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Derdzakyan NA, Lava CX, Hakimi AA, Johns JD, Kim HJ, Hoa M. Variability in Perioperative Steroid Therapy Regimen for Cochlear Implantation as It Relates to Hearing Preservation. Otol Neurotol 2024; 45:e28-e35. [PMID: 38085763 DOI: 10.1097/mao.0000000000004058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
HYPOTHESIS We aimed to identify practice trends and association between physician training and administration of perioperative steroids for cochlear implantation (CI) as it relates to hearing preservation. BACKGROUND Perioperative steroid therapy regimens are postulated to protect residual hearing and improve hearing preservation outcomes in CI. METHODS A 27-question online survey was developed by the senior authors using the Qualtrics Survey Tool, then distributed via email from September to November 2022 to otolaryngologists specializing in otology or neurotology and who practice in the United States or Canada. RESULTS The survey was sent to 463 physicians, 162 (35.0%) of whom completed the survey. One hundred forty-four (31.1%) responses underwent analysis. All physicians administering preoperative steroids (n = 31) prefer preoperative oral prednisone. Of 143 physicians administering intraoperative steroids, 54.5% prefer intraoperative intravenous dexamethasone. More than half (77.6%) of 85 physicians administering postoperative steroids prefer postoperative oral prednisone. Postoperative steroid administration (p < 0.006) and taper utilization (p < 0.041) were greater among physicians who complete greater than 40 CIs annually (n = 47 [71.2%]; n = 30 [49.2%]) than physicians who complete up to 40 CIs annually (n = 37 [48.7%]; n = 20 [31.3%]), respectively. Physicians practicing for 5 to 20 years after residency are more prevalent in using postoperative steroid tapers than physicians practicing for fewer than 5 years after and more than 20 years after residency (n = 37 [51.4%] versus n = 14 [25.5%], p < 0.001). CONCLUSION Consensus is needed about the optimal steroid treatment for CI patients. LEVEL OF EVIDENCE 4.
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Affiliation(s)
| | | | - Amir A Hakimi
- Department of Otolaryngology-Head and Neck Surgery, Georgetown University Medical Center, Washington, DC
| | - J Dixon Johns
- Department of Otolaryngology-Head and Neck Surgery, Georgetown University Medical Center, Washington, DC
| | - H Jeffrey Kim
- Department of Otolaryngology-Head and Neck Surgery, Georgetown University Medical Center, Washington, DC
| | - Michael Hoa
- Department of Otolaryngology-Head and Neck Surgery, Georgetown University Medical Center, Washington, DC
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Van de Heyning P, Atlas M, Baumgartner WD, Caversaccio M, Gavilan J, Godey B, Gstöttner W, Hagen R, Yongxin L, Karltorp E, Kameswaran M, Kuzovkov V, Lassaletta L, Manoj M, Parnes L, Pillsbury H, Raine C, Rajan G, Schmutzhard J, Skarzynski H, Staecker H, Usami SI, Zernotti M. The reliability of hearing implants: report on the type and incidence of cochlear implant failures. Cochlear Implants Int 2020; 21:228-237. [PMID: 32156201 DOI: 10.1080/14670100.2020.1735678] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: This study presents the data collected through a database on the type and incidence of cochlear implant device failures and major complications and quantifies the risk of failures across time based on the Association for the Advancement of Medical Instrumentation (AAMI) CI86:2017 standard. Methods: Information on reliability of MED-EL cochlear implants was collected from the MED-EL complaint database between 2003 and2013. Explants were categorized and device reliability was calculated according to the AAMI CI86:2017 standard principles. Results: Data were collected for 11662 devices (5462 children, 6200 adults). The mean duration of follow up was 46.16 months. The total failure rate for all devices and all subjects was 2.41%. Medical related explants (MRE) were significantly worse for children than for adults with the ceramic implants, C40+ (p = 0.008) and PULSAR (p = 0.020). Device failure explants (DFE) were significantly worse for children than for adults with all four devices in the study, the C40+ (p < 0.001), PULSAR (p < 0.001), SONATA (p < 0.001), and CONCERTO (p = 0.023). The mean annual failure rate for all subjects and devices was 0.63% (1.03% for children, 0.28% for adults). The mean annual failure rate was 0.90% for the C40+; 0.57% for the PULSAR; 0.46% for the SONATA; and 0.39% for the CONCERTO. Conclusions: Compared to adults, children had significantly worse MRE and DFE due to a higher risk of head trauma and more vulnerable skull anatomy. Further, the authors conclude that the AAMI standard will ensure a more comprehensive and transparent evaluation of cochlear implant reliability in the future.
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Affiliation(s)
| | - Marcus Atlas
- Ear Science Centre, School of Surgery, The University of Western Australia, Nedlands, Australia.,Ear Science Institute Australia Implant Centre, Subiaco, Australia
| | - Wolf-Dieter Baumgartner
- Medizinische Universität Wien, Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Vienna, Austria
| | - Marco Caversaccio
- Universitätsklinik für HNO, Kopf- und Halschirurgie, Inselspital Bern, Bern, Switzerland
| | - Javier Gavilan
- Hospital Universitario La Paz, Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Benoit Godey
- Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Wolfgang Gstöttner
- Medizinische Universität Wien, Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Vienna, Austria
| | - Rudolph Hagen
- Klinik und Poliklinik für Hals-, Nasen und Ohren- Krankheiten, Universität Würzburg, Würzburg, Germany
| | - Li Yongxin
- Capital Medical University, Beijing Tongren Hospital, Beijing, People's Republic of China
| | - Eva Karltorp
- Karolinska University Hospital, Karolinska vägen, 171 76 Solna, Sweden
| | - Mohan Kameswaran
- Madras ENT Research Foundation (MERF), No-1, 1st Cross Street, Off. II Main Road, Raja Annamalai Puram Chennai, Tamil Nadu 600028, India
| | - Vlad Kuzovkov
- St. Petersburg ENT and Speech Research Institute, St. Petersburg, Russia
| | - Luis Lassaletta
- Hospital Universitario La Paz, Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Manikoth Manoj
- ENT Super Speciality Institute and Research Center, East Hill, Kozhikode, Kerala 673005, India
| | | | - Harold Pillsbury
- UNC Ear & Hearing Center at Chapel Hill School of Medicine, 170 Manning Dr #7070 Chapel Hill, NC 27514, USA
| | | | - Gunesh Rajan
- Otolaryngology, Head & Neck Surgery Unit, School of Surgery, University of Western Australia, Fremantle Hospital, Fremantle, Australia
| | - Joachim Schmutzhard
- Universitätsklinik für Hals- Nasen- Ohrenheilkunde Innsbruck, Innsbruck, Austria
| | - Henryk Skarzynski
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,World Hearing Center, Nadarzyn, Poland.,Institute of Sensory Organs, Nadarzyn, Poland
| | - Hinrich Staecker
- Kansas University Center for Hearing and Balance Disorders, 3901 Rainbow Blvd, Kansas City, KS 66160, USA
| | - Shin-Ichi Usami
- Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Mario Zernotti
- Instituto de ORL, Av Ambrosio Olmos 754, Córdoba, Argentina
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Su PL, Roberts MY. Quantity and Quality of Parental Utterances and Responses to Children With Hearing Loss Prior to Cochlear Implant. JOURNAL OF EARLY INTERVENTION 2019; 41:366-387. [PMID: 33311963 PMCID: PMC7731922 DOI: 10.1177/1053815119867286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This study investigated the extent to which parental language input to children with hearing loss (HL) prior to cochlear implant (CI) differs from input to children with typical hearing (TH). A 20-min parent-child interaction sample was collected for 13 parent-child dyads in the HL group and 17 dyads in the TH group during free play. Ten minutes were transcribed and were coded for four variables: (a) overall utterances, (b) high-quality utterances, (c) utterances in response to child communicative acts (i.e., overall responses), and (d) high-quality utterances in response to child communicative acts (i.e., high-quality responses). Differences were detected for both quantity and quality of parental language input across the two groups. Early language skills correlated with three out of the four parental variables in both groups. Post hoc analyses suggested that the lower rate of high-quality responses in parents of children with HL could be attributed to lower intelligibility of child communication.
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Kim JR, Tejani VD, Abbas PJ, Brown CJ. Intracochlear Recordings of Acoustically and Electrically Evoked Potentials in Nucleus Hybrid L24 Cochlear Implant Users and Their Relationship to Speech Perception. Front Neurosci 2017; 11:216. [PMID: 28469553 PMCID: PMC5395645 DOI: 10.3389/fnins.2017.00216] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/30/2017] [Indexed: 11/26/2022] Open
Abstract
The Hybrid cochlear implant (CI) has been developed for individuals with high frequency hearing loss who retain good low frequency hearing. Outcomes have been encouraging but individual variability is high; the health of the cochlea and the auditory nerve may be important factors driving outcomes. Electrically evoked compound action potentials (ECAPs) reflect the response of the auditory nerve to electrical stimulation while electrocochleography (ECochG) reflects the response of the cochlear hair cells and auditory nerve to acoustic stimulation. In this study both ECAPs and ECochG responses were recorded from Nucleus Hybrid L24 CI users. Correlations between these two measures of peripheral auditory function and speech perception are reported. This retrospective study includes data from 25 L24 CI users. ECAPs and ECochG responses were recorded from an intracochlear electrode using stimuli presented at or near maximum acceptable loudness levels. Speech perception was assessed using Consonant-Nucleus-Consonant (CNC) word lists presented in quiet and AzBio sentences presented at a +5 dB signal-to-noise ratio in both the combined acoustic and electric (A+E) and electric (E) alone listening modes. Acoustic gain was calculated by subtracting these two scores. Correlations between these physiologic and speech perception measures were then computed. ECAP amplitudes recorded from the most apical electrode were significantly correlated with CNC scores measured in the E alone (r = 0.56) and A+E conditions (r = 0.64), but not with performance on the AzBio test. ECochG responses recorded using the most apical electrode in the intracochlear array but evoked using a 500 Hz tone burst were not correlated with either the scores on the CNC or AzBio tests. However, ECochG amplitude was correlated with a composite metric relating the additional benefit of acoustic gain in noise relative to quiet conditions (r = 0.67). Both measures can be recorded from Hybrid L24 CI users and both ECAP and ECochG measures may result in more complete characterization of speech perception outcomes than either measure alone.
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Affiliation(s)
- Jae-Ryong Kim
- Department of Communication Sciences and Disorders, University of IowaIowa City, IA, USA.,Department of Otolaryngology-Head and Neck Surgery, Inje University College of MedicineBusan, South Korea
| | - Viral D Tejani
- Department of Communication Sciences and Disorders, University of IowaIowa City, IA, USA.,Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and ClinicsIowa City, IA, USA
| | - Paul J Abbas
- Department of Communication Sciences and Disorders, University of IowaIowa City, IA, USA.,Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and ClinicsIowa City, IA, USA
| | - Carolyn J Brown
- Department of Communication Sciences and Disorders, University of IowaIowa City, IA, USA.,Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and ClinicsIowa City, IA, USA
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Pecci A, Verver EJJ, Schlegel N, Canzi P, Boccio CM, Platokouki H, Krause E, Benazzo M, Topsakal V, Greinacher A. Cochlear implantation is safe and effective in patients with MYH9-related disease. Orphanet J Rare Dis 2014; 9:100. [PMID: 24980457 PMCID: PMC4105151 DOI: 10.1186/1750-1172-9-100] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 06/19/2014] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND MYH9-related disease (MYH9-RD) is a rare syndromic disorder deriving from mutations in MYH9, the gene for the heavy chain of non-muscle myosin IIA. Patients present with congenital thrombocytopenia and giant platelets and have a variable risk of developing sensorineural deafness, kidney damage, presenile cataract, and liver abnormalities. Almost all MYH9-RD patients develop the hearing defect, which, in many individuals, progresses to severe to profound deafness with high impact on quality of life. These patients are potential candidates for cochlear implantation (CI), however, no consistent data are available about the risk to benefit ratio of CI in MYH9-RD. The only reported patient who received CI experienced perisurgery complications that have been attributed to concurrent platelet defects and/or MYH9 protein dysfunction. METHODS By international co-operative study, we report the clinical outcome of 10 patients with MYH9-RD and severe to profound deafness who received a CI at 8 institutions. RESULTS Nine patients benefited from CI: in particular, eight of them obtained excellent performances with restoration of a practically normal hearing function and verbal communication abilities. One patient had a slightly worse performance that could be explained by the very long duration of severe deafness before CI. Finally, one patient did not significantly benefit from CI. No adverse events attributable to MYH9-RD syndrome were observed, in particular no perisurgery bleeding complications due to the platelet defects were seen. Patients' perioperative management is described and discussed. CONCLUSIONS CI is safe and effective in most patients with MYH9-RD and severe to profound deafness and should be offered to these subjects, possibly as soon as they develop the criteria for candidacy.
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Affiliation(s)
- Alessandro Pecci
- Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation and University of Pavia, Piazzale Golgi, 27100 Pavia, Italy.
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Nittrouer S, Tarr E, Bolster V, Caldwell-Tarr A, Moberly AC, Lowenstein JH. Low-frequency signals support perceptual organization of implant-simulated speech for adults and children. Int J Audiol 2014; 53:270-84. [PMID: 24456179 PMCID: PMC3954900 DOI: 10.3109/14992027.2013.871649] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Using signals processed to simulate speech received through cochlear implants and low-frequency extended hearing aids, this study examined the proposal that low-frequency signals facilitate the perceptual organization of broader, spectrally degraded signals. DESIGN In two experiments, words and sentences were presented in diotic and dichotic configurations as four-channel noise-vocoded signals (VOC-only), and as those signals combined with the acoustic signal below 0.25 kHz (LOW-plus). Dependent measures were percent correct recognition, and the difference between scores for the two processing conditions given as proportions of recognition scores for VOC-only. The influence of linguistic context was also examined. STUDY SAMPLE Participants had normal hearing. In all, 40 adults, 40 seven-year-olds, and 20 five-year-olds participated. RESULTS Participants of all ages showed benefits of adding the low-frequency signal. The effect was greater for sentences than words, but no effect of diotic versus dichotic presentation was found. The influence of linguistic context was similar across age groups, and did not contribute to the low-frequency effect. Listeners who had poorer VOC-only scores showed greater low-frequency effects. CONCLUSION The benefit of adding a low-frequency signal to a broader, spectrally degraded signal derives in some part from its facilitative influence on perceptual organization of the sensory input.
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Affiliation(s)
- Susan Nittrouer
- Department of Otolaryngology, The Ohio State University , Columbus , USA
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8
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Baiduc RR, Poling GL, Hong O, Dhar S. Clinical measures of auditory function: the cochlea and beyond. Dis Mon 2013; 59:147-56. [PMID: 23507354 DOI: 10.1016/j.disamonth.2013.01.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Stronks HC, Versnel H, Prijs VF, de Groot JCMJ, Grolman W, Klis SFL. The Role of Electrophonics in Electroacoustic Stimulation of the Guinea Pig Cochlea. Otol Neurotol 2013; 34:579-87. [DOI: 10.1097/mao.0b013e318280db5a] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Spatial Overlap of Combined Electroacoustic Stimulation Determines the Electrically Evoked Response in the Guinea Pig Cochlea. Otol Neurotol 2012; 33:1535-42. [DOI: 10.1097/mao.0b013e318271c0b6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhang T, Dorman MF, Fu QJ, Spahr AJ. Auditory training in patients with unilateral cochlear implant and contralateral acoustic stimulation. Ear Hear 2012; 33:e70-9. [PMID: 22622705 PMCID: PMC3463714 DOI: 10.1097/aud.0b013e318259e5dd] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES It was hypothesized that auditory training would allow bimodal patients to combine in a better manner the low-frequency acoustic information provided by a hearing aid with the electric information provided by a cochlear implant, thus maximizing the benefit of combining acoustic (A) and electric (E) stimulation (EAS). DESIGN Performance in quiet or in the presence of a multitalker babble at +5 dB signal to noise ratio was evaluated in seven bimodal patients before and after auditory training. The performance measures comprised identification of vowels and consonants, consonant-nucleus-consonant words, sentences, voice gender, and emotion. Baseline performance was evaluated in the A-alone, E-alone, and combined EAS conditions once per week for 3 weeks. A phonetic-contrast training protocol was used to facilitate speech perceptual learning. Patients trained at home 1 hour a day, 5 days a week, for 4 weeks with both their cochlear implant and hearing aid devices on. Performance was remeasured after the 4 weeks of training and 1 month after training stopped. RESULTS After training, there was significant improvement in vowel, consonant, and consonant-nucleus-consonant word identification in the E and EAS conditions. The magnitude of improvement in the E condition was equivalent to that in the EAS condition. The improved performance was largely retained 1 month after training stopped. CONCLUSION Auditory training, in the form administered in this study, can improve bimodal patients' overall speech understanding by improving E-alone performance.
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Affiliation(s)
- Ting Zhang
- Department of Speech and Hearing Science, Arizona State University, Tempe, Arizona, USA.
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Cochlear implantation in children with cochlear nerve deficiency: a report of nine cases. Int J Pediatr Otorhinolaryngol 2012; 76:1188-95. [PMID: 22664315 DOI: 10.1016/j.ijporl.2012.05.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 04/30/2012] [Accepted: 05/03/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Cochlear implantation for children with cochlear nerve deficiency remains controversial, as the presence of the cochlear nerve has been central to the success of cochlear implantation. This study sought to investigate whether there is any benefit from cochlear implantation for children with cochlear nerve deficiency. METHODS Nine children with cochlear nerve deficiency and bilateral prelingual profound sensorineural hearing loss were included in this study. Inner ear and internal auditory canal structures were evaluated using magnetic resonance imaging and temporal bone computed tomography scans. Meaningful auditory integration scales, categories of auditory performance scores, speech intelligibility ratings and pure tone average threshold with cochlear implantation were measured for evaluation of hearing and speech performance. RESULTS Only four (44.4%) children had a significant improvement in pure tone average threshold with the cochlear implant device (77.5 dBHL, 45 dBHL, 51.3 dBHL and 68.8 dBHL). No child achieved sufficient speech intelligibility or perception ability during a follow-up of at least one year after surgery. CONCLUSIONS The decision to perform cochlear implantation in children with cochlear nerve deficiency must be undertaken with caution as it has limited effectiveness and uncertain cost-benefit.
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Bouccara D, Mosnier I, Bernardeschi D, Ferrary E, Sterkers O. Implants cochléaires chez l’adulte. Rev Med Interne 2012; 33:143-9. [DOI: 10.1016/j.revmed.2011.11.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Revised: 11/14/2011] [Accepted: 11/29/2011] [Indexed: 10/14/2022]
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O'Brien LCG, Valim C, Neault M, Kammerer B, Clark T, Johnston J, Culver S, Zhou J, Kenna MA, Licameli GR. Prognosis Tool Based on a Modified Children's Implant Profile for Use in Pediatric Cochlear Implant Candidacy Evaluation. Ann Otol Rhinol Laryngol 2012; 121:73-84. [DOI: 10.1177/000348941212100201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: We developed a prediction tool to assist in evaluation of pediatric candidates for cochlear implantation (CI) and to help plan for preoperative and postoperative support. Methods: Between 1995 and 2005, 277 patients underwent CI at Children's Hospital Boston. Of these 277 patients, 250 had at least 2 years of post-CI follow-up and adequate pre-CI information for rating by our prediction tool. Of the 250, 106 were randomly selected for inclusion. The patients were divided into group A (auditory/oral communicator); group B (auditory/oral communicator with visual assistance), group C (visual/manual communicator with auditory/oral skills assistance), and group D (will not derive communicative benefit from implant). Predictions were performed with clinical assessment and two statistical techniques: Regression modeling and classification and regression tree (CART) analysis. Results: Among patients who became auditory/oral communicators (group A), clinical assessment predicted that outcome accurately 65% of the time, CART analysis had intermediate sensitivity (79%), and regression modeling was the most sensitive (95%). Groups B through D were predicted 45% of the time by regression modeling, 90% of the time by clinical assessment, and 100% of the time by CART analysis. Conclusions: A combination of speech-language, medical, and educational constructs can provide a reliable prediction of the communication outcome. Our goal for the prognosis tool is to make it part of the overall candidacy process in supporting decision-making about CI and planning for post-CI therapy.
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Effects of electrical stimulation on the acoustically evoked auditory-nerve response in guinea pigs with a high-frequency hearing loss. Hear Res 2011; 272:95-107. [DOI: 10.1016/j.heares.2010.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 10/01/2010] [Accepted: 10/21/2010] [Indexed: 11/18/2022]
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Stark T, Niedermeyer HP, Knopf A, Sudhoff H. Surgical Technique for Implantation of the MED-EL SONATATI100. ACTA ACUST UNITED AC 2011; 73:196-200. [DOI: 10.1159/000328978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 04/26/2011] [Indexed: 11/19/2022]
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Achiques MT, Morant A, Muñoz N, Marco J, Llópez I, Latorre E, Pitarch I. Complicaciones y fallos de la implantación coclear. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010; 61:412-7. [DOI: 10.1016/j.otorri.2010.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2010] [Revised: 07/15/2010] [Accepted: 07/19/2010] [Indexed: 10/19/2022]
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O'Brien LCG, Kenna M, Neault M, Clark TA, Kammerer B, Johnston J, Waldman E, Thomas SP, Forbes P, Licameli GR. Not a "sound" decision: is cochlear implantation always the best choice? Int J Pediatr Otorhinolaryngol 2010; 74:1144-8. [PMID: 20692711 DOI: 10.1016/j.ijporl.2010.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2009] [Revised: 06/25/2010] [Accepted: 07/03/2010] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To review the candidacy criteria used to counsel parents of profoundly deaf children, to determine if these criteria have changed over time, and to evaluate eventual communication outcomes for these patients. DESIGN Retrospective review of 483 pediatric cochlear implant candidates from September 1995 to December 2006 seen at a tertiary care pediatric hospital. RESULTS Out of 483 implant candidates, 191 patients were initially felt not to be favorable candidates based on CI team evaluation. Of this group, 3 had insufficient records to review and were excluded. The remaining 188 patients underwent a detailed analysis of specific possible contraindications to implantation. This included audiologic, medical and psychosocial parameters. The data was divided into two time periods: Group 1 included 44 patients from 1995 to 2000, and Group 2 included 144 patients from 2001 to 2006. In Group 1, there was a higher percentage of children with language deprivation and developmental concerns and patients not ready, compared to Group 2 which had a higher percentage of families not ready and inadequate support systems. Group 1 had a higher percentage of patients who ultimately underwent cochlear implant, but otherwise the two groups were largely similar. CONCLUSION Analysis of our data showed that the degree of concern that the cochlear implant team has in relationship to specific candidacy criteria has changed over time. Recommendations against a cochlear implant were often revisited after initial concerns were addressed. The use of a team approach, in conjunction with a validation tool, is important for establishing criteria for successful cochlear implantation in children to support appropriate counseling of patients and families and to plan post-implant management.
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Affiliation(s)
- Lynne C Graham O'Brien
- Department of Otolaryngology and Communication Enhancement, Children's Hospital Boston, United States
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Berrettini S, Passetti S, Giannarelli M, Forli F. Benefit from bimodal hearing in a group of prelingually deafened adult cochlear implant users. Am J Otolaryngol 2010; 31:332-8. [PMID: 20015774 DOI: 10.1016/j.amjoto.2009.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2008] [Revised: 03/10/2009] [Accepted: 04/06/2009] [Indexed: 11/16/2022]
Abstract
PURPOSE People who receive a unilateral cochlear implant find speech perception in acoustically complex situations very challenging, in part because they do not have access to binaural hearing. For cochlear implant patients with some residual hearing in the nonimplanted ear, bilateral auditory input can be obtained by the use of a cochlear implant and a contralateral conventional hearing aid. This condition is referred to as "bimodal hearing." MATERIALS AND METHODS We evaluated the benefits from bimodal stimulation in a group of 10 prelingually deafened adult cochlear implant users, submitted to unilateral cochlear implantation at the ENT Unit of the University of Pisa. RESULTS Of 10 patients, 9 decided to continue using bimodal stimulation and demonstrated improvements in speech perception both in quiet and in noise condition from bimodal hearing, in comparison to the cochlear implant alone condition. CONCLUSIONS Our results show that bimodal hearing offers some advantages in speech understanding in quiet and noise conditions also in prelingually deafened adults. Moreover, most of our patients reported advantages from bimodal hearing in localizing sound and in perceiving a more natural sound.
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Affiliation(s)
- Stefano Berrettini
- Otology-Cochlear Implant Centre, Department of Neuroscience, University of Pisa, Italy.
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Kim LS, Jeong SW, Lee YM, Kim JS. Cochlear implantation in children. Auris Nasus Larynx 2010; 37:6-17. [DOI: 10.1016/j.anl.2009.09.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 09/10/2009] [Accepted: 09/22/2009] [Indexed: 10/20/2022]
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21
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Cochlear implant complications and failures. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010. [DOI: 10.1016/s2173-5735(10)70076-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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22
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Abstract
The technique of cochlear implantation was the first method which allowed replacement of a sense organ by a (partially) implantable electronic prosthesis. By this method the cells of the spiral ganglion of the cochlea are directly stimulated by the electrodes introduced into the cochlea, bypassing the functions of the outer and middle ear as well as the cochlea. Treatment with a cochlear implant (CI) has been established over the last 20-30 years as a reliable method for restoring hearing in adults and children with severe hearing disorders and is now a routine method in many centers. For optimal results in understanding speech and for children in the speech development phase, rehabilitation must be an integral part of the total treatment and follow soon after implantation. To achieve this early diagnosis of hearing difficulties or deafness is necessary, which is simplified by a consistent hearing screening of newborns, now a statutory procedure in Germany.
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Affiliation(s)
- J Maurer
- Direktor der Klinik für HNO-Krankheiten, Kopf-Hals- und Schädelbasischirurgie Sowie Plastische Operationen und des Zentrums für Hören und Kommunikation, Katholisches Klinikum Koblenz, Koblenz, Germany.
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23
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A Review of Device Failure in More Than 23 Years of Clinical Experience of a Cochlear Implant Program With More Than 3,400 Implantees. Otol Neurotol 2009; 30:455-63. [DOI: 10.1097/mao.0b013e31819e6206] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Craddock L, Brinton J, Saeed SR, Balkany TJ. Editorial. Bilateral cochlear implantation : the British Cochlear Implant Group position. Cochlear Implants Int 2009; 9:65-9. [PMID: 18756442 DOI: 10.1179/cim.2008.9.2.65] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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25
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Sainz M, García-Valdecasas J, Ballesteros JM. Posibilidades de tratamiento quirúrgico de la hipoacusia en pacientes afectados de osteogénesis imperfecta. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2009. [DOI: 10.1016/s0001-6519(09)02009-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Sainz M, García-Valdecasas J, Ballesteros JM. Surgical options for hearing loss in patients with osteogenesis imperfecta. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2009. [DOI: 10.1016/s2173-5735(09)70115-2] [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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Abstract
BACKGROUND The most pressing problem facing cochlear implant research is no longer making artificial hearing a reality. Instead, it is to develop devices that can more clearly reflect the capabilities of the human auditory system. Current cochlear implants rarely provide adequate pitch perception. As hearing loss commonly affects higher, more than lower frequencies, a possible solution is to preserve acoustic hearing at low frequencies by inserting a short electrode array and thus deliver combined electro-acoustic stimulation (EAS). OBJECTIVE OF REVIEW To determine whether individuals with severe-to-profound high-frequency hearing loss have realised this predicted benefit of combined EAS, over conventional cochlear implants, with respect to pitch. TYPE OF REVIEW A systematic review of publications pertaining to the benefits of combined EAS over conventional cochlear implantation, with specific reference to pitch perception. SEARCH STRATEGY A systematic literature search was conducted across multiple databases and supplemented by searching the reference lists of relevant trials and identified reviews. RESULTS The included studies suggest an overall benefit of combined EAS, over conventional cochlear implants, with respect to pitch. In addition, (i) 13% sustained a total loss of low-frequency hearing post-implantation of the short electrode array and, (ii) 24% had >20 dB hearing loss across all frequencies and/or total hearing loss. CONCLUSIONS For patients with severe-to-profound high-frequency hearing loss combined EAS appears to offer a significant, everyday, long-term benefit. However, further clinical trials with larger numbers of candidates are necessary to confirm this finding. The risks involved cannot be ignored, but there is potential for a variety of strategies to improve the safety margin.
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Affiliation(s)
- K N Talbot
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK.
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Nourski KV, Abbas PJ, Miller CA, Robinson BK, Jeng FC. Acoustic-electric interactions in the guinea pig auditory nerve: simultaneous and forward masking of the electrically evoked compound action potential. Hear Res 2007; 232:87-103. [PMID: 17723284 PMCID: PMC2048988 DOI: 10.1016/j.heares.2007.07.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2007] [Revised: 06/29/2007] [Accepted: 07/03/2007] [Indexed: 11/27/2022]
Abstract
The study investigated the time course of the effects of acoustic and electric stimulation on the electrically evoked compound action potential (ECAP). Adult guinea pigs were used in acute experimental sessions. Bursts of acoustic noise and high-rate (5000 pulses/s) electric pulse trains were used as maskers. Biphasic electric pulses were used as probes. ECAPs were recorded from the auditory nerve trunk. Simultaneous masking of the ECAP with acoustic noise featured an onset effect and a decrease in the amount of masking to a steady state. It was characterized by a two-component exponential function. The amount of masking increased with masker level and decreased with probe level. Post-stimulatory ECAP recovery often featured a non-monotonic time course, described by a three-component exponent. Electric maskers produced similar post-stimulatory effects in hearing and acutely deafened subjects. Acoustic stimulation affects the ECAP in a level- and time-dependent manner. Simultaneous masking follows a time course comparable to that of adaptation to an acoustic stimulus. Refractoriness, spontaneous activity, and adaptation are suggested to play a role in ECAP recovery. Post-stimulatory changes in synchrony, possibly due to recovery of spontaneous activity and an additional hair-cell independent mechanism, are hypothesized to contribute to the observed non-monotonicity of recovery.
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Affiliation(s)
- Kirill V Nourski
- Department of Otolaryngology--Head and Neck Surgery, The University of Iowa, Iowa City, IA 52242, USA.
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Hallum LE, Dagnelie G, Suaning GJ, Lovell NH. Simulating auditory and visual sensorineural prostheses: a comparative review. J Neural Eng 2007; 4:S58-71. [PMID: 17325417 DOI: 10.1088/1741-2560/4/1/s08] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Microelectronic vision prosthesis proposes to render luminous spots (so-called phosphenes) in the visual field of the otherwise blind subject by way of an implanted array of stimulating electrodes, and in doing so restore some spatial vision. There are now many research teams worldwide working towards a therapeutic device, analogous to the cochlear implant, for the profoundly blind. Despite the similarities between the cochlear implant and vision prostheses, there are few instances in the literature where the two approaches are compared and contrasted with a mind to informing the science and engineering of the latter. This is the focus of the present review; specifically, our interest is psychophysics and signal processing. Firstly, we examine the cochlear implant, and review a handful of psychophysical work: the acoustic simulation of cochlear implants and the method used. We focus on the use of normally hearing subjects (played coloured noise bands or sine waves) as a means of investigating cochlear-implant efficacy and speech processing algorithms. These results provide guidance to vision researchers, for they address the interpretation of simulation data, and flag key areas, such as 'artificial' perception in the presence of noise, that require experimental work in coming years. Secondly, we provide an up-to-date review of the body of analogous psychophysical work: the visual simulation, involving normal observers, of microelectronic vision prosthesis. These simulations allow predictions as to the likely clinical efficacy of the prosthesis; indeed, results to date suggest that a number on the order of 100 implanted electrodes will afford subjects mobility and recognition of faces (and other complex stimuli), while even fewer electrodes facilitate reading printed text and very simple visuomanual tasks. Further, the simulations allow investigations of image and signal processing strategies, plus they provide researchers in the field, and other interested persons, a perceptual experience that approximates what a prosthesis will likely afford implantees.
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Affiliation(s)
- L E Hallum
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney 2052, Australia
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Hildebrand MS, de Silva MG, Gardner RJM, Rose E, de Graaf CA, Bahlo M, Dahl HHM. Cochlear implants for DFNA17 deafness. Laryngoscope 2007; 116:2211-5. [PMID: 17146397 DOI: 10.1097/01.mlg.0000242089.72880.f8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Nonsyndromic autosomal-dominant, adult-onset sensorineural hearing loss resulting from DFNA17 was described in a single American kindred in 1997, and the causative gene was subsequently identified as MYH9. OBJECTIVE The objective of this study was to report clinical and genetic analyses of an Australian family with nonsyndromic adult-onset sensorineural hearing loss. METHODS The clinical presentation of the family was detailed and identification of the causative gene was conducted by SNP genotyping and direct sequencing. RESULTS Sequence analysis of the MYH9 gene revealed the same missense mutation as in the original DFNA17 family. We are not aware of a link between the two kindreds, making the present one only the second DFNA17 family to be reported. CONCLUSIONS One important point of clinical relevance is the excellent outcome with cochlear implants in the Australian family compared with a "poor" response in the American family. Thus, cochlear implants should be strongly considered for clinical management of patients with DFNA17 deafness.
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Affiliation(s)
- Michael S Hildebrand
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.
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Mok M, Grayden D, Dowell RC, Lawrence D. Speech perception for adults who use hearing aids in conjunction with cochlear implants in opposite ears. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2006; 49:338-51. [PMID: 16671848 DOI: 10.1044/1092-4388(2006/027)] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2004] [Revised: 10/20/2004] [Accepted: 07/03/2005] [Indexed: 05/09/2023]
Abstract
This study aimed to (a) investigate the effect of using a hearing aid in conjunction with a cochlear implant in opposite ears on speech perception in quiet and in noise, (b) identify the speech information obtained from a hearing aid that is additive to the information obtained from a cochlear implant, and (c) explore the relationship between aided thresholds in the nonimplanted ear and speech perception benefit from wearing a hearing aid in conjunction with a cochlear implant in opposite ears. Fourteen adults who used the Nucleus 24 cochlear implant system in 1 ear participated in the study. All participants had either used a hearing aid in the nonimplanted ear for at least 75% of waking hours after cochlear implantation, and/or, hearing loss less than 90 dB HL in the low frequencies in the nonimplanted ear. Speech perception was evaluated in 3 conditions: cochlear implant alone (CI), hearing aid alone (HA), and cochlear implant in conjunction with hearing aid in opposite ears (CIHA). Three speech perception tests were used: consonant-vowel nucleus-consonant (CNC) words in quiet, City University of New York style (CUNY) sentences in coincident signal and noise, and spondees in coincidental and spatially separated signal and noise. Information transmission analyses were performed on the CNC responses. Of the 14 participants tested, 6 showed significant bimodal benefit on open-set speech perception measures and 5 showed benefit on close-set spondees. However, 2 participants showed poorer speech perception with CIHA than CI in at least 1 of the speech perception tests. Results of information transmission analyses showed that bimodal benefit (performance with CIHA minus that with CI) in quiet arises from improved perception of the low frequency components in speech. Results showed that participants with poorer aided thresholds in the mid-to-high frequencies demonstrated greater bimodal benefit. It is possible that the mid-to-high frequency information provided by the hearing aids may be conflicting with the cochlear implants.
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Affiliation(s)
- Mansze Mok
- Department of Otolaryngology, The University of Melbourne, Melbourne, Victoria, Australia.
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Stöver T, Issing P, Graurock G, Erfurt P, ElBeltagy Y, Paasche G, Lenarz T. Evaluation of the Advance Off-Stylet Insertion Technique and the Cochlear Insertion Tool in Temporal Bones. Otol Neurotol 2005; 26:1161-70. [PMID: 16272935 DOI: 10.1097/01.mao.0000179527.17285.85] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The concept and design of new cochlear implant electrodes is a challenging process. To evaluate new electrode designs, we present a study that uses a microgrinding procedure to evaluate damage to the microstructures of the cochlea resulting from the insertion procedure. In this study, we compared different insertion techniques with the Contour electrode with Softip for placement inside the cochlea and any resulting damage. METHODS Twenty-five fresh frozen human temporal bones were used to compare electrode insertion characteristics with three insertion techniques (i.e., conventional insertion, Advance Off-Stylet performed manually, and Advance Off-Stylet performed with insertion tool) and two prototype variants of the Contour electrode with Softip (referred as Softip I and Softip II in this article). Five temporal bones were used for each arm of the study: Softip I electrode and conventional insertion; Softip I electrode and manual Advance Off-Stylet insertion; Softip I electrode and Advance Off-Stylet insertion with an early experimental insertion tool; Softip II prototype electrode and manual Advance Off-Stylet insertion; and Softip II prototype and Advance Off-Stylet insertion with a prototype insertion tool. The temporal bones were dehydrated and embedded in epoxy and used for the microgrinding procedure. Resulting images were documented and compared with conventional radiographic images. RESULTS Our results showed that, especially when using the conventional insertion technique with Softip I electrode arrays, basilar membrane perforations were observable. Using the prototype insertion tool, good placement of the electrode array but also two basilar membrane perforations (one with each type of electrode) were observed. In contrast, the Advance Off-Stylet insertion technique did not show basilar membrane perforation with Softip I and II electrodes and resulted in reliable perimodiolar placement of the arrays. CONCLUSION Using microgrinding of temporal bones, the Advance Off-Stylet insertion technique was proven to enable more atraumatic insertions of Contour electrodes with Softip and to provide very reliable perimodiolar placements.
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Affiliation(s)
- Timo Stöver
- Department of Otolaryngology, Medical University of Hannover, Hannover, Germany.
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Bouccara D, Avan P, Mosnier I, Bozorg Grayeli A, Ferrary E, Sterkers O. Réhabilitation auditive. Med Sci (Paris) 2005; 21:190-7. [PMID: 15691492 DOI: 10.1051/medsci/2005212190] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Auditory rehabilitation depends of the cause and the severity of the hearing loss (or deafness). Hearing losses dues to middle ear pathologies can beneficiate of medical or surgical treatments, by ossicular prostheses, if it is necessary to restore the function of the ossicles chain. In the sensorineural hearing losses, with inner ear pathology, the use of auditory aid is immediately considered. In the cases for which they are insufficient because of severity of the hearing loss or not suitable because of local non-tolerance, it is possible to use middle ear implant or cochlear implant. The indications of the auditory brainstern implants remain at this day limited to the total bilateral hearing losses due to a complete destruction of cochleae and auditory nerves. These therapeutic orientations are selected after a multidisciplinary evaluation of the deaf person, evaluation that allows the characterization of the hearing loss and its repercussion. In all the cases, the restoration of a bilateral hearing has to be done if possible, making an improvement of the speech comprehension, mainly in the noisy situations, as well as the localization of the sound sources.
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Affiliation(s)
- Didier Bouccara
- Inserm EMI-U.0112, Faculté de médecine Xavier Bichat, Université Paris 7, 16, rue Henri Huchard, 75870 Paris Cedex 18, France.
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