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Silva AL, Stumpf IMDS, Lacroix LP, Alves DMF, Silveira ALD, Costa SSD, Rosito LPS. Language development in children from a public cochlear implant program. Braz J Otorhinolaryngol 2024; 90:101458. [PMID: 39032465 PMCID: PMC11315129 DOI: 10.1016/j.bjorl.2024.101458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 05/16/2024] [Accepted: 06/03/2024] [Indexed: 07/23/2024] Open
Abstract
OBJECTIVE To evaluate the rate of loss to follow-up in a cochlear implant program from the public health system in Southern Brazil as well as the characteristics of hearing loss, sociodemographic, sociocultural and the development of oral language in children with prelingual deafness. METHODS Retrospective cohort study with children who underwent CI surgery between 2010 and 2020. Data was collected through of interviews and review of medical records. The language development assessment was performed using the MUSS, MAIS and IT-MAIS scales. For the classification of language development, we used as parameters the values (mean ± SD) found in a previous national study. From those values, the Z-score for each patient at each hearing age (time of experience with the cochlear implant) was calculated. RESULTS Of the 225 children implanted between 2010-2020, 129 were included in this study. The rate of loss to follow-up in the program was 42.6%. The mean age at first surgery was 40.5 (±16.9) months, with 77.5% of patients having received a unilateral implant. Language results below the expected for hearing age ( CONCLUSIONS Most patients had an elevated mean age at cochlear implantation and there was a high rate of loss to follow-up and low attendance to speech and programming sessions. An overall poor language performance was found for this pediatric cochlear implant program from the public health system in Southern Brazil. LEVEL OF EVIDENCE Level 3 (Non-randomized cohort study).
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Affiliation(s)
- Alice Lang Silva
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.
| | | | - Laura Prolla Lacroix
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Porto Alegre, RS, Brazil
| | | | | | - Sady Selaimen da Costa
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Serviço de Otorrinolaringologia, Porto Alegre, RS, Brazil
| | - Letícia Petersen Schmidt Rosito
- Hospital de Clínicas de Porto Alegre (HCPA), Serviço de Otorrinolaringologia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Porto Alegre, RS, Brazil
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Moon PK, Ward KM, Din TF, Saki S, Cheng AG, Yeom KW, Ahmad IN. Microstructural Changes in the Brainstem Auditory Pathway in Children With Hearing Loss. Otol Neurotol 2024; 45:e170-e176. [PMID: 38361295 PMCID: PMC10919892 DOI: 10.1097/mao.0000000000004129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To assess the utility of diffusion tensor imaging of the auditory pathway in children with sensorineural hearing loss (SNHL). STUDY DESIGN Retrospective cohort study. SETTING A single academic tertiary children's hospital. PATIENTS Sixteen pediatric patients with bilateral SNHL of at least moderate severity in the poorer ear (eight male; mean age, 5.3 ± 4.9 yrs). Controls consisted of age- and sex-matched children with normal hearing who were imaged for nonotologic, non-neurologic medical concerns and found to have normal magnetic resonance imaging (MRI). INTERVENTIONS Three Tesla MRI scanners were used for diffusion tensor imaging. MAIN OUTCOME MEASURES Quantitative diffusion tensor metrics were extracted from the superior olivary nucleus (SON), inferior colliculus (IC), and ipsilateral fiber tracts between the SON and IC delineated by tractography. RESULTS We identified differences in fractional anisotropy of the SON between the SNHL cohort and controls (0.377 ± 0.056 vs. 0.422 ± 0.052; p = 0.009), but not in the IC. There were no differences in the mean diffusivity (MD) values in the IC and SON. Among younger children (≤5 yrs), MD was decreased in the SNHL cohort compared with controls in the IC (0.918 ± 0.051 vs. 1.120 ± 0.142; p < 0.001). However, among older children (>5 yrs), there were no differences in MD (1.124 ± 0.198 vs. 0.997 ± 0.103; p = 0.119). There were no differences in MD or fractional anisotropy in the white matter fibers of the IC-SON tract. CONCLUSIONS Our results suggest abnormal neural tracts along the central auditory pathway among children with SNHL. Longitudinal studies should assess the prognostic value of these MRI-based findings for assessing long-term outcomes and determining intervention efficacy.
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Affiliation(s)
- Peter K. Moon
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Kristina M. Ward
- Pediatric Audiology, Lucile Packard Children’s Hospital, Stanford, CA 94305, USA
| | - Taseer F. Din
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Sara Saki
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Alan G. Cheng
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Kristen W. Yeom
- Department of Radiology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Iram N. Ahmad
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
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Gomez MVSG. When May Cochlear Implant Not Work Even at a Very Young Age? Int Arch Otorhinolaryngol 2023; 27:e179-e182. [PMID: 37125357 PMCID: PMC10147465 DOI: 10.1055/s-0043-1768155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Affiliation(s)
- Maria Valéria Schmidt Goffi Gomez
- Division of Otorhinolaryngology Clinic, Speech Therapy Team of the Cochlear Implant Group, Hospital das Clínicas of the University of São Paulo (HCFMUSP), São Paulo, Brazil
- Department of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, University of São Paulo (FMUSP), São Paulo, Brazil
- Address for correspondence Maria Valéria Schmidt Goffi Gomez, PhD Departamento de Otorrinolaringologia, Faculdade de Medicina, Universidade de São PauloAv. Dr. Enéas de Carvalho Aguiar, 255, 6° Andar, São Paulo, SP, 05403-000Brazil
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李 果, 刘 莉, 杨 婷, 郎 春, 马 秀, 赵 丽, 唐 贤, 王 翔, 张 铁, 马 静. [Evaluation of hearing and speech rehabilitation after cochlear implantation in children with Waardenburg syndrome]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:347-352. [PMID: 35483684 PMCID: PMC10128261 DOI: 10.13201/j.issn.2096-7993.2022.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Indexed: 06/14/2023]
Abstract
Objective:By comparing the hearing and speech rehabilitation effects of cochlear implantation (CI) in children with Waardenburg syndrome (WS) and children with common deafness genes (SLC26A4, GJB2) in the Chinese population, and the hearing and speech rehabilitation effects of bilateral CI and unilateral CI in children with WS, to provide a reference for clinical CIin children with WS. Methods:Follow up and return visit 72 pedestrian cochlear implant children with severe and above sensorineural hearing loss and clear gene mutation type diagnosed by Kunming Children's Hospital from 2017 to 2019, including 24 cases in the WS group, 24 cases in the control group (SLC26A4 deafness group and GJB2 deafness group). All enrolled children were evaluated for auditory and speech ability 12 months after startup. Results:The hearing aid threshold, the correct recognition rate of speech recognition ability evaluation, IT-MAIS / MAIS score rate, CAP score, SIR score, there was no significant difference(P>0.05). The correct recognition rates of IT-MAIS / MAIS score, SIR score, natural environment sound recognition, vowel recognition, tone recognition, monosyllabic word recognition, disyllabic word recognition and short sentence recognition in children with WS bilateral CI were significantly higher than those in children with WS unilateral CI (P<0.05). There was no significant difference in CAP score, initial recognition and correct recognition rate of trisyllabic words between children with WS bilateral CI and children with WS unilateral CI (P>0.05). Conclusion:Common deafness genes in children with WS and Chinese population (SLC26A4, GJB2) the effect of cochlear implantation on hearing and speech rehabilitation of sick children is equivalent. For children with severe and above sensorineural hearing loss associated with this syndrome, CI can be used clinically to improve their hearing and speech ability. WS bilateral CI has advantages in some hearing and speech abilities compared with unilateral CI, so those whomeet the conditions should be encouraged bilateral implantation.
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Affiliation(s)
- 果 李
- 昆明市儿童医院(云南省儿童医学中心,昆明医科大学附属儿童医院)耳鼻咽喉头颈外科(昆明,650100)Department of Otolaryngology Head and Neck Surgery, Kunming Children's Hospital[Yunnan Children's Medical Center, Children's Hospital Affiliated to Kunming Medical University], Kunming, 650100, China
| | - 莉 刘
- 丽江市特殊教育学校资源中心Lijiang Special Education School Resource Center
| | - 婷 杨
- 昆明市儿童医院(云南省儿童医学中心,昆明医科大学附属儿童医院)感染一科Department of Infection, Kunming Children's Hospital[Yunnan Children's Medical Center, Children's Hospital Affiliated to Kunming Medical University]
| | - 春梅 郎
- 昆明市儿童医院(云南省儿童医学中心,昆明医科大学附属儿童医院)耳鼻咽喉头颈外科(昆明,650100)Department of Otolaryngology Head and Neck Surgery, Kunming Children's Hospital[Yunnan Children's Medical Center, Children's Hospital Affiliated to Kunming Medical University], Kunming, 650100, China
| | - 秀丽 马
- 昆明市儿童医院(云南省儿童医学中心,昆明医科大学附属儿童医院)耳鼻咽喉头颈外科(昆明,650100)Department of Otolaryngology Head and Neck Surgery, Kunming Children's Hospital[Yunnan Children's Medical Center, Children's Hospital Affiliated to Kunming Medical University], Kunming, 650100, China
| | - 丽萍 赵
- 昆明市儿童医院(云南省儿童医学中心,昆明医科大学附属儿童医院)耳鼻咽喉头颈外科(昆明,650100)Department of Otolaryngology Head and Neck Surgery, Kunming Children's Hospital[Yunnan Children's Medical Center, Children's Hospital Affiliated to Kunming Medical University], Kunming, 650100, China
| | - 贤超 唐
- 昆明市儿童医院(云南省儿童医学中心,昆明医科大学附属儿童医院)放射科Department of Radiology, Kunming Children's Hospital[Yunnan Children's Medical Center, Children's Hospital Affiliated to Kunming Medical University]
| | - 翔 王
- 上海交通大学附属上海儿童医学中心耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University
| | - 铁松 张
- 昆明市儿童医院(云南省儿童医学中心,昆明医科大学附属儿童医院)耳鼻咽喉头颈外科(昆明,650100)Department of Otolaryngology Head and Neck Surgery, Kunming Children's Hospital[Yunnan Children's Medical Center, Children's Hospital Affiliated to Kunming Medical University], Kunming, 650100, China
| | - 静 马
- 昆明市儿童医院(云南省儿童医学中心,昆明医科大学附属儿童医院)耳鼻咽喉头颈外科(昆明,650100)Department of Otolaryngology Head and Neck Surgery, Kunming Children's Hospital[Yunnan Children's Medical Center, Children's Hospital Affiliated to Kunming Medical University], Kunming, 650100, China
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Purcell PL, Deep NL, Waltzman SB, Roland JT, Cushing SL, Papsin BC, Gordon KA. Cochlear Implantation in Infants: Why and How. Trends Hear 2021; 25:23312165211031751. [PMID: 34281434 PMCID: PMC8295935 DOI: 10.1177/23312165211031751] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 04/22/2021] [Accepted: 06/23/2021] [Indexed: 11/25/2022] Open
Abstract
In children with congenital deafness, cochlear implantation (CI) prior to 12 months of age offers the opportunity to foster more typical auditory development during late infancy and early childhood. Recent studies have found a positive association between early implantation and expressive and receptive language outcomes, with some children able to achieve normal language skills by the time of school entry. Universal newborn hearing screening improved early detection and diagnosis of congenital hearing loss, allowing for earlier intervention, including decision-making regarding cochlear implant (CI) candidacy. It can be more challenging to confirm CI candidacy in infants; therefore, a multidisciplinary approach, including objective audiometric testing, is recommended to not only confirm the diagnosis but also to counsel families regarding expectations and long-term management. Surgeons performing CI surgery in young children should consider both the anesthetic risks of surgery in infancy and the ways in which mastoid anatomy may differ between infants and older children or adults. Multiple studies have found CI surgery in infants can be performed safely and effectively. This article reviews current evidence regarding indications for implantation in children younger than 12 months of age and discusses perioperative considerations and surgical technique.
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Affiliation(s)
- Patricia L. Purcell
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nicholas L. Deep
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - Susan B. Waltzman
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - J. Thomas Roland
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - Sharon L. Cushing
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Blake C. Papsin
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen A. Gordon
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
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Abstract
INTRODUCTION Cochlear implants (CIs) are biomedical devices that restore sound perception for people with severe-to-profound sensorineural hearing loss. Most postlingually deafened CI users are able to achieve excellent speech recognition in quiet environments. However, current CI sound processors remain limited in their ability to deliver fine spectrotemporal information, making it difficult for CI users to perceive complex sounds. Limited access to complex acoustic cues such as music, environmental sounds, lexical tones, and voice emotion may have significant ramifications on quality of life, social development, and community interactions. AREAS COVERED The purpose of this review article is to summarize the literature on CIs and music perception, with an emphasis on music training in pediatric CI recipients. The findings have implications on our understanding of noninvasive, accessible methods for improving auditory processing and may help advance our ability to improve sound quality and performance for implantees. EXPERT OPINION Music training, particularly in the pediatric population, may be able to continue to enhance auditory processing even after performance plateaus. The effects of these training programs appear generalizable to non-trained musical tasks, speech prosody and, emotion perception. Future studies should employ rigorous control groups involving a non-musical acoustic intervention, standardized auditory stimuli, and the provision of feedback.
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Affiliation(s)
- Nicole T Jiam
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco School of Medicine , San Francisco, CA, USA
| | - Charles Limb
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco School of Medicine , San Francisco, CA, USA
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Noble AR, Christianson E, Norton SJ, Ou HC, Phillips GS, Khalatbari H, Friedman SD, Horn DL. Reliability of Measuring Insertion Depth in Cochlear Implanted Infants and Children Using Cochlear View Radiography. Otolaryngol Head Neck Surg 2020; 163:822-828. [PMID: 32450736 DOI: 10.1177/0194599820921857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Cochlear implant depth of insertion affects audiologic outcomes and can be measured in adults using plain films obtained in the "cochlear view." The objective of this study was to assess interrater and intrarater reliability of measuring depth of insertion using cochlear view radiography. STUDY DESIGN Prospective, observational. SETTING Tertiary referral pediatric hospital. SUBJECTS AND METHODS Patients aged 11 months to 20 years (median, 4 years; interquartile range [IQR], 1-8 years) undergoing cochlear implantation at our institution were studied over 1 year. Children underwent cochlear view imaging on postoperative day 1. Films were deidentified and 1 image per ear was selected. Two cochlear implant surgeons and 2 radiologists evaluated each image and determined angular depth of insertion. Images were re-reviewed 6 weeks later by all raters. Inter- and intrarater reliability were calculated with intraclass correlation coefficients (ICCs). RESULTS Fifty-seven ears were imaged from 42 children. Forty-nine ears (86%) had successful cochlear view x-rays. Median angular depth of insertion was 381° (minimum, 272°; maximum, 450°; IQR, 360°-395°) during the first round of measurement. Measurements of the same images reviewed 6 weeks later showed median depth of insertion of 382° (minimum, 272°; maximum, 449°; IQR, 360°-397°). Interrater and intrarater reliability ICCs ranged between 0.81 and 0.96, indicating excellent reliability. CONCLUSIONS Postoperative cochlear view radiography is a reliable tool for measurement of cochlear implant depth of insertion in infants and children. Further studies are needed to determine reliability of intraoperatively obtained cochlear view radiographs in this population.
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Affiliation(s)
- Anisha R Noble
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Erin Christianson
- Childhood Communication Center, Seattle Children's Hospital, Seattle, Washington, USA
| | - Susan J Norton
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA.,Childhood Communication Center, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
| | - Henry C Ou
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Grace S Phillips
- Department of Radiology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Hedieh Khalatbari
- Department of Radiology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Seth D Friedman
- Department of Radiology, Seattle Children's Hospital, Seattle, Washington, USA
| | - David L Horn
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA.,Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
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