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Park B, Thak PK, Park E, Choi SJ, Lee J, Kwak S, Jung HH, Im GJ. Dynamic Range and Neural Response Threshold in Cochlear Implant Mapping Can Be Useful in Predicting Prognosis Related to Postoperative Speech Perception. J Audiol Otol 2023; 27:212-218. [PMID: 37872755 PMCID: PMC10603277 DOI: 10.7874/jao.2023.00374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/13/2023] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVES To analyze mapping changes in dynamic range (DR) and neural response threshold (NRT) as prognostic factors for cochlear implant (CI). To analyze whether postoperative speech perception performance could be predicted using DR change and initial NRT. SUBJECTS AND METHODS The speech comprehension data of 33 patients with CI were retrospectively analyzed after 1, 3, 6, and 12 months of device use. All subjects were adult, postlingually hearing-impaired, and Cochlear Nucleus CI users. Speech perception performance was evaluated using aided pure tone audiometry, consonant, vowel, one-word, two-word, and sentence tests. RESULTS The averages of initial NRT and DR changes were 197.8±25.9 CU (104-236) and 22.2±18.4 CU (-15-79), respectively. The initial DR was 40.8±16.6 CU. The postoperative DR was 50.3±16.4 CU at 3 months, 58±12.3 CU at 6 months, and 62.9±10.4 CU at 12 months. A gradual increase of DR was observed during the first year of CI. Compared with the initial DR, significant increases in DR were observed at 3 (p<0.05), 6 (p<0.001), and 12 (p<0.001) months. Compared with initial speech performance outcomes, a significant gain in all performance outcomes was achieved at 12 months (p<0.001). CONCLUSIONS Patients with low NRT after CI surgery could initially set DR to a wider range and had better final speech perception outcomes. Conversely, patients with high NRT after CI surgery had to set up a gradual increase in DR while adjusting the T-C level, and the final speech perception outcomes were worse. DR and NRT, the main CI mapping variables, can help predict prognosis related to speech perception outcomes after CI surgery. In conclusion, the post-CI speech perception is better with a lower initial NRT, wider final DR, or younger age.
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Affiliation(s)
- Bongil Park
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Pyung Kon Thak
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Euyhyun Park
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Soo Jeong Choi
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Juhyun Lee
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Sooun Kwak
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Hak Hyun Jung
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Gi Jung Im
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
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Oghalai JS, Bortfeld H, Feldman HM, Chimalakonda N, Emery C, Choi JS, Zhou S. Cochlear Implants for Deaf Children With Early Developmental Impairment. Pediatrics 2022; 149:188094. [PMID: 35607935 PMCID: PMC9648123 DOI: 10.1542/peds.2021-055459] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Infants with profound hearing loss are typically considered for cochlear implantation. Many insurance providers deny implantation to children with developmental impairments because they have limited potential to acquire verbal communication. We took advantage of differing insurance coverage restrictions to compare outcomes after cochlear implantation or continued hearing aid use. METHODS Young children with deafness were identified prospectively from 2 different states, Texas and California, and followed longitudinally for an average of 2 years. Children in cohort 1 (n = 138) had normal cognition and adaptive behavior and underwent cochlear implantation. Children in cohorts 2 (n = 37) and 3 (n = 29) had low cognition and low adaptive behavior. Those in cohort 2 underwent cochlear implantation, whereas those in cohort 3 were treated with hearing aids. RESULTS Cohorts did not substantially differ in demographic characteristics. Using cohort 2 as the reference, children in cohort 1 showed more rapid gains in cognitive, adaptive function, language, and auditory skills (estimated coefficients, 0.166 to 0.403; P ≤ .001), whereas children in cohort 3 showed slower gains (-0.119 to -0.243; P ≤ .04). Children in cohort 3 also had greater increases in stress within the parent-child system (1.328; P = .02), whereas cohorts 1 and 2 were not different. CONCLUSIONS Cochlear implantation benefits children with deafness and developmental delays. This finding has health policy implications not only for private insurers but also for large, statewide, publicly administered programs. Cognitive and adaptive skills should not be used as a "litmus test" for pediatric cochlear implantation.
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Affiliation(s)
- John S. Oghalai
- Caruso Department of Otolaryngology–Head and Neck
Surgery, University of Southern California, Los Angeles, California,Address correspondence to John S. Oghalai, MD, Caruso Department
of Otolaryngology–Head and Neck Surgery, University of Southern
California, Healthcare Center 4, 1450 San Pablo St, Ste 5800, Los Angeles, CA
90033. E-mail:
| | - Heather Bortfeld
- Department of Psychological Sciences, University of
California, Merced, Merced, California
| | - Heidi M. Feldman
- Department of Pediatrics, Stanford University, Stanford,
California
| | | | | | - Janet S. Choi
- Caruso Department of Otolaryngology–Head and Neck
Surgery, University of Southern California, Los Angeles, California
| | - Shane Zhou
- Caruso Department of Otolaryngology–Head and Neck
Surgery, University of Southern California, Los Angeles, California
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Changes in Vestibular Function Following Pediatric Cochlear Implantation: a Prospective Study. Ear Hear 2021; 43:620-630. [PMID: 34593688 DOI: 10.1097/aud.0000000000001125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Given the close interconnection between the auditory and vestibular end organs, the increasingly broad application of (bilateral) cochlear implantation (CI) in children raises concern about its impact on the vestibular function. Unfortunately, literature on this matter is inconclusive and subject to several limitations. Therefore, this study aimed to elucidate the impact of pediatric CI on the vestibular function in a large sample of children, representative for the current CI population. DESIGN Fifty hearing-impaired children followed in the Ghent University Hospital were included in this prospective study. Twenty-seven patients underwent unilateral CI, and 23 were bilaterally implanted (9 sequentially, 14 simultaneously), adding up to 73 implanted ears. Children's median age at first implantation was 29 (range 8 to 194) months. Vestibular assessment was scheduled on average 2.8 months (SD: 3.6) before and 4.6 (SD: 4.0) months after implantation and consisted of video Head Impulse Testing of the lateral semicircular canals, rotatory testing (0.16, 0.04, and 0.01 Hz) and cervical vestibular evoked myogenic potential (cVEMP) testing with bone conduction stimulation. Caloric testing was added in children older than 3 years of age. RESULTS Overall, group analysis in our sample of 73 CI-ears did not reveal any significant impact on the vestibular function, except for a significantly shortened ipsilateral N1 latency of the cVEMP responses (p = 0.027) after CI. Complete ipsilateral loss of function after implantation was seen in 5% (3/54) of all CI-ears on the video head impulse testing, in 0% (0/10) on the caloric test and in 2% (1/52) on the cVEMP, notably all patients deafened by a congenital cytomegalovirus infection. CONCLUSIONS The impact of CI on the vestibular function in our dataset was limited. Therefore, the many advantages of simultaneous bilateral implantation may outweigh the risk for vestibular damage postoperatively. However, the impact on the vestibular function may be dependent on various factors (e.g., etiology of the hearing loss), and the clinical outcome is still difficult to predict. Vestibular assessment remains thus an important aspect in the pediatric CI population; first because the vestibular function should be considered in the decision-making process on (simultaneous or sequential bilateral) CI and second because it is essential to reveal a possible additional sensory deficit, allowing an opportunity for rehabilitation to improve the overall outcome of these children.
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Purcell PL, Deep NL, Waltzman SB, Roland JT, Cushing SL, Papsin BC, Gordon KA. Cochlear Implantation in Infants: Why and How. Trends Hear 2021; 25:23312165211031751. [PMID: 34281434 PMCID: PMC8295935 DOI: 10.1177/23312165211031751] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 04/22/2021] [Accepted: 06/23/2021] [Indexed: 11/25/2022] Open
Abstract
In children with congenital deafness, cochlear implantation (CI) prior to 12 months of age offers the opportunity to foster more typical auditory development during late infancy and early childhood. Recent studies have found a positive association between early implantation and expressive and receptive language outcomes, with some children able to achieve normal language skills by the time of school entry. Universal newborn hearing screening improved early detection and diagnosis of congenital hearing loss, allowing for earlier intervention, including decision-making regarding cochlear implant (CI) candidacy. It can be more challenging to confirm CI candidacy in infants; therefore, a multidisciplinary approach, including objective audiometric testing, is recommended to not only confirm the diagnosis but also to counsel families regarding expectations and long-term management. Surgeons performing CI surgery in young children should consider both the anesthetic risks of surgery in infancy and the ways in which mastoid anatomy may differ between infants and older children or adults. Multiple studies have found CI surgery in infants can be performed safely and effectively. This article reviews current evidence regarding indications for implantation in children younger than 12 months of age and discusses perioperative considerations and surgical technique.
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Affiliation(s)
- Patricia L. Purcell
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nicholas L. Deep
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - Susan B. Waltzman
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - J. Thomas Roland
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - Sharon L. Cushing
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Blake C. Papsin
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen A. Gordon
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
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Svrakic M. Rare case of bilateral aural atresia and cochlear dysplasia: when cochlear implantation is not the answer. Cochlear Implants Int 2018; 19:234-238. [PMID: 29455623 DOI: 10.1080/14670100.2018.1438767] [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: 10/18/2022]
Abstract
OBJECTIVE AND IMPORTANCE Reports of patients with concurrent middle and inner ear anomalies are rare. These patients present a surgical challenge for cochlear implantation. The surgical risk must be weighed against the predicted benefit of the patient's hearing outcome and subsequent development of speech and language as well as their quality of life. CLINICAL PRESENTATION Thirteen-year-old boy presented to the Otology clinic for auditory rehabilitation options. He has mild developmental delay, is non-verbal and communicates via American Sign Language. He was born with bilateral aural atresia and never wore amplification. On exam he has grade 1 microtia and complete ear canal atresia bilaterally. His behavioural hearing test shows profound sensorineural hearing loss of both ears. The computed tomography scan shows bilateral underdeveloped and completely opacified mastoid and middle ear, complete bony atresia of the ear canals, and an under-partitioned cochlea with poorly defined modiolus, among other abnormalities. The patient and his family were counselled on the available options as well as the need for any further studies. INTERVENTION Counselling of patient and family. CONCLUSION While there have been reports in the literature of performing cochlear implantations in patients with a concurrent atresia and cochlear dysplasia, these were patients whose degree of inner ear anomalies was relatively minor and their prognosis of a good audiological outcome was favourable. The presented case is that of a patient for whom the surgical approach to the cochlea alone would be difficult. More importantly, his quality of life would not significantly improve in light of the predicted limited hearing and language development outcomes, given the severity of his inner ear abnormalities, limited communication abilities, prolonged period of deafness and developmental delays.
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Affiliation(s)
- Maja Svrakic
- a Department of Otolaryngology , Northwell Health , New Hyde Park , NY , USA
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Kant AR, Banik AA. The Use of Lexical Neighborhood Test (LNT) in the Assessment of Speech Recognition Performance of Cochlear Implantees with Normal and Malformed Cochlea. Indian J Otolaryngol Head Neck Surg 2017; 69:338-344. [PMID: 28929065 DOI: 10.1007/s12070-017-1142-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 04/27/2017] [Indexed: 11/29/2022] Open
Abstract
The present study aims to use the model-based test Lexical Neighborhood Test (LNT), to assess speech recognition performance in early and late implanted hearing impaired children with normal and malformed cochlea. The LNT was administered to 46 children with congenital (prelingual) bilateral severe-profound sensorineural hearing loss, using Nucleus 24 cochlear implant. The children were grouped into Group 1-(early implantees with normal cochlea-EI); n = 15, 31/2-61/2 years of age; mean age at implantation-3½ years. Group 2-(late implantees with normal cochlea-LI); n = 15, 6-12 years of age; mean age at implantation-5 years. Group 3-(early implantees with malformed cochlea-EIMC); n = 9; 4.9-10.6 years of age; mean age at implantation-3.10 years. Group 4-(late implantees with malformed cochlea-LIMC); n = 7; 7-12.6 years of age; mean age at implantation-6.3 years. The following were the malformations: dysplastic cochlea, common cavity, Mondini's, incomplete partition-1 and 2 (IP-1 and 2), enlarged IAC. The children were instructed to repeat the words on hearing them. Means of the word and phoneme scores were computed. The LNT can also be used to assess speech recognition performance of hearing impaired children with malformed cochlea. When both easy and hard lists of LNT are considered, although, late implantees (with or without normal cochlea), have achieved higher word scores than early implantees, the differences are not statistically significant. Using LNT for assessing speech recognition enables a quantitative as well as descriptive report of phonological processes used by the children.
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Affiliation(s)
- Anjali R Kant
- Department of Speech and Language Pathology, Ali Yavar Jung National Institute of Speech and Hearing Disabilities (Divyangjan) (AYJNISHDD), Mumbai, Maharashtra India
| | - Arun A Banik
- Material Development Department, Ali Yavar Jung National Institute of Speech and Hearing Disabilities (Divyangjan) (AYJNISHDD), Mumbai, Maharashtra India
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Abstract
OBJECTIVE CHARGE syndrome is associated with a variety of temporal bone anomalies and deafness. The lack of surgical landmarks and facial nerve irregularities make cochlear implantation in this population a challenging endeavor. This study aims to describe a safe and efficacious transcanal approach for cochlear implantation that obviates the need to perform a mastoidectomy and facial recess. PATIENTS Three children with profound hearing loss secondary to CHARGE syndrome. INTERVENTION Transcanal cochlear implantation with closure of the ear canal via a modified Rambo meatoplasty. MAIN OUTCOME MEASURE(S) Retrospective chart review of temporal bone anomalies associated with CHARGE syndrome, technical nuances of this transcanal approach, and cochlear implant outcomes. RESULTS The mean patient age was 2.5 years (range 1.5-3.8 yr). Two were male and two were left ears. All patients had a hypoplastic mastoid, semicircular canal aplasia, and had some degree of cochlear dysplasia. A full cochlear implant insertion was achieved in all cases, even in the presence of grossly abnormal middle ear and facial nerve anatomy. There were no intraoperative or postoperative complications. The mean follow-up was 12.4 months (range, 3.9-25.2 mo). All three patients use their device daily. Their guardians report improved vocalization and environmental awareness. CONCLUSIONS The modified Rambo transcanal approach provides a safe corridor for cochlear implantation in patients with CHARGE syndrome. This approach minimizes the anatomical variations associated with the syndrome and may reduce the risk of electrode extrusion. Implant outcomes in this patient population remain highly variable based on the patient's global cognitive capacity.
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Fontenot TE, Giardina CK, Teagle HF, Park LR, Adunka OF, Buchman CA, Brown KD, Fitzpatrick DC. Clinical role of electrocochleography in children with auditory neuropathy spectrum disorder. Int J Pediatr Otorhinolaryngol 2017; 99:120-127. [PMID: 28688553 PMCID: PMC5538887 DOI: 10.1016/j.ijporl.2017.05.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 05/26/2017] [Accepted: 05/31/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To assess electrocochleography (ECochG) to tones as an instrument to account for CI speech perception outcomes in children with auditory neuropathy spectrum disorder (ANSD). MATERIALS & METHODS Children (<18 years) receiving CIs for ANSD (n = 30) and non-ANSD (n = 74) etiologies of hearing loss were evaluated with ECochG using tone bursts (0.25-4 kHz). The total response (TR) is the sum of spectral peaks of responses across frequencies. The compound action potential (CAP) and the auditory nerve neurophonic (ANN) in ECochG waveforms were used to estimate nerve activity and calculate nerve score. Performance on open-set monosyllabic word tests was the outcome measure. Standard statistical methods were applied. RESULTS On average, TR was larger in ANSD than in non-ANSD subjects. Most ANSD (73.3%) and non-ANSD (87.8%) subjects achieved open-set speech perception; TR accounted for 33% and 20% of variability in the outcomes, respectively. In the ANSD group, the PTA accounted for 69.3% of the variability, but there was no relationship with outcomes in the non-ANSD group. In both populations, nerve score was sensitive in identifying subjects at risk for not acquiring open-set speech perception, while the CAP and the ANN were more specific. CONCLUSION In both subject groups, the TRs correlated with outcomes but these measures were notably larger in the ANSD group. There was also strong correlation between PTA and speech perception outcome in ANSD group. In both subject populations, weaker evidence of neural activity was related to failure to achieve open-set speech perception.
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Affiliation(s)
- Tatyana E Fontenot
- University of North Carolina at Chapel Hill, Department of Otolaryngology, Chapel Hill, NC, United States.
| | - Christopher K Giardina
- University of North Carolina at Chapel Hill, Department of Otolaryngology, Chapel Hill, NC, United States; University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Holly F Teagle
- University of North Carolina at Chapel Hill, Department of Otolaryngology, Chapel Hill, NC, United States
| | - Lisa R Park
- University of North Carolina at Chapel Hill, Department of Otolaryngology, Chapel Hill, NC, United States
| | - Oliver F Adunka
- The Ohio State University, Department of Otolaryngology, Columbus, OH, United States
| | - Craig A Buchman
- Washington University in St. Louis, Department of Otolaryngology, St. Louis, MO, United States
| | - Kevin D Brown
- University of North Carolina at Chapel Hill, Department of Otolaryngology, Chapel Hill, NC, United States
| | - Douglas C Fitzpatrick
- University of North Carolina at Chapel Hill, Department of Otolaryngology, Chapel Hill, NC, United States; University of North Carolina School of Medicine, Chapel Hill, NC, United States
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Riggs WJ, Roche JP, Giardina CK, Harris MS, Bastian ZJ, Fontenot TE, Buchman CA, Brown KD, Adunka OF, Fitzpatrick DC. Intraoperative Electrocochleographic Characteristics of Auditory Neuropathy Spectrum Disorder in Cochlear Implant Subjects. Front Neurosci 2017; 11:416. [PMID: 28769753 PMCID: PMC5515907 DOI: 10.3389/fnins.2017.00416] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 07/04/2017] [Indexed: 11/13/2022] Open
Abstract
Auditory neuropathy spectrum disorder (ANSD) is characterized by an apparent discrepancy between measures of cochlear and neural function based on auditory brainstem response (ABR) testing. Clinical indicators of ANSD are a present cochlear microphonic (CM) with small or absent wave V. Many identified ANSD patients have speech impairment severe enough that cochlear implantation (CI) is indicated. To better understand the cochleae identified with ANSD that lead to a CI, we performed intraoperative round window electrocochleography (ECochG) to tone bursts in children (n = 167) and adults (n = 163). Magnitudes of the responses to tones of different frequencies were summed to measure the "total response" (ECochG-TR), a metric often dominated by hair cell activity, and auditory nerve activity was estimated visually from the compound action potential (CAP) and auditory nerve neurophonic (ANN) as a ranked "Nerve Score". Subjects identified as ANSD (45 ears in children, 3 in adults) had higher values of ECochG-TR than adult and pediatric subjects also receiving CIs not identified as ANSD. However, nerve scores of the ANSD group were similar to the other cohorts, although dominated by the ANN to low frequencies more than in the non-ANSD groups. To high frequencies, the common morphology of ANSD cases was a large CM and summating potential, and small or absent CAP. Common morphologies in other groups were either only a CM, or a combination of CM and CAP. These results indicate that responses to high frequencies, derived primarily from hair cells, are the main source of the CM used to evaluate ANSD in the clinical setting. However, the clinical tests do not capture the wide range of neural activity seen to low frequency sounds.
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Affiliation(s)
- William J Riggs
- Department of Otolaryngology/Head and Neck Surgery, Ohio State University College of MedicineColumbus, OH, United States
| | - Joseph P Roche
- Lab Department of Otolaryngology/Head and Neck Surgery, University of Wisconsin School of MedicineMadison, WI, United States
| | - Christopher K Giardina
- Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill School of MedicineChapel Hill, NC, United States
| | - Michael S Harris
- Department of Otolaryngology/Head and Neck Surgery, Ohio State University College of MedicineColumbus, OH, United States
| | - Zachary J Bastian
- Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill School of MedicineChapel Hill, NC, United States
| | - Tatyana E Fontenot
- Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill School of MedicineChapel Hill, NC, United States
| | - Craig A Buchman
- Department of Otolaryngology/Head and Neck Surgery, Washington University School of Medicine in St. LouisSt. Louis, MO, United States
| | - Kevin D Brown
- Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill School of MedicineChapel Hill, NC, United States
| | - Oliver F Adunka
- Department of Otolaryngology/Head and Neck Surgery, Ohio State University College of MedicineColumbus, OH, United States
| | - Douglas C Fitzpatrick
- Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill School of MedicineChapel Hill, NC, United States
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Tavartkiladze GA, Bakhshinyan VV, Markova TG, Tsygankova ER, Petrova IP, Goykhburg MV, Chibisova SS, Bliznetz EA, Polyakov AV. [The results of cochlear implantation in the patient with hereditary and non-hereditary hearing loss]. Vestn Otorinolaringol 2017; 81:17-21. [PMID: 28091470 DOI: 10.17116/otorino201681617-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The objective of the present study was to evaluate the effectiveness of rehabilitation of the patients after cochlear implantation in the early and late periods after operation taking into consideration the etiology of congenital deafness. The comprehensive clinico-audiological examination performed during the period from 2010 to 2015 involved 246 children who had undergone cochlear implantation (CI). All children were operated at the National Research Center for Audiology and Hearing Rehabilitation in the period from 2003 to 2013. 83 (56%) patients were aged 1 to 3 years at the time of surgery. Their age varied from 3 to 18 years when they underwent the clinico-audiological examination. Thus, the study is based on the experience with cochlear implantation varying from 3 to 12 years. The genetic analysis revealed mutations in the GJB2 gene in 49% of the children, in agreement with the data of earlier studies. 85% of all the children with GJB2 deafness surgically treated at the age under 4 years attend ordinary institutions of learning. Within 24 months after the onset of the observations the majority of the children with hereditary deafness (63%) were referred to the groups with good and excellent results of the rehabilitation and only 6 (12%) patients presented with unsatisfactory results. It was shown that the acquired causes of the loss of hearing including severe prenatal pathology have a negative influence on the long-term outcomes of rehabilitation. The results of the genetic analysis for the elucidation of the cause of impaired hearing can be employed as a prognostic criteria not only for the prediction but also for the guarantee of the success of cochlear implantation provided the rehabilitative process was initiated in a proper time.
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Affiliation(s)
- G A Tavartkiladze
- National Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513; Russian Medical Academy of Postgraduate Education, Moscow, Russia, 125993
| | - V V Bakhshinyan
- National Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513
| | - T G Markova
- National Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513; Russian Medical Academy of Postgraduate Education, Moscow, Russia, 125993
| | - E R Tsygankova
- National Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513; Russian Medical Academy of Postgraduate Education, Moscow, Russia, 125993
| | - I P Petrova
- National Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513
| | - M V Goykhburg
- National Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513
| | - S S Chibisova
- National Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513
| | - E A Bliznetz
- DNA-diagnostics laboratory, Federal State Budgetary Institution 'Research Centre for Medical Genetics', Moscow, Russia, 115478
| | - A V Polyakov
- DNA-diagnostics laboratory, Federal State Budgetary Institution 'Research Centre for Medical Genetics', Moscow, Russia, 115478
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Hayward DV, Ritter K, Mousavi A, Vatanapour S. The Sound Access Parent Outcomes Instrument (SAPOI): Construction of a new instrument for children with severe multiple disabilities who use cochlear implants or hearing aids. Cochlear Implants Int 2016; 17:81-9. [PMID: 26841928 DOI: 10.1080/14670100.2015.1110897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To report on the Phase 2 development of the Sound Access Parent Outcomes Instrument (SAPOI), a new instrument focused on formalizing outcomes that parents of children with severe multiple disabilities (SMD) who use amplification prioritize as important. METHODS Phase 2 of this project involved item selection and refinement of the SAPOI based on (a) Phase 1 study participant input, (b) clinical specialist feedback, and (c) test-retest instrument reliability. Phase 1 participant responses were utilized to construct a draft version of the SAPOI. Next, clinical specialists examined the instrument for content validity and utility and instrument reliability was examined through a test-retest process with parents of children with SMD. RESULTS The draft SAPOI was constructed based on Phase 1 participant input. Clinical specialists supported content validity and utility of the instrument and the inclusion of 19 additional items across four categories, namely Child Affect, Child Interaction, Parent Well-being, and Child's Device Use. The SAPOI was completed twice at one-month intervals by parents of children with SMD to examine instrument reliability across the four categories (Child Affect, Child Interaction, Parent Well-being, and Child's Device Use). Instrument reliability was strong-to-excellent across all four sections. DISCUSSION The SAPOI shows promise as a much-needed addition to the assessment battery currently used for children with SMD who use cochlear implants and hearing aids. It provides valuable information regarding outcomes resulting from access to sound in this population that currently used assessments do not identify.
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Affiliation(s)
- Denyse V Hayward
- a Department of Educational Psychology , University of Alberta , Canada
| | - Kathryn Ritter
- b Glenrose Rehabilitation Hospital and Department of Communication Sciences and Disorders , University of Alberta , Canada
| | - Amin Mousavi
- a Department of Educational Psychology , University of Alberta , Canada
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Lee J. Cochlear Implantation, Enhancements, Transhumanism and Posthumanism: Some Human Questions. SCIENCE AND ENGINEERING ETHICS 2016; 22:67-92. [PMID: 25962718 DOI: 10.1007/s11948-015-9640-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/09/2015] [Indexed: 05/28/2023]
Abstract
Biomedical engineering technologies such as brain-machine interfaces and neuroprosthetics are advancements which assist human beings in varied ways. There are exciting yet speculative visions of how the neurosciences and bioengineering may influence human nature. However, these could be preparing a possible pathway towards an enhanced and even posthuman future. This article seeks to investigate several ethical themes and wider questions of enhancement, transhumanism and posthumanism. Four themes of interest are: autonomy, identity, futures, and community. Three larger questions can be asked: will everyone be enhanced? Will we be "human" if we are not, one day, transhuman? Should we be enhanced or not? The article proceeds by concentrating on a widespread and sometimes controversial application: the cochlear implant, an auditory prosthesis implanted into Deaf patients. Cochlear implantation and its reception in both the deaf and hearing communities have a distinctive moral discourse, which can offer surprising insights. The paper begins with several points about the enhancement of human beings, transhumanism's reach beyond the human, and posthuman aspirations. Next it focuses on cochlear implants on two sides. Firstly, a shorter consideration of what technologies may do to humans in a transhumanist world. Secondly, a deeper analysis of cochlear implantation's unique socio-political movement, its ethical explanations and cultural experiences linked with pediatric cochlear implantation-and how those wary of being thrust towards posthumanism could marshal such ideas by analogy. As transhumanism approaches, the issues and questions merit continuing intense analysis.
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Affiliation(s)
- Joseph Lee
- Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
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Willaredt MA, Ebbers L, Nothwang HG. Central auditory function of deafness genes. Hear Res 2014; 312:9-20. [DOI: 10.1016/j.heares.2014.02.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 01/31/2014] [Accepted: 02/10/2014] [Indexed: 01/11/2023]
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Analysis of Speech Perception Outcomes Among Patients Receiving Cochlear Implants With Auditory Neuropathy Spectrum Disorder. Otol Neurotol 2013; 34:1610-4. [DOI: 10.1097/mao.0b013e318299a950] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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