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Al-Khateeb M, Di Pierro F, Piras G, Lauda L, Almashhadani M, Damam SK, Sanna M. Cochlear implantation in otosclerosis: surgical and audiological outcomes between ossified and non-ossified cochlea. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08970-w. [PMID: 39327290 DOI: 10.1007/s00405-024-08970-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 09/04/2024] [Indexed: 09/28/2024]
Abstract
AIM To evaluate (1) Audiological and surgical outcomes in patients with otosclerosis following cochlear implantation. (2) surgical difficulties and outcomes between both groups. (3) Audiological outcomes between both groups. STUDY DESIGN AND SETTING Retrospective study conducted at Otology and Skull Base Surgery Center. SUBJECTS AND METHODS Data were analyzed from 111 patients with otosclerosis (114 ears) who underwent cochlear implant surgery using the cochlear implant database. Demographic characteristics (age, sex, and operated ear), auditory outcomes, and operative details (extent of cochlear ossification, surgical approach [posterior tympanotomy or subtotal petrosectomy], electrode insertion [partial/complete, scala tympani or vestibuli], and complications) were analyzed Auditory outcomes were assessed over at least one year follow-up period using pure tone audiometry and speech discrimination scores. Patients were divided into two groups (with and without cochlear ossification) to compare auditory outcomes and surgical outcomes. RESULTS The mean age of patients with ossified and non-ossified cochlea was 60.04 and 62.22 years respectively. Sixty-five of 114 ears had cochlear ossification, with complete round window involvement in 75.4% of these patients, while the rest had partial or complete basal turn ossification. Subtotal petrosectomy was performed in 63.1% and 28.6% of ossified and non-ossified cochlea respectively while the rest underwent cochlear implantation through posterior tympanotomy. Only one case had scala vestibuli insertion and four had incomplete electrode insertion. Six patients underwent re-implantation due to infection, device failure, and erosion of the posterior canal wall. Auditory outcomes among patients with ossified otosclerosis were slightly better than those without ossification but this difference was not statistically significant. CONCLUSION Cochlear implantation for otosclerosis yields excellent auditory outcomes with a low rate of surgical complications, despite the high incidence of cochlear ossification.
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Affiliation(s)
- Mohammed Al-Khateeb
- Department of Otology and Skull Base Surgery, Gruppo Otologico, Rome, Piacenza, Italy.
- Rizgary Teaching Hospital, Erbil, Iraq.
| | | | - Gianluca Piras
- Department of Otology and Skull Base Surgery, Gruppo Otologico, Rome, Piacenza, Italy
| | - Lorenzo Lauda
- Department of Otology and Skull Base Surgery, Gruppo Otologico, Rome, Piacenza, Italy
| | - Mohanad Almashhadani
- Department of Otology and Skull Base Surgery, Gruppo Otologico, Rome, Piacenza, Italy
- Al-Yarmouk Teaching Hospital, Baghdad, Iraq
| | - Sachin K Damam
- Department of Otology and Skull Base Surgery, Gruppo Otologico, Rome, Piacenza, Italy
- Vijaya Health Centre - Vidyaranyapura, Bangalore, India
| | - Mario Sanna
- Department of Otology and Skull Base Surgery, Gruppo Otologico, Rome, Piacenza, Italy
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2
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Ho PH, Huang PK, Chen PY, Chu CH, Hsu HM, Chen XX, Lin HC. Speech Perception and Quality-of-Life Outcomes in Mandarin-Speaking Postlingual Deaf Adults With Cochlear Implant: Any Difference With the Intonation Language Users? Otol Neurotol 2024; 45:e483-e489. [PMID: 38865725 DOI: 10.1097/mao.0000000000004209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
OBJECTIVE To evaluate the effects of related factors on long-term speech perception and quality-of-life (QoL) outcomes in postlingual deaf Mandarin-speaking adult cochlear implant (CI) recipients and to assess any differences between tone language and other intonation language CI adult users. STUDY DESIGN Retrospective cases review. SETTING Tertiary referral center. PATIENTS Forty-five adult CI recipients (48 implanted ears). MAIN OUTCOME MEASURES Post-CI outcomes were evaluated after follow-ups of more than 24 months using speech perception tests and QoL questionnaires. We analyzed the related factors affecting CI outcomes. RESULTS A shorter duration of profound deafness was predictive factors for better post-CI speech perception. Earlier implantation and better performance of vowel scores were predictive of better subjective improvements in social and emotional life. Post-CI vowel scores of over 56% indicated promising improvements in QoL. CONCLUSION Shorter duration of deafness could have better post-CI speech perception. Post-CI vowel scores instead of monosyllable words have the more potential to predict the QoL in Mandarin-speaking adult CI recipients.
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Affiliation(s)
| | - Po-Kai Huang
- Department of Otolaryngology and Head Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan
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3
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Gundogdu O, Serbetcioglu MB, Kara E, Eser BN. Effects of Cognitive Functions on Speech Recognition in Noise in Cochlear Implant Recipients. ORL J Otorhinolaryngol Relat Spec 2023; 85:208-214. [PMID: 37331341 DOI: 10.1159/000530233] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/08/2023] [Indexed: 06/20/2023]
Abstract
INTRODUCTION There are substantial differences in speech recognition performance of adult cochlear implant (CI) recipients. This study investigated the effects of cognitive function on speech recognition in CI recipients. METHODS The verbal working memory of 36 adults with unilateral CIs was tested using digit span tests. Attention and inhibition abilities were assessed by using the Stroop test (both congruent and incongruent tasks). Speech recognition in noise was measured using the Turkish matrix test. RESULTS A moderate negative correlation was observed between the critical signal-to-noise ratio obtained via speech recognition in noise test and the digit span test scores (backward and digit span total scores). There was no correlation between Stroop test scores and speech recognition in noise in CI recipients. CONCLUSION The findings indicated that verbal working memory correlated well with speech recognition outcomes in adult CI recipients and that higher working memory capacity led to better speech recognition performance in noise.
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Affiliation(s)
- Oğulcan Gundogdu
- Department of Audiology, Graduate School of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | | | - Eyyup Kara
- Department of Audiology, Faculty Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Busra Nur Eser
- Department of Audiology, Graduate School of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
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4
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Jaiswal AS, Kumar R, Kumar R, Kairo AK, Raveendran S, Sagar P. Cochlear Implantation in Adults with Post-lingual Hearing Loss: Clinico-Demographical Study and Outcomes in the Current Times. Indian J Otolaryngol Head Neck Surg 2023; 75:548-551. [PMID: 37200896 PMCID: PMC10016170 DOI: 10.1007/s12070-022-03467-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/31/2022] [Indexed: 03/17/2023] Open
Abstract
To describe clinico-demographical profile for post-lingual hearing loss in the adults undergoing cochlear implantation and their outcomes. A retrospective chart review was conducted including adult patients (> 18 years) with bilateral post-lingual severe to profound hearing loss who underwent cochlear implantation in a tertiary care hospital of north India. The clinico-demographical details were collected and the outcomes of the procedure were assessed in terms of speech intelligibility scores, usage and satisfaction scores. Twenty-one patients were included with a mean age of 38.6 years with 15 males and 6 females. The major cause of deafness was infections followed by ototoxicity. The complication rate was 4.8%. Preoperative SDS was not recordable in any of the patients. The mean postoperative SDS was 74%, with no issue of device malfunction in a mean follow-up of 44 months. Cochlear implantation is a safe surgery with good outcomes in post-lingually deafened adults with the major cause for deafness being infections.
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Affiliation(s)
- Avinash Shekhar Jaiswal
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Rajeev Kumar
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Rakesh Kumar
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Arvind Kumar Kairo
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Sarath Raveendran
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Prem Sagar
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
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5
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Nix E, Willgruber A, Rawls C, Kinealy BP, Zeitler D, Schuh M, Bush M. Readability and Quality of English and Spanish Online Health Information about Cochlear Implants. Otol Neurotol 2023; 44:223-228. [PMID: 36728625 PMCID: PMC9928885 DOI: 10.1097/mao.0000000000003791] [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: 02/03/2023]
Abstract
OBJECTIVE According to the American Medical Association, Internet web site health information should be written at or below a 6th grade reading level. The purpose of this study was to evaluate the readability and quality of cochlear implant web site health information. STUDY DESIGN Cross-sectional web site analysis. SETTING Four Internet search engines involving the top 200 web sites (English and Spanish). INTERVENTION/METHODS "Cochlear implant" was queried in four Internet search engines, and the top 200 English and Spanish web sites were aggregated. After removing duplicates, the web sites were evaluated for readability by using the following validated online readability calculators: Flesch Reading Ease score for English web sites and the Fernandez-Huerta Formula for Spanish web sites. Information quality was assessed using the validated DISCERN quality criteria and the presence of Health on the Net Code of Conduct (HONcode) certification. RESULTS A total of 80 non-industry-sponsored (43 English and 37 Spanish) and 11 industry-sponsored (4 English and 7 Spanish) cochlear implant health information web sites were included in the study. English web sites were written at a higher reading level (mean = 50.88, SD = 11.98) compared with Spanish web sites (mean = 59.79, SD = 6.04) ( p < 0.01). For both English and Spanish web sites, these scores correlate to the reading level of the average 10th to 12th grade student. Only 12% of Spanish web sites and 27% of English web sites were HONcode certified. The average DISCERN quality score was 41.67 for English web sites and 43.46 for Spanish, indicating significant concerns for quality. There was no association found between readability and quality of the web sites analyzed. CONCLUSIONS Patient-directed English and Spanish web sites regarding cochlear implantation were written at reading levels that significantly exceed those recommended by the AMA. Furthermore, these web sites have significant quality shortcomings. Patients would benefit from more rigorous editing to improve readability and quality of content.
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Affiliation(s)
- Evan Nix
- Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, KY
| | | | - Chase Rawls
- College of Medicine, University of Kentucky, Lexington, KY
| | - Brian P Kinealy
- Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, KY
| | - Daniel Zeitler
- Department of Otolaryngology-Head and Neck Surgery, Virginia Mason Medical Center, Seattle, WA
| | - Marissa Schuh
- Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, KY
| | - Matthew Bush
- Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, KY
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Schoo DP, Ayiotis AI, Brillet CF, Chow MR, Lane KE, Ward BK, Carey JP, Santina CCD. Vestibular Implantation Can Work Even After More Than 20 Years of Bilateral Vestibular Hypofunction. Otol Neurotol 2023; 44:168-171. [PMID: 36624598 PMCID: PMC9851668 DOI: 10.1097/mao.0000000000003768] [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: 01/11/2023]
Abstract
OBJECTIVE To determine whether prosthetic stimulation delivered via a vestibular implant can elicit artificial sensation of head movement despite long (23-yr) duration adult-onset ototoxic bilateral vestibular hypofunction (BVH). STUDY DESIGN Case report. SETTING Tertiary care center as part of a first-in-human clinical trial. PATIENTS One. INTERVENTIONS Unilateral vestibular implantation with an investigational multichannel vestibular implant in a 55-year-old man with a well-documented 23-year history of aminoglycoside-induced BVH. MAIN OUTCOME MEASURES Electrically evoked vestibulo-ocular reflexes (eeVOR). RESULTS Vestibular implant stimulation can drive stimulus-aligned eeVOR and elicit a vestibular percept 23 years after the onset of bilateral vestibulopathy. Prosthetic stimulation targeting individual semicircular canals elicited eye movements that approximately aligned with each targeted canal's axis. The magnitude of the eeVOR response increased with increasing stimulus current amplitude. Response alignment and magnitude were similar to those observed for implant recipients who underwent vestibular implantation less than 10 years after BVH onset. Responses were approximately stable for 18 months of continuous device use (24 h/d except during sleep). CONCLUSIONS Vestibular implantation and prosthetic electrical stimulation of semicircular canal afferent nerves can drive canal-specific eye movement responses more than 20 years after the onset of ototoxic vestibular hypofunction.
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Affiliation(s)
- Desi P. Schoo
- Johns Hopkins University School of Medicine, Department of Otolaryngology-Head and Neck Surgery
| | - Andrianna I. Ayiotis
- Johns Hopkins University School of Medicine, Department of Biomedical Engineering
| | | | - Margaret R. Chow
- Johns Hopkins University School of Medicine, Department of Biomedical Engineering
- Labyrinth Devices, LLC, Baltimore, Maryland, USA
| | - Kelly E. Lane
- Johns Hopkins University School of Medicine, Department of Biomedical Engineering
| | - Bryan K. Ward
- Johns Hopkins University School of Medicine, Department of Otolaryngology-Head and Neck Surgery
| | - John P. Carey
- Johns Hopkins University School of Medicine, Department of Otolaryngology-Head and Neck Surgery
| | - Charles C. Della Santina
- Johns Hopkins University School of Medicine, Department of Otolaryngology-Head and Neck Surgery
- Johns Hopkins University School of Medicine, Department of Biomedical Engineering
- Labyrinth Devices, LLC, Baltimore, Maryland, USA
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7
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Cochlear Implantation in Advanced Otosclerosis: Pitfalls and Successes. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-021-00383-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Purpose of Review
This review will highlight recent outcome-based evidence guiding decision making for cochlear implantation in advanced otosclerosis, related complications, and technical surgical considerations in otosclerosis and the obstructed cochlea.
Recent Findings
Cochlear implantation in advanced otosclerosis results in consistent, excellent auditory outcomes with improvement in both objective speech recognition scores and subjective quality of life measures. Facial nerve stimulation may occur at higher rates in otosclerosis cochlear implant recipients. Cochlear implantation in the setting of luminal obstruction in osteosclerotic patients may be managed with altered surgical technique to achieve successful auditory improvements. Pre-operative imaging with high resolution CT or MRI may help anticipate intraoperative challenges and post-operative complications in cochlear implantation.
Summary
Cochlear implantation is an established, successful treatment for profound hearing loss in advanced otosclerosis. Surgeon knowledge of outcomes, complications, and potential surgical challenges is important to appropriately counsel patients regarding auditory rehabilitation options in advanced otosclerosis.
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8
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Alnıaçık A, Çakmak E, Öz O. Cross-cultural adaptation of the Nijmegen cochlear implant questionnaire into Turkish language: validity, reliability and effects of demographic variables. Eur Arch Otorhinolaryngol 2021; 279:2175-2182. [PMID: 34837517 PMCID: PMC8627160 DOI: 10.1007/s00405-021-07191-9] [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: 08/17/2021] [Accepted: 11/15/2021] [Indexed: 11/12/2022]
Abstract
Purpose The purpose of this study was to evaluate the validity and reliability of the Turkish version of the Nijmegen Cochlear Implant Questionnaire (Tr-NCIQ) and reveal the demographic factors contributing to the outcomes. Methods A group of 118 cochlear implant users aged between 18 and 70 years filled the Tr-NCIQ and the Turkish Hearing Handicapped Inventory for Adults (the Tr-HHI-Adult) via electronic survey. Cross-cultural adaptation of the Tr-NCIQ was performed. The reliability and validity of the questionnaire were evaluated utilizing internal consistency coefficient, split-half method, and predictive validity. Results The overall Cronbach’s alpha coefficient of the scale was 0.91, and the Spearman-Brown coefficient was 0.91. A moderately significant and negative correlation was present between the basic sound perception, speech production, self-esteem, activity, and social interactions subdomain scores and the HHI-Adult scores. Patients with post-lingual onset of hearing loss had significantly better results than those with pre-lingual onset, in the advanced sound perception subdomain. In addition, bilateral cochlear implant users had better results than the unilateral and bimodal users in the speech production subdomain and then the bimodal users in the self-esteem subdomain. There was no effect of age, duration of implant use, age at implantation, and the daily usage of cochlear implant (CI) on the quality-of-life outcomes. Conclusion The Tr-NCIQ is a reliable and valid tool to evaluate the subjective quality of life in CI users. In addition, as a standardized instrument, it can be easily self-administered both in clinical practice and for research purposes.
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Affiliation(s)
- Asuman Alnıaçık
- Department of Audiology, Faculty of Health Sciences, Başkent University, Bağlıca Campus, Eskişehir Road, 18. km, 06790, Ankara, Turkey.
| | - Eda Çakmak
- Department of Audiology, Faculty of Health Sciences, Başkent University, Bağlıca Campus, Eskişehir Road, 18. km, 06790, Ankara, Turkey
| | - Okan Öz
- The Eargroup, Antwerp, Belgium
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9
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Goudey B, Plant K, Kiral I, Jimeno-Yepes A, Swan A, Gambhir M, Büchner A, Kludt E, Eikelboom RH, Sucher C, Gifford RH, Rottier R, Anjomshoa H. A MultiCenter Analysis of Factors Associated with Hearing Outcome for 2,735 Adults with Cochlear Implants. Trends Hear 2021; 25:23312165211037525. [PMID: 34524944 PMCID: PMC8450683 DOI: 10.1177/23312165211037525] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
While the majority of cochlear implant recipients benefit from the device, it
remains difficult to estimate the degree of benefit for a specific patient prior
to implantation. Using data from 2,735 cochlear-implant recipients from across
three clinics, the largest retrospective study of cochlear-implant outcomes to
date, we investigate the association between 21 preoperative factors and speech
recognition approximately one year after implantation and explore the
consistency of their effects across the three constituent datasets. We provide
evidence of 17 statistically significant associations, in either univariate or
multivariate analysis, including confirmation of associations for several
predictive factors, which have only been examined in prior smaller studies.
Despite the large sample size, a multivariate analysis shows that the variance
explained by our models remains modest across the datasets (R2=0.12–0.21). Finally, we report a novel statistical interaction
indicating that the duration of deafness in the implanted ear has a stronger
impact on hearing outcome when considered relative to a candidate’s age. Our
multicenter study highlights several real-world complexities that impact the
clinical translation of predictive factors for cochlear implantation outcome. We
suggest several directions to overcome these challenges and further improve our
ability to model patient outcomes with increased accuracy.
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Affiliation(s)
- Benjamin Goudey
- 127113IBM Research Australia, Southbank, Victoria, Australia.,School of Computing and Information Systems, University of Melbourne, Parkville, Victoria, Australia
| | - Kerrie Plant
- 104148Cochlear Limited, Sydney, New South Wales, Australia
| | - Isabell Kiral
- 127113IBM Research Australia, Southbank, Victoria, Australia
| | | | - Annalisa Swan
- 127113IBM Research Australia, Southbank, Victoria, Australia
| | - Manoj Gambhir
- 127113IBM Research Australia, Southbank, Victoria, Australia
| | - Andreas Büchner
- 9177Medizinische Hochschule Hannover, Hannover, Niedersachsen, Germany
| | - Eugen Kludt
- 9177Medizinische Hochschule Hannover, Hannover, Niedersachsen, Germany
| | - Robert H Eikelboom
- 104182Ear Science Institute Australia, Subiaco, Western Australia, Australia.,Ear Sciences Centre, The University of Western Australia, Nedlands, Western Australia, Australia.,Department of Speech Language Pathology and Audiology, University of Pretoria, South Africa
| | - Cathy Sucher
- 104182Ear Science Institute Australia, Subiaco, Western Australia, Australia.,Ear Sciences Centre, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Rene H Gifford
- Department of Hearing and Speech Sciences, 12328Vanderbilt University Medical Center, Nashville, TN, USA
| | - Riaan Rottier
- 104148Cochlear Limited, Sydney, New South Wales, Australia
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10
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Hammond-Kenny A, Borsetto D, Manjaly JG, Panova T, Vijendren A, Bance M, Tysome JR, Axon PR, Donnelly NP. Cochlear Implantation in Elderly Patients: Survival Duration, Hearing Outcomes, Complication Rates, and Cost Utility. Audiol Neurootol 2021; 27:156-165. [PMID: 34419952 DOI: 10.1159/000517315] [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: 11/23/2020] [Accepted: 05/19/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The prevalence of hearing loss and its consequences is increasing as the elderly population grows. As the guidelines for cochlear implantation (CI) expand, the number of elderly CI recipients is also increasing. We report complication rates, survival duration, and audiological outcomes for CI recipients aged 80 years and over and discuss the cost utility of CI in this age group. METHODS A retrospective cohort study was undertaken of all CI recipients (126 cases), aged 80 years and over at the time of their surgery, implanted at our institution (Cambridge University Hospitals) during a period from January 1, 2001, to March 31, 2019. Data on survival at 1, 3, and 5 years post-implantation, post-operative complications and functional hearing outcomes including audiometric and speech discrimination outcomes (Bamford-Kowal-Bench sentence test) have been reported. RESULTS The mean age at implantation was 84 years. The mean audiometric score improved from 108 dB HL to 28 dB HL post-implantation. The mean Bamford-Kowal-Bench score improved from 14% to 66% and 73% at 2 and 12 months post-implantation, respectively. The complication rate was 15.3%. The survival probability at 1 year post-implantation was 0.95 for females and 0.93 for males, at 3 years was 0.89 for females and 0.81 for males, and at 5 years was 0.74 for females and 0.54 for males. CONCLUSION CI is safe and well-tolerated in this age group and elderly patients gain similar audiometric and functional benefit as found for younger age groups.
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Affiliation(s)
- Amy Hammond-Kenny
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Daniele Borsetto
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Joseph G Manjaly
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Tsvetemira Panova
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Ananth Vijendren
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Manohar Bance
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - James R Tysome
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Patrick R Axon
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Neil P Donnelly
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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11
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Liu R, Wang Q, Jiao Q, Ji F, Zhao H, Li J, Yang S. Factors influencing rehabilitation effect in prelingually deafened late implanted cochlear implant users, and the construction of a nomogram. Clin Otolaryngol 2021; 47:61-66. [PMID: 34387028 DOI: 10.1111/coa.13848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/23/2021] [Accepted: 07/31/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Our study aimed to identify potential factors that may influence rehabilitation outcomes in late-implanted adolescents and adults with prelingual deafness and to construct a user-friendly nomogram. DESIGN This cross-sectional study included 120 subjects under 30 years of age who had received cochlear implantation at a single medical center. The Categories of Auditory Performance (CAP) scale was used to evaluate the rehabilitation outcomes. A nomogram was constructed by using the R and EmpowerStats software. RESULTS Univariate analysis indicated higher rates of auditory performance improvement in younger aged subjects. Residual hearing and regular implant use were more frequently seen among subjects with auditory performance improvement. Multivariate analysis identified residual hearing (Hazard Ratio, 6.11; 95% Confidence Interval, 1.83-20.41; P<0.01), age group (Hazard Ratio, 0.31; 95% Confidence Interval, 0.14-0.83; P=0.02) and regular CI use (Hazard Ratio, 7.79; 95% Confidence Interval, 2.50-24.20; P<0.01) as independent predictors for auditory performance improvement. The nomogram's predictive performance was satisfactory as shown by the calibration curve and Receiver operating characteristic (ROC) curve. CONCLUSIONS Factors such as residual hearing, younger age, and regular CI use are associated with auditory performance improvement in this cochlear implant user population. The nomogram model also demonstrates a satisfactory predictive performance.
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Affiliation(s)
- Riyuan Liu
- Department of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.,China National Clinical Research Center for Otolaryngologic Diseases; Key Lab of Hearing Impairment Science of Ministry of Education, Beijing, China.,Key Lab of Hearing Impairment Prevention and Treatment of Beijing, China
| | - Qian Wang
- Department of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.,China National Clinical Research Center for Otolaryngologic Diseases; Key Lab of Hearing Impairment Science of Ministry of Education, Beijing, China.,Key Lab of Hearing Impairment Prevention and Treatment of Beijing, China
| | - Qingshan Jiao
- Department of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.,China National Clinical Research Center for Otolaryngologic Diseases; Key Lab of Hearing Impairment Science of Ministry of Education, Beijing, China.,Key Lab of Hearing Impairment Prevention and Treatment of Beijing, China
| | - Fei Ji
- Department of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.,China National Clinical Research Center for Otolaryngologic Diseases; Key Lab of Hearing Impairment Science of Ministry of Education, Beijing, China.,Key Lab of Hearing Impairment Prevention and Treatment of Beijing, China
| | - Hui Zhao
- Department of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.,China National Clinical Research Center for Otolaryngologic Diseases; Key Lab of Hearing Impairment Science of Ministry of Education, Beijing, China.,Key Lab of Hearing Impairment Prevention and Treatment of Beijing, China
| | - Jianan Li
- Department of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.,China National Clinical Research Center for Otolaryngologic Diseases; Key Lab of Hearing Impairment Science of Ministry of Education, Beijing, China.,Key Lab of Hearing Impairment Prevention and Treatment of Beijing, China
| | - Shiming Yang
- Department of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.,China National Clinical Research Center for Otolaryngologic Diseases; Key Lab of Hearing Impairment Science of Ministry of Education, Beijing, China.,Key Lab of Hearing Impairment Prevention and Treatment of Beijing, China
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Debruyne JA, Janssen AM, Brokx JPL. Systematic Review on Late Cochlear Implantation in Early-Deafened Adults and Adolescents: Clinical Effectiveness. Ear Hear 2021; 41:1417-1430. [PMID: 33136619 DOI: 10.1097/aud.0000000000000884] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Cochlear implantation in early-deafened patients, implanted as adolescents or adults, is not always advised due to poor expected outcomes. In order to judge whether such reluctance is justified, the current systematic review aimed to gather all available evidence on postoperative outcomes obtained by early-deafened patients using a state-of-the art cochlear implant (CI). DESIGN Five electronic databases (PubMed, Embase, the Cochrane library, CINAHL, and PsycInfo) were systematically searched for studies in English, French, German, or Dutch, published between 2000 and September 2017. Studies that reported pre- and postoperative outcomes on any measure of speech or sound perception, audiovisual or subjective benefit (quality of life) were included. Study quality was assessed with the Institute of Health Economics quality appraisal tool for case series studies. RESULTS The systematic search and subsequent full-text evaluation identified 38 studies meeting the inclusion criteria. Only a limited number of studies were judged to be of high quality according to the Institute of Health Economics tool, with lack of (clear) presentation of relevant study information being a recurring problem. Twenty-five studies presented viable outcomes on open-set speech understanding in quiet: mean postoperative scores obtained with CI remained below 50% for the vast majority of studies; significant postoperative improvements were found in 16 studies, although this number might have been higher if appropriate statistical testing had been performed in all studies. Eight studies observed increased audiovisual performance after implantation, which was statistically significant in six studies. A validated measure of hearing-related quality of life was used in only 5 of the 16 studies assessing subjective outcomes, showing significant postoperative improvements for most questionnaire domains. The relation between auditory and subjective outcomes was assessed in two studies, with contradictory results. CONCLUSIONS The current review showed that late cochlear implantation in early-deafened subjects resulted in significantly improved open-set speech perception, audiovisual speech perception, and (hearing-related) quality of life in the majority of the studies involved. Nonetheless, more and especially higher-quality research is needed in order to gain a more detailed understanding of the outcomes of cochlear implantation in this population.
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Affiliation(s)
- Joke A Debruyne
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - A Miranda Janssen
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jan P L Brokx
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
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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: 26] [Impact Index Per Article: 8.7] [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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14
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The Sensitivity of the Electrically Stimulated Auditory Nerve to Amplitude Modulation Cues Declines With Advanced Age. Ear Hear 2021; 42:1358-1372. [PMID: 33795616 DOI: 10.1097/aud.0000000000001035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to investigate effects of aging and duration of deafness on sensitivity of the auditory nerve (AN) to amplitude modulation (AM) cues delivered using trains of biphasic pulses in adult cochlear implant (CI) users. DESIGN There were 21 postlingually deaf adult CI users who participated in this study. All study participants used a Cochlear Nucleus device with a full electrode array insertion in the test ear. The stimulus was a 200-ms pulse train with a pulse rate of 2000 pulses per second. This carrier pulse train was sinusodially AM at four modulation rates (20, 40, 100, 200 Hz). The peak amplitude of the modulated pulse train was the maximum comfortable level (i.e., C level) measured for the carrier pulse train. The electrically evoked compound action potential (eCAP) to each of the 20 pulses selected over the last two AM cycles were measured. In addition, eCAPs to single pulses were measured with the probe levels corresponding to the levels of 20 selected pulses from each AM pulse train. There were seven electrodes across the array evaluated in 16 subjects (i.e., electrodes 3 or 4, 6, 9, 12, 15, 18, and 21). For the remaining five subjects, 4 to 5 electrodes were tested due to impedance issues or time constraints. The modulated response amplitude ratio (MRAR) was calculated as the ratio of the difference in the maximum and the minimum eCAP amplitude measured for the AM pulse train to that measured for the single pulse, and served as the dependent variable. Age at time of testing and duration of deafness measured/defined using three criteria served as the independent variables. Linear Mixed Models were used to assess the effects of age at testing and duration of deafness on the MRAR. RESULTS Age at testing had a strong, negative effect on the MRAR. For each subject, the duration of deafness varied substantially depending on how it was defined/measured, which demonstrates the difficulty of accurately measuring the duration of deafness in adult CI users. There was no clear or reliable trend showing a relationship between the MRAR measured at any AM rate and duration of deafness defined by any criteria. After controlling for the effect of age at testing, MRARs measured at 200 Hz and basal electrode locations (i.e., electrodes 3 and 6) were larger than those measured at any other AM rate and apical electrode locations (i.e., electrodes 18 and 21). CONCLUSIONS The AN sensitivity to AM cues implemented in the pulse-train stimulation significantly declines with advanced age. Accurately measuring duration of deafness in adult CI users is challenging, which, at least partially, might have accounted for the inconclusive findings in the relationship between the duration of deafness and the AN sensitivity to AM cues in this study.
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Zhao EE, Dornhoffer JR, Loftus C, Nguyen SA, Meyer TA, Dubno JR, McRackan TR. Association of Patient-Related Factors With Adult Cochlear Implant Speech Recognition Outcomes: A Meta-analysis. JAMA Otolaryngol Head Neck Surg 2021; 146:613-620. [PMID: 32407461 DOI: 10.1001/jamaoto.2020.0662] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Importance Multiple studies have evaluated associations between post-cochlear implant (CI) speech recognition outcomes and patient-related factors. Current literature often appears equivocal or contradictory, so little is known about the factors that contribute to successful speech recognition outcomes with CIs. Objective To use a meta-analysis to pool data from the extant literature and provide an objective summary of existing evidence on associations of patient-related factors and CI speech recognition outcomes. Data Sources A literature search was performed using PubMed, Scopus, and CINAHL databases in January 2019 using the following search terms: cochlear implant or cochlear implants or cochlear implantation and speech recognition or word recognition or sentence recognition. Studies of postlingually deafened adult CI recipients that reported word or sentence recognition scores were included. Study Selection Inclusion criteria were postlingual adult CI recipients 18 years or older with word or sentence recognition scores at minimum 6-month postimplantation. Studies that included patients undergoing revision or reimplantation surgery were excluded. Data Extraction and Synthesis Following the Preferred Reporting Items for Systemic Reviews and Meta-analyses (PRISMA) guidelines, 1809 unique articles underwent review by abstract, and 121 articles underwent full-text review, resulting in 13 articles of 1095 patients for a meta-analysis of correlations. Random-effects model was used when the heterogeneity test yielded a low P value (P < .05). Main Outcomes and Measures The planned primary outcome was the pooled correlation values between postimplant speech recognition scores and patient-related factors. Results Of the 1095 patients included from the 13 studies, the mean age at implantation ranged from 51.2 to 63.7 years and the mean duration of hearing loss ranged from 9.5 to 31.8 years; for the 825 patients for whom sex was reported, 421 (51.0%) were women. A weak negative correlation was observed between age at implantation and postimplant sentence recognition in quiet (r = -0.31 [95% CI, -0.41 to -0.20]). Other correlations between patient-related factors and postimplant word or sentence recognition were statistically significant, but all correlations were absent to negligible (r = 0.02-0.27). Conclusions and Relevance Given that most associations were weak, negligible, or absent, patient-related factors often thought to affect CI speech recognition ability offer limited assistance in clinical decision-making in cochlear implantation. Additional research is needed to identify patient-related and other factors that predict CI outcomes, including speech recognition and other important variables related to success with CIs.
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Affiliation(s)
- Elise E Zhao
- Medical University of South Carolina, Charleston
| | | | | | | | - Ted A Meyer
- Medical University of South Carolina, Charleston
| | - Judy R Dubno
- Medical University of South Carolina, Charleston
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16
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Sorrentino F, Gheller F, Lunardi G, Brotto D, Trevisi P, Martini A, Marioni G, Bovo R. Cochlear implantation in adults with auditory deprivation: What do we know about it? Am J Otolaryngol 2020; 41:102366. [PMID: 31837837 DOI: 10.1016/j.amjoto.2019.102366] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 12/02/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION In the ENT community, auditory deprivation is frequently considered as a negative prognostic factor for a good hearing outcome of cochlear implantation (CI), even if a growing literature suggests that this is not completely true. The purpose of this study is to evaluate the results of CI in patients with hearing deprivation, to compare them to results from non-deprived patients and then estimate how time of deprivation impacts on CI outcome and how a bilateral deprivation can affect the outcome compared to a unilateral deprivation. METHODS Seventy-eight adults with severe to profound post-verbal hearing loss, with and without auditory deprivation history, received CI; audiological results obtained at 3-6-12-24 months follow up post CI were analyzed. RESULTS No differences were founded between patients with unilateral deprivation and patients with no deprivation. Patients with bilateral deprivation seem to have a worse hearing outcome compared to that of those patients with unilateral deprivation or no deprivation at all. Long time deprivation (>15 years) seems to have a negative influence on the hearing outcome but results with CI remain excellent. CONCLUSIONS Auditory deprivation should not be considered a contraindication to CI. The duration of auditory deprivation in the implanted ear seems to be a negative prognostic factor only for ears deprived from more of 15 years.
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Affiliation(s)
- Flavia Sorrentino
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy.
| | - Flavia Gheller
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Giuseppe Lunardi
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Davide Brotto
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Patrizia Trevisi
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Alessandro Martini
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Gino Marioni
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
| | - Roberto Bovo
- Department of Neuroscience DNS, Section of Otolaryngology, Padova University Hospital, Padova, Italy
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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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Fuller C, Başkent D, Free R. Early Deafened, Late Implanted Cochlear Implant Users Appreciate Music More Than and Identify Music as Well as Postlingual Users. Front Neurosci 2019; 13:1050. [PMID: 31680802 PMCID: PMC6798179 DOI: 10.3389/fnins.2019.01050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/19/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Typical cochlear implant (CI) users, namely postlingually deafened and implanted, report to not enjoy listening to music, and find it difficult to perceive music. Another group of CI users, the early-deafened (during language acquisition) and late-implanted (after a long period of auditory deprivation; EDLI), report a higher music appreciation, but is this related to a better music perception? Materials and Methods: Sixteen EDLI and fifteen postlingually deafened (control group) CI users participated in the study. The inclusion criteria for EDLI were: severe or profound hearing loss onset before the age of 6 years, implantation after the age of 16 years, and CI experience more than 1 year. Subjectively, music perception and appreciation was evaluated using the Dutch Musical Background Questionnaire. Behaviorally, music perception was measured with melodic contour identification (MCI), using two instruments (piano and organ), each tested with and without a masking contour. Semitone distance between successive tones of the target varied from 1 to 3 semitones. Results: Subjectively, the EDLI group reported to appreciate music more than postlingually deafened CI users. Behaviorally, while clinical phoneme recognition test score on average was lower in the EDLI group, melodic contour identification did not significantly differ between the two groups. There was, however, an effect of instrument and masker for both groups; the piano was the best-recognized instrument, and for both instruments, the masker with non-overlapping pitch was best recognized. Discussion: EDLI group reported higher appreciation of music than postlingual control group, even though behaviorally measured music perception did not differ significantly between the two groups. Both surprising findings since EDLI CI users would be expected to have lower outcomes based on the early deafness onset, long duration of auditory deprivation, and on average lower clinical speech scores. Perhaps, the music perception difficulty comes from similar electric hearing limitations in both groups. The higher subjective appreciation in EDLI might be due to the lack of a musical memory, with no ability to compare music heard via the CI to acoustic music perception. Overall, our findings support a benefit from implantation for a positive music experience in EDLI CI users.
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Affiliation(s)
- Christina Fuller
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Research School of Behavioral and Cognitive Neurosciences, Graduate School of Medical Sciences, University of Groningen, Groningen, Netherlands.,Department of Otorhinolaryngology, Treant Zorggroep, Emmen, Netherlands
| | - Deniz Başkent
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Research School of Behavioral and Cognitive Neurosciences, Graduate School of Medical Sciences, University of Groningen, Groningen, Netherlands
| | - Rolien Free
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Research School of Behavioral and Cognitive Neurosciences, Graduate School of Medical Sciences, University of Groningen, Groningen, Netherlands
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Kurz A, Grubenbecher M, Rak K, Hagen R, Kühn H. The impact of etiology and duration of deafness on speech perception outcomes in SSD patients. Eur Arch Otorhinolaryngol 2019; 276:3317-3325. [PMID: 31535291 DOI: 10.1007/s00405-019-05644-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/10/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate a cohort of adult single-sided deafness (SSD) patients who received a cochlear implant and to determine the impact of underlying causes of etiology and duration of deafness on outcome STUDY DESIGN: Retrospective data analysis SETTING: Tertiary referral centre with a large cochlear implant program SUBJECTS AND METHODS: A demographic description of 55 adult patients implanted between 2009 and 2016. The best available speech perception score in every patient using the Freiburg Numbers, Freiburg Monosyllables and the Hochmair-Schulz-Moser (HSM) sentence test measured at the 1-, 3-, 6- and 12-month intervals, and the yearly follow-up appointments were examined. A multivariate regression analysis was conducted on the variables speech test, duration of deafness and etiology. Patients were split into four groups according to their duration of deafness (shorter duration of 10 years or less versus longer duration of more than 10 years) and etiology (inflammatory disease versus other causes). RESULTS The median word reception score for the Monosyllables at 65 dB SPL were 43.75% (IQR: 29.38) and 67.50% (IQR: 25.63) at 80 dB SPL at 1 year following cochlear implantation. The median percentage score correct for the HSM sentence test was 80% (IQR: 62.95). Etiology of the reviewed patient cohort revealed that most frequent causes for deafness were sudden hearing losses and inflammatory etiologies, e.g. otitis media, labyrinthitis, meningitis, cholesteatoma or mumps. The duration of deafness was not significantly associated with poor speech perception outcome. A significant correlation was found for inflammatory diseases and duration of deafness of longer than 10 years. CONCLUSION The etiology and duration of deafness are important factors for the estimated outcome in speech perception in SSD patients. Presented data reveal that an inflammatory disease leading to deafness in combination with a long duration of deafness (10 + years) lead to poorer speech perception outcomes.
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Affiliation(s)
- Anja Kurz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital Würzburg, Josef Schneider Str. 11, 97080, Würzburg, Germany.
| | - Marius Grubenbecher
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital Würzburg, Josef Schneider Str. 11, 97080, Würzburg, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital Würzburg, Josef Schneider Str. 11, 97080, Würzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital Würzburg, Josef Schneider Str. 11, 97080, Würzburg, Germany
| | - Heike Kühn
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital Würzburg, Josef Schneider Str. 11, 97080, Würzburg, Germany
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Favaretto N, Marioni G, Brotto D, Sorrentino F, Gheller F, Castiglione A, Montino S, Giacomelli L, Trevisi P, Martini A, Bovo R. Cochlear implant outcomes in the elderly: a uni- and multivariate analyses of prognostic factors. Eur Arch Otorhinolaryngol 2019; 276:3089-3094. [DOI: 10.1007/s00405-019-05613-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/21/2019] [Indexed: 12/01/2022]
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21
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Chronic Deafness Degrades Temporal Acuity in the Electrically Stimulated Auditory Pathway. J Assoc Res Otolaryngol 2018; 19:541-557. [PMID: 29968099 PMCID: PMC6226412 DOI: 10.1007/s10162-018-0679-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 05/29/2018] [Indexed: 11/28/2022] Open
Abstract
Electrical stimulation of the auditory nerve with a penetrating intraneural (IN) electrode in acutely deafened cats produces much more restricted spread of excitation than is obtained in that preparation with a conventional cochlear implant (CI) as reported by Middlebrooks and Snyder (J Assoc Res Otolaryngol 8:258–279, 2007). That suggests that a future auditory prosthesis employing IN stimulation might offer human patients greater frequency selectivity than is available with a present-day CI. Nevertheless, it is a concern that the electrical field produced by an IN electrode might be too restricted to produce adequate stimulation of the partially depopulated auditory nerve of a deaf patient. We evaluated this by testing responses to IN and CI stimulation in adult-deafened cats. Activation of the auditory pathway was monitored by recording from the central nucleus of the inferior colliculus (ICC). Cats deaf for 153–277 days exhibited a ~ 30 % loss of auditory nerve fibers compared to cats deaf for < 18 h. Contrary to our concern, measures of thresholds and dynamic ranges showed no significant deafness-related impairment of excitation by IN or CN stimulation. Surprisingly, however, temporal acuity decreased dramatically in these adult-deafened cats, as demonstrated by a marked decrease in the maximum rate of electrical cochlear stimulation to which ICC neurons synchronized to IN or CI stimulation. For instance, half of ICC neurons synchronized to IN stimulation up to 203 pulses per second (pps) in acute deafness, whereas that number dropped to 79 pps for chronic deafness. Such a loss of temporal acuity might contribute to the poor sensitivity to temporal fine structure that has been reported in human CI users. Seemingly, the degraded temporal acuity that we observed in cats was even worse than the fine-structure sensitivity of human CI users, suggesting that most patients experience some improvement of temporal acuity resulting from restoration of patterned auditory nerve stimulation by a CI.
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