1
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Frånlund K, Lindehammar H, Mäki-Torkko E, Hergils L. Cortical auditory evoked potentials (P1 latency) in children with cochlear implants in relation to clinical language tests. Int J Audiol 2024; 63:802-808. [PMID: 37933984 DOI: 10.1080/14992027.2023.2276048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 09/22/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
Abstract
Objective - To study the correlation between P1 latency and the results of clinical language tests (Reynell III and TROG-2), the latter were used as they are recommended for follow-up assessments of children with cochlear implants (Cis) by the Swedish National Quality Register for children with hearing impairment.Design - A clinical cohort study.Study sample - Cross-sectional and consecutive sampling of 49 children with CIs coming for clinical follow-up assessment from March 2017 - December 2019.Results - For all children tested, there was a significant negative correlation (Spearman's rho= -0.403, p = 0.011) between hearing age and P1 latency. A significant correlation between P1 latency and the Reynell III result (Spearman's rho = -0.810, p = 0.015) was found. In the TROG-2 group, there was no significant correlation between their P1 latency and their language test results (Spearman's rho -0.239, p = 0.196).Conclusion - This method seems to be feasible and easily accepted. The study was conducted in a heterogeneous group of children that we meet daily in our clinic. The results indicated that P1 latency has a negative correlation with language development among our youngest patients fitted with CIs and might be a clinical tool to assess the maturation of central auditory pathways.
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Affiliation(s)
- Karin Frånlund
- Department of Otorhinolaryngology, Linköping University Hospital, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Hans Lindehammar
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
| | - Elina Mäki-Torkko
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Audiological Research Center, Örebro University, Sweden
| | - Leif Hergils
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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2
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Kim H, Ha J, Gil ES, Jang JH, Park HY, Choung YH. Selection of the optimal first ear for sequential bilateral cochlear implantation in children. EAR, NOSE & THROAT JOURNAL 2024; 103:NP432-NP439. [PMID: 34898304 DOI: 10.1177/01455613211064012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES When there is a difference in hearing on both ears, where to perform the first cochlear implantation (CI) becomes an important issue. The purpose of the study was to evaluate which ear should be chosen for the first implantation in sequential bilateral CI with a long inter-implant period. METHODS The study population consisted of 34 severe-to-profound sensorineural hearing loss pediatrics with the inter-implant period of ≥3 years between the first CI (CI-1) and the second CI (CI-2) before the age of 19 (mean of inter-implant period: 7.1-year). The patients were classified into Group A (CI-1 was performed on the ear with better hearing), Group B (CI-1 on the ear with worse hearing), or Group C (symmetrical hearing in both ears). Speech intelligibility test results were compared between the groups. RESULTS The monosyllabic word scores of CI-1 were excellent in Groups A (91.7±7.9%) and B (92.5±3.6%) but slightly lower in Group C (85.7±14.9%) before the second implantation (P = .487). At 3 years after the second implantation, all groups demonstrated excellent scores in the bilateral CI condition (95.9±3.0% in Group A; 99.1±.8% in Group B; 97.5±2.9% in Group C, P = .600). However, when the patients were tested in using CI-2 only in Groups A and B after using bilateral CI for 3 years, the scores were inconsistent in Group A (79.6±23.9%; range: 22.2-94.4%), while those were higher and more constant in Group B (92.9±4.8%; 86.8-100.0%). CONCLUSIONS The first CI is strongly recommended to perform on a worse hearing ear if they had different hearing levels between ears. Even with the first CI on a worse hearing ear, its performance never deteriorates. In addition, if they receive the second CI several years later, it will be likely that the second one functions better.
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Affiliation(s)
- Hantai Kim
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea
- Department of Medical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea
| | - Jungho Ha
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea
- Department of Medical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea
| | - Eun Sol Gil
- Department of Medical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea
| | - Jeong Hun Jang
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Hun Yi Park
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Yun-Hoon Choung
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea
- Department of Medical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea
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3
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Franchella S, Concheri S, Di Pasquale Fiasca VM, Brotto D, Sorrentino F, Ortolani C, Agostinelli A, Montino S, Gregori D, Lorenzoni G, Borghini C, Trevisi P, Marioni G, Zanoletti E. Bilateral simultaneous cochlear implants in children: Best timing of surgery and long-term auditory outcomes. Am J Otolaryngol 2024; 45:104124. [PMID: 38035465 DOI: 10.1016/j.amjoto.2023.104124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023]
Abstract
PURPOSE Evaluate the hearing outcomes of bilateral deaf children implanted simultaneously and define the most appropriate timing for surgery. MATERIALS AND METHODS Audiological CI results were retrieved in both the short-term and long-term period and compared by stratifying the patients into different subcohorts according to their age at surgery. Additional data collected were age at implant activation, etiology and timing of onset of deafness, presence of psychomotor delay. RESULTS fifty-six bilaterally implanted children were included. The short-term outcomes differed significantly when comparing groups of different ages at implantation: younger patients achieved better aided pure tone audiometry results. Considering long-term follow-up, a significant correlation was identified between an early age at implantation and the hearing outcome at ages 2 to 5 years. Perceptive levels were better at 4 years of age in the younger group. No significant differences were found between children implanted at before 12 months and between 12 and 16 months of age. CONCLUSIONS The results of the analyzed follow-up data support the hypothesis that children implanted at before 24 months are expected to have better hearing performances. Nevertheless, these results are referred to a widely heterogeneous group of patients and the duration of auditory deprivation should be considered.
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Affiliation(s)
- Sebastiano Franchella
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Stefano Concheri
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | | | - Davide Brotto
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Flavia Sorrentino
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Caterina Ortolani
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Anna Agostinelli
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Silvia Montino
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, via Loredan, 18, 35121 Padova, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, via Loredan, 18, 35121 Padova, Italy
| | - Carlotta Borghini
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, via Loredan, 18, 35121 Padova, Italy
| | - Patrizia Trevisi
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Gino Marioni
- Phoniatrics and Audiology Unit, Department of Neuroscience, University of Padova, Treviso, Italy.
| | - Elisabetta Zanoletti
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
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4
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Fatani N, Hamed N, Hagr A. Simultaneous Bilateral Cochlear Implantation in Adults. J Pers Med 2023; 13:1462. [PMID: 37888073 PMCID: PMC10607989 DOI: 10.3390/jpm13101462] [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: 08/31/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/28/2023] Open
Abstract
The objective of this study is to review our experience with simultaneous bilateral cochlear implantation (BiCI) in adults, and assess its feasibility. This could shorten the time required to regain binaural hearing, prevent social isolation, and potentially eliminate the need for hearing aids, as seen with sequential BiCI. A retrospective study was conducted involving adult patients who received simultaneous BiCI at our center between 2010 and 2023. The feasibility of simultaneous BiCI was assessed through postoperative clinical evaluations, outpatient visits, discharge status, and the acceptance of device fitting. Twenty-seven patients underwent simultaneous BiCIs. Their mean age was 37 years, comprising 59.3% males and 40.7% females. Out of the included patients, 51.9% had childhood-onset hearing loss, while 29.6% developed hearing loss later in life. Causes of hearing loss included meningitis 7.4%, trauma 11.1%, non-specific high-grade fever 11.1%, and Brucellosis infection 3.7%. Labyrinthine ossificans (LO) was present in 7.4%, and retrofenestral otospongiosis in 3.7%. The post-operative period and initial outpatient visit were uneventful for 88.8% and 81.5% of patients, respectively. Intraoperative complications were absent in 96.2% of cases. Simultaneous BiCI is feasible in adults without major intraoperative complications or troublesome recovery periods, offering potential benefits by reducing the number of surgeries and hospital admissions compared to the sequential method.
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Affiliation(s)
- Nawaf Fatani
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh 11411, Saudi Arabia
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5
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Vibert D, Kompis M, Caversaccio M, Mantokoudis G. Vestibular function, subjective complaints, perceived disability in daily life, and sports activities in patients with cochlear implants performed during childhood: a prospective cross-section study. Acta Otolaryngol 2023; 143:735-741. [PMID: 37897347 DOI: 10.1080/00016489.2023.2268159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/28/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Vestibular function (VF) in patients with cochlear implantation (CI) performed during childhood is underinvestigated. OBJECTIVE To study VF in patients receiving CI during childhood. MATERIAL & METHODS Sixty patients (22 females) from 7-34 years old, unilaterally (n = 21) and bilaterally (n = 39) implanted, were included. Deafness was congenital (n = 45), consequential to meningitis (n = 3), skull fracture (n = 1), perinatal CMV infection (n = 1), ototoxic drugs (n = 1), unknown etiology (n = 9). VF was measured between 1 to 22 years after implantation, including calorics, v-HIT, c-VEMPS. Dizziness handicap inventory (DHI), age at independent walking(IW), sport activities were also investigated. RESULTS Nine CI-patients (15%) reported dizziness/vertigo either prior or months to years after surgery. Comparison between symptomatic (15%), asymptomatic (85%), uni-bilaterally CI-patients showed no significant difference on VF's impairment for calorics (p = .603) and v-HIT (p = 1). Symptoms were not related to vestibular impairment. Age at implantation (p = 0.956), uni- bilateral (p = .32), simultaneous versus sequential (p = .134) did not influence IW age. DHI showed a tendency for being symptomatic at higher implantation age. Interval between CI, IWage, current age between surgery and vestibular evaluation did not have a significant effect on symptomatology. CONCLUSION & SIGNIFICANCE This first middle to long-term evaluation of the VF in CI-patients, implanted in childhood, pointed out that 85% of patients were asymptomatic, with a mean time of >10 years after surgery. Vestibular impairment and symptoms seem to be mainly due to the underlying inner ear's disease rather than surgery.
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Affiliation(s)
- Dominique Vibert
- Department of Otorhinolaryngology, Head & Neck Surgery, Inselspital, University of Bern, Switzerland
| | - Martin Kompis
- Department of Otorhinolaryngology, Head & Neck Surgery, Inselspital, University of Bern, Switzerland
| | - Marco Caversaccio
- Department of Otorhinolaryngology, Head & Neck Surgery, Inselspital, University of Bern, Switzerland
| | - Georgios Mantokoudis
- Department of Otorhinolaryngology, Head & Neck Surgery, Inselspital, University of Bern, Switzerland
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6
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Neonatal Deafening Selectively Degrades the Sensitivity to Interaural Time Differences of Electrical Stimuli in Low-Frequency Pathways in Rats. eNeuro 2023; 10:ENEURO.0437-22.2022. [PMID: 36609304 PMCID: PMC9850913 DOI: 10.1523/eneuro.0437-22.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/30/2022] [Accepted: 12/31/2022] [Indexed: 01/07/2023] Open
Abstract
We examined the effect of neonatal deafening on frequency-specific pathways for processing of interaural time differences (ITDs) in cochlear-implant stimuli. Animal studies have demonstrated differences in neural ITD sensitivity in the inferior colliculus (IC) depending on the intracochlear location of intracochlear stimulating electrodes. We used neonatally deafened (ND) rats of both sexes and recorded the responses of single neurons in the IC to electrical stimuli with ITDs delivered to the apical or basal cochlea and compared them with acutely deafened (AD) rats of both sexes with normal hearing (NH) during development. We found that neonatal deafness significantly impacted the ITD sensitivity and the ITD tuning patterns restricted to apically driven IC neurons. In ND rats, the ITD sensitivity of apically driven neurons is reduced to values similar to basally driven neurons. The prevalence of ITD-sensitive apical neurons with a peak-shaped ITD tuning curve, which may reflect predominant input from the medial superior olivary (MSO) complex, in ND rats was diminished compared with that in AD rats (67%, AD vs 40%, ND). Conversely, monotonic-type responses rarely occurred in AD rats (14%) but were approximately equally as prevalent as peak-type tuning curves in ND rats (42%). Nevertheless, in ND rats, the ITD at the maximum slope of the ITD tuning curve was still more concentrated within the physiological ITD range in apically driven than in basally driven neurons. These results indicate that the development of high ITD sensitivity processed by low-frequency pathways depends on normal auditory experience and associated biases in ITD tuning strategies.
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7
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Yin X, Gu H, Kong W, Li G, Zheng Y. Early prelingual auditory and language development in children with simultaneous bilateral and unilateral cochlear implants. Front Pediatr 2022; 10:999689. [PMID: 36405825 PMCID: PMC9669896 DOI: 10.3389/fped.2022.999689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE This current study aimed to explore early prelingual auditory development (EPLAD) and early language development in Mandarin-speaking children who received simultaneous bilateral cochlear implants (BICI) during the first year of cochlear implantation and compare the performance of the children who received BICI with those received unilateral cochlear implant (UCI). METHODS 39 Mandarin-speaking children who received BICIs simultaneously and 36 children with UCIs were enrolled in this study. To access the EPLAD, the Infant-Toddler Meaningful Auditory Integration Scale (IT/MAIS) was conducted, and a subtest of the simplified short-form version of the Mandarin Communicative Development Inventory (SSF-MCDI) was used to evaluate the development of expressive and receptive vocabulary for the children at indicated time points after surgery. RESULTS In both the simultaneous BICI and UCI groups, we observed significantly increased scores of the SSF-MCDI and IT/MAIS 1 year after the surgery. There are indications of early advantages in children with BICI in IT/MAIS scores (at 1, 3, and 6 months after activation). For early development of language, a great difference between the expressive vocabulary scores and the receptive vocabulary scores was observed in both groups. We found there were not significant differences between the two groups on expressive or receptive vocabulary scores, the use of more differentiated measures might be required in future research. We further found that the development of the receptive or expressive vocabulary is dramatically correlated with the age at implantation and the total scores of IT/MAIS for children with simultaneous BICIs. CONCLUSION These results may supplement the skills development of early language and auditory in Mandarin-native children with simultaneous CIs. It is obvious that children with normal hearing have mastery of receptive vocabulary before that of expressive vocabulary, which is the same as children with unilateral and bilateral CIs in this research. IT/MAIS total scores and age at CI were important factors for early language performance in children with simultaneous BICIs.
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Affiliation(s)
- Xiaoling Yin
- Department of Otolaryngology/Head and Neck Surgery, Hearing Center/Hearing & Speech Science Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Hailing Gu
- Department of Otolaryngology/Head and Neck Surgery, Hearing Center/Hearing & Speech Science Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Weili Kong
- Department of Otolaryngology/Head and Neck Surgery, Hearing Center/Hearing & Speech Science Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Gang Li
- Department of Otolaryngology/Head and Neck Surgery, Hearing Center/Hearing & Speech Science Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Yun Zheng
- Department of Otolaryngology/Head and Neck Surgery, Hearing Center/Hearing & Speech Science Laboratory, West China Hospital of Sichuan University, Chengdu, China
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8
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Gordon KA, Papsin BC, Papaioannou V, Cushing SL. The Importance of Access to Bilateral Hearing through Cochlear Implants in Children. Semin Hear 2021; 42:381-388. [PMID: 34912166 PMCID: PMC8660169 DOI: 10.1055/s-0041-1739371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Children with hearing loss require early access to sound in both ears to support their development. In this article, we describe barriers to providing bilateral hearing and developmental consequences of delays during early sensitive periods. Barriers include late identification of hearing loss in one or both ears and delayed access to intervention with hearing devices such as cochlear implants. Effects of delayed bilateral input on the auditory pathways and brain are discussed as well as behavioral effects on speech perception and other developmental outcomes including language and academics. Evidence for these effects has supported an evolution in cochlear implant candidacy in children that was started with unilateral implantation in children with profound deafness bilaterally to bilateral implantation to implantation of children with asymmetric hearing loss including children with single-side deafness. Opportunities to enhance the developmental benefits of bilateral hearing in children with hearing loss are also discussed including efforts to improve binaural/spatial hearing and consideration of concurrent vestibular deficits which are common in children with hearing loss.
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Affiliation(s)
- Karen A Gordon
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Canada.,Department of Communication Disorders, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Blake C Papsin
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Vicky Papaioannou
- Department of Communication Disorders, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Sharon L Cushing
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology, The Hospital for Sick Children, Toronto, Canada.,Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada
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9
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McSweeny C, Cushing SL, Campos JL, Papsin BC, Gordon KA. Functional Consequences of Poor Binaural Hearing in Development: Evidence From Children With Unilateral Hearing Loss and Children Receiving Bilateral Cochlear Implants. Trends Hear 2021; 25:23312165211051215. [PMID: 34661482 PMCID: PMC8527588 DOI: 10.1177/23312165211051215] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Poor binaural hearing in children was hypothesized to contribute to related cognitive and
academic deficits. Children with unilateral hearing have normal hearing in one ear but no
access to binaural cues. Their cognitive and academic deficits could be unique from
children receiving bilateral cochlear implants (CIs) at young ages who have poor access to
spectral cues and impaired binaural sensitivity. Both groups are at risk for
vestibular/balance deficits which could further contribute to memory and learning
challenges. Eighty-eight children (43 male:45 female, aged 9.89 ± 3.40 years), grouped
by unilateral hearing loss (n = 20), bilateral CI
(n = 32), and typically developing (n = 36), completed a
battery of sensory, cognitive, and academic tests. Analyses revealed that children in both
hearing loss groups had significantly poorer skills (accounting for age) on most tests
than their normal hearing peers. Children with unilateral hearing loss had more asymmetric
speech perception than children with bilateral CIs (p < .0001) but
balance and language deficits (p = .0004, p < .0001,
respectively) were similar in the two hearing loss groups (p > .05).
Visuospatial memory deficits occurred in both hearing loss groups
(p = .02) but more consistently across tests in children with unilateral
hearing loss. Verbal memory was not significantly different than normal
(p > .05). Principal component analyses revealed deficits in a main
cluster of visuospatial memory, oral language, mathematics, and reading measures
(explaining 46.8% data variability). The remaining components revealed clusters of
self-reported hearing, balance and vestibular function, and speech perception deficits.
The findings indicate significant developmental impacts of poor binaural hearing in
children.
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Affiliation(s)
- Claire McSweeny
- Archie's Cochlear Implant Lab, 7979Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sharon L Cushing
- Archie's Cochlear Implant Lab, 7979Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Otolaryngology, Head & Neck Surgery, Faculty of Medicine, University of Toronto, Ontario, Canada.,Department of Otolaryngology, Head & Neck Surgery, 7979Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jennifer L Campos
- KITE-Toronto Rehabilitation Institute, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Blake C Papsin
- Archie's Cochlear Implant Lab, 7979Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Otolaryngology, Head & Neck Surgery, Faculty of Medicine, University of Toronto, Ontario, Canada.,Department of Otolaryngology, Head & Neck Surgery, 7979Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen A Gordon
- Archie's Cochlear Implant Lab, 7979Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Otolaryngology, Head & Neck Surgery, Faculty of Medicine, University of Toronto, Ontario, Canada
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10
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Zhang D, Yuan Y, Su Y, Wang G, Guo C, Wang Q, Gao S, Dai P, Gao X. Sequential Bilateral Cochlear Implantation in a Child with Severe External, Middle, and Inner Ear Malformations: Surgical Considerations and Practical Aspects. ORL J Otorhinolaryngol Relat Spec 2021; 83:471-477. [PMID: 34433162 DOI: 10.1159/000515179] [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: 12/07/2020] [Accepted: 01/29/2021] [Indexed: 11/19/2022]
Abstract
Cochlear implantation (CI) is a safe and beneficial surgery for children with congenital inner ear malformations, with the exception of cochlear nerve aplasia. The combination of microtia with middle and inner ear abnormalities is extremely uncommon and sufficiently severe to make a surgical approach to the cochlea difficult. We report herein the case of a 2-year-old girl who presented with profound bilateral sensorineural hearing loss, congenital aural atresia, microtia, and inner ear malformations. High-resolution computed tomography revealed poor development of the bilateral middle ear spaces, absence of the incus and stapes, aberrant courses of facial nerves, aplastic lateral semicircular canals, and covered round windows. With intraoperative imaging assistance, sequential bilateral CI was performed using a transmastoid approach with no complication. We propose that CI is feasible in patients with severe external and middle ear malformations. However, major malformations increase the risk of complications. As the facial nerve and cochlea are difficult to locate due to the lack of important anatomical landmarks, detailed planning and adequate preparation, including review of the preoperative imaging data, and the use of facial nerve monitoring and intraoperative imaging are very important. In addition, experienced surgeons should perform CI to ensure the success of the operation.
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Affiliation(s)
- Dejun Zhang
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA G General Hospital, Beijing, China.,Department of Otolaryngology Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Key Lab of Hearing Science, Ministry of Education, Beijing, China.,Beijing Key Lab of Hearing Impairment for Prevention and Treatment, Beijing, China
| | - Yongyi Yuan
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA G General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Key Lab of Hearing Science, Ministry of Education, Beijing, China.,Beijing Key Lab of Hearing Impairment for Prevention and Treatment, Beijing, China
| | - Yu Su
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA G General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Key Lab of Hearing Science, Ministry of Education, Beijing, China.,Beijing Key Lab of Hearing Impairment for Prevention and Treatment, Beijing, China
| | - Guojian Wang
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA G General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Key Lab of Hearing Science, Ministry of Education, Beijing, China.,Beijing Key Lab of Hearing Impairment for Prevention and Treatment, Beijing, China
| | - Chang Guo
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA G General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Key Lab of Hearing Science, Ministry of Education, Beijing, China.,Beijing Key Lab of Hearing Impairment for Prevention and Treatment, Beijing, China
| | - Qiuquan Wang
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA G General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Key Lab of Hearing Science, Ministry of Education, Beijing, China.,Beijing Key Lab of Hearing Impairment for Prevention and Treatment, Beijing, China
| | - Song Gao
- Department of Otolaryngology, The 175th Hospital of PLA, South-East Hospital Affiliated to Xiamen University, Zhangzhou, China
| | - Pu Dai
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA G General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Key Lab of Hearing Science, Ministry of Education, Beijing, China.,Beijing Key Lab of Hearing Impairment for Prevention and Treatment, Beijing, China
| | - Xue Gao
- Department of Otolaryngology, PLA Rocket Force Characteristic Medical Center, Beijing, China
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Bilateral cochlear implantation in children: simultaneously or in consecutive sessions? The Journal of Laryngology & Otology 2021; 135:327-331. [PMID: 33829979 DOI: 10.1017/s0022215121000931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to evaluate and compare cases of simultaneous and consecutive bilateral cochlear implantation from the perspective of the duration of anaesthesia, surgical complications and hospitalisation. METHOD Fifty patients with simultaneous bilateral cochlear implantation (group 1) and 47 patients with consecutive bilateral cochlear implantation (group 2) were included in this study. The two groups were compared in terms of the duration of anaesthesia, the duration of surgery, radiological findings, the complications and the post-operative hospitalisation time. RESULTS Group 1 had a significantly shorter operation time than group 2 (p < 0.01). The mean total operation time was 189 minutes in group 1. In group 2, the mean operation times for the first and second surgery were 134 minutes and 136 minutes, respectively, and the total operation time for both surgical procedures in group 2 was 270 minutes. The duration of post-operative hospitalisation of the patients in group 1 was significantly shorter than the total post-operative hospitalisation after both operations for the patients in group 2 (p < 0.01). CONCLUSION In conclusion, if there is no anatomical problem that may lead to a prolonged operation time or any risk regarding anaesthesia, simultaneous bilateral cochlear implantation can be performed safely.
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Lee Y, Sim H. Bilateral cochlear implantation versus unilateral cochlear implantation in deaf children: Effects of sentence context and listening conditions on recognition of spoken words in sentences. Int J Pediatr Otorhinolaryngol 2020; 137:110237. [PMID: 32658807 DOI: 10.1016/j.ijporl.2020.110237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 06/13/2020] [Accepted: 06/28/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Previous studies have investigated the efficacy of bilateral cochlear implants (CIs) in deaf children. The current study focused on the use of sentence-context information in different listening conditions to better explain the benefits of bilateral cochlear implantation. We compared the word recognition abilities of children with bilateral CIs and children with unilateral CIs in relation to sentence context and listening conditions. Additionally, we investigated whether sentence context- and listening condition-dependent word recognition scores can differentiate children with bilateral CIs from children with unilateral CIs. METHODS Twenty children with bilateral CIs and 20 children with unilateral CIs participated in this study. All children were presented with semantically controlled sentences (high vs. low predictability) in quiet and noisy conditions and were asked to repeat the final words of each sentence. RESULTS Children with bilateral CIs had significantly higher word recognition scores than children with unilateral CIs on words embedded in both high- and low-predictability sentences in noisy conditions. The two groups recognized more words in high-predictability sentences than in low-predictability sentences in noisy conditions. The scores on the high-predictability sentences in noisy conditions significantly differentiated children with bilateral CIs from children with unilateral CIs. CONCLUSION Bilateral cochlear implantation is more advantageous than unilateral cochlear implantation at the auditory-linguistic processing level in complex listening conditions.
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Affiliation(s)
- Youngmee Lee
- Department of Communication Disorders, Ewha Womans University, Seoul, Republic of Korea
| | - Hyunsub Sim
- Department of Communication Disorders, Ewha Womans University, Seoul, Republic of Korea.
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Grinblat G, Vlad D, Caruso A, Sanna M. Evaluation of Subtotal Petrosectomy Technique in Difficult Cases of Cochlear Implantation. Audiol Neurootol 2020; 25:323-335. [PMID: 32474562 DOI: 10.1159/000507419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 03/23/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To assess the validity of the subtotal petrosectomy (STP) technique in problematic cases of cochlear implant (CI) surgery, and review indications, outcomes, and related controversies. STUDY DESIGN This is a retrospective review of data from a private quaternary referral center of otology and skull base surgery. PATIENTS AND METHODS A review of patients who underwent CI with STP (STP-CI) as the leading approach was performed. Demographics, indications, surgical details, and main outcomes were evaluated. The surgeries performed were usually single-stage procedures encompassing a comprehensive mastoidectomy, blind sac closure of the external auditory canal (EAC), and mastoid obliteration with autologous fat. RESULTS A total of 107 cases were included. Mean follow-up was 7.1 years (range 1-13 years). The most frequent indication for STP-CI was chronic otitis media with/without cholesteatoma (32.7%), followed by open mastoid cavity (26.1%), and cochlear ossification (17.7%). Other difficult conditions where STP facilitates successful implantation include inner-ear malformations, temporal-bone trauma, unfavorable anatomic conditions, and revision surgery. A planned staged procedure was performed in 3 cases. The rate of major complications was 5.6% (n = 6). Three patients developed postauricular wound dehiscence which eventually resulted in device extrusion. No cases of recurrent/entrapped cholesteatoma, EAC breakdown, or meningitis were encountered. This is the largest single-center series of STP-CI reported in the literature. CONCLUSIONS When CI is intended in technically challenging cases or associated with a high risk of complications, STP is effective and reliable. Safe implantation and excellent long-term outcomes can be achieved provided surgical steps are properly followed. Single-stage procedures can be performed in most cases, even when there is active middle-ear disease.
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Affiliation(s)
- Golda Grinblat
- Department of Otorhinolaryngology, Hillel Yaffe Medical Center Affiliated to the Technion University Haifa, Hadera, Israel, .,Gruppo Otologico, Quaternary Referral Center for Otology, Neurotology and Skull Base Surgery, Piacenza, Italy,
| | - Diana Vlad
- Gruppo Otologico, Quaternary Referral Center for Otology, Neurotology and Skull Base Surgery, Piacenza, Italy.,Second Department of Otolaryngology, University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Antonio Caruso
- Gruppo Otologico, Quaternary Referral Center for Otology, Neurotology and Skull Base Surgery, Piacenza, Italy
| | - Mario Sanna
- Gruppo Otologico, Quaternary Referral Center for Otology, Neurotology and Skull Base Surgery, Piacenza, Italy
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Abstract
OBJECTIVE To compare outcomes of bilateral cochlear implantation between simultaneous and sequential surgeries. STUDY DESIGN Retrospective study of surgical outcome for 54 children who received bilateral cochlear implants (CIs) over a five-year period. SETTING Tertiary health care PATIENTS:: We analyze surgical outcomes for 54 children who received two CIs over a five-year period. Thirty-two of these children received these implants simultaneously and 22 of these children received their implants sequentially (76 CI operations and 108 CI). INTERVENTION One hundred and eight CIs; Group A-bilateral simultaneous CI; Group B- bilateral sequential CI. MAIN OUTCOME MEASURES Measurement of body temperature; recording drug administration measurement of the total length of hospital stay, surgery time, and total operating room utilization; recording complications. RESULTS Simultaneous bilateral CI-implantation is associated with a significantly reduced cumulative surgical time and cumulative operating room time. It shortens the total in-patient stay for children in comparison to sequential implantations. There were no clinically significant, adverse consequences of simultaneous implant surgery. Further information include medical history including cochlear malformations as well as complications after the surgery, use of analgesic and antiemetic medication and length of hospital stay. CONCLUSIONS Simultaneous bilateral surgery is a safe option of pediatric cochlear implantation.
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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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Bhamjee A, Roux TL, Schlemmer K, Perold J, Cass N, Schroeder K, Schlesinger D, Ceronio D, Vinck B. Parent-perceived challenges related to the pediatric cochlear implantation process and support services received in South Africa. Int J Pediatr Otorhinolaryngol 2019; 126:109635. [PMID: 31421357 DOI: 10.1016/j.ijporl.2019.109635] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/31/2019] [Accepted: 08/07/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine and describe parent-perceived challenges related to the pediatric cochlear implantation process and support services received. METHOD A multicenter survey study across six cochlear implant (CI) programs in South Africa (SA) was conducted. The study sample included 82 parents of pediatric (≤18 years) CI recipients with at least 12 months CI experience. A self-administered questionnaire was developed for the purpose of this study, exploring parental challenges regarding the CI process, education of their implanted children and the support services received. RESULTS The financial implications of cochlear implantation, including CI device maintenance, were identified by parents as the most prominent challenge. Financing issues were the highest scoring reason that attributed to the delay between diagnosis of hearing loss and cochlear implantation, as well as the greatest barrier to bilateral implantation. Parent-perceived educational challenges included finding adequate educational settings specific to the individual needs of their child and a shortage of trained teachers equipped to support children with CIs. The presence of one/more additional developmental conditions and grade repetition were associated with more pronounced parent-perceived educational challenges. Parents considered speech-language therapy as the most critical support service for their implanted children to achieve optimal outcomes, while parent guidance was indicated to be the most critical support service required for parents of pediatric CI recipients. CONCLUSION A greater understanding of parent-perceived challenges will guide CI professionals to promote optimal outcomes, evidence-based service delivery and on-going support to pediatric CI recipients and their families. Study results imply a call for action regarding financial and educational support for pediatric CI recipients in SA.
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Affiliation(s)
- Aaqilah Bhamjee
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Talita le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa.
| | - Kurt Schlemmer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Kwazulu Natal, Durban, South Africa; Durban Cochlear Implant Program, Durban, South Africa
| | - Jenny Perold
- Tygerberg Hospital-Stellenbosch University Cochlear Implant Unit, Cape Town, South Africa
| | - Nicolize Cass
- Pretoria Cochlear Implant Unit, Pretoria, South Africa
| | - Kelly Schroeder
- Port Elizabeth Cochlear Implant Unit, Port Elizabeth, South Africa
| | - Dani Schlesinger
- Chris Hani Baragwanath Academic Hospital Cochlear Implant Program, Soweto, South Africa
| | - Deon Ceronio
- Bloemfontein Cochlear Implant Program, Bloemfontein, South Africa
| | - Bart Vinck
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa; Speech-Language Audiology Department, Ghent University, Gent, Belgium
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Yanov YK, Kuzovkov VE, Lilenko AS, Sugarova SB, Kostevich IV, Drozdova MV. [Round window niche area anatomy in terms of cochlear implantation]. Vestn Otorinolaringol 2019; 84:25-27. [PMID: 30938337 DOI: 10.17116/otorino20198401125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cochlear implantation is the most effective method of rehabilitation of patients with a high degree of hearing loss and deafness. This is a complex, multi-stage way of rehabilitation that includes selection of candidates for surgical intervention, a surgical stage and postoperative long-term auditory rehabilitation. In carrying out the surgical stage of cochlear implantation the round window niche area is of great interest, since the variability of its anatomical features affects the access to scala tympani. The article presents the data obtained from study of the round window niche area anatomy on cadaveric temporal bones. Variations of structures important for cochlear implantation have been determined.
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Affiliation(s)
- Yu K Yanov
- St.-Petersburg Scientific Research Institute of Ear, Nose, and Tongue of the Ministry of Health of the Russian Federation, St.-Petersburg, Russia, 190013
| | - V E Kuzovkov
- St.-Petersburg Scientific Research Institute of Ear, Nose, and Tongue of the Ministry of Health of the Russian Federation, St.-Petersburg, Russia, 190013
| | - A S Lilenko
- St.-Petersburg Scientific Research Institute of Ear, Nose, and Tongue of the Ministry of Health of the Russian Federation, St.-Petersburg, Russia, 190013
| | - S B Sugarova
- St.-Petersburg Scientific Research Institute of Ear, Nose, and Tongue of the Ministry of Health of the Russian Federation, St.-Petersburg, Russia, 190013
| | - I V Kostevich
- St.-Petersburg Scientific Research Institute of Ear, Nose, and Tongue of the Ministry of Health of the Russian Federation, St.-Petersburg, Russia, 190013
| | - M V Drozdova
- St.-Petersburg Scientific Research Institute of Ear, Nose, and Tongue of the Ministry of Health of the Russian Federation, St.-Petersburg, Russia, 190013
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Hess CL, Misurelli SM, Litovsky RY. Spatial Release From Masking in 2-Year-Olds With Normal Hearing and With Bilateral Cochlear Implants. Trends Hear 2019; 22:2331216518775567. [PMID: 29761735 PMCID: PMC5956632 DOI: 10.1177/2331216518775567] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
This study evaluated spatial release from masking (SRM) in 2- to 3-year-old children who are deaf and were implanted with bilateral cochlear implants (BiCIs), and in age-matched normal-hearing (NH) toddlers. Here, we examined whether early activation of bilateral hearing has the potential to promote SRM that is similar to age-matched NH children. Listeners were 13 NH toddlers and 13 toddlers with BiCIs, ages 27 to 36 months. Speech reception thresholds (SRTs) were measured for target speech in front (0°) and for competitors that were either Colocated in front (0°) or Separated toward the right (+90°). SRM was computed as the difference between SRTs in the front versus in the asymmetrical condition. Results show that SRTs were higher in the BiCI than NH group in all conditions. Both groups had higher SRTs in the Colocated and Separated conditions compared with Quiet, indicating masking. SRM was significant only in the NH group. In the BiCI group, the group effect of SRM was not significant, likely limited by the small sample size; however, all but two children had SRM values within the NH range. This work shows that to some extent, the ability to use spatial cues for source segregation develops by age 2 to 3 in NH children and is attainable in most of the children in the BiCI group. There is potential for the paradigm used here to be used in clinical settings to evaluate outcomes of bilateral hearing in very young children.
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Dieleman E, Percy-Smith L, Caye-Thomasen P. Language outcome in children with congenital hearing impairment: The influence of etiology. Int J Pediatr Otorhinolaryngol 2019; 117:37-44. [PMID: 30579085 DOI: 10.1016/j.ijporl.2018.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 11/01/2018] [Accepted: 11/01/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the possible association between the etiology of hearing impairment (HI) and language outcome in children with congenital HI after an early medical-technical intervention and three years of AVT. METHODS A retrospective, two-center study was conducted of 53 patients who were divided in four categories of etiology (degeneratio labyrinthi acustici (DLA) congenita hereditaria, DLA congenita non specificata, DLA congenita postinfectiosa and auditory neuropathy). Language outcome was assessed by examining receptive vocabulary (Peabody Picture Vocabulary Test, PPVT-4), receptive language (Reynell test) and productive language (the Danish 'Viborgmaterialet'). All tests were conducted 1, 2 and 3 years after the children received their hearing device. Test scores were calculated from the child's chronological age. Analysis of possible associations was performed using Fisher's exact test and McNemar's test was conducted to examine possible differences between each year of testing for every speech-language test. Subsequently, univariate analyses were performed to search for other possible covariates associated with language outcome. RESULTS No significant associations were found between the etiology of the HI and the language outcome of children with HI after 1 year of AVT (PPVT, p = 0,234; Reynell, p = 0,845; Viborgmaterialet, p = 0,667), neither after 2 years of AVT (PPVT, p = 0,228; Reynell, p = 0,172; Viborgmaterialet, p = 0,659) nor after 3 years of AVT (PPVT, p = 0,102; Reynell, p = 0,512 Viborgmaterialet, p = 0,580). Some significant associations were found between language outcome and the type of hearing device and between language outcome and additional disabilities, however no strong evidence was found. CONCLUSION Most children with congenital HI developed a comparable level of speech and language regardless of the etiology of their HI. This study highlights the interest of further research using objective assessments techniques in a larger and more homogeneous population. If the findings from this study will be confirmed in future studies, this will have a clinical and societal impact regarding the diagnostics of HI.
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Affiliation(s)
- Eveline Dieleman
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Lone Percy-Smith
- Patientforening Decibel, Rygårdsallé 43, 2900, Hellerup, Denmark
| | - Per Caye-Thomasen
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark
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Sheffield SW, Romigh GD, Zurek PM, Bernstein JGW, Brungart DS. A method for degrading sound localization while preserving binaural advantages for speech reception in noise. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 145:1129. [PMID: 30823825 DOI: 10.1121/1.5090494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 01/25/2019] [Indexed: 06/09/2023]
Abstract
This study developed and tested a real-time processing algorithm designed to degrade sound localization (LocDeg algorithm) without affecting binaural benefits for speech reception in noise. Input signals were divided into eight frequency channels. The odd-numbered channels were mixed between the ears to confuse the direction of interaural cues while preserving interaural cues in the even-numbered channels. The LocDeg algorithm was evaluated for normal-hearing listeners performing sound localization and speech-reception tasks. Results showed that the LocDeg algorithm successfully degraded sound-localization performance without affecting speech-reception performance or spatial release from masking for speech in noise. The LocDeg algorithm did, however, degrade speech-reception performance in a task involving spatially separated talkers in a multi-talker environment, which is thought to depend on differences in perceived spatial location of concurrent talkers. This LocDeg algorithm could be a valuable tool for isolating the importance of sound-localization ability from other binaural benefits in real-world environments.
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Affiliation(s)
- Sterling W Sheffield
- National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, 4954 North Palmer Road, Bethesda, Maryland 20889, USA
| | - Griffin D Romigh
- United States Air Force Research Laboratory, 5135 Pearson Road, Building 10, Wright Patterson Air Force Base, Ohio 45433, USA
| | - Patrick M Zurek
- Sensimetrics Corporation, 110 Winn Street, Suite 205A, Woburn, Massachusetts 01801, USA
| | - Joshua G W Bernstein
- National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, 4954 North Palmer Road, Bethesda, Maryland 20889, USA
| | - Douglas S Brungart
- National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, 4954 North Palmer Road, Bethesda, Maryland 20889, USA
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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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Chen F, Ni W, Li W, Li H. Cochlear Implantation and Rehabilitation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1130:129-144. [PMID: 30915705 DOI: 10.1007/978-981-13-6123-4_8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Cochlear implant (CI) is currently the only medical treatment available to partially restore hearing to patients with profound-to-severe hearing loss. CI is fundamentally distinct from hearing aid (HA) use, as implants are surgically placed under the skin behind the ear where they bypass the normal sound-conducting mechanism, convert sound signals into electrical stimulation, and directly stimulate the residual auditory nerves. In recent years, CI has evolved into one of the most profound advances in modern medicine and provided hearing to more than 320,000 deaf patients. According to the time of onset, deafness is classified as prelingual and postlingual deafness, and the indications of cochlear implants vary slightly. The medical evaluation must be made before surgery, including the medical history, objective and subjective audiometry, imaging of the ear, as well as the genetic diagnostic. Here we reviewed the surgical approaches for cochlear implants as well as the complications.
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Affiliation(s)
- Fei Chen
- Southern University of Science and Technology, Shenzhen, China
| | - Wenli Ni
- Key Laboratory of Hearing Medicine of NHFPC, ENT Institute and Otorhinolaryngology Department, Shanghai Engineering Research Centre of Cochlear Implant, Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Wenyan Li
- Key Laboratory of Hearing Medicine of NHFPC, ENT Institute and Otorhinolaryngology Department, Shanghai Engineering Research Centre of Cochlear Implant, Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Huawei Li
- Key Laboratory of Hearing Medicine of NHFPC, ENT Institute and Otorhinolaryngology Department, Shanghai Engineering Research Centre of Cochlear Implant, Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China.
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Almeida GFL, Martins MF, Costa LBAD, Costa OAD, Martinho de Carvalho AC. Sequential bilateral cochlear implant: results in children and adolescents. Braz J Otorhinolaryngol 2018; 85:774-779. [PMID: 30166120 PMCID: PMC9443053 DOI: 10.1016/j.bjorl.2018.07.008] [Citation(s) in RCA: 7] [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: 05/05/2018] [Accepted: 07/24/2018] [Indexed: 11/18/2022] Open
Abstract
Introduction The use of the bilateral cochlear implants can promote the symmetrical development of the central auditory pathways, thus benefiting the development of auditory abilities and improving sound localization and the ability of auditory speech perception in situations of competitive noise. Objective To evaluate the ability of speech perception in children and adolescents using sequential bilateral cochlear implants, considering the association of these variables: age at surgery, time of device use and interval between surgeries. Methods A total of 14 individuals between 10 and 16 years of age, who demonstrated surgical indication for the use of sequential bilateral cochlear implants as intervention in the auditory habilitation process, were assessed. The speech perception ability was assessed through sentence lists constructed in the Portuguese language, presented in two situations: in silence, with fixed intensity of 60 dB SPL, and in competitive noise, with a signal-to-noise ratio of +15 dB. The evaluation was performed under the following conditions: unilateral with the first activated cochlear implant, unilateral with the second activated cochlear implant and bilateral with both devices activated. Results The results of the speech perception tests showed better performance in both silence and in noise for the bilateral cochlear implant condition when compared to the 1st cochlear implant and the 2nd cochlear implant alone. A worse result of speech perception was found using the 2nd cochlear implant alone. No statistically significant correlation was found between age at the surgical procedure, interval between surgeries and the time of use of the 2nd cochlear implant, and the auditory speech perception performance for all assessed conditions. The use of a hearing aid prior to the 2nd cochlear implant resulted in benefits for auditory speech perception with the 2nd cochlear implant, both in silence and in noise. Conclusion The bilateral cochlear implant provided better speech perception in silence and in noise situations when compared to the unilateral cochlear implant, regardless of the interval between surgeries, age at the surgical procedure and the time of use of the 2nd cochlear implant. Speech perception with the 1st cochlear implant was significantly better than with the 2nd cochlear implant, both in silence and in noise. The use of the hearing aid prior to the 2nd cochlear implant influenced speech perception performance with the 2nd cochlear implant, both in silence and in noise.
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Kumari A, Goyal S, Chauhan N, Sarankumar T, Chaitanya K, Kameswaran M. Audit of Bilateral Simultaneous Cochlear Implantation in Pediatric Population: South Indian Study. Turk Arch Otorhinolaryngol 2018; 56:36-41. [PMID: 29988273 DOI: 10.5152/tao.2018.2804] [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: 10/02/2017] [Accepted: 01/02/2018] [Indexed: 11/22/2022] Open
Abstract
Objective To conduct a medical audit of bilateral simultaneous cochlear implantation (CI) in patients with severe prelingual sensorineural hearing loss (SNHL). Methods A medical audit of a tertiary care ear, nose, and throat center in Southern India was conducted on data collected from January 2007 to December 2014. All cochlear implantees <6 years of age with severe bilateral SNHL who underwent bilateral simultaneous CI were included in the present study. The exclusion criteria were children >6 years, sequential bilateral CI, revision cases, abnormal or malformed cochlea, and children with global developmental delay in milestones. Subjective outcome scores used were Category of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR). Results The CAP and SIR results showed that 20% of implantees achieved peak scores of 7 and 5, respectively. Mean CAP and SIR scores at 12 months were 5.4 and 3.1, respectively. Conclusion The present study supports the claim that bilateral CI in severe prelingual bilateral SNHL is better than unilateral and recommends that bilateral CI should be the standard of care in children.
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Affiliation(s)
- Abha Kumari
- Department of Otorhinolaryngology and Head & Neck Surgery, Madras ENT Research Foundation, Tamil Nadu, India
| | - Sunil Goyal
- Department of Otorhinolaryngology and Head & Neck Surgery, Armed Forces Medical College, Maharashtra, India
| | - Neha Chauhan
- Department of Otorhinolaryngology and Head & Neck Surgery, Madras ENT Research Foundation, Tamil Nadu, India
| | - Thirugnanam Sarankumar
- Department of Otorhinolaryngology and Head & Neck Surgery, Madras ENT Research Foundation, Tamil Nadu, India
| | - Krushna Chaitanya
- Department of Otorhinolaryngology and Head & Neck Surgery, Madras ENT Research Foundation, Tamil Nadu, India
| | - Mohan Kameswaran
- Department of Otorhinolaryngology and Head & Neck Surgery, Madras ENT Research Foundation, Tamil Nadu, India
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Dhondt CMC, Swinnen FKR, Dhooge IJM. Bilateral cochlear implantation or bimodal listening in the paediatric population: Retrospective analysis of decisive criteria. Int J Pediatr Otorhinolaryngol 2018; 104:170-177. [PMID: 29287861 DOI: 10.1016/j.ijporl.2017.10.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/25/2017] [Accepted: 10/27/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION In children with bilateral severe to profound hearing loss, bilateral hearing can be achieved by either bimodal stimulation (CIHA) or bilateral cochlear implantation (BICI). The aim of this study was to analyse the audiologic test protocol that is currently applied to make decisions regarding the bilateral hearing modality in the paediatric population. METHODS Pre- and postoperative audiologic test results of 21 CIHA, 19 sequential BICI and 12 simultaneous BICI children were examined retrospectively. RESULTS Deciding between either simultaneous BICI or unilateral implantation was mainly based on the infant's preoperative Auditory Brainstem Response thresholds. Evolution from CIHA to sequential BICI was mainly based on the audiometric test results in the contralateral (hearing aid) ear after unilateral cochlear implantation. Preoperative audiometric thresholds in the hearing aid ear were significantly better in CIHA versus sequential BICI children (p < 0.001 and p = 0.001 in unaided and aided condition, respectively). Decisive values obtained in the hearing aid ear in favour of BICI were: An average hearing threshold measured at 0.5, 1, 2 and 4 kHz of at least 93 dB HL without, and at least 52 dB HL with hearing aid together with a 40% aided speech recognition score and a 70% aided score on the phoneme discrimination subtest of the Auditory Speech Sounds Evaluation test battery. CONCLUSIONS Although pure tone audiometry offers no information about bimodal benefit, it remains the most obvious audiometric evaluation in the decision process on the mode of bilateral stimulation in the paediatric population. A theoretical test protocol for adequate evaluation of bimodal benefit in the paediatric population is proposed.
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Affiliation(s)
- Cleo M C Dhondt
- Department of Ear Nose Throat, Ghent University, De Pintelaan 185 (1P1), B - 9000, Ghent, Belgium.
| | - Freya K R Swinnen
- Department of Otorhinolaryngology, Ghent University Hospital, De Pintelaan 185 (1P1), B - 9000, Ghent, Belgium.
| | - Ingeborg J M Dhooge
- Department of Ear Nose Throat, Ghent University, De Pintelaan 185 (1P1), B - 9000, Ghent, Belgium; Department of Otorhinolaryngology, Ghent University Hospital, De Pintelaan 185 (1P1), B - 9000, Ghent, Belgium.
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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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Easwar V, Yamazaki H, Deighton M, Papsin B, Gordon K. Simultaneous bilateral cochlear implants: Developmental advances do not yet achieve normal cortical processing. Brain Behav 2017; 7:e00638. [PMID: 28413698 PMCID: PMC5390830 DOI: 10.1002/brb3.638] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/15/2016] [Accepted: 12/18/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Simultaneous bilateral cochlear implantation promotes symmetric development of bilateral auditory pathways but binaural hearing remains abnormal. To evaluate whether bilateral cortical processing remains impaired in such children, cortical activity to unilateral and bilateral stimuli was assessed in a unique cohort of 16 children who received bilateral cochlear implants (CIs) simultaneously at 1.97 ± 0.86 years of age and had ~4 years of CI experience, providing the first opportunity to assess electrically driven cortical development in the absence of reorganized asymmetries from sequential implantation. METHODS Cortical activity to unilateral and bilateral stimuli was measured using multichannel electro-encephalography. Cortical processing in children with bilateral CIs was compared with click-elicited activity in 13 normal hearing children matched for time-in-sound. Source activity was localized using the Time Restricted, Artefact and Coherence source Suppression (TRACS) beamformer method. RESULTS Consistent with dominant crossed auditory pathways, normal P1 activity (~100 ms) was weaker to ipsilateral stimuli relative to contralateral and bilateral stimuli and both auditory cortices preferentially responded to the contralateral ear. Right hemisphere dominance was evident overall. Children with bilateral CIs maintained the expected right dominance but differences from normal included: (i) minimal changes between ipsilateral, contralateral and bilateral stimuli, (ii) weaker than normal contralateral stimulus preference, (iii) symmetric activity to bilateral stimuli, and (iv) increased occipital lobe recruitment during bilateral relative to unilateral stimulation. Between-group contrasts demonstrated lower than normal activity in the inferior parieto-occipital lobe (suggesting deficits in sensory integration) and greater than normal left frontal lobe activity (suggesting increased attention), even during passive listening. CONCLUSIONS Together, findings suggest that early simultaneous bilateral cochlear implantation promotes normal-like auditory symmetry but that abnormalities in cortical processing consequent to deafness and/or electrical stimulation through two independent speech processors persist.
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Affiliation(s)
- Vijayalakshmi Easwar
- Archie's Cochlear Implant Laboratory The Hospital for Sick Children Toronto ON Canada.,Collaborative Program in Neuroscience The University of Toronto Toronto ON Canada
| | - Hiroshi Yamazaki
- Archie's Cochlear Implant Laboratory The Hospital for Sick Children Toronto ON Canada
| | - Michael Deighton
- Archie's Cochlear Implant Laboratory The Hospital for Sick Children Toronto ON Canada
| | - Blake Papsin
- Otolaryngology The University of Toronto Toronto ON Canada.,Otolaryngology The Hospital for Sick Children Toronto ON Canada
| | - Karen Gordon
- Archie's Cochlear Implant Laboratory The Hospital for Sick Children Toronto ON Canada.,Otolaryngology The University of Toronto Toronto ON Canada
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Cortical Representation of Interaural Time Difference Is Impaired by Deafness in Development: Evidence from Children with Early Long-term Access to Sound through Bilateral Cochlear Implants Provided Simultaneously. J Neurosci 2017; 37:2349-2361. [PMID: 28123078 DOI: 10.1523/jneurosci.2538-16.2017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 12/21/2016] [Accepted: 01/18/2017] [Indexed: 11/21/2022] Open
Abstract
Accurate use of interaural time differences (ITDs) for spatial hearing may require access to bilateral auditory input during sensitive periods in human development. Providing bilateral cochlear implants (CIs) simultaneously promotes symmetrical development of bilateral auditory pathways but does not support normal ITD sensitivity. Thus, although binaural interactions are established by bilateral CIs in the auditory brainstem, potential deficits in cortical processing of ITDs remain. Cortical ITD processing in children with simultaneous bilateral CIs and normal hearing with similar time-in-sound was explored in the present study. Cortical activity evoked by bilateral stimuli with varying ITDs (0, ±0.4, ±1 ms) was recorded using multichannel electroencephalography. Source analyses indicated dominant activity in the right auditory cortex in both groups but limited ITD processing in children with bilateral CIs. In normal-hearing children, adult-like processing patterns were found underlying the immature P1 (∼100 ms) response peak with reduced activity in the auditory cortex ipsilateral to the leading ITD. Further, the left cortex showed a stronger preference than the right cortex for stimuli leading from the contralateral hemifield. By contrast, children with CIs demonstrated reduced ITD-related changes in both auditory cortices. Decreased parieto-occipital activity, possibly involved in spatial processing, was also revealed in children with CIs. Thus, simultaneous bilateral implantation in young children maintains right cortical dominance during binaural processing but does not fully overcome effects of deafness using present CI devices. Protection of bilateral pathways through simultaneous implantation might be capitalized for ITD processing with signal processing advances, which more consistently represent binaural timing cues.SIGNIFICANCE STATEMENT Multichannel electroencephalography demonstrated impairment of binaural processing in children who are deaf despite early access to bilateral auditory input by first finding that foundations for binaural hearing are normally established during early stages of cortical development. Although 4- to 7-year-old children with normal hearing had immature cortical responses, adult patterns in cortical coding of binaural timing cues were measured. Second, children receiving two cochlear implants in the same surgery maintained normal-like input from both ears, but this did not support significant effects of binaural timing cues in either auditory cortex. Deficits in parieto-occiptal areas further suggested impairment in spatial processing. Results indicate that cochlear implants working independently in each ear do not fully overcome deafness-related binaural processing deficits, even after long-term experience.
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Active inhibition of the first over the second ear implanted sequentially. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133 Suppl 1:S31-5. [DOI: 10.1016/j.anorl.2016.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 02/02/2016] [Accepted: 04/28/2016] [Indexed: 11/21/2022]
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Boisvert I, McMahon CM, Dowell RC. Speech recognition outcomes following bilateral cochlear implantation in adults aged over 50 years old. Int J Audiol 2016; 55 Suppl 2:S39-44. [DOI: 10.3109/14992027.2016.1152403] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Caldas FF, Cardoso CC, Barreto MADSC, Teixeira MS, Hilgenberg AMDS, Serra LSM, Bahmad F. Analysis of electrically evoked compound action potential of the auditory nerve in children with bilateral cochlear implants. Braz J Otorhinolaryngol 2016; 82:123-30. [PMID: 26727607 PMCID: PMC9449066 DOI: 10.1016/j.bjorl.2014.12.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 12/24/2014] [Indexed: 11/14/2022] Open
Abstract
Introduction The cochlear implant device has the capacity to measure the electrically evoked compound action potential of the auditory nerve. The neural response telemetry is used in order to measure the electrically evoked compound action potential of the auditory nerve. Objective To analyze the electrically evoked compound action potential, through the neural response telemetry, in children with bilateral cochlear implants. Methods This is an analytical, prospective, longitudinal, historical cohort study. Six children, aged 1–4 years, with bilateral cochlear implant were assessed at five different intervals during their first year of cochlear implant use. Results There were significant differences in follow-up time (p = 0.0082) and electrode position (p = 0.0019) in the T-NRT measure. There was a significant difference in the interaction between time of follow-up and electrode position (p = 0.0143) when measuring the N1-P1 wave amplitude between the three electrodes at each time of follow-up. Conclusion The electrically evoked compound action potential measurement using neural response telemetry in children with bilateral cochlear implants during the first year of follow-up was effective in demonstrating the synchronized bilateral development of the peripheral auditory pathways in the studied population.
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Marsella P, Giannantonio S, Scorpecci A, Pianesi F, Micardi M, Resca A. Role of bimodal stimulation for auditory-perceptual skills development in children with a unilateral cochlear implant. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2015; 35:442-8. [PMID: 26900251 PMCID: PMC4755050 DOI: 10.14639/0392-100x-617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 09/03/2015] [Indexed: 12/04/2022]
Abstract
This is a prospective randomised study that evaluated the differences arising from a bimodal stimulation compared to a monaural electrical stimulation in deaf children, particularly in terms of auditory-perceptual skills development. We enrolled 39 children aged 12 to 36 months, suffering from severe-to-profound bilateral sensorineural hearing loss with residual hearing on at least one side. All were unilaterally implanted: 21 wore only the cochlear implant (CI) (unilateral CI group), while the other 18 used the CI and a contralateral hearing aid at the same time (bimodal group). They were assessed with a test battery designed to appraise preverbal and verbal auditory-perceptual skills immediately before and 6 and 12 months after implantation. No statistically significant differences were observed between groups at time 0, while at 6 and 12 months children in the bimodal group had better scores in each test than peers in the unilateral CI group. Therefore, although unilateral deafness/hearing does not undermine hearing acuity in normal listening, the simultaneous use of a CI and a contralateral hearing aid (binaural hearing through a bimodal stimulation) provides an advantage in terms of acquisition of auditory-perceptual skills, allowing children to achieve the basic milestones of auditory perception faster and in greater number than children with only one CI. Thus, "keeping awake" the contralateral auditory pathway, albeit not crucial in determining auditory acuity, guarantees benefits compared with the use of the implant alone. These findings provide initial evidence to establish shared guidelines for better rehabilitation of patients undergoing unilateral cochlear implantation, and add more evidence regarding the correct indications for bilateral cochlear implantation.
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Affiliation(s)
- P Marsella
- Audiology-Otology Unit and Cochlear Implant Referral Center, "Bambino Gesù" Pediatric Hospital, Rome, Italy
| | - S Giannantonio
- Audiology-Otology Unit and Cochlear Implant Referral Center, "Bambino Gesù" Pediatric Hospital, Rome, Italy
| | - A Scorpecci
- Audiology-Otology Unit and Cochlear Implant Referral Center, "Bambino Gesù" Pediatric Hospital, Rome, Italy
| | - F Pianesi
- Audiology-Otology Unit and Cochlear Implant Referral Center, "Bambino Gesù" Pediatric Hospital, Rome, Italy
| | - M Micardi
- Audiology-Otology Unit and Cochlear Implant Referral Center, "Bambino Gesù" Pediatric Hospital, Rome, Italy
| | - A Resca
- Audiology-Otology Unit and Cochlear Implant Referral Center, "Bambino Gesù" Pediatric Hospital, Rome, Italy
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Simultaneous bilateral cochlear implantation in a five-month-old child with Usher syndrome. The Journal of Laryngology & Otology 2015; 129:919-22. [PMID: 26177750 DOI: 10.1017/s0022215115001760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To report a rare case of simultaneous bilateral cochlear implantation in a five-month-old child with Usher syndrome. METHOD Case report. RESULTS A five-month-old boy with Usher syndrome and congenital profound bilateral deafness underwent simultaneous bilateral cochlear implantation. The decision to perform implantation in such a young child was based on his having a supportive family and the desire to foster his audiological development before his vision deteriorated. The subject experienced easily resolvable intra- and post-operative adverse events, and was first fitted with an externally worn audio processor four weeks after implantation. At 14 months of age, his audiological development was age-appropriate. CONCLUSION Simultaneous bilateral cochlear implantation is possible, and even advisable, in children as young as five months old when performed by an experienced implantation team.
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Guo LY, McGregor KK, Spencer LJ. Are Young Children With Cochlear Implants Sensitive to the Statistics of Words in the Ambient Spoken Language? JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2015; 58:987-1000. [PMID: 25677929 PMCID: PMC4490103 DOI: 10.1044/2015_jslhr-h-14-0135] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 10/14/2014] [Accepted: 01/09/2015] [Indexed: 05/27/2023]
Abstract
PURPOSE The purpose of this study was to determine whether children with cochlear implants (CIs) are sensitive to statistical characteristics of words in the ambient spoken language, whether that sensitivity changes in expected ways as their spoken lexicon grows, and whether that sensitivity varies with unilateral or bilateral implantation. METHOD We analyzed archival data collected from the parents of 36 children who received cochlear implantation (20 unilateral, 16 bilateral) before 24 months of age. The parents reported their children's word productions 12 months after implantation using the MacArthur Communicative Development Inventories: Words and Sentences (Fenson et al., 1993). We computed the number of words, out of 292 possible monosyllabic nouns, verbs, and adjectives, that each child was reported to say and calculated the average phonotactic probability, neighborhood density, and word frequency of the reported words. RESULTS Spoken vocabulary size positively correlated with average phonotactic probability and negatively correlated with average neighborhood density, but only in children with bilateral CIs. CONCLUSION At 12 months postimplantation, children with bilateral CIs demonstrate sensitivity to statistical characteristics of words in the ambient spoken language akin to that reported for children with normal hearing during the early stages of lexical development. Children with unilateral CIs do not.
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Friedmann DR, Green J, Fang Y, Ensor K, Roland JT, Waltzman SB. Sequential bilateral cochlear implantation in the adolescent population. Laryngoscope 2015; 125:1952-8. [PMID: 25946482 DOI: 10.1002/lary.25293] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To examine the variables affecting outcomes for sequential bilateral cochlear implantation patients in the adolescent population. STUDY DESIGN Retrospective chart review at tertiary care center. METHODS Main outcome measures were open set speech recognition tests at the word (Consonant-Nucleus-Consonant/Phonetically Balanced Kindergarten List Test [CNC/PBK]) and sentence levels in noise (Hearing in Noise Test-Noise [HINT-N]) in different test conditions with respect to the age at first and sequential implantation, as well as the interval between implants. RESULTS Despite a mean age at sequential implantation of 13.5 years, sequential bilateral implanted adolescents revealed significant improvement in the sequential cochlear implant (CI2) ear. The mean time interval between implants was 8.2 years. A wide range of performance was noted, and age at implantation and interval between first cochlear implant (CI1) and CI2 did not predict outcome. Mean CNC/PBK score with CI1 alone was 83.0%, with the CI2 alone was 56.5%, and with bilateral implants was 86.8%. Sentence scores (HINT-N) were 89.5% for CI1, 74.2% for CI2, and 94.4% for bilateral CI condition. The clinical relevance of these enhanced perception abilities requires attention to individual device use, performance with the first implant, and subjective benefits reported by patients. CONCLUSIONS Bilateral sequential cochlear implantation leads to improved speech perception in the adolescent population and should be considered in this population, even after a long period of deafness and despite a prolonged interval between implants. Numerous factors affect the ability to predict performance, but age at implantation and interimplant interval were not correlated with performance measures. Extensive preoperative counseling and individualized evaluation are critical to ensure that patients and families understand the range of possible outcomes. LEVEL OF EVIDENCE 4
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Affiliation(s)
- David R Friedmann
- Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, New York, U.S.A
| | - Janet Green
- Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, New York, U.S.A
| | - Yixin Fang
- Division of Biostatistics, Department of Population Health, New York University School of Medicine, New York, New York, U.S.A
| | - Kelsey Ensor
- Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, New York, U.S.A
| | - J Thomas Roland
- Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, New York, U.S.A
| | - Susan B Waltzman
- Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, New York, U.S.A
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Thompson DM, Koppes AN, Hardy JG, Schmidt CE. Electrical stimuli in the central nervous system microenvironment. Annu Rev Biomed Eng 2015; 16:397-430. [PMID: 25014787 DOI: 10.1146/annurev-bioeng-121813-120655] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Electrical stimulation to manipulate the central nervous system (CNS) has been applied as early as the 1750s to produce visual sensations of light. Deep brain stimulation (DBS), cochlear implants, visual prosthetics, and functional electrical stimulation (FES) are being applied in the clinic to treat a wide array of neurological diseases, disorders, and injuries. This review describes the history of electrical stimulation of the CNS microenvironment; recent advances in electrical stimulation of the CNS, including DBS to treat essential tremor, Parkinson's disease, and depression; FES for the treatment of spinal cord injuries; and alternative electrical devices to restore vision and hearing via neuroprosthetics (retinal and cochlear implants). It also discusses the role of electrical cues during development and following injury and, importantly, manipulation of these endogenous cues to support regeneration of neural tissue.
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Affiliation(s)
- Deanna M Thompson
- Department of Biomedical Engineering and Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, New York 12180;
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Binaural fusion and listening effort in children who use bilateral cochlear implants: a psychoacoustic and pupillometric study. PLoS One 2015; 10:e0117611. [PMID: 25668423 PMCID: PMC4323344 DOI: 10.1371/journal.pone.0117611] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 12/29/2014] [Indexed: 11/23/2022] Open
Abstract
Bilateral cochlear implants aim to provide hearing to both ears for children who are deaf and promote binaural/spatial hearing. Benefits are limited by mismatched devices and unilaterally-driven development which could compromise the normal integration of left and right ear input. We thus asked whether children hear a fused image (ie. 1 vs 2 sounds) from their bilateral implants and if this “binaural fusion” reduces listening effort. Binaural fusion was assessed by asking 25 deaf children with cochlear implants and 24 peers with normal hearing whether they heard one or two sounds when listening to bilaterally presented acoustic click-trains/electric pulses (250 Hz trains of 36 ms presented at 1 Hz). Reaction times and pupillary changes were recorded simultaneously to measure listening effort. Bilaterally implanted children heard one image of bilateral input less frequently than normal hearing peers, particularly when intensity levels on each side were balanced. Binaural fusion declined as brainstem asymmetries increased and age at implantation decreased. Children implanted later had access to acoustic input prior to implantation due to progressive deterioration of hearing. Increases in both pupil diameter and reaction time occurred as perception of binaural fusion decreased. Results indicate that, without binaural level cues, children have difficulty fusing input from their bilateral implants to perceive one sound which costs them increased listening effort. Brainstem asymmetries exacerbate this issue. By contrast, later implantation, reflecting longer access to bilateral acoustic hearing, may have supported development of auditory pathways underlying binaural fusion. Improved integration of bilateral cochlear implant signals for children is required to improve their binaural hearing.
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Neurocognitive development in congenitally deaf children. THE HUMAN AUDITORY SYSTEM - FUNDAMENTAL ORGANIZATION AND CLINICAL DISORDERS 2015; 129:335-56. [DOI: 10.1016/b978-0-444-62630-1.00019-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Perception of binaural cues develops in children who are deaf through bilateral cochlear implantation. PLoS One 2014; 9:e114841. [PMID: 25531107 PMCID: PMC4273969 DOI: 10.1371/journal.pone.0114841] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 11/04/2014] [Indexed: 11/19/2022] Open
Abstract
There are significant challenges to restoring binaural hearing to children who have been deaf from an early age. The uncoordinated and poor temporal information available from cochlear implants distorts perception of interaural timing differences normally important for sound localization and listening in noise. Moreover, binaural development can be compromised by bilateral and unilateral auditory deprivation. Here, we studied perception of both interaural level and timing differences in 79 children/adolescents using bilateral cochlear implants and 16 peers with normal hearing. They were asked on which side of their head they heard unilaterally or bilaterally presented click- or electrical pulse- trains. Interaural level cues were identified by most participants including adolescents with long periods of unilateral cochlear implant use and little bilateral implant experience. Interaural timing cues were not detected by new bilateral adolescent users, consistent with previous evidence. Evidence of binaural timing detection was, for the first time, found in children who had much longer implant experience but it was marked by poorer than normal sensitivity and abnormally strong dependence on current level differences between implants. In addition, children with prior unilateral implant use showed a higher proportion of responses to their first implanted sides than children implanted simultaneously. These data indicate that there are functional repercussions of developing binaural hearing through bilateral cochlear implants, particularly when provided sequentially; nonetheless, children have an opportunity to use these devices to hear better in noise and gain spatial hearing.
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Weder S, Kompis M, Caversaccio M, Stieger C. Benefit of a contralateral routing of signal device for unilateral cochlear implant users. Audiol Neurootol 2014; 20:73-80. [PMID: 25501444 DOI: 10.1159/000363212] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 04/25/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To investigate objective and subjective effects of an adjunctive contralateral routing of signal (CROS) device at the untreated ear in patients with a unilateral cochlear implant (CI). DESIGN Prospective study of 10 adult experienced unilateral CI users with bilateral severe-to-profound hearing loss. Speech in noise reception (SNR) and sound localization were measured with and without the additional CROS device. SNR was measured by applying speech signals at the untreated/CROS side while noise signals came from the front (S90N0). For S0N90, signal sources were switched. Sound localization was measured in a 12-loudspeaker full circle setup. To evaluate the subjective benefit, patients tried the device for 2 weeks at home, then filled out the abbreviated Speech, Spatial and Qualities of Hearing Scale as well as the Bern benefit in single-sided deafness questionnaires. RESULTS In the setting S90N0, all patients showed a highly significant SNR improvement when wearing the additional CROS device (mean 6.4 dB, p < 0.001). In the unfavorable setting S0N90, only a minor deterioration of speech understanding was noted (mean -0.66 dB, p = 0.54). Sound localization did not improve substantially with CROS. In the two questionnaires, 12 of 14 items showed an improvement in mean values, but none of them was statistically significant. CONCLUSION Patients with unilateral CI benefit from a contralateral CROS device, particularly in a noisy environment, when speech comes from the CROS ear side.
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Affiliation(s)
- Stefan Weder
- Department of ENT, Head and Neck Surgery, Inselspital, University of Bern, Bern, Switzerland
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Vincenti V, Bacciu A, Guida M, Marra F, Bertoldi B, Bacciu S, Pasanisi E. Pediatric cochlear implantation: an update. Ital J Pediatr 2014; 40:72. [PMID: 25179127 PMCID: PMC4282008 DOI: 10.1186/s13052-014-0072-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 08/04/2014] [Indexed: 11/10/2022] Open
Abstract
Deafness in pediatric age can adversely impact language acquisition as well as educational and social-emotional development. Once diagnosed, hearing loss should be rehabilitated early; the goal is to provide the child with maximum access to the acoustic features of speech within a listening range that is safe and comfortable. In presence of severe to profound deafness, benefit from auditory amplification cannot be enough to allow a proper language development. Cochlear implants are partially implantable electronic devices designed to provide profoundly deafened patients with hearing sensitivity within the speech range. Since their introduction more than 30 years ago, cochlear implants have improved their performance to the extent that are now considered to be standard of care in the treatment of children with severe to profound deafness. Over the years patient candidacy has been expanded and the criteria for implantation continue to evolve within the paediatric population. The minimum age for implantation has progressively reduced; it has been recognized that implantation at a very early age (12-18 months) provides children with the best outcomes, taking advantage of sensitive periods of auditory development. Bilateral implantation offers a better sound localization, as well as a superior ability to understand speech in noisy environments than unilateral cochlear implant. Deafened children with special clinical situations, including inner ear malformation, cochlear nerve deficiency, cochlear ossification, and additional disabilities can be successfully treated, even thogh they require an individualized candidacy evaluation and a complex post-implantation rehabilitation. Benefits from cochlear implantation include not only better abilities to hear and to develop speech and language skills, but also improved academic attainment, improved quality of life, and better employment status. Cochlear implants permit deaf people to hear, but they have a long way to go before their performance being comparable to that of the intact human ear; researchers are looking for more sophisticated speech processing strategies as well as a more efficient coupling between the electrodes and the cochlear nerve with the goal of dramatically improving the quality of sound of the next generation of implants.
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Affiliation(s)
- Vincenzo Vincenti
- Department of Clinical and Experimental Medicine, Unit of Audiology and Pediatric Otorhinolaryngology, University of Parma, Via Gramsci, 14 43126, Parma, Italy
| | - Andrea Bacciu
- Department of Clinical and Experimental Medicine, Unit of Audiology and Pediatric Otorhinolaryngology, University of Parma, Via Gramsci, 14 43126, Parma, Italy
| | - Maurizio Guida
- Department of Clinical and Experimental Medicine, Unit of Audiology and Pediatric Otorhinolaryngology, University of Parma, Via Gramsci, 14 43126, Parma, Italy
| | - Francesca Marra
- Department of Clinical and Experimental Medicine, Unit of Audiology and Pediatric Otorhinolaryngology, University of Parma, Via Gramsci, 14 43126, Parma, Italy
| | - Barbara Bertoldi
- Department of Clinical and Experimental Medicine, Unit of Audiology and Pediatric Otorhinolaryngology, University of Parma, Via Gramsci, 14 43126, Parma, Italy
| | - Salvatore Bacciu
- Department of Clinical and Experimental Medicine, Unit of Audiology and Pediatric Otorhinolaryngology, University of Parma, Via Gramsci, 14 43126, Parma, Italy
| | - Enrico Pasanisi
- Department of Clinical and Experimental Medicine, Unit of Audiology and Pediatric Otorhinolaryngology, University of Parma, Via Gramsci, 14 43126, Parma, Italy
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A New Comprehensive Cochlear Implant Questionnaire for Measuring Quality of Life After Sequential Bilateral Cochlear Implantation. Otol Neurotol 2014; 35:407-13. [DOI: 10.1097/mao.0000000000000229] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Broomfield SJ, Murphy J, Wild DC, Emmett SR, O'Donoghue GM. Results of a prospective surgical audit of bilateral paediatric cochlear implantation in the UK. Cochlear Implants Int 2014; 15:246-53. [DOI: 10.1179/1754762813y.0000000041] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Schwartz SR, Watson SD, Backous DD. Assessing candidacy for bilateral cochlear implants: A survey of practices in the United States and Canada. Cochlear Implants Int 2013; 13:86-92. [DOI: 10.1179/1754762811y.0000000016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Dezso A, Ramsden R, Saeed SR, Wessels J, Mawman D. Bilateral cochlear implantation after ethylene glycol intoxication: a case report. Cochlear Implants Int 2013; 12:170-2. [DOI: 10.1179/146701010x12711475887270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Grainger J, Jonas NE, Cochrane LA. Simultaneous cochlear implantation in children: the Great Ormond Street experience. Cochlear Implants Int 2013; 13:137-41. [DOI: 10.1179/146701011x12950038111891] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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A case study assessing the auditory and speech development of four children implanted with cochlear implants by the chronological age of 12 months. Case Rep Otolaryngol 2013; 2013:359218. [PMID: 23509653 PMCID: PMC3590554 DOI: 10.1155/2013/359218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 12/25/2012] [Indexed: 11/17/2022] Open
Abstract
Children with severe hearing loss most likely receive the greatest benefit from a cochlear implant (CI) when implanted at less than 2 years of age. Children with a hearing loss may also benefit greater from binaural sensory stimulation. Four children who received their first CI under 12 months of age were included in this study. Effects on auditory development were determined using the German LittlEARS Auditory Questionnaire, closed- and open-set monosyllabic word tests, aided free-field, the Mainzer and Göttinger speech discrimination tests, Monosyllabic-Trochee-Polysyllabic (MTP), and Listening Progress Profile (LiP). Speech production and grammar development were evaluated using a German language speech development test (SETK), reception of grammar test (TROG-D) and active vocabulary test (AWST-R). The data showed that children implanted under 12 months of age reached open-set monosyllabic word discrimination at an age of 24 months. LiP results improved over time, and children recognized 100% of words in the MTP test after 12 months. All children performed as well as or better than their hearing peers in speech production and grammar development. SETK showed that the speech development of these children was in general age appropriate. The data suggests that early hearing loss intervention benefits speech and language development and supports the trend towards early cochlear implantation. Furthermore, the data emphasizes the potential benefits associated with bilateral implantation.
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Kim JS, Kim LS, Jeong SW. Functional benefits of sequential bilateral cochlear implantation in children with long inter-stage interval between two implants. Int J Pediatr Otorhinolaryngol 2013; 77:162-9. [PMID: 23137855 DOI: 10.1016/j.ijporl.2012.10.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 10/11/2012] [Accepted: 10/12/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Older children are increasingly deriving binaural benefits from sequential bilateral cochlear implantation, and this procedure should be considered by experienced cochlear implant centers. This study aimed to identify the influence of a long inter-stage interval between two implants in older children. Speech perception and everyday listening performance were investigated and analyzed according to the length of the inter-stage interval. STUDY DESIGN AND SETTINGS Forty-two children who received sequential bilateral cochlear implantation participated in this study. Their average ages at the first and second implantation were 4.2 and 9.7 years, respectively. All subjects acquired excellent speech performance from their first implant, and the mean inter-stage interval was 5.5 years. Speech perception in quiet was assessed by formal speech measures, and postoperative performance using the second implant only was compared with the preoperative performance. Speech perception in noise test was administered using three noise directions with noise (+10 dB signal-to-noise ratio) from front and 90° to each side, and the change in performance using the first implant only and both implants were analyzed across the three noise directions. Subjects were divided into three groups according to their inter-stage interval (group I, 3-4.9 years; group II, 5-6.9 years; and group III, 7-9.9 years), and the test results were compared between the groups. Functional hearing benefits in daily life were measured by a questionnaire before and after bilateral cochlear implantation. RESULTS The speech perception abilities in quiet using the second implant only improved quickly and were similar to those using the first implant only within 1 year after the second implantation. The scores for the monosyllabic word test (phoneme: p=0.052; word: p=0.125) and common phrases sentence test (p=0.062) 6 month after the second implantation, and the Categories of Auditory Performance score (p=1.000) 1 year after the second implantation using the second implant only did not differ significantly from those using the first implant only. Speech perception was significantly better using both implants than using the first implant in all three noise conditions (speech and noise in front: p=0.004; speech in front and noise to the first implant: p=0.003; speech in front and noise to the second implant: p<0.001), and the effect of noise direction was negligibly small. No salient influence of inter-stage interval was observed in both quiet and noise tests. The second and third groups with longer inter-stage intervals (>5 years) achieved performance close to the level of the first group with a shorter interval. These subjects obtained significantly better functional hearing benefits in the everyday environment with bilateral implants compared with the first implant (p=0.018). CONCLUSION The subjects in this study showed rapid postoperative progression within 6 months after the second implantation, and more listening benefits in noise and daily life with bilateral implants. This group of older children, who were good performers with the first implant, developed auditory perceptual competence in the second ear and achieved functional binaural benefits with their two implants. Sequential bilateral cochlear implantation should be recommended to this group of older children despite a long inter-stage interval between two implants.
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Affiliation(s)
- Jeong-Seo Kim
- Department of Otolaryngology - Head & Neck Surgery, College of Medicine, Dong-A University, Busan, Republic of Korea
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Percy-Smith L, Busch G, Sandahl M, Nissen L, Josvassen JL, Lange T, Rusch E, Cayé-Thomasen P. Language understanding and vocabulary of early cochlear implanted children. Int J Pediatr Otorhinolaryngol 2013; 77:184-8. [PMID: 23141802 DOI: 10.1016/j.ijporl.2012.10.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 10/14/2012] [Accepted: 10/19/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The aim of the study was to identify factors associated with the level of language understanding, the level of receptive and active vocabulary, and to estimate effect-related odds ratios for cochlear implanted children's language level. METHODS The patient material included all children born in Denmark between January 2005 and January 2011, having received a cochlear implant (CI) and with a minimum of 6 months of hearing with their CI (N=94). The participation rate was 88% (N=83). Sixty-eight (82%) of the participating children were implanted bilaterally. Mean age at implantation was 19.6 months. The mean age at test was 46.3 months and the mean age of hearing with CI was 25.9 months. The children were tested with three different tests, the PPVT-4, the Reynell receptive part and a Danish test "Viborgmaterialet" for active vocabulary. Logistic regression models were used for analysis of the potential influence of eighteen different factors upon the test outcomes. RESULTS The majority of children did not have age equivalent language understanding and vocabulary. There was significant effect of the following factors upon the test outcomes: age at hearing aid start before implantation, age at implantation, length of hearing, communication mode, mode of implantation, amount of support teaching, residence and educational placement. Children who started HA treatment before 6 months of age, were implanted before 12 months or did not use total communication had the highest odds of having age equivalent language understanding and vocabulary. CONCLUSIONS The majority of hearing impaired children in Denmark received hearing aids before six months of hearing and the majority was implanted before 18 months of age. Despite these medical and technical advances the vast majority did not have age equivalent language understanding and vocabulary. Data suggest that the language gap is not closed in two years after implantation.
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Affiliation(s)
- Lone Percy-Smith
- East Danish Cochlear Implant Center, Department of Audiology, Rigshospitalet University Hospital of Copenhagen, Denmark.
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Faulkner KF, Pisoni DB. Some observations about cochlear implants: challenges and future directions. ACTA ACUST UNITED AC 2013. [DOI: 10.7243/2052-6946-1-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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