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Bharadwaja S, Patnaik U, Sahoo L, Raghavan D, Mathur Y, Badal S, Srivastava K. Role of Pre-Operative High-Resolution Computed Tomography for Surgical Planning in Patients Undergoing Cochlear Implantation - An Observational Study. Indian J Otolaryngol Head Neck Surg 2024; 76:1630-1636. [PMID: 38566635 PMCID: PMC10982146 DOI: 10.1007/s12070-023-04372-2] [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: 08/16/2023] [Accepted: 11/17/2023] [Indexed: 04/04/2024] Open
Abstract
Background Currently preoperative magnetic resonance imaging (MRI) brain and High-Resolution Computed Tomography (HRCT) scanning of temporal bones form part of routine Cochlear implantation (CI) assessment. Pre- operative imaging demonstrates anatomic details or anomalies if any, that prove essential in pre-surgical evaluation of patients. These form a road map for the surgeon to anticipate any difficulty during surgery, to aid in decision making to implant the most appropriate ear, plan surgical technique, or select electrode arrays. Methods A descriptive observational pilot study was conducted at tertiary care hospital involving 51 paediatric patients worked-up for CI. Patients after detailed clinical evaluation and MRI Brain, a tentative surgical plan was formulated by a candidacy CI screening committee. Patients selected for surgery underwent HRCT temporal bones and surgical plan was modified after analysing the same. Percentage of cases in which surgical plan changed (in terms of laterality of surgery) after correlating with HRCT findings were determined and data analysed. Results A total of 51 patients worked up for CI were included in the study. In 37.3% cases, there were unfavourable MRI findings. HRCT scan was used to aid the surgical road map in these patients, which based on MRI findings would have had suboptimal outcome. Conclusion With this understanding, we recommend that, MRI with precise interpretation would be sufficient to furnish all necessary information in preoperative assessment of CI patients, and a HRCT temporal bones maybe indicated only in difficult cases or those with unfavourable MRI findings, may aid predict surgical events.
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Affiliation(s)
- Sanjeeva Bharadwaja
- Senior Resident, Dept of ENT, INHS Jeevanti, Goa Naval Area, Vasco da gama, Goa 401803 India
| | - Uma Patnaik
- Professor (ENT) and CO, 359 Field Hospital, Panagarh, West Bengal 700072 India
| | | | - Dilip Raghavan
- Professor (ENT) and Brig AFMS (Stdn). O/o DGAFMS, New Delhi, India
| | - Yashvir Mathur
- Professor, Dept of Radiology, Command Hospital (Southern Command), Pune, 411040 India
| | - Sachendra Badal
- Associate Professor, Dept of Pediatrics, AFMC–Command Hospital (Southern Command), Pune, 411040 India
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Agarwal P, Gupta Y, Mundra RK. Role of Imaging in Evaluating Patients for Cochlear Implantation. Indian J Otolaryngol Head Neck Surg 2023; 75:2760-2768. [PMID: 37974843 PMCID: PMC10646041 DOI: 10.1007/s12070-023-03845-8] [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: 04/20/2023] [Accepted: 05/03/2023] [Indexed: 11/19/2023] Open
Abstract
Role of Imaging in evaluating patients for Cochlear Implantation. To assess the role of imaging using High resolution computed tomography (HRCT) and Magnetic resonance imaging (MRI) temporal bone for evaluating candidates for cochlear implantation (CI). It was a prospective study conducted in the department of Otorhinolaryngology at a tertiary care centre, 30 children up to 5 years of age with severe to profound sensorineural hearing loss(SNHL) were included in the study, radiological evaluation was done in all children. 20(66.67%) children were in 2-4 years age group with female preponderance. Radiological abnormalities were reported in 13(43.33%) children. Abnormalities of inner ear were seen in 8(26.67%) cases, which included bilateral cochlear nerve aplasia, unilateral cochlear aplasia with bilateral cochlear nerve aplasia, bilateral severe cochlear hypoplasia, mondini's dysplasia. Cochlear nerve deficiency was found in 3(10%) children and narrow Internal auditory canal in 4(13.33%) children. 2(6.67%) patients out of 30 were not the candidates for CI, they had bilateral absent cochlear nerve which is an absolute contraindication for CI. 28(93.33%) patients were evaluated as candidates for CI. Imaging is a fundamental part of the preoperative workup for cochlear implantation, HRCT and MRI temporal bone are complementary to each other in evaluating children for cochlear implantation as HRCT is excellent for demonstrating bony details but, lack in providing details of inner ear neural structures and MRI is better than CT in demonstrating vestibulocochlear nerves.
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Affiliation(s)
- Priyanshi Agarwal
- Department of Otorhinolaryngology, Head and Neck Surgery, MGM Medical College, Indore, M.P. India
- Present Address: Government Medical College Datia, Datia, M.P. India
| | - Yamini Gupta
- Department of Otorhinolaryngology, Head and Neck Surgery, MGM Medical College, Indore, M.P. India
| | - R. K. Mundra
- Department of Otorhinolaryngology, Head and Neck Surgery, MGM Medical College, Indore, M.P. India
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3
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Kashani A, Shariatpanahi E, Ayubi E, Emami SF. The Best Users of Cochlear Implants. Indian J Otolaryngol Head Neck Surg 2023; 75:3639-3644. [PMID: 37974846 PMCID: PMC10646021 DOI: 10.1007/s12070-023-04073-w] [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: 05/23/2023] [Accepted: 07/10/2023] [Indexed: 11/19/2023] Open
Abstract
The aim of this descriptive-analytical study was to compare the categories of auditory performance (CAP) and speech intelligibility rating (SIR) in people with cochlear implants (CI) based on the implanted ear. CAP and SIR were evaluated in 184 people with CI of right (110) and left (74) ears every 6 to 24 months (6,12,18,24). The significance level was less than 0.05. People with CI in the right-ears had better mean CAP and SIR scores than the left-ears (P values6,12,18, 24= 0.001, 0.004, 0.004, 0.002, and 0.001, 0.010, 0.010, 0.006). There were the relationship between the means of language acquisition status at the time of surgery and the means of CAP and SIR scores (P values6,12,18, 24= 0.005, 0.031, 0.006, 0.019, and 0.000, 0.000, 0.000, 0.002). The highest mean SIR scores were found in people with high school education (P values6,12,18, 24= 0.000, 0.000, 0.000, 0.008). The means of CAP scores did not show a relationship with the level of education (P values6, 12, 18, 24= 0.388, 0.217, 0.297, 0.213). Mean SIR and CAP scores were not related to gender. People who received right ear prostheses after the language learning age and have a higher level of education are the best users of cochlear implants. Compared to others who do not have these facilities, they gain more ability in auditory-speech skills. Gender, does not affect these capabilities.
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Affiliation(s)
- Amin Kashani
- Department of Otorhinolaryngology, School of Medicine, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Elnaz Shariatpanahi
- Department of Otorhinolaryngology, School of Medicine, Hearing Disorder Research Center, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Erfan Ayubi
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Seyede Faranak Emami
- Department of Audiology, School of Rehabilitation Sciences, Hearing Disorder Research Center, Hamadan University of Medical Sciences, Hamedan, Iran
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4
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Skidmore J, Oleson JJ, Yuan Y, He S. The Relationship Between Cochlear Implant Speech Perception Outcomes and Electrophysiological Measures of the Electrically Evoked Compound Action Potential. Ear Hear 2023; 44:1485-1497. [PMID: 37194125 DOI: 10.1097/aud.0000000000001389] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVE This study assessed the relationship between electrophysiological measures of the electrically evoked compound action potential (eCAP) and speech perception scores measured in quiet and in noise in postlingually deafened adult cochlear implant (CI) users. It tested the hypothesis that how well the auditory nerve (AN) responds to electrical stimulation is important for speech perception with a CI in challenging listening conditions. DESIGN Study participants included 24 postlingually deafened adult CI users. All participants used Cochlear Nucleus CIs in their test ears. In each participant, eCAPs were measured at multiple electrode locations in response to single-pulse, paired-pulse, and pulse-train stimuli. Independent variables included six metrics calculated from the eCAP recordings: the electrode-neuron interface (ENI) index, the neural adaptation (NA) ratio, NA speed, the adaptation recovery (AR) ratio, AR speed, and the amplitude modulation (AM) ratio. The ENI index quantified the effectiveness of the CI electrodes in stimulating the targeted AN fibers. The NA ratio indicated the amount of NA at the AN caused by a train of constant-amplitude pulses. NA speed was defined as the speed/rate of NA. The AR ratio estimated the amount of recovery from NA at a fixed time point after the cessation of pulse-train stimulation. AR speed referred to the speed of recovery from NA caused by previous pulse-train stimulation. The AM ratio provided a measure of AN sensitivity to AM cues. Participants' speech perception scores were measured using Consonant-Nucleus-Consonant (CNC) word lists and AzBio sentences presented in quiet, as well as in noise at signal-to-noise ratios (SNRs) of +10 and +5 dB. Predictive models were created for each speech measure to identify eCAP metrics with meaningful predictive power. RESULTS The ENI index and AR speed individually explained at least 10% of the variance in most of the speech perception scores measured in this study, while the NA ratio, NA speed, the AR ratio, and the AM ratio did not. The ENI index was identified as the only eCAP metric that had unique predictive power for each of the speech test results. The amount of variance in speech perception scores (both CNC words and AzBio sentences) explained by the eCAP metrics increased with increased difficulty under the listening condition. Over half of the variance in speech perception scores measured in +5 dB SNR noise (both CNC words and AzBio sentences) was explained by a model with only three eCAP metrics: the ENI index, NA speed, and AR speed. CONCLUSIONS Of the six electrophysiological measures assessed in this study, the ENI index is the most informative predictor for speech perception performance in CI users. In agreement with the tested hypothesis, the response characteristics of the AN to electrical stimulation are more important for speech perception with a CI in noise than they are in quiet.
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Affiliation(s)
- Jeffrey Skidmore
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Jacob J Oleson
- Department of Biostatistics, University of Iowa, Iowa City, Iowa, USA
| | - Yi Yuan
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Shuman He
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
- Department of Audiology, Nationwide Children's Hospital, Columbus, Ohio, USA
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5
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Hashemi SB, Janipour M, Jahangiri R, Babaei A. The effect of cochlear implant insertion technique on post-operative neural response telemetry and impedance in paediatric patients. J Laryngol Otol 2023; 137:363-367. [PMID: 35445650 DOI: 10.1017/s0022215122000901] [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] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to compare neural response telemetry and impedance between the round window and cochleostomy approaches for cochlear implantation. METHODS In this case-control study, 64 patients aged less than 3.5 years underwent cochlear implantation via the round window or cochleostomy approach. Post-operative neural response telemetry and impedance were measured. RESULTS The impedance measurements at electrodes 1, 11 and 22 showed no significant differences between the two groups three months after implantation (p = 0.90, p = 0.08 and p = 0.37, respectively). Similar results were observed six months after implantation (p = 0.71, p = 0.65 and p = 0.70, respectively). There was no significant difference in neural response telemetry between the two groups after three months. The neural response telemetry of electrode 1 in the cochleostomy group (171.26 ± 19.81 μV) was significantly higher in comparison with that of electrode 1 in the round window group (161.97 ± 12.71 μV) after six months (p = 0.03). The neural response telemetry values for electrodes 11 and 22 did not show any significant difference after six months (p = 0.14 and p = 0.48, respectively). CONCLUSION Both approaches provide equal stimulation of the cochlear nerve and impedance.
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Affiliation(s)
- S B Hashemi
- Otolaryngology Research Centre, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M Janipour
- Otolaryngology Research Centre, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - R Jahangiri
- Otolaryngology Research Centre, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - A Babaei
- Otolaryngology Research Centre, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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6
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Wang Y, Wu M, Wu K, Liu H, Wu S, Zhang Z, Liu M, Wei C, Zhang YX, Liu Y. Differential auditory cortical development in left and right cochlear implanted children. Cereb Cortex 2022; 32:5438-5454. [PMID: 35165693 DOI: 10.1093/cercor/bhac025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 12/27/2022] Open
Abstract
Unilateral aural stimulation has been shown to cause massive cortical reorganization in brain with congenital deafness, particularly during the sensitive period of brain development. However, it is unclear which side of stimulation provides most advantages for auditory development. The left hemisphere dominance of speech and linguistic processing in normal hearing adult brain has led to the assumption of functional and developmental advantages of right over left implantation, but existing evidence is controversial. To test this assumption and provide evidence for clinical choice, we examined 34 prelingually deaf children with unilateral cochlear implants using near-infrared spectroscopy. While controlling for age of implantation, residual hearing, and dominant hand, cortical processing of speech showed neither developmental progress nor influence of implantation side weeks to months after implant activation. In sharp contrast, for nonspeech (music signal vs. noise) processing, left implantation showed functional advantages over right implantation that were not yet discernable using clinical, questionnaire-based outcome measures. These findings support the notion that the right hemisphere develops earlier and is better preserved from adverse environmental influences than its left counterpart. This study thus provides, to our knowledge, the first evidence for differential influences of left and right auditory peripheral stimulation on early cortical development of the human brain.
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Affiliation(s)
- Yuyang Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.,Department of Otolaryngology Head and Neck Surgery, Hunan Provincial People's Hospital (First Affiliated Hospital of Hunan Normal University), Changsha 610041, China
| | - Meiyun Wu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
| | - Kun Wu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
| | - Haotian Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.,Department of Otolaryngology Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Shinan Wu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
| | - Zhikai Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.,Department of Otolaryngology Head and Neck Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100043, China
| | - Min Liu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
| | - Chaogang Wei
- Department of Otolaryngology Head and Neck Surgery, Peking University First Hospital, Beijing 100034, China
| | - Yu-Xuan Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
| | - Yuhe Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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7
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Zhou X, Feng M, Hu Y, Zhang C, Zhang Q, Luo X, Yuan W. The Effects of Cortical Reorganization and Applications of Functional Near-Infrared Spectroscopy in Deaf People and Cochlear Implant Users. Brain Sci 2022; 12:brainsci12091150. [PMID: 36138885 PMCID: PMC9496692 DOI: 10.3390/brainsci12091150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 11/22/2022] Open
Abstract
A cochlear implant (CI) is currently the only FDA-approved biomedical device that can restore hearing for the majority of patients with severe-to-profound sensorineural hearing loss (SNHL). While prelingually and postlingually deaf individuals benefit substantially from CI, the outcomes after implantation vary greatly. Numerous studies have attempted to study the variables that affect CI outcomes, including the personal characteristics of CI candidates, environmental variables, and device-related variables. Up to 80% of the results remained unexplainable because all these variables could only roughly predict auditory performance with a CI. Brain structure/function differences after hearing deprivation, that is, cortical reorganization, has gradually attracted the attention of neuroscientists. The cross-modal reorganization in the auditory cortex following deafness is thought to be a key factor in the success of CI. In recent years, the adaptive and maladaptive effects of this reorganization on CI rehabilitation have been argued because the neural mechanisms of how this reorganization impacts CI learning and rehabilitation have not been revealed. Due to the lack of brain processes describing how this plasticity affects CI learning and rehabilitation, the adaptive and deleterious consequences of this reorganization on CI outcomes have recently been the subject of debate. This review describes the evidence for different roles of cross-modal reorganization in CI performance and attempts to explore the possible reasons. Additionally, understanding the core influencing mechanism requires taking into account the cortical changes from deafness to hearing restoration. However, methodological issues have restricted longitudinal research on cortical function in CI. Functional near-infrared spectroscopy (fNIRS) has been increasingly used for the study of brain function and language assessment in CI because of its unique advantages, which are considered to have great potential. Here, we review studies on auditory cortex reorganization in deaf patients and CI recipients, and then we try to illustrate the feasibility of fNIRS as a neuroimaging tool in predicting and assessing speech performance in CI recipients. Here, we review research on the cross-modal reorganization of the auditory cortex in deaf patients and CI recipients and seek to demonstrate the viability of using fNIRS as a neuroimaging technique to predict and evaluate speech function in CI recipients.
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Affiliation(s)
- Xiaoqing Zhou
- Department of Otolaryngolgy, Chongqing General Hospital, Chongqing 401147, China
- Chongqing Medical University, Chongqing 400042, China
- Chongqing School, University of Chinese Academy of Sciences, Chongqing 400714, China
- Chongqing Institute of Green and Intelligent Technology, University of Chinese Academy of Sciences, Chongqing 400714, China
| | - Menglong Feng
- Department of Otolaryngolgy, Chongqing General Hospital, Chongqing 401147, China
- Chongqing Medical University, Chongqing 400042, China
- Chongqing School, University of Chinese Academy of Sciences, Chongqing 400714, China
- Chongqing Institute of Green and Intelligent Technology, University of Chinese Academy of Sciences, Chongqing 400714, China
| | - Yaqin Hu
- Department of Otolaryngolgy, Chongqing General Hospital, Chongqing 401147, China
- Chongqing Medical University, Chongqing 400042, China
- Chongqing School, University of Chinese Academy of Sciences, Chongqing 400714, China
- Chongqing Institute of Green and Intelligent Technology, University of Chinese Academy of Sciences, Chongqing 400714, China
| | - Chanyuan Zhang
- Department of Otolaryngolgy, Chongqing General Hospital, Chongqing 401147, China
- Chongqing Medical University, Chongqing 400042, China
- Chongqing School, University of Chinese Academy of Sciences, Chongqing 400714, China
- Chongqing Institute of Green and Intelligent Technology, University of Chinese Academy of Sciences, Chongqing 400714, China
| | - Qingling Zhang
- Department of Otolaryngolgy, Chongqing General Hospital, Chongqing 401147, China
- Chongqing Medical University, Chongqing 400042, China
- Chongqing School, University of Chinese Academy of Sciences, Chongqing 400714, China
- Chongqing Institute of Green and Intelligent Technology, University of Chinese Academy of Sciences, Chongqing 400714, China
| | - Xiaoqin Luo
- Department of Otolaryngolgy, Chongqing General Hospital, Chongqing 401147, China
- Chongqing Medical University, Chongqing 400042, China
- Chongqing School, University of Chinese Academy of Sciences, Chongqing 400714, China
- Chongqing Institute of Green and Intelligent Technology, University of Chinese Academy of Sciences, Chongqing 400714, China
| | - Wei Yuan
- Department of Otolaryngolgy, Chongqing General Hospital, Chongqing 401147, China
- Chongqing Medical University, Chongqing 400042, China
- Chongqing School, University of Chinese Academy of Sciences, Chongqing 400714, China
- Chongqing Institute of Green and Intelligent Technology, University of Chinese Academy of Sciences, Chongqing 400714, China
- Correspondence: ; Tel.: +86-23-63535180
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8
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Deliano M, Seidel P, Vorwerk U, Stadler B, Angenstein N. Effect of cochlear implant side on early speech processing in adults with single-sided deafness. Clin Neurophysiol 2022; 140:29-39. [DOI: 10.1016/j.clinph.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 04/22/2022] [Accepted: 05/04/2022] [Indexed: 11/03/2022]
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9
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McGuire K, Firestone GM, Zhang N, Zhang F. The Acoustic Change Complex in Response to Frequency Changes and Its Correlation to Cochlear Implant Speech Outcomes. Front Hum Neurosci 2021; 15:757254. [PMID: 34744668 PMCID: PMC8566680 DOI: 10.3389/fnhum.2021.757254] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/01/2021] [Indexed: 12/12/2022] Open
Abstract
One of the biggest challenges that face cochlear implant (CI) users is the highly variable hearing outcomes of implantation across patients. Since speech perception requires the detection of various dynamic changes in acoustic features (e.g., frequency, intensity, timing) in speech sounds, it is critical to examine the ability to detect the within-stimulus acoustic changes in CI users. The primary objective of this study was to examine the auditory event-related potential (ERP) evoked by the within-stimulus frequency changes (F-changes), one type of the acoustic change complex (ACC), in adult CI users, and its correlation to speech outcomes. Twenty-one adult CI users (29 individual CI ears) were tested with psychoacoustic frequency change detection tasks, speech tests including the Consonant-Nucleus-Consonant (CNC) word recognition, Arizona Biomedical Sentence Recognition in quiet and noise (AzBio-Q and AzBio-N), and the Digit-in-Noise (DIN) tests, and electroencephalographic (EEG) recordings. The stimuli for the psychoacoustic tests and EEG recordings were pure tones at three different base frequencies (0.25, 1, and 4 kHz) that contained a F-change at the midpoint of the tone. Results showed that the frequency change detection threshold (FCDT), ACC N1' latency, and P2' latency did not differ across frequencies (p > 0.05). ACC N1'-P2 amplitude was significantly larger for 0.25 kHz than for other base frequencies (p < 0.05). The mean N1' latency across three base frequencies was negatively correlated with CNC word recognition (r = -0.40, p < 0.05) and CNC phoneme (r = -0.40, p < 0.05), and positively correlated with mean FCDT (r = 0.46, p < 0.05). The P2' latency was positively correlated with DIN (r = 0.47, p < 0.05) and mean FCDT (r = 0.47, p < 0.05). There was no statistically significant correlation between N1'-P2' amplitude and speech outcomes (all ps > 0.05). Results of this study indicated that variability in CI speech outcomes assessed with the CNC, AzBio-Q, and DIN tests can be partially explained (approximately 16-21%) by the variability of cortical sensory encoding of F-changes reflected by the ACC.
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Affiliation(s)
- Kelli McGuire
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, United States
| | - Gabrielle M. Firestone
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, United States
| | - Nanhua Zhang
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Fawen Zhang
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, United States
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10
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Goudey B, Plant K, Kiral I, Jimeno-Yepes A, Swan A, Gambhir M, Büchner A, Kludt E, Eikelboom RH, Sucher C, Gifford RH, Rottier R, Anjomshoa H. A MultiCenter Analysis of Factors Associated with Hearing Outcome for 2,735 Adults with Cochlear Implants. Trends Hear 2021; 25:23312165211037525. [PMID: 34524944 PMCID: PMC8450683 DOI: 10.1177/23312165211037525] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
While the majority of cochlear implant recipients benefit from the device, it
remains difficult to estimate the degree of benefit for a specific patient prior
to implantation. Using data from 2,735 cochlear-implant recipients from across
three clinics, the largest retrospective study of cochlear-implant outcomes to
date, we investigate the association between 21 preoperative factors and speech
recognition approximately one year after implantation and explore the
consistency of their effects across the three constituent datasets. We provide
evidence of 17 statistically significant associations, in either univariate or
multivariate analysis, including confirmation of associations for several
predictive factors, which have only been examined in prior smaller studies.
Despite the large sample size, a multivariate analysis shows that the variance
explained by our models remains modest across the datasets (R2=0.12–0.21). Finally, we report a novel statistical interaction
indicating that the duration of deafness in the implanted ear has a stronger
impact on hearing outcome when considered relative to a candidate’s age. Our
multicenter study highlights several real-world complexities that impact the
clinical translation of predictive factors for cochlear implantation outcome. We
suggest several directions to overcome these challenges and further improve our
ability to model patient outcomes with increased accuracy.
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Affiliation(s)
- Benjamin Goudey
- 127113IBM Research Australia, Southbank, Victoria, Australia.,School of Computing and Information Systems, University of Melbourne, Parkville, Victoria, Australia
| | - Kerrie Plant
- 104148Cochlear Limited, Sydney, New South Wales, Australia
| | - Isabell Kiral
- 127113IBM Research Australia, Southbank, Victoria, Australia
| | | | - Annalisa Swan
- 127113IBM Research Australia, Southbank, Victoria, Australia
| | - Manoj Gambhir
- 127113IBM Research Australia, Southbank, Victoria, Australia
| | - Andreas Büchner
- 9177Medizinische Hochschule Hannover, Hannover, Niedersachsen, Germany
| | - Eugen Kludt
- 9177Medizinische Hochschule Hannover, Hannover, Niedersachsen, Germany
| | - Robert H Eikelboom
- 104182Ear Science Institute Australia, Subiaco, Western Australia, Australia.,Ear Sciences Centre, The University of Western Australia, Nedlands, Western Australia, Australia.,Department of Speech Language Pathology and Audiology, University of Pretoria, South Africa
| | - Cathy Sucher
- 104182Ear Science Institute Australia, Subiaco, Western Australia, Australia.,Ear Sciences Centre, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Rene H Gifford
- Department of Hearing and Speech Sciences, 12328Vanderbilt University Medical Center, Nashville, TN, USA
| | - Riaan Rottier
- 104148Cochlear Limited, Sydney, New South Wales, Australia
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11
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Eskridge HR, Park LR, Brown KD. The impact of unilateral, simultaneous, or sequential cochlear implantation on pediatric language outcomes. Cochlear Implants Int 2021; 22:187-194. [PMID: 33430719 DOI: 10.1080/14670100.2020.1871267] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The purpose of this study was to determine the impact of unilateral versus bilateral cochlear implantation on receptive and expressive spoken language outcomes. Secondary aims were to investigate factors timing of first and second implant placement and reliance on government funded health plans on language outcome. METHODS This was a retrospective chart review of spoken language users with bilateral severe-to-profound hearing loss. A total of 204 children were included, 105 in the bilateral group and 99 in the unilateral group. Multiple regression analyses were completed to investigate factors that influence language outcomes at age 5. RESULTS Recipients who received bilateral CIs performed significantly higher on measures of receptive and expressive language than those with unilateral implants. DISCUSSION This study demonstrates that bilateral implantation has a significant impact on receptive and expressive aspects of language development, and should be strongly considered as standard practice for children with bilateral severe to profound hearing loss. CONCLUSION These results indicate that families should be counseled that language outcomes are better with bilateral cochlear implantation than unilateral implantation. Cochlear implant teams should continue to consider the impact of socioeconomic status on outcomes and explore new methods to reduce the impacts and barriers of poverty to language development.
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Affiliation(s)
- Hannah R Eskridge
- Department of Otolaryngology, University of North Carolina, Durham, NC, USA
| | - Lisa R Park
- Department of Otolaryngology, University of North Carolina, Durham, NC, USA
| | - Kevin D Brown
- Department of Otolaryngology, University of North Carolina, Durham, NC, USA
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Wang M, Han Y, Wang X, Liang S, Bo C, Zhang Z, Wang M, Xu L, Zhang D, Liu W, Wang H. Characterization of EGR-1 Expression in the Auditory Cortex Following Kanamycin-Induced Hearing Loss in Mice. J Mol Neurosci 2021; 71:2260-2274. [PMID: 33423191 DOI: 10.1007/s12031-021-01791-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 01/02/2021] [Indexed: 10/22/2022]
Abstract
Deprivation of acoustic input during a critical period leads to abnormal auditory development in humans. The molecular basis underlying the susceptibility of auditory cortex to loss of afferent input remains largely unknown. The transcription factor early growth response-1 (EGR-1) expression in the visual cortex has been shown to be crucial in the formation of vision, but the role of EGR-1 during the process of auditory function formation is still unclear. In this study, we presented data showing that EGR-1 was expressed in the neurons of the primary auditory cortex (A1) in mice. We observed that the auditory deprivation induced by kanamycin during the auditory critical period leads to laminar-specific alteration of neuronal distribution and EGR-1 expression in A1. In addition, MK-801 administration inhibited the expression of EGR-1 in A1 and aggravated the abnormal cortical electric response caused by kanamycin injection. Finally, we showed that the expression of PI3K, the phosphorylation of Akt, as well as the phosphorylation of cAMP-responsive element-binding protein (CREB) were decreased in A1 after kanamycin-induced hearing loss. These results characterized the expression of EGR-1 in A1 in response to the acoustic input and suggested the involvement of EGR-1 in auditory function formation.
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Affiliation(s)
- Man Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250022, People's Republic of China
| | - Yuechen Han
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250022, People's Republic of China
| | - Xue Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250022, People's Republic of China
| | - Shuo Liang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250022, People's Republic of China
| | - Chuan Bo
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250022, People's Republic of China
| | - Zhenbiao Zhang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250022, People's Republic of China
| | - Mingming Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250022, People's Republic of China
| | - Lei Xu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250022, People's Republic of China
| | - Daogong Zhang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250022, People's Republic of China
| | - Wenwen Liu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250022, People's Republic of China.
| | - Haibo Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250022, People's Republic of China.
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Liang C, Wenstrup LH, Samy RN, Xiang J, Zhang F. The Effect of Side of Implantation on the Cortical Processing of Frequency Changes in Adult Cochlear Implant Users. Front Neurosci 2020; 14:368. [PMID: 32410947 PMCID: PMC7201306 DOI: 10.3389/fnins.2020.00368] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 03/25/2020] [Indexed: 12/03/2022] Open
Abstract
Cochlear implants (CI) are widely used in children and adults to restore hearing function. However, CI outcomes are vary widely. The affected factors have not been well understood. It is well known that the right and left hemispheres play different roles in auditory perception in adult normal hearing listeners. It is unknown how the implantation side may affect the outcomes of CIs. In this study, the effect of the implantation side on how the brain processes frequency changes within a sound was examined in 12 right-handed adult CI users. The outcomes of CIs were assessed with behaviorally measured frequency change detection threshold (FCDT), which has been reported to significantly affect CI speech performance. The brain activation and regions were also examined using acoustic change complex (ACC, a type of cortical potential evoked by acoustic changes within a stimulus), on which the waveform analysis and the standardized low-resolution brain electromagnetic tomography (sLORETA) were performed. CI users showed activation in the temporal lobe and non-temporal areas, such as the frontal lobe. Right-ear CIs could more efficiently activate the contralateral hemisphere compared to left-ear CIs. For right-ear CIs, the increased activation in the contralateral temporal lobe together with the decreased activation in the contralateral frontal lobe was correlated with good performance of frequency change detection (lower FCDTs). Such a trend was not found in left-ear CIs. These results suggest that the implantation side may significantly affect neuroplasticity patterns in adults.
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Affiliation(s)
- Chun Liang
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, United States.,Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Lisa H Wenstrup
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, OH, United States
| | - Ravi N Samy
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, OH, United States
| | - Jing Xiang
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Fawen Zhang
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, United States
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Auditory Selective Attention Hindered by Visual Stimulus in Prelingually Deaf Children With Cochlear Implants. Otol Neurotol 2019; 40:e542-e547. [PMID: 31083094 DOI: 10.1097/mao.0000000000002169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the influence of visual distractors on the performance of auditory selective attention between prelingually deaf children with a CI (cochlear implant) and children with normal-hearing. DESIGN Twenty-two patients who had a cochlear implant device (10 males and 12 females, aged 6.64 ± 0.99 yrs) and 16 normal-hearing children (6 males and 10 females, aged 6.09 ± 0.51 yrs) were recruited. Half of the auditory stimuli were presented together with visual stimuli, and participants were required to complete an auditory identification task. Reaction times and discriminability (d') for these two groups were recorded and calculated. RESULTS The normal-hearing group had shorter mean reaction times than the CI group in detecting auditory targets. With visual distraction, the d' of the normal-hearing group was significantly better than that of CI group (t = 2.649, p = 0.012), while no statistical significance was found between the two groups without visual distraction (t = 0.693, p = 0.493). CONCLUSION Enhanced processing of visual stimuli interferes with auditory perception in CI users by occupying the capacity-limited attention.
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