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Speck I, Gundlach E, Schmidt S, Spyckermann N, Lesinski-Schiedat A, Rauch AK, Aschendorff A, Thangavelu K, Reimann K, Arndt S. Auditory capacity of the better-hearing ear in asymmetric hearing loss. Eur Arch Otorhinolaryngol 2024; 281:2303-2312. [PMID: 38006462 PMCID: PMC11024001 DOI: 10.1007/s00405-023-08342-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 11/06/2023] [Indexed: 11/27/2023]
Abstract
PURPOSE Our aim was to investigate the course of the hearing capacity of the better-hearing ear in single-sided deafness (SSD) and asymmetric hearing loss (AHL) over time, in a multicenter study. METHODS We included 2086 pure-tone audiograms from 323 patients with SSD and AHL from four hospitals and 156 private practice otorhinolaryngologists. We collected: age, gender, etiology, duration of deafness, treatment with CI, number and monosyllabic speech recognition, numerical rating scale (NRS) of tinnitus intensity, and the tinnitus questionnaire according to Goebel and Hiller. We compared the pure tone audiogram of the better-hearing ear in patients with SSD with age- and gender-controlled hearing thresholds from ISO 7029:2017. RESULTS First, individuals with SSD showed a significantly higher hearing threshold from 0.125 to 8 kHz in the better-hearing ear compared to the ISO 7029:2017. The duration of deafness of the poorer-hearing ear showed no relationship with the hearing threshold of the better-hearing ear. The hearing threshold was significantly higher in typically bilaterally presenting etiologies (chronic otitis media, otosclerosis, and congenital hearing loss), except for Menière's disease. Second, subjects that developed AHL did so in 5.19 ± 5.91 years and showed significant reduction in monosyllabic word and number recognition. CONCLUSIONS Individuals with SSD show significantly poorer hearing in the better-hearing ear than individuals with NH from the ISO 7029:2017. In clinical practice, we should, therefore, inform our SSD patients that their disease is accompanied by a reduced hearing capacity on the contralateral side, especially in certain etiologies.
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Affiliation(s)
- Iva Speck
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany.
| | - Elisabeth Gundlach
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany
| | - Sandra Schmidt
- Department of Oto-Rhino-Laryngology, Central Army Hospital Koblenz, Ruebenacher Str. 170, 56072, Koblenz, Germany
| | - Nadine Spyckermann
- Department of Oto-Rhino-Laryngology, Central Army Hospital Koblenz, Ruebenacher Str. 170, 56072, Koblenz, Germany
| | - Anke Lesinski-Schiedat
- Department of Otorhinolaryngology, Medical University Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Ann-Kathrin Rauch
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany
| | - Antje Aschendorff
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany
| | - Kruthika Thangavelu
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-University Marburg, Marburg, Germany
| | - Katrin Reimann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-University Marburg, Marburg, Germany
| | - Susan Arndt
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany
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Penwal SS, Chandanshive CU, Ambetkar J. Prevalence of Single-Sided Deafness in a Tertiary Healthcare Hospital in Mumbai. Indian J Otolaryngol Head Neck Surg 2024; 76:1498-1502. [PMID: 38566641 PMCID: PMC10982265 DOI: 10.1007/s12070-023-04319-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/21/2023] [Indexed: 04/04/2024] Open
Abstract
PURPOSE The current study was taken up to estimate the prevalence of Single Sided Deafness (SSD) in a tertiary healthcare hospital in Mumbai. Also to determine the acceptance of Contralateral routing of offside signal (CROS) devices by individuals with SSD. METHOD A retrospective study design was followed to collect data from September 2020 to September 2022. The data were collected by reviewing the files of the cases diagnosed with Single-Sided Deafness in a tertiary health care hospital in Mumbai. RESULT The prevalence of SSD was found to be 24% for the given period. It was observed that 50 out of 4456 took a free trial and 2 bought the device. CONCLUSION The poor acceptance and purchase of CROS are attributed to the cost, and missed benefits of true binaural hearing in localization and hearing in noise. These benefits can be achieved by using CI, however, the cost and fear of surgery refrained the participants. Also, participants were observed to learn great use of communication repair strategies. Therefore, it is required to counsel individuals with SSD for CI and provide knowledge about care for the better with regular audiological follow-up.
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Affiliation(s)
- Suman Shankar Penwal
- Department of Audiology and Speech Language Pathology in Sumandeeo Vidyapeeth deemed to be university, Vadodara, India
| | | | - Janhavi Ambetkar
- Department of Audiology and Speech Therapy, Topiwala National Medical College and B.Y.L Nair Charitable Hospital, Mumbai Central, Maharashtra India
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Wazen JJ, Kim CS, Ortega C, King T, Schwartz SR, Zeitler DM. Benefits of unilateral cochlear implantation in adults with asymmetric hearing loss: Audiologic and patient-related outcome measures. Am J Otolaryngol 2024; 45:104138. [PMID: 38101137 DOI: 10.1016/j.amjoto.2023.104138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/03/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE To investigate the benefits of cochlear implantation in adults with single-sided deafness (SSD) and asymmetric hearing loss (AHL). STUDY DESIGN Prospective within-subjects repeated-measures. SETTING Two tertiary cochlear implant centers. PATIENTS Fourteen adults with severe-to-profound sensorineural hearing loss in the worse hearing ear and up to moderate SNHL in the better hearing ear. INTERVENTION Cochlear implantation in the worse hearing ear. MAIN OUTCOME MEASURES Consonant-nucleus-consonant (CNC) test, AzBio sentence test in noise, and lateralization testing were conducted preoperatively and at 3-, 6-, and 12-months post-activation. Patient-related outcomes were measured using the Speech, Spatial, and Qualities of Hearing Scale and Glasgow Benefit Inventory. Tinnitus Handicap Inventory was administered to subjects with tinnitus. RESULTS Mean length of hearing loss in the worse hearing ear was 3.5 years. The mean CNC change scores from baseline were 54.8, 55.9, and 58.9 percentage points at 3-, 6-, and 12-months (p < 0.001). AzBio sentence test in noise demonstrated improved scores in all spatial configurations, although statistically significant in S0N0 (speech front, noise front) only. Lateralization testing showed significant improvement of 22.9, 24.5, and 24.0 percentage points at 3-, 6-, and 12 months post-activation (p = 0.002). All patient-related outcome measures revealed significant improvement. CONCLUSION This study demonstrates improved speech perception in noise, sound lateralization, quality of life, and reduction in tinnitus perception in adults with SSD/AHL who undergo cochlear implantation. Our results add to the growing body of evidence that cochlear implant should be offered to this population.
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Affiliation(s)
- Jack J Wazen
- First Physicians Group Silverstein Institute, 1901 Floyd Street, Sarasota, FL 34239, United States of America
| | - Christine S Kim
- First Physicians Group Silverstein Institute, 1901 Floyd Street, Sarasota, FL 34239, United States of America.
| | - Carmelo Ortega
- First Physicians Group Silverstein Institute, 1901 Floyd Street, Sarasota, FL 34239, United States of America
| | - Tonya King
- Sarasota Memorial Hospital Research Institute, 1700 South Tamiami Trail, Sarasota, FL 34239, United States of America
| | - Seth R Schwartz
- Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA 98101, United States of America
| | - Daniel M Zeitler
- Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA 98101, United States of America
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Tetard S, Guigou C, Sonnet CE, Al Burshaid D, Charlery-Adèle A, Bozorg Grayeli A. Free-Field Hearing Test in Noise with Free Head Rotation for Evaluation of Monaural Hearing. J Clin Med 2023; 12:7143. [PMID: 38002755 PMCID: PMC10672306 DOI: 10.3390/jcm12227143] [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: 09/28/2023] [Revised: 11/06/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
There is a discrepancy between the hearing test results in patients with single-sided deafness (SSD) and their reported outcome measures. This is probably due to the presence of two elements in everyday situations: noise and head movements. We developed a stereo-audiometric test in noise with free head movements to evaluate movements and auditory performance in monaural and binaural conditions in normal hearing volunteers with one occluded ear. Tests were performed in the binaural condition (BIN), with the left ear (LEO) or the right ear occluded (REO). The signal was emitted by one of the seven speakers, placed every 30° in a semicircle, and the noise (cocktail party) by all speakers. Subjects turned their head freely to obtain the most comfortable listening position, then repeated 10 sentences in this position. In monaural conditions, the sums of rotations (head rotations for an optimal hearing position in degrees, random signal azimuth, 1 to 15 signal ad lib signal presentations) were higher (LEO 255 ± 212°, REO 308 ± 208° versus BIN 74 ± 76, p < 0.001, ANOVA) than those in the BIN condition and the discrimination score (out of 10) was lower than that in the BIN condition (LEO 5 ± 1, REO 7 ± 1 versus BIN 8 ± 1, respectively p < 0.001 and p < 0.05 ANOVA). In the monaural condition, total rotation and discrimination in noise were negatively correlated with difficulty (Pearson r = -0.68, p < 0.01 and -0.51, p < 0.05, respectively). Subjects' behaviors were different in optimizing their hearing in noise via head rotation. The evaluation of head movements seems to be a significant parameter in predicting the difficulty of monaural hearing in noisy environments.
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Affiliation(s)
- Stanley Tetard
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France
| | - Caroline Guigou
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France
- ImViA, Laboratory of Imagery and Artificial Vision (EA 7535), Burgundy University, 21078 Dijon, France
| | - Charles-Edouard Sonnet
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France
- Amplifon Hearing Aid Center, 21000 Dijon, France
| | - Dhari Al Burshaid
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France
| | - Ambre Charlery-Adèle
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France
| | - Alexis Bozorg Grayeli
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France
- ImViA, Laboratory of Imagery and Artificial Vision (EA 7535), Burgundy University, 21078 Dijon, France
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Potier M, Gallego S, Fournier P, Marx M, Noreña A. Amplification of the poorer ear by StereoBiCROS in case of asymmetric sensorineural hearing loss: effect on tinnitus. Front Neurosci 2023; 17:1141096. [PMID: 37304020 PMCID: PMC10248029 DOI: 10.3389/fnins.2023.1141096] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/12/2023] [Indexed: 06/13/2023] Open
Abstract
Tinnitus is prevalent among patients suffering from Single-Sided Deafness (SSD) and Asymmetrical Hearing Loss (AHL). In addition to bothersome tinnitus in the poorer ear, these patients also report issues with understanding speech in noise and sound localization. The conventional treatment options offered to these patients to improve auditory abilities are cochlear implantation, bone conduction devices or Contralateral Routing Of Signal (CROS) hearing aids. It was recently found that the benefit of cochlear implantation for tinnitus associated with AHL/SSD was greater than the other two approaches. It is conceivable that the lack of stimulation provided to the poorer ear in these last approaches explains their modest impact on tinnitus perception. A new technology that combines the ability to reroute the sound from the poorer ear to the good ear (CROS system) while still stimulating the poorer ear with conventional sound amplification has recently been developed: the StereoBiCROS system. The aim of this study was to investigate the effects of this new device on tinnitus. Twelve AHL and two SSD patients aged 70.7 ± 7.9 years with tinnitus were fitted with bilateral hearing aids that included 3 programs: Stereophonic, BiCROS and StereoBiCROS (CROS + bilateral amplification). The short-and long-term effect of the approach on tinnitus was assessed using a tinnitus Loudness Visual Analog Scale (VAS) and the Tinnitus Handicap Inventory (THI), respectively. Both the VAS and the THI were used before and one month after the hearing aid fitting. Of the 14 patients who used their hearing aids daily (12.6 ± 1.6 h per day) the StereoBiCROS program was the most used program (81.8 ± 20.5% of the time). The average THI total score decreased from 47 (± 22) to 15 (± 16) (p = 0.002) and the VAS-Loudness score decreased from 7 (± 1) to 2 (± 2) (p < 0.001) after the one-month trial period. In conclusion, StereoBiCROS stimulation strategy seems to offer an effective alternative to reduce tinnitus handicap and loudness for patients with AHL/SSD and tinnitus. This effect may be driven by sound amplification of the poorer ear.
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Affiliation(s)
- Morgan Potier
- CNRS UMR, Laboratoire de Neurosciences Cognitives, Aix-Marseille–Université Centre Saint-Charles, Marseille, France
- Laboratoire d’Audiologie Clinique, Narbonne, France
| | - Stéphane Gallego
- CNRS UMR, Laboratoire de Neurosciences Cognitives, Aix-Marseille–Université Centre Saint-Charles, Marseille, France
- Institut des Sciences et Technologies de Réadaptation, Université de Lyon, Lyon, France
| | - Philippe Fournier
- CNRS UMR, Laboratoire de Neurosciences Cognitives, Aix-Marseille–Université Centre Saint-Charles, Marseille, France
- Département de réadaptation, Faculté de Médecine, Université Laval, Quebec, QC, Canada
| | - Mathieu Marx
- CNRS UMR, Centre de Recherche Cerveau et Cognition (CERCO), Université Paul Sabatier, Toulouse, France
| | - Arnaud Noreña
- CNRS UMR, Laboratoire de Neurosciences Cognitives, Aix-Marseille–Université Centre Saint-Charles, Marseille, France
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Deng X, Liu L, Li J, Yao H, He S, Guo Z, Sun J, Liu W, Hui X. Brain structural network to investigate the mechanism of cognitive impairment in patients with acoustic neuroma. Front Aging Neurosci 2022; 14:970159. [PMID: 36389069 PMCID: PMC9650538 DOI: 10.3389/fnagi.2022.970159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/13/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Acoustic neuroma (AN) is a common benign tumor. Little is known of neuropsychological studies in patients with acoustic neuroma, especially cognitive neuropsychology, and the neuropsychological abnormalities of patients affect their life quality. The purpose of this study was to explore the changes in the cognitive function of patients with acoustic neuroma, and the possible mechanism of these changes by structural magnetic resonance imaging. Materials and methods We used a neuropsychological assessment battery to assess cognitive function in 69 patients with acoustic neuroma and 70 healthy controls. Then, we used diffusion tensor imaging data to construct the structural brain network and calculate topological properties based on graph theory, and we studied the relation between the structural brain network and cognitive function. Moreover, three different subnetworks (short-range subnetwork, middle-range subnetwork, and long-range subnetwork) were constructed by the length of nerve fibers obtained from deterministic tracking. We studied the global and local efficiency of various subnetworks and analyzed the correlation between network metrics and cognitive function. Furthermore, connectome edge analysis directly assessed whether there were differences in the number of fibers in the different brain regions. We analyzed the relation between the differences and cognitive function. Results Compared with the healthy controls, the general cognitive function, memory, executive function, attention, visual space executive ability, visual perception ability, movement speed, and information processing speed decreased significantly in patients with acoustic neuroma. A unilateral hearing loss due to a left acoustic neuroma had a greater impact on cognitive function. The results showed that changes in the global and local metrics, the efficiency of subnetworks, and cognitively-related fiber connections were associated with cognitive impairments in patients with acoustic neuroma. Conclusion Patients exhibit cognitive impairments caused by the decline of the structure and function in some brain regions, and they also develop partial compensation after cognitive decline. Cognitive problems are frequent in patients with acoustic neuroma. Including neuropsychological aspects in the routine clinical evaluation and appropriate treatments may enhance the clinical management and improve their life quality.
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Affiliation(s)
- Xueyun Deng
- Department of Neurosurgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, China
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China
| | - Lihua Liu
- Department of Geriatrics, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, China
| | - Jiuhong Li
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China
| | - Hui Yao
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Shuai He
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Zhiwei Guo
- Department of Radiology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, China
| | - Jiayu Sun
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Wenke Liu
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China
| | - Xuhui Hui
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China
- *Correspondence: Xuhui Hui,
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Cochlear implantation in patients with asymmetric hearing loss: reporting and discussing the benefits in speech perception, speech reception threshold, squelch abilities, and patients’ reported outcomes. The Journal of Laryngology & Otology 2022; 136:964-969. [DOI: 10.1017/s0022215121004333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectivesThis study presents the results obtained in a group of patients with asymmetric hearing loss undergoing cochlear implantation at our institution. Prognostic factors are discussed in relation to different rehabilitative approaches for asymmetric hearing loss remediation. The current literature is also discussed.MethodsNineteen adult patients with post-verbal asymmetric hearing loss were enrolled. The results were assessed by means of a speech perception test, completed in silence and with background noise, and a speech reception threshold test (Oldenburg Sentence Test). The subjectively perceived benefits were assessed using the Speech, Spatial and Qualities of Hearing Scale.ResultsStatistically significant improvements were achieved by all patients in terms of speech perception and speech reception threshold, and in subjective benefits.ConclusionThe results confirm the literature findings which suggest that patients with asymmetric hearing loss generally gain substantial benefit from cochlear implantation because of the binaural input, with significant improvement in speech perception abilities in noise, speech reception threshold, and squelch abilities.
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Achena A, Achena F, Dragonetti AG, Sechi S, Pili AW, Locci MC, Turnu G, Maniaci A, Ferlito S. Cochlear Implant Evolving Indications: Our Outcomes in Adult Patients. Audiol Res 2022; 12:414-422. [PMID: 36004950 PMCID: PMC9404933 DOI: 10.3390/audiolres12040042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The eligibility criteria for cochlear implantation are constantly evolving, following the continuous progress in technology, knowledge about cochlear implant (CI) fitting, and the possibility to preserve residual hearing. Appropriate attention should be given to asymmetric hearing loss (AHL) and single-side deafness (SSD) subjects. This study aimed to analyze cochlear implant indications and evaluate the longitudinal performance outcomes for patients with different kinds and degrees of sensorineural hearing loss. Methods: A total of 69 adult hearing loss CI recipients were included and divided into four subgroups according to our CI indication criteria. We performed objective and subjective measures, including speech perception analysis in silence and with background noise, comparing the outcomes obtained in the four groups. Results: After cochlear implant surgery, concerning the preimplantation daily listening condition, a significantly improved speech perception score in silence and noise was found in all four groups (p < 0.05 for all). Conclusion: CI could represent an efficient solution for patients with AHL and SSD classes.
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Affiliation(s)
- Andrea Achena
- U.O.C di Otorinolaringoiatria ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy, (A.A.)
| | - Francesco Achena
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Alberto Giulio Dragonetti
- U.O.C di Otorinolaringoiatria ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy, (A.A.)
| | - Serena Sechi
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Andrea Walter Pili
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Maria Cristina Locci
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Giuseppe Turnu
- U.O.C. di Otorinolaringoiatria, P.O. CTO-Iglesias, Assl Carbonia-ATS Sardegna Italia, 09016 Cagliari, Italy
| | - Antonino Maniaci
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia; 95123 Catania, Italy
| | - Salvatore Ferlito
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia; 95123 Catania, Italy
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Deng X, Liu L, Luo J, Liu L, Hui X, Feng H. Research on the Mechanism of Cognitive Decline in Patients With Acoustic Neuroma. Front Neurosci 2022; 16:933825. [PMID: 35860298 PMCID: PMC9289464 DOI: 10.3389/fnins.2022.933825] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022] Open
Abstract
Little is known about neuropsychological research on patients with acoustic neuroma (AN), especially cognitive neuropsychology. We aim to compare the cognitive function of patients with AN and healthy controls (HCs) and explore possible underlying mechanisms. Various neuropsychological assessments were performed on all participants. Tract-based spatial statistics (TBSS) was used to compare DTI metrics such as fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD). Correlation analysis was analyzed between DTI metrics and cognitive scales. Compared with the HC group, the AN group performed worse in the neuropsychological evaluations, and TBSS analysis showed widespread alteration of the FA, AD, RD, and MD, which correlated with the cognitive function. These white matter tracts include minor forceps, major forceps, anterior thalamic radiation, superior longitudinal fasciculus, corticospinal tract, and right inferior fronto-occipital fasciculus. Meanwhile, we found for the first time that cognitive decline was related to the decrease of FA in minor forceps, which can be used as a neurobiological marker of cognitive impairment in patients with AN. The occurrence of cognition impairment is common in patients with AN. Including neuropsychological evaluation in the routine clinical assessment and appropriate treatment may strengthen clinical management and improve the quality of life of patients.
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Affiliation(s)
- Xueyun Deng
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Army Medical University, Chongqing, China
- Department of Neurosurgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, China
| | - Lizhen Liu
- Department of Radiology, Southwest Hospital, Third Military Medical University, Army Medical University, Chongqing, China
| | - Jun Luo
- Department of Radiology, Southwest Hospital, Third Military Medical University, Army Medical University, Chongqing, China
| | - Lihua Liu
- Department of Geriatrics, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, China
| | - Xuhui Hui
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
- Xuhui Hui
| | - Hua Feng
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Army Medical University, Chongqing, China
- *Correspondence: Hua Feng
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Bassiouni M, Häußler SM, Gräbel S, Szczepek AJ, Olze H. Lateralization Pattern of the Weber Tuning Fork Test in Longstanding Unilateral Profound Hearing Loss: Implications for Cochlear Implantation. Audiol Res 2022; 12:347-356. [PMID: 35892662 PMCID: PMC9326649 DOI: 10.3390/audiolres12040036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 12/10/2022] Open
Abstract
The Weber tuning fork test is a standard otologic examination tool in patients with unilateral hearing loss. Sound should typically lateralize to the contralateral side in unilateral sensorineural hearing loss. The observation that the Weber test does not lateralize in some patients with longstanding unilateral deafness has been previously described but remains poorly understood. In the present study, we conducted a retrospective analysis of the medical records of patients with unilateral profound hearing loss (single-sided deafness or asymmetric hearing loss) for at least ten years. In this patient cohort, childhood-onset unilateral profound hearing loss was significantly associated with the lack of lateralization of the Weber tuning fork test (Fisher’s exact test, p < 0.05) and the absence of tinnitus in the affected ear (Fisher’s exact test, p < 0.001). The findings may imply a central adaptation process due to chronic unilateral auditory deprivation starting before the critical period of auditory maturation. This notion may partially explain the poor outcome of adult cochlear implantation in longstanding single-sided deafness. The findings may suggest a role for the Weber test as a simple, quick, and economical tool for screening poor cochlear implant candidates, thus potentially supporting the decision-making and counseling of patients with longstanding single-sided deafness.
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Affiliation(s)
- Mohamed Bassiouni
- Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Charitéplatz 1, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.G.); (A.J.S.); (H.O.)
- Correspondence: ; Tel.: +49-30-450-555-072
| | - Sophia Marie Häußler
- Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany;
| | - Stefan Gräbel
- Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Charitéplatz 1, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.G.); (A.J.S.); (H.O.)
| | - Agnieszka J. Szczepek
- Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Charitéplatz 1, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.G.); (A.J.S.); (H.O.)
| | - Heidi Olze
- Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Charitéplatz 1, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.G.); (A.J.S.); (H.O.)
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Neural activity of the auditory cortex predicts speech recognition of patients with asymmetric hearing loss after cochlear implantation. Sci Rep 2022; 12:8068. [PMID: 35577877 PMCID: PMC9110403 DOI: 10.1038/s41598-022-12139-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/05/2022] [Indexed: 11/25/2022] Open
Abstract
Patients with asymmetric hearing loss show an asymmetry of glucose metabolism of the primary auditory cortex (PAC). We investigated whether this asymmetry could serve as an objective predictor for speech recognition with CI. Nine patients underwent 18FDG PET prior to CI surgery. Average normalized 18FDG uptake of 25% of voxels with highest uptake was calculated for the PAC employing a probabilistic atlas and cerebellar cortex as reference. Differences in glucose metabolism of the PAC were assessed by an asymmetry index (AI-PAC). We tested the correlation between outcome of CI surgery (6 months post implantation), AI-PAC and clinical predictors. Pre-operative AI-PAC showed a positive correlation with speech recognition with CI (significant for sentences and numbers; trend for monosyllabic words). With a pre-operative AI-PAC ≥ 4.2%, patients reached good CI outcome in sentence recognition of 59–90% and number recognition of 90–100% and less favorable CI outcome in monosyllabic word recognition of 25–45%. Age at symptom onset was significantly associated with all measures of speech recognition, while deafness duration was only associated with sentence recognition. AI-PAC allows for a reliable and quantitative pre-operative prediction of early improvement in speech recognition after CI. 18FDG PET may be a valuable addition to the objective pre-operative assessment of CI candidates. Further studies in larger cohorts and with longer follow-up times are needed.
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American Cochlear Implant Alliance Task Force Guidelines for Clinical Assessment and Management of Cochlear Implantation in Children With Single-Sided Deafness. Ear Hear 2022; 43:255-267. [PMID: 35213890 PMCID: PMC8862768 DOI: 10.1097/aud.0000000000001204] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Speech Perception Performance Growth and Benchmark Score Achievement After Cochlear Implantation for Single-Sided Deafness. Otol Neurotol 2022; 43:e64-e71. [PMID: 34889843 DOI: 10.1097/mao.0000000000003407] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Compare speech perception performance growth and benchmark score achievement among adult cochlear implant (CI) recipients with single-sided deafness (SSD) versus bilateral moderate to profound hearing loss. STUDY DESIGN Retrospective matched cohort analysis. SETTING Tertiary referral center. PATIENTS Adults with SSD or bilateral moderate to profound hearing sensorineural hearing loss who underwent cochlear implantation from 2014 to 2019. INTERVENTIONS Cochlear implantation. MAIN OUTCOME MEASURES Time-to-benchmark speech perception score (CNC, AzBio in quiet) and speech performance within first postoperative year. RESULTS Thirty-three SSD patients were matched to 66 bilateral hearing loss patients (referent cohort) for duration of deafness and preoperative ipsilateral CNC scores. Although SSD patients were more likely to achieve benchmark CNC scores more quickly compared with matched referents, this difference did not reach statistical significance (HR 1.72; 95% CI 0.78-3.82; p = 0.18). AzBio scores showed similar trends (HR 1.40; 95% CI 0.66-2.98; p = 0.38). At last follow-up, the SSD cohort had lower CNC (median 54% vs. 62%; p = 0.019) and AzBio scores (median 72% vs. 84%; p = 0.029) compared to the referent cohort. CONCLUSIONS No significant difference in speech perception performance growth (i.e., time-to-benchmark speech perception score) was identified between SSD and bilateral hearing loss CI recipients, although patients with bilateral hearing loss achieved higher scores in the implanted ear within the first year of follow-up.
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Impact of Duration of Deafness on Speech Perception in Single-Sided Deafness Cochlear Implantation in Adults. Otol Neurotol 2022; 43:e45-e49. [PMID: 34889841 DOI: 10.1097/mao.0000000000003357] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the impact of prolonged auditory deprivation on speech perception outcomes in adult acquired single-sided deafness (SSD) cochlear implant (CI) recipients. STUDY DESIGN Retrospective case series. SETTING Tertiary care academic center. PATIENTS Acquired SSD in adults with and without prolonged duration of deafness (defined as >10 yr) who underwent CI between 2014 and 2019. INTERVENTIONS CI. MAIN OUTCOME MEASURES Consonant-nucleus-consonant (CNC) and AzBio in quiet scores within first year of follow-up. RESULTS A total of 35 adult patients with SSD were evaluated, with a median overall duration of deafness of 2.4 years (interquartile range [IQR] 1.2-6.0 yr): seven patients with prolonged auditory deprivation (median 18 yr, IQR 15-28) were compared with 28 SSD patients with duration of deafness less than 10 years (median 1.7 yr, IQR 1.1-3.2). At last follow-up, the median CNC scores were 39% (IQR 31-64) and 54% (IQR 46-64) for the prolonged and shorter duration of deafness cohorts, respectively (p = 0.3). The median AzBio scores were 66% (IQR 65-68) and 72% (IQR 60-82) for the prolonged and shorter duration of deafness cohorts, respectively (p = 0.6). In a separate analysis evaluating duration of deafness as a continuous variable across all 35 patients, Spearman correlation coefficients for associations of duration of deafness with most recent CNC and AzBio scores were -0.02 (p = 0.9) and 0.02 (p = 0.9), respectively. CONCLUSIONS Adult CI recipients with acquired SSD, with and without prolonged auditory deprivation, demonstrated comparable speech perception scores. Prolonged duration of deafness alone should not preclude a motivated SSD patient from undergoing cochlear implantation.
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Malhotra PS, Densky J, Melachuri M, Melachuri S, Onwuka A, Winner K, Lucius S, Findlen U. The impact of cochlear implantation on speech and language outcomes in children with asymmetric sensorineural hearing loss. Int J Pediatr Otorhinolaryngol 2022; 152:110979. [PMID: 34844163 DOI: 10.1016/j.ijporl.2021.110979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/27/2021] [Accepted: 11/09/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Cochlear implantation (CI) is considered in children with asymmetric sensorineural hearing loss (ASHL), or severe to profound sensorineural hearing loss in one ear, and better hearing contralaterally. The benefits of a CI in these children are not well established. This study investigated the impact of unilateral CI on speech and language outcomes in pediatric patients with ASHL. METHODS The retrospective chart review identified pediatric patients who underwent cochlear implantation for ASHL at a tertiary single center institution between 2014 and 2017. Children who underwent cochlear implantation in the poorer ear and maintained a hearing aid in the better ear were included, while children with cognitive impairment or prior cochlear nerve deficiency and auditory neuropathy were excluded. Speech and language measures were evaluated prior to implantation and at regular six-month intervals postoperatively. Ear specific Audiometry was evaluated at every visit and varied developmentally appropriate speech recognition tasks, including questionnaires, closed-set, and open-set measures, accounted for advancing childhood milestones. Specific measures of speech articulation, expressive and receptive language, and vocabulary were assessed including: Goldman Fristoe Test of Articulation (GFTA-3), Clinical Evaluation of Language Fundamentals (CELF-P2 or CELF-5), Receptive One-Word Picture Vocabulary Test (ROWPVT) and Expressive One Word Picture Vocabulary Test (EOWPVT). The mean difference and standard deviation of speech and language outcomes at preoperative and postoperative evaluations were calculated. The change in outcomes were further assessed over each post-operative time point. RESULTS Twenty-six children with asymmetric sensorineural hearing loss were included in the analysis, with 11 (42%) having bilateral enlarged vestibular aqueducts (EVA). At time of CI, unaided mean Pure Tone Average (PTA-4) for the better ear was 62Db HL, and worse ear was 92Db HL. There was an improvement in speech recognition in the implanted ear as expected. All preoperative speech and language evaluations were conducted within 7 months of cochlear implantation. Twenty-three patients had at least 1 postoperative re-evaluation. Fourteen children had preoperative and postoperative assessments with the same tool, with 13 patients (93%) showing improvement in at least 1 domain. For patients with repeated assessment within 12 months of surgery, we observed an average improvement in standard scores of: GFTA-3 (+11.2), CELF-P2 Core Language (+10.3), CELF-5 Core Language (+7.0), ROWPVT (+2.8) and EOWPVT (+4.5). Individual results are described. CONCLUSION Improvement in speech and language measures can be demonstrated in children undergoing unilateral cochlear implantation for asymmetric sensorineural hearing losses. These children, who are not typical CI candidates, can benefit from a CI in the poorer ear.
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Affiliation(s)
- Prashant S Malhotra
- Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH, USA.
| | - Jaron Densky
- Department of Otolaryngology - Head & Neck Surgery, Division of Otology & Neurotology, Ohio State University, Columbus, OH, USA.
| | | | | | - Amanda Onwuka
- Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH, USA.
| | - Krista Winner
- Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH, USA.
| | - Shana Lucius
- Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH, USA.
| | - Ursula Findlen
- Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH, USA.
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Kim JH, Shim L, Bahng J, Lee HJ. Proficiency in Using Level Cue for Sound Localization Is Related to the Auditory Cortical Structure in Patients With Single-Sided Deafness. Front Neurosci 2021; 15:749824. [PMID: 34707477 PMCID: PMC8542703 DOI: 10.3389/fnins.2021.749824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Spatial hearing, which largely relies on binaural time/level cues, is a challenge for patients with asymmetric hearing. The degree of the deficit is largely variable, and better sound localization performance is frequently reported. Studies on the compensatory mechanism revealed that monaural level cues and monoaural spectral cues contribute to variable behavior in those patients who lack binaural spatial cues. However, changes in the monaural level cues have not yet been separately investigated. In this study, the use of the level cue in sound localization was measured using stimuli of 1 kHz at a fixed level in patients with single-sided deafness (SSD), the most severe form of asymmetric hearing. The mean absolute error (MAE) was calculated and related to the duration/age onset of SSD. To elucidate the biological correlate of this variable behavior, sound localization ability was compared with the cortical volume of the parcellated auditory cortex. In both SSD patients (n = 26) and normal controls with one ear acutely plugged (n = 23), localization performance was best on the intact ear side; otherwise, there was wide interindividual variability. In the SSD group, the MAE on the intact ear side was worse than that of the acutely plugged controls, and it deteriorated with longer duration/younger age at SSD onset. On the impaired ear side, MAE improved with longer duration/younger age at SSD onset. Performance asymmetry across lateral hemifields decreased in the SSD group, and the maximum decrease was observed with the most extended duration/youngest age at SSD onset. The decreased functional asymmetry in patients with right SSD was related to greater cortical volumes in the right posterior superior temporal gyrus and the left planum temporale, which are typically involved in auditory spatial processing. The study results suggest that structural plasticity in the auditory cortex is related to behavioral changes in sound localization when utilizing monaural level cues in patients with SSD.
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Affiliation(s)
- Ja Hee Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, South Korea.,Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, South Korea
| | - Leeseul Shim
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, South Korea
| | - Junghwa Bahng
- Department of Audiology and Speech-Language Pathology, Hallym University of Graduate Studies, Seoul, South Korea
| | - Hyo-Jeong Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, South Korea.,Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, South Korea
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Vermiglio AJ, Fang X. The World Health Organization (WHO) hearing impairment guidelines and a speech recognition in noise (SRN) disorder. Int J Audiol 2021; 61:818-825. [PMID: 34533433 DOI: 10.1080/14992027.2021.1976424] [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] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The WHO uses the better ear PTA(0.5, 1.0, 2.0, 4.0 kHz) to infer speech recognition in noise (SRN) ability. The purpose of this study was to determine the ability of this measure to detect an SRN disorder. DESIGN The reference standard was the Hearing in Noise Test (HINT). The index test was better ear PTA(0.5, 1.0, 2.0, 4.0 kHz). Diagnostic accuracy was determined with receiver operating characteristic curves and the area under the curve (AUC) for data sets with and without complete audibility of the HINT stimuli. STUDY SAMPLE Data from previously published studies (n = 381) were retrospectively divided into disordered and control groups. RESULTS For the All Data analysis, better ear PTA(0.5, 1.0, 2.0, 4.0 kHz) was a significant predictor of an SRN disorder, however, the AUC was just above chance (AUC = 0.59, p < 0.001). For the Partial Audibility analysis, better ear PTA(0.5, 1.0, 2.0, 4.0 kHz) was a significant predictor of the target disorder (AUC = 0.85, p = 0.001). CONCLUSIONS The utilization of better ear PTA(0.5, 1.0, 2.0, 4.0 kHz) to infer SRN ability is questionable for individuals with complete audibility of the reference test speech and noise stimuli.
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Affiliation(s)
- Andrew J Vermiglio
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Xiangming Fang
- Department of Biostatistics, East Carolina University, Greenville, NC, USA
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Monini S, Filippi C, De Luca A, Salerno G, Barbara M. On the Effect of Bimodal Rehabilitation in Asymmetric Hearing Loss. J Clin Med 2021; 10:jcm10173927. [PMID: 34501373 PMCID: PMC8432242 DOI: 10.3390/jcm10173927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/18/2021] [Accepted: 08/30/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Bone conductive implants (BCI) have been reported to provide greater beneficial effects for the auditory and perceptual functions of the contralateral ear in patients presenting with asymmetric hearing loss (AHL) compared to those with single-sided deafness (SSD). The aim of the study was to assess the effects of wearing a conventional hearing aid in the contralateral ear on BCI in terms of an improved overall auditory performance. METHODS eleven AHL subjects wearing a BCI in their worse hearing ear underwent an auditory evaluation by pure tone and speech audiometry in free field. This study group was obtained by adding to the AHL patients those SSD subjects that, during the follow-up, showed deterioration of the hearing threshold of the contralateral ear, thus presenting with the features of AHL. Four different conditions were tested and compared: unaided, with BCI only, with contralateral hearing aid (CHA) only and with BCI combined with CHA. RESULTS all of the prosthetic conditions caused a significant improvement with respect to the unaided condition. When a CHA was adopted, its combination with the BCI showed significantly better auditory performances than those achieved with the BCI only. CONCLUSIONS the present study suggests the beneficial role of a CHA in BCI-implanted AHL subjects in terms of overall auditory performance.
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Affiliation(s)
- Simonetta Monini
- ENT Unit, NESMOS Department, Sapienza University, 00189 Rome, Italy; (S.M.); (C.F.); (A.D.L.)
| | - Chiara Filippi
- ENT Unit, NESMOS Department, Sapienza University, 00189 Rome, Italy; (S.M.); (C.F.); (A.D.L.)
| | - Alessandra De Luca
- ENT Unit, NESMOS Department, Sapienza University, 00189 Rome, Italy; (S.M.); (C.F.); (A.D.L.)
| | - Gerardo Salerno
- Laboratory Unit, Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Maurizio Barbara
- ENT Unit, NESMOS Department, Sapienza University, 00189 Rome, Italy; (S.M.); (C.F.); (A.D.L.)
- Correspondence: ; Tel.: +39-06-3377-5628
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Müller V, Lang-Roth R. Speech Recognition With Informational and Energetic Maskers in Patients With Single-Sided Deafness After Cochlear Implantation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:3343-3356. [PMID: 34310192 DOI: 10.1044/2021_jslhr-20-00677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose The aim of the study was to assess the susceptibility to energetic and informational masking in patients with single-sided deafness (SSD) with one normal-hearing (NH) ear and a cochlear implant (CI) in the contralateral ear, understand the effect on speech recognition when spatially separating noise and speech maskers, and investigate the influence of the CI in situations with energetic and informational masking. Method Speech recognition was measured in the presence of either a modulated speech-shaped noise or one of two competing speech maskers in 11 SSD-CI listeners. The speech maskers were manipulated with respect to fundamental frequency to consider the effect of different voices. Measurements were conducted in the unaided (NH) and aided (NHCI) conditions. Spatial release from masking (SRM) was calculated for each masker type and both listening conditions (NH and NHCI) by subtracting scores of the colocated target and masker condition (S0N0) from the spatially separated target and masker conditions (S0N≠0). Results Speech recognition was highly variable depending on the type of masker. SRM occurred in the unaided (NH) and aided (NHCI) conditions when the speech masker had the same gender as the target talker. Adding the CI improved speech recognition when this speech masker was ipsilateral to the NH ear. Conclusions The amount of informational masking is substantial in SSD-CI listeners with both colocated and spatially separated target and masker signals. The contribution of SRM to better speech recognition largely depends on the masker and is considerable when no differences in voices between the target and the competing talker occur. There is only a slight improvement in speech recognition by adding the CI.
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Affiliation(s)
- Verena Müller
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Cologne, Germany
| | - Ruth Lang-Roth
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Cologne, Germany
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Abstract
OBJECTIVES Cochlear implants (CIs) restore some spatial advantages for speech understanding in noise to individuals with single-sided deafness (SSD). In addition to a head-shadow advantage when the CI ear has a better signal-to-noise ratio, a CI can also provide a binaural advantage in certain situations, facilitating the perceptual separation of spatially separated concurrent voices. While some bilateral-CI listeners show a similar binaural advantage, bilateral-CI listeners with relatively large asymmetries in monaural speech understanding can instead experience contralateral speech interference. Based on the interference previously observed for asymmetric bilateral-CI listeners, this study tested the hypothesis that in a multiple-talker situation, the acoustic ear would interfere with rather than improve CI speech understanding for SSD-CI listeners. DESIGN Experiment 1 measured CI-ear speech understanding in the presence of competing speech or noise for 13 SSD-CI listeners. Target speech from the closed-set coordinate response-measure corpus was presented to the CI ear along with one same-gender competing talker or stationary noise at target-to-masker ratios between -8 and 20 dB. The acoustic ear was presented with silence (monaural condition) or with a copy of the competing speech or noise (bilateral condition). Experiment 2 tested a subset of 6 listeners in the reverse configuration for which SSD-CI listeners have previously shown a binaural benefit (target and competing speech presented to the acoustic ear; silence or competing speech presented to the CI ear). Experiment 3 examined the possible influence of a methodological difference between experiments 1 and 2: whether the competing talker spoke keywords that were inside or outside the response set. For each experiment, the data were analyzed using repeated-measures logistic regression. For experiment 1, a correlation analysis compared the difference between bilateral and monaural speech-understanding scores to several listener-specific factors: speech understanding in the CI ear, preimplantation duration of deafness, duration of CI experience, ear of deafness (left/right), acoustic-ear audiometric thresholds, and listener age. RESULTS In experiment 1, presenting a copy of the competing speech to the acoustic ear reduced CI speech-understanding scores for target-to-masker ratios ≥4 dB. This interference effect was limited to competing-speech conditions and was not observed for a noise masker. There was dramatic intersubject variability in the magnitude of the interference (range: 1 to 43 rationalized arcsine units), which was found to be significantly correlated with listener age. The interference effect contrasted sharply with the reverse configuration (experiment 2), whereby presenting a copy of the competing speech to the contralateral CI ear significantly improved performance relative to monaural acoustic-ear performance. Keyword condition (experiment 3) did not influence the observed pattern of interference. CONCLUSIONS Most SSD-CI listeners experienced interference when they attended to the CI ear and competing speech was added to the acoustic ear, although there was a large amount of intersubject variability in the magnitude of the effect, with older listeners particularly susceptible to interference. While further research is needed to investigate these effects under free-field listening conditions, these results suggest that for certain spatial configurations in a multiple-talker situation, contralateral speech interference could reduce the benefit that an SSD-CI otherwise provides.
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Sampathkumar R, Kaehne A, Kumar N, Kameswaran M, Irving R. Systematic review of cochlear implantation in adults with asymmetrical hearing loss. Cochlear Implants Int 2021; 22:311-329. [PMID: 34126876 DOI: 10.1080/14670100.2021.1936363] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Rapid advances in cochlear implantation has witnessed an expanding spectrum for candidacy worldwide. This includes a subgroup of adults with asymmetrical hearing loss who have a wide range in their hearing capacity between the two ears. As per guidelines they are not included in mainstream candidacy for CI across the world. Evidence is now emerging to support the benefits of CI in AHL. METHODS This review analyzed literature regarding the outcomes of CI in AHL. Primary outcome measure was to assess audiological benefits and secondary outcome measure was to assess hearing related quality of life. 15 relevant articles, published worldwide between 2009 and 2019 were chosen. CASP checklist for systematic reviews was used to ascertain the quality of literature. The strength of recommendations from each study was analyzed and classified as strong, moderate, weak or none based on GRADE guidelines. RESULTS Heterogeneity in samples was obvious and samples varied largely between the studies. The levels of evidence ranged from systematic review to expert opinion, but overall they reflected positively on both audiological and QOL benefits. CONCLUSION CI provides important auditory and QOL benefits in AHL, but there is no high level evidence as yet to strongly support CI for AHL. A long term multi-centric study is necessary to influence a change in practice for a growing population of AHL.Trial registration: ClinicalTrials.gov identifier: NCT03052920.
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Affiliation(s)
| | - Axel Kaehne
- Health Services Research, Edge Hill University, Lancashire, UK
| | - Nirmal Kumar
- ENT-H&N Surgery, Edge Hill University, Lancashire, UK
| | | | - Richard Irving
- ENT-H&N Surgery Department, Queen Elizabeth University Hospitals, Birmingham, UK
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Lee SY, Choe G, Lee SY, Kim NJ, Carandang M, Oh SH, Lee JH, Choi BY. Outcome of cochlear implantation in the worse ear of post-lingual asymmetric hearing loss: elucidation of prognostic markers. Acta Otolaryngol 2021; 141:495-501. [PMID: 33586571 DOI: 10.1080/00016489.2021.1880632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Specific correlations between the outcomes of cochlear implantation (CI) and hearing thresholds of the both ears in post-lingual asymmetric hearing loss (AHL) patients were not clear. AIMS/OBJECTIVES To identify the variables influencing the outcome of CI in post-lingual AHL patients. METHOD We included 18 adult subjects who had CI in the worse ear due to post-lingual AHL with average hearing asymmetry of 36 dB. Speech perception scores were evaluated in the sound field with hearing aid on the better ear before CI, and with the cochlear implant in the worse ear at 3, 6, and 12 months after CI switch-on. RESULTS Average increases in phonetically balanced word score, spondee word score, and everyday sentence score at 12 months from CI switch-on compared with those before CI were 38.9%p, 46.2%p, and 52.4%p, respectively. Multiple linear regression analysis showed that speech perception scores were negatively influenced by age at implantation and hearing threshold difference of both ears (HTD-Both) itself, rather than the worse or better ear hearing thresholds. CONCLUSIONS AND SIGNIFICANCE Post-lingual AHL subjects with high average hearing asymmetry can benefit from CI in the worse ear, while CI outcomes can be adversely influenced by HTD-Both and age at implantation both in the short- and long-term follow-up.
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Affiliation(s)
- Sang-Youp Lee
- Department of Otolaryngology, Wonkwang University School of Medicine, Wonkwang University Hospital, Iksan, Republic of Korea
| | - Goun Choe
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Namju Justin Kim
- Department of Biological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Marge Carandang
- Department of Otorhinolaryngology-Head and Neck Surgery, Quezon City, Philippines
| | - Seung Ha Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jun Ho Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Byung Yoon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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Marx M, Mosnier I, Venail F, Mondain M, Uziel A, Bakhos D, Lescanne E, N'Guyen Y, Bernardeschi D, Sterkers O, Deguine O, Lepage B, Godey B, Schmerber S, Bonne NX, Vincent C, Fraysse B. Cochlear Implantation and Other Treatments in Single-Sided Deafness and Asymmetric Hearing Loss: Results of a National Multicenter Study Including a Randomized Controlled Trial. Audiol Neurootol 2021; 26:414-424. [PMID: 33789270 DOI: 10.1159/000514085] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 12/28/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Cochlear implantation is a recent approach proposed to treat single-sided deafness (SSD) and asymmetric hearing loss (AHL). Several cohort studies showed its effectiveness on tinnitus and variable results on binaural hearing. The main objective of this study is to assess the outcomes of cochlear implantation and other treatment options in SSD/AHL on quality of life. METHODS This prospective multicenter study was conducted in 7 tertiary university hospitals and included an observational cohort study of SSD/AHL adult patients treated using contralateral routing of the signal (CROS) hearing aids or bone-anchored hearing systems (BAHSs) or who declined all treatments, and a randomized controlled trial in subjects treated by cochlear implantation, after failure of CROS and BAHS trials. In total, 155 subjects with SSD or AHL, with or without associated tinnitus, were enrolled. After 2 consecutive trials with CROS hearing aids and BAHSs on headband, all subjects chose any of the 4 treatment options (abstention, CROS, BAHS, or cochlear implant [CI]). The subjects who opted for a CI were randomized between 2 arms (CI vs. initial observation). Six months after the treatment choice, quality of life was assessed using both generic (EuroQoL-5D, EQ-5D) and auditory-specific quality-of-life indices (Nijmegen Cochlear implant Questionnaire [NCIQ] and Visual Analogue Scale [VAS] for tinnitus severity). Performances for speech-in-noise recognition and localization were measured as secondary outcomes. RESULTS CROS was chosen by 75 subjects, while 51 opted for cochlear implantation, 18 for BAHSs, and 11 for abstention. Six months after treatment, both EQ-5D VAS and auditory-specific quality-of-life indices were significantly better in the "CI" arm versus "observation" arm. The mean effect of the CI was particularly significant in subjects with associated severe tinnitus (mean improvement of 20.7 points ± 19.7 on EQ-5D VAS, 20.4 ± 12.4 on NCIQ, and 51.4 ± 35.4 on tinnitus). No significant effect of the CI was found on binaural hearing results. Before/after comparisons showed that the CROS and BAHS also improved significantly NCIQ scores (for CROS: +7.7, 95% confidence interval [95% CI] = [4.5; 10.8]; for the BAHS: +14.3, 95% CI = [7.9; 20.7]). CONCLUSION Cochlear implantation leads to significant improvements in quality of life in SSD and AHL patients, particularly in subjects with associated severe tinnitus, who are thereby the best candidates to an extension of CI indications.
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Affiliation(s)
- Mathieu Marx
- Service d'Otologie, Otoneurologie et ORL pédiatrique, Hôpital Pierre-Paul Riquet, CHU Purpan, Toulouse, France.,Brain & Cognition Research Centre, UMR 5549, Université Toulouse III, Toulouse, France
| | - Isabelle Mosnier
- AP-HP6, GHU Pitié-Salpêtrière, Service ORL, Unité Fonctionnelle Implants Auditifs et explorations fonctionnelles, Paris, France
| | - Frederic Venail
- Service d'ORL, Hôpital Gui de Chauliac, CHU, Montpellier, France
| | - Michel Mondain
- Service d'ORL, Hôpital Gui de Chauliac, CHU, Montpellier, France
| | - Alain Uziel
- Service d'ORL, Hôpital Gui de Chauliac, CHU, Montpellier, France
| | - David Bakhos
- Service d'ORL, Hôpital Bretonneau, CHU Tours, Tours, France
| | | | - Yann N'Guyen
- AP-HP6, GHU Pitié-Salpêtrière, Service ORL, Unité Fonctionnelle Implants Auditifs et explorations fonctionnelles, Paris, France
| | - Daniele Bernardeschi
- AP-HP6, GHU Pitié-Salpêtrière, Service ORL, Unité Fonctionnelle Implants Auditifs et explorations fonctionnelles, Paris, France
| | - Olivier Sterkers
- AP-HP6, GHU Pitié-Salpêtrière, Service ORL, Unité Fonctionnelle Implants Auditifs et explorations fonctionnelles, Paris, France
| | - Olivier Deguine
- Service d'Otologie, Otoneurologie et ORL pédiatrique, Hôpital Pierre-Paul Riquet, CHU Purpan, Toulouse, France.,Brain & Cognition Research Centre, UMR 5549, Université Toulouse III, Toulouse, France
| | - Benoît Lepage
- Unité de Soutien Méthodologique à la Recherche, Faculté de Médecine, Université de Toulouse, Toulouse, France
| | - Benoit Godey
- Service d'ORL, Hôpital Pontchaillou, CHU, Rennes, France
| | | | - Nicolas-Xavier Bonne
- Université Lille, Inserm, CHU Lille, Service d'ORL, U1192 - PRISM, Lille, France
| | | | - Bernard Fraysse
- Service d'Otologie, Otoneurologie et ORL pédiatrique, Hôpital Pierre-Paul Riquet, CHU Purpan, Toulouse, France
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Kil HK, Kim KW, Lee DH, Lee SM, Lee CH, Kim SY. Changes in the Gene Expression Profiles of the Inferior Colliculus Following Unilateral Cochlear Ablation in Adult Rats. Biochem Genet 2021; 59:731-750. [PMID: 33515340 DOI: 10.1007/s10528-021-10034-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
This study aimed to explore gene expression changes in the inferior colliculus (IC) after single-sided deafness (SSD). Forty 8-week-old female Sprague-Dawley rats were used. Twenty rats underwent right-side cochlear ablation, and IC tissues were harvested after 2 weeks (SSD 2-week group). Twenty rats underwent a sham operation and were sacrificed after 2 weeks (control group). Both sides of the IC were analyzed using a gene expression array. Pathway analyses were performed on genes that were differentially expressed compared with their levels in the control group. The expression levels of genes involved in the candidate pathways were confirmed using reverse transcription polymerase chain reaction (RT-PCR). Among the genes with ≥ 1.5-fold changes in expression levels and P < 0.05, there were 7 and 9 genes with increased and decreased expression, respectively, in the ipsilateral IC and 10 and 12 genes with increased and decreased expression, respectively, in the contralateral IC. The pathway analysis did not identify significantly related pathway. In the bilateral analysis, a total of 14 genes were ≥ 1.3-fold downregulated in both the ipsilateral and contralateral IC in the SSD 2-week group compared with their expression in the control group. Pathway analyses of these 14 genes included 7 genes, namely, amine compound solute carrier (Slc)5a7; Slc18a3; Slc6a5; synaptic vesicle glycoprotein 2C (Sv2c); S100 calcium binding protein A10 (S100a10); a gene with sequence similarity to family 111, member A (Fam111a); and peripherin (Prph), that were related to the acetylcholine neurotransmitter release cycle, SLC transporters, and the neurotransmitter release cycle pathways. RT-PCR showed reduced expression of Slc5a7, Sv2c, and Prph in the contralateral IC and Slc18a3 and Slc6a5 in the ipsilateral IC of the SSD 2-week group compared with that in the control group.
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Affiliation(s)
- Hog Kwon Kil
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA University College of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam, Gyeonggi-do, 13496, Korea
| | - Kyung Woon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA University College of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam, Gyeonggi-do, 13496, Korea
| | - Da-Hye Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA University College of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam, Gyeonggi-do, 13496, Korea
| | - So Min Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA University College of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam, Gyeonggi-do, 13496, Korea
| | - Chang Ho Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA University College of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam, Gyeonggi-do, 13496, Korea
| | - So Young Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA University College of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam, Gyeonggi-do, 13496, Korea.
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Speck I, Ketterer MC, Arndt S, Aschendorff A, Jakob TF, Hassepass F. Comparison of Speech Recognition and Localization Ability in Single-sided Deaf Patients Implanted With Different Cochlear Implant Electrode Array Designs. Otol Neurotol 2021; 42:e22-e32. [PMID: 33026780 DOI: 10.1097/mao.0000000000002864] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Choice of electrode array (EA) design and differences in outcome are major concerns both to patients with single-sided deafness (SSD) and to surgeons before cochlear implant (CI) surgery. The present work investigates the effects of EA design on 1) insertion depths, and 2) audiological outcomes of SSD CI recipients. STUDY DESIGN Retrospective study. SETTING Tertiary academic center. PATIENTS Forty patients with acquired SSD matched according to duration of deafness MAIN OUTCOME MEASURES:: Fourteen CI recipients were implanted with a perimodiolar electrode (cochlear perimodiolar [CPM]), 12 with a shorter lateral wall electrode (cochlear lateral wall [CLW]), and 14 with a longer lateral wall electrode array (medEl lateral wall [MLW]). Postoperative rotational tomography was evaluated to determine cochlear size and EA angle of insertion depth (AID). Binaural speech comprehension in noise (in three configuration presentations) and localization ability were assessed 12 months postoperatively with CI. RESULTS AID was significantly deeper in MLW (mean 527.94 degrees) compared with the CPM (mean 366.35 degrees) and CLW groups (mean 367.01 degrees). No significant difference in AID was seen between the CPM and CLW groups (difference 0.66 degrees). Cochlear sizes revealed no significant differences between any groups. All three groups showed significant improvement in head shadow effect (difference on average CPM: 6.3 dB SPL, CLW 5 dB SPL, and MLW 4.05 dB SPL) and localization ability at 12 months postoperatively (difference on average CPM: 19.72 degrees, CLW: 24 degrees, and MLW: 12.9 degrees). No significant difference in the extent of audiological benefit was observed between any groups. CONCLUSION No effect on binaural benefit was apparent from the selection of the three EA designs in SSD CI recipients. Further studies focusing on subjective results, sound quality, and music perception depending on EA design in SSD CI recipients are needed.
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Affiliation(s)
- Iva Speck
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Liu J, Zhou M, He X, Wang N. Single-sided deafness and unilateral auditory deprivation in children: current challenge of improving sound localization ability. J Int Med Res 2020; 48:300060519896912. [PMID: 31948312 PMCID: PMC7113713 DOI: 10.1177/0300060519896912] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Interaural time difference and interaural level difference signals are insufficient in patients with single-sided deafness (SSD). This insufficiency leads to an absence of sound localization abilities and a decrease in speech intelligibility in noisy environments. SSD occurring in children further affects their language learning and cognitive abilities and their academic performance because they lack spatial abilities and binaural hearing. The early stages of central auditory system development are critical for auditory function development and morphological refinement. SSD occurring in the critical period can cause significant lateralization in the bilateral auditory pathway. This may increase the risk that affected individuals cannot re-establish binaural benefits after rehabilitation of hearing loss in the post-sensitive period. For otorhinolaryngologists, there is the concern that children with congenital SSD cannot benefit from cochlear implantation. Only a few studies have investigated auditory rehabilitation in children with congenital SSD with cochlear implantation and their results were inconsistent. The present review aims to clarify the main problems and challenges of clinical rehabilitation of congenital SSD, particularly focusing on the effect of CI on sound localization ability in children with congenital SSD.
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Affiliation(s)
- Jinfeng Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, PR China
| | - Mo Zhou
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, PR China
| | - Xiaolin He
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, PR China
| | - Ningyu Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, PR China
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Marx M, Mosnier I, Vincent C, Bonne NX, Bakhos D, Lescanne E, Flament J, Bernardeschi D, Sterkers O, Fraysse B, Lepage B, Godey B, Schmerber S, Uziel A, Mondain M, Venail F, Deguine O. Treatment choice in single-sided deafness and asymmetric hearing loss. A prospective, multicentre cohort study on 155 patients. Clin Otolaryngol 2020; 46:736-743. [PMID: 33236413 DOI: 10.1111/coa.13672] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 10/29/2020] [Accepted: 11/08/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To describe the treatment choice in a cohort of subjects with single-sided deafness (SSD) and asymmetric hearing loss (AHL). To assess the reliability of the treatment trials. DESIGN In this national, multicentre, prospective study, the choice of subjects was made after two consecutive trials of Contralateral Routing Of the Signal (CROS) hearing aids and a Bone Conduction Device (BCD) on a headband. Subjects could proceed with one of these two options, opt for cochlear implantation or decline all treatments. SETTING Seven tertiary university hospitals. PARTICIPANTS One hundred fifty-five subjects with SSD or AHL fulfilling the candidacy criteria for cochlear implantation, with or without associated tinnitus. MAIN OUTCOME MEASURES After the two trials, the number of subjects choosing each option was described. Repeated assessments of both generic and auditory-specific quality of life were conducted, as well as hearing assessments (speech recognition in noise and horizontal localization). RESULTS CROS was chosen by 75 subjects, followed by cochlear implantation (n = 51), BCD (n = 18) and abstention (n = 11). Patients who opted for cochlear implantation had a poorer quality of life (P = .03). The improvement of quality of life indices after each trial was significantly associated with the final treatment choice (P = .008 for generic indices, P = .002 for auditory-specific indices). The follow-up showed that this improvement had been overestimated in the CROS group, with a long-term retention rate of 52.5%. CONCLUSIONS More than one third of SSD/AHL subjects are unsatisfied after CROS and BCD trials. Repeated quality of life assessments help counselling the patient for his/her treatment choice.
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Affiliation(s)
- Mathieu Marx
- Service d'Otologie, Otoneurologie et ORL Pédiatrique, Hôpital Pierre-Paul Riquet, CHU Toulouse Purpan, France.,Brain & Cognition Research Centre, UMR 5549, Université Toulouse III, France
| | - Isabelle Mosnier
- AP-HP, GHU Pitié-Salpêtrière, Service ORL, Otologie, Implants Auditifs et Chirurgie de la Base du Crâne, Paris, France
| | | | | | - David Bakhos
- Service d'ORL, Hôpital Bretonneau, CHU Tours, Tours, France
| | | | - Jonathan Flament
- AP-HP, GHU Pitié-Salpêtrière, Service ORL, Otologie, Implants Auditifs et Chirurgie de la Base du Crâne, Paris, France.,Laboratoire Audika, Paris, France
| | - Daniele Bernardeschi
- AP-HP, GHU Pitié-Salpêtrière, Service ORL, Otologie, Implants Auditifs et Chirurgie de la Base du Crâne, Paris, France
| | - Olivier Sterkers
- AP-HP, GHU Pitié-Salpêtrière, Service ORL, Otologie, Implants Auditifs et Chirurgie de la Base du Crâne, Paris, France
| | - Bernard Fraysse
- Service d'Otologie, Otoneurologie et ORL Pédiatrique, Hôpital Pierre-Paul Riquet, CHU Toulouse Purpan, France
| | - Benoit Lepage
- Unité de Soutien Méthodologique à la Recherche, Faculté de Médecine, Université de Toulouse, Toulouse, France
| | - Benoit Godey
- Service d'ORL, Hôpital Pontchaillou, CHU Rennes, Rennes, France
| | | | - Alain Uziel
- Service d'ORL, Hôpital Gui de Chauliac, CHU Montpellier, Montpellier, France
| | - Michel Mondain
- Service d'ORL, Hôpital Gui de Chauliac, CHU Montpellier, Montpellier, France
| | - Frédéric Venail
- Service d'ORL, Hôpital Gui de Chauliac, CHU Montpellier, Montpellier, France
| | - Olivier Deguine
- Service d'Otologie, Otoneurologie et ORL Pédiatrique, Hôpital Pierre-Paul Riquet, CHU Toulouse Purpan, France.,Brain & Cognition Research Centre, UMR 5549, Université Toulouse III, France
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Legris E, Henriques J, Aussedat C, Aoustin JM, Robier M, Bakhos D. Emotional prosody perception in presbycusis patients after auditory rehabilitation. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:163-168. [PMID: 33162354 DOI: 10.1016/j.anorl.2020.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Perception of emotion plays a major role in social interaction. Studies have shown that hearing loss and aging degrade emotional recognition. The main aim of the present study was to evaluate the benefit of first-time hearing aids (HA) for emotional prosody perception in presbycusis patients. Secondary objectives comprised comparison with normal-hearing subjects, and assessment of the impact of demographic and audiologic factors. METHODS To assess HA impact, 29 subjects with presbycusis were included. They were tested without HA and 1 month after starting to use HA. A test with emotional hearing stimuli (Montreal Affective Voice test: MAV) was performed at various intensities (50, 65 and 80dB SPL). Patients' experience was evaluated on the Profile of Emotional Competence questionnaire, before and after HA fitting. Results were compared with those of 29 normal-hearing subjects. RESULTS Auditory rehabilitation did not significantly improve MAV results (P>0.005), or subjective questionnaire results (P>0.005). Scores remained lower than those of normal-hearing subjects (P<0.001). MAV results, before and after HA, showed significant correlation with pure-tone average (r=-0.88, P<0.001) and age (r=0.44, P=0.018). The older the presbycusis patient and the more severe the hearing loss, the greater the difficulty in recognising emotional prosody. CONCLUSION Despite hearing rehabilitation, presbycusis patients' results remained poorer than in normal-hearing subjects.
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Affiliation(s)
- E Legris
- Ear, nose and throat department, CHRU de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
| | | | - C Aussedat
- Ear, nose and throat department, CHRU de Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - J-M Aoustin
- Ear, nose and throat department, CHRU de Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - M Robier
- Ear, nose and throat department, CHRU de Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - D Bakhos
- Ear, nose and throat department, CHRU de Tours, 2, boulevard Tonnellé, 37000 Tours, France; Université François-Rabelais de Tours, UMR-S1253, Tours, France; INSERM U1253, iBrain, équipe 3, Tours, France
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Is the cochlear implant a successful long-term solution for single-sided deaf and asymmetric hearing-impaired patients? Eur Arch Otorhinolaryngol 2020; 278:3257-3265. [PMID: 33067677 PMCID: PMC8328895 DOI: 10.1007/s00405-020-06411-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/28/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE We investigated the long-term results of cochlear implant (CI) recipients with asymmetric hearing loss (AHL) or single-sided deafness (SSD). We focused on wearing behavior, audiometric hearing rehabilitation, and subjective benefits of the CI. CI is expected to improve audiological results, subjective hearing perception, and tinnitus burden. METHODS Speech recognition in background noise and sound localization were assessed preoperatively and after at least six years of CI experience. Validated questionnaires determined the subjective benefit of CI use and the subjective evaluation of tinnitus. RESULTS Over 80% of the included AHL and SSD CI recipients used their CI between 6 and 10 h daily; four subjects with SSD were non-users. Speech recognition in background noise and sound localization improved significantly compared with the unaided preoperative situation. Additionally, CI improved subjective speech intelligibility and spatial hearing impression while reducing tinnitus burden. CONCLUSION Subjects with AHL and SSD benefit from CI, subjectively and audiologically. Cochlear implant is a successful long-term treatment for AHL and SSD.
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Effects of SoundBite Bone Conduction Hearing Aids on Speech Recognition and Quality of Life in Patients with Single-Sided Deafness. Neural Plast 2020; 2020:4106949. [PMID: 32963516 PMCID: PMC7495220 DOI: 10.1155/2020/4106949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 08/05/2020] [Accepted: 08/18/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives To analyze the clinical application of SoundBite bone conduction hearing aids by assessing the improvement of speech recognition and the scores of the benefit scale questionnaire for patients with single-sided deafness (SSD). Design Nine patients aged 24 to 61 years with SSD for more than 3 months were enrolled in this study. The patients could understand and repeat Mandarin and have good compliance with the study. The measurements were evaluated before and after one month of wearing hearing aids using the pure tone audiometry threshold, speech recognition in quiet and in noise, and the Glasgow Benefit Inventory (GBI) benefit scale score. Results Pure tone audiometry results showed that the average hearing threshold of good ears and bad ears was 11.4 ± 2.6 dB HL and 89.9 ± 6.4 dB HL, respectively. The average hearing threshold of bad ears after wearing hearing aids was 23.5 ± 9.0 dB HL. Statistical analysis showed that the hearing improvement for the bad ears after wearing hearing aids was significant. The speech audiometry results showed that the disyllable word recognition score of the bad ears in quiet increased significantly at 50 dB SPL by 40 ± 12 percentage points and at 65 dB SPL by 71 ± 15 percentage points. As for the speech recognition in noise, when the signal sound came from the bad ear side and the noise from the good ear side (SSSDNAH), the speech recognition score (SRS) significantly increased by 17 ± 6 and 9 ± 4 at a signal-to-noise ratio (SNR) of -2 dB and -5 dB, respectively, after wearing the hearing aids. When the signal sound came from the front of the patient and the noise from the bad ear side (S0NSSD), the SRS scores were reduced by 5 ± 5 and 7 ± 5 percentage points at SNR equal to -2 dB and -5 dB, which was significantly different from that before wearing the hearing aids. When the signal and noise both came from the front of the patients (S0N0), the SRS was not significantly increased by 5 ± 4 percentage points at SNR equal to -2 dB compared to before wearing hearing aids. However, the SRS was significantly increased by 5 ± 2 percentage points at SNR equal to -5 dB compared to before wearing hearing aids. The average total GBI score was 31 ± 12 for the nine patients, with an average score of 32 ± 10, 31 ± 8, and 30 ± 7 for general conditions, social support, and physical health, respectively. The results of the questionnaires showed that patients' quality of life was improved after wearing SoundBite bone conduction hearing aids. Conclusions SoundBite bone conduction hearing aids are a good choice for patients with SSD, as it could improve the speech recognition ability of patients both in a quiet and noisy environment and improves the quality of life after wearing hearing aids.
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Monini S, Battilocchi L, Salerno G, Filippi C, Barbara M. Bone conductive implantation in asymmetric hearing loss (AHL). Acta Otolaryngol 2020; 140:651-658. [PMID: 32329667 DOI: 10.1080/00016489.2020.1752396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Bone conductive implants (BCI) represent one possible solution for rehabilitation of single-sided deafness (SSD).Aims: The aim of the present study was to verify the efficacy of bone conduction implantation in subjects with unilateral severe-to-profound hearing loss and contralaterally impaired hearing, that is, asymmetric hearing loss (AHL), and to compare it with known BCI indications for SSD.Material and methods: Twenty-one subjects received BCI for either SSD or AHL. All of the subjects underwent a battery of audiological and subjective tests, Data were collected and statistically evaluated within and between the SSD group and the AHL group.Results: A PTA threshold gain was observed in AHL patients along with improved values in speech audiometry in quiet and noise. The two visual analogue scale evaluations (QoL and QoS) and the GBI showed significantly better scores in AHL patients compared to SSD patients.Conclusions: BCI provided improvement for auditory or speech recognition in AHL subjects, as compare to SSD. From these findings, it is possible to predict a positive role of BCI for some audiological aspects of AHL subjects that are generally not present or not detectable in SSD cases.
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Affiliation(s)
- Simonetta Monini
- NESMOS Department, ENT Clinic, Medicine and Psychology, Sapienza University, Rome, Italy
| | - Ludovica Battilocchi
- NESMOS Department, ENT Clinic, Medicine and Psychology, Sapienza University, Rome, Italy
| | - Gerardo Salerno
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Chiara Filippi
- NESMOS Department, ENT Clinic, Medicine and Psychology, Sapienza University, Rome, Italy
| | - Maurizio Barbara
- NESMOS Department, ENT Clinic, Medicine and Psychology, Sapienza University, Rome, Italy
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Calvino M, Sánchez-Cuadrado I, Gavilán J, Lassaletta L. Does bimodal hearing increase self-assessed abilities and hearing outcomes when compared to unilateral cochlear implantation? Int J Audiol 2020; 59:654-660. [PMID: 32174222 DOI: 10.1080/14992027.2020.1735653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: The primary objective of this study was to compare the applicability and benefit of providing unilateral cochlear implant (CI) users with a contralateral hearing aid (HA).Design: This retrospective (case-control) study was conducted in a hospital-based CI centre. Participants self-assessed their hearing via two questionnaires (SSQ12 and HISQUI19). Objective postoperative speech perception was assessed via aided thresholds and speech perception tests (monosyllabic words, disyllabic words, and sentences) in quiet and noise.Study sample: A CI-only group (n = 113, mean age 55.1 ± 14.2 years) and a bimodal group (n = 50, mean age 56.7 ± 15.2) participated in the study.Results: No significant difference in SSQ12 or HISQUI19 scores was observed between groups. The bimodal group had a significantly better aided hearing level (p = 0.020) and speech discrimination score (p = 0.019).Conclusions: Bimodal (CI + HA) users have significantly better speech understanding than unilateral CI-only users, although this benefit may not be reflected in self-assessed outcomes. Counselling about bimodal hearing must cover expectations about potential benefits.
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Affiliation(s)
- Miryam Calvino
- Department of Otolaryngology, "La Paz" University Hospital. IdiPAZ Research Institute, Madrid, Spain.,Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, (CIBERER-U761), Madrid, Spain
| | - Isabel Sánchez-Cuadrado
- Department of Otolaryngology, "La Paz" University Hospital. IdiPAZ Research Institute, Madrid, Spain
| | - Javier Gavilán
- Department of Otolaryngology, "La Paz" University Hospital. IdiPAZ Research Institute, Madrid, Spain
| | - Luis Lassaletta
- Department of Otolaryngology, "La Paz" University Hospital. IdiPAZ Research Institute, Madrid, Spain.,Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, (CIBERER-U761), Madrid, Spain
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Impact of Underlying Diagnosis on Speech and Quality of Life Outcomes After Cochlear Implantation for Single-Sided Deafness. Otol Neurotol 2020; 41:e432-e440. [PMID: 32176127 DOI: 10.1097/mao.0000000000002578] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Our objective was to compare outcomes in speech and quality of life in those undergoing cochlear implantation for single-sided deafness (SSD), with the aim to characterize the clinical impact of underlying diagnosis in the affected ear and pre-operative hearing status. STUDY DESIGN Prospective case series. SETTING Academic Cochlear Implant Center. PATIENTS 42 adult patients implanted with the diagnosis of SSD. INTERVENTIONS Patients were evaluated at 3-, 6-, and 12-months post-operatively using AZBio sentence and speech, and consonant-nucleus-consonant (CNC) depending on appropriate testing level. Our previously validated Comprehensive Cochlear Implant Quality of Life (CCIQ) questionnaire was administered. MAIN OUTCOME MEASURES Speech perception, quality of life. RESULTS Subjects were stratified by the underlying diagnosis: Meniere's Disease (MD; n = 10), sudden sensorineural hearing loss (SSNHL; n = 13), and Other (eg TBI, acoustic neuroma, progressive, noise-induced; n = 19). Mean preoperative PTA of the implanted ear was 82dB ± 17; that of the nonimplanted ear was 32dB ± 17. SSNHL and MD demonstrated the highest speech perception score at 3 months (93 and 95%), and "Other" demonstrated the lowest scores at 88%. All 3 groups demonstrated nadir in speech scores at 6 months before improving at 12 months, but the "Other" diagnoses maintained the lowest speech testing across all time points. All 3 groups reported improved quality of life on CCIQ. CONCLUSIONS Subjects with SSNHL and MD demonstrate excellent speech perception and quality of life outcomes after cochlear implantation for SSD. Subjects with "Other" diagnoses underlying their SSD demonstrated lower scores on speech testing but nonetheless reported improved quality of life.
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Evaluating the Decision for Cochlear Implantation in Individuals With Single-Sided Deafness (SSD); Implementing the SSD Consensus Protocol Into Clinical Routine. Otol Neurotol 2020; 41:727-735. [DOI: 10.1097/mao.0000000000002618] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Binaural Hearing Rehabilitation Improves Speech Perception, Quality of Life, Tinnitus Distress, and Psychological Comorbidities. Otol Neurotol 2020; 41:e563-e574. [DOI: 10.1097/mao.0000000000002590] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wyss J, Mecklenburg DJ, Graham PL. Self-assessment of daily hearing function for implant recipients: A comparison of mean total scores for the Speech Spatial Qualities of Hearing Scale (SSQ49) with the SSQ12. Cochlear Implants Int 2019; 21:167-178. [PMID: 31887255 DOI: 10.1080/14670100.2019.1707993] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess the relationship and agreement between mean total scores for the Speech Spatial Qualities of Hearing Scale (SSQ49) and the shorter SSQ12 to measure daily hearing function for a large group of auditory implant recipients. METHODS Prospective, longitudinal self-assessment by 1013 implant recipients using the SSQ49 at preimplant and at annual post-implant intervals (one, two and three-years) via an international registry. Mean total scores were calculated for the SSQ49 and the extracted SSQ12 responses. Pearson correlation and Bland-Altman agreement were examined between the SSQ49, SSQ12 and transformed SSQ12 versions. Longitudinal mixed-effects models were used to compare changes over time. RESULTS Very high correlation was shown between mean total scores for all versions while perfect agreement was not reached. Clinically acceptable agreement (<1.0 unit) between all versions was obtained with the transformed SSQ12 being least biased. All versions showed statistically significant improvement at one-year post-implant (>2.2 units; p < 0.001). CONCLUSIONS All scale-versions showed comparable sensitivity to changes in self-reported hearing function over time. TheSSQ12 may be considered as a potential time-efficient self-assessment of hearing function for implant recipients in routine practice. Further research may involve independent repeated administration of each scale version.
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Affiliation(s)
| | | | - Petra L Graham
- Department of Economics, GenIMPACT, Macquarie University, North Ryde, Australia
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Seong J, Yang SK, Jang P, Lee SY, Carandang M, Choi BY. Clinical Factors Influencing the Trial and Purchase of Bilateral Microphones with Contralateral Routing of Signal in Patients with Asymmetric Sensorineural Hearing Loss. J Audiol Otol 2019; 24:29-34. [PMID: 31852175 PMCID: PMC6949478 DOI: 10.7874/jao.2019.00409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 11/11/2019] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives Bilateral microphones with contralateral routing of signal (BiCROS) hearing aid is an option for hearing rehabilitation in individuals with asymmetric sensorineural hearing loss (ASNHL). The clinical factors influencing the trial and purchase of BiCROS were investigated. Subjects and Methods We reviewed the medical records of 78 patients with ASNHL who were recommended to use BiCROS and analyzed the demographic and audiological factors influencing the trial and purchase of BiCROS. Results Among the 78 patients, 52 (66.7%) availed of the free BiCROS trial and 21 (26.9%) purchased BiCROS. The mean pure tone audiometry (PTA) air conduction (AC) threshold of the better- and worse-hearing ears were 44.2±12.8 dB and 90.7±22.5 dB HL, respectively. The decision for trial or purchase of BiCROS was not influenced by age, sex, duration of hearing loss of the worse-hearing ear, or PTA AC threshold or speech discrimination score of both ears. The first and third quartiles of the PTA AC thresholds for the better-hearing ear of BiCROS buyers were 38.75 dB and 53.75 dB HL, respectively. The counterpart values for the worse-hearing ear were 72.50 dB and 118.75 dB HL, respectively. Conclusions The clinical factors analyzed in this study were found to be irrelevant to the trial and purchase of BiCROS in patients with ASNHL. Nevertheless, the distribution range of the auditory thresholds of the subjects using BiCROS can be a useful basis for the counseling of patients with ASNHL and selection of candidates for BiCROS use.
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Affiliation(s)
- Jeon Seong
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Seung Koo Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Pilkeun Jang
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Marge Carandang
- Department of Otorhinolaryngology-Head and Neck Surgery, East Avenue Medical Center, Metro Manila, Philippines
| | - Byung-Yoon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Kurz A, Grubenbecher M, Rak K, Hagen R, Kühn H. The impact of etiology and duration of deafness on speech perception outcomes in SSD patients. Eur Arch Otorhinolaryngol 2019; 276:3317-3325. [PMID: 31535291 DOI: 10.1007/s00405-019-05644-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/10/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate a cohort of adult single-sided deafness (SSD) patients who received a cochlear implant and to determine the impact of underlying causes of etiology and duration of deafness on outcome STUDY DESIGN: Retrospective data analysis SETTING: Tertiary referral centre with a large cochlear implant program SUBJECTS AND METHODS: A demographic description of 55 adult patients implanted between 2009 and 2016. The best available speech perception score in every patient using the Freiburg Numbers, Freiburg Monosyllables and the Hochmair-Schulz-Moser (HSM) sentence test measured at the 1-, 3-, 6- and 12-month intervals, and the yearly follow-up appointments were examined. A multivariate regression analysis was conducted on the variables speech test, duration of deafness and etiology. Patients were split into four groups according to their duration of deafness (shorter duration of 10 years or less versus longer duration of more than 10 years) and etiology (inflammatory disease versus other causes). RESULTS The median word reception score for the Monosyllables at 65 dB SPL were 43.75% (IQR: 29.38) and 67.50% (IQR: 25.63) at 80 dB SPL at 1 year following cochlear implantation. The median percentage score correct for the HSM sentence test was 80% (IQR: 62.95). Etiology of the reviewed patient cohort revealed that most frequent causes for deafness were sudden hearing losses and inflammatory etiologies, e.g. otitis media, labyrinthitis, meningitis, cholesteatoma or mumps. The duration of deafness was not significantly associated with poor speech perception outcome. A significant correlation was found for inflammatory diseases and duration of deafness of longer than 10 years. CONCLUSION The etiology and duration of deafness are important factors for the estimated outcome in speech perception in SSD patients. Presented data reveal that an inflammatory disease leading to deafness in combination with a long duration of deafness (10 + years) lead to poorer speech perception outcomes.
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Affiliation(s)
- Anja Kurz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital Würzburg, Josef Schneider Str. 11, 97080, Würzburg, Germany.
| | - Marius Grubenbecher
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital Würzburg, Josef Schneider Str. 11, 97080, Würzburg, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital Würzburg, Josef Schneider Str. 11, 97080, Würzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital Würzburg, Josef Schneider Str. 11, 97080, Würzburg, Germany
| | - Heike Kühn
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital Würzburg, Josef Schneider Str. 11, 97080, Würzburg, Germany
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Rauch AK, Kagermann S, Wesarg T, Jakob T, Aschendorff A, Ihorst G, Speck I, Arndt S. Data Logging Evidence of Cochlear Implant Use in Single-Sided and Bilateral Deafness. Audiol Neurootol 2019; 24:206-216. [DOI: 10.1159/000502051] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 07/10/2019] [Indexed: 11/19/2022] Open
Abstract
Purpose: This study analyses data logs in order to investigate the usage pattern of cochlear implant (CI) recipients with single-sided deafness (SSD-CI) and bilaterally deaf, uni- or bilaterally implanted CI recipients (Uni-CI and Bil-CI). Data logging is available from SCAN, an automated auditory scene classifier which categorizes auditory input into 6 listening environments. Methods: CI usage data were retrospectively available from data logs of 206 CI recipients using the Nucleus 6 system obtained between January 2013 and June 2015. For all recipients, we analysed time on air and time spent in the listening environments. For statistical analysis, we matched the CI recipients according to age and duration of CI experience and classified them into 4 age groups. Results: SSD-CI showed a similar time on air compared to Uni- and Bil-CI. Usage behaviour of SSD-CI was comparable to Uni- and Bil-CI regarding exposure to music, speech in quiet and speech in noise. With increasing age, exposure to quiet increased and exposure to music decreased across all CI recipient groups in relation to time on air. Conclusion: In total, the CI usage pattern of SSD-CI is comparable for the majority of listening environments and age groups to that of Uni- and Bil-CI. The results of our study show that SSD-CI benefit equally from CI implantation.
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Speck I, Arndt S, Thurow J, Blazhenets G, Aschendorff A, Meyer PT, Frings L. 18F-FDG PET Imaging of the Inferior Colliculus in Asymmetric Hearing Loss. J Nucl Med 2019; 61:418-422. [DOI: 10.2967/jnumed.119.231407] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/06/2019] [Indexed: 11/16/2022] Open
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41
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Gordon K, Kral A. Animal and human studies on developmental monaural hearing loss. Hear Res 2019; 380:60-74. [DOI: 10.1016/j.heares.2019.05.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 05/29/2019] [Accepted: 05/30/2019] [Indexed: 11/26/2022]
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[Cochlear implant treatment of patients with single-sided deafness or asymmetric hearing loss. German version]. HNO 2019; 65:586-598. [PMID: 27995277 DOI: 10.1007/s00106-016-0294-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The rehabilitation of patients with single-sided deafness (SSD) or asymmetric hearing loss can be achieved with conventional (bilateral) contralateral routing of signals ((Bi)CROS) hearing aids ((Bi)CROS-HA, (Bi)CROS), bone-anchored hearing systems (BAHS) or cochlear implants (CI). To date, only small case series have been published on treatment outcomes in SSD patients after CI surgery and there are only a few comparative studies evaluating rehabilitation outcomes. OBJECTIVE The aim of this study was to provide evidence of successful treatment of SSD and asymmetric hearing loss with a CI compared to the untreated monaural hearing condition and the BAHS and (Bi)CROS treatment options in a large number of patients. MATERIALS AND METHODS In a single-centre study, 45 patients with SSD and 40 patients with asymmetric hearing loss were treated with a CI after careful evaluation for CI candidacy. Monaural speech comprehension in noise and localisation ability were examined with (Bi)CROS-HA and BAHS devices (on a test rod) both preoperatively and at 12 months after CI switch-on. At the same intervals, subjective evaluation of hearing ability was conducted using the Speech, Spatial and Qualities of Hearing Scale (SSQ). RESULTS This report presents the first evidence of successful binaural rehabilitation with CI in a relatively large patient cohort and the advantages over (Bi)CROS and BAHS in smaller subgroups, thus confirming the indication for CI treatment. Moreover, patients with long-term acquired deafness (>10 years) show a benefit from the CI comparable to that observed in patients with shorter-term deafness.
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Lipschitz N, Kohlberg GD, Scott M, Greinwald JH. Imaging findings in pediatric single-sided deafness and asymmetric hearing loss. Laryngoscope 2019; 130:1007-1010. [PMID: 31132141 DOI: 10.1002/lary.28095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/07/2019] [Accepted: 05/13/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine the imaging findings on computer tomography (CT) and magnetic resonance imaging (MRI) in pediatric single-sided deafness (SSD) and asymmetric hearing loss (ASH). METHODS The medical records of 189 pediatric patients with SSD and ASH were retrospectively reviewed, and imaging findings were compared. SSD was defined as unilateral profound hearing loss and contralateral normal hearing ear. In the ASH group, ASHw was defined as the worse hearing ear with profound hearing loss, while ASHb was defined as the better hearing ear with mild-moderate hearing loss. RESULTS There were 170 patients with SSD and 19 patients with ASH. In the SSD group, 83 patients (48.8%) had imaging findings associated with hearing loss. In the ASH group, such imaging findings were found in six (31.6%) of the ASHw and in five (26.3%) of the ASHb ears. The most common finding in the SSD group was cochlear nerve deficiency (50.6%), followed by cochlear dysplasia (39.8%) and enlarged vestibular aqueduct (26.5%). In the ASH groups, cochlear dysplasia was seen in three (50%) of ASHw ears and in two (40%) of the ASHb ears, and enlarged vestibular aqueduct was seen in three (50%) of ASHw ears and in two (40%) of the ASHb ears. CONCLUSION Imaging studies identified the etiology in half of the cases of SSD and in one-third of ASH patients. Our findings strongly support the use of imaging studies in the evaluation of pediatric SSD and ASH. LEVEL OF EVIDENCE 4 Laryngoscope, 130:1007-1010, 2020.
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Affiliation(s)
- Noga Lipschitz
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Gavriel D Kohlberg
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Michael Scott
- Division of Audiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - John H Greinwald
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.,Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
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Peter N, Liyanage N, Pfiffner F, Huber A, Kleinjung T. The Influence of Cochlear Implantation on Tinnitus in Patients with Single-Sided Deafness: A Systematic Review. Otolaryngol Head Neck Surg 2019; 161:576-588. [DOI: 10.1177/0194599819846084] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
ObjectivesThis systematic review provides an overview of the available studies (published by January 29, 2018) with descriptive data analysis about the influence of cochlear implantation on tinnitus in patients with single-sided deafness (SSD).Data SourcesPubMed, EMBASE, Web of Science, Cochrane Library, and Google Scholar.Review MethodsOriginal studies about the influence of cochlear implantation on tinnitus, measured with different tinnitus questionnaires or visual analog scale, in patients with SSD were included. The pre- and postimplantation tinnitus scores of the included studies were extracted for the further systematic review.ResultsThe systematic search yielded 1028 studies. After evaluating titles, abstracts, and full texts, 1011 of these were dismissed. From the remaining 17 studies, 4 showed a low directness of evidence or high risk of bias and were therefore excluded. Due to the nature of cochlear implantation in SSD, only cohort studies and no randomized trials exist, which limits the evaluation in a systematic review. Generally, the mean tinnitus questionnaire scores decreased after cochlear implantation in these 13 studies with a total of 153 patients. The most widely used tinnitus questionnaire was the Tinnitus Handicap Inventory. In these studies, 34.2% of patients demonstrated complete suppression, 53.7% an improvement, 7.3% a stable value, and 4.9% an increase of tinnitus, and none of the patients reported an induction of tinnitus.ConclusionThis review shows a clear improvement of tinnitus complaints after cochlear implantation in patients with SSD. Therefore, tinnitus might be considered as an additional indication for cochlear implantation in SSD.
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Affiliation(s)
- Nicole Peter
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Nuwan Liyanage
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Flurin Pfiffner
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Alexander Huber
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
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Häußler SM, Köpke V, Knopke S, Gräbel S, Olze H. Multifactorial positive influence of cochlear implantation on patients with single‐sided deafness. Laryngoscope 2019; 130:500-506. [DOI: 10.1002/lary.28007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/02/2019] [Accepted: 03/28/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Sophia M. Häußler
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
| | - Vanessa Köpke
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
| | - Steffen Knopke
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
| | - Stefan Gräbel
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
| | - Heidi Olze
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
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Marx M, Costa N, Lepage B, Taoui S, Molinier L, Deguine O, Fraysse B. Cochlear implantation as a treatment for single-sided deafness and asymmetric hearing loss: a randomized controlled evaluation of cost-utility. BMC EAR, NOSE, AND THROAT DISORDERS 2019; 19:1. [PMID: 30766449 PMCID: PMC6362575 DOI: 10.1186/s12901-019-0066-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/09/2019] [Indexed: 11/26/2022]
Abstract
Background Single-sided deafness (SSD) and asymmetric hearing loss (AHL) have recently been proposed as a new indication for cochlear implantation. There is still no recommended treatment for these hearing deficits, and most options considered rely on the transfer of sound from the poor ear to the better ear, using Contralateral Routing of the Signal (CROS) hearing aids or bone conduction (BC) devices. In contrast, cochlear implantation allows the poor ear to be stimulated and binaural hearing abilities to be partially restored. Indeed, most recently published studies have reported an improvement in the spatial localisation of an incoming sound and better speech recognition in noisy environments after cochlear implantation in SSD/AHL subjects. It also provides consistent relief of tinnitus when associated. These encouraging hearing outcomes raise the question of the cost-utility of this expensive treatment in an extended indication. Methods The final endpoint of this national multicentre study is to determine the incremental cost-utility ratio (ICUR) of cochlear implantation in comparison to the current standard of care in France through simple observation, using a randomised controlled trial. Firstly, the study comprises a prospective and descriptive part, where 150 SSD/AHL subjects try CROS hearing aids and a BC device for three weeks each. Secondly, the choice is made between CROS hearing aids, BC implanted device and cochlear implantation. Hearing outcomes and quality of life measurements are described after 6 months for the subjects who chose CROS, BC or declined any option. The subjects who opt for cochlear implantation are randomised between one group where the cochlear implant is inserted without delay and one group of simple initial observation. Hearing outcomes and quality of life measurements are compared after 6 months. Discussion The present study was designed to assess the efficiency of cochlear implantation in SSD/AHL. A favourable cost-utility ratio in this extended indication would strengthen the promising clinical results and justify a reimbursement by the health insurance. The efficiency of other options (CROS, BC) will also be described. Trial registration This research has been registered in ClinicalTrials.gov (http://www.clinicaltrials.gov/), the 29th July 2014 under the n°NCT02204618.
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Affiliation(s)
- Mathieu Marx
- 1Service d'Oto-Rhino-Laryngologie, d'Oto-Neurologie et d'ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Place du Dr Baylac, 31059 Toulouse Cedex 9, France.,Université de Toulouse, CerCo UMR 5549 CNRS, Université Paul Sabatier, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
| | - Nadège Costa
- 3Health Economic Unit, Centre Hospitalier Universitaire de Toulouse, Hôtel-Dieu Saint-Jacques, 2, rue viguerie, 31059 Toulouse Cedex 9, France.,4Unité Inserm UMR 1027, Faculté de Médecine, National Institute for Health and Medical Research (Inserm), 37 allées Jules Guesde, 31073 Toulouse, France
| | - Benoit Lepage
- Department of Epidemiology, USMR, 37 allées Jules Guesde, 31073 Toulouse, France
| | - Soumia Taoui
- 1Service d'Oto-Rhino-Laryngologie, d'Oto-Neurologie et d'ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
| | - Laurent Molinier
- 3Health Economic Unit, Centre Hospitalier Universitaire de Toulouse, Hôtel-Dieu Saint-Jacques, 2, rue viguerie, 31059 Toulouse Cedex 9, France.,4Unité Inserm UMR 1027, Faculté de Médecine, National Institute for Health and Medical Research (Inserm), 37 allées Jules Guesde, 31073 Toulouse, France
| | - Olivier Deguine
- 1Service d'Oto-Rhino-Laryngologie, d'Oto-Neurologie et d'ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Place du Dr Baylac, 31059 Toulouse Cedex 9, France.,Université de Toulouse, CerCo UMR 5549 CNRS, Université Paul Sabatier, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
| | - Bernard Fraysse
- 1Service d'Oto-Rhino-Laryngologie, d'Oto-Neurologie et d'ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
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Asymmetric hearing loss and the benefit of cochlear implantation regarding speech perception, tinnitus burden and psychological comorbidities: a prospective follow-up study. Eur Arch Otorhinolaryngol 2018; 275:2683-2693. [DOI: 10.1007/s00405-018-5135-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/15/2018] [Indexed: 11/27/2022]
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48
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Bönitz H, Kopp B, Büchner A, Lunner T, Lyxell B, Finke M. Event-related neuronal responses to acoustic novelty in single-sided deaf cochlear implant users: Initial findings. Clin Neurophysiol 2018; 129:133-142. [DOI: 10.1016/j.clinph.2017.10.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/24/2017] [Accepted: 10/31/2017] [Indexed: 12/19/2022]
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Lucas L, Katiri R, Kitterick PT. The psychological and social consequences of single-sided deafness in adulthood. Int J Audiol 2017; 57:21-30. [DOI: 10.1080/14992027.2017.1398420] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Laura Lucas
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, UK,
- Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK, and
| | - Roulla Katiri
- Department of Audiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Pádraig Thomas Kitterick
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, UK,
- Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK, and
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Nevoux J, Coez A, Truy É. [Medical devices correcting the deafness: Hearing aids and auditory implants]. Presse Med 2017; 46:1043-1054. [PMID: 29097034 DOI: 10.1016/j.lpm.2017.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 09/14/2017] [Accepted: 09/14/2017] [Indexed: 11/28/2022] Open
Abstract
The management of deafness has become a major public health issue as their lack of detection has a deleterious effect in children and increases the risk factors for aggravation of other pathologies in adults. The detection of deafness remains a real challenge: in the newborn, systematic screening at birth is a good strategy, in adults, much remains to be done. The functional rehabilitation of deafness is based on the use of hearing aids by aerial or bone conduction or of auditory implants. There are three types of auditory implants available: bone anchored hearing implants, middle ear implants and cochlear implants. Many actors, in particular social organizations, can intervene in the financial management of these medical devices.
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Affiliation(s)
- Jérôme Nevoux
- AP-HP, hôpital Bicêtre, service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 94270 Le Kremlin-Bicêtre, France; Université Paris-Saclay, faculté de médecine, 94275 Le Kremlin-Bicêtre, France; Inserm U1185, 94275 Le Kremlin-Bicêtre, France.
| | - Arnaud Coez
- Collège national d'audioprothèse, 75001 Paris, France; Laboratoire correction auditive, Bizaguet, 75001 Paris, France; Inserm U1000, neuro-imaging unit, service hospitalier Frédéric-Joliot, 91401 Orsay, France
| | - Éric Truy
- Hospices civils de Lyon, hôpital Edouard-Herriot, service d'oto-rhino-laryngologie, de chirurgie cervico-faciale et d'audiophonologie, 69003 Lyon, France; Université Claude-Bernard-Lyon 1, 69437 Lyon, France; Inserm U1028, CNRS UMR5292, centre de recherches en neurosciences de Lyon, équipe IMPACT, 69003 Lyon, France
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