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Spitzer ER, Attlassy Y, Roland JT, Waltzman SB. Early cochlear implantation for children with single sided deafness. Int J Pediatr Otorhinolaryngol 2024; 177:111857. [PMID: 38244481 DOI: 10.1016/j.ijporl.2024.111857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/27/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVES Single-sided deafness (SSD) can have consequences for a child's language, educational, and social development. A cochlear implant (CI) is the only device which can restore true binaural hearing, yet they are only approved for children with (SSD) over the age of five in the United States. Reports on speech perception outcomes for children implanted at a younger age are limited. The present study aims to examine the effects of age at implantation, duration of deafness, hearing loss etiology, and presence of additional disabilities on device usage and speech perception outcomes. METHODS A retrospective chart review was used to examine demographics and speech perception outcomes for 18 children implanted at age five or younger. RESULTS Speech perception results were highly variable, with some children deriving significant benefit and others demonstrating no sound awareness through the implant alone. Age at implantation and duration of deafness did not have a clear impact on outcomes. Device usage was low in many children, often those with anatomical abnormalities such as a hypoplastic cochlear nerve. There are challenges to assessing speech perception in young children with SSD, leading to a lack of standardized outcome measures. CONCLUSIONS Early CI for children with SSD may improve speech perception, but benefit is not guaranteed. Candidacy evaluation should consider both medical and audiological factors, in addition to the degree of family support and realistic expectations. Caution is especially warranted in children with significant anatomical anomalies.
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Affiliation(s)
- Emily R Spitzer
- New York University Grossman School of Medicine, Department of Otolaryngology-Head and Neck Surgery, New York, NY, USA.
| | - Younes Attlassy
- New York University Grossman School of Medicine, New York, NY, USA
| | - J Thomas Roland
- New York University Grossman School of Medicine, Department of Otolaryngology-Head and Neck Surgery, New York, NY, USA
| | - Susan B Waltzman
- New York University Grossman School of Medicine, Department of Otolaryngology-Head and Neck Surgery, New York, NY, USA
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Tóth TF, Németh A, Bakó P, Révész P, Gerlinger I, Szanyi I. Matching the pitch perception of the cochlear implanted ear with the contralateral ear in patients with single-sided deafness: a novel approach. Eur Arch Otorhinolaryngol 2023; 280:4851-4859. [PMID: 37133499 PMCID: PMC10562495 DOI: 10.1007/s00405-023-08002-z] [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: 11/17/2022] [Accepted: 04/26/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE Single-sided deaf patients following cochlear implantation often compare the sound quality of their implanted ear with normal hearing. The interaural differences can result in dissatisfaction with speech comprehension and reduced time of usage of the speech processor; hence, prolonging auditory adaptation time. The proposed calibration method presented in this study demonstrates how the frequency distribution of the cochlear implant can be set to adequately approximate the pitch perception of the contralateral normal hearing ear towards improving speech intelligibility in a noisy environment. METHODS In 12 postlingual single-sided deaf patients, subjective interaural pitch-matching was carried out to determine new central frequencies for the reallocation of the frequency bands of their speech processor (CP910, CP950 or CP1000, Cochlear, Australia). The patients were asked to compare the pitch of the tones presented to their normal hearing ear to the pitch of individual channels of their cochlear implant (CI522 or CI622, Cochlear, Australia). A third-degree polynomial curve was fit to the acquired matching frequencies to create the new frequency allocation table. Audiological measurements (free-field aided thresholds, speech reception thresholds, and monosyllabic word recognition score) in noise, together with a Speech, Spatial and Qualities of Hearing Scale (SSQ12) questionnaire (short version of the original SSQ) results were evaluated prior to the pitch-matching procedure, and again, 2 weeks later. RESULTS The free-field aided thresholds of the patients showed no greater shift than ± 5 dB following the procedure; however, their monosyllabic word recognition score in noise improved significantly (mean - 9.58%, SD 4.98%, matched pairs t test comparison: p < 0.001). The results of the SSQ12 questionnaire also showed significant improvement in speech intelligibility, sound localization, and sound quality (mean 0.96 points, SD 0.45 points, matched pairs t test comparison: p < 0.001). CONCLUSIONS Matching the pitch perception of the implanted cochlea with the sensation of the normal hearing contralateral ear, resulted in significant changes in the quality of hearing in patients with single-sided deafness. It is plausible the procedure can usher positive results in bimodal patients or following sequential bilateral cochlear implantation.
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Affiliation(s)
- Tamás Ferenc Tóth
- Department of Otorhinolaryngology and Head Neck Surgery, Medical School, University of Pécs, 2. Munkácsy M. Str., Pécs, 7621, Hungary.
| | - Adrienne Németh
- Department of Otorhinolaryngology and Head Neck Surgery, Medical School, University of Pécs, 2. Munkácsy M. Str., Pécs, 7621, Hungary
| | - Péter Bakó
- Department of Otorhinolaryngology and Head Neck Surgery, Medical School, University of Pécs, 2. Munkácsy M. Str., Pécs, 7621, Hungary
| | - Péter Révész
- Department of Otorhinolaryngology and Head Neck Surgery, Medical School, University of Pécs, 2. Munkácsy M. Str., Pécs, 7621, Hungary
| | - Imre Gerlinger
- Department of Otorhinolaryngology and Head Neck Surgery, Medical School, University of Pécs, 2. Munkácsy M. Str., Pécs, 7621, Hungary
| | - István Szanyi
- Department of Otorhinolaryngology and Head Neck Surgery, Medical School, University of Pécs, 2. Munkácsy M. Str., Pécs, 7621, Hungary
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Ullah MN, Cevallos A, Shen S, Carver C, Dunham R, Marsiglia D, Yeagle J, Della Santina CC, Bowditch S, Sun DQ. Cochlear implantation in unilateral hearing loss: impact of short- to medium-term auditory deprivation. Front Neurosci 2023; 17:1247269. [PMID: 37877013 PMCID: PMC10591100 DOI: 10.3389/fnins.2023.1247269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023] Open
Abstract
Introduction Single sided deafness (SSD) results in profound cortical reorganization that presents clinically with a significant impact on sound localization and speech comprehension. Cochlear implantation (CI) has been approved for two manufacturers' devices in the United States to restore bilateral function in SSD patients with up to 10 years of auditory deprivation. However, there is great variability in auditory performance and it remains unclear how auditory deprivation affects CI benefits within this 10-year window. This prospective study explores how measured auditory performance relates to real-world experience and device use in a cohort of SSD-CI subjects who have between 0 and 10 years of auditory deprivation. Methods Subjects were assessed before implantation and 3-, 6-, and 12-months post-CI activation via Consonant-Nucleus-Consonant (CNC) word recognition and Arizona Biomedical Institute (AzBio) sentence recognition in varying spatial speech and noise presentations that simulate head shadow, squelch, and summation effects (S0N0, SSSDNNH, SNHNSSD; 0 = front, SSD = impacted ear, NH = normal hearing ear). Patient-centered assessments were performed using Tinnitus Handicap Inventory (THI), Spatial Hearing Questionnaire (SHQ), and Health Utility Index Mark 3 (HUI3). Device use data was acquired from manufacturer software. Further subgroup analysis was performed on data stratified by <5 years and 5-10 years duration of deafness. Results In the SSD ear, median (IQR) CNC word scores pre-implant and at 3-, 6-, and 12-months post-implant were 0% (0-0%), 24% (8-44%), 28% (4-44%), and 18% (7-33%), respectively. At 6 months post-activation, AzBio scores in S0N0 and SSSDNNH configurations (n = 25) demonstrated statistically significant increases in performance by 5% (p = 0.03) and 20% (p = 0.005), respectively. The median HUI3 score was 0.56 pre-implant, lower than scores for common conditions such as anxiety (0.68) and diabetes (0.77), and comparable to stroke (0.58). Scores improved to 0.83 (0.71-0.91) by 3 months post-activation. These audiologic and subjective benefits were observed even in patients with longer durations of deafness. Discussion By merging CI-associated changes in objective and patient-centered measures of auditory function, our findings implicate central mechanisms of auditory compensation and adaptation critical in auditory performance after SSD-CI and quantify the extent to which they affect the real-world experience reported by individuals.
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Affiliation(s)
- Mohammed N. Ullah
- Johns Hopkins Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Ashley Cevallos
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Sarek Shen
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Courtney Carver
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Rachel Dunham
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Dawn Marsiglia
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Jennifer Yeagle
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Charles C. Della Santina
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Steve Bowditch
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Daniel Q. Sun
- Department of Otolaryngology – Head and Neck Surgery and Cochlear Implant Center, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
- Department of Otolaryngology – Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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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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Potier M, Gallego S, Fournier P, Marx M, Noreña A. Amplification of the poorer ear by StereoBiCROS in case of asymmetric sensorineural hearing loss: effect on tinnitus. Front Neurosci 2023; 17:1141096. [PMID: 37304020 PMCID: PMC10248029 DOI: 10.3389/fnins.2023.1141096] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/12/2023] [Indexed: 06/13/2023] Open
Abstract
Tinnitus is prevalent among patients suffering from Single-Sided Deafness (SSD) and Asymmetrical Hearing Loss (AHL). In addition to bothersome tinnitus in the poorer ear, these patients also report issues with understanding speech in noise and sound localization. The conventional treatment options offered to these patients to improve auditory abilities are cochlear implantation, bone conduction devices or Contralateral Routing Of Signal (CROS) hearing aids. It was recently found that the benefit of cochlear implantation for tinnitus associated with AHL/SSD was greater than the other two approaches. It is conceivable that the lack of stimulation provided to the poorer ear in these last approaches explains their modest impact on tinnitus perception. A new technology that combines the ability to reroute the sound from the poorer ear to the good ear (CROS system) while still stimulating the poorer ear with conventional sound amplification has recently been developed: the StereoBiCROS system. The aim of this study was to investigate the effects of this new device on tinnitus. Twelve AHL and two SSD patients aged 70.7 ± 7.9 years with tinnitus were fitted with bilateral hearing aids that included 3 programs: Stereophonic, BiCROS and StereoBiCROS (CROS + bilateral amplification). The short-and long-term effect of the approach on tinnitus was assessed using a tinnitus Loudness Visual Analog Scale (VAS) and the Tinnitus Handicap Inventory (THI), respectively. Both the VAS and the THI were used before and one month after the hearing aid fitting. Of the 14 patients who used their hearing aids daily (12.6 ± 1.6 h per day) the StereoBiCROS program was the most used program (81.8 ± 20.5% of the time). The average THI total score decreased from 47 (± 22) to 15 (± 16) (p = 0.002) and the VAS-Loudness score decreased from 7 (± 1) to 2 (± 2) (p < 0.001) after the one-month trial period. In conclusion, StereoBiCROS stimulation strategy seems to offer an effective alternative to reduce tinnitus handicap and loudness for patients with AHL/SSD and tinnitus. This effect may be driven by sound amplification of the poorer ear.
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Affiliation(s)
- Morgan Potier
- CNRS UMR, Laboratoire de Neurosciences Cognitives, Aix-Marseille–Université Centre Saint-Charles, Marseille, France
- Laboratoire d’Audiologie Clinique, Narbonne, France
| | - Stéphane Gallego
- CNRS UMR, Laboratoire de Neurosciences Cognitives, Aix-Marseille–Université Centre Saint-Charles, Marseille, France
- Institut des Sciences et Technologies de Réadaptation, Université de Lyon, Lyon, France
| | - Philippe Fournier
- CNRS UMR, Laboratoire de Neurosciences Cognitives, Aix-Marseille–Université Centre Saint-Charles, Marseille, France
- Département de réadaptation, Faculté de Médecine, Université Laval, Quebec, QC, Canada
| | - Mathieu Marx
- CNRS UMR, Centre de Recherche Cerveau et Cognition (CERCO), Université Paul Sabatier, Toulouse, France
| | - Arnaud Noreña
- CNRS UMR, Laboratoire de Neurosciences Cognitives, Aix-Marseille–Université Centre Saint-Charles, Marseille, France
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Voola M, Wedekind A, Nguyen AT, Marinovic W, Rajan G, Tavora-Vieira D. Event-Related Potentials of Single-Sided Deaf Cochlear Implant Users: Using a Semantic Oddball Paradigm in Noise. Audiol Neurootol 2023; 28:280-293. [PMID: 36940674 PMCID: PMC10413801 DOI: 10.1159/000529485] [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: 06/22/2022] [Accepted: 01/31/2023] [Indexed: 03/23/2023] Open
Abstract
INTRODUCTION In individuals with single-sided deafness (SSD), who are characterised by profound hearing loss in one ear and normal hearing in the contralateral ear, binaural input is no longer present. A cochlear implant (CI) can restore functional hearing in the profoundly deaf ear, with previous literature demonstrating improvements in speech-in-noise intelligibility with the CI. However, we currently have limited understanding of the neural processes involved (e.g., how the brain integrates the electrical signal produced by the CI with the acoustic signal produced by the normal hearing ear) and how modulation of these processes with a CI contributes to improved speech-in-noise intelligibility. Using a semantic oddball paradigm presented in the presence of background noise, this study aims to investigate how the provision of CI impacts speech-in-noise perception of SSD-CI users. METHOD Task performance (reaction time, reaction time variability, target accuracy, subjective listening effort) and high density electroencephalography from twelve SSD-CI participants were recorded, while they completed a semantic acoustic oddball task. Reaction time was defined as the time taken for a participant to press the response button after stimulus onset. All participants completed the oddball task in three different free-field conditions with the speech and noise coming from different speakers. The three tasks were: (1) CI-On in background noise, (2) CI-Off in background noise, and (3) CI-On without background noise (Control). Task performance and electroencephalography data (N2N4 and P3b) were recorded for each condition. Speech in noise and sound localisation ability were also measured. RESULTS Reaction time was significantly different between all tasks with CI-On (M [SE] = 809 [39.9] ms) having faster RTs than CI-Off (M [SE] = 845 [39.9] ms) and Control (M [SE] = 785 [39.9] ms) being the fastest condition. The Control condition exhibited significantly shorter N2N4 and P3b area latency compared to the other two conditions. However, despite these differences noticed in RTs and area latency, we observed similar results between all three conditions for N2N4 and P3b difference area. CONCLUSION The inconsistency between the behavioural and neural results suggests that EEG may not be a reliable measure of cognitive effort. This rationale is further supported by different explanations used in past studies to explain N2N4 and P3b effects. Future studies should look to alternative measures of auditory processing (e.g., pupillometry) to gain a deeper understanding of the underlying auditory processes that facilitate speech-in-noise intelligibility.
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Affiliation(s)
- Marcus Voola
- Division of Surgery, Medical School, The University of Western Australia, Perth, WA, Australia
- Department of Audiology, Fiona Stanley Fremantle Hospitals Group, Perth, WA, Australia
| | - Andre Wedekind
- Division of Surgery, Medical School, The University of Western Australia, Perth, WA, Australia
- Department of Audiology, Fiona Stanley Fremantle Hospitals Group, Perth, WA, Australia
| | - An T. Nguyen
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Welber Marinovic
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Gunesh Rajan
- Division of Surgery, Medical School, The University of Western Australia, Perth, WA, Australia
- Deptartment of Otolaryngology, Head and Neck Surgery, Luzerner Kantonsspital, Luzern, Switzerland
| | - Dayse Tavora-Vieira
- Division of Surgery, Medical School, The University of Western Australia, Perth, WA, Australia
- Department of Audiology, Fiona Stanley Fremantle Hospitals Group, Perth, WA, Australia
- School of Population Health, Curtin University, Perth, WA, Australia
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Oh SJ, Mavrommatis MA, Fan CJ, DiRisio AC, Villavisanis DF, Berson ER, Schwam ZG, Wanna GB, Cosetti MK. Cochlear Implantation in Adults With Single-Sided Deafness: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2023; 168:131-142. [PMID: 35230924 DOI: 10.1177/01945998221083283] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 02/09/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine the clinical outcomes of adult patients with single-sided deafness (SSD) undergoing ipsilateral cochlear implantation. DATA SOURCE An electronic search of Medline and Embase articles. REVIEW METHODS A systematic review was performed with a search strategy developed by a licensed librarian to identify studies of adult patients with SSD who underwent ipsilateral cochlear implantation. Articles were managed in Covidence and evaluated by 2 independent reviewers. Risk of bias was assessed and data were extracted, including patient demographics, etiology of deafness, duration of deafness, and postoperative change in speech recognition, tinnitus, sound localization, and quality of life (QoL). A meta-analysis was performed, and pooled mean differences were calculated for each outcome of interest via random effects models by each outcome, as well as subgroup analyses by the individual clinical score used. RESULTS Of 2309 studies identified, 185 full texts were evaluated, and 50 were ultimately included involving 674 patients. Speech perception scores in quiet and noise, tinnitus control, sound localization, and QoL all significantly improved after implantation. Pooled outcomes demonstrated score improvements in speech perception (standardized mean difference [SMD], 2.8 [95% CI, 2.16-3.43]), QoL (SMD, 0.68 [95% CI, 0.45-0.91]), sound localization (SMD, -1.13 [95% CI, -1.68 to -0.57]), and tinnitus score reduction (SMD, -1.32 [95% CI, -1.85 to -0.80]). CONCLUSIONS Cochlear implantation in adults with SSD results in significant improvements in speech perception, tinnitus control, sound localization, and QoL. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Samuel J Oh
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Maria A Mavrommatis
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Caleb J Fan
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Aislyn C DiRisio
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Dillan F Villavisanis
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Elisa R Berson
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Zachary G Schwam
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - George B Wanna
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Maura K Cosetti
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
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Cochlear Implant Facilitates the Use of Talker Sex and Spatial Cues to Segregate Competing Speech in Unilaterally Deaf Listeners. Ear Hear 2023; 44:77-91. [PMID: 35733275 DOI: 10.1097/aud.0000000000001254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Talker sex and spatial cues can facilitate segregation of competing speech. However, the spectrotemporal degradation associated with cochlear implants (CIs) can limit the benefit of talker sex and spatial cues. Acoustic hearing in the nonimplanted ear can improve access to talker sex cues in CI users. However, it's unclear whether the CI can improve segregation of competing speech when maskers are symmetrically placed around the target (i.e., when spatial cues are available), compared with acoustic hearing alone. The aim of this study was to investigate whether a CI can improve segregation of competing speech by individuals with unilateral hearing loss. DESIGN Speech recognition thresholds (SRTs) for competing speech were measured in 16 normal-hearing (NH) adults and 16 unilaterally deaf CI users. All participants were native speakers of Mandarin Chinese. CI users were divided into two groups according to thresholds in the nonimplanted ear: (1) single-sided deaf (SSD); pure-tone thresholds <25 dB HL at all audiometric frequencies, and (2) Asymmetric hearing loss (AHL; one or more thresholds > 25 dB HL). SRTs were measured for target sentences produced by a male talker in the presence of two masker talkers (different male or female talkers). The target sentence was always presented via loudspeaker directly in front of the listener (0°), and the maskers were either colocated with the target (0°) or spatially separated from the target at ±90°. Three segregation cue conditions were tested to measure masking release (MR) relative to the baseline condition: (1) Talker sex, (2) Spatial, and (3) Talker sex + Spatial. For CI users, SRTs were measured with the CI on or off. RESULTS Binaural MR was significantly better for the NH group than for the AHL or SSD groups ( P < 0.001 in all cases). For the NH group, mean MR was largest with the Talker sex + spatial cues (18.8 dB) and smallest for the Talker sex cues (10.7 dB). In contrast, mean MR for the SSD group was largest with the Talker sex + spatial cues (14.7 dB), and smallest with the Spatial cues (4.8 dB). For the AHL group, mean MR was largest with the Talker sex + spatial cues (7.8 dB) and smallest with the Talker sex (4.8 dB) and the Spatial cues (4.8 dB). MR was significantly better with the CI on than off for both the AHL ( P = 0.014) and SSD groups ( P < 0.001). Across all unilaterally deaf CI users, monaural (acoustic ear alone) and binaural MR were significantly correlated with unaided pure-tone average thresholds in the nonimplanted ear for the Talker sex and Talker sex + spatial conditions ( P < 0.001 in both cases) but not for the Spatial condition. CONCLUSION Although the CI benefitted unilaterally deaf listeners' segregation of competing speech, MR was much poorer than that observed in NH listeners. Different from previous findings with steady noise maskers, the CI benefit for segregation of competing speech from a different talker sex was greater in the SSD group than in the AHL group.
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Landsberger DM, Stupak N, Dahl C, Aronoff JM. Musical Interval Perception With a Cochlear Implant Alone and With a Contralateral Normal Hearing Ear. Trends Hear 2022; 26:23312165221142689. [PMID: 36464788 PMCID: PMC9726843 DOI: 10.1177/23312165221142689] [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] [Indexed: 12/12/2022] Open
Abstract
Music through a cochlear implant (CI) is described as out-of-tune, suggesting that musical intervals are not accurately provided by a CI. One potential reason is that pitch may be insufficiently conveyed to provide reliable intervals. Another potential reason is that the size of intervals is distorted through a CI as they would be when produced by a mistuned piano. To measure intervals through a CI, listeners selected prerecorded vowels with different fundamental frequencies to represent each note in Happy Birthday. Each listener had contralateral normal hearing (NH); repeating the experiment with their NH ear allowed for a within-subject control. Additionally, the effect of listening simultaneously to both a CI and NH ear was measured. The resulting versions of Happy Birthday were analyzed in terms of their contours, interval sizes, magnitudes, consistency, and direction. Intervals with NH ears ranged from perfect to uncorrelated with target intervals. Chosen interval size with the CI was poorer than with the NH ear for all subjects. Across listeners, chosen intervals with the CI ranged from highly correlated to uncorrelated with target intervals. That CI intervals were highly correlated with target intervals for some listeners suggests that accurate intervals can be provided through a CI. For some listeners, chosen intervals were larger than target intervals, suggesting that intervals may be perceived as too small. Overall, intervals with the combination of the NH and CI ears were similar to those with the NH ear alone, suggesting that the addition of a CI has little-to-no effect on interval perception.
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Affiliation(s)
- David M. Landsberger
- Department of Otolaryngology, New York University Grossman School of Medicine, New York, NY, USA,David M. Landsberger, Department of Otolaryngology, New York University Grossman School of Medicine, 550 1st Avenue, STE NBV 5E5, New York, NY 10016, USA.
| | - Natalia Stupak
- Department of Otolaryngology, New York University Grossman School of Medicine, New York, NY, USA
| | - Cori Dahl
- Speech and Hearing Science Department, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Justin M. Aronoff
- Speech and Hearing Science Department, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
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Thompson NJ, Dillon MT, Buss E, Rooth MA, Richter ME, Pillsbury HC, Brown KD. Long-Term Improvement in Localization for Cochlear Implant Users with Single-Sided Deafness. Laryngoscope 2022; 132:2453-2458. [PMID: 35174886 PMCID: PMC9514235 DOI: 10.1002/lary.30065] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/03/2022] [Accepted: 02/08/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVES/HYPOTHESIS To assess whether early, significant improvements in sound source localization observed in cochlear implant (CI) recipients with normal hearing (NH) in the contralateral ear are maintained after 5 years of CI use. STUDY DESIGN Prospective, repeated measures study. METHODS Participants were recruited from a sample of CI + NH listeners (n = 20) who received their device as part of a prospective clinical trial investigating outcomes of CI use for adult cases of single-sided deafness. Sound source localization was assessed annually after the clinical trial endpoint (1-year post-activation). Listeners were asked to indicate the perceived sound source for a broadband noise burst presented randomly at varied intensity levels from one of 11 speakers along a 180° arc. Performance was quantified as root-mean-squared (RMS) error. RESULTS Linear mixed models showed superior post-activation performance was maintained with long-term CI use as compared to preoperative abilities (P < .001). Unexpectedly, a significant improvement (P = .009) in sound source localization was observed over the long-term post-activation period (1-5 years). To better understand these long-term findings, the response patterns for the 11 participants who were evaluated at the 1- and 5-year visits were reviewed. This subgroup demonstrated a significant improvement in RMS error (P = .020) and variable error (P = .031), indicating more consistent responses at the 5-year visit. CONCLUSION Adult CI + NH listeners experience significant improvements in sound source localization within the initial weeks of listening experience, with additional improvements observed after long-term device use. The present sample demonstrated significant improvements between the 1-year and 5-year visits, with greater accuracy and consistency noted in their response patterns. LEVEL OF EVIDENCE 3 Laryngoscope, 132:2453-2458, 2022.
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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, USA
| | - Margaret T Dillon
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Emily Buss
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Meredith A Rooth
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Margaret E Richter
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Harold C Pillsbury
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kevin D Brown
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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11
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Bestel J, Legris E, Rembaud F, Mom T, Galvin JJ. Speech understanding in diffuse steady noise in typically hearing and hard of hearing listeners. PLoS One 2022; 17:e0274435. [PMID: 36103551 PMCID: PMC9473430 DOI: 10.1371/journal.pone.0274435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/29/2022] [Indexed: 12/02/2022] Open
Abstract
Spatial cues can facilitate segregation of target speech from maskers. However, in clinical practice, masked speech understanding is most often evaluated using co-located speech and maskers (i.e., without spatial cues). Many hearing aid centers in France are equipped with five-loudspeaker arrays, allowing masked speech understanding to be measured with spatial cues. It is unclear how hearing status may affect utilization of spatial cues to segregate speech and noise. In this study, speech reception thresholds (SRTs) for target speech in “diffuse noise” (target speech from 1 speaker, noise from the remaining 4 speakers) in 297 adult listeners across 9 Audilab hearing centers. Participants were categorized according to pure-tone-average (PTA) thresholds: typically-hearing (TH; ≤ 20 dB HL), mild hearing loss (Mild; >20 ≤ 40 dB HL), moderate hearing loss 1 (Mod-1; >40 ≤ 55 dB HL), and moderate hearing loss 2 (Mod-2; >55 ≤ 65 dB HL). All participants were tested without aided hearing. SRTs in diffuse noise were significantly correlated with PTA thresholds, age at testing, as well as word and phoneme recognition scores in quiet. Stepwise linear regression analysis showed that SRTs in diffuse noise were significantly predicted by a combination of PTA threshold and word recognition scores in quiet. SRTs were also measured in co-located and diffuse noise in 65 additional participants. SRTs were significantly lower in diffuse noise than in co-located noise only for the TH and Mild groups; masking release with diffuse noise (relative to co-located noise) was significant only for the TH group. The results are consistent with previous studies that found that hard of hearing listeners have greater difficulty using spatial cues to segregate competing speech. The data suggest that speech understanding in diffuse noise provides additional insight into difficulties that hard of hearing individuals experience in complex listening environments.
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Affiliation(s)
| | | | | | - Thierry Mom
- Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - John J. Galvin
- University Hospital Center of Tours, Tours, France
- House Institute Foundation, Los Angeles, CA, United States of America
- * E-mail:
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12
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Cochlear implantation for paediatric and adult cases of unilateral and asymmetric hearing loss. Curr Opin Otolaryngol Head Neck Surg 2022; 30:303-308. [PMID: 36004791 DOI: 10.1097/moo.0000000000000838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Children and adults with unilateral or asymmetric hearing loss (UHL/AHL) have poorer spatial hearing (e.g. speech understanding in complex maskers and localization) and quality of life compared with peers with normal hearing bilaterally. Patients with UHL/AHL experience limited benefits with contralateral-routing technologies (e.g. bone conduction, CROS hearing aid systems). Cochlear implantation allows for stimulation of the auditory pathway for the poorer hearing ear. The present study reviews the recent literature on outcomes of cochlear implant use for recipients with UHL/AHL. RECENT FINDINGS Recent research corroborates previous investigations of the significant benefits on measures of spatial hearing, tinnitus severity and quality of life for adult cochlear implant recipients. These benefits are also observed in pediatric cochlear implant recipients, with an association of better outcomes with younger ages at implantation for congenital cases and shorter durations of UHL/AHL for acquired cases. In addition, randomized trials demonstrate better outcomes with cochlear implant use versus contralateral-routing technologies. SUMMARY Cochlear implantation supports better spatial hearing and quality of life in children and adults with UHL/AHL as compared to alternative listening conditions. Current research supports the expansion of candidacy criteria and insurance coverage for cochlear implantation for patients with UHL/AHL to improve their binaural hearing.
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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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Anderson KM, Buss E, Rooth MA, Richter ME, Overton AB, Brown KD, Dillon MT. Masked Speech Recognition as a Function of Masker Location for Cochlear Implant Users With Single-Sided Deafness. Am J Audiol 2022; 31:757-763. [PMID: 35877957 DOI: 10.1044/2022_aja-21-00268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Cochlear implant (CI) recipients with normal or near normal hearing (NH) in the contralateral ear, referred to as single-sided deafness (SSD), experience significantly better speech recognition in noise with their CI than without it, although reported outcomes vary. One possible explanation for differences in outcomes across studies could be differences in the spatial configurations used to assess performance. This study compared speech recognition for different spatial configurations of the target and masker, with test materials used clinically. METHOD Sixteen CI users with SSD completed tasks of masked speech recognition presented in five spatial configurations. The target speech was presented from the front speaker (0° azimuth). The masker was located either 90° or 45° toward the CI-ear or NH-ear or colocated with the target. Materials were the AzBio sentences in a 10-talker masker and the Bamford-Kowal-Bench Speech-in-Noise test (BKB-SIN; four-talker masker). Spatial release from masking (SRM) was computed as the benefit associated with spatial separation relative to the colocated condition. RESULTS Performance was significantly better when the masker was separated toward the CI-ear as compared to colocated. No benefit was observed for spatial separations toward the NH-ear. The magnitude of SRM for spatial separations toward the CI-ear was similar for 45° and 90° when tested with the AzBio sentences, but a larger benefit was observed for 90° as compared to 45° for the BKB-SIN. CONCLUSIONS Masked speech recognition in CI users with SSD varies as a function of the spatial configuration of the target and masker. Results supported an expansion of the clinical test battery at the study site to assess binaural hearing abilities for CI candidates and recipients with SSD. The revised test battery presents the target from the front speaker and the masker colocated with the target, 90° toward the CI-ear, or 90° toward the NH-ear.
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Affiliation(s)
- Kelly M Anderson
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill.,Division of Speech and Hearing Sciences, Department of Allied Health Sciences, 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
| | - Margaret E Richter
- 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
| | - Margaret T Dillon
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill.,Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill
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15
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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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16
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Dillon MT, Rooth MA, Canfarotta MW, Richter ME, Thompson NJ, Brown KD. Sound Source Localization by Cochlear Implant Recipients with Normal Hearing in the Contralateral Ear: Effects of Spectral Content and Duration of Listening Experience. Audiol Neurootol 2022; 27:437-448. [PMID: 35439753 DOI: 10.1159/000523969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/24/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Cochlear implant (CI) recipients with normal hearing (NH) in the contralateral ear experience a significant improvement in sound source localization when listening with the CI in combination with their NH-ear (CI + NH) as compared to with the NH-ear alone. The improvement in localization is primarily due to sensitivity to interaural level differences (ILDs). Sensitivity to interaural timing differences (ITDs) may be limited by auditory aging, frequency-to-place mismatches, the signal coding strategy, and duration of CI use. The present report assessed the sensitivity of ILD and ITD cues in CI + NH listeners who were recipients of long electrode arrays that provide minimal frequency-to-place mismatches and were mapped with a coding strategy that presents fine structure cues on apical channels. METHODS Sensitivity to ILDs and ITDs for localization was assessed using broadband noise (BBN), as well as high-pass (HP) and low-pass (LP) filtered noise for adult CI + NH listeners. Stimuli were 200-ms noise bursts presented from 11 speakers spaced evenly over an 180° arc. Performance was quantified in root-mean-squared error and response patterns were analyzed to evaluate the consistency, accuracy, and side bias of the responses. Fifteen listeners completed the task at the 2-year post-activation visit; seven listeners repeated the task at a later annual visit. RESULTS Performance at the 2-year visit was best with the BBN and HP stimuli and poorer with the LP stimulus. Responses to the BBN and HP stimuli were significantly correlated, consistent with the idea that CI + NH listeners primarily use ILD cues for localization. For the LP stimulus, some listeners responded consistently and accurately and with limited side bias, which may indicate sensitivity to ITD cues. Two of the 7 listeners who repeated the task at a later annual visit experienced a significant improvement in performance with the LP stimulus, which may indicate that sensitivity to ITD cues may improve with long-term CI use. CONCLUSIONS CI recipients with a NH-ear primarily use ILD cues for sound source localization, though some may use ITD cues as well. Sensitivity to ITD cues may improve with long-term CI listening experience.
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Affiliation(s)
- Margaret T Dillon
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Meredith A Rooth
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Michael W Canfarotta
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Margaret E Richter
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Nicholas J Thompson
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kevin D Brown
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Calmels MN, Gallois Y, Marx M, Deguine O, Taoui S, Arnaud E, Strelnikov K, Barone P. Functional Reorganization of the Central Auditory System in Children with Single-Sided Deafness: A Protocol Using fNIRS. Brain Sci 2022; 12:brainsci12040423. [PMID: 35447955 PMCID: PMC9029510 DOI: 10.3390/brainsci12040423] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/04/2023] Open
Abstract
In children, single-sided deafness (SSD) affects the development of linguistic and social skills and can impede educational progress. These difficulties may relate to cortical changes that occur following SSD, such as reduced inter-hemispheric functional asymmetry and maladaptive brain plasticity. To investigate these neuronal changes and their evolution in children, a non-invasive technique is required that is little affected by motion artifacts. Here, we present a research protocol that uses functional near-infrared spectroscopy (fNIRS) to evaluate the reorganization of cortical auditory asymmetry in children with SSD; it also examines how the cortical changes relate to auditory and language skills. The protocol is designed for children whose SSD has not been treated, because hearing restoration can alter both brain reorganization and behavioral performance. We propose a single-center, cross-sectional study that includes 30 children with SSD (congenital or acquired moderate-to-profound deafness) and 30 children with normal hearing (NH), all aged 5–16 years. The children undergo fNIRS during monaural and binaural stimulation, and the pattern of cortical activity is analyzed using measures of the peak amplitude and area under the curve for both oxy- and deoxyhemoglobin. These cortical measures can be compared between the two groups of children, and analyses can be run to determine whether they relate to binaural hearing (speech-in-noise and sound localization), speech perception and production, and quality of life (QoL). The results could be of relevance for developing individualized rehabilitation programs for SSD, which could reduce patients’ difficulties and prevent long-term neurofunctional and clinical consequences.
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Affiliation(s)
- Marie-Noëlle Calmels
- Service d′Oto-Rhino-Laryngologie, d′Oto-Neurologie et d′ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, CEDEX 9, 31059 Toulouse, France; (Y.G.); (M.M.); (O.D.); (S.T.); (K.S.)
- Correspondence:
| | - Yohan Gallois
- Service d′Oto-Rhino-Laryngologie, d′Oto-Neurologie et d′ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, CEDEX 9, 31059 Toulouse, France; (Y.G.); (M.M.); (O.D.); (S.T.); (K.S.)
| | - Mathieu Marx
- Service d′Oto-Rhino-Laryngologie, d′Oto-Neurologie et d′ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, CEDEX 9, 31059 Toulouse, France; (Y.G.); (M.M.); (O.D.); (S.T.); (K.S.)
- Centre de Recherche cerveau et Cognition, Université de Toulouse, Université Paul Sabatier, 31052 Toulouse, France; (E.A.); (P.B.)
- UMR 5549, Faculté de Médecine de Purpan, Centre National de la Recherche Scientifique, 31055 Toulouse, France
| | - Olivier Deguine
- Service d′Oto-Rhino-Laryngologie, d′Oto-Neurologie et d′ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, CEDEX 9, 31059 Toulouse, France; (Y.G.); (M.M.); (O.D.); (S.T.); (K.S.)
- Centre de Recherche cerveau et Cognition, Université de Toulouse, Université Paul Sabatier, 31052 Toulouse, France; (E.A.); (P.B.)
- UMR 5549, Faculté de Médecine de Purpan, Centre National de la Recherche Scientifique, 31055 Toulouse, France
| | - Soumia Taoui
- Service d′Oto-Rhino-Laryngologie, d′Oto-Neurologie et d′ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, CEDEX 9, 31059 Toulouse, France; (Y.G.); (M.M.); (O.D.); (S.T.); (K.S.)
| | - Emma Arnaud
- Centre de Recherche cerveau et Cognition, Université de Toulouse, Université Paul Sabatier, 31052 Toulouse, France; (E.A.); (P.B.)
- UMR 5549, Faculté de Médecine de Purpan, Centre National de la Recherche Scientifique, 31055 Toulouse, France
| | - Kuzma Strelnikov
- Service d′Oto-Rhino-Laryngologie, d′Oto-Neurologie et d′ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, CEDEX 9, 31059 Toulouse, France; (Y.G.); (M.M.); (O.D.); (S.T.); (K.S.)
| | - Pascal Barone
- Centre de Recherche cerveau et Cognition, Université de Toulouse, Université Paul Sabatier, 31052 Toulouse, France; (E.A.); (P.B.)
- UMR 5549, Faculté de Médecine de Purpan, Centre National de la Recherche Scientifique, 31055 Toulouse, France
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American Cochlear Implant Alliance Task Force Guidelines for Clinical Assessment and Management of Cochlear Implantation in Children With Single-Sided Deafness. Ear Hear 2022; 43:255-267. [PMID: 35213890 PMCID: PMC8862768 DOI: 10.1097/aud.0000000000001204] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Saadoun A, Schein A, Péan V, Legrand P, Aho Glélé LS, Bozorg Grayeli A. Frequency Fitting Optimization Using Evolutionary Algorithm in Cochlear Implant Users with Bimodal Binaural Hearing. Brain Sci 2022; 12:brainsci12020253. [PMID: 35204015 PMCID: PMC8870060 DOI: 10.3390/brainsci12020253] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 02/04/2023] Open
Abstract
Optimizing hearing in patients with a unilateral cochlear implant (CI) and contralateral acoustic hearing is a challenge. Evolutionary algorithms (EA) can explore a large set of potential solutions in a stochastic manner to approach the optimum of a minimization problem. The objective of this study was to develop and evaluate an EA-based protocol to modify the default frequency settings of a MAP (fMAP) of the CI in patients with bimodal hearing. Methods: This monocentric prospective study included 27 adult CI users (with post-lingual deafness and contralateral functional hearing). A fitting program based on EA was developed to approach the best fMAP. Generated fMAPs were tested by speech recognition (word recognition score, WRS) in noise and free-field-like conditions. By combining these first fMAPs and adding some random changes, a total of 13 fMAPs over 3 generations were produced. Participants were evaluated before and 45 to 60 days after the fitting by WRS in noise and questionnaires on global sound quality and music perception in bimodal binaural conditions. Results: WRS in noise improved with the EA-based fitting in comparison to the default fMAP (41.67 ± 9.70% versus 64.63 ± 16.34%, respectively, p = 0.0001, signed-rank test). The global sound quality and music perception were also improved, as judged by ratings on questionnaires and scales. Finally, most patients chose to keep the new fitting definitively. Conclusions: By modifying the default fMAPs, the EA improved the speech discrimination in noise and the sound quality in bimodal binaural conditions.
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Affiliation(s)
- Alexis Saadoun
- Department of Otolaryngology—Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France; (A.S.); (A.S.)
| | - Antoine Schein
- Department of Otolaryngology—Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France; (A.S.); (A.S.)
| | - Vincent Péan
- Clinical Support Department, MED-EL, 75012 Paris, France;
| | - Pierrick Legrand
- Institute of Mathematics of Bordeaux, UMR CNRS 5251, ASTRAL Team, Inria Bordeaux Sud-Ouest, University of Bordeaux, 33405 Talence, France;
| | - Ludwig Serge Aho Glélé
- Department of Hospital Epidemiology and Infection Control, Dijon University Hospital, 21000 Dijon, France;
| | - Alexis Bozorg Grayeli
- Department of Otolaryngology—Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France; (A.S.); (A.S.)
- ImVia Research Laboratory, Bourgogne-Franche Comté University, 21000 Dijon, France
- Correspondence:
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Ludwig AA, Meuret S, Battmer RD, Schönwiesner M, Fuchs M, Ernst A. Sound Localization in Single-Sided Deaf Participants Provided With a Cochlear Implant. Front Psychol 2021; 12:753339. [PMID: 34744930 PMCID: PMC8566543 DOI: 10.3389/fpsyg.2021.753339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/28/2021] [Indexed: 11/21/2022] Open
Abstract
Spatial hearing is crucial in real life but deteriorates in participants with severe sensorineural hearing loss or single-sided deafness. This ability can potentially be improved with a unilateral cochlear implant (CI). The present study investigated measures of sound localization in participants with single-sided deafness provided with a CI. Sound localization was measured separately at eight loudspeaker positions (4°, 30°, 60°, and 90°) on the CI side and on the normal-hearing side. Low- and high-frequency noise bursts were used in the tests to investigate possible differences in the processing of interaural time and level differences. Data were compared to normal-hearing adults aged between 20 and 83. In addition, the benefit of the CI in speech understanding in noise was compared to the localization ability. Fifteen out of 18 participants were able to localize signals on the CI side and on the normal-hearing side, although performance was highly variable across participants. Three participants always pointed to the normal-hearing side, irrespective of the location of the signal. The comparison with control data showed that participants had particular difficulties localizing sounds at frontal locations and on the CI side. In contrast to most previous results, participants were able to localize low-frequency signals, although they localized high-frequency signals more accurately. Speech understanding in noise was better with the CI compared to testing without CI, but only at a position where the CI also improved sound localization. Our data suggest that a CI can, to a large extent, restore localization in participants with single-sided deafness. Difficulties may remain at frontal locations and on the CI side. However, speech understanding in noise improves when wearing the CI. The treatment with a CI in these participants might provide real-world benefits, such as improved orientation in traffic and speech understanding in difficult listening situations.
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Affiliation(s)
- Alexandra Annemarie Ludwig
- Section of Phoniatrics and Audiology, Department of Otorhinolaryngology, University Hospital of Leipzig, Leipzig, Germany.,Faculty of Life Sciences, University of Leipzig, Leipzig, Germany
| | - Sylvia Meuret
- Section of Phoniatrics and Audiology, Department of Otorhinolaryngology, University Hospital of Leipzig, Leipzig, Germany
| | - Rolf-Dieter Battmer
- Department of Otolaryngology, Unfallkrankenhaus Berlin, Berlin, Germany.,Hearing Therapy Center Potsdam, Potsdam, Germany
| | | | - Michael Fuchs
- Section of Phoniatrics and Audiology, Department of Otorhinolaryngology, University Hospital of Leipzig, Leipzig, Germany
| | - Arne Ernst
- Department of Otolaryngology, Unfallkrankenhaus Berlin, Berlin, Germany.,Hospital of the University of Berlin, Charité Medical School, Berlin, Germany
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Song M, Li J, Lan L, Xie L, Xiong F, Yu L, Shi W, Wang D, Guan J, Wang H, Wang Q. Clinical characteristics of patients with unilateral auditory neuropathy. Am J Otolaryngol 2021; 42:103143. [PMID: 34175691 DOI: 10.1016/j.amjoto.2021.103143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/14/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To analyze the clinical characteristics of patients with unilateral auditory neuropathy (UAN), and to provide guidance for future clinical diagnosis and research. METHODS Patients who were clinically diagnosed with UAN from 2004 to 2019 were included. Clinical characteristics, audiological features, imaging findings, genetic test results and management effect were summarized and followed. RESULTS A total of 44 patients [mean age, 4.35 ± 4.39 years; 22 (50.00%) males and 22 (50.00%) females] were enrolled for analyses. Among the 38 patients who were tested by pure-tone or behavioral audiometry, the degree of hearing loss of the affected ear was characterized as mild in 2 ears (5.26%), moderate in 5 (13.16%), severe in 9 (23.68%) and profound in 22 (57.89%). For the 44 contralateral ears, 33 (75.00%) showed normal hearing and 11 (25.00%) presented with sensorineural hearing loss. Auditory brainstem responses were absent or abnormal in all 44 affected ears, while otoacoustic emissions and/or cochlear microphonics were present. Among the 18 patients who underwent magnetic resonance imaging (MRI), 7 (38.89%) presented cochlear nerve deficiency (CND). Nineteen candidate variants were found in 12 patients among the 15 UAN patients who were conducted targeted gene capture and next generation sequencing. Thirty patients were followed up by telephone to investigate their management effect. CONCLUSIONS Our study demonstrates comprehensive audiological features of patients with UAN to improve the clinical understanding and diagnosis. Some patients with UAN could show ipsilateral CND and MRI is essential to evaluate if the nerve is deficient. No pathogenic variants that directly related to the pathogenesis of UAN have been found in this study currently.
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Park LR, Dillon MT, Buss E, O'Connell BP, Brown KD. Spatial Release From Masking in Pediatric Cochlear Implant Recipients With Single-Sided Deafness. Am J Audiol 2021; 30:443-451. [PMID: 33769866 PMCID: PMC9522323 DOI: 10.1044/2020_aja-20-00119] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Children with single-sided deafness (SSD) experience difficulty understanding speech in multisource listening situations. Case reports and retrospective studies have indicated that a cochlear implant (CI) may improve masked speech recognition in children with SSD. This prospective study was conducted to determine whether providing a CI to children with SSD supports spatial release from masking (SRM), an improvement in speech recognition associated with separating the target and masker sources. Method Twenty children with at least a moderate-to-profound hearing loss in one ear and normal hearing in the contralateral ear underwent cochlear implantation. The average age of implantation was 5.5 years (range: 3.5-12.7). After 12 months of CI use, subjects completed a sentence recognition task in multitalker masker with and without the CI. The target was presented from the front, and the masker was either colocated with the target (0°) or from the side (+90° or -90°). A two-way repeated-measures analysis of variance was completed to investigate SRM with and without the CI. Results Pediatric CI recipients experienced significant SRM when the masker was directed to the normal-hearing ear or to the affected ear. Conclusions The results indicate that cochlear implantation in children with SSD supports binaural skills required for speech recognition in noise. These results are consistent with improved functional communication in multisource environments, like classrooms.
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Affiliation(s)
- Lisa R. Park
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Margaret T. Dillon
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Emily Buss
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Brendan P. O'Connell
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Kevin D. Brown
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
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23
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Burg EA, Thakkar T, Fields T, Misurelli SM, Kuchinsky SE, Roche J, Lee DJ, Litovsky RY. Systematic Comparison of Trial Exclusion Criteria for Pupillometry Data Analysis in Individuals With Single-Sided Deafness and Normal Hearing. Trends Hear 2021; 25:23312165211013256. [PMID: 34024219 PMCID: PMC8150669 DOI: 10.1177/23312165211013256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The measurement of pupil dilation has become a common way to assess listening effort. Pupillometry data are subject to artifacts, requiring highly contaminated data to be discarded from analysis. It is unknown how trial exclusion criteria impact experimental results. The present study examined the effect of a common exclusion criterion, percentage of blinks, on speech intelligibility and pupil dilation measures in 9 participants with single-sided deafness (SSD) and 20 participants with normal hearing. Participants listened to and repeated sentences in quiet or with speech maskers. Pupillometry trials were processed using three levels of blink exclusion criteria: 15%, 30%, and 45%. These percentages reflect a threshold for missing data points in a trial, where trials that exceed the threshold are excluded from analysis. Results indicated that pupil dilation was significantly greater and intelligibility was significantly lower in the masker compared with the quiet condition for both groups. Across-group comparisons revealed that speech intelligibility in the SSD group decreased significantly more than the normal hearing group from quiet to masker conditions, but the change in pupil dilation was similar for both groups. There was no effect of blink criteria on speech intelligibility or pupil dilation results for either group. However, the total percentage of blinks in the masker condition was significantly greater than in the quiet condition for the SSD group, which is consistent with previous studies that have found a relationship between blinking and task difficulty. This association should be carefully considered in future experiments using pupillometry to gauge listening effort.
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Affiliation(s)
- Emily A Burg
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Tanvi Thakkar
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Taylor Fields
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Sara M Misurelli
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, United States.,Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Stefanie E Kuchinsky
- Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland, United States
| | - Joseph Roche
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Daniel J Lee
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States
| | - Ruth Y Litovsky
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, United States.,Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States
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Abstract
OBJECTIVE To describe our experience with adults undergoing cochlear implantation (CI) for treatment of single-sided deafness (SSD). STUDY DESIGN Retrospective case review. SETTING Tertiary referral center. PATIENTS Fifty-three adults with SSD. INTERVENTIONS Unilateral CI. MAIN OUTCOME MEASURES Speech perception testing in quiet and noise, tinnitus suppression, and device usage from datalogs. RESULTS The mean age at CI was 53.2 years (SD 11.9). The mean duration of deafness was 4.0 years (SD 7.8). The most common etiology was idiopathic sudden SNHL (50%). Word recognition improved from 8.7% (SD 15) preoperatively to 61.8% (SD 20) at a mean follow-up of 3.3 years (SD 1.8) (p < 0.0001). Adaptive speech recognition testing in the "binaural with CI" condition (speech directed toward the front and noise toward the normal hearing ear) revealed a significant improvement by 2.6-dB SNR compared to the preoperative unaided condition (p = 0.0002) and by 3.6-dB SNR compared to when a device to route sound to the contralateral side was used (p < 0.0001). Tinnitus suppression was reported to be complete in 23 patients (43%) and improved in 20 patients (38%) while the device was on. The addition of the CI did not lead to a decrement in hearing performance in any spatial configuration. Device usage averaged 8.7 (SD 3.7) hours/day. CONCLUSIONS Cochlear implantation in adult SSD patients can suppress tinnitus and achieve speech perception outcomes comparable with CI in conventional candidates. Modest improvements in spatial hearing were also observed and primarily attributable to the head shadow effect. Careful patient selection and counseling regarding potential benefits are important to optimize outcomes.
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25
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Park LR, Preston E, Noxon AS, Dillon MT. Comparison of test methods to assess the implanted ear alone for pediatric cochlear implant recipients with single-sided deafness. Cochlear Implants Int 2021; 22:283-290. [PMID: 33761831 DOI: 10.1080/14670100.2021.1903715] [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] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The purpose of this investigation was to compare three test methods for isolating the test ear for children with single-sided deafness (SSD) who use a cochlear implant (CI). METHODS Word recognition was assessed for five CI recipients with SSD and six bilateral CI recipients with no acoustic hearing. For the SSD subjects, performance was compared: 1) in the sound field with masking in the normal-hearing ear, 2) in the sound field with an earplug and earmuff ("plug-and-muff"), and 3) via direct connect (DC). For the bilateral CI subjects, performance was compared: 1) in the sound field and 2) via DC. RESULTS For the bilateral CI subjects, word recognition was similar when assessed in the sound field versus via DC. For the SSD subjects, performance was similar when assessed with the plug-and-muff and DC methods but was significantly poorer with masking presented to the normal-hearing ear. DISCUSSION Masking the normal-hearing ear to isolate the CI for word recognition is problematic in this population. The plug-and-muff and DC test methods may provide a more accurate assessment. CONCLUSION DC or plug-and-muff methods are recommended to isolate the CI-ear for word recognition testing in children with SSD. Patient specific variables should be considered.
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Affiliation(s)
- Lisa R Park
- Department of Otolaryngology / Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elizabeth Preston
- Department of Otolaryngology / Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amy S Noxon
- Division of Speech & Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Margaret T Dillon
- Department of Otolaryngology / Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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26
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Katiri R, Hall DA, Killan CF, Smith S, Prayuenyong P, Kitterick PT. Systematic review of outcome domains and instruments used in designs of clinical trials for interventions that seek to restore bilateral and binaural hearing in adults with unilateral severe to profound sensorineural hearing loss ('single-sided deafness'). Trials 2021; 22:220. [PMID: 33743802 PMCID: PMC7981927 DOI: 10.1186/s13063-021-05160-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/27/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND This systematic review aimed to identify, compare and contrast outcome domains and outcome instruments reported in studies investigating interventions that seek to restore bilateral (two-sided) and/or binaural (both ears) hearing in adults with single-sided deafness (SSD). Findings can inform the development of evidence-based guidance to facilitate design decisions for confirmatory trials. METHODS Records were identified by searching MEDLINE, EMBASE, PubMed, CINAHL, ClinicalTrials.gov, ISRCTN, CENTRAL, WHO ICTRP and the NIHR UK clinical trials gateway. The search included records published from 1946 to March 2020. Included studies were those as follows: (a) recruiting adults aged 18 years or older diagnosed with SSD of average threshold severity worse than 70 dB HL in the worse-hearing ear and normal (or near-normal) hearing in the better-hearing ear, (b) evaluating interventions to restore bilateral and/or binaural hearing and (c) enrolling those adults in a controlled trial, before-and-after study or cross-over study. Studies that fell just short of the participant eligibility criteria were included in a separate sensitivity analysis. RESULTS Ninety-six studies were included (72 full inclusion, 24 sensitivity analysis). For fully included studies, 37 exclusively evaluated interventions to re-establish bilateral hearing and 29 exclusively evaluated interventions to restore binaural hearing. Overall, 520 outcome domains were identified (350 primary and 170 secondary). Speech-related outcome domains were the most common (74% of studies), followed by spatial-related domains (60% of studies). A total of 344 unique outcome instruments were reported. Speech-related outcome domains were measured by 73 different instruments and spatial-related domains by 43 different instruments. There was considerable variability in duration of follow-up, ranging from acute (baseline) testing to 10 years after the intervention. The sensitivity analysis identified no additional outcome domains. CONCLUSIONS This review identified large variability in the reporting of outcome domains and instruments in studies evaluating the therapeutic benefits and harms of SSD interventions. Reports frequently omitted information on what domains the study intended to assess, and on what instruments were used to measure which domains. TRIAL REGISTRATION The systematic review protocol is registered on PROSPERO (International Prospective Register of Systematic Reviews): Registration Number CRD42018084274 . Registered on 13 March 2018, last revised on 7th of May 2019.
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Affiliation(s)
- Roulla Katiri
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Department of Audiology, Mater Misericordiae University Hospital, Dublin, D07 R2WY Ireland
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
| | - Deborah A. Hall
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
- University of Nottingham Malaysia, Jalan Broga, 43500 Semenyih, Selangor Darul Ehsan Malaysia
| | - Catherine F. Killan
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
- Yorkshire Auditory Implant Service, Bradford Teaching Hospitals Foundation NHS Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
| | - Sandra Smith
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
| | - Pattarawadee Prayuenyong
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Pádraig T. Kitterick
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
- Nottingham University Hospitals NHS Trust, Queen’s Medical Centre, Derby Road, Nottingham, NG7 2UH UK
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27
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Donato M, Santos R, Correia F, Escada P. Single-sided deafness: Bone conduction devices or cochlear implantation? A systematic review with meta-analysis. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2021. [DOI: 10.1016/j.otoeng.2020.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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28
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Plontke SK, Caye-Thomasen P, Strauss C, Kösling S, Götze G, Siebolts U, Vordermark D, Wagner L, Fröhlich L, Rahne T. Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation. HNO 2021; 69:7-19. [PMID: 33044580 PMCID: PMC7862215 DOI: 10.1007/s00106-020-00919-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction Hearing rehabilitation with cochlear implants has attracted increasing interest also for patients with cochleovestibular schwannoma. The authors report their experience with the surgical management of tumors with rare transmodiolar or transmacular extension and outcomes after cochlear implantation (CI). Methods This retrospective case series included nine patients with either primary intralabyrinthine tumors or secondary invasion of the inner ear from the internal auditory canal. The primary endpoint with CI, performed in six patients, was word recognition score at 65 dB SPL (sound pressure level). Secondary endpoints were intra- and postoperative electrophysiological parameters, impedance measures, the presence of a wave V in the electrically evoked (via the CI) auditory brainstem responses, the specifics of postoperative CI programming, and adverse events. Results Hearing rehabilitation with CI in cases of transmodiolar tumor growth could be achieved only with incomplete tumor removal, whereas tumors with transmacular growth could be completely removed. All six patients with CI had good word recognition scores for numbers in quiet conditions (80–100% at 65 dB SPL, not later than 6 to 12 months post CI activation). Four of these six patients achieved good to very good results for monosyllabic words within 1–36 months (65–85% at 65 dB SPL). The two other patients, however, had low scores for monosyllables at 6 months (25 and 15% at 65 dB SPL, respectively) with worsening of results thereafter. Conclusions Cochleovestibular schwannomas with transmodiolar and transmacular extension represent a rare entity with specific management requirements. Hearing rehabilitation with CI is a principal option in these patients. Video online The online version of this article (10.1007/s00106-020-00919-9) includes a video (2D and 3D versions) of the described surgical technique. Article and supplementary material are available at www.springermedizin.de. Please enter the title of the article in the search field, the supplementary material can be found under “Ergänzende Inhalte”. ![]()
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Affiliation(s)
- S K Plontke
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.
| | - P Caye-Thomasen
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - C Strauss
- Department of Neurosurgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - S Kösling
- Department of Radiation Medicine, Clinic for Radiology, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - G Götze
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - U Siebolts
- Institute of Pathology, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - D Vordermark
- Department of Radiation Medicine, Clinic for Radiotherapy, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - L Wagner
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - L Fröhlich
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - T Rahne
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
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Wedekind A, Távora-Vieira D, Nguyen AT, Marinovic W, Rajan GP. Cochlear implants in single-sided deaf recipients: Near normal higher-order processing. Clin Neurophysiol 2020; 132:449-456. [PMID: 33450565 DOI: 10.1016/j.clinph.2020.11.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 11/01/2020] [Accepted: 11/17/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Single-sided deafness (SSD) is a condition where an individual has a severe to profound sensorineural hearing loss in one ear and normal hearing on the contralateral side. The use of cochlear implants in individuals with SSD leads to functional improvements in hearing. However, it is relatively unclear how sounds incoming via the cochlear implant (independent of the hearing ear) are processed and interpreted by higher-order processes in the brain. METHODS Scalp electroencephalography and auditory event-related potentials were recorded monaurally from nine experienced single sided cochlear implant users. Speech-in-noise and localisation tests were used to measure functional changes in hearing. RESULTS cochlear implant use was associated with improvement in speech-in-noise and localisation tests (compared to cochlear implant off). Significant N2 and P3b effects were observed in both cochlear implant and normal hearing ear conditions, with similar waveform morphology and scalp distribution across conditions. Delayed response times and a reduced N2 (but not P3b) effect was measured in the CI condition. CONCLUSION The brain is capable of using processes similar to those in normal hearing to discriminate sounds presented to the cochlear implant. There was evidence of processing difficulty in the cochlear implant condition which could be due to the relatively degraded signals produced by the cochlear implant compared to the normal hearing ear. SIGNIFICANCE Understanding how the brain processes sound provided by a cochlear implant highlights how cortical responses can be used to guide implantation candidacy guidelines and influence rehabilitation recommendations.
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Affiliation(s)
- Andre Wedekind
- Otolaryngology, Head and Neck Surgery, Medical School. University of Western Australia, Perth, Australia; Department of Audiology, Fiona Stanley Hospital, Perth, Australia.
| | - Dayse Távora-Vieira
- Otolaryngology, Head and Neck Surgery, Medical School. University of Western Australia, Perth, Australia; Department of Audiology, Fiona Stanley Hospital, Perth, Australia
| | - An T Nguyen
- School of Psychology, Curtin University, Perth, Australia
| | | | - Gunesh P Rajan
- Otolaryngology, Head and Neck Surgery, Medical School. University of Western Australia, Perth, Australia; Deptartment of Otolaryngology, Head & Neck Surgery, Luzerner Kantonsspital, Luzern, Switzerland
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Donato M, Santos R, Correia F, Escada P. Single-sided deafness: Bone conduction devices or cochlear implantation? A systematic review with meta-analysis. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2020; 72:101-108. [PMID: 33160618 DOI: 10.1016/j.otorri.2020.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/25/2020] [Accepted: 02/25/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To perform a systematic review with meta-analysis of the studies published on the efficacy of bone conduction devices and cochlear implantation in single-sided deafness, through the evaluation of speech discrimination in noise, sound localization and tinnitus suppression. As a secondary outcome, patient satisfaction is also assessed. DESIGN A systematic search in PubMed, Embase and CENTRAL was conducted, including all articles written in English and published in the last 10 years. The outcomes selected were speech perception in noise, sound localization, tinnitus intensity and, secondarily, quality of life assessment. Studies that met prospectively defined criteria were subjected to random effects meta-analyses. The review protocol is registered on PROSPERO with number CRD42019121444. RESULTS Nineteen articles reporting a total of 210 patients (95 patients with bone conduction devices and 115 in the cochlear implantation group) were included. The meta-analysis identifies statistically significant benefits in cochlear implantation for sound localization, tinnitus suppression, in global quality of life assessment and in 2 of the 3 subscales of quality of life assessment (ease of communication and reverberation). Bone conduction devices are better regarding speech discrimination in noise and background noise quality of life assessment. CONCLUSION Cochlear implants effectively offer better results in 2 of the 3 evaluated parameters, being a very valid option. Bone conduction devices should continue to be considered in the treatment of these patients because, in addition to allowing better discrimination in noise, patient satisfaction is greater in environments with background noise.
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Affiliation(s)
- Mariana Donato
- Otorhinolaryngology Department, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
| | - Ricardo Santos
- Otorhinolaryngology Department, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Filipe Correia
- Otorhinolaryngology Department, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Pedro Escada
- Otorhinolaryngology Department, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
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31
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Is the cochlear implant a successful long-term solution for single-sided deaf and asymmetric hearing-impaired patients? Eur Arch Otorhinolaryngol 2020; 278:3257-3265. [PMID: 33067677 PMCID: PMC8328895 DOI: 10.1007/s00405-020-06411-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/28/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE We investigated the long-term results of cochlear implant (CI) recipients with asymmetric hearing loss (AHL) or single-sided deafness (SSD). We focused on wearing behavior, audiometric hearing rehabilitation, and subjective benefits of the CI. CI is expected to improve audiological results, subjective hearing perception, and tinnitus burden. METHODS Speech recognition in background noise and sound localization were assessed preoperatively and after at least six years of CI experience. Validated questionnaires determined the subjective benefit of CI use and the subjective evaluation of tinnitus. RESULTS Over 80% of the included AHL and SSD CI recipients used their CI between 6 and 10 h daily; four subjects with SSD were non-users. Speech recognition in background noise and sound localization improved significantly compared with the unaided preoperative situation. Additionally, CI improved subjective speech intelligibility and spatial hearing impression while reducing tinnitus burden. CONCLUSION Subjects with AHL and SSD benefit from CI, subjectively and audiologically. Cochlear implant is a successful long-term treatment for AHL and SSD.
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[Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation. German version]. HNO 2020; 68:734-748. [PMID: 32886128 DOI: 10.1007/s00106-020-00918-w] [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] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Hearing rehabilitation with cochlear implants has attracted increasing interest also for patients with cochleovestibular schwannoma. The authors report their experience with the surgical management of tumors with rare transmodiolar or transmacular extension and outcomes after cochlear implantation (CI). METHODS This retrospective case series included nine patients with either primary intralabyrinthine tumors or secondary invasion of the inner ear from the internal auditory canal. The primary endpoint with CI, performed in six patients, was word recognition score at 65 dB SPL (sound pressure level). Secondary endpoints were intra- and postoperative electrophysiological parameters, impedance measures, the presence of a wave V in the electrically evoked (via the CI) auditory brainstem responses, the specifics of postoperative CI programming, and adverse events. RESULTS Hearing rehabilitation with CI in cases of transmodiolar tumor growth could be achieved only with incomplete tumor removal, whereas tumors with transmacular growth could be completely removed. All six patients with CI had good word recognition scores for numbers in quiet conditions (80-100% at 65 dB SPL, not later than 6 to 12 months post CI activation). Four of these six patients achieved good to very good results for monosyllabic words within 1-36 months (65-85% at 65 dB SPL). The two other patients, however, had low scores for monosyllables at 6 months (25 and 15% at 65 dB SPL, respectively) with worsening of results thereafter. CONCLUSIONS Cochleovestibular schwannomas with transmodiolar and transmacular extension represent a rare entity with specific management requirements. Hearing rehabilitation with CI is a principal option in these patients.
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Effects of SoundBite Bone Conduction Hearing Aids on Speech Recognition and Quality of Life in Patients with Single-Sided Deafness. Neural Plast 2020; 2020:4106949. [PMID: 32963516 PMCID: PMC7495220 DOI: 10.1155/2020/4106949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 08/05/2020] [Accepted: 08/18/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives To analyze the clinical application of SoundBite bone conduction hearing aids by assessing the improvement of speech recognition and the scores of the benefit scale questionnaire for patients with single-sided deafness (SSD). Design Nine patients aged 24 to 61 years with SSD for more than 3 months were enrolled in this study. The patients could understand and repeat Mandarin and have good compliance with the study. The measurements were evaluated before and after one month of wearing hearing aids using the pure tone audiometry threshold, speech recognition in quiet and in noise, and the Glasgow Benefit Inventory (GBI) benefit scale score. Results Pure tone audiometry results showed that the average hearing threshold of good ears and bad ears was 11.4 ± 2.6 dB HL and 89.9 ± 6.4 dB HL, respectively. The average hearing threshold of bad ears after wearing hearing aids was 23.5 ± 9.0 dB HL. Statistical analysis showed that the hearing improvement for the bad ears after wearing hearing aids was significant. The speech audiometry results showed that the disyllable word recognition score of the bad ears in quiet increased significantly at 50 dB SPL by 40 ± 12 percentage points and at 65 dB SPL by 71 ± 15 percentage points. As for the speech recognition in noise, when the signal sound came from the bad ear side and the noise from the good ear side (SSSDNAH), the speech recognition score (SRS) significantly increased by 17 ± 6 and 9 ± 4 at a signal-to-noise ratio (SNR) of -2 dB and -5 dB, respectively, after wearing the hearing aids. When the signal sound came from the front of the patient and the noise from the bad ear side (S0NSSD), the SRS scores were reduced by 5 ± 5 and 7 ± 5 percentage points at SNR equal to -2 dB and -5 dB, which was significantly different from that before wearing the hearing aids. When the signal and noise both came from the front of the patients (S0N0), the SRS was not significantly increased by 5 ± 4 percentage points at SNR equal to -2 dB compared to before wearing hearing aids. However, the SRS was significantly increased by 5 ± 2 percentage points at SNR equal to -5 dB compared to before wearing hearing aids. The average total GBI score was 31 ± 12 for the nine patients, with an average score of 32 ± 10, 31 ± 8, and 30 ± 7 for general conditions, social support, and physical health, respectively. The results of the questionnaires showed that patients' quality of life was improved after wearing SoundBite bone conduction hearing aids. Conclusions SoundBite bone conduction hearing aids are a good choice for patients with SSD, as it could improve the speech recognition ability of patients both in a quiet and noisy environment and improves the quality of life after wearing hearing aids.
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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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Varadarajan VV, Sydlowski SA, Li MM, Anne S, Adunka OF. Evolving Criteria for Adult and Pediatric Cochlear Implantation. EAR, NOSE & THROAT JOURNAL 2020; 100:31-37. [PMID: 32804575 DOI: 10.1177/0145561320947258] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The indications for cochlear implantation have gradually expanded as advancements in technology have evolved, resulting in improved audiologic outcomes for both adult and children. There remains a significant underutilization of cochlear implant technology in the United States, and recognition of the potential benefits of cochlear implantation for non-traditional indications is critical for encouraging the evolution of candidacy criteria. Adult cochlear implantation candidacy has progressed from patients with bilateral profound sensorineural hearing loss (SNHL) to include patients with greater degrees of residual hearing, single-sided deafness and asymmetric hearing, and atypical etiologies of hearing loss (eg, vestibular schwannoma, Ménière's disease, and otosclerosis). Indications for pediatric cochlear implantation have similarly evolved from children with bilateral severe to profound SNHL to implanting children at a younger age, including those with residual hearing, asymmetric hearing loss, inner ear malformations, as well as cochlear nerve deficiency. In this editorial, the literature investigating cochlear implantation for nontraditional indications is reviewed with an aim to use the best available evidence to encourage the evolution of candidacy criteria.
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Affiliation(s)
- Varun V Varadarajan
- Department of Otolaryngology-Head and Neck Surgery, 2647The Ohio State University, Columbus, OH, USA
| | | | - Michael M Li
- Department of Otolaryngology-Head and Neck Surgery, 2647The Ohio State University, Columbus, OH, USA
| | - Samantha Anne
- Head and Neck Institute, 443553Cleveland Clinic, Cleveland, OH, USA
| | - Oliver F Adunka
- Department of Otolaryngology-Head and Neck Surgery, 2647The Ohio State University, Columbus, OH, USA
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Lubner RJ, Knoll RM, Trakimas DR, Bartholomew RA, Lee DJ, Walters B, Nadol JB, Remenschneider AK, Kozin ED. Long-term cochlear implantation outcomes in patients following head injury. Laryngoscope Investig Otolaryngol 2020; 5:485-496. [PMID: 32596492 PMCID: PMC7314488 DOI: 10.1002/lio2.378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 01/27/2020] [Accepted: 03/17/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE In cases of a severe to profound sensorineural hearing loss following head injury, the cochlear implant (CI) is the primary option for auditory rehabilitation. Few studies, however, have investigated long-term CI outcomes in patients following head trauma, including those without temporal bone fracture (TBF). Herein, the aim of this study is to examine CI outcomes following cases of head injury with and without TBF. METHODS Audiometric outcomes of patients who received a CI due to a head injury resulting in severe to profound hearing loss at two tertiary care hospitals were analyzed. Patients were divided into those who received a CI in a fractured temporal bone (group A, n = 11 patients corresponding to 15 ears) and those who received a CI in a non-fractured temporal bone (group B, n = 8 patients corresponding to nine ears). Primary outcomes included duration of deafness prior to CI and postoperative consonant-nucleus-constant whole word (CNC) scores. RESULTS Nineteen patients (84% male), corresponding to 24 CIs, were identified. Fifteen CI were performed on ears with TBF (group A), and nine CI were performed on ears without TBF (group B). No patients had an enlarged vestibular aqueduct (EVA). The mean duration of deafness was 5.7 and 11.3 years in group A and group B, respectively. The mean duration of CI follow-up (CI experience) was 6.5 years in group A and 2.1 years in group B. The overall mean postoperative CNC score for all subjects was 68.6% (±21.2%, n = 19 with CNC testing). There was no difference in CNC score between group A and group B (69.8% and 66% respectively, P = .639). CONCLUSION The study is among the largest series examining long-term outcomes of CI after head injury. CI is an effective method for auditory rehabilitation in patients after head injury. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Rory J. Lubner
- Department of OtolaryngologyMassachusetts Eye and EarBostonMassachusettsUSA
- Department of OtolaryngologyHarvard Medical SchoolBostonMassachusettsUSA
- Warren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Renata M. Knoll
- Department of OtolaryngologyMassachusetts Eye and EarBostonMassachusettsUSA
- Department of OtolaryngologyHarvard Medical SchoolBostonMassachusettsUSA
| | - Danielle R. Trakimas
- Department of OtolaryngologyMassachusetts Eye and EarBostonMassachusettsUSA
- Department of OtolaryngologyHarvard Medical SchoolBostonMassachusettsUSA
- Department of OtolaryngologyJohns Hopkins Medical SchoolBaltimoreMDUSA
| | - Ryan A. Bartholomew
- Department of OtolaryngologyMassachusetts Eye and EarBostonMassachusettsUSA
- Department of OtolaryngologyHarvard Medical SchoolBostonMassachusettsUSA
| | - Daniel J. Lee
- Department of OtolaryngologyMassachusetts Eye and EarBostonMassachusettsUSA
- Department of OtolaryngologyHarvard Medical SchoolBostonMassachusettsUSA
| | - Brad Walters
- Department of OtolaryngologyUniversity of Mississippi Medical CenterJacksonMississippi
| | - Joseph B. Nadol
- Department of OtolaryngologyMassachusetts Eye and EarBostonMassachusettsUSA
- Department of OtolaryngologyHarvard Medical SchoolBostonMassachusettsUSA
| | - Aaron K. Remenschneider
- Department of OtolaryngologyMassachusetts Eye and EarBostonMassachusettsUSA
- Department of OtolaryngologyHarvard Medical SchoolBostonMassachusettsUSA
- Department of OtolaryngologyUniversity of Massachusetts Medical CenterWorcesterMassachusettsUSA
| | - Elliott D. Kozin
- Department of OtolaryngologyMassachusetts Eye and EarBostonMassachusettsUSA
- Department of OtolaryngologyHarvard Medical SchoolBostonMassachusettsUSA
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Mechanisms of Localization and Speech Perception with Colocated and Spatially Separated Noise and Speech Maskers Under Single-Sided Deafness with a Cochlear Implant. Ear Hear 2020; 40:1293-1306. [PMID: 30870240 DOI: 10.1097/aud.0000000000000708] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study tested listeners with a cochlear implant (CI) in one ear and acoustic hearing in the other ear, to assess their ability to localize sound and to understand speech in collocated or spatially separated noise or speech maskers. DESIGN Eight CI listeners with contralateral acoustic hearing ranging from normal hearing to moderate sensorineural hearing loss were tested. Localization accuracy was measured in five of the listeners using stimuli that emphasized the separate contributions of interaural level differences (ILDs) and interaural time differences (ITD) in the temporal envelope and/or fine structure. Sentence recognition was tested in all eight CI listeners, using collocated and spatially separated speech-shaped Gaussian noise and two-talker babble. Performance was compared with that of age-matched normal-hearing listeners via loudspeakers or via headphones with vocoder simulations of CI processing. RESULTS Localization improved with the CI but only when high-frequency ILDs were available. Listeners experienced no additional benefit via ITDs in the stimulus envelope or fine structure using real or vocoder-simulated CIs. Speech recognition in two-talker babble improved with a CI in seven of the eight listeners when the target was located at the front and the babble was presented on the side of the acoustic-hearing ear, but otherwise showed little or no benefit of a CI. CONCLUSION Sound localization can be improved with a CI in cases of significant residual hearing in the contralateral ear, but only for sounds with high-frequency content, and only based on ILDs. In speech understanding, the CI contributed most when it was in the ear with the better signal to noise ratio with a speech masker.
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Snapp HA, Ausili SA. Hearing with One Ear: Consequences and Treatments for Profound Unilateral Hearing Loss. J Clin Med 2020; 9:jcm9041010. [PMID: 32260087 PMCID: PMC7230949 DOI: 10.3390/jcm9041010] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 03/28/2020] [Accepted: 03/31/2020] [Indexed: 12/02/2022] Open
Abstract
There is an increasing global recognition of the negative impact of hearing loss, and its association to many chronic health conditions. The deficits and disabilities associated with profound unilateral hearing loss, however, continue to be under-recognized and lack public awareness. Profound unilateral hearing loss significantly impairs spatial hearing abilities, which is reliant on the complex interaction of monaural and binaural hearing cues. Unilaterally deafened listeners lose access to critical binaural hearing cues. Consequently, this leads to a reduced ability to understand speech in competing noise and to localize sounds. The functional deficits of profound unilateral hearing loss have a substantial impact on socialization, learning and work productivity. In recognition of this, rehabilitative solutions such as the rerouting of signal and hearing implants are on the rise. This review focuses on the latest insights into the deficits of profound unilateral hearing impairment, and current treatment approaches.
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Karoui C, James C, Barone P, Bakhos D, Marx M, Macherey O. Searching for the Sound of a Cochlear Implant: Evaluation of Different Vocoder Parameters by Cochlear Implant Users With Single-Sided Deafness. Trends Hear 2020; 23:2331216519866029. [PMID: 31533581 PMCID: PMC6753516 DOI: 10.1177/2331216519866029] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cochlear implantation in subjects with single-sided deafness (SSD) offers a unique opportunity to directly compare the percepts evoked by a cochlear implant (CI) with those evoked acoustically. Here, nine SSD-CI users performed a forced-choice task evaluating the similarity of speech processed by their CI with speech processed by several vocoders presented to their healthy ear. In each trial, subjects heard two intervals: their CI followed by a certain vocoder in Interval 1 and their CI followed by a different vocoder in Interval 2. The vocoders differed either (i) in carrier type-(sinusoidal [SINE], bandfiltered noise [NOISE], and pulse-spreading harmonic complex) or (ii) in frequency mismatch between the analysis and synthesis frequency ranges-(no mismatch, and two frequency-mismatched conditions of 2 and 4 equivalent rectangular bandwidths [ERBs]). Subjects had to state in which of the two intervals the CI and vocoder sounds were more similar. Despite a large intersubject variability, the PSHC vocoder was judged significantly more similar to the CI than SINE or NOISE vocoders. Furthermore, the No-mismatch and 2-ERB mismatch vocoders were judged significantly more similar to the CI than the 4-ERB mismatch vocoder. The mismatch data were also interpreted by comparing spiral ganglion characteristic frequencies with electrode contact positions determined from postoperative computed tomography scans. Only one subject demonstrated a pattern of preference consistent with adaptation to the CI sound processor frequency-to-electrode allocation table and two subjects showed possible partial adaptation. Those subjects with adaptation patterns presented overall small and consistent frequency mismatches across their electrode arrays.
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Affiliation(s)
- Chadlia Karoui
- Centre de Recherche Cerveau et Cognition, Toulouse, France.,Cochlear France SAS, Toulouse, France
| | - Chris James
- Cochlear France SAS, Toulouse, France.,Department of Otology-Neurotology and Skull Base Surgery, Purpan University Hospital, Toulouse, France
| | - Pascal Barone
- Centre de Recherche Cerveau et Cognition, Toulouse, France
| | - David Bakhos
- Université François-Rabelais de Tours, CHRU de Tours, France.,Ear Nose and Throat department, CHUR de Tours, Tours, France
| | - Mathieu Marx
- Centre de Recherche Cerveau et Cognition, Toulouse, France.,Department of Otology-Neurotology and Skull Base Surgery, Purpan University Hospital, Toulouse, France
| | - Olivier Macherey
- Aix Marseille University, CNRS, Centrale Marseille, LMA, Marseille, France
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Katiri R, Hall DA, Buggy N, Hogan N, Horobin A, van de Heyning P, Firszt JB, Bruce IA, Kitterick PT. Core Rehabilitation Outcome Set for Single Sided Deafness (CROSSSD) study: protocol for an international consensus on outcome measures for single sided deafness interventions using a modified Delphi survey. Trials 2020; 21:238. [PMID: 32131880 PMCID: PMC7057560 DOI: 10.1186/s13063-020-4094-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 01/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Single-sided deafness (SSD) describes the presence of a unilateral severe to profound sensorineural hearing loss. SSD disrupts spatial hearing and understanding speech in background noise. It has functional, psychological and social consequences. Potential options for rehabilitation include hearing aids and auditory implants. Benefits and harms of these interventions are documented inconsistently in the literature, using a variety of outcomes ranging from tests of speech perception to quality of life questionnaires. It is therefore difficult to compare interventions when rehabilitating SSD. The Core Rehabilitation Outcome Set for Single Sided Deafness (CROSSSD) study is an international initiative that aims to develop a minimum set of core outcomes for use in future trials of SSD interventions. METHODS/DESIGN The CROSSSD study adopts an international two-round online modified Delphi survey followed by a stakeholder consensus meeting to identify a patient-centred core outcome domain set for SSD based on what is considered critical and important for assessing whether an intervention for SSD has worked. DISCUSSION The resulting core outcome domain set will act as a minimum standard for reporting in future clinical trials and could have further applications in guiding the use of outcome measures in clinical practice. Standardisation will facilitate comparison of research findings.
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Affiliation(s)
- Roulla Katiri
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom
- Department of Audiology, Mater Misericordiae University Hospital, Dublin, D07 R2WY, Ireland
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, United Kingdom
| | - Deborah A Hall
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, United Kingdom
- University of Nottingham Malaysia, Jalan Broga, 43500, Semenyih, Selangor Darul Ehsan, Malaysia
| | - Nora Buggy
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom
| | - Nicholas Hogan
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom
| | - Adele Horobin
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, United Kingdom
| | - Paul van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Jill B Firszt
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Iain A Bruce
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, United Kingdom
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - Pádraig T Kitterick
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom.
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, United Kingdom.
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, United Kingdom.
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Ehrmann-Mueller D, Kurz A, Kuehn H, Rak K, Mlynski R, Hagen R, Shehata-Dieler W. Usefulness of cochlear implantation in children with single sided deafness. Int J Pediatr Otorhinolaryngol 2020; 130:109808. [PMID: 31809969 DOI: 10.1016/j.ijporl.2019.109808] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Children with single sided deafness (SSD) show a poorer performance at school, which is attributable to reduced speech discrimination in noise, to reduced localization ability, and to a decreased power of concentration due to faster hearing exhaustion. Therefore, it is important to provide children with SSD with adequate hearing amplification to restore binaural hearing. This can only be achieved by provision with a cochlear implant (CI). But these treatment option in children with SSD is still under discussion. The aim of the present study is to evaluate audiological and clinical results in children with SSD following cochlear implantation. A special focus was placed on the duration of deafness before implantation and on the frequency of CI-use in everyday life. METHODS Seven children with SSD of different etiologies who were provided with a CI between 3 and 16 years of age were evaluated. Every child underwent multiple audiological tests before and after cochlear implantation. After cochlear implantation speech recognition tests in noise using the HSM (Hochmair, Schulz and Moser 1997) test and localization tests were performed. Furthermore, the frequency of implant use was evaluated. RESULTS Speech recognition in noise with CI compared to the unaided condition significantly improved in all children in different settings. Improvement of the localization ability measured by the root mean square error (RMSE) was shown in all children. All children are very satisfied with the decision to have undergone cochlear implantation and are all full-time users. CONCLUSIONS Cochlear implantation benefits speech recognition in noise and sound localization ability in children with SSD at different ages. All implanted children are full-time users regardless of age or duration of deafness before implantation.
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Affiliation(s)
- Désirée Ehrmann-Mueller
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany.
| | - Anja Kurz
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany
| | - Heike Kuehn
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany
| | - Kristen Rak
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany
| | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery, "Otto-Koerner", University of Rostock, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany
| | - Wafaa Shehata-Dieler
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany
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Wedekind A, Rajan G, Van Dun B, Távora-Vieira D. Restoration of cortical symmetry and binaural function: Cortical auditory evoked responses in adult cochlear implant users with single sided deafness. PLoS One 2020; 15:e0227371. [PMID: 31935234 PMCID: PMC6959557 DOI: 10.1371/journal.pone.0227371] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 12/17/2019] [Indexed: 11/23/2022] Open
Abstract
Background Cochlear implantation for single-sided deafness (SSD) is the only treatment option with the potential to restore binaural hearing cues. Significant binaural benefit has been measured in adults by speech in noise and localisation tests, who receive a cochlear implant for SSD, however, little is known on the cortical changes that help provide this benefit. In the present study, detection of sound in the auditory cortex, speech testing and localisation was used to investigate the ability of a cochlear implant (CI) to restore auditory cortical latencies and improve binaural benefit in the adult SSD population. Methods Twenty-nine adults with acquired single-sided deafness who received a CI in adulthood were studied. Speech perception in noise was tested using the Bamford-Kowal-Bench speech-in-noise test, localisation ability was measured using the auditory speech sounds evaluation (AδE) localisation test and cortical auditory evoked responses, comparing N1-P2 latencies recorded from the normal hearing ear and cochlear implant were used to investigate the synchrony of the cortical pathway from the CI and normal hearing ear (NHe) with binaural hearing function. Results There was a significant improvement in speech perception in noise in all spatial configurations S0/N0 (Z = -3.066, p<0.002), S0/NHE (Z = -4.031, p<0.001), SCI/NHE (Z = -3.851, p<0.001). Localization significantly improved when tested with the cochlear implant on (p<0.001) with a shorter duration of deafness correlating to a greater improvement in localisation ability F(1:18) = 6.854; p = 0.017). There was no significant difference in N1-P2 latency recorded from the normal hearing ear and the CI. Conclusion Cortical auditory evoked response latencies recorded from the CI and NHe showed no significant difference, indicating that the detection of sound in the auditory cortex occurred simultaneously, providing the cortex with auditory information for binaural hearing.
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Affiliation(s)
- Andre Wedekind
- Otolaryngology, Head and Neck Surgery, School of Surgery, University of Western Australia, Perth, Australia
- Fiona Stanley Hospital, Perth, Australia
- * E-mail:
| | - Gunesh Rajan
- Otolaryngology, Head and Neck Surgery, School of Surgery, University of Western Australia, Perth, Australia
- Department of Otolaryngology, Head & Neck Surgery, Luzerner Kantonsspital, Luzern, Switzerland
| | - Bram Van Dun
- The National Acoustic Laboratories, Sydney, Australia
| | - Dayse Távora-Vieira
- Otolaryngology, Head and Neck Surgery, School of Surgery, University of Western Australia, Perth, Australia
- Fiona Stanley Hospital, Perth, Australia
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Jafari Z, Kolb BE, Mohajerani MH. Age-related hearing loss and tinnitus, dementia risk, and auditory amplification outcomes. Ageing Res Rev 2019; 56:100963. [PMID: 31557539 DOI: 10.1016/j.arr.2019.100963] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/20/2019] [Accepted: 09/18/2019] [Indexed: 01/07/2023]
Abstract
Age-related hearing loss (ARHL) or presbycusis, as the third leading cause of chronic disability in older adults, has been shown to be associated with predisposing cognitive impairment and dementia. Tinnitus is also a chronic auditory disorder demonstrating a growth rate with increasing age. Recent evidence stands for the link between bothersome tinnitus and impairments in various aspects of cognitive function. Both ARHL and age-related tinnitus affect mental health and contribute to developing anxiety, stress, and depression. The present review is a comprehensive multidisciplinary study on diverse interactions among ARHL, tinnitus, and cognitive decline in older adults. This review incorporates the latest evidence in prevalence and risk factors of ARHL and tinnitus, the neural substrates of tinnitus-related cognitive impairments, hypothesized mechanisms concerning the association between ARHL and increased risk of dementia, hearing amplification outcomes in cases with ARHL and cognitive decline, and preliminary findings on the link between ARHL and cognitive impairment in animal studies. Given extensive evidence that demonstrates advantages of using auditory amplification in the alleviation of hearing handicap, depression, and tinnitus, and the improvement of cognition, social communication, and quality of life, regular hearing screening programs for identification and management of midlife hearing loss and tinnitus is strongly recommended.
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García JM, Urquijo DP, Puerta M, Mosquera CA, Hernández LM, Aparicio ML, Barón C, Otoya Tono AM, Peñaranda A. Cochlear implant in patients with single sided deafness: hearing results and communicative benefits. Cochlear Implants Int 2019; 21:136-144. [PMID: 31741427 DOI: 10.1080/14670100.2019.1691321] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Evaluate auditory results and communicative benefits in adult patients with single-sided deafness (SSD) treated with cochlear implantation.Study Design: Observational descriptive case series.Setting: Hospital Universitario Fundación Santa Fe de Bogotá.Patients: Ten patients with profound post-lingual SSD were treated with cochlear implantation between January 2011 and March 2016. Two patients were excluded because of incomplete follow-up.Interventions: Medical records included demographic information, pre and post-operative audiometric results, and binaural and monoaural speech discrimination tests in three sound-in-noise configurationswith the cochlear implant turned on and off, respectively. Subjective improvement was evaluated using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and Speech, Spatial, and Qualities of Hearing Scale (SSQ-B).Main Outcome Measures: Pre and post-operative audiometric and speech discrimination results, post-operative binaural and monoaural speech discrimination in noise results, and APHAB and SSQ-B questionnaire results.Results: Significant improvement in speech discrimination in a noisy environment was found when the noise and signal were presented from the front, and when the signal was presented to the implanted ear and the noise to the healthy ear. SSQ-B questionnaire showed improvement in all subscales, while APHAB showed improvement in all subscales except sound aversion.Conclusion: Patients with SSD showed improvement regarding communication skills and sound discrimination in a noisy environment.
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Affiliation(s)
- Juan M García
- Otolaryngology and Otology Service, Hospital San José, School of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.,Otolaryngology Section, Hospital Universitario Fundación Santa Fe de Bogotá, School of Medicine, Universidad de los Andes, Bogotá, Colombia.,Otolaryngology Section: Cochlear Implant program, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Diana Paola Urquijo
- Otolaryngology and Otology Service, Hospital San José, School of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia
| | - Mauricio Puerta
- Otolaryngology and Otology Service, Hospital San José, School of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia
| | | | - Lina María Hernández
- Otolaryngology Section: Cochlear Implant program, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - María Leonor Aparicio
- Otolaryngology Section: Cochlear Implant program, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Clemencia Barón
- Otolaryngology Section: Cochlear Implant program, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Ana M Otoya Tono
- Otolaryngology and Otology Service, Hospital San José, School of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia
| | - Augusto Peñaranda
- Otolaryngology Section, Hospital Universitario Fundación Santa Fe de Bogotá, School of Medicine, Universidad de los Andes, Bogotá, Colombia.,Otolaryngology Section: Cochlear Implant program, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
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Sullivan CB, Al-Qurayshi Z, Zhu V, Liu A, Dunn C, Gantz BJ, Hansen MR. Long-term audiologic outcomes after cochlear implantation for single-sided deafness. Laryngoscope 2019; 130:1805-1811. [PMID: 31710701 DOI: 10.1002/lary.28358] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/19/2019] [Accepted: 09/23/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the long-term audiometric outcomes, sound localization abilities, binaural benefits, and tinnitus assessment of subjects with cochlear implant (CI) after a diagnosis of unilateral severe-to-profound hearing loss. METHOD The study group consisted of 60 (mean age 52 years, range 19-84) subjects with profound hearing loss in one ear and normal to near-normal hearing in the other ear who underwent CI. Data analysis included pre- and postoperative Consonant-Nucleus-Consonant (CNC) Word scores, AzBio Sentence scores, pure tone thresholds, sound localization, and Iowa Tinnitus Handicap Questionnaire scores. RESULTS Preoperative average duration of deafness was 3.69 years (standard deviation 4.31), with an average follow-up time of 37.9 months (range 1-87). CNC and AzBio scores significantly improved (both P < 0.001) postoperatively among the entire cohort, and there was much heterogeneity in outcomes with respect to deafness etiology subgroup analysis. Sound localization abilities tended to improve longitudinally in the entire cohort. Binaural benefits using an adaptive Hearing in Noise Test test showed a significant (P < 0.001) improvement with head shadow effect. Utilizing the Iowa Tinnitus Handicap Questionnaire, there was significant improvement in social, physical, and emotional well-being (P = 0.011), along with hearing abilities (P = 0.001). CONCLUSIONS This case series is the largest cohort of CI SSD subjects to date and systematically analyzes their functional outcomes. Subjects have meaningful improvement in word understanding, and sound localization tends to gradually improve over time. Binaural benefit analysis showed significant improvement with head shadow effect, which likely provides ease of listening. LEVEL OF EVIDENCE 4 Laryngoscope, 130:1805-1811, 2020.
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Affiliation(s)
- Christopher Blake Sullivan
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Zaid Al-Qurayshi
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Vivian Zhu
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Andrew Liu
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Camille Dunn
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Bruce J Gantz
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A.,Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Marlan R Hansen
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A.,Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
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Banakis Hartl RM, Greene NT, Benichoux V, Dondzillo A, Brown AD, Tollin DJ. Establishing an Animal Model of Single-Sided Deafness in Chinchilla lanigera. Otolaryngol Head Neck Surg 2019; 161:1004-1011. [PMID: 31570054 DOI: 10.1177/0194599819877649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES (1) To characterize changes in brainstem neural activity following unilateral deafening in an animal model. (2) To compare brainstem neural activity from unilaterally deafened animals with that of normal-hearing controls. STUDY DESIGN Prospective controlled animal study. SETTING Vivarium and animal research facilities. SUBJECTS AND METHODS The effect of single-sided deafness on brainstem activity was studied in Chinchilla lanigera. Animals were unilaterally deafened via gentamycin injection into the middle ear, which was verified by loss of auditory brainstem responses (ABRs). Animals underwent measurement of ABR and local field potential in the inferior colliculus. RESULTS Four animals underwent chemical deafening, with 2 normal-hearing animals as controls. ABRs confirmed unilateral loss of auditory function. Deafened animals demonstrated symmetric local field potential responses that were distinctly different than the contralaterally dominated responses of the inferior colliculus seen in normal-hearing animals. CONCLUSION We successfully developed a model for unilateral deafness to investigate effects of single-sided deafness on brainstem plasticity. This preliminary investigation serves as a foundation for more comprehensive studies that will include cochlear implantation and manipulation of binaural cues, as well as functional behavioral tests.
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Affiliation(s)
- Renee M Banakis Hartl
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Nathaniel T Greene
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | | | - Anna Dondzillo
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Andrew D Brown
- Department of Physiology and Biophysics, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Daniel J Tollin
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, Colorado, USA.,Department of Physiology and Biophysics, School of Medicine, University of Colorado, Aurora, Colorado, USA
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Bagatto M, DesGeorges J, King A, Kitterick P, Laurnagaray D, Lewis D, Roush P, Sladen DP, Tharpe AM. Consensus practice parameter: audiological assessment and management of unilateral hearing loss in children. Int J Audiol 2019; 58:805-815. [PMID: 31486692 DOI: 10.1080/14992027.2019.1654620] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective: Provide recommendations to audiologists for the management of children with unilateral hearing loss (UHL) and for needed research that can lend further insight into important unanswered questions.Design: An international panel of experts on children with UHL was convened following a day and a half of presentations on the same. The evidence reviewed for this parameter was gathered through web-based literature searches specifically designed for academic and health care resources, recent systematic reviews of literature, and new research presented at the conference that underwent peer review for publication by the time of this writing.Study sample: Expert opinions and electronic databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Education Resources Information Centre (ERIC), Google Scholar, PsycINFO, PubMed, ScienceDirect, and Turning Research into Practice (TRIP) Database.Results: The resulting practice parameter requires a personalised, family-centred process: (1) routine surveillance of speech-language, psychosocial, auditory, and academic or pre-academic development; (2) medical assessments for determination of aetiology of hearing loss; (3) assessment of hearing technologies; and (4) considerations for family-centred counselling.Conclusions: This practice parameter provides guidance to clinical audiologists on individualising the management of children with UHL. In addition, the paper concludes with recommendations for research priorities.
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Affiliation(s)
- Marlene Bagatto
- School of Communication Sciences and Disorders, Western University, London, Canada
| | | | - Alison King
- Australian Hearing, Paediatric Services, Box Hill, Australia
| | | | | | - Dawna Lewis
- Center for Hearing Research, Boys Town National Research Hospital
| | - Patricia Roush
- Department of Otolaryngology, University of North Carolina
| | - Douglas P Sladen
- Department of Communication Sciences and Disorders, Western Washington University
| | - Anne Marie Tharpe
- Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine
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Spitzer ER, Landsberger DM, Friedmann DR, Galvin JJ. Pleasantness Ratings for Harmonic Intervals With Acoustic and Electric Hearing in Unilaterally Deaf Cochlear Implant Patients. Front Neurosci 2019; 13:922. [PMID: 31551686 PMCID: PMC6733976 DOI: 10.3389/fnins.2019.00922] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/16/2019] [Indexed: 11/13/2022] Open
Abstract
Background Harmony is an important part of tonal music that conveys context, form and emotion. Two notes sounded simultaneously form a harmonic interval. In normal-hearing (NH) listeners, some harmonic intervals (e.g., minor 2nd, tritone, major 7th) typically sound more dissonant than others (e.g., octave, major 3rd, 4th). Because of the limited spectro-temporal resolution afforded by cochlear implants (CIs), music perception is generally poor. However, CI users may still be sensitive to relative dissonance across intervals. In this study, dissonance ratings for harmonic intervals were measured in 11 unilaterally deaf CI patients, in whom ratings from the CI could be compared to those from the normal ear. Methods Stimuli consisted of pairs of equal amplitude MIDI piano tones. Intervals spanned a range of two octaves relative to two root notes (F3 or C4). Dissonance was assessed in terms of subjective pleasantness ratings for intervals presented to the NH ear alone, the CI ear alone, and both ears together (NH + CI). Ratings were collected for both root notes for within- and across-octave intervals (1–12 and 13–24 semitones). Participants rated the pleasantness of each interval by clicking on a line anchored with “least pleasant” and “most pleasant.” A follow-up experiment repeated the task with a smaller stimulus set. Results With NH-only listening, within-octave intervals minor 2nd, major 2nd, and major 7th were rated least pleasant; major 3rd, 5th, and octave were rated most pleasant. Across-octave counterparts were similarly rated. With CI-only listening, ratings were consistently lower and showed a reduced range. Mean ratings were highly correlated between NH-only and CI-only listening (r = 0.845, p < 0.001). Ratings were similar between NH-only and NH + CI listening, with no significant binaural enhancement/interference. The follow-up tests showed that ratings were reliable for the least and most pleasant intervals. Discussion Although pleasantness ratings were less differentiated for the CI ear than the NH ear, there were similarities between the two listening modes. Given the lack of spectro-temporal detail needed for harmonicity-based distinctions, temporal envelope interactions (within and across channels) associated with a perception of roughness may contribute to dissonance perception for harmonic intervals with CI-only listening.
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Affiliation(s)
- Emily R Spitzer
- Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, NY, United States
| | - David M Landsberger
- Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, NY, United States
| | - David R Friedmann
- Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, NY, United States
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Távora-Vieira D, Rajan GP, Van de Heyning P, Mertens G. Evaluating the Long-Term Hearing Outcomes of Cochlear Implant Users With Single-Sided Deafness. Otol Neurotol 2019; 40:e575-e580. [PMID: 31135665 DOI: 10.1097/mao.0000000000002235] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To investigate the long-term outcomes of cochlear implantation in individuals with single-sided deafness (SSD) in terms of speech perception, subjective hearing performance, and sound localization. METHODS Thirty-four subjects with SSD were recruited across two large cochlear implant (CI) centers (Antwerp, Belgium and Perth, Australia). The long-term hearing outcomes (between 4 and 10 years of CI use) were evaluated using speech in noise tests, a subjective hearing performance questionnaire (Speech, Spatial and Qualities Questionnaire [SSQ12]), and sound localization tests. RESULTS Statistically significant improvements were observed in speech perception in noise and sound localization results postoperatively with the use of a CI in comparison to preoperative measurements. Subjective hearing abilities also significantly improved after long-term CI use. CONCLUSION Access to binaural hearing is important for subjects with SSD. CI users with SSD experience long-term benefits in speech understanding, sound localization, and quality of life.
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Affiliation(s)
- Dayse Távora-Vieira
- Otolaryngology, Head & Neck Surgery, Medical School, University of Western Australia
- Fiona Stanley Hospital, Perth, Australia
| | - Gunesh P Rajan
- Otolaryngology, Head & Neck Surgery, Medical School, University of Western Australia
- Otolaryngology, Head & Neck Surgery Department, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Paul Van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Griet Mertens
- Otolaryngology, Head & Neck Surgery Department, Luzerner Kantonsspital, Lucerne, Switzerland
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp
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Benefits of Cochlear Implantation for Single-Sided Deafness: Data From the House Clinic-University of Southern California-University of California, Los Angeles Clinical Trial. Ear Hear 2019; 40:766-781. [DOI: 10.1097/aud.0000000000000671] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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