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Huang PK, Ho PH, Chu CH, Chen PY, Lin HC. Can Mandarin-speaking prelingual deaf adults benefit from cochlear implant? Acta Otolaryngol 2024; 144:44-51. [PMID: 38400594 DOI: 10.1080/00016489.2024.2315299] [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: 12/01/2023] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND With advances in cochlear implant (CI) technology, prelingual deaf adults may experience improved speech perception and quality of life (QoL). It is still a challenge for Mandarin-speaking CI user with tone recognition due to CI technology focused on intonation language. OBJECTIVES To evaluate the long-term post-CI auditory performance and social-emotional benefits in prelingual deaf Mandarin-speaking adults and the difference between them and post-lingual deaf adults. MATERIAL AND METHODS Fifty-five adult implanted ears were included (forty-six postlingual deaf group; nine prelingual deaf group). Post-CI long-term outcomes were using vowels, consonants, disyllabic words, Mandarin monosyllable words, categories of audiology performance, speech intelligibility rating, subjective social-emotional questionnaires. RESULTS Post-CI auditory performance and speech intelligibility of prelingual deafness adults was significantly inferior to that of those with postlingual deafness. However, both groups presented improved social-emotional benefits, with no significant difference between both groups. CONCLUSIONS Adult CI recipients who deaf before the age of 4 can experience benefits in social-emotional life functioning, regardless of their limited auditory performance and speech intelligibility. Therefore, prelingual Mandarin-speaking deaf adults, especially those using oral communication, can be considered as relative indications for cochlear implantation. SIGNIFICANCE To clarify and validate the benefits among Mandarin-speaking prelingual deaf adult recipients.
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Affiliation(s)
- Po-Kai Huang
- Department of Otolaryngology and Head Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan
| | - Pei-Hsuan Ho
- Department of Otolaryngology and Head Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Audiology and Speech Language Pathology, MacKay Medical College, New Taipei City, Taiwan
| | - Chia-Huei Chu
- Department of Otolaryngology and Head Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Audiology and Speech Language Pathology, MacKay Medical College, New Taipei City, Taiwan
| | - Pey-Yu Chen
- Department of Otolaryngology and Head Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Audiology and Speech Language Pathology, MacKay Medical College, New Taipei City, Taiwan
| | - Hung-Ching Lin
- Department of Otolaryngology and Head Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Audiology and Speech Language Pathology, MacKay Medical College, New Taipei City, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
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Spitzer ER, Waltzman SB. Cochlear implants: the effects of age on outcomes. Expert Rev Med Devices 2023; 20:1131-1141. [PMID: 37969071 DOI: 10.1080/17434440.2023.2283619] [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: 07/13/2023] [Accepted: 11/10/2023] [Indexed: 11/17/2023]
Abstract
INTRODUCTION Cochlear implants (CIs) provide access to sound for children and adults who do not receive adequate benefit from hearing aids. Age at implantation is known to affect outcomes across the lifespan. AREAS COVERED The effects of age on CI outcomes are examined for infants, children, adolescents, and older adults. A variety of outcome measures are considered, including speech perception, language, cognition, and quality of life measures. EXPERT OPINION/COMMENTARY For those meeting candidacy criteria, CIs are beneficial at any age. In general, younger age is related to greater benefit when considering pre-lingual deafness. Other factors such as additional disabilities, may mitigate this effect. Post-lingually deafened adults demonstrate similar benefit regardless of age, though the oldest individuals (80+) may see smaller degrees of improvement from preoperative scores. Benefit can be measured in many ways, and the areas of greatest benefit may vary based on age: young children appear to see the greatest effects of age at implantation on language measures, whereas scores on cognitive measures appear to be most impacted for the oldest population. Future research should consider implantation at extreme ages (5-9 months or > 90 years), unconventional measures of CI benefit including qualitative assessments, and longitudinal designs.
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Affiliation(s)
- Emily R Spitzer
- Department of Otolaryngology-Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Susan B Waltzman
- Department of Otolaryngology-Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
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Lee E, Pisa J, Hochman J. Comorbidity associated with worse outcomes in a population of limited cochlear implant performers. Laryngoscope Investig Otolaryngol 2023; 8:230-235. [PMID: 36846419 PMCID: PMC9948576 DOI: 10.1002/lio2.985] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 10/30/2022] [Accepted: 11/15/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Most patients significantly benefit from cochlear implantation (CI). However, speech understanding varies widely, with a small proportion of patients demonstrating limited audiometric outcomes. While there are well-documented determinants of poor performance, there remains a cohort of patients that do not meet expected outcomes. Preoperative prognostication is desirable to manage expectations, ensure value of the intervention, and reduce risk. The objective of the study is to evaluate variables found within a single CI center's most limited functioning cohort following implantation. Methods A retrospective review of a single CI program's cohort of (344 ears) patients implanted between 2011 and 2018 whose 1-year postimplantation AzBio scores fall 2 SDs below the mean was performed. Exclusion criteria includes skullbase pathology, pre/peri-lingual deafness, cochlear anatomic abnormalities, English as an additional language, and limited electrode insertion depth. Overall, 26 patients were identified. Results The study population's postimplantation net benefit AzBio score is 18% compared to the entire program's 47% (p < 0.05). This group is older (71.8 vs. 59.0 years, p < 0.05) with a longer duration of hearing loss (26.4 vs. 18.0 years, p < 0.05) and with a lower preoperative AzBio score [14% lower (p < 0.05)]. A host of medical conditions were identified in the subpopulation, with a trend towards significance in those suffering from either malignancy or cardiac condition. Escalating comorbid status was associated with worse performance (p < 0.05). Conclusion Within a cohort of limited-performing CI users, benefit tended to decrease with escalating number of comorbid conditions. This information may serve to inform preoperative patient counseling. Level of evidence Level IV (evidence from a case control study).
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Affiliation(s)
- Erika Lee
- University of Manitoba Faculty of MedicineOtolaryngology ‐ Head and Neck SurgeryWinnipegManitobaCanada
| | - Justyn Pisa
- University of Manitoba Faculty of MedicineSurgical Hearing Implant Program, Department of Otolaryngology‐Head and Neck SurgeryWinnipegManitobaCanada
| | - Jordan Hochman
- University of Manitoba Faculty of MedicineNeurotologic Surgery, Department of Otolaryngology ‐ Head and Neck SurgeryWinnipegManitobaCanada
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Functional Outcomes and Quality of Life after Cochlear Implantation in Patients with Long-Term Deafness. J Clin Med 2022; 11:jcm11175156. [PMID: 36079089 PMCID: PMC9457208 DOI: 10.3390/jcm11175156] [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: 07/21/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Hearing-related quality of life (QoL) after cochlear implantation (CI) is as important as audiological performance. We evaluated the functional results and QoL after CI in a heterogeneous patient cohort with emphasis on patients with long-term deafness (>10 years). Methods: Twenty-eight patients (n = 32 implanted ears, within n = 12 long-term deaf ears) implanted with a mid-scala electrode array were included in this retrospective mono-centric cohort study. Speech intelligibility for monosyllables (SIM), speech reception thresholds (SRT50) and QoL with Nijmegen Cochlear Implant Questionnaire (NCIQ) were registered. Correlation of SIM and QoL was analyzed. Results: SIM and SRT50 improved significantly 12 months postoperatively up to 54.8 ± 29.1% and 49.3 ± 9.6 dB SPL, respectively. SIM progressively improved up to 1 year, but some early-deafened, late implanted patients developed speech understanding several years after implantation. The global and all subdomain QoL scores increased significantly up to 12 months postoperatively and we found a correlation of SIM and global QoL score at 12 months postoperatively. Several patients of the “poor performer” (SIM < 40%) group reported high improvement of hearing-related QoL. Conclusions: Cochlear implantation provides a benefit in hearing-related QoL, even in some patients with low postoperative speech intelligibility results. Consequently, hearing-related QoL scores should be routinely used as outcome measure beside standard speech understanding tests, as well. Further studies with a prospective multi-centric design are needed to identify factors influencing post-implantation functional results and QoL in the patient group of long-term deafness.
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Candidacy for Cochlear Implantation in Prelingual Profoundly Deaf Adult Patients. J Clin Med 2022; 11:jcm11071874. [PMID: 35407482 PMCID: PMC8999851 DOI: 10.3390/jcm11071874] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/14/2022] [Accepted: 03/21/2022] [Indexed: 12/04/2022] Open
Abstract
Cochlear implantation is usually not recommended for prelingual profoundly deaf adults, although some of these patients might benefit from it. This study aims to define the candidates for cochlear implantation in this population. This retrospective study reviewed 34 prelingual profoundly deaf patients who had received a cochlear implant at 32 ± 1.7 years old (16−55), with at least 1 year of follow-up. Speech perception and quality of life were assessed before and 3, 6, and 12 months after cochlear implantation, then every year thereafter. According to the word speech intelligibility in quiet (WSI) 1 year after implantation, two groups were identified: good performer (GP) with WSI ≥ 50% (n = 15), and poor performer (PP) with WSI ≤ 40% (n = 19). At the 1 year mark, mean WSI improved by 28 ± 4.6% (−20−100) (p < 0.0001). In GP, the intelligibility for words and sentences, communication and quality of life scales improved. In PP, the communication scale improved, but not auditory performance or quality of life. GP and PP differed pre-operatively in speech production, communication abilities, and WSI in best-aided conditions. In prelingual profoundly deaf adults, a dramatic auditory performance benefit could be expected after cochlear implantation if the patients have some degree of speech intelligibility in aided conditions and have developed oral communication and speech production.
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Forli F, Lazzerini F, Montecchiari V, Morganti R, Bruschini L, Berrettini S. Cochlear implant in prelingually hearing-impaired adults: prognostic factors and results. ACTA ACUST UNITED AC 2021; 41:173-179. [PMID: 34028463 PMCID: PMC8142735 DOI: 10.14639/0392-100x-n1146] [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: 09/29/2020] [Accepted: 11/27/2020] [Indexed: 11/23/2022]
Abstract
Objectives The aim of present study is to evaluate the impact of prognostic factors on the outcome in a group of prelingually hearing-impaired patients submitted to cochlear implantation (CI) at an adult age. Methods This is a retrospective study on a cohort of prelingually severe-to-profound hearing-impaired patients cochlear implanted in adulthood and followed by a single audiology centre. We correlated post-CI results in term of speech perception with patients’ speech perception with hearing aids before implantation, history of progression of hearing loss (HL), and levels of education and cognition. The study group was composed of 49 patients. Results Post-CI open-set recognition score in silence and noise was significantly correlated with pre-CI open-set recognition score in silence and with background noise. Patients with a history of progression of HL gained significantly better results. Furthermore, we found higher improvements in patients with a higher level of education. Conclusions Prelingually deafened patients implanted in adulthood achieved satisfactory results. Significantly better results were achieved by patients with better pre-operative speech perception scores, progressive HL and higher level of education.
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Affiliation(s)
- Francesca Forli
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy
| | - Francesco Lazzerini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy
| | | | | | - Luca Bruschini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy
| | - Stefano Berrettini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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7
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Debruyne JA, Janssen AM, Brokx JPL. Systematic Review on Late Cochlear Implantation in Early-Deafened Adults and Adolescents: Predictors of Performance. Ear Hear 2021; 41:1431-1441. [PMID: 33136620 DOI: 10.1097/aud.0000000000000889] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Early-deafened, late-implanted adolescents and adults constitute a unique group of cochlear implant (CI) users, showing a large variability in outcomes. The current systematic review aimed to determine which preimplantation factors are relevant in predicting postoperative outcomes in this patient group. DESIGN A systematic search for studies published between 2000 and September 2017 was performed in five electronic databases (PubMed, Embase, the Cochrane library, CINAHL, and PsycInfo). Prognostic studies that assessed the relation between patient-related factors and CI outcomes in early-deafened but late-implanted adolescent and adult CI users were included. Study quality was assessed with the Quality In Prognosis Studies (QUIPS) tool. RESULTS The systematic search and subsequent full-text evaluation identified 13 studies that had a clear prognostic study goal. Eight out of these 13 studies had a high risk of bias for at least one of the five QUIPS domains. Analysis of the outcomes identified that communication mode (in childhood), preoperative speech intelligibility, and preoperative speech recognition scores were significantly related to speech perception outcomes for this group of CI users. A number of additional factors considered worth for further investigation were also identified. CONCLUSIONS The analysis of the studies assessing the effect of a number of patient-related factors on outcome with CI in early-deafened adolescents and adults identified three potential prognostic factors and a number of additional factors to be incorporated in future research. More high-quality prognosis studies in the investigated patient population are still needed.
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Affiliation(s)
- Joke A Debruyne
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - A Miranda Janssen
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jan P L Brokx
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
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8
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Debruyne JA, Janssen AM, Brokx JPL. Systematic Review on Late Cochlear Implantation in Early-Deafened Adults and Adolescents: Clinical Effectiveness. Ear Hear 2021; 41:1417-1430. [PMID: 33136619 DOI: 10.1097/aud.0000000000000884] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Cochlear implantation in early-deafened patients, implanted as adolescents or adults, is not always advised due to poor expected outcomes. In order to judge whether such reluctance is justified, the current systematic review aimed to gather all available evidence on postoperative outcomes obtained by early-deafened patients using a state-of-the art cochlear implant (CI). DESIGN Five electronic databases (PubMed, Embase, the Cochrane library, CINAHL, and PsycInfo) were systematically searched for studies in English, French, German, or Dutch, published between 2000 and September 2017. Studies that reported pre- and postoperative outcomes on any measure of speech or sound perception, audiovisual or subjective benefit (quality of life) were included. Study quality was assessed with the Institute of Health Economics quality appraisal tool for case series studies. RESULTS The systematic search and subsequent full-text evaluation identified 38 studies meeting the inclusion criteria. Only a limited number of studies were judged to be of high quality according to the Institute of Health Economics tool, with lack of (clear) presentation of relevant study information being a recurring problem. Twenty-five studies presented viable outcomes on open-set speech understanding in quiet: mean postoperative scores obtained with CI remained below 50% for the vast majority of studies; significant postoperative improvements were found in 16 studies, although this number might have been higher if appropriate statistical testing had been performed in all studies. Eight studies observed increased audiovisual performance after implantation, which was statistically significant in six studies. A validated measure of hearing-related quality of life was used in only 5 of the 16 studies assessing subjective outcomes, showing significant postoperative improvements for most questionnaire domains. The relation between auditory and subjective outcomes was assessed in two studies, with contradictory results. CONCLUSIONS The current review showed that late cochlear implantation in early-deafened subjects resulted in significantly improved open-set speech perception, audiovisual speech perception, and (hearing-related) quality of life in the majority of the studies involved. Nonetheless, more and especially higher-quality research is needed in order to gain a more detailed understanding of the outcomes of cochlear implantation in this population.
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Affiliation(s)
- Joke A Debruyne
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - A Miranda Janssen
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jan P L Brokx
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
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9
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Canale A, Macocco F, Ndrev D, Gabella G, Scozzari G, Albera R, Pecorari G, Albera A. Cochlear Implant Outcomes in Prelingually Deafened Adults with and without Sound Deprivation: Are There Differences in Quality of Life? Med Sci Monit 2021; 27:e930232. [PMID: 34001843 PMCID: PMC8140525 DOI: 10.12659/msm.930232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Indications for cochlear implantation (CI) are constantly being updated, and with them, the audiometric results achieved by patients. Patient satisfaction should always be considered, even in patients with lower audiological results. The aim of the present study was to compare quality of life (QoL), self-perceived hearing benefit, and audiometric results between prelingually and postlingually deafened patients, with and without sound deprivation, after CI. MATERIAL AND METHODS The sample included 46 patients with bilateral sensorineural hearing loss: 22 postlingually deafened and 24 prelingually deafened, further subdivided into sound-deprived (n=10) and non-sound-deprived (n=14). Auditory performance was evaluated with pure tone audiometry, speech recognition scores (SRS), and self-perceived hearing benefit, whereas QoL was evaluated with 2 self-reported questionnaires (Comprehensive Cochlear Implant Questionnaire and World Health Organization Quality of Life-BREF). RESULTS Audiometric results were worse in the prelingually deafened than in the postlingually deafened group, and worse in the prelingually deafened patients with sound deprivation. There was no marked difference in perceived CI benefit or QoL between the 2 groups or within the 2 prelingually deafened subgroups. No correlation was found between SRS and duration of CI use or between QoL and SRS in the prelingually and postlingually deafened groups. CONCLUSIONS Our findings demonstrate better auditory performance for the postlingually deafened group and no differences in perceived QoL or benefit of CI between the groups. The sound-deprived patients had equal scores on the perceived QoL questionnaire. These analyses suggest that sound-deprived, prelingually deafened patients may benefit from CI.
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Affiliation(s)
- Andrea Canale
- Ear, Nose and Throat (ENT) Unit, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Francesco Macocco
- Ear, Nose and Throat (ENT) Unit, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Drita Ndrev
- Ear, Nose and Throat (ENT) Unit, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Giulia Gabella
- Ear, Nose and Throat (ENT) Unit, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Gitana Scozzari
- Molinette Hospital Medical Direction, AOU City of Health and Science of Turin, Turin, Italy
| | - Roberto Albera
- Ear, Nose and Throat (ENT) Unit, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Giancarlo Pecorari
- Ear, Nose and Throat (ENT) Unit, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Andrea Albera
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
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A Systematic Review of Cochlear Implant Outcomes in Prelingually-deafened, Late-implanted Patients. Otol Neurotol 2020; 41:444-451. [DOI: 10.1097/mao.0000000000002555] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Fuller C, Başkent D, Free R. Early Deafened, Late Implanted Cochlear Implant Users Appreciate Music More Than and Identify Music as Well as Postlingual Users. Front Neurosci 2019; 13:1050. [PMID: 31680802 PMCID: PMC6798179 DOI: 10.3389/fnins.2019.01050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/19/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Typical cochlear implant (CI) users, namely postlingually deafened and implanted, report to not enjoy listening to music, and find it difficult to perceive music. Another group of CI users, the early-deafened (during language acquisition) and late-implanted (after a long period of auditory deprivation; EDLI), report a higher music appreciation, but is this related to a better music perception? Materials and Methods: Sixteen EDLI and fifteen postlingually deafened (control group) CI users participated in the study. The inclusion criteria for EDLI were: severe or profound hearing loss onset before the age of 6 years, implantation after the age of 16 years, and CI experience more than 1 year. Subjectively, music perception and appreciation was evaluated using the Dutch Musical Background Questionnaire. Behaviorally, music perception was measured with melodic contour identification (MCI), using two instruments (piano and organ), each tested with and without a masking contour. Semitone distance between successive tones of the target varied from 1 to 3 semitones. Results: Subjectively, the EDLI group reported to appreciate music more than postlingually deafened CI users. Behaviorally, while clinical phoneme recognition test score on average was lower in the EDLI group, melodic contour identification did not significantly differ between the two groups. There was, however, an effect of instrument and masker for both groups; the piano was the best-recognized instrument, and for both instruments, the masker with non-overlapping pitch was best recognized. Discussion: EDLI group reported higher appreciation of music than postlingual control group, even though behaviorally measured music perception did not differ significantly between the two groups. Both surprising findings since EDLI CI users would be expected to have lower outcomes based on the early deafness onset, long duration of auditory deprivation, and on average lower clinical speech scores. Perhaps, the music perception difficulty comes from similar electric hearing limitations in both groups. The higher subjective appreciation in EDLI might be due to the lack of a musical memory, with no ability to compare music heard via the CI to acoustic music perception. Overall, our findings support a benefit from implantation for a positive music experience in EDLI CI users.
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Affiliation(s)
- Christina Fuller
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Research School of Behavioral and Cognitive Neurosciences, Graduate School of Medical Sciences, University of Groningen, Groningen, Netherlands.,Department of Otorhinolaryngology, Treant Zorggroep, Emmen, Netherlands
| | - Deniz Başkent
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Research School of Behavioral and Cognitive Neurosciences, Graduate School of Medical Sciences, University of Groningen, Groningen, Netherlands
| | - Rolien Free
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Research School of Behavioral and Cognitive Neurosciences, Graduate School of Medical Sciences, University of Groningen, Groningen, Netherlands
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12
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Huinck WJ, Mylanus EAM, Snik AFM. Expanding unilateral cochlear implantation criteria for adults with bilateral acquired severe sensorineural hearing loss. Eur Arch Otorhinolaryngol 2019; 276:1313-1320. [PMID: 30810818 PMCID: PMC6458976 DOI: 10.1007/s00405-019-05358-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 02/21/2019] [Indexed: 01/17/2023]
Abstract
Objectives To report on a retrospective cohort study on the effects of expanding inclusion criteria for application of cochlear implants (CIs) on the performance 1-year post-implantation. Methods Based on pre-implantation audiometric thresholds and aided speech recognition scores, the data of 164 CI recipients were divided into a group of patients that fulfilled conservative criteria (mean hearing loss at 0.5, 1 and 2 kHz > 85 dB HL and phoneme scores with hearing aids < 30%), and the remaining group of patients that felt outside this conservative criterion. Speech recognition scores (in quiet) and quality of life (using the NCIQ) of both groups, measured at 1-year post-implantation, were compared. Results The group that felt outside the conservative criterion showed a higher phoneme score at 1-year post-implantation compared to the conservative group, suggesting that relaxed criteria have a positive influence on the speech recognition results with CI. With respect to quality of life, both groups significantly improved 1-year post-implantation. The conservative group showed a higher benefit on the advanced perception domain of the NCIQ. Based on their worse pre-implantation hearing, this was expected. Conclusions The data suggest that relaxation of CI indication positively affects the speech recognition performance of patients with severe hearing loss. Both groups of patients showed a positive effect of CI on the quality of life. This benefit relates to communication skills and the subjective day-to-day functioning in society.
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Affiliation(s)
- Wendy J Huinck
- Department of Otorhinolaryngology, Head and Neck Surgery, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. .,Donders Department of Biophysics, Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
| | - Emmanuel A M Mylanus
- Department of Otorhinolaryngology, Head and Neck Surgery, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.,Donders Department of Biophysics, Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Ad F M Snik
- Department of Otorhinolaryngology, Head and Neck Surgery, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.,Donders Department of Biophysics, Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
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13
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Forli F, Turchetti G, Giuntini G, Bellelli S, Fortunato S, Bruschini L, Barillari MR, Berrettini S. Cochlear implant in prelingually deafened oralist adults: speech perception outcomes, subjective benefits and quality of life improvement. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 37:416-422. [PMID: 29165436 PMCID: PMC5720870 DOI: 10.14639/0392-100x-1493] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 03/11/2017] [Indexed: 11/23/2022]
Abstract
The aim of this study is to report our results in a group of prelingually deafened adults, who followed an oralist rehabilitation programme, and submitted to cochlear implant at our institution. We evaluated 30 prelingually deafened adult patients, 18 males and 12 females, median age 35 years, of a group of 36 prelingually deafened adult patients consecutively submitted to unilateral cochlear implantation at the ENT Unit of the University of Pisa. After implantation, patients achieved significant benefits in terms of speech perception skills, including the ability to have telephone conversations in some cases, quality of life and their own perception of disability. According to literature data, the results herein reported are quite variable but generally satisfactory. Procedures other than traditional speech perception measures should be used to evaluate the benefits of cochlear implant in such patients, to compressively evaluate the global benefits, not only in terms of speech perception, but also in terms of quality of life and daily life.
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Affiliation(s)
- F Forli
- ENT, Audiology and Phoniatric Unit, University of Pisa, Italy
| | - G Turchetti
- Istituto di Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - G Giuntini
- ENT, Audiology and Phoniatric Unit, University of Pisa, Italy
| | - S Bellelli
- Istituto di Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - S Fortunato
- ENT, Audiology and Phoniatric Unit, University of Pisa, Italy
| | - L Bruschini
- ENT, Audiology and Phoniatric Unit, University of Pisa, Italy
| | - M R Barillari
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Divisione di Audiologia e Foniatria, II Università di Napoli, Italy
| | - S Berrettini
- ENT, Audiology and Phoniatric Unit, University of Pisa, Italy.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 17177, Stockholm, Sweden
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14
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Debruyne J, Janssen M, Brokx J. Late Cochlear Implantation in Early-Deafened Adults: A Detailed Analysis of Auditory and Self-Perceived Benefits. Audiol Neurootol 2018; 22:364-376. [PMID: 29953973 DOI: 10.1159/000488023] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 02/26/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES It is known that early-deafened cochlear implant (CI) users are a very heterogeneously performing group. To gain more insight into this population, this study investigated (1) postoperative changes in auditory performance over time based on various outcome measures, focusing on poor performers, (2) self-perceived outcomes, (3) relations between auditory and self-perceived outcomes, and (4) preimplantation factors predicting postoperative outcomes. METHODS Outcomes were assessed prospectively in a group of 27 early-deafened, late-implanted CI users, up to 3 years after implantation. Outcome measures included open-set word and sentence recognition, closed-set word recognition, speech tracking and a questionnaire on self-perceived outcomes. Additionally, the relative influence of 8 preimplantation factors on CI outcome was assessed with linear regression analyses. RESULTS Significant improvements were found for auditory performance measures and most of the questionnaire domains. Significant changes of the closed-set word test, speech tracking and questionnaire were also found for a subgroup of poor performers. Correlations between auditory and self-perceived outcomes were weak and nonsignificant. Preoperative word recognition and preoperative hearing thresholds, both for the implanted ear, were significant predictors of postoperative outcome in the multivariable regression model, explaining 63.5% of the variation. CONCLUSIONS Outcome measurement in this population should be adjusted to the patients' individual performance level and include self-perceived benefit. There is still a need for more knowledge regarding predictors of CI outcomes in this group, but the current study suggests the importance of the preoperative performance of the ear to be implanted.
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Affiliation(s)
- Joke Debruyne
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.,School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Miranda Janssen
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.,Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Jan Brokx
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.,School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
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15
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Duchesne L, Millette I, Bhérer M, Gobeil S. Auditory performance and subjective benefits in adults with congenital or prelinguistic deafness who receive cochlear implants during adulthood. Cochlear Implants Int 2017; 18:143-152. [DOI: 10.1080/14670100.2017.1290925] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Louise Duchesne
- Département d'orthophonie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Isabelle Millette
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - Maurice Bhérer
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - Suzie Gobeil
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
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