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Patro A, Lindquist NR, Holder JT, Freeman MH, Gifford RH, Tawfik KO, O’Malley MR, Bennett ML, Haynes DS, Perkins EL. Improved Postoperative Speech Recognition and Processor Use With Early Cochlear Implant Activation. Otol Neurotol 2024; 45:386-391. [PMID: 38437818 PMCID: PMC10939836 DOI: 10.1097/mao.0000000000004150] [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: 03/06/2024]
Abstract
OBJECTIVE To report speech recognition outcomes and processor use based on timing of cochlear implant (CI) activation. STUDY DESIGN Retrospective cohort. SETTING Tertiary referral center. PATIENTS A total of 604 adult CI recipients from October 2011 to March 2022, stratified by timing of CI activation (group 1: ≤10 d, n = 47; group 2: >10 d, n = 557). MAIN OUTCOME MEASURES Average daily processor use; Consonant-Nucleus-Consonant (CNC) and Arizona Biomedical (AzBio) in quiet at 1-, 3-, 6-, and 12-month visits; time to peak performance. RESULTS The groups did not differ in sex ( p = 0.887), age at CI ( p = 0.109), preoperative CNC ( p = 0.070), or preoperative AzBio in quiet ( p = 0.113). Group 1 had higher median daily processor use than group 2 at the 1-month visit (12.3 versus 10.7 h/d, p = 0.017), with no significant differences at 3, 6, and 12 months. The early activation group had superior median CNC performance at 3 months (56% versus 46%, p = 0.007) and 12 months (60% versus 52%, p = 0.044). Similarly, the early activation group had superior median AzBio in quiet performance at 3 months (72% versus 59%, p = 0.008) and 12 months (75% versus 68%, p = 0.049). Both groups were equivalent in time to peak performance for CNC and AzBio. Earlier CI activation was significantly correlated with higher average daily processor use at all follow-up intervals. CONCLUSION CI activation within 10 days of surgery is associated with increased early device usage and superior speech recognition at both early and late follow-up visits. Timing of activation and device usage are modifiable factors that can help optimize postoperative outcomes in the CI population.
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Affiliation(s)
- Ankita Patro
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Nathan R. Lindquist
- Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine, Houston, Texas
| | - Jourdan T. Holder
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Michael H. Freeman
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - René H. Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kareem O. Tawfik
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Matthew R. O’Malley
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Marc L. Bennett
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - David S. Haynes
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Elizabeth L. Perkins
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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Hershey E, Chionis L, Kazemi R, Valenzuela C, El-Kashlan HK, Basura GJ, Stucken EZ. Changing Management of Intravestibular Schwannomas in the Era of Cochlear Implantation for Single-Sided Deafness. Otol Neurotol 2024; 45:e337-e341. [PMID: 38361345 DOI: 10.1097/mao.0000000000004140] [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: 02/17/2024]
Abstract
OBJECTIVE Intralabyrinthine schwannomas (ILSs) are a rare cause of deafness. Patients with ILS confined to the semicircular canals and the vestibule (intravestibular schwannomas) are potential candidates for cochlear implantation for hearing rehabilitation, a new option for patients with unilateral hearing loss since the 2019 FDA approval of cochlear implant (CI) for single-sided deafness. In this report, we describe an evolving management approach for ILSs causing hearing loss. PATIENTS Adults (≥18 years) who underwent simultaneous ILS resection and CI between January 2019 and June 2023 (n = 3). INTERVENTION Transmastoid labyrinthectomy with simultaneous cochlear implantation. MAIN OUTCOME MEASURES Hearing performance with cochlear implantation measured as CNC Word Recognition scores and AzBio Sentence scores. RESULTS Three patients with ILS confined to the semicircular canals and vestibule underwent simultaneous tumor resection via labyrinthectomy with CI placement. In all cases, complete tumor resection and full CI insertion were achieved. No patients experienced postoperative complications. Patients 1 and 2 underwent 6- and 9-month postactivation testing, respectively, with CNC scores 64% to 80% and AzBio 81% to 99% in the implanted ears. Patient 3 scored 0% on CNC and AzBio testing at 3 months and deferred her 6-month audiometry. CONCLUSIONS Patients with ILS confined to the vestibule and semicircular canals can be considered for simultaneous tumor resection and CI placement.
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Affiliation(s)
- Emma Hershey
- University of Michigan Medical School, Ann Arbor, MI
| | - Lisa Chionis
- University of Michigan Medical School, Ann Arbor, MI
| | - Ruby Kazemi
- University of Michigan Medical School, Ann Arbor, MI
| | - Carla Valenzuela
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Hussam K El-Kashlan
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Gregory J Basura
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Emily Z Stucken
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
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Zeitler DM, Prentiss SM, Sydlowski SA, Dunn CC. American Cochlear Implant Alliance Task Force: Recommendations for Determining Cochlear Implant Candidacy in Adults. Laryngoscope 2024; 134 Suppl 3:S1-S14. [PMID: 37435829 PMCID: PMC10914083 DOI: 10.1002/lary.30879] [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] [Received: 09/30/2022] [Revised: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023]
Abstract
The indications for cochlear implantation have expanded over time due to evidence demonstrating identification and implantation of appropriate cochlear implant (CI) candidates lead to significant improvements in speech recognition and quality of life (QoL). However, clinical practice is variable, with some providers using outdated criteria and others exceeding current labeled indications. As a results, only a fraction of those persons who could benefit from CI technology receive it. This document summarizes the current evidence for determining appropriate referrals for adults with bilateral hearing loss into CI centers for formal evaluation by stressing the importance of treating each ear individually and a "revised 60/60 rule". By mirroring contemporary clinical practice and available evidence, these recommendations will also provide a standardized testing protocol for CI candidates using a team-based approach that prioritizes individualized patient care. This manuscript was developed by the Adult Cochlear Implantation Candidacy Task Force of the American Cochlear Implant Alliance using review of the existing literature and clinical consensus. LEVEL OF EVIDENCE: N/A Laryngoscope, 134:S1-S14, 2024.
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Affiliation(s)
- Daniel M. Zeitler
- Listen for Life Center, Department of Otolaryngology-Head and Neck Surgery, Virginia Mason Medical Center, Seattle, WA
| | - Sandra M. Prentiss
- Department of Otolaryngology-Head and Neck Surgery, University of Miami, Miami, FL
| | | | - Camille C. Dunn
- The University of Iowa Cochlear Implant Clinical Research Center, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, IA
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Bruschini L, Canzi P, Canale A, Covelli E, Laborai A, Monteforte M, Cinquini M, Barbara M, Beltrame MA, Bovo R, Castigliano B, De Filippis C, Della Volpe A, Dispenza F, Marsella P, Mainardi A, Orzan E, Piccirillo E, Ricci G, Quaranta N, Cuda D. Implantable hearing devices in clinical practice. Systematic review and consensus statements. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2024; 44:52-67. [PMID: 38165206 PMCID: PMC10914359 DOI: 10.14639/0392-100x-n2651] [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: 05/22/2023] [Accepted: 09/21/2023] [Indexed: 01/03/2024]
Abstract
Objective Implantable hearing devices represent a modern and innovative solution for hearing restoration. Over the years, these high-tech devices have increasingly evolved but their use in clinical practice is not universally agreed in the scientific literature. Congresses, meetings, conferences, and consensus statements to achieve international agreement have been made. This work follows this line and aims to answer unsolved questions regarding examinations, selection criteria and surgery for implantable hearing devices. Materials and methods A Consensus Working Group was established by the Italian Society of Otorhinolaryngology. A method group performed a systematic review for each single question to identify the current best evidence on the topic and to guide a multidisciplinary panel in developing the statements. Results Twenty-nine consensus statements were approved by the Italian Society of Otorhinolaryngology. These were associated with 4 key area subtopics regarding pre-operative tests, otological, audiological and surgical indications. Conclusions This consensus can be considered a further step forward to establish realistic guidelines on the debated topic of implantable hearing devices.
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Affiliation(s)
- Luca Bruschini
- Otolaryngology, ENT Audiology and Phoniatrics Unit, University Hospital of Pisa, Pisa, Italy
| | - Pietro Canzi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Canale
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Edoardo Covelli
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Andrea Laborai
- Department of Otolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Marta Monteforte
- Laboratory of systematic review methodology and guidelines production, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Michela Cinquini
- Laboratory of systematic review methodology and guidelines production, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maurizio Barbara
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Millo Achille Beltrame
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberto Bovo
- Department of Neuroscience DNS, Otolaryngology Section, Padua University, Padua, Italy
| | - Bruno Castigliano
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Cosimo De Filippis
- Department of Neuroscience, Audiology Section, University of Padua, Treviso, Italy
| | - Antonio Della Volpe
- Otology and Cochlear Implant Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - Francesco Dispenza
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Azienda Ospedaliera Universitaria Policlinico ‘’Paolo Giaccone’’, University of Palermo, Palermo, Italy
| | - Pasquale Marsella
- Audiology and Otosurgery Department, “Bambino Gesù” Children’s Hospital, Rome, Italy
| | - Anna Mainardi
- Department of Otolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Eva Orzan
- ENT and Audiology Unit, Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, Trieste, Italy
| | | | - Giampietro Ricci
- Department of Surgical and Biomedical Sciences, Section of Otorhinolaryngology, University of Perugia, Perugia, Italy
| | - Nicola Quaranta
- Translational Biomedicine and Neurosciences Department, University of Bari, Bari, Italy
| | - Domenico Cuda
- Department of Otolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
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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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Tessler I, Gecel NA, Glicksberg BS, Shivatzki S, Shapira Y, Zimlichman E, Alon EE, Klang E, Wolfovitz A. A Five-Decade Text Mining Analysis of Cochlear Implant Research: Where We Started and Where We Are Heading. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1891. [PMID: 38003940 PMCID: PMC10673015 DOI: 10.3390/medicina59111891] [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: 09/06/2023] [Revised: 10/09/2023] [Accepted: 10/19/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Since its invention in the 1970s, the cochlear implant (CI) has been substantially developed. We aimed to assess the trends in the published literature to characterize CI. Materials and Methods: We queried PubMed for all CI-related entries published during 1970-2022. The following data were extracted: year of publication, publishing journal, title, keywords, and abstract text. Search terms belonged to the patient's age group, etiology for hearing loss, indications for CI, and surgical methodological advancement. Annual trends of publications were plotted. The slopes of publication trends were calculated by fitting regression lines to the yearly number of publications. Results: Overall, 19,428 CIs articles were identified. Pediatric-related CI was the most dominant sub-population among the age groups, with the highest rate and slope during the years (slope 5.2 ± 0.3, p < 0.001), while elderly-related CIs had significantly fewer publications. Entries concerning hearing preservation showed the sharpest rise among the methods, from no entries in 1980 to 46 entries in 2021 (slope 1.7 ± 0.2, p < 0.001). Entries concerning robotic surgery emerged in 2000, with a sharp increase in recent years (slope 0.5 ± 0.1, p < 0.001). Drug-eluting electrodes and CI under local-anesthesia have been reported only in the past five years, with a gradual rise. Conclusions: Publications regarding CI among pediatrics outnumbered all other indications, supporting the rising, pivotal role of CI in the rehabilitation of children with sensorineural hearing loss. Hearing-preservation publications have recently rapidly risen, identified as the primary trend of the current era, followed by a sharp rise of robotic surgery that is evolving and could define the next revolution.
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Affiliation(s)
- Idit Tessler
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Ramat Gan 52621, Israel (S.S.); (Y.S.); (E.E.A.); (A.W.)
- ARC Innovation Center, Sheba Medical Center, Ramat Gan 52621, Israel; (E.Z.); (E.K.)
| | - Nir A. Gecel
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Ramat Gan 52621, Israel (S.S.); (Y.S.); (E.E.A.); (A.W.)
| | - Benjamin S. Glicksberg
- Hasso Plattner Institute for Digital Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Shaked Shivatzki
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Ramat Gan 52621, Israel (S.S.); (Y.S.); (E.E.A.); (A.W.)
| | - Yisgav Shapira
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Ramat Gan 52621, Israel (S.S.); (Y.S.); (E.E.A.); (A.W.)
| | - Eyal Zimlichman
- ARC Innovation Center, Sheba Medical Center, Ramat Gan 52621, Israel; (E.Z.); (E.K.)
| | - Eran E. Alon
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Ramat Gan 52621, Israel (S.S.); (Y.S.); (E.E.A.); (A.W.)
| | - Eyal Klang
- ARC Innovation Center, Sheba Medical Center, Ramat Gan 52621, Israel; (E.Z.); (E.K.)
- Hasso Plattner Institute for Digital Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Amit Wolfovitz
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Ramat Gan 52621, Israel (S.S.); (Y.S.); (E.E.A.); (A.W.)
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Dourado RPB, Caldas FF, Cardoso CC, Santos DCD, Bahmad F. Benefits of Bimodal Stimulation to Speech Perception in Noise and Silence. Int Arch Otorhinolaryngol 2023; 27:e645-e653. [PMID: 37876694 PMCID: PMC10593532 DOI: 10.1055/s-0043-1761169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/26/2022] [Indexed: 10/26/2023] Open
Abstract
Introduction Understanding all the benefits of bimodality with self-assessment questionnaires on the effect of hearing on quality of life is still necessary. Objective To present whether bimodality still offers hearing benefits to the population who uses acoustic stimulation associated with electrical stimulation. Methods The present study included 13 participants aged between 16 and 80 years old who were users of cochlear implants from Cochlear Corporation and hearing aids. All patients underwent the Hearing in Noise Test, and their visual analog scale score was obtained. Four-tone means were collected, and the participants answered the Speech, Spatial and Hearing Qualities questionnaire. Results Bimodal users had an average sentence recognition rate of 76.0% in silence and 67.6% in fixed noise, and the signal-to-noise ratio in adaptive noise was +2.89dB. In addition, a lower level of difficulty was observed in the test using the visual analog scale. The domain with the highest average was auditory qualities (6.50), followed by spatial hearing (6.26) and hearing for speech (5.81). Individuals with an average between 50 and 70 dB of hearing level showed better sentence recognition in silence and noise. Conclusion Bimodal stimulation showed benefits for users with different degrees of hearing loss; however, individuals who presented greater hearing residue had better performance in speech recognition with noise and in silence in addition to a good perception of hearing quality.
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Affiliation(s)
- Rayssa Pacheco Brito Dourado
- Health Sciences Postgraduate Program in Ciências da Saúde, Campus Universitário Darcy Ribeiro, Universidade de Brasília, Brasília, DF, Brazil
| | | | | | - Danielle Cristovão dos Santos
- Faculdade de Ciências da Saúde, Universidade de Brasília, Brasilia, DF, Brazil
- Centro de Reabilitação da Audição e Fala, Instituto Brasiliense de Otorrino, Asa Norte, Brasília, DF, Brazil
| | - Fayez Bahmad
- Health Science School, Universidade de Brasilia, Brasilia, DF, Brazil
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van der Straaten TFK, Burger AVM, Briaire JJ, Boermans PPBM, Vickers D, Frijns JHM. Diagnostic value of preoperative measures in selecting post-lingually deafened candidates for cochlear implantation - a different approach. Int J Audiol 2023; 62:983-991. [PMID: 35997570 DOI: 10.1080/14992027.2022.2106453] [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] [Received: 09/29/2021] [Accepted: 07/21/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES We examined which preoperative diagnostic measure is most suited to serve as a selection criterion to determine adult cochlear implantation (CI) candidacy. DESIGN Preoperative diagnostic measures included pure tone audiometry (PTA; 0.5, 1, 2, 4 kHz), speech perception tests (SPT) unaided with headphones and with best-aided hearing aids (in quiet and in noise). Gain in speech perception was used as outcome measure. Performance of preoperative measures was analysed using the area under the curve (AUC) of receiver operating characteristic (ROC) curves. STUDY SAMPLE This retrospective longitudinal cohort study included 552 post-lingually deafened adults with CI in a tertiary referral centre in the Netherlands. RESULTS Best-aided SPT in quiet was the most accurate in defining which CI candidates improved their speech perception in quiet postoperatively. For an improvement in speech perception in noise, the best-aided SPT in noise was the most accurate in defining which adult would benefit from CI. PTA measures performed lower compared to the SPT measures. CONCLUSIONS SPT is better than PTA for selecting CI candidates who will benefit in terms of speech perception. Best-aided SPT in noise was the most accurate for indicating an improvement of speech perception in noise but was only evaluated in high performers with residual hearing. These insights will assist in formulating more effective selection criteria for CI.
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Affiliation(s)
- Tirza F K van der Straaten
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Anouk V M Burger
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeroen J Briaire
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter Paul B M Boermans
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Deborah Vickers
- Clinical Neurosciences, University of Cambridge, Cambridge, The United Kingdom
| | - Johan H M Frijns
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
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Pavelchek C, Lee DS, Walia A, Michelson AP, Ortmann A, Gentile B, Herzog JA, Buchman CA, Shew MA. Responsible Imputation of Missing Speech Perception Testing Data & Analysis of 4,739 Observations and Predictors of Performance. Otol Neurotol 2023; 44:e369-e378. [PMID: 37231531 PMCID: PMC10330090 DOI: 10.1097/mao.0000000000003903] [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: 05/27/2023]
Abstract
OBJECTIVE To address outcome heterogeneity in cochlear implant (CI) research, we built imputation models using multiple imputation by chained equations (MICEs) and K-nearest neighbors (KNNs) to convert between four common open-set testing scenarios: Consonant-Nucleus-Consonant word (CNCw), Arizona Biomedical (AzBio) in quiet, AzBio +5, and AzBio +10. We then analyzed raw and imputed data sets to evaluate factors affecting CI outcome variability. STUDY DESIGN Retrospective cohort study of a national CI database (HERMES) and a nonoverlapping single-institution CI database. SETTING Multi-institutional (32 CI centers). PATIENTS Adult CI recipients (n = 4,046 patients). MAIN OUTCOME MEASURES Mean absolute error (MAE) between imputed and observed speech perception scores. RESULTS Imputation models of preoperative speech perception measures demonstrate a MAE of less than 10% for feature triplets of CNCw/AzBio in quiet/AzBio +10 (MICE: MAE, 9.52%; 95% confidence interval [CI], 9.40-9.64; KNN: MAE, 8.93%; 95% CI, 8.83-9.03) and AzBio in quiet/AzBio +5/AzBio +10 (MICE: MAE, 8.85%; 95% CI, 8.68-9.02; KNN: MAE, 8.95%; 95% CI, 8.74-9.16) with one feature missing. Postoperative imputation can be safely performed with up to four of six features missing in a set of CNCw and AzBio in quiet at 3, 6, and 12 months postcochlear implantation using MICE (MAE, 9.69%; 95% CI, 9.63-9.76). For multivariable analysis of CI performance prediction, imputation increased sample size by 72%, from 2,756 to 4,739, with marginal change in adjusted R2 (0.13 raw, 0.14 imputed). CONCLUSIONS Missing data across certain sets of common speech perception tests may be safely imputed, enabling multivariate analysis of one of the largest CI outcomes data sets to date.
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Affiliation(s)
- Cole Pavelchek
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - David S Lee
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Amit Walia
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | | | - Amanda Ortmann
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Brynn Gentile
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Jacques A Herzog
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Craig A Buchman
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Matthew A Shew
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
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Thompson NJ, Brown KD, Buss E, Rooth MA, Richter ME, Dillon MT. Long-Term Binaural Hearing Improvements for Cochlear Implant Users with Asymmetric Hearing Loss. Laryngoscope 2023; 133:1480-1485. [PMID: 36053850 DOI: 10.1002/lary.30368] [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] [Received: 04/18/2022] [Revised: 06/30/2022] [Accepted: 08/09/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess long-term binaural hearing abilities for cochlear implant (CI) users with unilateral hearing loss (UHL) or asymmetric hearing loss (AHL). METHODS A prospective, longitudinal, repeated measures study was completed at a tertiary referral center evaluating adults with UHL or AHL undergoing cochlear implantation. Binaural hearing abilities were assessed with masked speech recognition tasks using AzBio sentences in a 10-talker masker. Performance was evaluated as the ability to benefit from spatial release from masking (SRM). SRM was calculated as the difference in scores when the masker was presented toward the CI-ear (SRMci ) or the contralateral ear (SRMcontra ) relative to the co-located condition (0°). Assessments were completed pre-operatively and at annual intervals out to 5 years post-activation. RESULTS Twenty UHL and 19 AHL participants were included in the study. Linear Mixed Models showed significant main effects of interval and group for SRMcontra . There was a significant interaction between interval and group, with UHL participants reaching asymptotic performance early and AHL participants demonstrating continued growth in binaural abilities to 5 years post-activation. The improvement in SRM showed a significant positive correlation with contralateral unaided hearing thresholds (p = 0.050) as well as age at implantation (p = 0.031). CONCLUSIONS CI recipients with UHL and AHL showed improved SRM with long-term device use. The time course of improvement varied by cohort, with the UHL cohort reaching asymptotic performance early and the AHL cohort continuing to improve beyond 1 year. Differences between cohorts could be driven by differences in age at implantation as well as contralateral unaided hearing thresholds. LEVEL OF EVIDENCE 3 Laryngoscope, 133:1480-1485, 2023.
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Affiliation(s)
- Nicholas J Thompson
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Kevin D Brown
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Emily Buss
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Meredith A Rooth
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Margaret E Richter
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| | - Margaret T Dillon
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
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Di Pasquale Fiasca VM, Tealdo G. Intraoperative Cochlear Nerve Monitoring in Cochlear Implantation after Vestibular Schwannoma Resection. Audiol Res 2023; 13:398-407. [PMID: 37366681 DOI: 10.3390/audiolres13030035] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/25/2023] [Accepted: 05/27/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND The use of a cochlear implant (CI) for hearing rehabilitation after vestibular schwannoma (VS) resection is widely spreading. The procedure is usually performed simultaneously to tumor resection with a translabyrinthine approach. To ensure the best device function, assessing the integrity of the cochlear nerve is of primary importance. METHODS A narrative review of the literature on the present topic was carried out up to June 2022. Finally, nine studies were considered. RESULTS Electrically evoked auditory brainstem responses (eABR) is the most widely used method of intraoperative monitoring of cochlear nerve (CN) during VS resection, although its limits are known. It can be assessed through the CI electrode array or through an intracochlear test electrode (ITE). Variations of the graph are evaluated during the surgical procedure, in particular the wave V amplitude and latency. As tumor dissection progresses, the parameters may change, informing of the CN status, and the surgical procedure may be modulated. CONCLUSION An eABR positive result seems to be reliably correlated with a good CI outcome in those cases in which a clear wave V is recorded before and after tumor removal. On the contrary, in those cases in which the eABR is lost or altered during the surgical procedure, the positioning of a CI is still debatable.
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Affiliation(s)
- Valerio Maria Di Pasquale Fiasca
- Section of Otolaryngology, Otolaryngology Unit, Department of Neurosciences, University of Padova, Via Giustiniani, 2, 35128 Padua, Italy
| | - Giulia Tealdo
- Section of Otolaryngology, Otolaryngology Unit, Department of Neurosciences, University of Padova, Via Giustiniani, 2, 35128 Padua, Italy
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12
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Thomas M, Galvin JJ, Fu QJ. Importance of ipsilateral residual hearing for spatial hearing by bimodal cochlear implant users. Sci Rep 2023; 13:4960. [PMID: 36973380 PMCID: PMC10042848 DOI: 10.1038/s41598-023-32135-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/22/2023] [Indexed: 03/29/2023] Open
Abstract
AbstractBimodal cochlear implant (CI) listeners have difficulty utilizing spatial cues to segregate competing speech, possibly due to tonotopic mismatch between the acoustic input frequency and electrode place of stimulation. The present study investigated the effects of tonotopic mismatch in the context of residual acoustic hearing in the non-CI ear or residual hearing in both ears. Speech recognition thresholds (SRTs) were measured with two co-located or spatially separated speech maskers in normal-hearing adults listening to acoustic simulations of CIs; low frequency acoustic information was available in the non-CI ear (bimodal listening) or in both ears. Bimodal SRTs were significantly better with tonotopically matched than mismatched electric hearing for both co-located and spatially separated speech maskers. When there was no tonotopic mismatch, residual acoustic hearing in both ears provided a significant benefit when maskers were spatially separated, but not when co-located. The simulation data suggest that hearing preservation in the implanted ear for bimodal CI listeners may significantly benefit utilization of spatial cues to segregate competing speech, especially when the residual acoustic hearing is comparable across two ears. Also, the benefits of bilateral residual acoustic hearing may be best ascertained for spatially separated maskers.
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13
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Schvartz-Leyzac KC, Colesa DJ, Swiderski DL, Raphael Y, Pfingst BE. Cochlear Health and Cochlear-implant Function. J Assoc Res Otolaryngol 2023; 24:5-29. [PMID: 36600147 PMCID: PMC9971430 DOI: 10.1007/s10162-022-00882-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/24/2022] [Indexed: 01/06/2023] Open
Abstract
The cochlear implant (CI) is widely considered to be one of the most innovative and successful neuroprosthetic treatments developed to date. Although outcomes vary, CIs are able to effectively improve hearing in nearly all recipients and can substantially improve speech understanding and quality of life for patients with significant hearing loss. A wealth of research has focused on underlying factors that contribute to success with a CI, and recent evidence suggests that the overall health of the cochlea could potentially play a larger role than previously recognized. This article defines and reviews attributes of cochlear health and describes procedures to evaluate cochlear health in humans and animal models in order to examine the effects of cochlear health on performance with a CI. Lastly, we describe how future biologic approaches can be used to preserve and/or enhance cochlear health in order to maximize performance for individual CI recipients.
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Affiliation(s)
- Kara C Schvartz-Leyzac
- Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, Kresge Hearing Research Institute, University of Michigan, 1150 Medical Center Drive, Ann Arbor, MI, 48109-5616, USA
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Ave, Charleston, SC, 29425, USA
| | - Deborah J Colesa
- Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, Kresge Hearing Research Institute, University of Michigan, 1150 Medical Center Drive, Ann Arbor, MI, 48109-5616, USA
| | - Donald L Swiderski
- Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, Kresge Hearing Research Institute, University of Michigan, 1150 Medical Center Drive, Ann Arbor, MI, 48109-5616, USA
| | - Yehoash Raphael
- Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, Kresge Hearing Research Institute, University of Michigan, 1150 Medical Center Drive, Ann Arbor, MI, 48109-5616, USA
| | - Bryan E Pfingst
- Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, Kresge Hearing Research Institute, University of Michigan, 1150 Medical Center Drive, Ann Arbor, MI, 48109-5616, USA.
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14
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Rader T, Waleka OJ, Strieth S, Eichhorn KWG, Bohnert A, Koutsimpelas D, Matthias C, Ernst BP. Hearing rehabilitation for unilateral deafness using a cochlear implant: the influence of the subjective duration of deafness on speech intelligibility. Eur Arch Otorhinolaryngol 2023; 280:651-659. [PMID: 35792917 PMCID: PMC9849293 DOI: 10.1007/s00405-022-07531-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/27/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND For patients with single sided deafness (SSD) or severe asymmetric sensorineural hearing loss (ASHL), cochlear implantation remains the only solution to restore bilateral hearing capacity. Prognostically, the duration of hearing loss in terms of audiological outcome is not yet clear. Therefore, the aim of this study was to retrospectively investigate the influence of subjective deafness duration on postoperative speech perception after cochlear implantation for SSD as well as its impact on quality of life. MATERIALS AND METHODS The present study included a total of 36 adults aged 50.2 ± 15.5 years who underwent CI for SSD/ASHL at our clinic between 2010 and 2015. Patients were audiometrically assessed at 3 and 12-36 months postoperatively. Test results were correlated with self-reported duration of deafness. Quality of life was assessed by questionnaire. RESULTS Mean duration of deafness was 193.9 ± 185.7 months. The side-separated hearing threshold showed an averaged target range between 30 and 40 dB HL. Freiburg monosyllable test increased from 0% pre-operatively to 20% after 3 months (p = 0.001) and to 50% after 12-36 months (p = 0.002). There was a significant correlation between audiometric outcome and subjective deafness duration at 12-36 months postoperatively (r = - 0.564; p = 0.02) with a cutoff for open-set monosyllable recognition at a duration of deafness of greater than 408 months. Quality of life was significantly improved by CI. CONCLUSIONS CI implantation in unilaterally deafened patients provides objective and subjective benefits. Duration of deafness is unlikely to be an independent negative predictive factor and thus should not generally be considered as contraindication.
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Affiliation(s)
- Tobias Rader
- Division of Audiology, Department of Otorhinolaryngology, Ludwig-Maximilians-University Medical Center, Munich, Germany. .,Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany. .,LMU Klinikum, Klinik für Hals-Nasen-Ohrenheilkunde, Abteilung Audiologie, Marchioninistr. 15, 81377, Munich, Germany.
| | - Oliver Julian Waleka
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany
| | - Sebastian Strieth
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany.,Department of Otorhinolaryngology, University Medical Center Bonn (UKB), Bonn, Germany
| | | | - Andrea Bohnert
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany
| | | | - Christoph Matthias
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany
| | - Benjamin Philipp Ernst
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany.,Department of Otorhinolaryngology, University Medical Center Bonn (UKB), Bonn, Germany
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15
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Cochlear implantation in patients with asymmetric hearing loss: reporting and discussing the benefits in speech perception, speech reception threshold, squelch abilities, and patients’ reported outcomes. The Journal of Laryngology & Otology 2022; 136:964-969. [DOI: 10.1017/s0022215121004333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectivesThis study presents the results obtained in a group of patients with asymmetric hearing loss undergoing cochlear implantation at our institution. Prognostic factors are discussed in relation to different rehabilitative approaches for asymmetric hearing loss remediation. The current literature is also discussed.MethodsNineteen adult patients with post-verbal asymmetric hearing loss were enrolled. The results were assessed by means of a speech perception test, completed in silence and with background noise, and a speech reception threshold test (Oldenburg Sentence Test). The subjectively perceived benefits were assessed using the Speech, Spatial and Qualities of Hearing Scale.ResultsStatistically significant improvements were achieved by all patients in terms of speech perception and speech reception threshold, and in subjective benefits.ConclusionThe results confirm the literature findings which suggest that patients with asymmetric hearing loss generally gain substantial benefit from cochlear implantation because of the binaural input, with significant improvement in speech perception abilities in noise, speech reception threshold, and squelch abilities.
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16
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Patro A, Lindquist NR, Holder JT, Tawfik KO, O’Malley MR, Bennett ML, Haynes DS, Gifford R, Perkins EL. Further Evidence for Individual Ear Consideration in Cochlear Implant Candidacy Evaluation. Otol Neurotol 2022; 43:1033-1040. [PMID: 36075098 PMCID: PMC9481725 DOI: 10.1097/mao.0000000000003677] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To report speech outcomes after cochlear implantation (CI) for asymmetric hearing loss (AHL) and assess the influence of contralateral hearing. STUDY DESIGN Retrospective review. SETTING Tertiary referral center. PATIENTS One hundred eighty-eight adults (mean age, 70 yr) undergoing CI for AHL from 2015 to 2020. Candidacy included pure-tone average (PTA) at least 70 dB hearing level and AzBio in quiet 60% or less in the implanted ear and AzBio in quiet greater than 40% in the contralateral ear. MAIN OUTCOME MEASURES PTA; Consonant-Nucleus-Consonant (CNC) word, AzBio sentences scores; Speech, Spatial, and Qualities of Hearing Scale (SSQ). RESULTS Mean preoperative PTA and AzBio in the implanted and contralateral ears were 85.2 and 68.1 dB hearing level and 24.7% and 69.2%, respectively. Mean CNC in the implanted ear increased from 18.3% preoperatively to 44.4% ( p < 0.0001) at 6 months and 49.3% ( p < 0.0001) at 12 months. Mean AzBio in the implanted ear improved from 24.7% preoperatively to 60.3% ( p < 0.0001) at 6 months and 64.3% ( p < 0.0001) at 12 months. Patients demonstrated significant improvement in all SSQ domains at 6 and 12 months. When comparing patients with preoperative contralateral AzBio greater than 60% versus 41% to 60%, no significant differences existed in postoperative CNC scores (6-mo: 47% versus 41%, p = 0.276; 12-mo: 51% versus 47%, p = 0.543). There were no significant differences in 6-month ( p = 0.936) or 12-month ( p = 0.792) CNC scores between patients with AHL (contralateral ear AzBio >40%) and 169 unilateral CI patients meeting the traditional Medicare criteria (contralateral ear AzBio ≤40%). CONCLUSION CI recipients with AHL derive significant speech improvements, supporting individual ear consideration for CI candidacy and patient benefit outside of current Medicare criteria.
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Affiliation(s)
- Ankita Patro
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Nathan R. Lindquist
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jourdan T. Holder
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kareem O. Tawfik
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Matthew R. O’Malley
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Marc L. Bennett
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - David S. Haynes
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - René Gifford
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Elizabeth L. Perkins
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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17
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Cavallaro G, Murri A, Nelson E, Gorrasi R, Quaranta N. The Impact of the COVID-19 Lockdown on Quality of Life in Adult Cochlear Implant Users: A Survey Study. Audiol Res 2022; 12:518-526. [PMID: 36285909 PMCID: PMC9598621 DOI: 10.3390/audiolres12050052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background: The COVID-19 pandemic rapidly spread through Europe in the first months of 2020. On the 9th of March 2020, the Italian government ordered a national lock-down. The study’s objectives were: to investigate the effect of lockdown on CI users; and to detect the difference in the perception of discomfort existing between unilateral cochlear implant (UCI) users and bilateral cochlear implant (BCI) users, due to the lockdown experience. Methods: A 17-item, web-based, anonymous online survey was administered to 57 CI users, exploring hearing performance, emotions, practical issues, behavior, and tinnitus. Participation in the study was voluntary. Results: all CI users obtained an abnormal score in all questionnaire themes. For the emotion theme and the practical issue theme, the age range 61–90 showed a significant difference between UCI and BCI users in favor of BCI users (emotion theme: UCI mean = 3.9, BCI mean = 2.3, p = 0.0138; practical issues: UCI mean = 4, BCI mean = 3, p = 0.0031). Conclusions: CI users experienced the lockdown negatively as regards behavior, emotions, hearing performance, and in practical issues. CI subjects with UCI in old age suffered more from the experience of lockdown than subjects with BCI in the same age, with regards to emotions and practical issues.
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18
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Ma C, Fried J, Nguyen SA, Schvartz-Leyzac KC, Camposeo EL, Meyer TA, Dubno JR, McRackan TR. Longitudinal Speech Recognition Changes After Cochlear Implant: Systematic Review and Meta-analysis. Laryngoscope 2022; 133:1014-1024. [PMID: 36004817 DOI: 10.1002/lary.30354] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To examine patterns of change and plateau in speech recognition scores in postlingually hearing impaired adult cochlear implant recipients. The study also examines variations in change patterns for different speech materials and testing conditions. STUDY DESIGN Used systematic review with meta-analysis. METHODS Articles in English reporting speech recognition scores of adults with postlingual hearing loss at pre-implantation and at least two post-implantation time points were included. Statistically significant changes were determined by meta-analysis and the 95% confidence interval. RESULTS A total of 22 articles representing 1954 patients were included. Meta-analysis of mean difference demonstrated significant improvements in speech recognition score for words in quiet (37.4%; 95% confidence interval [34.7%, 40.7%]), sentences in quiet (49.4%; 95% confidence interval [44.9%, 53.9%]), and sentences in noise (30.8%; 95% confidence interval [25.2%, 36.4%]) from pre-op to 3 months. Scores continued to increase from 3 to 12 months but did not reach significance. Similarly, significant improvements from pre-op to 3 months were observed for consonant nucleus consonant (CNC) words in quiet (37.1%; 95% confidence interval [33.8%, 40.4%]), hearing in noise test (HINT) sentences in quiet (46.5%; 95% confidence interval [37.0%, 56.0%]), AzBio sentences in quiet (45.9%; 95% confidence interval [44.2%, 47.5%]), and AzBio sentences in noise (26.4%; 95% confidence interval [18.6%, 34.2%]). HINT sentences in noise demonstrated improvement from pre-op to 3 months (35.1%; 95% confidence interval [30.0%, 40.3%]) and from 3 to 12 months (15.5%; 95% confidence interval [7.2%, 23.8%]). CONCLUSIONS Mean speech recognition scores demonstrate significant improvement within the first 3 months, with no further statistically significant improvement after 3 months. However, large individual variation should be expected and future research is needed to explain the sources of these individual differences. Laryngoscope, 2022.
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Affiliation(s)
- Cheng Ma
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Jacob Fried
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Kara C Schvartz-Leyzac
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Elizabeth L Camposeo
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Ted A Meyer
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Judy R Dubno
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Theodore R McRackan
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
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American Cochlear Implant Alliance Task Force Guidelines for Clinical Assessment and Management of Adult Cochlear Implantation for Single-Sided Deafness. Ear Hear 2022; 43:1605-1619. [PMID: 35994570 PMCID: PMC9592177 DOI: 10.1097/aud.0000000000001260] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The indications for cochlear implantation have expanded to include individuals with profound sensorineural hearing loss in the impaired ear and normal hearing (NH) in the contralateral ear, known as single-sided deafness (SSD). There are additional considerations for the clinical assessment and management of adult cochlear implant candidates and recipients with SSD as compared to conventional cochlear implant candidates with bilateral moderate to profound sensorineural hearing loss. The present report reviews the current evidence relevant to the assessment and management of adults with SSD. A systematic review was also conducted on published studies that investigated outcomes of cochlear implant use on measures of speech recognition in quiet and noise, sound source localization, tinnitus perception, and quality of life for this patient population. Expert consensus and systematic review of the current literature were combined to provide guidance for the clinical assessment and management of adults with SSD.
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20
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Achena A, Achena F, Dragonetti AG, Sechi S, Pili AW, Locci MC, Turnu G, Maniaci A, Ferlito S. Cochlear Implant Evolving Indications: Our Outcomes in Adult Patients. Audiol Res 2022; 12:414-422. [PMID: 36004950 PMCID: PMC9404933 DOI: 10.3390/audiolres12040042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The eligibility criteria for cochlear implantation are constantly evolving, following the continuous progress in technology, knowledge about cochlear implant (CI) fitting, and the possibility to preserve residual hearing. Appropriate attention should be given to asymmetric hearing loss (AHL) and single-side deafness (SSD) subjects. This study aimed to analyze cochlear implant indications and evaluate the longitudinal performance outcomes for patients with different kinds and degrees of sensorineural hearing loss. Methods: A total of 69 adult hearing loss CI recipients were included and divided into four subgroups according to our CI indication criteria. We performed objective and subjective measures, including speech perception analysis in silence and with background noise, comparing the outcomes obtained in the four groups. Results: After cochlear implant surgery, concerning the preimplantation daily listening condition, a significantly improved speech perception score in silence and noise was found in all four groups (p < 0.05 for all). Conclusion: CI could represent an efficient solution for patients with AHL and SSD classes.
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Affiliation(s)
- Andrea Achena
- U.O.C di Otorinolaringoiatria ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy, (A.A.)
| | - Francesco Achena
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Alberto Giulio Dragonetti
- U.O.C di Otorinolaringoiatria ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy, (A.A.)
| | - Serena Sechi
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Andrea Walter Pili
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Maria Cristina Locci
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Giuseppe Turnu
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Antonino Maniaci
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia; 95123 Catania, Italy
| | - Salvatore Ferlito
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia; 95123 Catania, Italy
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21
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Holder JT, Holcomb MA, Snapp H, Labadie RF, Vroegop J, Rocca C, Elgandy MS, Dunn C, Gifford RH. Guidelines for Best Practice in the Audiological Management of Adults Using Bimodal Hearing Configurations. OTOLOGY & NEUROTOLOGY OPEN 2022; 2:e011. [PMID: 36274668 PMCID: PMC9581116 DOI: 10.1097/ono.0000000000000011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Clinics are treating a growing number of patients with greater amounts of residual hearing. These patients often benefit from a bimodal hearing configuration in which acoustic input from a hearing aid on 1 ear is combined with electrical stimulation from a cochlear implant on the other ear. The current guidelines aim to review the literature and provide best practice recommendations for the evaluation and treatment of individuals with bilateral sensorineural hearing loss who may benefit from bimodal hearing configurations. Specifically, the guidelines review: benefits of bimodal listening, preoperative and postoperative cochlear implant evaluation and programming, bimodal hearing aid fitting, contralateral routing of signal considerations, bimodal treatment for tinnitus, and aural rehabilitation recommendations.
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Affiliation(s)
| | | | | | | | | | - Christine Rocca
- Guy’s and St. Thomas’ Hearing Implant Centre, London, United Kingdom
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22
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Comparison of Speech Test Outcomes After Cochlear Implantation in Patients With and Without Asymmetric Hearing Loss. Otol Neurotol 2022; 43:559-566. [PMID: 35261377 DOI: 10.1097/mao.0000000000003515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Determine whether asymmetric hearing loss (AHL) affects postoperative speech outcomes in cochlear implant (CI) patients. STUDY DESIGN Retrospective cohort study. SETTING Tertiary care hospital. PATIENTS Adult English-speaking patients with unilateral CIs implanted between 2014 and 2018 were stratified into NonAHL and AHL groups based on preoperative AzBio scores in quiet from the nonimplanted ear (0-50% vs. 51-100%, respectively). INTERVENTIONS CI surgery in the poorer performing ear. MAIN OUTCOME MEASURES Postoperative consonant-nucleusconsonant (CNC) word and AzBio sentence test scores in quiet and/or noise at +5 dB signal-to-noise ratio (SNR). RESULTS Of 512 patients, 33 non-AHL and 27 AHL patients were included. Average ages were 65.6 and 63.6 years, respectively. As expected, preoperative AzBio scores in quiet from the nonimplanted ear were higher in the AHL group (95% confidence interval [95%CI]: 66.4-76.4%) than the non-AHL group at baseline (95%CI: 12.3-23.6%). In both cohorts, AzBio scores in quiet from the implanted ear improved from baseline, with 24-month scores (95%CI: 73.8 - 84.9%) being higher than preoperative scores (95%CI: 13.2-23.1%). There were also significant differences in AzBio scores in quiet between cohorts overall (p = 0.0120) on mixed model analysis, with the AHL group performing ∼6.4% better than the non-AHL group; however, differences were not significant when scores were stratified by time. In addition, there were no significant differences in CNC in quiet and AzBio scores in noise at +5 dB SNR between cohorts (p = 0.1786 and p = 0.6215, respectively). CONCLUSIONS After CI, patients with AHL can achieve scores on word and sentence tests at least comparable to traditional CI candidates, supporting the expansion of CI candidacy to include patients with AHL.
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Dirks CE, Nelson PB, Oxenham AJ. No Benefit of Deriving Cochlear-Implant Maps From Binaural Temporal-Envelope Sensitivity for Speech Perception or Spatial Hearing Under Single-Sided Deafness. Ear Hear 2022; 43:310-322. [PMID: 34291758 PMCID: PMC8770730 DOI: 10.1097/aud.0000000000001094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study tested whether speech perception and spatial acuity improved in people with single-sided deafness and a cochlear implant (SSD+CI) when the frequency allocation table (FAT) of the CI was adjusted to optimize frequency-dependent sensitivity to binaural disparities. DESIGN Nine SSD+CI listeners with at least 6 months of CI listening experience participated. Individual experimental FATs were created to best match the frequency-to-place mapping across ears using either sensitivity to binaural temporal-envelope disparities or estimated insertion depth. Spatial localization ability was measured, along with speech perception in spatially collocated or separated noise, first with the clinical FATs and then with the experimental FATs acutely and at 2-month intervals for 6 months. Listeners then returned to the clinical FATs and were retested acutely and after 1 month to control for long-term learning effects. RESULTS The experimental FAT varied between listeners, differing by an average of 0.15 octaves from the clinical FAT. No significant differences in performance were observed in any of the measures between the experimental FAT after 6 months and the clinical FAT one month later, and no clear relationship was found between the size of the frequency-allocation shift and perceptual changes. CONCLUSION Adjusting the FAT to optimize sensitivity to interaural temporal-envelope disparities did not improve localization or speech perception. The clinical frequency-to-place alignment may already be sufficient, given the inherently poor spectral resolution of CIs. Alternatively, other factors, such as temporal misalignment between the two ears, may need to be addressed before any benefits of spectral alignment can be observed.
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Affiliation(s)
- Coral E Dirks
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis, Minnesota, USA
- Center for Applied and Translational Sensory Sciences, Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Peggy B Nelson
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis, Minnesota, USA
- Center for Applied and Translational Sensory Sciences, Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Andrew J Oxenham
- Center for Applied and Translational Sensory Sciences, Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
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Dornhoffer JR, Reddy P, Ma C, Schvartz-Leyzac KC, Dubno JR, McRackan TR. Use of Auditory Training and Its Influence on Early Cochlear Implant Outcomes in Adults. Otol Neurotol 2022; 43:e165-e173. [PMID: 34772887 PMCID: PMC8752503 DOI: 10.1097/mao.0000000000003417] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Assess associations between postcochlear implant (CI) auditory training and early outcomes related to speech recognition and CI quality of life (CIQOL). STUDY DESIGN Longitudinal, prospective cohort. SETTING Tertiary academic center. PATIENTS Seventy-two adults undergoing cochlear implantation for bilateral severe-to-profound hearing loss. INTERVENTIONS Self-reported use of three categories of auditory training post-CI activation: (1) face-to-face training (e.g., speech pathologist), (2) passive home-based training (e.g., listening to audiobooks), and (3) computer-based training (e.g., interactive software). MAIN OUTCOME MEASURES Change in Consonant-Nucleus-Consonant phoneme (CNCp), CNC word (CNCw), AzBio sentences in quiet, and CIQOL-35 Profile global and domain scores from pre-CI to 3-month post-CI. RESULTS Of 72 patients, 52 (72.2%) used an auditory training resource. Of all patients, 18.4% used face-to-face training, 58.3% passive home-based training, and 33.3% computer-based training. At 3 months post-CI, use of any training was associated with greater improvement in speech recognition (d-range = 0.57-0.85) and global and domain-specific CIQOL scores, except entertainment (d-range = -0.33 to 0.77). Use of computer-based training demonstrated the greatest effect, with larger improvements in speech recognition (CNCp: d = 0.69[0.03,1.35]; CNCw: d = 0.80[0.14,1.46]; AzBio: d = 1.11[0.44,1.77]) and global and all domain-specific CIQOL scores (d-range = 0.05-1.35). Controlling for age, sex, household income, and use of multiple training resources, computer-based training remained the strongest positive predictor of speech recognition and CIQOL improvement, with significant associations with CNCp (ß = 33.07[1,43,64.719]), AzBio (ß = 33.03[5.71,60.35]), and CIQOL-global (ß = 10.92[1.15,20.70]) score improvement. CONCLUSIONS Our findings provide preliminary evidence-based recommendations for use of specific auditory training resources for new adult CI recipients. Auditory training, especially self-directed computer software, resulted in improved speech recognition and CIQOL outcomes after 3 months and are widely available for CI users.
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Affiliation(s)
- James R Dornhoffer
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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Lopez EM, Dillon MT, Park LR, Rooth MA, Richter ME, Thompson NJ, O'Connell BP, Pillsbury HC, Brown KD. Influence of Cochlear Implant Use on Perceived Listening Effort in Adult and Pediatric Cases of Unilateral and Asymmetric Hearing Loss. Otol Neurotol 2021; 42:e1234-e1241. [PMID: 34224547 PMCID: PMC8448920 DOI: 10.1097/mao.0000000000003261] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Assess the influence of cochlear implant (CI) use on the perceived listening effort of adult and pediatric subjects with unilateral hearing loss (UHL) or asymmetric hearing loss (AHL). STUDY DESIGN Prospective cohort. SETTING Tertiary referral center. PATIENTS Adults and children with UHL or AHL. INTERVENTION Cochlear implantation. Subjects received their CI as part of a clinical trial assessing the effectiveness of cochlear implantation in cases of UHL and AHL. MAIN OUTCOME MEASURES Responses to the Listening Effort pragmatic subscale on the Speech, Spatial, and Qualities of Hearing Scale (SSQ) or SSQ for Children with Impaired Hearing (SSQ-C) were compared over the study period. Subjects or their parents completed the questionnaires preoperatively and at predetermined postactivation intervals. For the adult subjects, responses were compared to word recognition in quiet and sentence recognition in noise. RESULTS Forty adult subjects (n = 20 UHL, n = 20 AHL) and 16 pediatric subjects with UHL enrolled and underwent cochlear implantation. Subjects in all three groups reported a significant reduction in perceived listening effort within the initial months of CI use (p < 0.001; η2 ≥ 0.351). The perceived benefit was significantly correlated with speech recognition in noise for the adult subjects with UHL at the 12-month interval (r(20) = .59, p = 0.006). CONCLUSIONS Adult and pediatric CI recipients with UHL or AHL report a reduction in listening effort with CI use as compared to their preoperative experiences. Use of the SSQ and SSQ-C Listening Effort pragmatic subscale may provide additional information about a CI recipient's experience beyond the abilities measured in the sound booth.
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Affiliation(s)
- Erin M Lopez
- Department of Otolaryngology/Head & Neck Surgery
| | | | - Lisa R Park
- Department of Otolaryngology/Head & Neck Surgery
| | | | - Margaret E Richter
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, North Carolina
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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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Dreyfuss M, Giat Y, Veraguth D, Röösli C, Huber AM, Laske RD. Cost Effectiveness of Cochlear Implantation in Single-Sided Deafness. Otol Neurotol 2021; 42:1129-1135. [PMID: 34191788 DOI: 10.1097/mao.0000000000003135] [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: 11/25/2022]
Abstract
OBJECTIVE To analyze the cost effectiveness of cochlear implantation (CI) for the treatment of single-sided deafness (SSD). STUDY DESIGN Cost-utility analysis in an adapted Markov model. SETTING Adults with single-sided deafness in a high-income country. INTERVENTION Unilateral CI was compared with no intervention. MAIN OUTCOME MEASURE Incremental cost-effectiveness ratios were compared with different cost-effectiveness thresholds ($10,000 to $150,000) for different age, sex, and cost combinations. The calculations were based on the quality-adjusted life year (QALY), national life expectancy tables, and different cost settings. The health utility values for the QALY were either directly collected from published data, or, derived from published data using a regression model of multiple utility indices (regression estimate). RESULTS The regression estimate showed an increase of the health utility value from 0.62 to 0.74 for SSD patients who underwent CI. CI for SSD was cost effective for women up to 64 years ($50,000 per-QALY threshold), 80 years ($100,000 per-QALY threshold), and 86 years ($150,000 per-QALY threshold). For men, these values were 58, 77, and 84, respectively. Changing the discount rate by up to 5% further increased the cutoff ages up to 5 years. A detailed cost and age sensitivity analysis is presented and allows testing for cost effectiveness in local settings worldwide. CONCLUSIONS CI is a cost-effective option to treat patients with SSD.
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Affiliation(s)
- Michael Dreyfuss
- Department of Industrial Engineering and Management, Jerusalem College of Technology, Jerusalem, Israel
| | - Yahel Giat
- Department of Industrial Engineering and Management, Jerusalem College of Technology, Jerusalem, Israel
| | - Dorothe Veraguth
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
| | - Christof Röösli
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
| | - Alexander M Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
| | - Roman D Laske
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
- HNO Wiedikon, Zurich, Switzerland
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Gheorghe DC, Ilie A, Niculescu AG, Grumezescu AM. Preventing Biofilm Formation and Development on Ear, Nose and Throat Medical Devices. Biomedicines 2021; 9:1025. [PMID: 34440229 PMCID: PMC8394763 DOI: 10.3390/biomedicines9081025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/10/2021] [Accepted: 08/14/2021] [Indexed: 12/17/2022] Open
Abstract
Otorhinolaryngology is a vast domain that requires the aid of many resources for optimal performance. The medical devices utilized in this branch share common problems, such as the formation of biofilms. These structured communities of microbes encased in a 3D matrix can develop antimicrobial resistance (AMR), thus making it a problem with challenging solutions. Therefore, it is of concern the introduction in the medical practice involving biomaterials for ear, nose and throat (ENT) devices, such as implants for the trachea (stents), ear (cochlear implants), and voice recovery (voice prosthetics). The surface of these materials must be biocompatible and limit the development of biofilm while still promoting regeneration. In this respect, several surface modification techniques and functionalization procedures can be utilized to facilitate the success of the implants and ensure a long time of use. On this note, this review provides information on the intricate underlying mechanisms of biofilm formation, the large specter of implants and prosthetics that are susceptible to microbial colonization and subsequently related infections. Specifically, the discussion is particularized on biofilm development on ENT devices, ways to reduce it, and recent approaches that have emerged in this field.
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Affiliation(s)
- Dan Cristian Gheorghe
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- “M.S. Curie” Clinical Emergency Hospital for Children, 077120 Bucharest, Romania
| | - Andrei Ilie
- Faculty of Engineering in Foreign Languages, University Politehnica of Bucharest, 060042 Bucharest, Romania; (A.I.); (A.-G.N.)
| | - Adelina-Gabriela Niculescu
- Faculty of Engineering in Foreign Languages, University Politehnica of Bucharest, 060042 Bucharest, Romania; (A.I.); (A.-G.N.)
- Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 060042 Bucharest, Romania
| | - Alexandru Mihai Grumezescu
- Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 060042 Bucharest, Romania
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania
- Academy of Romanian Scientists, 3 Ilfov Street, 50044 Bucharest, Romania
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Butler MJ, Wick CC, Shew MA, Chicoine MR, Ortmann AJ, Vance J, Buchman CA. Intraoperative Cochlear Nerve Monitoring for Vestibular Schwannoma Resection and Simultaneous Cochlear Implantation in Neurofibromatosis Type 2: A Case Series. Oper Neurosurg (Hagerstown) 2021; 21:324-331. [PMID: 34332508 DOI: 10.1093/ons/opab274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 06/06/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Neurofibromatosis type 2 (NF2) often results in profound hearing loss and cochlear implantation is an emerging hearing rehabilitation option. However, cochlear implant (CI) outcomes in this population vary, and intraoperative monitoring to predict cochlear nerve viability and subsequent outcomes is not well-established. OBJECTIVE To review the use of intraoperative electrically evoked cochlear nerve monitoring in patients with NF2 simultaneous translabyrinthine (TL) vestibular schwannoma (VS) resection and cochlear implantation. METHODS A retrospective review was performed of 3 patients with NF2 that underwent simultaneous TL VS resection and cochlear implantation with electrical auditory brainstem response (eABR) measured throughout tumor resection. Patient demographics, preoperative assessments, surgical procedures, and outcomes were reviewed. RESULTS Patients 1 and 3 had a reliable eABR throughout tumor removal. Patient 2 had eABR pretumor removal, but post-tumor removal eABR presence could not be reliably determined because of electrical artifact interference. All patients achieved auditory percepts upon CI activation. Patients 1 and 2 experienced a decline in CI performance after 1 yr and after 3 mo, respectively. Patient 3 continues to perform well at 9 mo. Patients 2 and 3 are daily users of their CI. CONCLUSION Cochlear implantation is attainable in cases of NF2-associated VS resection. Intraoperative eABR may facilitate cochlear nerve preservation during tumor removal, though more data and long-term outcomes are needed to refine eABR methodology and predictive value for this population.
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Affiliation(s)
- Margaret J Butler
- Program in Audiology and Communication Sciences, Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Cameron C Wick
- Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Matthew A Shew
- Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Michael R Chicoine
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Amanda J Ortmann
- Program in Audiology and Communication Sciences, Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Janet Vance
- Saint Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Craig A Buchman
- Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
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Single-Sided Deafness Cochlear Implant Sound-Localization Behavior With Multiple Concurrent Sources. Ear Hear 2021; 43:206-219. [PMID: 34320529 DOI: 10.1097/aud.0000000000001089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES For listeners with one deaf ear and the other ear with normal/near-normal hearing (single-sided deafness [SSD]) or moderate hearing loss (asymmetric hearing loss), cochlear implants (CIs) can improve speech understanding in noise and sound-source localization. Previous SSD-CI localization studies have used a single source with artificial sounds such as clicks or random noise. While this approach provides insights regarding the auditory cues that facilitate localization, it does not capture the complex nature of localization behavior in real-world environments. This study examined SSD-CI sound localization in a complex scenario where a target sound was added to or removed from a mixture of other environmental sounds, while tracking head movements to assess behavioral strategy. DESIGN Eleven CI users with normal hearing or moderate hearing loss in the contralateral ear completed a sound-localization task in monaural (CI-OFF) and bilateral (CI-ON) configurations. Ten of the listeners were also tested before CI activation to examine longitudinal effects. Two-second environmental sound samples, looped to create 4- or 10-sec trials, were presented in a spherical array of 26 loudspeakers encompassing ±144° azimuth and ±30° elevation at a 1-m radius. The target sound was presented alone (localize task) or concurrently with one or three additional sources presented to different loudspeakers, with the target cued by being added to (Add) or removed from (Rem) the mixture after 6 sec. A head-mounted tracker recorded movements in six dimensions (three for location, three for orientation). Mixed-model regression was used to examine target sound-identification accuracy, localization accuracy, and head movement. Angular and translational head movements were analyzed both before and after the target was switched on or off. RESULTS Listeners showed improved localization accuracy in the CI-ON configuration, but there was no interaction with test condition and no effect of the CI on sound-identification performance. Although high-frequency hearing loss in the unimplanted ear reduced localization accuracy and sound-identification performance, the magnitude of the CI localization benefit was independent of hearing loss. The CI reduced the magnitude of gross head movements used during the task in the azimuthal rotation and translational dimensions, both while the target sound was present (in all conditions) and during the anticipatory period before the target was switched on (in the Add condition). There was no change in pre- versus post-activation CI-OFF performance. CONCLUSIONS These results extend previous findings, demonstrating a CI localization benefit in a complex listening scenario that includes environmental and behavioral elements encountered in everyday listening conditions. The CI also reduced the magnitude of gross head movements used to perform the task. This was the case even before the target sound was added to the mixture. This suggests that a CI can reduce the need for physical movement both in anticipation of an upcoming sound event and while actively localizing the target sound. Overall, these results show that for SSD listeners, a CI can improve localization in a complex sound environment and reduce the amount of physical movement used.
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Auletta G, Franzè A, Laria C, Piccolo C, Papa C, Riccardi P, Pisani D, Sarnelli A, Del Vecchio V, Malesci R, Marciano E. Integrated Bimodal Fitting for Unilateral CI Users with Residual Contralateral Hearing. Audiol Res 2021; 11:200-206. [PMID: 34065802 PMCID: PMC8161435 DOI: 10.3390/audiolres11020018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 04/23/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The aim of this study was to compare, in users of bimodal cochlear implants, the performance obtained using their own hearing aids (adjusted with the standard NAL-NL1 fitting formula) with the performance using the Phonak Naìda Link Ultra Power hearing aid adjusted with both NAL-NL1 and a new bimodal system (Adaptive Phonak Digital Bimodal (APDB)) developed by Advanced Bionics and Phonak Corporations. METHODS Eleven bimodal users (Naìda CI Q70 + contralateral hearing aid) were enrolled in our study. The users' own hearing aids were replaced with the Phonak Naìda Link Ultra Power and fitted following the new formula. Speech intelligibility was assessed in quiet and noisy conditions, and comparisons were made with the results obtained with the users' previous hearing aids and with the Naída Link hearing aids fitted with the NAL-NL1 generic prescription formula. RESULTS Using Phonak Naìda Link Ultra Power hearing aids with the Adaptive Phonak Digital Bimodal fitting formula, performance was significantly better than that with the users' own rehabilitation systems, especially in challenging hearing situations for all analyzed subjects. CONCLUSIONS Speech intelligibility tests in quiet settings did not reveal a significant difference in performance between the new fitting formula and NAL-NL1 fittings (using the Naída Link hearing aids), whereas the performance difference between the two fittings was very significant in noisy test conditions.
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Affiliation(s)
- Gennaro Auletta
- Unit of Audiology, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, via Pansini 5, 80131 Naples, Italy; (A.F.); (C.L.); (C.P.); (C.P.); (A.S.); (V.D.V.); (R.M.); (E.M.)
- Correspondence:
| | - Annamaria Franzè
- Unit of Audiology, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, via Pansini 5, 80131 Naples, Italy; (A.F.); (C.L.); (C.P.); (C.P.); (A.S.); (V.D.V.); (R.M.); (E.M.)
| | - Carla Laria
- Unit of Audiology, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, via Pansini 5, 80131 Naples, Italy; (A.F.); (C.L.); (C.P.); (C.P.); (A.S.); (V.D.V.); (R.M.); (E.M.)
| | - Carmine Piccolo
- Unit of Audiology, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, via Pansini 5, 80131 Naples, Italy; (A.F.); (C.L.); (C.P.); (C.P.); (A.S.); (V.D.V.); (R.M.); (E.M.)
| | - Carmine Papa
- Unit of Audiology, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, via Pansini 5, 80131 Naples, Italy; (A.F.); (C.L.); (C.P.); (C.P.); (A.S.); (V.D.V.); (R.M.); (E.M.)
| | - Pasquale Riccardi
- Advanced Bionics GmbH Max-Eyth Strasse 20, 70736 Fellbach-Oeffingen, Germany;
| | - Davide Pisani
- Unit of Audiology, Department of Experimental and Clinical Medicine, Magna Graecia University, Viale Europa, 88100 Catanzaro, Italy;
| | - Angelo Sarnelli
- Unit of Audiology, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, via Pansini 5, 80131 Naples, Italy; (A.F.); (C.L.); (C.P.); (C.P.); (A.S.); (V.D.V.); (R.M.); (E.M.)
| | - Valeria Del Vecchio
- Unit of Audiology, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, via Pansini 5, 80131 Naples, Italy; (A.F.); (C.L.); (C.P.); (C.P.); (A.S.); (V.D.V.); (R.M.); (E.M.)
| | - Rita Malesci
- Unit of Audiology, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, via Pansini 5, 80131 Naples, Italy; (A.F.); (C.L.); (C.P.); (C.P.); (A.S.); (V.D.V.); (R.M.); (E.M.)
| | - Elio Marciano
- Unit of Audiology, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples “Federico II”, via Pansini 5, 80131 Naples, Italy; (A.F.); (C.L.); (C.P.); (C.P.); (A.S.); (V.D.V.); (R.M.); (E.M.)
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Bernhard N, Gauger U, Romo Ventura E, Uecker FC, Olze H, Knopke S, Hänsel T, Coordes A. Duration of deafness impacts auditory performance after cochlear implantation: A meta-analysis. Laryngoscope Investig Otolaryngol 2021; 6:291-301. [PMID: 33869761 PMCID: PMC8035957 DOI: 10.1002/lio2.528] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Hearing loss is a highly disabling condition. Cochlear implantation is an established remedy if conventional hearing aids have failed to alleviate the level of disability. Unfortunately, cochlear implant (CI) performance varies dramatically. This study aims to examine the effects of duration of deafness (DoD) prior to cochlear implantation and the postoperative duration of implant experience with resulting hearing performance in postlingually deaf patients. METHODS A systematic literature review and two meta-analyses were conducted using the search terms cochlear implant AND duration deafness. Included studies evaluate the correlation between the DoD and auditory performance after cochlear implantation using monosyllabic and sentence tests. Correlation coefficients were determined using Pearson's correlation and Spearman rho. RESULTS A total of 36 studies were identified and included data on cochlear implantations following postlingual deafness and postoperative speech testing of hearing outcomes for 1802 patients. The mean age ranged from 44 to 68 years with a DoD of 0.1 to 77 years. Cochlear implant use varied from 3 months to 14 years of age. Speech perception, which was assessed by sentence and monosyllabic word perception, was negatively correlated with DoD. Subgroup analyses revealed worse outcomes for longer DoD and shorter postoperative follow-up. CONCLUSION DoD is one of the most important factors to predict speech perception after cochlear implantation in postlingually deaf patients. The meta-analyses revealed a negative correlation between length of auditory deprivation and postoperative sentence and monosyllabic speech perception. Longer DoD seems to lead to worse CI performance, whereas more experience with CI mitigates the effect.
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Affiliation(s)
- Nikolai Bernhard
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
| | | | | | - Florian C. Uecker
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
| | - Heidi Olze
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
| | - Steffen Knopke
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
| | - Toni Hänsel
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
| | - Annekatrin Coordes
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
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Chavant M, Hervais-Adelman A, Macherey O. Perceptual Learning of Vocoded Speech With and Without Contralateral Hearing: Implications for Cochlear Implant Rehabilitation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:196-205. [PMID: 33267729 DOI: 10.1044/2020_jslhr-20-00385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose An increasing number of individuals with residual or even normal contralateral hearing are being considered for cochlear implantation. It remains unknown whether the presence of contralateral hearing is beneficial or detrimental to their perceptual learning of cochlear implant (CI)-processed speech. The aim of this experiment was to provide a first insight into this question using acoustic simulations of CI processing. Method Sixty normal-hearing listeners took part in an auditory perceptual learning experiment. Each subject was randomly assigned to one of three groups of 20 referred to as NORMAL, LOWPASS, and NOTHING. The experiment consisted of two test phases separated by a training phase. In the test phases, all subjects were tested on recognition of monosyllabic words passed through a six-channel "PSHC" vocoder presented to a single ear. In the training phase, which consisted of listening to a 25-min audio book, all subjects were also presented with the same vocoded speech in one ear but the signal they received in their other ear differed across groups. The NORMAL group was presented with the unprocessed speech signal, the LOWPASS group with a low-pass filtered version of the speech signal, and the NOTHING group with no sound at all. Results The improvement in speech scores following training was significantly smaller for the NORMAL than for the LOWPASS and NOTHING groups. Conclusions This study suggests that the presentation of normal speech in the contralateral ear reduces or slows down perceptual learning of vocoded speech but that an unintelligible low-pass filtered contralateral signal does not have this effect. Potential implications for the rehabilitation of CI patients with partial or full contralateral hearing are discussed.
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Affiliation(s)
- Martin Chavant
- Aix-Marseille University, Centre National de la Recherche Scientifique, Centrale Marseille, Laboratoire de Mécanique et d'Acoustique, France
| | | | - Olivier Macherey
- Aix-Marseille University, Centre National de la Recherche Scientifique, Centrale Marseille, Laboratoire de Mécanique et d'Acoustique, France
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Jensen KK, Cosentino S, Bernstein JGW, Stakhovskaya OA, Goupell MJ. A Comparison of Place-Pitch-Based Interaural Electrode Matching Methods for Bilateral Cochlear-Implant Users. Trends Hear 2021; 25:2331216521997324. [PMID: 34057382 PMCID: PMC8182630 DOI: 10.1177/2331216521997324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 01/12/2021] [Accepted: 01/29/2021] [Indexed: 11/16/2022] Open
Abstract
Interaural place-of-stimulation mismatch for bilateral cochlear-implant (BI-CI) listeners is often evaluated using pitch-comparison tasks that can be susceptible to procedural biases. Bias effects were compared for three sequential interaural pitch-comparison tasks in six BI-CI listeners using single-electrode direct stimulation. The reference (right ear) was a single basal, middle, or apical electrode. The comparison electrode (left ear) was chosen from one of three ranges: basal half, full array, or apical half. In Experiment 1 (discrimination), interaural pairs were chosen randomly (method of constant stimuli). In Experiment 2 (ranking), an efficient adaptive procedure rank ordered 3 reference and 6 or 11 comparison electrodes. In Experiment 3 (matching), listeners adjusted the comparison electrode to pitch match the reference. Each experiment was evaluated for testing-range bias (point of subjective equality [PSE] vs. comparison-range midpoint) and reference-electrode slope bias (PSE vs. reference electrode). Discrimination showed large biases for both metrics; matching showed a smaller but significant reference-electrode bias; ranking showed no significant biases in either dimension. Ranking and matching were also evaluated for starting-point bias (PSE vs. adaptive-track starting point), but neither showed significant effects. A response-distribution truncation model explained a nonsignificant bias for ranking but it could not fully explain the observed biases for discrimination or matching. It is concluded that (a) BI-CI interaural pitch comparisons are inconsistent across test methods; (b) biases must be evaluated in more than one dimension before accepting the results as valid; and (c) of the three methods tested, ranking was least susceptible to biases and therefore emerged as the optimal approach.
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Affiliation(s)
- Kenneth K. Jensen
- National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland, United States
| | - Stefano Cosentino
- Department of Hearing and Speech Sciences, University of Maryland, College Park, United States
| | - Joshua G. W. Bernstein
- National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland, United States
| | - Olga A. Stakhovskaya
- National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland, United States
- Department of Hearing and Speech Sciences, University of Maryland, College Park, United States
| | - Matthew J. Goupell
- Department of Hearing and Speech Sciences, University of Maryland, College Park, United States
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Barnes JH, Yin LX, Marinelli JP, Carlson ML. Audiometric Profile of Cochlear Implant Recipients Demonstrates Need for Revising Insurance Coverage. Laryngoscope 2020; 131:E2007-E. [PMID: 33347621 DOI: 10.1002/lary.29334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/23/2020] [Accepted: 11/29/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS To describe the pre-implant audiometric profile of adult cochlear implant (CI) recipients to investigate whether current binaural candidacy requirements prevent access to patients who could benefit from CI. STUDY DESIGN Retrospective case series. METHODS Retrospective review from 2016 to 2018 evaluating preoperative pure-tone thresholds and speech perception scores in the ipsilateral and contralateral ear. RESULTS A total of 252 adult CI recipients undergoing 270 implants were identified. Median age at time of implantation was 70.5 years (IQR 61.3-78.3) for those undergoing unilateral implantation and 59.0 (IQR 48.0-72.3) for those undergoing bilateral implantation (P < .01). For unilateral implantation, median pre-implantation speech perception performance in the ear to be implanted was 8.0% (IQR 0%-26.0%) for CNC word scores, and 9.0% (IQR 0%-34.0%) for AzBio sentence scores in quiet. Median speech perception performance in the contralateral ear was 36.0% (IQR 14.0%-60.0%) on CNC word scores, and 48.5% (IQR 17.5%-76.0%) on AzBio sentence tests. Speech perception scores were significantly different between ears for word and sentence tests (P < .01). Patients older than age 65 were significantly less likely to undergo bilateral implantation (P = .03). CONCLUSIONS Adult CI recipients exhibit substantially poorer pre-implant speech perception scores than the commonly utilized ipsilateral qualifying threshold of 50% on sentence testing. Yet, existing insurance paradigms limit patients by excessively stringent binaural best-aided requirements. This limitation likely leads to worse device performance as patients often wait years for their binaural hearing to qualify while their ear to be implanted potentially experiences an unnecessarily extended duration of deafness. Older patients also experience a unique delay in referral for cochlear implantation. LEVEL OF EVIDENCE 3- Retrospective review Laryngoscope, 131:E2007-E2012, 2021.
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Affiliation(s)
- Jason H Barnes
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Linda X Yin
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - John P Marinelli
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.,Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
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Mancini P, Dincer D'Alessandro H, Portanova G, Atturo F, Russo FY, Greco A, de Vincentiis M, Giallini I, De Seta D. Bimodal cochlear implantation in elderly patients. Int J Audiol 2020; 60:469-478. [PMID: 33174776 DOI: 10.1080/14992027.2020.1843080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Bimodal stimulation is a standard option for asymmetric hearing loss in adults. Questions have been raised whether receiving two stimulations may conflict in elderly listeners where the central integration of an acoustic/electrical signal may be very important to obtain benefit in terms of speech perception. DESIGN Clinical retrospective study. STUDY SAMPLE The outcomes from 17 bimodal cochlear implant (CI) users were analysed. The test material consisted of speech audiometry in quiet and in noise (STARR and Matrix). RESULTS Bimodal PTA and speech perception both in quiet and in noise were significantly better than CI or HA alone. Age showed a significant effect on bimodal STARR outcomes. Similarly, bimodal STARR scores improved significantly in comparison to Better Ear. CONCLUSION Both Matrix and STARR tests were very difficult for many elderly CI listeners from the present study group, especially in unilateral listening condition. The performance improved significantly, emphasising a good integration of acoustic and electric hearing in this group of elderly bimodal listeners. Overall results highlighted how a specific study, based on speech perception in noise in the elderly listeners, might shed light on the effect of speech test modality on bimodal outcomes.
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Affiliation(s)
- Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Hilal Dincer D'Alessandro
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy.,Department of Audiology, Hacettepe University, Ankara, Turkey
| | - Ginevra Portanova
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Francesca Atturo
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | | | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Daniele De Seta
- Department of Surgical Sciences, Section of Otolaryngology, University of Cagliari, Cagliari, Italy
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Bruschini L, Canelli R, Morandi A, Cambi C, Fiacchini G, Berrettini S, Forli F. Bone Anchored Hearing Aids for the Treatment of Asymmetric Hearing Loss. J Int Adv Otol 2020; 16:313-317. [PMID: 33136009 DOI: 10.5152/iao.2020.8879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Asymmetric hearing loss is generally defined as a moderate-to-profound hearing loss in the poorer ear and a mild-to-moderate hearing loss in the better ear. Application of a bone conduction hearing aid is one of the possible treatments for the poorer ear in asymmetric hearing loss. However, the device essentially stimulates the contralateral better ear, precluding true binaural hearing. The aim of this paper is to evaluate the application and utility of bone-anchored hearing aids in the treatment of asymmetric hearing loss. MATERIALS AND METHODS We retrospectively evaluated 215 implanted subjects in our clinic and extracted a series of 27 patients affected by asymmetric hearing loss and treated with bone-anchored hearing aids. All 27 subjects had a mixed hearing loss after middle ear surgery. The preoperative and postoperative audiological data of these patients were collected and analyzed. RESULTS The audiological tests showed an improvement in the performance of hearing perception of sound and speech in quiet and noise. Moreover, the subjects have positively answered the questionnaires administered to evaluate subjective benefits. All subscales of the abbreviated profile of hearing aid benefit and speech, spatial, and qualities of hearing scale showed a significant improvement with the device. CONCLUSION Bone-anchored hearing aids are a suitable treatment for asymmetric hearing loss. When other devices cannot be utilized or are not indicated, the bone conduction devices may allow good audiological results.
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Affiliation(s)
- Luca Bruschini
- ENT Audiology and Phoniatric Unit, University Hospital of Pisa, Pisa, Italy
| | - Rachele Canelli
- ENT Audiology and Phoniatric Unit, University Hospital of Pisa, Pisa, Italy
| | - Andrea Morandi
- ENT Audiology and Phoniatric Unit, University Hospital of Pisa, Pisa, Italy
| | - Christina Cambi
- ENT Audiology and Phoniatric Unit, University Hospital of Pisa, Pisa, Italy
| | - Giacomo Fiacchini
- ENT Audiology and Phoniatric Unit, University Hospital of Pisa, Pisa, Italy
| | - Stefano Berrettini
- ENT Audiology and Phoniatric Unit, University Hospital of Pisa, Pisa, Italy
| | - Francesca Forli
- ENT Audiology and Phoniatric Unit, University Hospital of Pisa, Pisa, Italy
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Dillon MT, Buss E, Rooth MA, King ER, McCarthy SA, Bucker AL, Deres EJ, Richter ME, Thompson NJ, Canfarotta MW, O'Connell BP, Pillsbury HC, Brown KD. Cochlear Implantation in Cases of Asymmetric Hearing Loss: Subjective Benefit, Word Recognition, and Spatial Hearing. Trends Hear 2020; 24:2331216520945524. [PMID: 32808881 PMCID: PMC7586262 DOI: 10.1177/2331216520945524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A prospective clinical trial evaluated the effectiveness of cochlear implantation in adults with asymmetric hearing loss (AHL). Twenty subjects with mild-to-moderate hearing loss in the better ear and moderate-to-profound hearing loss in the poorer ear underwent cochlear implantation of the poorer hearing ear. Subjects were evaluated preoperatively and at 1, 3, 6, 9, and 12 months post-activation. Preoperative performance was evaluated unaided, with traditional hearing aids (HAs) or with a bone-conduction HA. Post-activation performance was evaluated with the cochlear implant (CI) alone or in combination with a contralateral HA (bimodal). Test measures included subjective benefit, word recognition, and spatial hearing (i.e., localization and masked sentence recognition). Significant subjective benefit was reported as early as the 1-month interval, indicating better performance with the CI compared with the preferred preoperative condition. Aided word recognition with the CI alone was significantly improved at the 1-month interval compared with preoperative performance with an HA and continued to improve through the 12-month interval. Subjects demonstrated early, significant improvements in the bimodal condition on the spatial hearing tasks compared with baseline preoperative performance tested unaided. The magnitude of the benefit was reduced for subjects with AHL when compared with published data on CI users with normal hearing in the contralateral ear; this finding may reflect significant differences in age at implantation and hearing sensitivity across cohorts.
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Affiliation(s)
- Margaret T Dillon
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Emily Buss
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Meredith A Rooth
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - English R King
- Department of Audiology, UNC Health Care, Chapel Hill, North Carolina, United States
| | - Sarah A McCarthy
- Department of Audiology, UNC Health Care, Chapel Hill, North Carolina, United States
| | - Andrea L Bucker
- Department of Audiology, UNC Health Care, Chapel Hill, North Carolina, United States
| | - Ellen J Deres
- Department of Audiology, UNC Health Care, Chapel Hill, North Carolina, United States
| | - Margaret E Richter
- Division of Speech & Hearing Sciences, Department of Allied Health, University of North Carolina at Chapel Hill
| | - Nicholas J Thompson
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Michael W Canfarotta
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Brendan P O'Connell
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Harold C Pillsbury
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Kevin D Brown
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
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Aligning Hearing Aid and Cochlear Implant Improves Hearing Outcome in Bimodal Cochlear Implant Users. Otol Neurotol 2020; 41:1350-1356. [PMID: 32810012 DOI: 10.1097/mao.0000000000002796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Patients with unilateral deafness and residual hearing on the contralateral ear can benefit from a cochlear implant (CI) on one side and a hearing aid (HA) on the other. However, hearing improvement among these patients is heterogenous. Interindividual differences in bimodal benefit may be caused by a mismatch of CI and HA. The aim of this study was to clinically apply a HA fitting strategy and to evaluate hearing outcome with and without a dedicated bimodal fitting formula. STUDY DESIGN Prospective non-randomized study. SETTING Tertiary referral center. PATIENTS Twelve patients using a CI processor and a conventional HA were enrolled. Before and after the new HA had been adjusted to the patient and linked to the CI, pure-tone audiometry and localization tests were performed. Speech perception was determined in quiet and noise. Tests were repeated after 6 and 12 weeks. To evaluate the subjective listening comfort two questionnaires (Oldenburg Inventory and HISQUI19) were assessed. INTERVENTION Therapeutic. RESULTS MAIN OUTCOME MEASURE Word recognition in quiet, sentence recognition in noise. Speech perception in noise improved significantly: directed suppression of noise helped to segregate the target speech signal from a mixture of sounds or competing speakers. Evaluation of the questionnaires revealed a positive subjective hearing experience compared with patients' initial settings of the devices. CONCLUSION By linking CI and HA hearing and speech perception can be improved. However, good counselling at the outset is essential to obtain enhanced outcome.
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Kurioka T, Sano H, Furuki S, Yamashita T. Speech discrimination impairment of the worse-hearing ear in asymmetric hearing loss. Int J Audiol 2020; 60:54-59. [PMID: 32720534 DOI: 10.1080/14992027.2020.1795282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE This study aimed to compare the difference in maximum speech discrimination score (SDSmax) of the worse-hearing ear in asymmetric hearing loss (ASHL) patients with that in symmetric hearing loss (SHL) patients. DESIGN We retrospectively reviewed medical records of patients with suspected hearing loss (HL) who underwent audiometric examinations. Patients were divided into two groups according to the difference in air conduction (AC) threshold between the right and left ears: the SHL group and the ASHL group. STUDY SAMPLE Of the 102 patients (204 ears), 74 (148 ears) had SHL, and 28 had ASHL. RESULTS The worse-hearing ear of ASHL patients exhibited a statistically significantly higher AC threshold and lower SDSmax, compared with ears of SHL patients and better-hearing ears of ASHL patients, and SDSmax exhibited a statistically significant negative correlation with AC threshold. The SDSmax was statistically significantly lower in the worse-hearing ear of the ASHL group than in moderate to severe HL ears of the SHL group, even though these groups had comparable AC thresholds. CONCLUSIONS ASHL patients' worse-hearing ear exhibited a lower SDSmax than SHL patients' ears, despite a comparable AC threshold. Management of hearing impairment in ASHL patients should receive more attention.
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Affiliation(s)
- Takaomi Kurioka
- Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Hajime Sano
- School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Shogo Furuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Taku Yamashita
- Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University, Sagamihara, Kanagawa, Japan
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Treating the Individual Ear in Children: Results of Cochlear Implantation in Children With Asymmetric Sensory Hearing Loss. Otol Neurotol 2020; 41:e700-e704. [PMID: 32574479 DOI: 10.1097/mao.0000000000002661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Determine speech outcomes of children undergoing cochlear implantation with severe-to-profound hearing loss in the implanted ear and moderate or better hearing loss in nonimplanted ear. STUDY DESIGN Retrospective chart review. SETTING Tertiary referral center. PATIENTS Forty-nine children with severe-to-profound hearing loss in the ear to be implanted (pure-tone average), and no worse than moderate hearing loss in the nonimplant ear. INTERVENTION Subjects underwent cochlear implantation from 2007 and 2017 in the ear with severe-to-profound hearing loss. MAIN OUTCOME MEASURES Consonant Nucleus Consonant or Phonetically Balanced Kindergarten word scores pre- and postoperatively were compared in both the implanted ear and binaural setting. Comparisons were made between Phonetically Balanced Kindergarten scores pre- and postoperatively or Consonant Nucleus Consonant scores pre- and postoperatively. RESULTS The average pure-tone average for the implant ear was 92 ± 13 dB HL and 55 ± 12 dB HL in the nonimplant ear. Word scores for the implant ear increased an average of 58 (±27) % following cochlear implantation at 12 months and 62 (±20) % at 24 months. Binaural best-aided word scores increased an average of 36 (±29) % at 12 months and 49 (±24) % at 24 months. CONCLUSION Children with asymmetric sensory hearing loss should have each ear treated individually as significant benefits can be gained not only in the implanted ear, but also in binaural hearing.
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Speech Perception Changes in the Acoustically Aided, Nonimplanted Ear after Cochlear Implantation: A Multicenter Study. J Clin Med 2020; 9:jcm9061758. [PMID: 32517138 PMCID: PMC7356938 DOI: 10.3390/jcm9061758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/23/2020] [Accepted: 06/02/2020] [Indexed: 11/17/2022] Open
Abstract
In recent years there has been an increasing percentage of cochlear implant (CI) users who have usable residual hearing in the contralateral, nonimplanted ear, typically aided by acoustic amplification. This raises the issue of the extent to which the signal presented through the cochlear implant may influence how listeners process information in the acoustically stimulated ear. This multicenter retrospective study examined pre- to postoperative changes in speech perception in the nonimplanted ear, the implanted ear, and both together. Results in the latter two conditions showed the expected increases, but speech perception in the nonimplanted ear showed a modest yet meaningful decrease that could not be completely explained by changes in unaided thresholds, hearing aid malfunction, or several other demographic variables. Decreases in speech perception in the nonimplanted ear were more likely in individuals who had better levels of speech perception in the implanted ear, and in those who had better speech perception in the implanted than in the nonimplanted ear. This raises the possibility that, in some cases, bimodal listeners may rely on the higher quality signal provided by the implant and may disregard or even neglect the input provided by the nonimplanted ear.
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Ciorba A, Guidi MP, Skarżyński PH, Bianchini C, Rosignoli M, Mazzoli M, Pelucchi S, Hatzopoulos S. Rehabilitation of Severe to Profound Sensorineural Hearing Loss in Adults: Audiological Outcomes. EAR, NOSE & THROAT JOURNAL 2019; 100:215S-219S. [PMID: 31838921 DOI: 10.1177/0145561319892461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this article is to describe the audiological patterns of 71 adult patients presenting severe to profound sensorineural hearing loss, who were rehabilitated by cochlear implants (CIs) and hearing aids. This is a retrospective study in a university setting, where the clinical records of 71 adult patients were reviewed and processed. Speech intelligibility was evaluated at one aided ear (CI) or at both aided ears (double CI or a combination of CI and hearing aid [HA]). Patients with a bilateral CI or with a bimodal hearing setup (CI and HA) performed better than those with a single CI; data from the phonetic matrices test showed that there was a statistically significant difference among patients aided by a single CI versus binaural setup (double CI or CI + HA). In particular, patients aided by a bilateral CI, or by a CI and HA, showed an improvement in the functional results of the speech tests, compared to patients using a single CI. Binaural hearing (either with a bilateral CI or bimodal) allows an improvement in the functional results at the speech tests, compared to the use of a CI only.
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Affiliation(s)
- Andrea Ciorba
- ENT and Audiology Clinic, University of Ferrara, Ferrara, Italy
| | | | - Piotr H Skarżyński
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Department of Heart Failure and Cardiac Rehabilitation, Medical University of Warsaw, Warsaw, Poland.,Institute of Sensory Organs, Kajetany, Poland
| | | | | | - Manuela Mazzoli
- ENT and Audiology Clinic, University of Ferrara, Ferrara, Italy
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Cuda D, Murri A, Mainardi A, Chalupper J. Effectiveness and efficiency of a dedicated bimodal fitting formula. Audiol Res 2019; 9:219. [PMID: 31183024 PMCID: PMC6536834 DOI: 10.4081/audiores.2019.219] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/12/2019] [Indexed: 11/23/2022] Open
Abstract
The population of unilateral cochlear implant (CI) users with aidable residual hearing in the contralateral ear is continuously growing. Aiding the contralateral ear with a hearing aid has been shown to provide substantial benefit regarding speech intelligibility in quiet and in noise, sound quality, localization ability and listening effort. In this study, a dedicated hearing aid with the accompanying fitting prescription, tailored to the needs of bimodal listeners was evaluated in nine bimodal CI users. Speech intelligibility scores in noise revealed on-par performance of the dedicated bimodal fitting compared to the clinical standard prescription. 78% of the bimodal CI users preferred the dedicated bimodal fitting over the clinical standard. The minimal subject-specific finetuning effort required during the dedicated bimodal fitting process emphasizes the clinical efficiency.
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Affiliation(s)
- Domenico Cuda
- Department of Otorhinolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Alessandra Murri
- Department of Otorhinolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Anna Mainardi
- Department of Otorhinolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Josef Chalupper
- Advanced Bionics GmbH, European Research Center, Hannover, Germany
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Skarzynski H, Lorens A, Dziendziel B, Rajchel J, Matusiak M, Skarzynski P. Electro-Natural Stimulation in Partial Deafness Treatment of Adult Cochlear Implant Users: Long-Term Hearing Preservation Results. ORL J Otorhinolaryngol Relat Spec 2019; 81:63-72. [DOI: 10.1159/000497060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 01/18/2019] [Indexed: 11/19/2022]
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46
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Front- and rear-facing horizontal sound localization results in adults with unilateral hearing loss and normal hearing. Hear Res 2019; 372:3-9. [DOI: 10.1016/j.heares.2018.03.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/18/2018] [Accepted: 03/15/2018] [Indexed: 11/20/2022]
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47
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Litovsky RY, Moua K, Godar S, Kan A, Misurelli SM, Lee DJ. Restoration of spatial hearing in adult cochlear implant users with single-sided deafness. Hear Res 2018; 372:69-79. [PMID: 29729903 DOI: 10.1016/j.heares.2018.04.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 03/29/2018] [Accepted: 04/11/2018] [Indexed: 01/16/2023]
Abstract
In recent years, cochlear implants (CIs) have been provided in growing numbers to people with not only bilateral deafness but also to people with unilateral hearing loss, at times in order to alleviate tinnitus. This study presents audiological data from 15 adult participants (ages 48 ± 12 years) with single sided deafness. Results are presented from 9/15 adults, who received a CI (SSD-CI) in the deaf ear and were tested in Acoustic or Acoustic + CI hearing modes, and 6/15 adults who are planning to receive a CI, and were tested in the unilateral condition only. Testing included (1) audiometric measures of threshold, (2) speech understanding for CNC words and AzBIO sentences, (3) tinnitus handicap inventory, (4) sound localization with stationary sound sources, and (5) perceived auditory motion. Results showed that when listening to sentences in quiet, performance was excellent in the Acoustic and Acoustic + CI conditions. In noise, performance was similar between Acoustic and Acoustic + CI conditions in 4/6 participants tested, and slightly worse in the Acoustic + CI in 2/6 participants. In some cases, the CI provided reduced tinnitus handicap scores. When testing sound localization ability, the Acoustic + CI condition resulted in improved sound localization RMS error of 29.2° (SD: ±6.7°) compared to 56.6° (SD: ±16.5°) in the Acoustic-only condition. Preliminary results suggest that the perception of motion direction, whereby subjects are required to process and compare directional cues across multiple locations, is impaired when compared with that of normal hearing subjects.
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Affiliation(s)
- Ruth Y Litovsky
- University of Wisconsin Madison, Waisman Center, USA; University of Wisconsin Madison, Department of Surgery, Division of Otolaryngology, USA.
| | - Keng Moua
- University of Wisconsin Madison, Waisman Center, USA
| | - Shelly Godar
- University of Wisconsin Madison, Waisman Center, USA
| | - Alan Kan
- University of Wisconsin Madison, Waisman Center, USA
| | - Sara M Misurelli
- University of Wisconsin Madison, Waisman Center, USA; University of Wisconsin Madison, Department of Surgery, Division of Otolaryngology, USA
| | - Daniel J Lee
- Department of Otolaryngology, Massachusetts Eye and Ear, USA; Department of Otology and Laryngology, Harvard Medical School, USA
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