI) are important inputs to help guide families and professionals in therapeutic and counselling processes. Based on these premises, the primary aim of the present study was to assess the long-term speech and language outcomes in a sample of prelingually deaf or hard of hearing (DHH) adolescents and young adults with unilateral or bilateral implantation in childhood. The secondary aim was to investigate the correlations of age at implantation with long-term speech and language outcomes. MATERIALS AND METHODS Retrospective observational study on 54 long-term CI users, 33 unilateral and 21 bilateral (mean age at CI surgery 38.1 ± 24.6 months; mean age at last follow-up assessment 19.1 ± 4.3 years of age and mean follow-up time 16 ± 3.7 years). Means and standards were used to describe speech perception (in quiet, in fixed noise and in adaptive noise using It-Matrix) and morphosyntactic comprehension (TROG-2) outcomes. A univariate analysis was used to evaluate outcome differences between unilateral and bilateral patients. Bivariate analysis was performed to investigate the relationships between age at CI, audiological variables, and language outcomes. Finally, multivariate analysis was performed to quantify the relationship between It-Matrix, sentence recognition in quiet and at SNR+10 and TROG-2. RESULTS The participants showed good speech recognition performance in quiet (94% for words and 89% for sentences) whilst their speech-in-noise scores decreased significantly. For the It-Matrix, only 9.2% of the participants showed scores within the normative range. This value was 60% for TROG-2 performance. For both auditory and language skills, group differences for unilateral versus bilateral CI users were not statistically significant (p > 0.05). Bivariate analysis showed that age at CI correlated significantly with overall results at TROG-2 (r = -0.6; p < 0.001) and with It-Matrix (r = 0.5; p < 0.001). TROG-2 was negatively correlated with results for It-Matrix (r = -0.5; p < 0.001). In the multivariate analysis with It-Matrix as a dependent variable, the model explained 63% of the variance, of which 60% was related to sentence recognition and 3% to morphosyntax. CONCLUSIONS These data contribute to the definition of average long-term outcomes expected in subjects implanted during childhood whilst increasing our knowledge of the effects of variables such as age at CI and morphosyntactic comprehension on speech perception. Although the majority of this prelingually DHH cohort did not achieve scores within a normative range, remarkably better It-Matrix scores were observed when compared to those from postlingually deafened adult CI users.
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Affiliation(s)
| | - Maria Nicastri
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Yilmaz Odabaşi
- Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Antonio Greco
- Department of Sense Organs, Sapienza University, Rome, Italy
| | | | - Ginevra Portanova
- Department of Sense Organs, Sapienza University, Rome, Italy; Clinical and Experimental Neuroscience and Psychiatry PhD Program, Italy
| | - Laura Mariani
- Department of Sense Organs, Sapienza University, Rome, Italy; Clinical and Experimental Neuroscience and Psychiatry PhD Program, Italy.
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Giallini I, Nicastri M, Inguscio BMS, Portanova G, Magliulo G, Greco A, Mancini P. Effects of the "Active Communication Education" Program on Hearing-Related Quality of Life in a Group of Italian Older Adults Cochlear Implant Users. Front Psychol 2022; 13:827684. [PMID: 35668973 PMCID: PMC9163787 DOI: 10.3389/fpsyg.2022.827684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 05/02/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction The present study aimed to evaluate the effects of the Active Communication Education (ACE) program on the social/emotional impacts of hearing loss (HL) in a group of older adults with a cochlear implant (CI). Design Prospective cohort study design, with a “within-subject” control procedure. Study Sample Twenty adults over-65 post-lingually deafened CI users. All subjects were required to be native Italian speakers, to have normal cognitive level, have no significant psychiatric conditions and/or diagnosed incident dementia, and used CI for at least 9 months. Materials and Methods Twenty participants were assessed using the Hearing Handicap Inventory for the Elderly (HHIE), the Geriatric Depression Scale (GDS), and the Speech, Spatial, and Qualities of Hearing Scale (SSQ) before, during, and after ACE program, with a one and 6-month follow up. The cognitive and audiological evaluation was carried out before commencing the ACE program. Results The ACE program had a positive impact by reducing HL’s social/emotional effects. Participants benefited from a rehabilitative approach by improving multilevel skills: comprehension of audiological and hearing dimensions, acquisition of communicative, pragmatic and problem-solving strategies, and interaction and sharing of experiences with peers. Conclusion Although targeting the older adults with moderate HL, the ACE program also seemed to benefit older adult CI users. An improvement in social and emotional adaptation to hearing difficulties can, in turn, significantly promote optimal use of CI in the older adults, thereby possibly reducing the risk of losing motivation and engagement in device use and in rehabilitation protocols.
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Affiliation(s)
- Ilaria Giallini
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | - Maria Nicastri
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | | | - Ginevra Portanova
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | - Giuseppe Magliulo
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | - Patrizia Mancini
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
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Inguscio BMS, Mancini P, Greco A, Nicastri M, Giallini I, Leone CA, Grassia R, Di Nardo W, Di Cesare T, Rossi F, Canale A, Albera A, Giorgi A, Malerba P, Babiloni F, Cartocci G. ‘Musical effort’ and ‘musical pleasantness’: a pilot study on the neurophysiological correlates of classical music listening in adults normal hearing and unilateral cochlear implant users. HEARING, BALANCE AND COMMUNICATION 2022. [DOI: 10.1080/21695717.2022.2079325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Carlo Antonio Leone
- Department of Otolaryngology/Head and Neck Surgery, Monaldi Hospital, Naples, Italy
| | - Rosa Grassia
- Department of Otolaryngology/Head and Neck Surgery, Monaldi Hospital, Naples, Italy
| | - Walter Di Nardo
- Otorhinolaryngology and Physiology, Catholic University of Rome, Rome, Italy
| | - Tiziana Di Cesare
- Otorhinolaryngology and Physiology, Catholic University of Rome, Rome, Italy
| | - Federica Rossi
- Otorhinolaryngology and Physiology, Catholic University of Rome, Rome, Italy
| | - Andrea Canale
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Italy
| | - Andrea Albera
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Italy
| | | | | | - Fabio Babiloni
- BrainSigns Srl, Rome, Italy
- Department of Computer Science, Hangzhou Dianzi University, Hangzhou, China
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Giulia Cartocci
- BrainSigns Srl, Rome, Italy
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
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Zwolan TA, Basura G. Determining Cochlear Implant Candidacy in Adults: Limitations, Expansions, and Opportunities for Improvement. Semin Hear 2021; 42:331-341. [PMID: 34912161 PMCID: PMC8660165 DOI: 10.1055/s-0041-1739283] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The safety, efficacy, and success of cochlear implants (CIs) are well established and have led to changes in criteria used by clinicians to determine who should receive a CI. Such changes in clinical decision-making have out-paced the slower-occurring changes that have taken place with regulatory bodies' and insurers' indications. We review the historical development of indications for CIs, including those of the U.S. Food and Drug Administration (FDA), Medicare, Medicaid, and private insurers. We report on expansion to include patients with greater residual hearing, such as those who receive Hybrid and EAS devices, and report on recent FDA approvals that place less emphasis on the patient's best-aided condition and greater emphasis on the ear to be treated. This includes expansion of CIs to patients with single-side deafness and asymmetric hearing loss. We review changes in the test materials used to determine candidacy, including transition from sentences in quiet to sentences in noise to the recent use of monosyllabic words and cognitive screening measures. Importantly, we discuss the recent trend to recommend CIs despite a patient not meeting FDA or insurers' indications (a practice known as “off-label”), which serves as attestation that current indications need to be updated.
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Affiliation(s)
- Teresa A Zwolan
- Department of Otolaryngology - Head and Neck Surgery, Michigan Medicine, Ann Arbor, Michigan
| | - Gregory Basura
- Department of Otolaryngology - Head and Neck Surgery, Michigan Medicine, Ann Arbor, Michigan
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Brumer N, Elkins E, Parada J, Hillyer J, Parbery-Clark A. Examining Delayed Recall in Cochlear Implant Users Using the Montreal Cognitive Assessment, California Verbal Learning Test, Third Edition, and Item Specific Deficit Approach: Preliminary Results. Front Psychol 2021; 12:749045. [PMID: 34803831 PMCID: PMC8599833 DOI: 10.3389/fpsyg.2021.749045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Recent studies using the Montreal Cognitive Assessment (MoCA) suggest delayed recall is challenging for cochlear implant (CI) users. To better understand the underlying processes associated with delayed recall in CI users, we administered the MoCA and the California Verbal Learning Test, Third Edition (CVLT-3), which provides a more comprehensive assessment of delayed recall ability. Methods: The MoCA and CVLT-3 were administered to 18 high-performing CI users. For the CVLT-3, both the traditional scoring and a newer scoring method, the Item-Specific Deficit Approach (ISDA), were employed. Results: The original MoCA score and MoCA delayed recall subtest score did not relate to performance on any CVLT-3 measures regardless of scoring metric applied (i.e., traditional or ISDA). Encoding performance for both the CVLT-3 and ISDA were related. Consolidation, which is only distinctly defined by the ISDA, related to CVLT-3 cued delay recall performance but not free delay recall performance. Lastly, ISDA retrieval only related to CVLT-3 measures when modified. Conclusion: Performance on the MoCA and CVLT-3 in a high performing CI patient population were not related. We demonstrate that the ISDA can be successfully applied to CI users for the quantification and characterization of delayed recall ability; however, future work addressing lower performing CI users, and comparing to normal hearing controls is needed to determine the extent of potential translational applications. Our work also indicates that a modified ISDA retrieval score may be beneficial for evaluating CI users although additional work addressing the clinical relevance of this is still needed.
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Affiliation(s)
- Nadav Brumer
- Auditory Research Laboratory, Center for Hearing and Skull Base Surgery, Swedish Neuroscience Institute, Seattle, WA, United States
| | - Elizabeth Elkins
- Auditory Research Laboratory, Center for Hearing and Skull Base Surgery, Swedish Neuroscience Institute, Seattle, WA, United States
| | - Jennifer Parada
- Department of Psychology, Bellevue College, Bellevue, WA, United States
| | - Jake Hillyer
- College of Medicine, University of Arizona, Phoenix, AZ, United States
| | - Alexandra Parbery-Clark
- Auditory Research Laboratory, Center for Hearing and Skull Base Surgery, Swedish Neuroscience Institute, Seattle, WA, United States
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