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Arras T, Boudewyns A, Dhooge I, Zarowski A, Philips B, Desloovere C, Wouters J, van Wieringen A. Duration of cochlear implant use in children with prelingual single-sided deafness is a predictor of word perception in the CI ear. Hear Res 2024; 450:109076. [PMID: 38991628 DOI: 10.1016/j.heares.2024.109076] [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: 03/21/2024] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 07/13/2024]
Abstract
As part of a longitudinal study regarding the benefit of early cochlear implantation for children with single-sided deafness, the current work explored the children's daily device use, potential barriers to full-time device use, and the children's ability to understand speech with the cochlear implant (CI). Data were collected from 20 children with prelingual SSD who received a CI before the age of 2.5 years, from the initial activation of the sound processor until the children were 4.8 to 11.0 years old. Daily device use was extracted from the CI's data logging, while word perception in quiet was assessed using direct audio input to the children's sound processor. The children's caregivers completed a questionnaire about habits, motivations, and barriers to device use. The children with SSD and a CI used their device on average 8.3 h per day, corresponding to 63 % of their time spent awake. All children except one could understand speech through the CI, with an average score of 59 % on a closed-set test and 73 % on an open-set test. More device use was associated with higher speech perception scores. Parents were happy with their decision to pursue a CI for their child. Certain habits, like taking off the sound processor during illness, were associated with lower device use. Providing timely counselling to the children's parents, focused on SSD-specific challenges, may be helpful to improve daily device use in these children.
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Affiliation(s)
- Tine Arras
- ExpORL, Dept. of Neurosciences, KU Leuven, Herestraat 49 bus 721, 3000 Leuven, Belgium; Cochlear Technology Centre, Schaliënhoevedreef 20i, 2800 Mechelen, Belgium.
| | - An Boudewyns
- Dept. of Otorhinolaryngology, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium; Faculty of Medicine and Translational Neurosciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Ingeborg Dhooge
- Dept. of Otorhinolaryngology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Andrzej Zarowski
- European Institute for ORL-HNS, Sint-Augustinus Hospital Antwerp, Oosterveldlaan 24, 2610 Wilrijk, Belgium
| | - Birgit Philips
- Cochlear Technology Centre, Schaliënhoevedreef 20i, 2800 Mechelen, Belgium
| | - Christian Desloovere
- Dept. of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Jan Wouters
- ExpORL, Dept. of Neurosciences, KU Leuven, Herestraat 49 bus 721, 3000 Leuven, Belgium
| | - Astrid van Wieringen
- ExpORL, Dept. of Neurosciences, KU Leuven, Herestraat 49 bus 721, 3000 Leuven, Belgium; Dept. of Special Needs Education, University of Oslo, Sem Sælands vei 7, 0371 Oslo, Norway
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Jakob TF, Aschendorff A, Arndt S. [Single-Sided Deafness (SSD) - With the "Second" You Hear Better]. Laryngorhinootologie 2024. [PMID: 39038456 DOI: 10.1055/a-2341-0371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
Single-sided deafness (SSD) is characterised by deafness in one ear while the other ear has normal hearing. The most common cause in congenital SSD is aplasia of the auditory nerve, and in post-lingual SSD idiopathic hearing loss. Patients with SSD mainly suffer from impaired sound localisation and difficulties in speech perception in noise. There are various therapy options, but binaural hearing is only possible with a cochlear implant (CI).
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Affiliation(s)
- Till F Jakob
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät der Albert-Ludwigs-Universität, Freiburg, Deutschland
| | - Antje Aschendorff
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät der Albert-Ludwigs-Universität, Freiburg, Deutschland
| | - Susan Arndt
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät der Albert-Ludwigs-Universität, Freiburg, Deutschland
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Wu SS, Dunn-Johnson C, Zeitler DM, Schwartz S, Sutliff S, Appachi S, Jamis C, Petter K, Vovos R, Goldberg D, Anne S. Auditory Outcomes Following Cochlear Implantation in Children with Unilateral Hearing Loss. Otol Neurotol 2024; 45:513-520. [PMID: 38511263 PMCID: PMC11087191 DOI: 10.1097/mao.0000000000004169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
OBJECTIVE Unilateral hearing loss (UHL) in children is associated with speech and language delays. Cochlear implantation (CI) is currently the only rehabilitative option that restores binaural hearing. This study aims to describe auditory outcomes in children who underwent CI for UHL and to determine the association between duration of hearing loss and auditory outcomes. STUDY DESIGN Retrospective case series. SETTING Three tertiary-level, academic institutions. PATIENTS Children <18 years with UHL who underwent CI between 2018 and 2021. INTERVENTION Cochlear implantation. MAIN OUTCOME MEASURES Speech perception and Speech, Spatial and Qualities of Hearing Scale (SSQ) were assessed postimplantation. Scores >50% on speech perception and SSQ scores >8 points were considered satisfactory. Associations between duration of UHL and implantation age and outcomes were assessed using Spearman's rank correlation. RESULTS Of the 38 children included, mean age at CI was 7.9 ± 3.2 years and mean UHL duration was 5.0 ± 2.8 years. Mean datalogging was 8.1 ± 3.1 hours/day. Mean auditory testing scores were SSQ, 7.9 ± 1.2; BABY BIO, 68.1 ± 30.2%; CNC, 38.4 ± 28.4%; WIPI, 52.5 ± 23.1%. Scores >50% on CNC testing were achieved by 40% of patients. SSQ scores >8 points were reported by 78% (7/9) of patients. There were no significant correlations between UHL duration and auditory outcomes. CONCLUSION Overall, children with UHL who undergo CI can achieve satisfactory speech perception scores and SSQ scores. There were no associations between duration of hearing loss and age at implantation with auditory outcomes. Multiple variables may impact auditory outcomes, including motivation, family support, access to technology, and consistent isolated auditory training postactivation and should be taken into consideration in addition to age at implantation and duration of UHL in determination of CI candidacy.
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Affiliation(s)
- Shannon S. Wu
- Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - Camille Dunn-Johnson
- Department of Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Daniel M. Zeitler
- Department of Otolaryngology, Virginia Mason Medical Center, Seattle, Washington
| | - Seth Schwartz
- Department of Otolaryngology, Virginia Mason Medical Center, Seattle, Washington
| | - Suzanne Sutliff
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Swathi Appachi
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Carmen Jamis
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Karen Petter
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Rachel Vovos
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Donald Goldberg
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Samantha Anne
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
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Garcia-Matte RJ, O'Neil LM, Chase C, Leeming P, Clack R, Rodrigues S, Kuthubutheen J. Long-Term Cochlear Implant Sound Processor Usage in Children with Single-Sided Deafness. Otol Neurotol 2024; 45:392-397. [PMID: 38478407 DOI: 10.1097/mao.0000000000004156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
OBJECTIVE To assess cochlear implant (CI) sound processor usage over time in children with single-sided deafness (SSD) and identify factors influencing device use. STUDY DESIGN Retrospective, chart review study. SETTING Pediatric tertiary referral center. PATIENTS Children with SSD who received CI between 2014 and 2020. OUTCOME MEASURE Primary outcome was average daily CI sound processor usage over follow-up. RESULTS Fifteen children with SSD who underwent CI surgery were categorized based on age of diagnosis and surgery timing. Over an average of 4.3-year follow-up, patients averaged 4.6 hours/day of CI usage. Declining usage trends were noted over time, with the first 2 years postactivation showing higher rates. No significant usage differences emerged based on age, surgery timing, or hearing loss etiology. CONCLUSIONS Long-term usage decline necessitates further research into barriers and enablers for continued CI use in pediatric SSD cases.
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Affiliation(s)
| | - Luke M O'Neil
- Department of Otolaryngology, Perth Children's Hospital
| | - Carl Chase
- Department of Otolaryngology, Perth Children's Hospital
| | - Pia Leeming
- Department of Otolaryngology, Perth Children's Hospital
| | - Rachel Clack
- Department of Otolaryngology, Perth Children's Hospital
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Arndt S, Findeis L, Wesarg T, Aschendorff A, Speck I, Ketterer MC, Rauch AK. Long-Term Outcome of Cochlear Implantation in Children With Congenital, Perilingual, and Postlingual Single-Sided Deafness. Ear Hear 2024; 45:316-328. [PMID: 37726884 DOI: 10.1097/aud.0000000000001426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
OBJECTIVES We investigated the long-term outcomes of children with single-sided deafness (SSD) after cochlear implant (CI) surgery, during and after rehabilitation, and compared the results of children with congenital, perilingual, and postlingual SSD. We evaluated the impact of SSD at age at onset and duration of deafness on their performance. DESIGN Thirty-six children with SSD treated with CI participated in the study: 20 had congenital, seven perilingual (defined: >0 to 4 years), and nine had postlingual deafness (defined as >4 years of age). Their outcome with CI were measured on both subjective and objective scales: duration of device use, speech intelligibility in noise and in quiet, bilateral hearing and localization ability, quality of life and hearing, presence and loudness of tinnitus, and hearing ability of the better hearing ear. RESULTS After a mean follow-up time of 4.75 years, 32 of the 36 children used their CI on a regular basis. The remaining four children were nonusers. These children had congenital SSD and were older than three years at the time of CI surgery. Overall, for congenital/perilingual and postlingual SSD, speech intelligibility in noise and the Speech, Spatial and Qualities of Hearing Scale (SSQ) speech subscore were significantly improved, as were their subjective and objective localization ability and hearing-related quality of life. Children with postlingual SSD benefited from the CI with regard to speech intelligibility, SSQ speech/spatial/total score, and localization error, and children with congenital SSD showed better results with a short duration of deafness of less than 3 years compared with those with a longer deafness period. CONCLUSIONS Cochlear implantation is a successful treatment for children with congenital/perilingual or postlingual SSD. Results largely differed with respect to the onset and duration of deafness, and better outcomes were achieved by children with postlingual SSD and with a short duration of deafness. Our data also confirmed that children with congenital SSD should be implanted with a CI within three years of age.
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Affiliation(s)
- Susan Arndt
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
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Pantaleo A, Murri A, Cavallaro G, Pontillo V, Auricchio D, Quaranta N. Single-Sided Deafness and Hearing Rehabilitation Modalities: Contralateral Routing of Signal Devices, Bone Conduction Devices, and Cochlear Implants. Brain Sci 2024; 14:99. [PMID: 38275519 PMCID: PMC10814000 DOI: 10.3390/brainsci14010099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Single sided deafness (SSD) is characterized by significant sensorineural hearing loss, severe or profound, in only one ear. SSD adversely affects various aspects of auditory perception, including causing impairment in sound localization, difficulties with speech comprehension in noisy environments, and decreased spatial awareness, resulting in a significant decline in overall quality of life (QoL). Several treatment options are available for SSD, including cochlear implants (CI), contralateral routing of signal (CROS), and bone conduction devices (BCD). The lack of consensus on outcome domains and measurement tools complicates treatment comparisons and decision-making. This narrative overview aims to summarize the treatment options available for SSD in adult and pediatric populations, discussing their respective advantages and disadvantages. Rerouting devices (CROS and BCD) attenuate the effects of head shadow and improve sound awareness and signal-to-noise ratio in the affected ear; however, they cannot restore binaural hearing. CROS devices, being non-implantable, are the least invasive option. Cochlear implantation is the only strategy that can restore binaural hearing, delivering significant improvements in speech perception, spatial localization, tinnitus control, and overall QoL. Comprehensive preoperative counseling, including a discussion of alternative technologies, implications of no treatment, expectations, and auditory training, is critical to optimizing therapeutic outcomes.
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Affiliation(s)
- Alessandra Pantaleo
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
| | - Alessandra Murri
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
| | - Giada Cavallaro
- Otolaryngology Unit, Madonna delle Grazie Hospital, 75100 Matera, Italy;
| | - Vito Pontillo
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
| | - Debora Auricchio
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
| | - Nicola Quaranta
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
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Patro A, Holder JT, Brown CL, DeFreese A, Virgin F, Perkins EL. Cochlear Implantation in Very Young Children With Single-Sided Deafness. Otolaryngol Head Neck Surg 2023; 169:1615-1623. [PMID: 37232481 DOI: 10.1002/ohn.375] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/17/2023] [Accepted: 04/29/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Cochlear implants (CIs) for single-sided deafness (SSD) have only been approved for patients 5 years and older despite data supporting that younger children can also benefit from implantation. This study describes our institution's experience with CI for SSD in children 5 years and younger. STUDY DESIGN Case series with chart review. SETTING Tertiary referral center. METHODS A case series with chart review identified 19 patients up to age 5 years who underwent CI for SSD between 2014 and 2022. Baseline characteristics, perioperative complications, device usage, and speech outcomes were collected. RESULTS The median age at CI was 2.8 (range, 1.0-5.4) years, with 15 (79%) patients being below age 5 at implantation. Etiologies of hearing loss were idiopathic (n = 8), cytomegalovirus (n = 4), enlarged vestibular aqueduct (n = 3), hypoplastic cochlear nerve (n = 3), and meningitis (n = 1). The median preoperative pure-tone average was 90 (range, 75-120) and 20 (range, 5-35) dB eHL in the poor and better hearing ears, respectively. No patients had postoperative complications. Twelve patients achieved consistent device use (average, 9 h/d). Three of the seven who were not consistent users had hypoplastic cochlear nerves and/or developmental delays. The three patients with available preoperative and postoperative speech testing showed significant benefits, and five patients with available postoperative testing demonstrated speech recognition in the implanted ear when isolated from the better ear. CONCLUSION CI can safely be performed in younger children with SSD. Patients and families accept early implantation, as evidenced by consistent device use, and derive notable benefits in speech recognition. Candidacy can be broadened to include SSD patients under age five years, particularly individuals without hypoplastic cochlear nerves or developmental delay.
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Affiliation(s)
- Ankita Patro
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jourdan T Holder
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christine L Brown
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Andrea DeFreese
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Frank Virgin
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Elizabeth L Perkins
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Wener E, Booth L, Bensky H, Desai V, Negandhi J, Cushing SL, Papsin BC, Gordon KA. Exposure to Spoken Communication During the COVID-19 Pandemic Among Children With Cochlear Implants. JAMA Netw Open 2023; 6:e2339042. [PMID: 37889489 PMCID: PMC10611997 DOI: 10.1001/jamanetworkopen.2023.39042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/07/2023] [Indexed: 10/28/2023] Open
Abstract
Importance School closures and other COVID-19-related restrictions could decrease children's exposure to speech during important stages of development. Objective To assess whether significant decreases in exposure to spoken communication found during the initial phase of the COVID-19 pandemic among children using cochlear implants are confirmed for a larger cohort of children and were sustained over the first years of the COVID-19 pandemic. Design, Setting, and Participants This cohort study used datalogs collected from children with cochlear implants during clinical visits to a tertiary pediatric hospital in Toronto, Ontario, Canada, from January 1, 2018, to November 11, 2021. Children with severe to profound hearing loss using cochlear implants were studied because their devices monitored and cataloged levels and types of sounds during hourly use per day (datalogs) and because their hearing and spoken language development was particularly vulnerable to reduced sound exposure. Statistical analyses were conducted between January 2022 and August 2023. Main Outcomes and Measures Daily hours of sound were captured by the cochlear implant datalogging system and categorized into 6 auditory scene categories, including speech and speech-in-noise. Time exposed to speech was calculated as the sum of daily hours in speech and daily hours in speech-in-noise. Residual hearing in the ear without an implant of children with unilateral cochlear implants was measured by pure tone audiometry. Mixed-model regression analyses revealed main effects with post hoc adjustment of 95% CIs using the Satterthwaite method. Results Datalogs (n = 2746) from 262 children (137 with simultaneous bilateral cochlear implants [74 boys (54.0%); mean (SD) age, 5.8 (3.5 years)], 38 with sequential bilateral cochlear implants [24 boys (63.2%); mean (SD) age, 9.1 (4.2) years], and 87 with unilateral cochlear implants [40 boys (46.0%); mean (SD) age, 7.9 (4.6) years]) who were preschool aged (n = 103) and school aged (n = 159) before the COVID-19 pandemic were included in analyses. There was a slight increase in use among preschool-aged bilateral cochlear implant users through the pandemic (early pandemic, 1.4 h/d [95% CI, 0.3-2.5 h/d]; late pandemic, 2.3 h/d [95% CI, 0.6-4.0 h/d]) and little change in use among school-aged bilateral cochlear implant users (early pandemic, -0.6 h/d [95% CI, -1.1 to -0.05 h/d]; late pandemic, -0.3 h/d [95% CI, -0.9 to 0.4 h/d]). However, use decreased during the late pandemic period among school-aged children with unilateral cochlear implants (-1.8 h/d [95% CI,-3.0 to -0.6 h/d]), particularly among children with good residual hearing in the ear without an implant. Prior to the pandemic, children were exposed to speech for approximately 50% of the time they used their cochlear implants (preschool-aged children: bilateral cochlear implants, 46.6% [95% CI, 46.5%-47.2%] and unilateral cochlear implants, 52.1% [95% CI, 50.7%-53.5%]; school-aged children: bilateral cochlear implants, 47.6% [95% CI, 46.8%-48.4%] and unilateral cochlear implants, 51.0% [95% CI, 49.4%-52.6%]). School-aged children in both groups experienced significantly decreased speech exposure in the early pandemic period (bilateral cochlear implants, -12.1% [-14.6% to -9.4%]; unilateral cochlear implants, -15.5% [-20.4% to -10.7%]) and late pandemic periods (bilateral cochlear implants, -5.3% [-8.0% to -2.6%]; unilateral cochlear implants, -11.2% [-15.3% to -7.1%]) compared with the prepandemic baseline. Conclusions and Relevance This cohort study using datalogs from children using cochlear implants suggests that a sustained reduction in children's access to spoken communication was found during more than 2 years of COVID-19 pandemic-related lockdowns and school closures.
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Affiliation(s)
- Emily Wener
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lindsay Booth
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Hailey Bensky
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Veeral Desai
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jaina Negandhi
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sharon L. Cushing
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Otolaryngology–Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Blake C. Papsin
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Otolaryngology–Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen A. Gordon
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Otolaryngology–Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Communication Disorders, The Hospital for Sick Children, Toronto, Ontario, Canada
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9
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Lindquist NR, Holder JT, Patro A, Cass ND, Tawfik KO, O'Malley MR, Bennett ML, Haynes DS, Gifford RH, Perkins EL. Cochlear Implants for Single-Sided Deafness: Quality of Life, Daily Usage, and Duration of Deafness. Laryngoscope 2023; 133:2362-2370. [PMID: 36254870 DOI: 10.1002/lary.30452] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/22/2022] [Accepted: 09/15/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To report our experience for adults undergoing cochlear implantation (CI) for single-sided deafness (SSD). METHODS This is a retrospective case series for adults with SSD who underwent CI between January 2013 and May 2021 at our institution. CNC and AzBio speech recognition scores, Tinnitus Handicap Inventory (THI), Speech, Spatial, and Qualities of Hearing Scale (SSQ12), datalogging, and the Cochlear Implant Quality of Life (CIQOL)-10 Global measure were utilized. RESULTS Sixty-six adults underwent CI for SSD (median 51.3 years, range 20.0-74.3 years), and 57 (86.4%) remained device users at last follow-up. Compared to pre-operative performance, device users demonstrated significant improvement in speech recognition scores and achieved peak performance at six months post-activation for CNC (8.0% increased to 45.6%, p < 0.0001) and AzBio in quiet (12.2% increased to 59.5%, p < 0.0001). THI was decreased at 6 months post-implantation (58.1-14.6, p < 0.0001), with 77% of patients reporting improved or resolved tinnitus. Patients demonstrated improved SSQ12 scores as well as the disease-specific CIQOL-10 Global questionnaire. Duration of deafness was not associated with significant differences in speech recognition performance. Average daily wear time was positively associated with CNC and AzBio scores as well as post-operative CIQOL-10 scores. CONCLUSIONS Herein we present the largest cohort of adult CI recipients with SSD with data on speech recognition scores, tinnitus measures, and SSQ12. Novel insights regarding the correlation of datalogging, duration of deafness, and CI-specific quality of life (CIQOL-10) metrics are discussed. Data continue to support CI as an efficacious treatment option for SSD. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2362-2370, 2023.
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Affiliation(s)
- Nathan R Lindquist
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jourdan T Holder
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ankita Patro
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Nathan D Cass
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kareem O Tawfik
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Matthew R O'Malley
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Marc L Bennett
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David S Haynes
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - René H Gifford
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Elizabeth L Perkins
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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10
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Park LR, Gagnon EB, Dillon MT. Factors that influence outcomes and device use for pediatric cochlear implant recipients with unilateral hearing loss. Front Hum Neurosci 2023; 17:1141065. [PMID: 37250696 PMCID: PMC10213360 DOI: 10.3389/fnhum.2023.1141065] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Candidacy criteria for cochlear implantation in the United States has expanded to include children with single-sided deafness (SSD) who are at least 5 years of age. Pediatric cochlear implant (CI) users with SSD experience improved speech recognition with increased daily device use. There are few studies that report the hearing hour percentage (HHP) or the incidence of non-use for pediatric CI recipients with SSD. The aim of this study was to investigate factors that impact outcomes in children with SSD who use CIs. A secondary aim was to identify factors that impact daily device use in this population. Methods A clinical database query revealed 97 pediatric CI recipients with SSD who underwent implantation between 2014 and 2022 and had records of datalogs. The clinical test battery included speech recognition assessment for CNC words with the CI-alone and BKB-SIN with the CI plus the normal-hearing ear (combined condition). The target and masker for the BKB-SIN were presented in collocated and spatially separated conditions to evaluate spatial release from masking (SRM). Linear mixed-effects models evaluated the influence of time since activation, duration of deafness, HHP, and age at activation on performance (CNC and SRM). A separate linear mixed-effects model evaluated the main effects of age at testing, time since activation, duration of deafness, and onset of deafness (stable, progressive, or sudden) on HHP. Results Longer time since activation, shorter duration of deafness, and higher HHP were significantly correlated with better CNC word scores. Younger age at device activation was not found to be a significant predictor of CNC outcomes. There was a significant relationship between HHP and SRM, with children who had higher HHP experiencing greater SRM. There was a significant negative correlation between time since activation and age at test with HHP. Children with sudden hearing loss had a higher HHP than children with progressive and congenital hearing losses. Conclusion The present data presented here do not support a cut-off age or duration of deafness for pediatric cochlear implantation in cases of SSD. Instead, they expand on our understanding of the benefits of CI use in this population by reviewing the factors that influence outcomes in this growing patient population. Higher HHP, or greater percentage of time spent each day using bilateral input, was associated with better outcomes in the CI-alone and in the combined condition. Younger children and those within the first months of use had higher HHP. Clinicians should discuss these factors and how they may influence CI outcomes with potential candidates with SSD and their families. Ongoing work is investigating the long-term outcomes in this patient population, including whether increasing HHP after a period of limited CI use results in improved outcomes.
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11
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Gordon KA, Alemu R, Papsin BC, Negandhi J, Cushing SL. Effects of Age at Implantation on Outcomes of Cochlear Implantation in Children with Short Durations of Single-Sided Deafness. Otol Neurotol 2023; 44:233-240. [PMID: 36728258 PMCID: PMC9924958 DOI: 10.1097/mao.0000000000003811] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Children with single-sided deafness (SSD) show reduced language and academic development and report hearing challenges. We aim to improve outcomes in children with SSD by providing bilateral hearing through cochlear implantation of the deaf ear with minimal delay. STUDY DESIGN Prospective cohort study of 57 children with SSD provided with cochlear implant (CI) between May 13, 2013, and June 25, 2021. SETTING Tertiary children's hospital. PARTICIPANTS Children with early onset (n = 40) or later onset of SSD (n = 17) received CIs at ages 2.47 ± 1.58 years (early onset group) and 11.67 ± 3.91 years (late onset group) (mean ± SD). Duration of unilateral deafness was limited (mean ± SD = 1.93 ± 1.56 yr). INTERVENTION Cochlear implantation of the deaf ear. MAIN OUTCOMES/MEASURES Evaluations of device use (data logging) and hearing (speech perception, effects of spatial release from masking on speech detection, localization of stationary and moving sound, self-reported hearing questionnaires). RESULTS Results indicated that daily device use is variable (mean ± SD = 5.60 ± 2.97, range = 0.0-14.7 h/d) with particular challenges during extended COVID-19 lockdowns, including school closures (daily use reduced by mean 1.73 h). Speech perception with the CI alone improved (mean ± SD = 65.7 ± 26.4 RAU) but, in the late onset group, remained poorer than in the normal hearing ear. Measures of spatial release from masking also showed asymmetric hearing in the late onset group ( t13 = 5.14, p = 0.001). Localization of both stationary and moving sound was poor (mean ± SD error = 34.6° ± 16.7°) but slightly improved on the deaf side with CI use ( F1,36 = 3.95, p = 0.05). Decreased sound localization significantly correlated with poorer self-reported hearing. CONCLUSIONS AND RELEVANCE Benefits of CI in children with limited durations of SSD may be more restricted for older children/adolescents. Spatial hearing challenges remain. Efforts to increase CI acceptance and consistent use are needed.
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Affiliation(s)
- Karen A. Gordon
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children
- Department of Communication Disorders, The Hospital for Sick Children
| | - Robel Alemu
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children
| | - Blake C. Papsin
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children
- Department of Otolaryngology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jaina Negandhi
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children
| | - Sharon L. Cushing
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto
- Archie’s Cochlear Implant Laboratory, The Hospital for Sick Children
- Department of Otolaryngology, The Hospital for Sick Children, Toronto, ON, Canada
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12
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Agostinelli A, Pegolo M, Montino S, Maritan F, Gambalonga M, Trevisi P, Brotto D. Improving Auditory Perception in Pediatric Single-Sided Deafness: Use of Cochlear Implants' Direct Connection for Remote Speech Perception Rehabilitation. Am J Audiol 2023; 32:52-58. [PMID: 36538514 DOI: 10.1044/2022_aja-21-00271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Unilateral cochlear implants (CIs) can restore binaural hearing in single-sided deafness (SSD). Direct stimulation of the CI can be obtained via the Bluetooth connection of a device to the CI, thus excluding the typical-hearing ear. This study aims to investigate the use of CI connectivity features as a rehabilitative strategy in a small cohort of children affected by SSD. METHOD A newly developed training protocol was presented to children with SSD who have less than 2 years of experience with CI. We developed a user-friendly and short-term (six sessions within 20 days) training protocol for speech perception that patients themselves can manage independently at home using CI connectivity systems. Children were telematically tested before and after the training by trained speech and language therapists. RESULTS Four patients met the inclusion criteria. They all showed better results in the final online assessment, when compared with the initial one. CONCLUSIONS To our knowledge, this is the first clinical focus article presenting an auditory training protocol for SSD patients with CI using the Bluetooth connectivity systems for teletherapy. The results, although preliminary, support the efficacy of this rehabilitative strategy. Further research is needed to support our findings.
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Affiliation(s)
- Anna Agostinelli
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Italy
| | - Margherita Pegolo
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Italy
| | - Silvia Montino
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Italy
| | - Francesca Maritan
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Italy
| | - Mattia Gambalonga
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Italy
| | - Patrizia Trevisi
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Italy
| | - Davide Brotto
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Italy
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13
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Hunter JB, Yancey KL, Lee KH. Pediatric Single-Sided Deafness. Otolaryngol Clin North Am 2022; 55:1139-1149. [DOI: 10.1016/j.otc.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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14
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Silva VAR, Pauna HF, Lavinsky J, Hyppolito MA, Vianna MF, Leal M, Massuda ET, Hamerschmidt R, Bahmad Jr F, Cal RV, Sampaio ALL, Felix F, Chone CT, Castilho AM. Task force Guideline of Brazilian Society of Otology - hearing loss in children - Part II - Treatment. Braz J Otorhinolaryngol 2022; 89:190-206. [PMID: 36528468 PMCID: PMC9874354 DOI: 10.1016/j.bjorl.2022.11.001] [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] [Received: 11/06/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To provide an overview of the main evidence-based recommendations for the diagnosis of hearing loss in children and adolescents aged 0-18 years. METHODS Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on childhood hearing loss were eligible for inclusion. The American College of Physicians' guideline grading system and the American Thyroid Association's guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. RESULTS The topics were divided into 2 parts: (1) treatment of sensorineural hearing loss: individual hearing aids, bilateral cochlear implants, cochlear implants in young children, unilateral hearing loss, and auditory neuropathy spectrum disorder; and (2) treatment of conductive/mixed hearing loss: external/middle ear malformations, ventilation tube insertion, and tympanoplasty in children. CONCLUSIONS In children with hearing loss, in addition to speech therapy, Hearing AIDS (HAs) or implantable systems may be indicated. Even in children with profound hearing loss, both the use of HAs and behavioral assessments while using the device are important.
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Affiliation(s)
- Vagner Antonio Rodrigues Silva
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil,Corresponding author.
| | - Henrique Furlan Pauna
- Hospital Universitário Cajuru, Departamento de Otorrinolaringologia, Curitiba, PR, Brazil
| | - Joel Lavinsky
- Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Cirurgia, Porto Alegre, RS, Brazil
| | - Miguel Angelo Hyppolito
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Melissa Ferreira Vianna
- Irmandade Santa Casa de Misericórdia de São Paulo, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Mariana Leal
- Universidade Federal de Pernambuco (UFPE), Departamento de Cirurgia, Recife, PE, Brazil
| | - Eduardo Tanaka Massuda
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Rogério Hamerschmidt
- Universidade Federal do Paraná (UFPR), Hospital de Clínicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Curitiba, PR, Brazil
| | - Fayez Bahmad Jr
- Universidade de Brasília (UnB), Programa de Pós-Graduação em Ciências da Saúde, Brasília, DF, Brazil,Instituto Brasiliense de Otorrinolaringologia (IBO), Brasília, DF, Brazil
| | - Renato Valério Cal
- Centro Universitário do Estado do Pará (CESUPA), Departamento de Otorrinolaringologia, Belém, PA, Brazil
| | - André Luiz Lopes Sampaio
- Universidade de Brasília (UnB), Faculdade de Medicina, Laboratório de Ensino e Pesquisa em Otorrinolaringologia, Brasília, DF, Brazil
| | - Felippe Felix
- Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho (HUCFF), Departamento de Otorrinolaringologia, Rio de Janeiro, RJ, Brazil
| | - Carlos Takahiro Chone
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Arthur Menino Castilho
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
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15
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A Prospective Study of Etiology and Auditory Profiles in Infants with Congenital Unilateral Sensorineural Hearing Loss. J Clin Med 2022; 11:jcm11143966. [PMID: 35887730 PMCID: PMC9324637 DOI: 10.3390/jcm11143966] [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: 06/03/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 12/10/2022] Open
Abstract
Congenital unilateral sensorineural hearing loss (uSNHL) is associated with speech-language delays and academic difficulties. Yet, controversy exists in the choice of diagnosis and intervention methods. A cross-sectional prospective design was used to study hearing loss cause in twenty infants with congenital uSNHL consecutively recruited from a universal neonatal hearing-screening program. All normal-hearing ears showed ≤20 dB nHL auditory brainstem response (ABR) thresholds (ABRthrs). The impaired ear median ABRthr was 55 dB nHL, where 40% had no recordable ABRthr. None of the subjects tested positive for congenital cytomegalovirus (CMV) infection. Fourteen subjects agreed to participate in magnetic resonance imaging (MRI). Malformations were common for all degrees of uSNHL and found in 64% of all scans. Half of the MRIs demonstrated cochlear nerve aplasia or severe hypoplasia and 29% showed inner ear malformations. Impaired ear and normal-hearing ear ABR input/output functions on a group level for subjects with ABRthrs < 90 dB nHL were parallel shifted. A significant difference in interaural acoustic reflex thresholds (ARTs) existed. In congenital uSNHL, MRI is powerful in finding a possible hearing loss cause, while congenital CMV infection may be relatively uncommon. ABRs and ARTs indicated an absence of loudness recruitment, with implications for further research on hearing devices.
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16
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Longitudinal auditory data of children with prelingual single-sided deafness managed with early cochlear implantation. Sci Rep 2022; 12:9376. [PMID: 35672363 PMCID: PMC9174487 DOI: 10.1038/s41598-022-13247-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 05/23/2022] [Indexed: 11/09/2022] Open
Abstract
Individuals with single-sided deafness (SSD) have no access to binaural hearing, which limits their ability to localize sounds and understand speech in noisy environments. In addition, children with prelingual SSD are at risk for neurocognitive and academic difficulties. Early cochlear implantation may lead to improved hearing outcomes by restoring bilateral hearing. However, its longitudinal impact on the development of children with SSD remains unclear. In the current study, a group of young children with prelingual SSD received a cochlear implant at an early age. From the age of four, the children’s spatial hearing skills could be assessed using a spatial speech perception in noise test and a sound localization test. The results are compared to those of two control groups: children with SSD without a cochlear implant and children with bilateral normal hearing. Overall, the implanted group exhibited improved speech perception in noise abilities and better sound localization skills, compared to their non-implanted peers. On average, the children wore their device approximately nine hours a day. Given the large contribution of maturation to the development of spatial hearing skills, further follow-up is important to understand the long-term benefit of a cochlear implant for children with prelingual SSD.
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17
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American Cochlear Implant Alliance Task Force Guidelines for Determining Cochlear Implant Candidacy in Children. Ear Hear 2022; 43:268-282. [PMID: 35213891 PMCID: PMC8862774 DOI: 10.1097/aud.0000000000001087] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article summarizes the available evidence on pediatric cochlear implantation to provide current guidelines for clinical protocols and candidacy recommendations in the United States. Candidacy determination involves specification of audiologic and medical criteria per guidelines of the Food and Drug Administration. However, recommendations for a cochlear implant evaluation also should maintain flexibility and consider a child’s skill progression (i.e., month-for-month progress in speech, language, and auditory development) and quality of life with appropriately fit hearing aids. Moreover, evidence supports medical and clinical decisions based on other factors, including (a) ear-specific performance, which affords inclusion of children with asymmetric hearing loss and single-sided deafness as implant candidates; (b) ear-specific residual hearing, which influences surgical technique and device selection to optimize hearing; and (c) early intervention to minimize negative long-term effects on communication and quality of life related to delayed identification of implant candidacy, later age at implantation, and/or limited commitment to an audiologic rehabilitation program. These evidence-based guidelines for current clinical protocols in determining pediatric cochlear implant candidacy encourage a team-based approach focused on the whole child and the family system.
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18
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Gordon KA, Papsin BC, Papaioannou V, Cushing SL. The Importance of Access to Bilateral Hearing through Cochlear Implants in Children. Semin Hear 2021; 42:381-388. [PMID: 34912166 PMCID: PMC8660169 DOI: 10.1055/s-0041-1739371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Children with hearing loss require early access to sound in both ears to support their development. In this article, we describe barriers to providing bilateral hearing and developmental consequences of delays during early sensitive periods. Barriers include late identification of hearing loss in one or both ears and delayed access to intervention with hearing devices such as cochlear implants. Effects of delayed bilateral input on the auditory pathways and brain are discussed as well as behavioral effects on speech perception and other developmental outcomes including language and academics. Evidence for these effects has supported an evolution in cochlear implant candidacy in children that was started with unilateral implantation in children with profound deafness bilaterally to bilateral implantation to implantation of children with asymmetric hearing loss including children with single-side deafness. Opportunities to enhance the developmental benefits of bilateral hearing in children with hearing loss are also discussed including efforts to improve binaural/spatial hearing and consideration of concurrent vestibular deficits which are common in children with hearing loss.
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Affiliation(s)
- Karen A Gordon
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Canada.,Department of Communication Disorders, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Blake C Papsin
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Vicky Papaioannou
- Department of Communication Disorders, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Sharon L Cushing
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada
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19
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Brown KD, Dillon MT, Park LR. Benefits of Cochlear Implantation in Childhood Unilateral Hearing Loss (CUHL Trial). Laryngoscope 2021; 132 Suppl 6:S1-S18. [PMID: 34542181 PMCID: PMC9293149 DOI: 10.1002/lary.29853] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/29/2021] [Accepted: 08/22/2021] [Indexed: 11/12/2022]
Abstract
Objectives/Hypotheses Children with unilateral sensory hearing loss (UHL) struggle to understand speech in noise and locate the origin of sound and have reduced quality of hearing. This clinical trial will determine the benefits of cochlear implantation in children with UHL. Study Design Prospective clinical trial. Methods Twenty children with at least moderate to profound sensory hearing loss and poor speech perception (word score <30%) in one ear and normal hearing in the contralateral ear participated in a Food and Drug Administration‐approved clinical trial. Subjects were evaluated for speech perception in quiet, speech perception in noise, sound localization, and subjective benefits after implantation. Results CNC word score perception in quiet significantly improved (1% to 50%, P < .0001) by 12 months after activation. Speech perception in noise by BKB‐SIN significantly improved in all three noise configurations; there was a 3.6 dB advantage in head shadow (P < .0001), a 1.6 dB advantage in summation (P = .003), and a 2.5 dB advantage in squelch (P = .0001). Localization improved by 26° at 9 months (P < .0001). Speech, Spatial, and Qualities (SSQ) demonstrated significant improvements in speech (5.2 to 7.4, P = .0012), qualities of hearing (5.9 to 7.5, P = .0056), and spatial hearing (2.7 to 6.6, P < .0001). SSQ subscales associated with binaural hearing were significantly improved, as was listening effort (P = .0082). Subjects demonstrated a non‐significant improvement in fatigue. Conclusions This study demonstrates that children with UHL significantly benefit from cochlear implantation. Level of Evidence Level 3 Laryngoscope, 132:S1–S18, 2022
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Affiliation(s)
- Kevin D Brown
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, U.S.A
| | - Margaret T Dillon
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, U.S.A
| | - Lisa R Park
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, U.S.A
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Children With Congenital Unilateral Sensorineural Hearing Loss: Effects of Late Hearing Aid Amplification-A Pilot Study. Ear Hear 2021; 41:55-66. [PMID: 30998543 DOI: 10.1097/aud.0000000000000730] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Although children with unilateral hearing loss (uHL) have high risk of experiencing academic difficulties, speech-language delays, poor sound localization, and speech recognition in noise, studies on hearing aid (HA) outcomes are few. Consequently, it is unknown when and how amplification is optimally provided. The aim was to study whether children with mild-to-moderate congenital unilateral sensorineural hearing loss (uSNHL) benefit from HAs. DESIGN All 6- to 11-year-old children with nonsyndromic congenital uSNHL and at least 6 months of HA use were invited (born in Stockholm county council, n = 7). Participants were 6 children (9.7- to 10.8-years-old) with late HA fittings (>4.8 years of age). Unaided and aided hearing was studied with a comprehensive test battery in a within-subject design. Questionnaires were used to study overall hearing performance and disability. Sound localization accuracy (SLA) and speech recognition thresholds (SRTs) in competing speech were measured in sound field to study hearing under demanding listening conditions. SLA was measured by recording eye-gaze in response to auditory-visual stimuli presented from 12 loudspeaker-video display pairs arranged equidistantly within ±55° in the frontal horizontal plane. The SRTs were measured for target sentences at 0° in spatially separated (±30° and ±150°) continuous speech. Auditory brainstem responses (ABRs) were obtained in both ears separately to study auditory nerve function at the brainstem level. RESULTS The mean ± SD pure-tone average (0.5, 1, 2, and 4 kHz) was 45 ± 8 dB HL and 6 ± 4 dB HL in the impaired and normal hearing ear, respectively (n = 6). Horizontal SLA was significantly poorer in the aided compared with unaided condition. A significant relationship was found between aided SLA (quantified by an error index) and the impaired ear's ABR I to V interval, suggesting a relationship between the two. Results from questionnaires revealed aided benefit in one-to-one communication, whereas no significant benefit was found for communication in background noise or reverberation. No aided benefit was found for the SRTs in competing speech. CONCLUSIONS Children with congenital uSNHL benefit from late HA intervention in one-to-one communication but not in demanding listening situations, and there is a risk of degraded SLA. The results indicate that neural transmission time from the impaired cochlea to the upper brainstem may have an important role in unilaterally aided spatial hearing, warranting further study in children with uHL receiving early HA intervention.
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Abstract
OBJECTIVES To measure the acceptance of a cochlear implant by children with single-sided deafness (SSD) using datalogging technology in the cochlear implant processor. DESIGN Datalogs from follow-up clinical audiology appointments for 23 children with SSD were extracted from their cochlear implant processors ranging from 1 to 8 visits (M = 3.74, SD = 1.79). The number of hours the cochlear implant was in use per day, the number of times the coil disconnected from the internal device, and the percentage of daily cochlear implant use in different auditory environments were collected from the datalogs. Linear mixed-effects regressions were used to analyze the relationship between age, hearing experience, cochlear implant use, and coil-offs per day. Nonlinear regressions were conducted to evaluate cochlear implant use in different environments. RESULTS Children with SSD wore their cochlear implants for 6.22 (SD = 2.81; range = 0.0004 to 14.74) hours per day on average. No significant change in cochlear implant use was seen as the children grew older or gained more hearing experience. As hearing experience increased, the number of coil-offs per day was reduced. Preschoolers spent more time in "music" and "speech" and less time in "noise" and "quiet" than older and younger children while older children spent more time in "speech-in-noise." CONCLUSIONS Children with SSD consistently wear their cochlear implants. However, the auditory environments to which they are exposed vary over time. Regular cochlear implant use by this population suggests that it does not detract from a normal-hearing ear and that children with SSD appreciate access to bilateral input.
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22
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Dewyer NA, Smith S, Herrmann B, Reinshagen KL, Lee DJ. Pediatric Single-Sided Deafness: A Review of Prevalence, Radiologic Findings, and Cochlear Implant Candidacy. Ann Otol Rhinol Laryngol 2021; 131:233-238. [PMID: 34036833 DOI: 10.1177/00034894211019519] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To characterize the prevalence, imaging characteristics, and cochlear implant candidacy of pediatric patients with single-sided deafness (SSD). METHODS An audiometric database of patients evaluated at a large tertiary academic medical center was retrospectively queried to identify pediatric patients (<18 years old) with SSD, defined as severe to profound sensorineural hearing loss in one ear and normal hearing in the other. Medical records of identified patients were reviewed to characterize the prevalence, etiology, and cochlear implant candidacy of pediatric patients with SSD. RESULTS We reviewed audiometric data obtained from 1993 to 2018 for 52,878 children at our institution. 191 (0.36%) had the diagnosis of SSD. Cochlear nerve deficiency (either hypoplasia or aplasia) diagnosed on MRI and/or CT was the most common etiology of SSD and was present in 22 of 88 (25%) pediatric SSD patients with available imaging data. 70 of 106 (66%) pediatric SSD patients with available imaging had anatomy amenable to cochlear implantation. CONCLUSIONS Pediatric SSD is a rare condition and the most common etiology based on radiology is cochlear nerve deficiency. High resolution imaging of the temporal bone is essential to determine cochlear nerve morphology prior to consideration of cochlear implantation.
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Affiliation(s)
- Nicholas A Dewyer
- Department of Otolaryngology-Head and Neck Surgery, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Sullivan Smith
- Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, IL, USA
| | - Barbara Herrmann
- Department of Audiology, Massachusetts Eye and Ear, Boston, MA, USA
| | - Katherine L Reinshagen
- Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Daniel J Lee
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear/Massachusetts General Hospital, Boston, MA, USA.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA
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Benchetrit L, Ronner EA, Anne S, Cohen MS. Cochlear Implantation in Children With Single-Sided Deafness: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg 2021; 147:58-69. [PMID: 33151295 DOI: 10.1001/jamaoto.2020.3852] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance In 2019, the US Food and Drug Administration approved cochlear implantation for children with single-sided deafness (SSD). The absence of robust clinical data specific to pediatric patients to guide shared decision-making and to identify potential advantages is a challenge in family counseling. Objective To evaluate the audiological and patient-reported outcomes in children who underwent cochlear implantation for SSD and to assess the association between time of implantation, subjective outcomes, and cochlear implant device use rates. Data Source MEDLINE, Embase, Scopus, Cochrane, and PubMed were searched for English-language articles that were published in a peer-reviewed journal from database inception to February 18, 2020. Study Selection Inclusion criteria were designed to capture studies that evaluated pediatric patients (1) younger than 18 years, (2) with a diagnosis of SSD for which they underwent a cochlear implantation, and (3) with at least 1 outcome of interest measured numerically: speech perception, sound localization, device use, and patient-reported outcomes. Of the 526 articles reviewed, 12 (2.3%) met the selection criteria. Data Extraction and Synthesis The Meta-analyses Of Observational Studies in Epidemiology (MOOSE) reporting guidelines were followed. Data were pooled using fixed-effect and random-effect models. The following information was obtained from each article: study characteristics, patient characteristics, hearing loss and intervention characteristics, and outcomes. Main Outcomes and Measures Outcomes were (1) postoperative changes in speech perception (in quiet was measured as a proportion of correct responses, and in noise was measured as decibel signal to noise ratio for speech reception threshold) and sound localization (measured in degree of localization error), (2) patient-reported audiological outcomes (measured by the speech, spatial, and qualities of hearing scale), and (3) device use rates among children who received cochlear implantation for SSD. Results Twelve observational studies that evaluated 119 children (mean [SD] age, 6.6 [4.0] years) with SSD who received a cochlear implant were included. Most children showed clinically meaningful improvement in speech perception in noise (39 of 49 children [79.6%]) and in quiet (34 of 42 children [81.0%]). Long duration of deafness (>4 years in congenital SSD and >7 years in perilingual SSD) was the most commonly proposed reason for lack of improvement. Sound localization as measured by degrees of error from true location (mean difference [MD], -24.78°; 95% CI, -34.16° to -15.40°; I2 = 10%) improved statistically significantly after cochlear implantation. Patients with acquired SSD and shorter duration of deafness compared with those with congenital SSD reported greater improvements in speech (MD, 2.27; 95% CI, 1.89-2.65 vs 1.58; 95% CI, 1.00-2.16) and spatial (MD, 2.95; 95% CI, 2.66-3.24 vs 1.68; 95% CI, 0.96-2.39) hearing qualities. The duration of deafness among device nonusers was statistically significantly longer than the duration of deafness among regular device users (median difference, 6.84; 95% CI, 4.02-9.58). Conclusions and Relevance This systematic review and meta-analysis found that cochlear implantation for children with SSD was associated with clinically meaningful improvements in audiological and patient-reported outcomes; shorter duration of deafness may lead to better outcomes. These findings can guide future research efforts, refine cochlear implantation candidacy criteria, and aid in family counseling and shared decision-making.
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Affiliation(s)
- Liliya Benchetrit
- Department of Otolaryngology-Head and Neck Surgery, Boston University Medical Center, Boston, Massachusetts
| | - Evette A Ronner
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Samantha Anne
- Cleveland Clinic, Head and Neck Institute, Cleveland, Ohio.,Section Editor, JAMA Otolaryngology-Head & Neck Surgery
| | - Michael S Cohen
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston
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Lee HJ, Smieja D, Polonenko MJ, Cushing SL, Papsin BC, Gordon KA. Consistent and chronic cochlear implant use partially reverses cortical effects of single sided deafness in children. Sci Rep 2020; 10:21526. [PMID: 33298987 PMCID: PMC7726152 DOI: 10.1038/s41598-020-78371-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/10/2020] [Indexed: 01/09/2023] Open
Abstract
Potentially neuroprotective effects of CI use were studied in 22 children with single sided deafness (SSD). Auditory-evoked EEG confirmed strengthened representation of the intact ear in the ipsilateral auditory cortex at initial CI activation in children with early-onset SSD (n = 15) and late-onset SSD occurring suddenly in later childhood/adolescence (n = 7). In early-onset SSD, representation of the hearing ear decreased with chronic CI experience and expected lateralization to the contralateral auditory cortex from the CI increased with longer daily CI use. In late-onset SSD, abnormally high activity from the intact ear in the ipsilateral cortex reduced, but responses from the deaf ear weakened despite CI use. Results suggest that: (1) cortical reorganization driven by unilateral hearing can occur throughout childhood; (2) chronic and consistent CI use can partially reverse these effects; and (3) CI use may not protect children with late-onset SSD from ongoing deterioration of pathways from the deaf ear.
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Affiliation(s)
- Hyo-Jeong Lee
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Rm 6D08, 555 University Ave, Toronto, ON, M5G 1X8, Canada
- Department of Communication Disorders, Hospital for Sick Children, Toronto, ON, Canada
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Daniel Smieja
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Rm 6D08, 555 University Ave, Toronto, ON, M5G 1X8, Canada
- Department of Communication Disorders, Hospital for Sick Children, Toronto, ON, Canada
| | - Melissa Jane Polonenko
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Rm 6D08, 555 University Ave, Toronto, ON, M5G 1X8, Canada
- Department of Communication Disorders, Hospital for Sick Children, Toronto, ON, Canada
| | - Sharon Lynn Cushing
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Rm 6D08, 555 University Ave, Toronto, ON, M5G 1X8, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Otolaryngology-Head and Neck Surgery, Hospital for Sick Children, Toronto, ON, Canada
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - Blake Croll Papsin
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Rm 6D08, 555 University Ave, Toronto, ON, M5G 1X8, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Otolaryngology-Head and Neck Surgery, Hospital for Sick Children, Toronto, ON, Canada
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - Karen Ann Gordon
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Rm 6D08, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
- Department of Communication Disorders, Hospital for Sick Children, Toronto, ON, Canada.
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
- Department of Otolaryngology-Head and Neck Surgery, Hospital for Sick Children, Toronto, ON, Canada.
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.
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Rauch AK, Arndt S, Aschendorff A, Beck R, Speck I, Ketterer MC, Jakob TF, Hassepass F. Long-term results of cochlear implantation in children with congenital single-sided deafness. Eur Arch Otorhinolaryngol 2020; 278:3245-3255. [PMID: 33079248 PMCID: PMC8328851 DOI: 10.1007/s00405-020-06409-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022]
Abstract
Purpose The purpose of this retrospective study was to investigate the outcome and critical age of cochlear implantation in congenital single-sided deafness (SSD). Methods 11 children with congenital SSD were implanted with a cochlear implant (CI). Auditory performance was measured through the results of speech discrimination, subjective assessment by the Categories of auditory performance (CAP) score, the Speech, Spatial and Qualities scale questionnaire (SSQ) and the German version of the IOI-HA [Internationales Inventar zur Evaluation von Hörgeräten (IIEH, version for CI)]. Results Long-term follow-up [median: 3 years and 5 months (3;5 years)] revealed that nine children use their CI (> 8 h/day) and two became nonusers. In children aged below 3;2 years at surgery, there was a substantial long-term increase in speech discrimination and subjective benefit. Children over 4;4 years of age at CI surgery improved partially in audiological/subjective measurements. Among children above 5 years, the SSQ score did not improve despite further slight improvement in speech discrimination long-term. Conclusion Our data suggest a critical age for CI surgery below 3 years in children with congenital SSD for successful hearing rehabilitation. It is mandatory to identify children with SSD as early as bilaterally deaf children.
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Affiliation(s)
- Ann-Kathrin Rauch
- Department of Otorhinolaryngology, ENT Clinic, Medical Centre, University of Freiburg, Freiburg, Germany.
| | - Susan Arndt
- Department of Otorhinolaryngology, ENT Clinic, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Antje Aschendorff
- Department of Otorhinolaryngology, ENT Clinic, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Rainer Beck
- Department of Otorhinolaryngology, ENT Clinic, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Iva Speck
- Department of Otorhinolaryngology, ENT Clinic, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Manuel Christoph Ketterer
- Department of Otorhinolaryngology, ENT Clinic, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Till Fabian Jakob
- Department of Otorhinolaryngology, ENT Clinic, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Frederike Hassepass
- Department of Otorhinolaryngology, ENT Clinic, Medical Centre, University of Freiburg, Freiburg, Germany
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Varadarajan VV, Sydlowski SA, Li MM, Anne S, Adunka OF. Evolving Criteria for Adult and Pediatric Cochlear Implantation. EAR, NOSE & THROAT JOURNAL 2020; 100:31-37. [PMID: 32804575 DOI: 10.1177/0145561320947258] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The indications for cochlear implantation have gradually expanded as advancements in technology have evolved, resulting in improved audiologic outcomes for both adult and children. There remains a significant underutilization of cochlear implant technology in the United States, and recognition of the potential benefits of cochlear implantation for non-traditional indications is critical for encouraging the evolution of candidacy criteria. Adult cochlear implantation candidacy has progressed from patients with bilateral profound sensorineural hearing loss (SNHL) to include patients with greater degrees of residual hearing, single-sided deafness and asymmetric hearing, and atypical etiologies of hearing loss (eg, vestibular schwannoma, Ménière's disease, and otosclerosis). Indications for pediatric cochlear implantation have similarly evolved from children with bilateral severe to profound SNHL to implanting children at a younger age, including those with residual hearing, asymmetric hearing loss, inner ear malformations, as well as cochlear nerve deficiency. In this editorial, the literature investigating cochlear implantation for nontraditional indications is reviewed with an aim to use the best available evidence to encourage the evolution of candidacy criteria.
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Affiliation(s)
- Varun V Varadarajan
- Department of Otolaryngology-Head and Neck Surgery, 2647The Ohio State University, Columbus, OH, USA
| | | | - Michael M Li
- Department of Otolaryngology-Head and Neck Surgery, 2647The Ohio State University, Columbus, OH, USA
| | - Samantha Anne
- Head and Neck Institute, 443553Cleveland Clinic, Cleveland, OH, USA
| | - Oliver F Adunka
- Department of Otolaryngology-Head and Neck Surgery, 2647The Ohio State University, Columbus, OH, USA
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27
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Zhan KY, Findlen UM, Allen DZ, Shannon MK, Mattingly JK, Adunka OF. Therapeutic challenges and clinical characteristics of single-sided deafness in children. Int J Pediatr Otorhinolaryngol 2020; 135:110116. [PMID: 32502913 DOI: 10.1016/j.ijporl.2020.110116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The clinical implications of single-sided deafness (SSD) in children has historically been underappreciated by patients and providers alike, despite a large body of literature on the wide-ranging neurocognitive, language, scholastic, and functional impairments that occur. Conventional amplification options are marked by variable results and frequent loss of follow-up. METHODS Retrospective case series for pediatric SSD from 2008 to 2018. RESULTS 88 children with congenital SSD were identified. Seventeen (N = 17/88, 23.9%) passed their newborn hearing screen. Median age at first otolaryngology evaluation was 0.65 years (range 0.1-16.9 years). Most common etiologies included cochlear nerve deficiency (N = 39, CND, 44.3%), unknown (N = 30, 35.2%), inner ear malformation (N = 7, 8.0%), and congenital cytomegalovirus (N = 6, 6.8%). 32.5% of patients elected for continued observation only, followed by bone conduction hearing aid (27.7%), contralateral routing of sound aid (20.5%), conventional hearing aid (13.3%), or cochlear implant (6%). Lack of follow-up at ≥1 year was common (39.8%). Of those with device use data (N = 39), 84.7% reported either discontinued or <6 h of daily use. CONCLUSIONS Despite early diagnosis and evaluation, the pediatric SSD cohort is characterized by high rates of loss of follow-up and amplification discontinuation. Cochlear nerve deficiency is commonly seen in congenital SSD. Early specialist referral is critical for habilitation evaluation. Patients and caregivers should be educated on the significant implications of unilateral hearing loss.
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Affiliation(s)
- Kevin Y Zhan
- Department of Otolaryngology - Head & Neck Surgery, Division of Otology, Neurotology & Cranial Base Surgery, The Ohio State University, Columbus, OH, USA; Department of Otolaryngology - Head & Neck Surgery, Division of Pediatric Otology & Hearing Program, Nationwide Children's Hospital, Columbus, OH, USA.
| | - Ursula M Findlen
- Department of Audiology - Nationwide Children's Hospital, Columbus, OH, USA; Department of Otolaryngology - Head & Neck Surgery, Division of Pediatric Otology & Hearing Program, Nationwide Children's Hospital, Columbus, OH, USA
| | - David Z Allen
- Department of Otolaryngology - Head & Neck Surgery, Division of Otology, Neurotology & Cranial Base Surgery, The Ohio State University, Columbus, OH, USA
| | - Michelle K Shannon
- Department of Audiology - Nationwide Children's Hospital, Columbus, OH, USA; Department of Otolaryngology - Head & Neck Surgery, Division of Pediatric Otology & Hearing Program, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jameson K Mattingly
- Department of Otolaryngology - Head & Neck Surgery, Division of Otology, Neurotology & Cranial Base Surgery, The Ohio State University, Columbus, OH, USA; Department of Otolaryngology - Head & Neck Surgery, Division of Pediatric Otology & Hearing Program, Nationwide Children's Hospital, Columbus, OH, USA
| | - Oliver F Adunka
- Department of Otolaryngology - Head & Neck Surgery, Division of Otology, Neurotology & Cranial Base Surgery, The Ohio State University, Columbus, OH, USA; Department of Otolaryngology - Head & Neck Surgery, Division of Pediatric Otology & Hearing Program, Nationwide Children's Hospital, Columbus, OH, USA
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Deep NL, Gordon SA, Shapiro WH, Waltzman SB, Roland JT, Friedmann DR. Cochlear Implantation in Children with Single-Sided Deafness. Laryngoscope 2020; 131:E271-E277. [PMID: 32065422 DOI: 10.1002/lary.28561] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 01/01/2020] [Accepted: 01/21/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To describe our experience with children undergoing unilateral cochlear implantation (CI) for treatment of single-sided deafness (SSD). STUDY DESIGN Retrospective case series. METHODS A retrospective case review from a tertiary referral center involving 14 pediatric patients (<18 years) with SSD who underwent unilateral CI. Speech perception testing in quiet and noise in the CI-only and bimodal conditions with at least 1 year of device use and device usage from data logs represent the main outcome measures. RESULTS The mean age at CI was 5.0 years (median 4.4, range 1.0-11.8 years). The mean duration of deafness was 3.0 years (median 2.4, range 0.6-7.0 years). Mean follow-up was 3.4 years. Speech perception testing with a minimum of 1 year post-CI was available in eight patients. The mean word recognition scores (WRS) in the CI-only condition was 56%; a significant improvement from baseline. Testing in background noise with spatially separated speech and noise revealed that patients scored as well or better with the CI-on versus CI-off in all conditions and in no cases was interference from the CI noted. Data logs were reviewed for device usage which revealed an average use of 6.5 hr/d. CONCLUSION Cochlear implantation is a viable treatment option for pediatric SSD in this self-selected cohort. Open-set speech and improvement in background noise can be achieved. Careful patient selection and thorough counseling on expectations is paramount to achieving successful outcomes. LEVEL OF EVIDENCE IV Laryngoscope, 131:E271-E277, 2021.
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Affiliation(s)
- Nicholas L Deep
- Department of Otolaryngology-Head & Neck Surgery, NYU School of Medicine, New York, New York, U.S.A
| | - Steven A Gordon
- Department of Otolaryngology-Head & Neck Surgery, NYU School of Medicine, New York, New York, U.S.A
| | - William H Shapiro
- Department of Otolaryngology-Head & Neck Surgery, NYU School of Medicine, New York, New York, U.S.A
| | - Susan B Waltzman
- Department of Otolaryngology-Head & Neck Surgery, NYU School of Medicine, New York, New York, U.S.A
| | - J Thomas Roland
- Department of Otolaryngology-Head & Neck Surgery, NYU School of Medicine, New York, New York, U.S.A
| | - David R Friedmann
- Department of Otolaryngology-Head & Neck Surgery, NYU School of Medicine, New York, New York, U.S.A
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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J. Early Diagnosis and Treatment of Unilateral or Asymmetrical Hearing Loss in Children: CODEPEH Recommendations. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2020. [DOI: 10.1016/j.otoeng.2018.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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30
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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J. Early diagnosis and treatment of unilateral or asymmetrical hearing loss in children: CODEPEH recommendations. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2020; 71:45-55. [PMID: 30579510 DOI: 10.1016/j.otorri.2018.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 09/20/2018] [Indexed: 11/28/2022]
Abstract
The aim of this document is to improve the management and the treatment of unilateral or asymmetrical hearing loss in children. One in one thousand newborn infants has unilateral hearing loss and this prevalence increases with age, due to cases of acquired and delayed-onset hearing loss. Although the impact on the development and learning processes of children of these kinds of hearing loss have usually been minimized, if they are not treated they will impact on language and speech development, as well as overall development, affecting the quality of life of the child and his/her family. The outcomes of the review are expressed as recommendations aimed at clinical diagnosis and therapeutic improvement for unilateral or asymmetrical hearing loss.
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Simon F, Roman S, Truy E, Barone P, Belmin J, Blanchet C, Borel S, Charpiot A, Coez A, Deguine O, Farinetti A, Godey B, Lazard D, Marx M, Mosnier I, Nguyen Y, Teissier N, Virole B, Lescanne E, Loundon N. Guidelines (short version) of the French Society of Otorhinolaryngology (SFORL) on pediatric cochlear implant indications. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:385-391. [DOI: 10.1016/j.anorl.2019.05.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Rauch AK, Kagermann S, Wesarg T, Jakob T, Aschendorff A, Ihorst G, Speck I, Arndt S. Data Logging Evidence of Cochlear Implant Use in Single-Sided and Bilateral Deafness. Audiol Neurootol 2019; 24:206-216. [DOI: 10.1159/000502051] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 07/10/2019] [Indexed: 11/19/2022] Open
Abstract
Purpose: This study analyses data logs in order to investigate the usage pattern of cochlear implant (CI) recipients with single-sided deafness (SSD-CI) and bilaterally deaf, uni- or bilaterally implanted CI recipients (Uni-CI and Bil-CI). Data logging is available from SCAN, an automated auditory scene classifier which categorizes auditory input into 6 listening environments. Methods: CI usage data were retrospectively available from data logs of 206 CI recipients using the Nucleus 6 system obtained between January 2013 and June 2015. For all recipients, we analysed time on air and time spent in the listening environments. For statistical analysis, we matched the CI recipients according to age and duration of CI experience and classified them into 4 age groups. Results: SSD-CI showed a similar time on air compared to Uni- and Bil-CI. Usage behaviour of SSD-CI was comparable to Uni- and Bil-CI regarding exposure to music, speech in quiet and speech in noise. With increasing age, exposure to quiet increased and exposure to music decreased across all CI recipient groups in relation to time on air. Conclusion: In total, the CI usage pattern of SSD-CI is comparable for the majority of listening environments and age groups to that of Uni- and Bil-CI. The results of our study show that SSD-CI benefit equally from CI implantation.
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Bagatto M, DesGeorges J, King A, Kitterick P, Laurnagaray D, Lewis D, Roush P, Sladen DP, Tharpe AM. Consensus practice parameter: audiological assessment and management of unilateral hearing loss in children. Int J Audiol 2019; 58:805-815. [PMID: 31486692 DOI: 10.1080/14992027.2019.1654620] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective: Provide recommendations to audiologists for the management of children with unilateral hearing loss (UHL) and for needed research that can lend further insight into important unanswered questions.Design: An international panel of experts on children with UHL was convened following a day and a half of presentations on the same. The evidence reviewed for this parameter was gathered through web-based literature searches specifically designed for academic and health care resources, recent systematic reviews of literature, and new research presented at the conference that underwent peer review for publication by the time of this writing.Study sample: Expert opinions and electronic databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Education Resources Information Centre (ERIC), Google Scholar, PsycINFO, PubMed, ScienceDirect, and Turning Research into Practice (TRIP) Database.Results: The resulting practice parameter requires a personalised, family-centred process: (1) routine surveillance of speech-language, psychosocial, auditory, and academic or pre-academic development; (2) medical assessments for determination of aetiology of hearing loss; (3) assessment of hearing technologies; and (4) considerations for family-centred counselling.Conclusions: This practice parameter provides guidance to clinical audiologists on individualising the management of children with UHL. In addition, the paper concludes with recommendations for research priorities.
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Affiliation(s)
- Marlene Bagatto
- School of Communication Sciences and Disorders, Western University, London, Canada
| | | | - Alison King
- Australian Hearing, Paediatric Services, Box Hill, Australia
| | | | | | - Dawna Lewis
- Center for Hearing Research, Boys Town National Research Hospital
| | - Patricia Roush
- Department of Otolaryngology, University of North Carolina
| | - Douglas P Sladen
- Department of Communication Sciences and Disorders, Western Washington University
| | - Anne Marie Tharpe
- Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine
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Etiology and therapy indication for cochlear implantation in children with single-sided deafness. HNO 2019; 67:750-759. [DOI: 10.1007/s00106-019-00729-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Benefits of Cochlear Implantation for Single-Sided Deafness: Data From the House Clinic-University of Southern California-University of California, Los Angeles Clinical Trial. Ear Hear 2019; 40:766-781. [DOI: 10.1097/aud.0000000000000671] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Sangen A, Dierckx A, Boudewyns A, Dhooge I, Offeciers E, Wouters J, Desloovere C, van Wieringen A. Longitudinal linguistic outcomes of toddlers with congenital single-sided deafness-Six with and twelve without cochlear implant and nineteen normal hearing peers. Clin Otolaryngol 2019; 44:671-676. [PMID: 31006171 DOI: 10.1111/coa.13347] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/28/2019] [Accepted: 04/14/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Anouk Sangen
- Department of Neurosciences, Experimental ORL, KU Leuven - University of Leuven, Leuven, Belgium
| | - Ann Dierckx
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - An Boudewyns
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Ingeborg Dhooge
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Ghent, Ghent, Belgium
| | - Erwin Offeciers
- Department of Otorhinolaryngology, Sint-Augustinus Antwerp, Antwerp, Belgium
| | - Jan Wouters
- Department of Neurosciences, Experimental ORL, KU Leuven - University of Leuven, Leuven, Belgium
| | - Christian Desloovere
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Astrid van Wieringen
- Department of Neurosciences, Experimental ORL, KU Leuven - University of Leuven, Leuven, Belgium
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van Wieringen A, Boudewyns A, Sangen A, Wouters J, Desloovere C. Unilateral congenital hearing loss in children: Challenges and potentials. Hear Res 2019; 372:29-41. [PMID: 29395617 DOI: 10.1016/j.heares.2018.01.010] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/17/2017] [Accepted: 01/21/2018] [Indexed: 11/16/2022]
Abstract
The estimated incidence of sensorineural hearing impairment (>40 dB HL) at birth is 1.86 per 1000 newborns in developed countries and 30-40% of these are unilateral. Profound sensorineural unilateral hearing impairment or single sided deafness (SSD) can be treated with a cochlear implant. However, this treatment is costly and invasive and unnecessary in the eyes of many. Very young children with SSD often do not exhibit language and cognitive delays and it is hard to imagine that neurocognitive skills will present difficulties with one good ear. In the current paper we review the most recent evidence on the consequences of unilateral hearing impairment for auditory and neurocognitive factors. While data of both adults and children are discussed, we focus on developmental factors, congenital deafness and a window of opportunity for intervention. We discuss which etiologies qualify for a cochlear implant and present our multi-center prospective study on cochlear implants in infants with one deaf ear. The large, state-of-the art body of research allows for evidence-based decisions regarding management of unilateral hearing loss in children.
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Affiliation(s)
- Astrid van Wieringen
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium.
| | - An Boudewyns
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, 2650 Edegem, Belgium
| | - Anouk Sangen
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium
| | - Jan Wouters
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium
| | - Christian Desloovere
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium; University Hospital Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium
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Polonenko MJ, Papsin BC, Gordon KA. Limiting asymmetric hearing improves benefits of bilateral hearing in children using cochlear implants. Sci Rep 2018; 8:13201. [PMID: 30181590 PMCID: PMC6123397 DOI: 10.1038/s41598-018-31546-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 08/17/2018] [Indexed: 11/08/2022] Open
Abstract
Neurodevelopmental changes occur with asymmetric hearing loss, limiting binaural/spatial hearing and putting children at risk for social and educational challenges. These deficits may be mitigated by providing bilateral hearing in children through auditory prostheses. Effects on speech perception and spatial hearing were measured in a large cohort of >450 children who were deaf and used bilateral cochlear implants or bimodal devices (one cochlear implant and a contralateral hearing aid). Results revealed an advantage of bilateral over unilateral device use but this advantage decreased as hearing in the two ears became increasingly asymmetric. Delayed implantation of an ear with severe to profound deafness allowed asymmetric hearing, creating aural preference for the better hearing ear. These findings indicate that bilateral input with the most appropriate device for each ear should be provided early and without delay during development.
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Affiliation(s)
- Melissa Jane Polonenko
- Institute of Medical Science, The University of Toronto, Toronto, ON, M5S 1A8, Canada.
- Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada.
| | - Blake Croll Papsin
- Institute of Medical Science, The University of Toronto, Toronto, ON, M5S 1A8, Canada
- Department of Otolaryngology - Head & Neck Surgery, The University of Toronto, Toronto, ON, M5G 2N2, Canada
- Otolaryngology - Head & Neck Surgery, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada
| | - Karen Ann Gordon
- Institute of Medical Science, The University of Toronto, Toronto, ON, M5S 1A8, Canada
- Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada
- Department of Otolaryngology - Head & Neck Surgery, The University of Toronto, Toronto, ON, M5G 2N2, Canada
- Otolaryngology - Head & Neck Surgery, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada
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Agterberg MJH, Snik AFM, Van de Goor RMG, Hol MKS, Van Opstal AJ. Sound-localization performance of patients with single-sided deafness is not improved when listening with a bone-conduction device. Hear Res 2018; 372:62-68. [PMID: 29703651 DOI: 10.1016/j.heares.2018.04.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 04/11/2018] [Accepted: 04/16/2018] [Indexed: 10/17/2022]
Abstract
An increased number of treatment options has become available for patients with single sided deafness (SSD), who are seeking hearing rehabilitation. For example, bone-conduction devices that employ contralateral routing of sound (CROS), by transmitting acoustic bone vibrations from the deaf side to the cochlea of the hearing ear, are widely used. However, in some countries, cochlear implantation is becoming the standard treatment. The present study investigated whether CROS intervention, by means of a CROS bone-conduction device (C-BCD), affected sound-localization performance of patients with SSD. Several studies have reported unexpected moderate to good unilateral sound-localization abilities in unaided SSD listeners. Listening with a C-BCD might deteriorate these localization abilities because sounds are transmitted, through bone conduction to the contralateral normal hearing ear, and could thus interfere with monaural level cues (i.e. ambiguous monaural head-shadow cues), or with the subtle spectral localization cues, on which the listener has learned to rely on. The present study included nineteen SSD patients who were using their C-BCD for more than five months. To assess the use of the different localization cues, we investigated their localization abilities to broadband (BB, 0.5-20 kHz), low-pass (LP, 0.5-1.5 kHz), and high-pass filtered noises (HP, 3-20 kHz) of varying intensities. Experiments were performed in complete darkness, by measuring orienting head-movement responses under open-loop localization conditions. We demonstrate that a minority of listeners with SSD (5 out of 19) could localize BB and HP (but not LP) sounds in the horizontal plane in the unaided condition, and that a C-BCD did not deteriorate their localization abilities.
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Affiliation(s)
- Martijn J H Agterberg
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands; Department of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
| | - Ad F M Snik
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands; Department of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Rens M G Van de Goor
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
| | - Myrthe K S Hol
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
| | - A John Van Opstal
- Department of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
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Polonenko MJ, Gordon KA, Cushing SL, Papsin BC. Cortical organization restored by cochlear implantation in young children with single sided deafness. Sci Rep 2017; 7:16900. [PMID: 29203800 PMCID: PMC5715123 DOI: 10.1038/s41598-017-17129-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 11/22/2017] [Indexed: 11/23/2022] Open
Abstract
Early treatment of single sided deafness in children has been recommended to protect from neurodevelopmental preference for the better hearing ear and from social and educational deficits. A fairly homogeneous group of five young children (≤3.6 years of age) with normal right sided hearing who received a cochlear implant to treat deafness in their left ears were studied. Etiology of deafness was largely cytomegalovirus (n = 4); one child had an enlarged vestibular aqueduct. Multi-channel electroencephalography of cortical evoked activity was measured repeatedly over time at: 1) acute (0.5 ± 0.7 weeks); 2) early chronic (1.1 ± 0.2 months); and 3) chronic (5.8 ± 3.4 months) cochlear implant stimulation. Results indicated consistent responses from the normal right ear with marked changes in activity from the implanted left ear. Atypical distribution of peak amplitude activity from the implanted ear at acute stimulation marked abnormal lateralization of activity to the ipsilateral left auditory cortex and recruitment of extra-temporal areas including left frontal cortex. These abnormalities resolved with chronic implant use and contralateral aural preference emerged in both auditory cortices. These findings indicate that early implantation in young children with single sided deafness can rapidly restore bilateral auditory input to the cortex needed to improve binaural hearing.
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Affiliation(s)
- Melissa Jane Polonenko
- Institute of Medical Sciences, The University of Toronto, Toronto, ON, M5S 1A8, Canada.
- Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada.
| | - Karen Ann Gordon
- Institute of Medical Sciences, The University of Toronto, Toronto, ON, M5S 1A8, Canada
- Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada
- Department of Otolaryngology - Head & Neck Surgery, The University of Toronto, Toronto, ON, M5G 2N2, Canada
- Otolaryngology - Head & Neck Surgery, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada
| | - Sharon Lynn Cushing
- Institute of Medical Sciences, The University of Toronto, Toronto, ON, M5S 1A8, Canada
- Department of Otolaryngology - Head & Neck Surgery, The University of Toronto, Toronto, ON, M5G 2N2, Canada
- Otolaryngology - Head & Neck Surgery, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada
| | - Blake Croll Papsin
- Institute of Medical Sciences, The University of Toronto, Toronto, ON, M5S 1A8, Canada
- Department of Otolaryngology - Head & Neck Surgery, The University of Toronto, Toronto, ON, M5G 2N2, Canada
- Otolaryngology - Head & Neck Surgery, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada
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Sokolov M, Cushing SL, Polonenko M, Blaser SI, Papsin BC, Gordon KA. Clinical Characteristics of Children With Single-Sided Deafness Presenting for Candidacy Assessment for Unilateral Cochlear Implantation. CURRENT OTORHINOLARYNGOLOGY REPORTS 2017. [DOI: 10.1007/s40136-017-0173-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lee DY, Lee JY, Kim YH. Management of tinnitus in children: Review of literature and effect of counseling. Auris Nasus Larynx 2017; 45:667-672. [PMID: 28943052 DOI: 10.1016/j.anl.2017.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/21/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Tinnitus in children has not been studied sufficiently to date. And, there is no consensus regarding the management of tinnitus in children. Tinnitus counseling can be considered as the most basic tool among therapeutic options of tinnitus in children. In this article, the importance of management in children with tinnitus is highlighted through the review of the literature. Also, we present survey results regarding usefulness and necessity of tinnitus counseling provided from parents of children with tinnitus. METHODS Studies reporting the management of pediatric tinnitus were reviewed by searching the Pubmed (MEDLINE) databases for studies published from 1980 through 2017. Three articles were eligible for review in terms of quantitative measurement of tinnitus improvement. Survey for eighteen participants were performed who visited our clinic, improvement by counseling and subjective benefit were evaluated by questionnaire. Various demographic and audiologic parameters were subjected into correlation analysis of benefit of counseling. RESULTS Three studies which included management of pediatric tinnitus were reviewed. One article reported that children with hearing loss failed to show improvement of tinnitus by hearing aids. However, recent two articles showed that children with or without hearing loss showed fair improvement of tinnitus by tinnitus retraining therapy and noise generator. The survey demonstrated that overall 83.3% showed subjective improvement by tinnitus counseling. Among demographic and audiological parameters, benefit from counseling was significantly associated with age and presence of hearing loss (p=0.037 and p=0.005, respectively). CONCLUSIONS Pediatric tinnitus is likely to have a higher chance of improvement by counseling alone or combination therapy without medication. Conservative management of tinnitus based on education and counseling instead of medical or surgical treatment should be developed more.
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Affiliation(s)
- Doh Young Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Korea University Anam Hospital, Seoul, South Korea
| | - Ji Young Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Young Ho Kim
- Department of Otorhinolaryngology - Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea.
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