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Gajecki T, Nogueira W. A Fused Deep Denoising Sound Coding Strategy for Bilateral Cochlear Implants. IEEE Trans Biomed Eng 2024; 71:2232-2242. [PMID: 38376983 DOI: 10.1109/tbme.2024.3367530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Cochlear implants (CIs) provide a solution for individuals with severe sensorineural hearing loss to regain their hearing abilities. When someone experiences this form of hearing impairment in both ears, they may be equipped with two separate CI devices, which will typically further improve the CI benefits. This spatial hearing is particularly crucial when tackling the challenge of understanding speech in noisy environments, a common issue CI users face. Currently, extensive research is dedicated to developing algorithms that can autonomously filter out undesired background noises from desired speech signals. At present, some research focuses on achieving end-to-end denoising, either as an integral component of the initial CI signal processing or by fully integrating the denoising process into the CI sound coding strategy. This work is presented in the context of bilateral CI (BiCI) systems, where we propose a deep-learning-based bilateral speech enhancement model that shares information between both hearing sides. Specifically, we connect two monaural end-to-end deep denoising sound coding techniques through intermediary latent fusion layers. These layers amalgamate the latent representations generated by these techniques by multiplying them together, resulting in an enhanced ability to reduce noise and improve learning generalization. The objective instrumental results demonstrate that the proposed fused BiCI sound coding strategy achieves higher interaural coherence, superior noise reduction, and enhanced predicted speech intelligibility scores compared to the baseline methods. Furthermore, our speech-in-noise intelligibility results in BiCI users reveal that the deep denoising sound coding strategy can attain scores similar to those achieved in quiet conditions.
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Chen Y, Li Y, Jia H, Gu W, Wang Z, Zhang Z, Xue M, Li J, Shi W, Jiang L, Yang L, Sterkers O, Wu H. Simultaneous Bilateral Cochlear Implantation in Very Young Children Improves Adaptability and Social Skills: A Prospective Cohort Study. Ear Hear 2023; 44:254-263. [PMID: 36126187 DOI: 10.1097/aud.0000000000001276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate the value of using the Gesell Development Diagnosis Scale (GDDS) to predict developmental outcomes in very young children who undergo simultaneous bilateral cochlear implantation. DESIGN In this prospective cohort study, a repeated-measures investigation was conducted in a tertiary referral hospital. A total of 62 children receiving simultaneous bilateral cochlear implantations were enrolled from April 2017 to August 2018. They were divided into 2 groups depending on the operative age: "Infants" group (6 to 12 months, N = 38) or "Children" group (12 to 36 months, N = 24). Data on the surgical outcomes, auditory development, speech production, and developmental indicators were collected until 2 years after the initial fitting. The primary outcome measure was the GDDS, a neuropsychological development examination. Secondary outcomes included the following: complication rate, aided pure-tone average, Infant-Toddler Meaningful Auditory Integration Scale, Categories of Auditory Performance-II, Meaningful Use of Speech Scale, Speech Intelligibility Rating, and the LittlEARS Auditory Questionnaire. RESULTS The mean ages at implantation in infants and children groups were 9.2 ± 1.17 and 16.6 ± 3.60 months, respectively. Significant differences were found in the social skills ( p = 0.001) and adaptability ( p = 0.031) domains of GDDS. The younger the age of bilateral cochlear implants surgery, the higher developmental quotient of language, social skills, and adaptability the child could achieve after 2 years. The complication rates in the infants and children groups were 0% versus 2.1% ( p = 0.57). There was no surgical complication in the infants group. In the children group, 1 case with enlarged vestibular aqueduct and Mondini malformation had a receiver-implant misplacement on the right side (2%, 1/48). In the two groups, auditory performance and speech production had improved similarly. In the infants group, social skills developmental quotient at baseline had a significant positive relationship with Meaningful Use of Speech Scale after 2 years. CONCLUSIONS Simultaneous bilateral cochlear implantation in younger children improves adaptability and social skills. GDDS is a sensitive tool of evaluating short-term effect of bilateral cochlear implants in neuropsychological development and constitutes a reliable predictor of speech production for the very younger pediatric cochlear implant users.
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Affiliation(s)
- Ying Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
- The authors contributed equally to this work
| | - Yun Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
- The authors contributed equally to this work
| | - Huan Jia
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
- The authors contributed equally to this work
| | - Wenxi Gu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
| | - Zhaoyan Wang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
| | - Zhihua Zhang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
| | - Minbo Xue
- Child Healthcare Department, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingjie Li
- Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wentao Shi
- Clinical Research Center, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linlin Jiang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
| | - Lu Yang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
| | - Olivier Sterkers
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
| | - Hao Wu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
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Thangavelu K, Nitzge M, Weiß RM, Mueller-Mazzotta J, Stuck BA, Reimann K. Role of cochlear reserve in adults with cochlear implants following post-lingual hearing loss. Eur Arch Otorhinolaryngol 2023; 280:1063-1071. [PMID: 35947149 PMCID: PMC9899754 DOI: 10.1007/s00405-022-07558-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/12/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Pre-operative assessments before cochlear implantation (CI) includes the examination of both tone hearing, and the level of the cochlear reserve indicated by speech understanding. The goal of this study was to explore the predictive influence of tone hearing and cochlear reserve in CI. METHODS We did a retrospective cohort study, which included adult patients who had undergone CI between January 2012 and December 2019 in a tertiary care center. The pre-operative tone hearing, unaided maximum monosyllabic word recognition score (WRSmax), aided hearing gain, aided monosyllabic word recognition score at 65 dB (WRS65(HA)), and speech perception gap (SPG) were measured. The duration of unaided hearing loss (UHL) was also assessed. These variables were compared with post-operative monosyllabic word recognition score after CI at 65 dB (WRS65(CI)). RESULTS 103 patients and 128 ears were included in this study. Regardless of tone hearing, patients with better pre-operative WRSmax and WRS65(HA) performed better post-operatively. WRSmax was found to be the most important factor that was statistically significantly associated with WRS65(CI). SPG was statistically significantly associated with WRSmax and SPG ≥ 20% group performed better post-operatively. Any duration of unaided hearing loss was statistically significantly inversely associated with WRSmax above 0%. CONCLUSION Cochlear reserve represented by WRSmax may play the most important role as a predictive factor in outcomes after CI. SPG should be considered for indicating CI in patients, when WRS65(HA) does not reach WRSmax. Early rehabilitation with hearing aids and duration of hearing aid usage might play an important role in preserving cochlear reserve in adults.
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Affiliation(s)
- Kruthika Thangavelu
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Baldingerstrasse, 35043, Marburg, Germany.
| | - Markus Nitzge
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Baldingerstrasse, 35043, Marburg, Germany
| | - Rainer M Weiß
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Baldingerstrasse, 35043, Marburg, Germany
| | - Jochen Mueller-Mazzotta
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Baldingerstrasse, 35043, Marburg, Germany
| | - Boris A Stuck
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Baldingerstrasse, 35043, Marburg, Germany
| | - Katrin Reimann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Baldingerstrasse, 35043, Marburg, Germany
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Arias-Vergara T, Batliner A, Rader T, Polterauer D, Högerle C, Müller J, Orozco-Arroyave JR, Nöth E, Schuster M. Adult Cochlear Implant Users Versus Typical Hearing Persons: An Automatic Analysis of Acoustic-Prosodic Parameters. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:4623-4636. [PMID: 36417788 DOI: 10.1044/2022_jslhr-21-00116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE The aim of this study was to investigate the speech prosody of postlingually deaf cochlear implant (CI) users compared with control speakers without hearing or speech impairment. METHOD Speech recordings of 74 CI users (37 males and 37 females) and 72 age-balanced control speakers (36 males and 36 females) are considered. All participants are German native speakers and read Der Nordwind und die Sonne (The North Wind and the Sun), a standard text in pathological speech analysis and phonetic transcriptions. Automatic acoustic analysis is performed considering pitch, loudness, and duration features, including speech rate and rhythm. RESULTS In general, duration and rhythm features differ between CI users and control speakers. CI users read slower and have a lower voiced segment ratio compared with control speakers. A lower voiced ratio goes along with a prolongation of the voiced segments' duration in male and with a prolongation of pauses in female CI users. Rhythm features in CI users have higher variability in the duration of vowels and consonants than in control speakers. The use of bilateral CIs showed no advantages concerning speech prosody features in comparison to unilateral use of CI. CONCLUSIONS Even after cochlear implantation and rehabilitation, the speech of postlingually deaf adults deviates from the speech of control speakers, which might be due to changed auditory feedback. We suggest considering changes in temporal aspects of speech in future rehabilitation strategies. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21579171.
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Affiliation(s)
- Tomás Arias-Vergara
- Department of Otorhinolaryngology and Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
- Faculty of Engineering, Universidad de Antioquia, Medellín, Colombia
- Pattern Recognition Lab, Friedrich-Alexander University, Erlangen-Nuremberg, Germany
| | - Anton Batliner
- Pattern Recognition Lab, Friedrich-Alexander University, Erlangen-Nuremberg, Germany
- Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Germany
| | - Tobias Rader
- Department of Otorhinolaryngology and Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
| | - Daniel Polterauer
- Department of Otorhinolaryngology and Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
| | - Catalina Högerle
- Department of Otorhinolaryngology and Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
| | - Joachim Müller
- Department of Otorhinolaryngology and Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
| | - Juan-Rafael Orozco-Arroyave
- Faculty of Engineering, Universidad de Antioquia, Medellín, Colombia
- Pattern Recognition Lab, Friedrich-Alexander University, Erlangen-Nuremberg, Germany
| | - Elmar Nöth
- Pattern Recognition Lab, Friedrich-Alexander University, Erlangen-Nuremberg, Germany
| | - Maria Schuster
- Department of Otorhinolaryngology and Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
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Anand AK, Suri N, Ganesh J, Vepuri R, Kumar R, Tiwari N. Comparison of Outcomes in Unilateral and Bilateral Pediatric Cochlear Implants: Our Experience. Indian J Otolaryngol Head Neck Surg 2022; 74:707-713. [PMID: 36032866 PMCID: PMC9411341 DOI: 10.1007/s12070-021-02458-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/08/2021] [Indexed: 10/21/2022] Open
Abstract
The aim of our study is to compare the outcomes in unilateral and bilateral cochlear implants in pediatric age and also between simultaneous and sequential cochlear implant surgery. This retrospective study was carried out with 83 children aged between 12 months to 2.5 years which included 41 children with bilateral Cochlear implants and 42 with unilateral implants. Out of these 41 children, 21 were simultaneous and 20 were sequential cochlear implant. All the children were operated at civil hospital Gandhinagar, Gujarat, India. CAP, SIR, localization, traffic noise and speech in noise scores were assessed at regular intervals over the period of 4 years. Also the drug administration time, surgical time, operating room time were assessed for simultaneous and sequential cochlear implant surgery. Children with bilateral simultaneous implants fared significantly better with CAP, SIR, localization, speech noise and traffic noise scores than sequential bilateral implants and unilateral implants with a significant difference of means t tests between the two groups. Simultaneous cochlear implant surgery is associated with reduced surgical time, operating room time, it shortens the total in patient stay. There is less of drug administration and bilateral ones are stimulated simultaneously. Bilateral cochlear implants perform better with respect to auditory perception skills and spontaneous speech when compared with unilateral implants, but simultaneous surgery is better and safe option for pediatric cochlear implantation.
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Affiliation(s)
- Amit Kumar Anand
- Department of Otolaryngology, GMERS Medical College and Civil Hospital, Gandhinagar, Gujarat India
- Asian Speech and Hearing Clinic, Cochlear Implant Centre, Ahmedabad, Gujarat India
- GMERS Medical College and Hospital, A/94, Shantam Towers, Behind Civil Hospital, Near Amul Garden, Shahibaug, Ahmedabad, Gujarat 380004 India
| | - Neeraj Suri
- Department of Otolaryngology, GMERS Medical College and Civil Hospital, Gandhinagar, Gujarat India
- Department of ENT, GMERS Medical College, Gandhinagar, Gujarat India
| | - Jayachandran Ganesh
- Department of Otolaryngology, GMERS Medical College and Civil Hospital, Gandhinagar, Gujarat India
- Asian Speech and Hearing Clinic, Cochlear Implant Centre, Ahmedabad, Gujarat India
| | - Rajesh Vepuri
- Department of Otolaryngology, GMERS Medical College and Civil Hospital, Gandhinagar, Gujarat India
- Department of ENT, GMERS Medical College, Gandhinagar, Gujarat India
| | - Rampravesh Kumar
- Department of Otolaryngology, GMERS Medical College and Civil Hospital, Gandhinagar, Gujarat India
- Asian Speech and Hearing Clinic, Cochlear Implant Centre, Ahmedabad, Gujarat India
| | - Neha Tiwari
- Department of Otolaryngology, GMERS Medical College and Civil Hospital, Gandhinagar, Gujarat India
- Asian Speech and Hearing Clinic, Cochlear Implant Centre, Ahmedabad, Gujarat India
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Holder JT, Holcomb MA, Snapp H, Labadie RF, Vroegop J, Rocca C, Elgandy MS, Dunn C, Gifford RH. Guidelines for Best Practice in the Audiological Management of Adults Using Bimodal Hearing Configurations. OTOLOGY & NEUROTOLOGY OPEN 2022; 2:e011. [PMID: 36274668 PMCID: PMC9581116 DOI: 10.1097/ono.0000000000000011] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Clinics are treating a growing number of patients with greater amounts of residual hearing. These patients often benefit from a bimodal hearing configuration in which acoustic input from a hearing aid on 1 ear is combined with electrical stimulation from a cochlear implant on the other ear. The current guidelines aim to review the literature and provide best practice recommendations for the evaluation and treatment of individuals with bilateral sensorineural hearing loss who may benefit from bimodal hearing configurations. Specifically, the guidelines review: benefits of bimodal listening, preoperative and postoperative cochlear implant evaluation and programming, bimodal hearing aid fitting, contralateral routing of signal considerations, bimodal treatment for tinnitus, and aural rehabilitation recommendations.
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Affiliation(s)
| | | | | | | | | | - Christine Rocca
- Guy’s and St. Thomas’ Hearing Implant Centre, London, United Kingdom
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Aminpour N, Levin L, Finkbone M, Morikawa M, Blumgart M, Kim HJ, Hoa M. Review of Speech Outcomes in Cochlear Implant Recipients at a Nascent Cochlear Implant Program. Cureus 2022; 14:e22543. [PMID: 35345736 PMCID: PMC8956478 DOI: 10.7759/cureus.22543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction: The use of cochlear implantation to rehabilitate moderate to profound sensorineural hearing loss has become more widespread; however, the adult utilization rate of cochlear implant candidates is still very less. The study aims to examine the percentage of adult patients in a heterogeneous group of cochlear implant recipients at a nascent cochlear implant program who demonstrate improvements in speech outcomes. Methods: Speech outcome scores were assessed preoperatively and postoperatively at three, six, and 12-month intervals using consonant-nucleus-consonant (CNC) words and AzBio sentences in quiet. Mean speech outcome scores at each time point and binomial distribution tables with 95% CI were used to assess individual improvement in speech understanding. Results: 45 patients underwent a total of 49 cochlear implantation surgeries. The mean age at surgery was 62 years. The mean preoperative CNC score in the ear to be implanted was 18%±18, while the mean postoperative CNC score at three, six, and 12 months was 35%±21, 44%±23, and 45%±25, respectively. The mean preoperative AzBio score in the ear to be implanted was 22%±26 while the mean postoperative AzBio score at three, six, and 12 months was 50%±29, 56%±27, and 63%±26, respectively. Of the implantations, 74% (32 of 43) and 69% (22 of 32) showed significant improvement at six months or one year using AzBio and CNC binomial distribution tables, respectively. Conclusions: Findings demonstrate significant improvements in speech perception following cochlear implantation for patients not benefiting from hearing aid aural rehabilitation. The study provides realistic expectations for new and emerging programs hoping to demonstrate cochlear implant utility for improving patients’ speech outcomes.
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Improvements in Hearing and in Quality of Life after Sequential Bilateral Cochlear Implantation in a Consecutive Sample of Adult Patients with Severe-to-Profound Hearing Loss. J Clin Med 2021; 10:jcm10112394. [PMID: 34071662 PMCID: PMC8199295 DOI: 10.3390/jcm10112394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 11/16/2022] Open
Abstract
Bilateral cochlear implantation is increasing worldwide. In adults, bilateral cochlear implants (BICI) are often performed sequentially with a time delay between the first (CI1) and the second (CI2) implant. The benefits of BICI have been reported for well over a decade. This study aimed at investigating these benefits for a consecutive sample of adult patients. Improvements in speech-in-noise recognition after CI2 were followed up longitudinally for 12 months with the internationally comparable Finnish matrix sentence test. The test scores were statistically significantly better for BICI than for either CI alone in all assessments during the 12-month period. At the end of the follow-up period, the bilateral benefit for co-located speech and noise was 1.4 dB over CI1 and 1.7 dB over CI2, and when the noise was moved from the front to 90 degrees on the side, spatial release from masking amounted to an improvement of 2.5 dB in signal-to-noise ratio. To assess subjective improvements in hearing and in quality of life, two questionnaires were used. Both questionnaires revealed statistically significant improvements due to CI2 and BICI. The association between speech recognition in noise and background factors (duration of hearing loss/deafness, time between implants) or subjective improvements was markedly smaller than what has been previously reported on sequential BICI in adults. Despite the relatively heterogeneous sample, BICI improved hearing and quality of life.
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Bimodal Stimulation in Children With Bilateral Profound Sensorineural Hearing Loss: A Suitable Intervention Model for Children at the Early Developmental Stage. Otol Neurotol 2021; 41:1357-1362. [PMID: 33492797 DOI: 10.1097/mao.0000000000002812] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the auditory and speech benefit of bimodal stimulation for prelingual deafened cochlear implantation recipients. STUDY DESIGN Retrospective and comparative study. SETTING Tertiary referral center. PATIENTS Fifty-six children with bilateral prelingual profound sensorineural hearing loss were enrolled, including 28 consecutive children with unilateral cochlear implantation (CI group), and 28 consecutive children with bimodal stimulation (BI group) who used an additional hearing aid (HA) in the contralateral ear. MAIN OUTCOME MEASURES Hearing assessments included the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) and Categories of Auditory Performance (CAP). Speech evaluations included the Meaningful Use of Speech Scale (MUSS), and Speech Intelligibility Rating (SIR). These measurements were evaluated at the first mapping of cochlear implants and 0.5, 1, 3, 6, 12, 18, 24 months after. Data were analyzed by repeated measures analysis. RESULTS The mean ages of BI and CI groups were similar (17.6 ± 6.87 vs 19.0 ± 8.10 months, p = 0.497). The initial scores for hearing and speech assessments showed no differences between the two groups, apart from IT-MAIS (2.46 ± 0.631 in BI group vs 0.50 ± 0.279 in CI group, p = 0.004). The auditory and speech development over time were different in the two groups as seen in IT-MAIS (p < 0.001), CAP (p = 0.029), MUSS (p < 0.001), and SIR (p < 0.001). A continuing but stable difference was observed in CAP, MUSS, and SIR at 3, 18, and 12 months after the first mapping, respectively. In addition, the BI group had better IT-MAIS scores at 3 and 6 months compared with the CI group; however, the difference was not significant after 12 months. CONCLUSION Bimodal stimulation is beneficial for prelingually deafened CI recipients who have minimal contralateral residual hearing when bilateral CIs are not available. Hearing aid use in the contralateral ear might be recommended for children after unilateral cochlear implantation to facilitate the development of auditory and speech skills.
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Cochlear implant and tinnitus-a meta-analysis. Braz J Otorhinolaryngol 2020; 87:353-365. [PMID: 33342697 PMCID: PMC9422519 DOI: 10.1016/j.bjorl.2020.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 01/16/2023] Open
Abstract
Introduction Tinnitus is a frequent symptom in cochlear implant patients, often reported as persistent and disabling in implant candidates. Tinnitus is rarely considered in the preoperative evaluation of patients who are eligible for cochlear implantation. Many studies have shown that a cochlear implant leads to a significant change in the perception of tinnitus. Objective To identify evidence in the scientific literature indicating that cochlear implant in eligible patients with tinnitus can improve tinnitus perception. Methods One hundred forty articles were found from nine databases, and 20 articles from the gray literature mentioned the relationship between cochlear implant and tinnitus perception in patients eligible for cochlear implant. The PICOS (population, intervention, comparison, and outcome) strategy, was used to define the eligibility criteria. The studies that met the inclusion criteria for this second step were included in a qualitative synthesis, and each type of study was analyzed using the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies and the Joanna Briggs Institute critical appraisal checklist for randomized clinical trials. Results The full texts of 11 articles were read, and 6 studies were selected for the meta-analysis. The total sample size in the evaluated articles was 136 patients with tinnitus who were eligible for cochlear implantation. Conclusions Taken together, these findings support the feasibility of cochlear implantation to reduce the perception of tinnitus, thus providing a new perspective in the treatment of tinnitus in patients with hearing loss who are candidates for cochlear implantation.
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Neural Tissue Degeneration in Rosenthal's Canal and Its Impact on Electrical Stimulation of the Auditory Nerve by Cochlear Implants: An Image-Based Modeling Study. Int J Mol Sci 2020; 21:ijms21228511. [PMID: 33198187 PMCID: PMC7697226 DOI: 10.3390/ijms21228511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 11/24/2022] Open
Abstract
Sensorineural deafness is caused by the loss of peripheral neural input to the auditory nerve, which may result from peripheral neural degeneration and/or a loss of inner hair cells. Provided spiral ganglion cells and their central processes are patent, cochlear implants can be used to electrically stimulate the auditory nerve to facilitate hearing in the deaf or severely hard-of-hearing. Neural degeneration is a crucial impediment to the functional success of a cochlear implant. The present, first-of-its-kind two-dimensional finite-element model investigates how the depletion of neural tissues might alter the electrically induced transmembrane potential of spiral ganglion neurons. The study suggests that even as little as 10% of neural tissue degeneration could lead to a disproportionate change in the stimulation profile of the auditory nerve. This result implies that apart from encapsulation layer formation around the cochlear implant electrode, tissue degeneration could also be an essential reason for the apparent inconsistencies in the functionality of cochlear implants.
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Gajecki T, Nogueira W. The effect of synchronized linked band selection on speech intelligibility of bilateral cochlear implant users. Hear Res 2020; 396:108051. [DOI: 10.1016/j.heares.2020.108051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 10/23/2022]
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Thum C, Lenarz T, Lesinski-Schiedat A, Fleßa S. Lifetime cost of unilateral cochlear implants in adults: a Monte Carlo simulation. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2020; 21:963-975. [PMID: 32333130 DOI: 10.1007/s10198-020-01188-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
BACKROUND/OBJECTIVE Due to increasing prevalence of hearing loss and relaxation of candidacy criteria of cochlear implant (CI) supply, the number of implantations is likely to further increase. Statutory health insurances are facing ever more urgent financing challenges since CI treatment causes high life-long costs. Additionally, increasing life expectancy and earlier implantation may extend therapy time and cost. With every case being individual, this study aims to calculate the possible lifetime cost of unilateral CI treatment in adults including stochastic uncertainties. METHODS Taking a statutory health insurance perspective, relevant cost components of CI therapy and their values were identified. The Monte Carlo method was used to simulate lifetime cost considering age at first implantation and distributions of costrelevant variables. A sensitivity analysis was conducted to determine the most crucial variables impacting on lifetime cost. RESULTS Lifetime cost of CI treatment varies according to age at first implantation, respectively remaining lifetime; the earlier the implantation, the higher the overall cost. According to our simulation, the average lifetime cost for an adult patient first implanted between the age of 20-80 is at 53,030 € (present value). Cost of implantation and periodic speech processor exchanges show the highest impact on the total cost. DISCUSSION Health care systems could face rising expenses for CI supply by technical development. Innovative life-long CIs could achieve significant savings per case that could finance additional implant cost. Until then, further targeted research will be required. CONCLUSION CI-related cost for statutory health insurance crucially depends on the patient-side demand for cochlear implants. Therefore, cost forecasts must also consider the development of demand.
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Affiliation(s)
- Christin Thum
- Department of General Business Administration and Health Care Management, Faculty of Law and Economics, University of Greifswald, Friedrich-Loeffler-Str. 70, 17489, Greifswald, Germany.
| | - Thomas Lenarz
- Department of Otolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany
| | - Anke Lesinski-Schiedat
- Department of Otolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany
| | - Steffen Fleßa
- Department of General Business Administration and Health Care Management, Faculty of Law and Economics, University of Greifswald, Friedrich-Loeffler-Str. 70, 17489, Greifswald, Germany
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14
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Lambriks LJG, van Hoof M, Debruyne JA, Janssen M, Chalupper J, van der Heijden KA, Hof JR, Hellingman CA, George ELJ, Devocht EMJ. Evaluating hearing performance with cochlear implants within the same patient using daily randomization and imaging-based fitting - The ELEPHANT study. Trials 2020; 21:564. [PMID: 32576247 PMCID: PMC7310427 DOI: 10.1186/s13063-020-04469-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/30/2020] [Indexed: 02/08/2023] Open
Abstract
Background Prospective research in the field of cochlear implants is hampered by methodological issues and small sample sizes. The ELEPHANT study presents an alternative clinical trial design with a daily randomized approach evaluating individualized tonotopical fitting of a cochlear implant (CI). Methods A single-blinded, daily-randomized clinical trial will be implemented to evaluate a new imaging-based CI mapping strategy. A minimum of 20 participants will be included from the start of the rehabilitation process with a 1-year follow-up period. Based on a post-operative cone beam CT scan (CBCT), mapping of electrical input will be aligned to natural place-pitch arrangement in the individual cochlea. The CI’s frequency allocation table will be adjusted to match the electrical stimulation of frequencies as closely as possible to corresponding acoustic locations in the cochlea. A randomization scheme will be implemented whereby the participant, blinded to the intervention allocation, crosses over between the experimental and standard fitting program on a daily basis, and thus effectively acts as his own control, followed by a period of free choice between both maps to incorporate patient preference. With this new approach the occurrence of a first-order carryover effect and a limited sample size is addressed. Discussion The experimental fitting strategy is thought to give rise to a steeper learning curve, result in better performance in challenging listening situations, improve sound quality, better complement residual acoustic hearing in the contralateral ear and be preferred by recipients of a CI. Concurrently, the suitability of the novel trial design will be considered in investigating these hypotheses. Trial registration ClinicalTrials.gov: NCT03892941. Registered 27 March 2019.
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Affiliation(s)
- L J G Lambriks
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands.
| | - M van Hoof
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands
| | - J A Debruyne
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands
| | - M Janssen
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, Maastricht, The Netherlands
| | - J Chalupper
- Advanced Bionics European Research Centre (AB ERC), Hannover, Germany
| | - K A van der Heijden
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands
| | - J R Hof
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands
| | - C A Hellingman
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands
| | - E L J George
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands
| | - E M J Devocht
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands
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15
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Gao Z, Wang S, Yang H, Feng G, Shang Y, Wang B, Tian X, Li Y, Wei X, Shu Z. Simultaneous bilateral cochlear implantation in children aged 12‒18 months is safe and can be performed using standard cochlear implant surgical techniques. Eur Arch Otorhinolaryngol 2020; 277:2193-2197. [DOI: 10.1007/s00405-020-05928-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 03/16/2020] [Indexed: 10/24/2022]
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16
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Sarin J, Salonen J, Hirvonen J, Jero J. From urinary tract infection to cochlear implantation: A case report. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2019. [DOI: 10.1080/23772484.2019.1673662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Jussi Sarin
- Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Jaakko Salonen
- Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Jussi Hirvonen
- Department of Radiology, University of Turku, Turku, Finland
| | - Jussi Jero
- Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
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17
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What Is the Sensitive Period to Initiate Auditory Stimulation for the Second Ear in Sequential Cochlear Implantation? Otol Neurotol 2019; 39:177-183. [PMID: 29227442 DOI: 10.1097/mao.0000000000001640] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Bilateral cochlear implants (CI) are the standard treatment for bilaterally deaf children, but it is unclear how much the second CI can be delayed in sequential bilateral CI. We investigated the performances of sequential CI to answer this question. STUDY DESIGN Retrospective case series review. SETTING Tertiary referral center. METHODS We studied a cohort of congenitally deaf children (n = 73) who underwent sequential CI without any inner ear anomaly or combined disabilities. Hearing threshold levels and speech perception were evaluated by aided pure tone audiometry and Asan-Samsung Korean word recognition test. The scores were analyzed by the ages at surgery and compared among the different age groups. RESULTS When the second CI was performed before 3.5 years (the optimal period for the first CI), the second CI scores (96.9%) were comparable to the first CI scores. Although the first CI scores were more than or equal to 80% when the first CI was implanted before the age of 7 years, the second CI scores were more than or equal to 80% when the second CI was implanted before the age of 12 to 13 years. The hearing threshold levels were not different regardless of the ages and between the first and second CIs. CONCLUSION Our cohort demonstrated that the second CI showed comparable results to the first CI when implanted before 3.5 years, suggesting that optimal periods for the first CI and the second CI are same. However, the sensitive period (12-13 yr) for the second CI with good scores (≥80%) was much longer than that (7 yr) of the first CI, suggesting that the first CI prolongs the sensitive period for the second CI. The second CI should be implanted early, but considered even at a later age.
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18
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Chang YS, Hong SH, Kim EY, Choi JE, Chung WH, Cho YS, Moon IJ. Benefit and predictive factors for speech perception outcomes in pediatric bilateral cochlear implant recipients. Braz J Otorhinolaryngol 2019; 85:571-577. [PMID: 29859680 PMCID: PMC9443016 DOI: 10.1016/j.bjorl.2018.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/22/2018] [Accepted: 04/17/2018] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Despite recent advancement in the prediction of cochlear implant outcome, the benefit of bilateral procedures compared to bimodal stimulation and how we predict speech perception outcomes of sequential bilateral cochlear implant based on bimodal auditory performance in children remain unclear. OBJECTIVES This investigation was performed: (1) to determine the benefit of sequential bilateral cochlear implant and (2) to identify the associated factors for the outcome of sequential bilateral cochlear implant. METHODS Observational and retrospective study. We retrospectively analyzed 29 patients with sequential cochlear implant following bimodal-fitting condition. Audiological evaluations were performed; the categories of auditory performance scores, speech perception with monosyllable and disyllables words, and the Korean version of Ling. Audiological evaluations were performed before sequential cochlear implant with the bimodal fitting condition (CI1+HA) and one year after the sequential cochlear implant with bilateral cochlear implant condition (CI1+CI2). The good performance group (GP) was defined as follows; 90% or higher in monosyllable and bisyllable tests with auditory-only condition or 20% or higher improvement of the scores with CI1+CI2. Age at first implantation, inter-implant interval, categories of auditory performance score, and various comorbidities were analyzed by logistic regression analysis. RESULTS Compared to the CI1+HA, CI1+CI2 provided significant benefit in categories of auditory performance, speech perception, and Korean version of Ling results. Preoperative categories of auditory performance scores were the only associated factor for being GP (odds ratio=4.38, 95% confidence interval - 95%=1.07-17.93, p=0.04). CONCLUSIONS The children with limited language development in bimodal condition should be considered as the sequential bilateral cochlear implant and preoperative categories of auditory performance score could be used as the predictor in speech perception after sequential cochlear implant.
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Affiliation(s)
- Young-Soo Chang
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul, South Korea
| | - Sung Hwa Hong
- Sungkyunkwan University School of Medicine, Samsung Changwon Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul, South Korea
| | - Eun Yeon Kim
- Myongji University Graduate School, Department of Speech and Language Pathology, Seoul, South Korea
| | - Ji Eun Choi
- Dankook University Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Cheonan, South Korea
| | - Won-Ho Chung
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul, South Korea
| | - Yang-Sun Cho
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul, South Korea
| | - Il Joon Moon
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul, South Korea.
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19
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McRackan TR, Fabie JE, Bhenswala PN, Nguyen SA, Dubno JR. General Health Quality of Life Instruments Underestimate the Impact of Bilateral Cochlear Implantation. Otol Neurotol 2019; 40:745-753. [PMID: 31192902 PMCID: PMC6578874 DOI: 10.1097/mao.0000000000002225] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the extent to which bilateral cochlear implantation increases patient-reported benefit as compared with unilateral implantation and no implantation. DATA SOURCES PubMed, Scopus, CINAHL, and Cochrane databases searches were performed using the keywords ("Cochlear Implant" or "Cochlear Implantation") and ("bilateral"). STUDY SELECTION Studies assessing hearing/CI-specific (CI) and general-health-related (HR) quality of life (QOL) in adult patients after bilateral cochlear implantation were included. DATA EXTRACTION Of the 31 articles meeting criteria, usable QOL data were available for 16 articles (n = 355 bilateral CI recipients). DATA SYNTHESIS Standardized mean difference (Δ) for each measure and weighted effects were determined. Meta-analysis was performed for all QOL measures and also independently for hearing/CI-specific QOL and HRQOL. CONCLUSION When measured using hearing/CI-specific QOL instruments, patients reported very large improvements in QOL comparing before cochlear implantation to bilateral CI (Δ=2.07 [1.76-2.38]) and medium improvements comparing unilateral CI to bilateral CI (Δ=0.51 [0.32- 0.71]). Utilization of parallel versus crossover study design did not impact QOL outcomes (χ = 0.512, p = 0.47). No detectable improvements were observed in either CI transition when using HRQOL instruments (no CI to bilateral CI: Δ=0.40 [-0.02 to 0.81]; unilateral CI to bilateral CI: Δ=0.22 [-0.02 to 0.46]).The universal nature of HRQOL instruments may render them insensitive to the medium to large QOL improvements reported by patients using hearing/CI-specific QOL instruments. Given that HRQOL instruments are used to determine the economic benefit of health interventions, these measurement differences suggest that the health economic value of bilateral cochlear implantation has been underestimated.
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Affiliation(s)
- Theodore R McRackan
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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20
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Benefits of a contralateral routing of signal device for unilateral Naída CI cochlear implant recipients. Eur Arch Otorhinolaryngol 2019; 276:2205-2213. [PMID: 31102018 DOI: 10.1007/s00405-019-05467-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 05/08/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Many bilaterally deaf adults are only able to receive one cochlear implant (CI), resulting in suboptimal listening performance, especially in challenging listening environments. Adding a contralateral routing of signal (CROS) device to a unilateral CI is one possibility to alleviate these challenges. This study examined the benefit of such a CROS device. METHODS Thirteen adult subjects with at least 6 months of CI use, and no or limited benefit of a hearing instrument in the contralateral ear were included in the study. The perceived benefit of a CROS device in everyday listening environments was evaluated up to 1 year after initial fitting using several questionnaires. Speech intelligibility performance was determined using the French matrix sentence test in quiet and in two speech-in-noise setups and was followed for 3 months after CROS fitting. RESULTS Subjects indicated high satisfaction with the practical usability of the CROS device and long-term device retention was high. Perceived benefits in everyday listening environments were reported. Formal speech intelligibility tests revealed statistically significant median improvements of 6.93 dB SPL (Wilcoxon Z = 2.380, p = 0.017) in quiet and up to 8.00 dB SNR (Wilcoxon Z = 2.366, p = 0.018) in noise. These benefits were accessible immediately without a need for prolonged acclimatization. CONCLUSIONS Subjective satisfaction and device retention as well as speech intelligibility benefits in quiet and in noise prove the CROS device to be a valuable addition to a unilateral CI in cases of bilateral deafness where bilateral implantation is not an option.
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21
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van Zon A, Smulders YE, Kraaijenga VJC, van Zanten GA, Stokroos RJ, Stegeman I. Comparison Between Simulated and Actual Unilateral Hearing in Sequentially Implanted Cochlear Implant Users, a Cohort Study. Front Surg 2019; 6:24. [PMID: 31134209 PMCID: PMC6517488 DOI: 10.3389/fsurg.2019.00024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 04/24/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Previous studies have proven the effectiveness of bilateral cochlear implantation compared to unilateral cochlear implantation. In many of these studies the unilateral hearing situation was simulated by switching off one of the cochlear implants in bilateral cochlear implant users. In the current study we assess the accuracy of this test method. Does simulated unilateral hearing (switching off one cochlear implant) result in the same outcomes as real life unilateral hearing with one cochlear implant and a non-implanted contralateral ear? Study design: We assessed the outcomes of one arm of a multicenter randomized controlled trial. Methods: In the original trial, 38 postlingually deafened adults were randomly allocated to either simultaneous bilateral cochlear implantation or sequential bilateral cochlear implantation. In the current study we used the data of the sequentially implanted group (n = 19). The primary outcome was speech perception-in-noise from straight ahead. Secondary outcomes were speech perception-in-silence, speech intelligibility-in-noise from spatially separated sources and localization capabilities. A within-subjects design was used to compare the results of hearing with one cochlear implant and a non-implanted contralateral ear (1- and 2-year follow-up) with the results of switching off one cochlear implant after sequential bilateral implantation (3-year follow-up). Results: We found no significant differences on any of the objective outcomes after 1-, 2-, or 3-year follow-up. Conclusion: This study shows that simulating unilateral hearing by switching off one cochlear implant seems a reliable method to compare unilateral and bilateral hearing in bilaterally implanted patients. Clinical Trial Registration: Dutch Trial Register NTR1722.
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Affiliation(s)
- Alice van Zon
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Yvette E Smulders
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Veronique J C Kraaijenga
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Gijsbert A van Zanten
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Robert J Stokroos
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
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22
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Williges B, Jürgens T, Hu H, Dietz M. Coherent Coding of Enhanced Interaural Cues Improves Sound Localization in Noise With Bilateral Cochlear Implants. Trends Hear 2019; 22:2331216518781746. [PMID: 29956589 PMCID: PMC6048749 DOI: 10.1177/2331216518781746] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Bilateral cochlear implant (BCI) users only have very limited spatial hearing
abilities. Speech coding strategies transmit interaural level differences (ILDs)
but in a distorted manner. Interaural time difference (ITD) information
transmission is even more limited. With these cues, most BCI users can coarsely
localize a single source in quiet, but performance quickly declines in the
presence of other sound. This proof-of-concept study presents a novel signal
processing algorithm specific for BCIs, with the aim to improve sound
localization in noise. The core part of the BCI algorithm duplicates a
monophonic electrode pulse pattern and applies quasistationary natural or
artificial ITDs or ILDs based on the estimated direction of the dominant source.
Three experiments were conducted to evaluate different algorithm variants:
Experiment 1 tested if ITD transmission alone enables BCI subjects to lateralize
speech. Results showed that six out of nine BCI subjects were able to lateralize
intelligible speech in quiet solely based on ITDs. Experiments 2 and 3 assessed
azimuthal angle discrimination in noise with natural or modified ILDs and ITDs.
Angle discrimination for frontal locations was possible with all variants,
including the pure ITD case, but for lateral reference angles, it was only
possible with a linearized ILD mapping. Speech intelligibility in noise,
limitations, and challenges of this interaural cue transmission approach are
discussed alongside suggestions for modifying and further improving the BCI
algorithm.
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Affiliation(s)
- Ben Williges
- 1 Medizinische Physik and Cluster of Excellence "Hearing4all," Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Tim Jürgens
- 1 Medizinische Physik and Cluster of Excellence "Hearing4all," Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.,2 Institute of Acoustics, University of Applied Sciences Lübeck, Lübeck, Germany
| | - Hongmei Hu
- 1 Medizinische Physik and Cluster of Excellence "Hearing4all," Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Mathias Dietz
- 1 Medizinische Physik and Cluster of Excellence "Hearing4all," Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.,3 National Centre for Audiology, School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
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23
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Kraaijenga VJC, Ramakers GGJ, Smulders YE, van Zon A, Free RH, Frijns JHM, Huinck WJ, Stokroos RJ, Grolman W. No Difference in Behavioral and Self-Reported Outcomes for Simultaneous and Sequential Bilateral Cochlear Implantation: Evidence From a Multicenter Randomized Controlled Trial. Front Neurosci 2019; 13:54. [PMID: 30842721 PMCID: PMC6391354 DOI: 10.3389/fnins.2019.00054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 01/21/2019] [Indexed: 11/13/2022] Open
Abstract
Objective: The primary aim of this study was to longitudinally compare the behavioral and self-reported outcomes of simultaneous bilateral cochlear implantation (simBiCI) and sequential BiCI (seqBiCI) in adults with severe-to-profound postlingual sensorineural hearing loss. Design: This study is a multicenter randomized controlled trial with a 4-year follow-up period after the first moment of implantation. Participants were allocated by randomization to receive bilateral cochlear implants (CIs) either, simultaneously (simBiCI group) or sequentially with an inter-implant interval of 2 years (UCI/seqBiCI group). All sequential patients where encouraged to use their hearing aid on the non-implanted ear over of the first 2 years. Patients were followed-up on an annual basis. The primary outcome was speech perception in noise coming from a source directly in front of the patient. Other behavioral outcome measures were speech intelligibility-in-noise from spatially separated sources, localization and speech perception in quiet. Self-reported outcome measures encompassed questionnaires on quality of life, quality of hearing and tinnitus. All outcome measures were analyzed longitudinally using a linear or logistic regression analysis with an autoregressive residual covariance matrix (generalized estimating equations type). Results: Nineteen participants were randomly allocated to the simBiCI group and 19 participants to the UCI/seqBiCI group. Three participants in the UCI/seqBiCI group did not proceed with their second implantation and were therefore unavailable for follow-up. Both study groups performed equally well on speech perception in noise from a source directly in front of the patient longitudinally. During all 4 years of follow-up the UCI/seqBiCI group performed significantly worse compared to the simBiCI group on spatial speech perception in noise in the best performance situation (8.70 dB [3.96 - 13.44], p < 0.001) and localization abilities (largest difference 60 degrees configuration: -44.45% [-52.15 - -36.74], p < 0.0001). Furthermore, during all years of follow-up, the UCI/seqBiCI group performed significantly worse on quality of hearing and quality of life questionnaires. The years of unilateral CI use were the reason for the inferior results in the UCI/SeqBiCI group. One year after receiving CI2, the UCI/seqBiCI group performance did not statistically differ from the performance of the simBiCI group on all these outcomes. Furthermore, no longitudinal differences were seen in tinnitus burden prevalence between groups. Finally, the complications that occurred during this trial were infection, dysfunction of CI, facial nerve palsy, tinnitus and vertigo. Conclusion: This randomized controlled trial on bilaterally severely hearing impaired participants found a significantly worse longitudinal performance of UCI/seqBiCI compared to simBiCI on multiple behavioral and self-reported outcomes regarding speech perception in noise and localization abilities. This difference is associated with the inferior performance of the UCI/seqBiCI participants during the years of unilateral CI use. After receiving the second CI however, the performance of the UCI/seqBiCI group did not significantly differ from the simBiCI group. Trial Registration: Dutch Trial Register NTR1722.
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Affiliation(s)
- Véronique J C Kraaijenga
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Geerte G J Ramakers
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Yvette E Smulders
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands.,Department of Otorhinolaryngology, Beatrix Hospital, Gorinchem, Netherlands
| | - Alice van Zon
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Rolien H Free
- Department of Otorhinolaryngology, University Medical Center Groningen, Groningen, Netherlands.,Graduate School of Medical Sciences, Research School of Behavioural and Cognitive Neurosciences, University Medical Center Groningen, Groningen, Netherlands
| | - Johan H M Frijns
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, Netherlands.,Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, Netherlands
| | - Wendy J Huinck
- Department of Otorhinolaryngology, Head and Neck Surgery, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Robert J Stokroos
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Wilko Grolman
- Causse Ear Clinic, Tertiary Ear Referral Center, Colombiers, France
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24
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Bilateral cochlear implantation is regarded as very beneficial: results from a worldwide survey by online questionnaire. Eur Arch Otorhinolaryngol 2019; 276:679-683. [PMID: 30617425 DOI: 10.1007/s00405-018-05271-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 12/24/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Bilateral cochlear implant (CI) provision is now widely regarded as the most beneficial hearing intervention for acceptable candidates. This study sought to determine if a number of well-regarded hearing professionals at highly reputable clinics shared similar practices and beliefs regarding bilateral CI provision, use, and rehabilitation in children and adults. METHODS An 11-question online questionnaire was created and distributed to all 27 clinics in the HEARRING group. Questions 1-5 asked for facts; questions 6-11 asked for opinions. RESULTS 20 completed questionnaires were returned. All 20 respondents reported that their clinics perform bilateral cochlear implantation in children; 18 do so in adults. Regarding the fact-based questions, bilateral CI provision is more commonly performed and more likely to be reimbursed in children than in adults. Children are also much more likely to be implanted simultaneously than are adults. Regarding the opinion-based questions, respondents gave broadly similar answers. Communication between the CIs and speech coding strategies specifically developed for bilateral CI users were regarded as the two future technologies that would most enhance the benefit of bilateral CI use. CONCLUSIONS Most clinics in the HEARRING group are very familiar with bilateral CI provision and hold similar opinions on its results and benefits. Hopefully the results described herein will lead to a greater acceptance and regular reimbursement of bilateral CI provision, especially in adults.
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Moeller MP, Stille LJ, Hughes ML, Lusk RP. Perceived improvements and challenges following sequential bilateral cochlear implantation in children and adults. Cochlear Implants Int 2018; 19:72-87. [PMID: 29291687 DOI: 10.1080/14670100.2017.1414021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Semi-structured interviews were conducted with sequentially implanted bilateral cochlear-implant (biCI) recipients to examine functional aspects of communication that are affected by listening with one versus two CIs. DESIGN Participants were 15 adult biCI recipients and parents of 30 children (categorized into three groups by age) with biCIs. All CI users had sequential placement of biCIs with at least six months' experience with the first CI before activation of the second device, and at least three months' experience with both CIs prior to the interview. The parent/paediatric and adult interviews were all conducted by the same examiner. Electronic transcripts of the interview responses were coded for perceived changes or lack thereof in 23 behaviours following biCI. Extent of reported benefit was quantified for each subject within and across these behaviours and at the group level as a function of age. RESULTS Most adults and parents of children reported multiple functional changes following biCI use, and changes often translated to enhanced social communication. Nearly all participants were consistent users of biCIs, and were satisfied with their perceived gains in communicating in everyday settings. Most reported ongoing challenges listening in noisy settings. Although many reports on children paralleled those of adults, developmental differences were apparent. Thirteen percent of adults and twenty percent of parents of children in each of the respective groups reported low levels of change. CONCLUSIONS Results suggest that many biCI users experience meaningful functional benefits that may be underestimated by traditional outcome measures. We suggest the need to expand measurement approaches to better quantify the nature of these benefits.
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Affiliation(s)
- Mary Pat Moeller
- a Cochlear Implant Program, Boys Town National Research Hospital , 555 N. 30th Street, Omaha , NE 68131 , USA
| | - Lisa J Stille
- a Cochlear Implant Program, Boys Town National Research Hospital , 555 N. 30th Street, Omaha , NE 68131 , USA
| | - Michelle L Hughes
- a Cochlear Implant Program, Boys Town National Research Hospital , 555 N. 30th Street, Omaha , NE 68131 , USA
| | - Rodney P Lusk
- a Cochlear Implant Program, Boys Town National Research Hospital , 555 N. 30th Street, Omaha , NE 68131 , USA
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Ngui LX, Tang IP, Rajan P, Prepageran N. Bilateral Simultaneous Cochlear Implant in Children and Adults—a Literature Review and Clinical Experience. CURRENT OTORHINOLARYNGOLOGY REPORTS 2017. [DOI: 10.1007/s40136-017-0165-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Arts RAGJ, George ELJ, Janssen MAML, Griessner A, Zierhofer C, Stokroos RJ. The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training. Int J Audiol 2017; 57:426-439. [DOI: 10.1080/14992027.2017.1408964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Remo A. G. J. Arts
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, The Netherlands,
| | - Erwin L. J. George
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, The Netherlands,
| | - Miranda A. M. L. Janssen
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, The Netherlands,
- Department of Methodology and Statistics, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands, and
| | - Andreas Griessner
- Institute of Mechatronics, University of Innsbruck, Innsbruck, Austria
| | - Clemens Zierhofer
- Institute of Mechatronics, University of Innsbruck, Innsbruck, Austria
| | - Robert J. Stokroos
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Center, MHeNS School for Mental Health and Neuroscience, Maastricht, The Netherlands,
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Ramakers GGJ, Smulders YE, van Zon A, Van Zanten GA, Grolman W, Stegeman I. Correlation between subjective and objective hearing tests after unilateral and bilateral cochlear implantation. BMC EAR, NOSE, AND THROAT DISORDERS 2017; 17:10. [PMID: 29209150 PMCID: PMC5704382 DOI: 10.1186/s12901-017-0043-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 11/21/2017] [Indexed: 11/10/2022]
Abstract
Background There are many methods for assessing hearing performance after cochlear implantation. Standard evaluations often encompass objective hearing tests only, while patients' subjective experiences gain importance in today's healthcare. The aim of the current study was to analyze the correlation between subjective (self-reported questionnaires) and objective (speech perception and localization) hearing test results in adult cochlear implant (CI) users. Secondary, the correlation between subjective and objective hearing tests was compared between bilateral and unilateral CI patients. Methods Data for this study were prospectively collected as part of a multicentre randomized controlled trial. Thirty-eight postlingually deafened adult patients were randomly allocated to receive either unilateral (n = 19) or bilateral (n = 19) cochlear implantation. We used data gathered after one year of follow-up. We studied the correlation between objectively measured speech perception and localization skills on the one hand and related domains of the Speech, Spatial and Qualities of Hearing Scale (SSQ) and Nijmegen Cochlear Implant Questionnaire (NCIQ) on the other hand. We also compared these correlations between unilateral and bilateral CI users. Results We found significant weak to moderate negative correlations between the subjective test results (speech domain of the SSQ and the advanced speech perception domain of the NCIQ) and the related objective speech perception in noise test results (r = -0.33 to -0.48). A significant moderate correlation was found between the subjective test results (spatial domain of the SSQ) and the related objective localization test results (r = 0.59). The correlations in the group of bilateral CI patients (r = -0.28 to -0.54) did not differ significantly from the correlations in the group of unilateral CI patients (r = 0.15 to -0.40). Conclusions Current objective tests do not fully reflect subjective everyday listening situations. This study elucidates the importance and necessity of questionnaires in the evaluation of cochlear implantation. Therefore, it is advised to evaluate both objective and subjective tests in CI patients on a regular basis. Trial registration This trial was registered on March 11, 2009 in the Dutch Trial Register. Trial registration number: NTR1722.
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Affiliation(s)
- Geerte G J Ramakers
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
| | - Yvette E Smulders
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
| | - Alice van Zon
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
| | - Gijsbert A Van Zanten
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
| | - Wilko Grolman
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
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Kraaijenga VJC, Ramakers GGJ, Smulders YE, van Zon A, Stegeman I, Smit AL, Stokroos RJ, Hendrice N, Free RH, Maat B, Frijns JHM, Briaire JJ, Mylanus EAM, Huinck WJ, Van Zanten GA, Grolman W. Objective and Subjective Measures of Simultaneous vs Sequential Bilateral Cochlear Implants in Adults: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg 2017; 143:881-890. [PMID: 28655036 DOI: 10.1001/jamaoto.2017.0745] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance To date, no randomized clinical trial on the comparison between simultaneous and sequential bilateral cochlear implants (BiCIs) has been performed. Objective To investigate the hearing capabilities and the self-reported benefits of simultaneous BiCIs compared with those of sequential BiCIs. Design, Setting, and Participants A multicenter randomized clinical trial was conducted between January 12, 2010, and September 2, 2012, at 5 tertiary referral centers among 40 participants eligible for BiCIs. Main inclusion criteria were postlingual severe to profound hearing loss, age 18 to 70 years, and a maximum duration of 10 years without hearing aid use in both ears. Data analysis was conducted from May 24 to June 12, 2016. Interventions The simultaneous BiCI group received 2 cochlear implants during 1 surgical procedure. The sequential BiCI group received 2 cochlear implants with an interval of 2 years between implants. Main Outcomes and Measures First, the results 1 year after receiving simultaneous BiCIs were compared with the results 1 year after receiving sequential BiCIs. Second, the results of 3 years of follow-up for both groups were compared separately. The primary outcome measure was speech intelligibility in noise from straight ahead. Secondary outcome measures were speech intelligibility in noise from spatially separated sources, speech intelligibility in silence, localization capabilities, and self-reported benefits assessed with various hearing and quality of life questionnaires. Results Nineteen participants were randomized to receive simultaneous BiCIs (11 women and 8 men; median age, 52 years [interquartile range, 36-63 years]), and another 19 participants were randomized to undergo sequential BiCIs (8 women and 11 men; median age, 54 years [interquartile range, 43-64 years]). Three patients did not receive a second cochlear implant and were unavailable for follow-up. Comparable results were found 1 year after simultaneous or sequential BiCIs for speech intelligibility in noise from straight ahead (difference, 0.9 dB [95% CI, -3.1 to 4.4 dB]) and all secondary outcome measures except for localization with a 30° angle between loudspeakers (difference, -10% [95% CI, -20.1% to 0.0%]). In the sequential BiCI group, all participants performed significantly better after the BiCIs on speech intelligibility in noise from spatially separated sources and on all localization tests, which was consistent with most of the participants' self-reported hearing capabilities. Speech intelligibility-in-noise results improved in the simultaneous BiCI group up to 3 years following the BiCIs. Conclusions and Relevance This study shows comparable objective and subjective hearing results 1 year after receiving simultaneous BiCIs and sequential BiCIs with an interval of 2 years between implants. It also shows a significant benefit of sequential BiCIs over a unilateral cochlear implant. Until 3 years after receiving simultaneous BiCIs, speech intelligibility in noise significantly improved compared with previous years. Trial Registration trialregister.nl Identifier: NTR1722.
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Affiliation(s)
- Véronique J C Kraaijenga
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Geerte G J Ramakers
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Yvette E Smulders
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Alice van Zon
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Adriana L Smit
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Robert J Stokroos
- Department of Otorhinolaryngology-Head and Neck Surgery, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Nadia Hendrice
- Department of Otorhinolaryngology-Head and Neck Surgery, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Rolien H Free
- Department of Otorhinolaryngology, University Medical Center Groningen, Groningen, the Netherlands.,Graduate School of Medical Sciences, Research School of Behavioural and Cognitive Neurosciences, University Medical Center Groningen, Groningen, the Netherlands
| | - Bert Maat
- Department of Otorhinolaryngology, University Medical Center Groningen, Groningen, the Netherlands.,Graduate School of Medical Sciences, Research School of Behavioural and Cognitive Neurosciences, University Medical Center Groningen, Groningen, the Netherlands
| | - Johan H M Frijns
- Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, the Netherlands
| | - Jeroen J Briaire
- Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, the Netherlands
| | - E A M Mylanus
- Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Wendy J Huinck
- Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Gijsbert A Van Zanten
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Wilko Grolman
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
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Abstract
OBJECTIVES Sequential and simultaneous bilateral cochlear implants are emerging as appropriate treatment options for Australian adults with sensory deficits in both cochleae. Current funding of Australian public hospitals does not provide for simultaneous bilateral cochlear implantation (CI) as a separate surgical procedure. Previous cost-effectiveness studies of sequential and simultaneous bilateral CI assumed 100% of unilaterally treated patients' transition to a sequential bilateral CI. This assumption does not place cochlear implantation in the context of the generally treated population. When mutually exclusive treatment options exist, such as unilateral CI, sequential bilateral CI, and simultaneous bilateral CI, the mean costs of the treated populations are weighted in the calculation of incremental cost-utility ratios. The objective was to evaluate the cost-utility of bilateral hearing aids (HAs) compared with unilateral, sequential, and simultaneous bilateral CI in Australian adults with bilateral severe to profound sensorineural hearing loss. RESEARCH DESIGN Cost-utility analysis of secondary sources input to a Markov model. SETTING Australian health care perspective, lifetime horizon with costs and outcomes discounted 5% annually. INTERVENTION Bilateral HAs as treatment for bilateral severe to profound sensorineural hearing loss compared with unilateral, sequential, and simultaneous bilateral CI. MAIN OUTCOME MEASURES Incremental costs per quality adjusted life year (AUD/QALY). RESULTS When compared with bilateral hearing aids the incremental cost-utility ratio for the CI treatment population was AUD11,160/QALY. The incremental cost-utility ratio was weighted according to the number of patients treated unilaterally, sequentially, and simultaneously, as these were mutually exclusive treatment options. CONCLUSION No peer-reviewed articles have reported the incremental analysis of cochlear implantation in a continuum of care for surgically treated populations with bilateral severe to profound sensorineural hearing loss. Unilateral, sequential, and simultaneous bilateral CI were cost-effective when compared with bilateral hearing aids. Technologies that reduce the total number of visits for a patient could introduce additional cost efficiencies into clinical practice.
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Economic Evaluation of Treatments for Pediatric Bilateral Severe to Profound Sensorineural Hearing Loss: An Australian Perspective. Otol Neurotol 2017; 37:462-9. [PMID: 26963667 DOI: 10.1097/mao.0000000000001000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES In Australia, surgical treatment options for children with bilateral severe to profound sensorineural hearing loss exist in a continuum ranging from unilateral cochlear implantation (CI), sequential bilateral CI through to simultaneous bilateral CI, depending on the condition. When treatment options are mutually exclusive, the mean costs and benefits of each treatment group are summed together to obtain the total mean costs and benefits. This enables an incremental analysis of treatment options in the context of the treated populations.The objective was to evaluate the cost-utility of current Australian CI treatment practices in children using domestic costs and consequences when compared with bilateral hearing aids (HAs). RESEARCH DESIGN Economic evaluation including a Markov model based on secondary sources. SETTING The base case modeled a government health payer perspective over a child's lifetime. Primary and secondary school education costs were also assessed. INTERVENTION Bilateral HAs compared with CI, including unilateral, sequential bilateral, or simultaneous bilateral CI weighted according to treatment. MAIN OUTCOME MEASURES Incremental costs per quality adjusted life year. RESULTS Approximately 42% of children in Australia with unilateral CI did not transition to sequential bilateral nor undergo simultaneous bilateral implantation. This differs from previous economic evaluations that assumed 100% of children transitioned to sequential bilateral CI treatment or were treated with simultaneous bilateral CI.The incremental cost utility of unilateral cochlear implantation compared with HAs was AUD 21,947/QALY. The weighted average incremental cost utility of the combined cochlear implantation treatment groups was AUD 31,238/QALY when compared with HAs. CONCLUSION Previous economic evaluations of cochlear implantation assumed 100% of unilaterally treated patients would transition to sequential bilateral or be treated with simultaneous bilateral implantation. This approach does not take into account the total treated population, where a proportion of patients are treated with unilateral CI.CI was cost effective when compared with HAs, and included children treated with unilateral, sequential bilateral, and simultaneous bilateral CI.The model was sensitive to the number of assessment and habilitation visits. Alternative health service models with cost efficiencies are needed to reduce after care costs.
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Pérez-Martín J, Artaso MA, Díez FJ. Cost-effectiveness of pediatric bilateral cochlear implantation in Spain. Laryngoscope 2017; 127:2866-2872. [PMID: 28776715 DOI: 10.1002/lary.26765] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/23/2017] [Accepted: 06/01/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine the incremental cost-effectiveness of bilateral versus unilateral cochlear implantation for 1-year-old children suffering from bilateral sensorineural severe to profound hearing loss from the perspective of the Spanish public health system. STUDY DESIGN Cost-utility analysis. METHODS We conducted a general-population survey to estimate the quality-of-life increase contributed by the second implant. We built a Markov influence diagram and evaluated it for a life-long time horizon with a 3% discount rate in the base case. RESULTS The incremental cost-effectiveness ratio of simultaneous bilateral implantation with respect to unilateral implantation for 1-year-old children with severe to profound deafness is €10,323 per quality-adjusted life year (QALY). For sequential bilateral implantation, it rises to €11,733/QALY. Both options are cost-effective for the Spanish health system, whose willingness to pay is estimated at around €30,000/QALY. The probabilistic sensitivity analysis shows that the probability of bilateral implantation being cost-effective reaches 100% for that cost-effectiveness threshold. CONCLUSIONS Bilateral implantation is clearly cost-effective for the population considered. If possible, it should be done simultaneously (i.e., in one surgical operation), because it is as safe and effective as sequential implantation, and saves costs for the system and for users and their families. Sequential implantation is also cost-effective for children who have received the first implant recently, but it is difficult to determine when it ceases to be so because of the lack of detailed data. These results are specific for Spain, but the model can easily be adapted to other countries. LEVEL OF EVIDENCE 2C. Laryngoscope, 127:2866-2872, 2017.
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Affiliation(s)
- Jorge Pérez-Martín
- Department of Artificial Intelligence, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - Miguel A Artaso
- Department of Artificial Intelligence, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - Francisco J Díez
- Department of Artificial Intelligence, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
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Ohta Y, Kawano A, Kawaguchi S, Shirai K, Tsukahara K. Speech recognition in bilaterally cochlear implanted adults in Tokyo, Japan. Acta Otolaryngol 2017; 137:837-841. [PMID: 28301272 DOI: 10.1080/00016489.2017.1293293] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The clinical effects of bilateral cochlear implantation (BCI) include binaural summation and better hearing under noise conditions. This study retrospectively examined the utility of BCI compared to unilateral cochlear implantation (CI) in adults. PATIENTS AND METHODS We investigated 34 adults who underwent BCI, comparing speech recognition between BCI and first CI under silent and noise conditions. We assessed correlations between speech recognition after first and second CIs, and between the interval from first to second CI surgery and speech recognition of second CI. RESULTS Word recognition score (WRS) and sentence recognition score (SRS) were significantly better after BCI than after first CI under conditions of silence and noise. No significant correlation was found between speech recognition after first CI and that after second CI, or between inter-implant interval and speech recognition of second CI for either WRS or SRS. CONCLUSIONS The utility of BCI in Japanese patients was shown. Patients have no need to be pessimistic about hearing after the second implantation even if speech recognition after the first implantation is poor. A long interval from first CI does not necessarily contraindicate contralateral implantation in adults.
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Affiliation(s)
- Yoko Ohta
- Department of Otorhinolaryngology-Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Atsushi Kawano
- Department of Otorhinolaryngology-Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Sachie Kawaguchi
- Department of Otorhinolaryngology-Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kyoko Shirai
- Department of Otorhinolaryngology-Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology-Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
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van Zon A, Smulders YE, Stegeman I, Ramakers GGJ, Kraaijenga VJC, Koenraads SPC, Zanten GAV, Rinia AB, Stokroos RJ, Free RH, Frijns JHM, Huinck WJ, Mylanus EAM, Tange RA, Smit AL, Thomeer HGXM, Topsakal V, Grolman W. Stable benefits of bilateral over unilateral cochlear implantation after two years: A randomized controlled trial. Laryngoscope 2016; 127:1161-1168. [DOI: 10.1002/lary.26239] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 07/04/2016] [Accepted: 07/12/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Alice van Zon
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Medical Center UtrechtUtrecht the Netherlands
- Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrecht the Netherlands
| | - Yvette E. Smulders
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Medical Center UtrechtUtrecht the Netherlands
- Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrecht the Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Medical Center UtrechtUtrecht the Netherlands
- Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrecht the Netherlands
| | - Geerte G. J. Ramakers
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Medical Center UtrechtUtrecht the Netherlands
- Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrecht the Netherlands
| | - Veronique J. C. Kraaijenga
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Medical Center UtrechtUtrecht the Netherlands
- Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrecht the Netherlands
| | - Simone P. C. Koenraads
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Medical Center UtrechtUtrecht the Netherlands
- Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrecht the Netherlands
| | - Gijsbert A. Van Zanten
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Medical Center UtrechtUtrecht the Netherlands
- Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrecht the Netherlands
| | - Albert B. Rinia
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Medical Center UtrechtUtrecht the Netherlands
| | - Robert J. Stokroos
- Department of Otorhinolaryngology–Head and Neck SurgeryMaastricht University Medical CenterMaastricht the Netherlands
| | - Rolien H. Free
- Department of OtorhinolaryngologyUniversity Medical Center GroningenGroningen the Netherlands
- Graduate School of Medical Sciences, Research School of Behavioural and Cognitive NeurosciencesUniversity Medical Center GroningenGroningen the Netherlands
| | - Johan H. M. Frijns
- Department of Otorhinolaryngology–Head and Neck SurgeryLeiden University Medical CenterLeiden the Netherlands
- Leiden Institute for Brain and CognitionLeiden University Medical CenterLeiden the Netherlands
| | - Wendy J. Huinck
- Department of Otorhinolaryngology–Head and Neck SurgeryRadboud University Medical CenterNijmegen the Netherlands
- Donders Institute for Brain, Cognition and BehaviourRadboud University Medical CenterNijmegen the Netherlands
| | - Emmanuel A. M. Mylanus
- Department of Otorhinolaryngology–Head and Neck SurgeryRadboud University Medical CenterNijmegen the Netherlands
- Donders Institute for Brain, Cognition and BehaviourRadboud University Medical CenterNijmegen the Netherlands
| | - Rinze A. Tange
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Medical Center UtrechtUtrecht the Netherlands
- Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrecht the Netherlands
| | - Adriana L. Smit
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Medical Center UtrechtUtrecht the Netherlands
- Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrecht the Netherlands
| | - Hans G. X. M. Thomeer
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Medical Center UtrechtUtrecht the Netherlands
- Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrecht the Netherlands
| | - Vedat Topsakal
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Medical Center UtrechtUtrecht the Netherlands
- Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrecht the Netherlands
| | - Wilko Grolman
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Medical Center UtrechtUtrecht the Netherlands
- Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrecht the Netherlands
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35
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Hoth S, Rösli-Khabas M, Herisanu I, Plinkert PK, Praetorius M. Cochlear implantation in recipients with single-sided deafness: Audiological performance. Cochlear Implants Int 2016; 17:190-199. [DOI: 10.1080/14670100.2016.1176778] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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36
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Speech Intelligibility in Noise With a Pinna Effect Imitating Cochlear Implant Processor. Otol Neurotol 2016; 37:19-23. [DOI: 10.1097/mao.0000000000000866] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chen C, Kong X, Lee IS. Modification of surface/neuron interfaces for neural cell-type specific responses: a review. ACTA ACUST UNITED AC 2015; 11:014108. [PMID: 26694886 DOI: 10.1088/1748-6041/11/1/014108] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Surface/neuron interfaces have played an important role in neural repair including neural prostheses and tissue engineered scaffolds. This comprehensive literature review covers recent studies on the modification of surface/neuron interfaces. These interfaces are identified in cases both where the surfaces of substrates or scaffolds were in direct contact with cells and where the surfaces were modified to facilitate cell adhesion and controlling cell-type specific responses. Different sources of cells for neural repair are described, such as pheochromocytoma neuronal-like cell, neural stem cell (NSC), embryonic stem cell (ESC), mesenchymal stem cell (MSC) and induced pluripotent stem cell (iPS). Commonly modified methods are discussed including patterned surfaces at micro- or nano-scale, surface modification with conducting coatings, and functionalized surfaces with immobilized bioactive molecules. These approaches to control cell-type specific responses have enormous potential implications in neural repair.
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Affiliation(s)
- Cen Chen
- Bio-X Center, College of Life Sciences, Zhejiang Sci-Tech University, Hangzhou 310018, People's Republic of China
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Takano K, Kaizaki A, Saikawa E, Konnno A, Ogasawara N, Himi T. Outcomes of visually impaired patients who received cochlear implantations. Auris Nasus Larynx 2015; 43:242-6. [PMID: 26388240 DOI: 10.1016/j.anl.2015.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 08/14/2015] [Accepted: 08/26/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Patients with multiple sensory deficits, including hearing loss and visual impairment, present a unique problem. We evaluated the clinical outcomes of cochlear implantation in patients with severe to profound sensorineural hearing loss and visual impairment. METHODS We retrospectively reviewed eight patients with severe sensorineural hearing loss and visual impairment who underwent cochlear implantation at our institution between 1993 and 2014. The follow-up period was between 2 and 20 years. We evaluated the case histories, etiologies of hearing loss and visual impairment, pre- and postoperative pure-tone thresholds, speech perception rates after CI using the Japanese CD speech discrimination scoring system (CI-2004 test) for words and sentences, and pre- and postoperative communication means. Postoperative speech discrimination scores were compared between patients with and without visual impairment who underwent cochlear implantation. RESULTS The outcomes of cochlear implantation were good in all patients, with seven showing the ability to hold a conversation with others. The average proportion of correct answers for words and sentences in the CI-2004 test was 72.3 ± 19.1% and 86.0 ± 16.1%, respectively, for the patients with visual impairment and 62.1 ± 21.7% and 78.5 ± 20.9%, respectively, for those without visual impairment (based on auditory senses only). There were no significant differences in results between the patients with and without visual impairment. CONCLUSIONS Cochlear implantation is important for the rehabilitation of patients with severe auditory loss and visual impairment. Medical staff members require additional skills to perform auditory evaluations and rehabilitate patients with multiple sensory deficits.
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Affiliation(s)
- Kenichi Takano
- Department of Otolaryngology, Sapporo Medical University School of Medicine, Japan.
| | - Aya Kaizaki
- Department of Otolaryngology, Sapporo Medical University School of Medicine, Japan
| | - Etsuko Saikawa
- Department of Otolaryngology, Sapporo Medical University School of Medicine, Japan
| | - Ayami Konnno
- Department of Otolaryngology, Sapporo Medical University School of Medicine, Japan
| | - Noriko Ogasawara
- Department of Otolaryngology, Sapporo Medical University School of Medicine, Japan
| | - Tetsuo Himi
- Department of Otolaryngology, Sapporo Medical University School of Medicine, Japan
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Cochlear implantation for patients with single-sided deafness or asymmetrical hearing loss: a systematic review of the evidence. Otol Neurotol 2015; 36:209-19. [PMID: 25502451 DOI: 10.1097/mao.0000000000000681] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE A systematic review of the literature to evaluate the clinical outcome of cochlear implantation for patients with single-sided deafness (SSD) or asymmetrical hearing loss (AHL). DATA SOURCES We searched the PubMed, Embase, Cochrane Library, and CINAHL databases from their inception up to December 10, 2013 for SSD or AHL and cochlear implantation or their synonyms. STUDY SELECTION In total, 781 articles were retrieved, of which 15 satisfied the eligibility criteria. Our outcomes of interest were speech perception in noise, sound localization, quality of life (QoL), and tinnitus. DATA EXTRACTION Critical appraisal showed that six studies reported on less than five patients or that they carried a low directness of evidence or a high risk of bias. Therefore, we extracted the data of nine studies (n = 112). Patient numbers, age, duration of deafness, classification of deafness, pure tone audiometry, follow-up duration, and outcome measurements were extracted from all nine articles. DATA SYNTHESIS Because of large heterogeneity between studies, we were not able to pool data in a meta-analysis. We therefore summarized the results of the studies specified per outcome. CONCLUSION There are no high-level-of-evidence studies concerning cochlear implantation in patients with SSD or AHL. Current literature suggests important benefits of cochlear implantation regarding sound localization, QoL, and tinnitus. Varying results were reported for speech perception in noise, possibly caused by the large clinical heterogeneity between studies. Larger and high-quality studies are certainly warranted.
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van Zon A, Smulders YE, Ramakers GGJ, Stegeman I, Smit AL, Van Zanten GA, Stokroos RJ, Hendrice N, Free RH, Maat B, Frijns JHM, Mylanus EAM, Huinck WJ, Topsakal V, Tange RA, Grolman W. Effect of unilateral and simultaneous bilateral cochlear implantation on tinnitus: A Prospective Study. Laryngoscope 2015; 126:956-61. [DOI: 10.1002/lary.25493] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 05/20/2015] [Accepted: 06/16/2015] [Indexed: 01/16/2023]
Affiliation(s)
- Alice van Zon
- Department of Otorhinolaryngology and Head and Neck Surgery; Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht
| | - Yvette E. Smulders
- Department of Otorhinolaryngology and Head and Neck Surgery; Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht
| | - Geerte G. J. Ramakers
- Department of Otorhinolaryngology and Head and Neck Surgery; Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht
| | - Inge Stegeman
- Department of Otorhinolaryngology and Head and Neck Surgery; Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht
| | - Adriana L. Smit
- Department of Otorhinolaryngology and Head and Neck Surgery; Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht
| | - Gijsbert A. Van Zanten
- Department of Otorhinolaryngology and Head and Neck Surgery; Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht
| | - Robert J. Stokroos
- Department of Otorhinolaryngology; Maastricht University Medical Center; Maastricht
| | - Nadia Hendrice
- Department of Otorhinolaryngology; Maastricht University Medical Center; Maastricht
| | - Rolien H. Free
- Department of Otorhinolaryngology; Graduate School of Medical Sciences, Research School of Behavioral and Cognitive Neurosciences, University Medical Center Groningen; Groningen
| | - Bert Maat
- Department of Otorhinolaryngology; Graduate School of Medical Sciences, Research School of Behavioral and Cognitive Neurosciences, University Medical Center Groningen; Groningen
| | - Johan H. M. Frijns
- Department of Otorhinolaryngology; Leiden Institute for Brain and Cognition, Leiden University Medical Center; Leiden
| | - Emmanuel A. M. Mylanus
- Department of Otorhinolaryngology; Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center; Nijmegen the Netherlands
| | - Wendy J. Huinck
- Department of Otorhinolaryngology; Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center; Nijmegen the Netherlands
| | - Vedat Topsakal
- Department of Otorhinolaryngology and Head and Neck Surgery; Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht
| | - Rinze A. Tange
- Department of Otorhinolaryngology and Head and Neck Surgery; Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht
| | - Wilko Grolman
- Department of Otorhinolaryngology and Head and Neck Surgery; Brain Center Rudolf Magnus, University Medical Center Utrecht; Utrecht
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Snik A, Agterberg M, Bosman A. How to quantify binaural hearing in patients with unilateral hearing using hearing implants. Audiol Neurootol 2015; 20 Suppl 1:44-7. [PMID: 25997479 DOI: 10.1159/000380747] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Application of bilateral hearing devices in bilateral hearing loss and unilateral application in unilateral hearing loss (second ear with normal hearing) does not a priori lead to binaural hearing. An overview is presented on several measures of binaural benefits that have been used in patients with unilateral or bilateral deafness using one or two cochlear implants, respectively, and in patients with unilateral or bilateral conductive/mixed hearing loss using one or two percutaneous bone conduction implants (BCDs), respectively. Overall, according to this overview, the most significant and sensitive measure is the benefit in directional hearing. Measures using speech (viz. binaural summation, binaural squelch or use of the head shadow effect) showed minor benefits, except for patients with bilateral conductive/mixed hearing loss using two BCDs. Although less feasible in daily practise, the binaural masking level difference test seems to be a promising option in the assessment of binaural function.
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Affiliation(s)
- Ad Snik
- Department of Otorhinolaryngology, Radboud University Centre Nijmegen, Nijmegen, The Netherlands
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Smulders YE, Rinia AB, Pourier VE, Van Zon A, Van Zanten GA, Stegeman I, Scherf FW, Smit AL, Topsakal V, Tange RA, Grolman W. Validation of the U-STARR with the AB-York Crescent of Sound, a New Instrument to Evaluate Speech Intelligibility in Noise and Spatial Hearing Skills. AUDIOLOGY AND NEUROTOLOGY EXTRA 2015. [DOI: 10.1159/000370300] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The Advanced Bionics® (AB)-York crescent of sound is a new test setup that comprises speech intelligibility in noise and localization tests that represent everyday listening situations. One of its tests is the Sentence Test with Adaptive Randomized Roving levels (STARR) with sentences and noise both presented from straight ahead. For the Dutch population, we adopted the AB-York setup and replaced the English sentences with a validated set of Dutch sentences. The Dutch version of the STARR is called the Utrecht-STARR (U-STARR). This study primarily assesses the validity and reliability of the U-STARR compared to the Plomp test, which is the current Dutch gold standard for speech-in-noise testing. The outcome of both tests is a speech reception threshold in noise (SRTn). Secondary outcomes are the SRTn measured with sounds from spatially separated sources (SISSS) as well as sound localization capability. We tested 29 normal-hearing adults and 18 postlingually deafened adult patients with unilateral cochlear implants (CI). This study shows that the U-STARR is adequate and reliable and seems better suited for severely hearing-impaired persons than the conventional Plomp test. Further, CI patients have poor spatial listening skills, as demonstrated with the AB-York test.
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Moteki H, Kitoh R, Tsukada K, Iwasaki S, Nishio SY, Usami SI. The advantages of sound localization and speech perception of bilateral electric acoustic stimulation. Acta Otolaryngol 2015; 135:147-53. [PMID: 25423260 PMCID: PMC4364269 DOI: 10.3109/00016489.2014.951453] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Bilateral electric acoustic stimulation (EAS) effectively improved speech perception in noise and sound localization in patients with high-frequency hearing loss. OBJECTIVE To evaluate bilateral EAS efficacy of sound localization detection and speech perception in noise in two cases of high-frequency hearing loss. METHODS Two female patients, aged 38 and 45 years, respectively, received bilateral EAS sequentially. Pure-tone audiometry was performed preoperatively and postoperatively to evaluate the hearing preservation in the lower frequencies. Speech perception outcomes in quiet and noise and sound localization were assessed with unilateral and bilateral EAS. RESULTS Residual hearing in the lower frequencies was well preserved after insertion of a FLEX(24) electrode (24 mm) using the round window approach. After bilateral EAS, speech perception improved in quiet and even more so in noise. In addition, the sound localization ability of both cases with bilateral EAS improved remarkably.
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Affiliation(s)
| | | | | | - Satoshi Iwasaki
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| | | | - Shin-Ichi Usami
- Department of Otorhinolaryngology
- Correspondence: Shin-ichi Usami MD PhD, Department of Otorhinolaryngology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan. +81 263 37 2666. +81 263 36 9164.
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Perreau AE, Ou H, Tyler R, Dunn C. Self-reported spatial hearing abilities across different cochlear implant profiles. Am J Audiol 2014; 23:374-84. [PMID: 25093507 DOI: 10.1044/2014_aja-14-0015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 07/24/2014] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The goal of this study was to determine how self-reported spatial hearing abilities differ across various cochlear implant (CI) profiles and to examine the degree of subjective benefit following cochlear implantation across different groups of CI users. METHOD This was a retrospective study of subjective spatial hearing ability of CI recipients. The subjects consisted of 99 unilateral CI users, 49 bilateral CI users, 32 subjects with a CI and contralateral hearing aid (bimodal users), and 37 short-electrode CI users. All subjects completed the Spatial Hearing Questionnaire (Tyler, Perreau, & Ji, 2009), a questionnaire assessing spatial hearing ability, after implantation, and a subset of the subjects completed the questionnaire pre- and postimplantation. RESULTS Subjective spatial hearing ability was rated higher for the bilateral and short electrode CI users compared to the unilateral and bimodal users. There was no significant difference in subjective spatial hearing performance between the bilateral and short electrode CI users and the unilateral CI and bimodal users. A separate analysis of pre- and postimplant performance revealed that all CI groups reported significant improvements in spatial hearing ability after implantation. CONCLUSION This study suggests that there are substantial differences in perceived spatial hearing ability among unilateral and bimodal CI users compared with bilateral and short electrode CI users.
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Affiliation(s)
| | - Hua Ou
- Illinois State University, Normal
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Improving Sound Localization After Cochlear Implantation and Auditory Training for the Management of Single-Sided Deafness. Otol Neurotol 2014; 35:271-6. [DOI: 10.1097/mao.0000000000000257] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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