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Umashankar A, Ramamoorthy S, Selvaraj JL, Dhandayutham S. Comparative Study on the Acoustic Analysis of Voice in Auditory Brainstem Implantees, Cochlear Implantees, and Normal Hearing Children. Indian J Otolaryngol Head Neck Surg 2024; 76:645-652. [PMID: 38440592 PMCID: PMC10908917 DOI: 10.1007/s12070-023-04236-9] [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: 06/13/2023] [Accepted: 09/11/2023] [Indexed: 03/06/2024] Open
Abstract
The aim of the study was to compare the acoustic characteristics of voice between Auditory Brainstem Implantees, Cochlear Implantees and normal hearing children. Voice parameters such as fundamental frequency, formant frequencies, perturbation measures, and harmonic to noise ratio were measured in a total of 30 children out of which 10 were Auditory Brainstem Implantees, 10 were Cochlear Implantees and 10 were normal hearing children. Parametric and nonparametric statistics were done to establish the nature of significance between the three groups. Overall deviancies were seen in the implanted group for all acoustic parameters. However abnormal deviations were seen in individuals with Auditory Brainstem Implants indicating the deficit in the feedback loop impacting the voice characteristics. The deviancy in feedback could attribute to the poor performance in ABI and CI. The CI performed comparatively better when compared to the ABI group indicating a slight feedback loop due to the type of Implant. However, there needs to be additional evidence supporting this and there is a need to carry out the same study using a larger sample size and a longitudinal design.
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Affiliation(s)
- Abishek Umashankar
- Department of Translational and Clinical Research, Newcastle University, Newcastle Upon Tyne, UK
| | - Santhoshi Ramamoorthy
- Department of Speech Language Pathology, MERF Institute of Speech and Hearing, Chennai, India
| | - Jasmine Lydia Selvaraj
- Department of Speech-Language Pathology, SRFASLP, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, 116 India
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Faes J, De Maeyer S, Gillis S. Speech intelligibility of children with an auditory brainstem implant: a triple-case study. CLINICAL LINGUISTICS & PHONETICS 2022; 36:1067-1092. [PMID: 35380929 DOI: 10.1080/02699206.2021.1988148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/11/2021] [Accepted: 09/25/2021] [Indexed: 06/14/2023]
Abstract
Auditory brainstem implantation (ABI) is a relative recent development in paediatric hearing restoration. Consequently, young-implanted children's productive language has not received much attention. This study investigated speech intelligibility of children with ABI (N = 3) in comparison to children with cochlear implants (CI) and children with typical hearing (TH). Spontaneous speech samples were recorded from children representing the three groups matched on cumulative vocabulary level. Untrained listeners (N = 101) rated the intelligibility of one-word utterances on a continuous scale and transcribed each utterance. The rating task yielded a numerical score between 0 and 100, and similarities and differences between the listeners' transcriptions were captured by a relative entropy score. The speech intelligibility of children with CI and children with TH was similar. Speech intelligibility of children with ABI was well below that of the children with CI and TH. But whereas one child with ABI's intelligibility approached that of the control groups with increasing lexicon size, the intelligibility of the two other children with ABI did not develop in a similar direction. Overall, speech intelligibility was only moderate in the three groups of children, with quite low ratings and considerable differences in the listeners' transcriptions, resulting in high relative entropy scores.
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Affiliation(s)
| | - Sven De Maeyer
- Department of Training and Education Sciences, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
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Faes J, Gillis S. Intraword Variability in Children With Auditory Brainstem Implants: A Longitudinal Comparison With Children With Cochlear Implants. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1787-1800. [PMID: 35737893 DOI: 10.1044/2022_ajslp-21-00312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Intraword variability designates the phenomenon that a particular target word is produced variably by a child at one point in the child's development. In this study, the amount of intraword variability is studied longitudinally in children with auditory brainstem implants (ABIs). Auditory brainstem implantation is a relative recent technique in pediatric hearing restoration. Therefore, little is known about the phonological development of these children's speech. METHOD The intraword variability is investigated in three children with ABI, in comparison to children with cochlear implants, matched on lexical development. Intraword variability is measured using relative entropy in order to take into account the frequency distribution in children's productions. RESULT Results showed considerable variation between the three children with ABI. Still, all children had higher levels of intraword variability in their spontaneous speech productions as compared to children with cochlear implants. CONCLUSION It seems that children with ABI are lagging behind their phonological development in reference to children with cochlear implants.
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Affiliation(s)
- Jolien Faes
- Centre for Computational Linguistics and Psycholinguistics, University of Antwerp, Belgium
| | - Steven Gillis
- Centre for Computational Linguistics and Psycholinguistics, University of Antwerp, Belgium
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Faes J, Gillis S. Consonant and vowel production in the spontaneous speech productions of children with auditory brainstem implants. CLINICAL LINGUISTICS & PHONETICS 2021; 35:1132-1160. [PMID: 33427516 DOI: 10.1080/02699206.2020.1869833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/23/2020] [Accepted: 12/23/2020] [Indexed: 06/12/2023]
Abstract
Auditory brainstem implantation provides hearing sensations in children and adults with anomalies of the auditory nerves. In children, perceptual benefits have been established, and research already demonstrated (limited) effects on children's speech production. The current study extends the literature by scrutinizing the phonological development of three children with ABI. Spontaneous speech samples were used to establish their phonemic inventories of vowels, word-initial consonants and word-final consonants, both independently of the target phoneme and relative to the target phoneme. The three children produced all vowels with longer device use and larger vocabulary size. Word-initial and word-final consonants appeared in the three children's spontaneous productions. However, the segmental accuracy was only moderate in the children's productions.
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Affiliation(s)
- Jolien Faes
- Computational Linguistics & Psycholinguistics (Clips) Research Center, University of Antwerp, Antwerp, Belgium
| | - Steven Gillis
- Computational Linguistics & Psycholinguistics (Clips) Research Center, University of Antwerp, Antwerp, Belgium
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Adult Auditory Brainstem Implant Outcomes and Three-Dimensional Electrode Array Position on Computed Tomography. Ear Hear 2021; 42:1741-1754. [PMID: 34282087 DOI: 10.1097/aud.0000000000001064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Factors contributing to auditory brainstem implant (ABI) outcomes are poorly understood. The aims of this study are to (1) characterize ABI electrode array position on postoperative imaging and (2) determine if variability in position is related to perceptual outcomes. DESIGN Retrospective cohort study. Subjects were selected from the adult ABI recipient population at Massachusetts Eye and Ear. Postoperative three-dimensional (3D) computed tomography (CT) reconstruction of the head was used to measure ABI array position in 20 adult ABI recipients (17 with Neurofibromatosis Type 2 (NF2) and three non-NF2 recipients). Three-dimensional electrode array position was determined based on angles from the horizontal using posterior and lateral views and on distances between the proximal array tip superiorly from the basion (D1), laterally (D2P) and posteriorly (D2L) from the midline. Array position was correlated with perceptual data (in 15 of the 20 recipients who used their ABI). Perceptual data included the number of electrodes that provided auditory sensation, location and type of side effects, level of speech perception (from no sound to open-set word recognition of monosyllables) and the amount of charge required for auditory perception. RESULTS Although the 3D orientation of the ABI array exhibited a variety of angles, all arrays were posteriorly tilted from the lateral view and most were medially tilted from the posterior view. ABI position relative to the basion from posterior showed mean distances of 1.71 ± 0.42 and 1.1 ± 0.29 cm for D1 and D2, respectively, and a mean D2 of 1.30 ± 0.45 cm from the lateral view. A strong linear negative correlation was found between the number of active electrodes and the distance of the proximal array tip laterally from the basion (D2P; rs = -0.73, p = 0.006) when measured in the posterior view. Although side effects were experienced in all recipients and varied in type and location across the array, electrodes in the middle part of the array tended to elicit auditory sensations while the proximal and distal tips of the array tended to elicit nonauditory side effects. Arrays with and without low charge thresholds appeared to generally overlap in position. However, the two recipients with the best (open-set) speech perception had low charge thresholds and had arrays that were tilted superiorly in the posterior view. CONCLUSION ABI recipients with better speech perception appear to share a profile of arrays that are tilted superiorly as compared to recipients with lower speech perception levels. These ABI recipients have a high number of active electrodes (10 or more) and require less electrical charge on individual electrodes to achieve optimal stimulation.
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Faes J, Gillis S. Word characteristics and speech production accuracy in children with auditory brainstem implants: a longitudinal triple case report. CLINICAL LINGUISTICS & PHONETICS 2021; 35:874-890. [PMID: 33146054 DOI: 10.1080/02699206.2020.1838613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 06/11/2023]
Abstract
Auditory brainstem implants (ABI) in children in the first years of life is a recent innovation. Analyses of their speech and language development on the basis of spontaneous language samples are still largely lacking. The aim was to investigate the phonological complexity of the words children with ABI use in their spontaneous speech, and to compare their accuracy with that of children with cochlear implants (CI) and children with normal hearing (NH). Longitudinal recordings of spontaneous speech were collected of three children with ABI. Children with ABI target mainly words of low phonological complexity in their spontaneous speech, just as children with NH and children with CI do. The complexity of the words they attempt increases over time, but this development is less outspoken in comparison to children with CI and NH at the same hearing ages. The accuracy of the ABI children's word productions is situated in the lower ranges of the 95% confidence intervals of the NH and the CI groups, and - depending on the specific measure - even fall below the 95% border. The ABI intervention appears to be beneficial in the three cases studied, although their development is slow compared to children with CI and NH.
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Affiliation(s)
- Jolien Faes
- Computational Linguistics & Psycholinguistics (Clips) Research Center, University of Antwerp, Antwerp, Belgium
| | - Steven Gillis
- Computational Linguistics & Psycholinguistics (Clips) Research Center, University of Antwerp, Antwerp, Belgium
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Yousef M, Mesallam TA, Almasaad A, Alhabib S, Hagr A, Alzhrani F. Cochlear implantation versus auditory brainstem implantation in children with auditory nerve deficiencies. Eur Arch Otorhinolaryngol 2021; 279:1295-1300. [PMID: 33866399 DOI: 10.1007/s00405-021-06792-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/31/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cochlear nerve deficiency is one of the known causes of congenital sensorineural hearing loss. Management of hearing loss in children with cochlear nerve deficiency poses a multidimensional challenge. The absent or hypoplastic cochlear nerve may prevent electrical stimulation from reaching the brainstem and the auditory cortex. A deficient cochlear nerve can be associated with other inner ear malformations, which may diminish the success of cochlear implantation in those children. Promising results in adults after auditory brainstem implantation led to the expansion of candidacy to include the pediatric populations who were contraindicated for CIs. OBJECTIVE To review the outcomes of cochlear implantation versus that of auditory brainstem implantation in children with various conditions of the auditory nerve. METHODS This retrospective chart review study comprised two pediatric groups. The first group consisted of seven ABI recipients with cochlear nerve aplasia and the second group consisted of another seven children with cochlear nerve deficiencies who underwent CI surgery. The participants' auditory skills and speech outcomes were assessed using different tests selected from the Evaluation of Auditory Responses to Speech (EARS) test battery. RESULTS There were some individual variations in outcomes depending on the status of the auditory nerve. The mean CAP score of the ABI group was 2.87, while the mean SIR score was 0.62. On the other hand, the mean CAP score of the CI group was 1.29, while the mean SIR score was 0.42. CONCLUSION Our results are in good agreement with the reported auditory perception and speech and language development outcomes of pediatric auditory brainstem implantation. We added to the growing body of literature on the importance of verifying and identifying the status of the cochlear nerve in the decision-making process of the surgical management of those pediatric groups.
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Affiliation(s)
- Medhat Yousef
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Otolaryngology Department, College of Medicine, Menoufia University, Shibin El Kom, Egypt
| | - Tamer A Mesallam
- Research Chair of Voice, Swallowing, and Communication Disorders, Otolaryngology Department, King Saud University, Riyadh, Saudi Arabia. .,Otolaryngology Department, College of Medicine, King Saud University, P.O Box 245, Riyadh, 11411, Saudi Arabia.
| | - Ayna Almasaad
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Salman Alhabib
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Farid Alzhrani
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Shetty KR, Ridge SE, Kanumuri V, Zhu A, Brown MC, Lee DJ. Clinical and scientific innovations in auditory brainstem implants. World J Otorhinolaryngol Head Neck Surg 2021; 7:109-115. [PMID: 33997720 PMCID: PMC8103538 DOI: 10.1016/j.wjorl.2021.02.002] [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: 04/21/2020] [Revised: 11/27/2020] [Accepted: 02/10/2021] [Indexed: 12/03/2022] Open
Abstract
The auditory brainstem implant (ABI) was originally developed to provide rehabilitation of retrocochlear deafness caused by neurofibromatosis type 2 (NF2). Recent studies of the ABI have investigated outcomes in non-NF2 cohorts, such as patients with cochlear nerve aplasia or cochlear ossification and more recently, intractable tinnitus. New technologies that improve the ABI-neural tissue interface are being explored as means to improve performance and decrease side effects. Innovative discoveries in optogenetics and bioengineering present opportunities to continually evolve this technology into the future, enhancing spatial selectivity of neuronal activation in the cochlear nucleus and preventing side effects through reduction in activation of non-target neuronal circuitry. These advances will improve surgical planning and ultimately improve patients’ audiological capabilities. ABI research has rapidly increased in the 21st century and applications of this technology are likely to continually evolve. Herein, we aim to characterize ongoing clinical, basic science, and bioengineering advances in ABIs and discuss future directions of this technology.
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Affiliation(s)
- Kunal R Shetty
- Department of Otorhinolaryngology Head and Neck Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA.,Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Sarah E Ridge
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Vivek Kanumuri
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Angela Zhu
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - M Christian Brown
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Daniel J Lee
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
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Rajeswaran R, Kameswaran M. Auditory brainstem implantation (ABI) in children without neurofibromatosis type II (NF2): communication performance and safety after 24 months of use. Cochlear Implants Int 2019; 21:127-135. [DOI: 10.1080/14670100.2019.1690264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Mohan Kameswaran
- Madras ENT Research Foundation (MERF), Chennai, Tamil Nadu, India
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Eisenberg LS, Hammes Ganguly D, Martinez AS, Fisher LM, Winter ME, Glater JL, Schrader DK, Loggins J, Wilkinson EP. Early Communication Development of Children with Auditory Brainstem Implants. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2018; 23:249-260. [PMID: 29718280 PMCID: PMC5995196 DOI: 10.1093/deafed/eny010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 03/20/2018] [Accepted: 04/12/2018] [Indexed: 06/06/2023]
Abstract
The auditory brainstem implant (ABI) is an auditory sensory device that is surgically placed on the cochlear nucleus of the brainstem for individuals who are deaf but unable to benefit from a cochlear implant (CI) due to anatomical abnormalities of the cochlea and/or eighth nerve, specific disease processes, or temporal bone fractures. In the United States, the Food and Drug Administration has authorized a Phase I clinical trial to determine safety and feasibility of the ABI in up to 10 eligible young children who are deaf and either derived no benefit from the CI or were anatomically unable to receive a CI. In this paper, we describe the study protocol and the children who have enrolled in the study thus far. In addition, we report the scores on speech perception, speech production, and language (spoken and signed) for five children with 1-3 years of assessment post-ABI activation. To date, the results indicate that spoken communication skills are slow to develop and that visual communication remains essential for post-ABI intervention.
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Affiliation(s)
| | | | - Amy S Martinez
- Keck School of Medicine of the University of Southern California
| | - Laurel M Fisher
- Keck School of Medicine of the University of Southern California
| | | | - Jamie L Glater
- Keck School of Medicine of the University of Southern California
| | - Debra K Schrader
- Keck School of Medicine of the University of Southern California
| | - Janice Loggins
- Keck School of Medicine of the University of Southern California
| | - Eric P Wilkinson
- Keck School of Medicine of the University of Southern California
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