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van Lieshout C, Abraham K, Smit AL, Frederix GWJ. A cost-utility analysis of cochlear implants for single sided deafness in adults and children in the Netherlands. PLoS One 2024; 19:e0307881. [PMID: 39102399 PMCID: PMC11299827 DOI: 10.1371/journal.pone.0307881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 07/13/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Cochlear Implant (CI) has been shown to improve speech comprehension, sound localization and tinnitus in adults with Single-Sided-Deafness (SSD) compared to standard treatment currently available in the Dutch setting such as a CROS (Contralateral Routing of Signals) hearing device or a BCD (Bone Conduction Device). Also, for the pediatric population with SSD, CI has shown to be clinically meaningful. Because currently no information is available on the health economic effects of CI in adults and children with SSD in the Netherlands, a cost-utility analysis was conducted. METHODS We developed a Markov cohort model, for both the adult and pediatric SSD population, with three states: implant, no implant, and dead. CI was compared with the Bone Conduction Device (BCD) treatment, requiring surgery and no specific treatment. The time horizon of the model was lifelong, costs were discounted with 3% and effects with 1.5%. A societal perspective was taken, including productivity costs in the analysis, with costing data based on publicly available prices for the Netherlands. Values for clinical outcome parameters, i.e. hearing gain, and event probabilities were based on existing literature. Deterministic and probabilistic sensitivity analyses as well as scenario analyses were performed to outline uncertainty of individual and combined parameters. RESULTS Mean per patient costs for CI in the adult population were €194,051 (95%-CrI €177,274 to €211,108) compared to the total costs of €185,310 (95%-CrI €182,367 to €194,142) for BCD resulting in a cost difference of €8,826 (95%-CrI -€5,020 to €18,252). Compared to no treatment, the cost difference was -€25,089 (95%-CrI -€31,678 to -€6,003). Adults who were treated with CI gained 18.41 (95%-CrI 18.07 to 18.75) quality adjusted life years (QALY) whereas BCD patients gained 15.81 QALYs (95%-CrI 15.53 to 16.10), a difference of 2.60 QALYs (95%-CrI 2.15 to 3.05). The Incremental Cost Effectiveness Ratio (ICER) for adults with CI was determined to be €3,494/QALY gained. Patient without treatment gained 13.46 QALY (95%-CrI 13.20 to 13.73), a difference of 4.95 (95%-CrI 4.87 to 5.01) resulting in CI dominating no treatment. The ICER remained below the Dutch threshold of €20,000/QALY. The probabilistic sensitivity analyses confirmed the results. For children, CI dominated when compared to BCD and when compared to no treatment. Compared to BCD, CI led to a cost saving of €29,611 (95%-CrI -€126,800 to €54,375) and compared to no treatment, CI resulted in a cost saving of €57,658 (95%-CrI -€146,687 to €5,919). The incremental QALY gain compared to BCD was 7.22 (95%-CrI 4.19 to 8.55) and 26.03 (95%-CrI 20.82 to 31.06) compared to no treatment. CONCLUSIONS Based on the results of this health economic evaluation with a Markov cohort model, it is very likely that CI is cost-effective compared to BCD and to no treatment in the Dutch adult and pediatric population with SSD. In both populations the ICER was below the Dutch cost-effectiveness threshold of €20,000/QALY.
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Affiliation(s)
- Chris van Lieshout
- The Healthcare Innovation Center (THINC), Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Epidemiology and Health Economics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Katharina Abraham
- The Healthcare Innovation Center (THINC), Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Epidemiology and Health Economics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Adriana L. Smit
- Department of Otorhinolaryngology–Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Geert W. J. Frederix
- Department of Epidemiology and Health Economics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Andries E, Lorens A, Skarżyński PH, Skarżyński H, Calvino M, Gavilán J, Lassaletta L, Tavora-Vieira D, Acharya A, Kurz A, Hagen R, Anderson I, Koinig K, Abdelsamad Y, Van de Heyning P, Van Rompaey V, Mertens G. Holistic assessment of cochlear implant outcomes using the international classification of functioning disability and health model: data analysis of a longitudinal prospective multicenter study. Eur Arch Otorhinolaryngol 2024; 281:4161-4173. [PMID: 38573516 DOI: 10.1007/s00405-024-08600-5] [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: 12/29/2023] [Accepted: 03/05/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE To study outcome after cochlear implantation using the Cochlear Implant (CI) outcome assessment protocol based on the International Classification of Functioning, Disability and Health (ICF) model (CI-ICF). METHODS Raw data of a prospective, longitudinal, multicenter study was analyzed. Seventy-two CI candidates were assessed preoperatively and six months postoperatively using the CI-ICF protocol. Following tools were used: (1) Work Rehabilitation Questionnaire (WORQ), (2) Abbreviated Profile of Hearing Aid Benefit (APHAB), (3) Audio Processor Satisfaction Questionnaire (APSQ), (4) Speech, Spatial, and Qualities of Hearing Scale (SSQ12), (5) Hearing Implant Sound Quality Index (HISQUI19), (6) Nijmegen CI Questionnaire (NCIQ) (7) pure tone audiometry, (8) speech audiometry, (9) sound localization. RESULTS There was a significant improvement of speech discrimination in quiet (p = 0.015; p < 0.001) and in noise (p = 0.041; p < 0.001), sound detection (p < 0.001), tinnitus (p = 0.026), listening (p < 0.001), communicating with-receiving-spoken messages (p < 0.001), conversation (p < 0.001), family relationships (p < 0.001), community life (p = 0.019), NCIQ total score and all subdomain scores (p < 0.001). Subjective sound localization significantly improved (p < 0.001), while psychometric sound localization did not. There was no significant subjective deterioration of vestibular functioning and no substantial change in sound aversiveness. CI users reported a high level of implant satisfaction postoperatively. CONCLUSION This study highlights the positive impact of cochlear implantation on auditory performance, communication, and subjective well-being. The CI-ICF protocol provides a holistic and comprehensive view of the evolution of CI outcomes.
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Affiliation(s)
- Ellen Andries
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium.
| | - Artur Lorens
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Warsaw, Poland
| | - Piotr Henryk Skarżyński
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Warsaw, Poland
- Center of Hearing and Speech 'Medincus', Kajetany, Poland
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Warsaw, Poland
- Institute of Sensory Organs, Kajetany, Poland
| | - Henryk Skarżyński
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Warsaw, Poland
| | - Miryam Calvino
- Department of Otolaryngology, La Paz University Hospital, IdiPAZ Institute for Health Research, Madrid, Spain
- Biomedical Research Networking Centre On Rare Diseases (CIBERER-U761), Institute of Health Carlos III, Madrid, Spain
| | - Javier Gavilán
- Department of Otolaryngology, La Paz University Hospital, IdiPAZ Institute for Health Research, Madrid, Spain
| | - Luis Lassaletta
- Department of Otolaryngology, La Paz University Hospital, IdiPAZ Institute for Health Research, Madrid, Spain
- Biomedical Research Networking Centre On Rare Diseases (CIBERER-U761), Institute of Health Carlos III, Madrid, Spain
| | - Dayse Tavora-Vieira
- Department of Otolaryngology, Head & Neck Surgery, Fiona Stanley Fremantle Hospital Group, Perth, Australia
- Medical School, Division of Surgery, The University of Western Australia, Perth, Australia
- Faculty of Health Sciences, School of Allied Health, Curtin University, Perth, Australia
| | - Aanand Acharya
- Department of Otolaryngology, Head & Neck Surgery, Fiona Stanley Fremantle Hospital Group, Perth, Australia
| | - Anja Kurz
- Comprehensive Hearing Center, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Rudolf Hagen
- Comprehensive Hearing Center, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Ilona Anderson
- Clinical Research Department, MED-EL GmbH, Innsbruck, Austria
| | - Karin Koinig
- Clinical Research Department, MED-EL GmbH, Innsbruck, Austria
| | | | - Paul Van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Griet Mertens
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
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Jakob TF, Aschendorff A, Arndt S. [Single-Sided Deafness (SSD) - With the "Second" You Hear Better]. Laryngorhinootologie 2024. [PMID: 39038456 DOI: 10.1055/a-2341-0371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
Single-sided deafness (SSD) is characterised by deafness in one ear while the other ear has normal hearing. The most common cause in congenital SSD is aplasia of the auditory nerve, and in post-lingual SSD idiopathic hearing loss. Patients with SSD mainly suffer from impaired sound localisation and difficulties in speech perception in noise. There are various therapy options, but binaural hearing is only possible with a cochlear implant (CI).
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Affiliation(s)
- Till F Jakob
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät der Albert-Ludwigs-Universität, Freiburg, Deutschland
| | - Antje Aschendorff
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät der Albert-Ludwigs-Universität, Freiburg, Deutschland
| | - Susan Arndt
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät der Albert-Ludwigs-Universität, Freiburg, Deutschland
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Dunn CC, Zwolan TA, Balkany TJ, Strader HL, Biever A, Gifford RH, Hall MW, Holcomb MA, Hill H, King ER, Larky J, Presley R, Reed M, Shapiro WH, Sydlowski SA, Wolfe J. A Consensus to Revise the Minimum Speech Test Battery-Version 3. Am J Audiol 2024:1-24. [PMID: 38980836 DOI: 10.1044/2024_aja-24-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024] Open
Abstract
PURPOSE The Minimum Speech Test Battery (MSTB) for adults was introduced in 1996 (Nilsson et al., 1996) and subsequently updated in 2011 (Advanced-Bionics et al., 2011). The MSTB has been widely used by clinicians as a guide for cochlear implant (CI) candidacy evaluations and to document post-operative speech recognition performance. Due to changes in candidacy over the past 10 years, a revision to the MSTB was needed. METHOD In 2022, the Institute for Cochlear Implant Training (ICIT) recruited a panel of expert CI audiologists to update and revise the MSTB. This panel utilized a modified Delphi consensus process to revise the test battery and to improve its applicability considering recent changes in CI care. RESULTS This resulted in the MTSB-Version 3 (MSTB-3), which includes test protocols for identifying not only traditional CI candidates but also possible candidates for electric-acoustic stimulation and patients with single-sided deafness and asymmetric hearing loss. The MSTB-3 provides information that supplements the earlier versions of the MSTB, such as recommendations of when to refer patients for a CI, recommended patient-reported outcome measures, considerations regarding the use of cognitive screeners, and sample report templates for clinical documentation of pre- and post-operative care. Electronic versions of test stimuli, along with all the materials described above, will be available to clinicians via the ICIT website (https://www.cochlearimplanttraining.com). CONCLUSION The goal of the MSTB-3 is to be an evidence-based test battery that will facilitate a streamlined standard of care for adult CI candidates and recipients that will be widely used by CI clinicians.
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Affiliation(s)
- Camille C Dunn
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology-Head and Neck Surgery, The University of Iowa, Iowa City
| | - Teresa A Zwolan
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor
- Cochlear Corporation, Denver, CO
| | | | | | - Allison Biever
- Institute for Cochlear Implant Training, Miami, FL
- Rocky Mountain Ear Clinic, Englewood, CO
| | - René H Gifford
- Institute for Cochlear Implant Training, Miami, FL
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Melissa W Hall
- Institute for Cochlear Implant Training, Miami, FL
- Department of Audiology, University of Florida Health, Gainesville
| | - Meredith A Holcomb
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology-Head and Neck Surgery, University of Miami, FL
| | - Heidi Hill
- Institute for Cochlear Implant Training, Miami, FL
- Hearing Health Clinic, Osseo, MN
| | - English R King
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology-Head and Neck Surgery, The University of North Carolina at Chapel Hill
| | - Jannine Larky
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, CA
| | - Regina Presley
- Institute for Cochlear Implant Training, Miami, FL
- Presbyterian Board of Governors Cochlear Implant Center, Greater Baltimore Medical Center, MD
| | - Meaghan Reed
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology-Head and Neck Surgery and Department of Audiology, Mass Eye and Ear, Boston, MA
| | - William H Shapiro
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology, New York University, NY
| | - Sarah A Sydlowski
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, OH
| | - Jace Wolfe
- Institute for Cochlear Implant Training, Miami, FL
- Hearts for Hearing Foundation, Oklahoma City, OK
- Hearing First, Philadelphia, PA
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Ha J, Park MK, Park SN, Cho HH, Choi JY, Lee CK, Lee IW, Moon IJ, Jung JY, Jung J, Lee KY, Oh JH, Park HJ, Seo JH, Song JJ, Kim H, Jang JH, Choung YH. Tinnitus reduction after active bone-conduction implantation in patients with single-sided deafness: a prospective multicenter study. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08780-0. [PMID: 38977483 DOI: 10.1007/s00405-024-08780-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/04/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE Single-sided deafness (SSD) presents significant challenges for patients, including compromised sound localization, reduced speech recognition, and often, tinnitus. These issues are typically addressed using interventions such as cochlear implantation (CI) and bone conduction implant (BCI). However, evidence regarding the efficacy of BCI in reducing tinnitus in SSD patients remains limited. This study explored the ability of a novel active transcutaneous BCI (Bonebridge BCI602) to alleviate tinnitus in SSD patients. STUDY DESIGN Prospective cohort multicenter study. SETTING Tertiary referral hospitals. METHODS A prospective multicenter study of 30 SSD patients was conducted. The patients were divided into two groups: those with (n = 19) and without (n = 11) tinnitus. Audiometric assessments, subjective questionnaires including the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Bern Benefit in Single-Sided Deafness (BBSS), and tinnitus evaluations with the Tinnitus Handicap Inventory (THI) and tinnitogram were conducted before and after BCI surgery. RESULTS THI scores after surgery were significantly reduced in SSD patients with tinnitus. Subjective satisfaction improved in both the tinnitus and non-tinnitus groups; however, the former group exhibited a significantly greater improvement in the APHAB questionnaire score. According to tinnitograms, the loudness of tinnitus decreased, particularly in patients with ipsilateral tinnitus. Patients with residual hearing had greater reductions in their THI scores. However, three patients without residual hearing had a relative worsening of tinnitus after surgery. CONCLUSION The Bonebridge BCI602 effectively reduced tinnitus in SSD patients, particularly in those with residual hearing. Subjective satisfaction improved in both the tinnitus and non-tinnitus groups. These findings demonstrate the therapeutic potential of BCI for managing SSD and associated tinnitus.
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Affiliation(s)
- Jungho Ha
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Shi Nae Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyong-Ho Cho
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Jae Young Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Chi Kyou Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Korea
| | - Il-Woo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University College of Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Il Joon Moon
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Yun Jung
- Department of Otolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
| | - Jinsei Jung
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Kyu-Yup Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jeong-Hoon Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
- Department of Otolaryngology, Tntn Hospital, Hwasung, Korea
| | - Hong Ju Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Hyun Seo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hantai Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, Korea
| | - Jeong Hun Jang
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea
| | - Yun-Hoon Choung
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea.
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Buth S, Baljić I, Mewes A, Hey M. [Speech discrimination with separated signal sources and sound localization with speech stimuli : Learning effects and reproducibility]. HNO 2024; 72:504-514. [PMID: 38536465 PMCID: PMC11192817 DOI: 10.1007/s00106-024-01426-x] [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] [Accepted: 12/12/2023] [Indexed: 06/22/2024]
Abstract
BACKGROUND Binaural hearing enables better speech comprehension in noisy environments and is necessary for acoustic spatial orientation. This study investigates speech discrimination in noise with separated signal sources and measures sound localization. The aim was to study characteristics and reproducibility of two selected measurement techniques which seem to be suitable for description of the aforementioned aspects of binaural hearing. MATERIALS AND METHODS Speech reception thresholds (SRT) in noise and test-retest reliability were collected from 55 normal-hearing adults for a spatial setup of loudspeakers with angles of ± 45° and ± 90° using the Oldenburg sentence test. The investigations of sound localization were conducted in a semicircle and fullcircle setup (7 and 12 equidistant loudspeakers). RESULTS SRT (S-45N45: -14.1 dB SNR; S45N-45: -16.4 dB SNR; S0N90: -13.1 dB SNR; S0N-90: -13.4 dB SNR) and test-retest reliability (4 to 6 dB SNR) were collected for speech intelligibility in noise with separated signals. The procedural learning effect for this setup could only be mitigated with 120 training sentences. Significantly smaller SRT values, resulting in better speech discrimination, were found for the test situation of the right compared to the left ear. RMS values could be gathered for sound localization in the semicircle (1,9°) as well as in the fullcircle setup (11,1°). Better results were obtained in the retest of the fullcircle setup. CONCLUSION When using the Oldenburg sentence test in noise with spatially separated signals, it is mandatory to perform a training session of 120 sentences in order to minimize the procedural learning effect. Ear-specific SRT values for speech discrimination in noise with separated signal sources are required, which is probably due to the right-ear advantage. A training is recommended for sound localization in the fullcircle setup.
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Affiliation(s)
- Svenja Buth
- Medizinische Fakultät, Christian-Albrechts-Universität zu Kiel, Kiel, Deutschland.
- HNO-Klinik, Audiologie, Campus Kiel, Universitätsklinikum Schleswig-Holstein, Arnold-Heller-Str. 3, Haus B1, 24105, Kiel, Deutschland.
| | - Izet Baljić
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Audiologisches Zentrum, Helios Klinikum Erfurt, Erfurt, Deutschland
| | - Alexander Mewes
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Audiologie, UKSH, Kiel, Deutschland
| | - Matthias Hey
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Audiologie, UKSH, Kiel, Deutschland
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Liu Y, Qiu W, Yang L, Wang Y, Zhu J, Lv M, Zhao S. Clinical experience of an adhesive bone conduction hearing system in children with congenital single-sided deafness. Braz J Otorhinolaryngol 2024; 90:101427. [PMID: 38608635 PMCID: PMC11016867 DOI: 10.1016/j.bjorl.2024.101427] [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: 11/28/2023] [Revised: 02/11/2024] [Accepted: 02/27/2024] [Indexed: 04/14/2024] Open
Abstract
OBJECTIVES This study aimed to investigate the effects of an adhesive bone conduction device (aBCD) in children with congenital single-sided deafness (SSD). Specifically, we examined whether the aBCD elicits improvement in the speech perception ability of children with congenital SSD and whether using this device would adversely affect the horizontal localisation abilities of these children. METHODS Thirteen school-aged children with SSD and seven children with Normal Hearing (NH) were included in this study. Speech perception in noise was measured using the Mandarin Speech Test Materials and sound localisation performance was evaluated using broadband noise stimuli (0.5-20 kHz), randomly played from seven loudspeakers at different stimulus levels (65-, 70-, and 75-dB SPL). RESULTS All children with SSD showed inferior speech perception and sound localisation performance compared with children with NH. The aBCD use remarkably improved the speech perception abilities of these children under quiet and noise conditions; however, their sound localisation abilities neither improved nor deteriorated. CONCLUSION This study reveals the effectiveness and safety of a non-surgical aBCD in paediatric patients with SSD. Our results provide a theoretical basis for early hearing intervention with an aBCD in children with congenital SSD who are temporarily unable to undergo ear surgery. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- Yujie Liu
- Capital Medical University, Beijing Tongren Hospital, Department of Otolaryngology Head and Neck Surgery, Beijing, China; Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing, China
| | - Wenxi Qiu
- Capital Medical University, Beijing Tongren Hospital, Department of Otolaryngology Head and Neck Surgery, Beijing, China; Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing, China
| | - Lin Yang
- Capital Medical University, Beijing Tongren Hospital, Department of Otolaryngology Head and Neck Surgery, Beijing, China; Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing, China
| | - Yuan Wang
- Capital Medical University, Beijing Tongren Hospital, Department of Otolaryngology Head and Neck Surgery, Beijing, China; Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing, China
| | - Jikai Zhu
- Capital Medical University, Beijing Tongren Hospital, Department of Otolaryngology Head and Neck Surgery, Beijing, China; Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing, China
| | - Mengshuang Lv
- Capital Medical University, Beijing Tongren Hospital, Department of Otolaryngology Head and Neck Surgery, Beijing, China; Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing, China
| | - Shouqin Zhao
- Capital Medical University, Beijing Tongren Hospital, Department of Otolaryngology Head and Neck Surgery, Beijing, China; Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing, China.
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Anari MR, Zarandy MM, Kouhi A, Rezaeian S, Vaziribozorg S, Mandegari M. The effect of cochlear implantation on tinnitus in patients with post lingual bilateral profound hearing loss. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08764-0. [PMID: 38914818 DOI: 10.1007/s00405-024-08764-0] [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: 02/24/2024] [Accepted: 05/27/2024] [Indexed: 06/26/2024]
Abstract
INTRODUCTION In this study we investigated the effect of cochlear implantation on tinnitus in patients with post lingual bilateral profound hearing loss. METHODS In this retrospective study, 66 post-lingual deaf patients over 18 years old who referred for cochlear implantation and complained of tinnitus were included. Patients were divided into two groups with residual hearing (in frequency 250-500 Hz) and without residual hearing. All data including age, gender, type of implants, type of surgery, cause of the disease, and information on the THI score before cochlear implantation, one month after cochlear implantation and one year after cochlear implantation was recorded and analyzed. RESULTS Nine patients had residual hearing, while 57 patients did not. After one month and one year, in both groups, the mean THI score has decreased significantly (p-value = 0.001), but there was no significant difference in the mean THI score before surgery and one month and one year after surgery between two groups with and without residual hearing. There was no significant difference in tinnitus severity according to THI-grade between two groups. Also there was no significant difference in THI score and the cause of the hearing loss, type and insertion method of implantation, one month and one year after the surgery between two groups. CONCLUSION According to our results, the was no significant correlation between residual hearing and tinnitus score before surgery, one month and one year after the surgery.
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Affiliation(s)
- Mahtab Rabbani Anari
- Amir-Alam Hospital, Department of Otolaryngology-Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Motasaddi Zarandy
- Amir-Alam Hospital, Department of Otolaryngology-Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Kouhi
- Amir-Alam Hospital, Department of Otolaryngology-Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Saman Rezaeian
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sedighe Vaziribozorg
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Mandegari
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Zurek PM, Freyman RL, Najem F. Investigating the Utility of a Compact Loudspeaker Array for Audiometric Testing. Am J Audiol 2024; 33:476-491. [PMID: 38668699 DOI: 10.1044/2024_aja-23-00199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
PURPOSE This project addressed the uses of a loudspeaker array for audiometric measurements. It sought to evaluate a prototype compact array in terms of the reliability of test results across sound booths. METHOD A seven-loudspeaker array was developed to deliver sounds from -60° to +60° on an arc with a radius of 0.5 m. The system was equipped with a head position sensing system to maintain the listener's head near the optimal test position. Three array systems were distributed to each of the two test sites for within-subject assessments of booth equivalence on tests of sound localization, speech reception in noise, and threshold detection. A total of 36 subjects participated, 18 at each test site. RESULTS Results showed excellent interbooth consistency on tests of sound localization using speech and noise signals, including conditions in which one or both ears were covered with a muff. Booth consistency was also excellent on sound field threshold measurements for detecting quasi-diffuse noise bands. Nonequivalence was observed in some cases of speech-in-noise tests, particularly with a small one-person booth. Acoustic analyses of in situ loudspeaker responses indicated that some of the nonequivalent comparisons on speech-in-noise tests could be traced to the effects of reflections. CONCLUSIONS Overall, the results demonstrate the utility and reliability of a compact array for the assessment of localization ability, speech reception in noise, and sound field thresholds. However, the results indicate that researchers and clinicians should be aware of the reflection effects that can influence the results of sound field tests in which signal and noise levels from separate loudspeakers are critical.
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Affiliation(s)
| | - Richard L Freyman
- Department of Speech, Language, and Hearing Sciences, University of Massachusetts Amherst
| | - Fadi Najem
- Hearing and Balance Center, University of the Pacific, San Francisco, CA
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Redó MA, Gil IP, Pérez-Carbonell T, González CE, Ventura AM, Algarra JM. Prospective study of sound localisation in patients with single sided deafness and asymmetric hearing loss treated with cochlear implant. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2024:S2173-5735(24)00062-0. [PMID: 38797372 DOI: 10.1016/j.otoeng.2024.05.002] [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: 11/06/2023] [Accepted: 05/10/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND AND OBJECTIVE Sound localization plays a crucial role in our daily lives, enabling us to recognize voices, respond to alarming situations, avoid dangers, and navigate towards specific signals. However, this ability is compromised in patients with Single-Sided Deafness (SSD) and Asymmetric Hearing Loss (AHL), negatively impacting their daily functioning. The main objective of the study was to quantify the degree of sound source localization in patients with single-sided deafness or asymmetric hearing loss using a Cochlear Implant (CI) and to compare between the two subgroups. MATERIALS AND METHODS This was a prospective, longitudinal, observational, single-center study involving adult patients diagnosed with profound unilateral or asymmetric sensorineural hearing loss who underwent cochlear implantation. Sound localization was assessed in a chamber equipped with seven speakers evenly distributed from -90º to 90º. Stimuli were presented at 1000 Hz and intensities of 65 dB, 70 dB, and 75 dB. Each stimulus was presented only once per speaker, totaling 21 presentations. The number of correct responses at different intensities was recorded, and angular error in degrees was calculated to determine the mean angular distance between the patient-indicated speaker and the speaker presenting the stimulus. Both assessments were conducted preoperatively without a cochlear implant and two years post-implantation. RESULTS The total sample comprised 20 patients, with 9 assigned to the SSD group and 11 to the AHL group. The Preoperative Pure Tone Average (PTA) in free field was 31.7 dB in the SSD group and 41.8 dB in the AHL group. There was a statistically significant improvement in sound localization ability and angular error with the use of the cochlear implant at all intensities in both SSD and AHL subgroups. CONCLUSIONS Cochlear implantation in patients with SSD and AHL enhances sound localization, reducing mean angular error and increasing the number of correct sound localization responses.
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Affiliation(s)
- María Aragonés Redó
- Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Spain; Universidad de Valencia, Valencia, Spain.
| | - Ignacio Pla Gil
- Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Spain; Universidad de Valencia, Valencia, Spain
| | - Tomàs Pérez-Carbonell
- Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Spain; Universidad de Valencia, Valencia, Spain
| | - Clara Espina González
- Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Spain; Universidad de Valencia, Valencia, Spain
| | - Antonio Morant Ventura
- Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Spain; Universidad de Valencia, Valencia, Spain
| | - Jaime Marco Algarra
- Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Spain; Universidad de Valencia, Valencia, Spain
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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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Kim H, Choo OS, Ha J, Yang J, Jang JH, Park HY, Choung YH. Objective and subjective efficacy of hearing aids in patients with mild-to-moderate unilateral hearing loss: a prospective study. Eur Arch Otorhinolaryngol 2024; 281:1671-1681. [PMID: 37803218 DOI: 10.1007/s00405-023-08255-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/20/2023] [Indexed: 10/08/2023]
Abstract
PURPOSE In patients with unilateral sensorineural hearing loss (USNHL), we explored both objective functional audiological gains and subjective satisfaction, indicating when a unilateral hearing aid is valuable. METHODS Thirty-seven patients with mild-to-moderate USNHL (mean pure-tone thresholds between 25 and 70 dB) were prescribed unilateral hearing aids. Functional gain, the aided speech discrimination score (SDS), the Hearing in Noise Test (HINT) score, and the sound localization test score were collected, and a questionnaire (the Hearing Handicap Inventory for the Elderly, HHIE) completed after 1, 2, and 3 months of hearing aid use. We classified the participants as having 'no handicap' (HHIE < 17), 'mild-to-moderate handicap' (17-42), and 'significant handicap' (> 42). RESULTS The decrease in handicap afforded by unilateral hearing aids was largest in the 'significant handicap' group (the HHIE total score fell from 59.1 to 37.2; P = 0.007). There were no between-group differences in either functional gain or the aided SDS. Only the 'significant handicap' group evidenced an improved HINT score; the composite signal-to-noise ratio (SNR) fell from - 1.5 to - 2.2 dB [S/N] (P = 0.023). The HHIE usefully indicated when a hearing aid alleviated the discomfort of USNHL; patients with unaided HHIE scores ≥ 20 evidenced significant decreases in the composite SNR (- 1.7 to - 2.0 dB [S/N]; P = 0.045). CONCLUSIONS When considering whether to prescribe a unilateral hearing aid for patients with mild-to-moderate USNHL, it is helpful to use the HHIE to evaluate discomfort. If the total score is ≥ 20, a hearing aid is appropriate.
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Affiliation(s)
- Hantai Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, 35365, Republic of Korea
| | - Oak-Sung Choo
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, 07441, Republic of Korea
| | - Jungho Ha
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea
| | - Jisun Yang
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea
| | - Jeong Hun Jang
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea
| | - Hun Yi Park
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea
| | - Yun-Hoon Choung
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea.
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Wesarg T, Kuntz I, Jung L, Wiebe K, Schatzer R, Brill S, Aschendorff A, Arndt S. Masked Speech Perception with Bone Conduction Device, Contralateral Routing of Signals Hearing Aid, and Cochlear Implant Use in Adults with Single-Sided Deafness: A Prospective Hearing Device Comparison using a Unified Testing Framework. Audiol Neurootol 2024; 29:271-289. [PMID: 38387454 PMCID: PMC11309078 DOI: 10.1159/000535383] [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: 07/22/2023] [Accepted: 11/19/2023] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION For the treatment of single-sided deafness (SSD), common treatment choices include a contralateral routing of signals (CROS) hearing aid, a bone conduction device (BCD), and a cochlear implant (CI). The primary aim of this study was to compare speech understanding in noise and binaural benefits in adults with postlingual SSD between preoperative unaided baseline, preoperative CROS and BCD trial devices, and CI, following recommendations from a consensus protocol. In addition, we investigated the effect of masker type on speech understanding. METHODS This was a prospective study with twelve participants. Binaural effects of head shadow, squelch, summation, and spatial release from masking were assessed by measuring speech reception thresholds (SRTs) in five different spatial target-masker configurations using two different maskers: two-talker babble (TTB), and speech-shaped noise (SSN). Preoperatively, participants were assessed unaided and with CROS and BCD trial devices. After cochlear implantation, participants were assessed at 1, 3, and 6 months post-activation. RESULTS For TTB, significant improvements in SRT with a CI relative to preoperatively unaided were found in all spatial configurations. With CI at 6 months, median benefits were 7.8 dB in SSSDNAH and 5.1 dB in S0NAH (head shadow), 3.4 dB in S0N0 (summation), and 4.6 dB in S0NSSD and 5.1 dB in SAHNSSD (squelch). CROS yielded a significant head shadow benefit of 2.4 dB in SSSDNAH and a significant deterioration in squelch of 2.5 dB in S0NSSD and SAHNSSD, but no summation effect. With BCD, there was a significant summation benefit of 1.5 dB, but no head shadow nor squelch effect. For SSN, significant improvements in SRT with CI compared to preoperatively unaided were found in three spatial configurations. Median benefits with CI at 6 months were: 8.5 dB in SSSDNAH and 4.6 dB in S0NAH (head shadow), 1.4 dB in S0N0 (summation), but no squelch. CROS showed a significant head shadow benefit of 1.7 dB in SSSDNAH, but no summation effect, and a significant deterioration in squelch of 2.9 dB in S0NSSD and 3.2 dB in SAHNSSD. With BCD, no binaural effect was obtained. Longitudinally, we found significant head shadow benefits with a CI in SSSDNAH in both maskers at all postoperative intervals and in S0NAH at 3 and 6 months post-activation. CONCLUSION With a CI, a clear benefit for masked speech perception was observed for all binaural effects. Benefits with CROS and BCD were more limited. CROS usage was detrimental to the squelch effect.
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Affiliation(s)
- Thomas Wesarg
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg in Breisgau, Germany
| | - Iris Kuntz
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg in Breisgau, Germany
| | - Lorenz Jung
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg in Breisgau, Germany
| | - Konstantin Wiebe
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg in Breisgau, Germany
| | | | | | - Antje Aschendorff
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg in Breisgau, Germany
| | - Susan Arndt
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg in Breisgau, Germany
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Kim H, Park MK, Park SN, Cho HH, Choi JY, Lee CK, Lee IW, Moon IJ, Jung JY, Jung J, Lee KY, Oh JH, Park HJ, Seo JH, Song JJ, Ha J, Jang JH, Choung YH. Efficacy of the Bonebridge BCI602 for Adult Patients with Single-sided Deafness: A Prospective Multicenter Study. Otolaryngol Head Neck Surg 2024; 170:490-504. [PMID: 37811702 DOI: 10.1002/ohn.520] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/09/2023] [Accepted: 08/12/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE To investigate the safety and efficacy of a novel active transcutaneous bone conduction implant (BCI) device for patients with single-sided deafness (SSD). STUDY DESIGN Prospective cohort study. SETTING Tertiary referral hospitals. METHODS This prospective multicenter study was conducted at 15 institutions nationwide. Thirty adult (aged ≥19 years) SSD patients were recruited. They underwent implantation of an active transcutaneous BCI device (Bonebridge BCI602). Objective outcomes included aided pure-tone thresholds, aided speech discrimination scores (SDSs), and the Hearing in Noise Test (HINT) and sound localization test results. The Bern Benefit in Single-Sided Deafness (BBSS) questionnaire, the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, and the Tinnitus Handicap Inventory (THI) were used to measure subjective benefits. RESULTS The mean aided pure-tone threshold was 34.2 (11.3), mean (SD), dB HL at 500 to 4000 Hz. The mean total BBSS score was 27.5 (13.8). All APHAB questionnaire domain scores showed significant improvements: ease of communication, 33.6 (23.2) versus 22.6 (21.3), P = .025; reverberation, 44.8 (16.6) versus 32.8 (15.9), P = .002; background noise, 55.5 (23.6) versus 35.2 (18.1), P < .001; and aversiveness, 36.7 (22.8) versus 25.8 (21.4), P = .028. Moreover, the THI scores were significantly reduced [47.4 (30.1) versus 31.1 (27.0), P = .003]. Congenital SSD was a significant factor of subjective benefit (-11.643; 95% confidence interval: -21.946 to -1.340). CONCLUSION The BCI602 active transcutaneous BCI device can provide functional hearing gain without any adverse effects and is a feasible option for acquired SSD patients with long-term deafness.
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Affiliation(s)
- Hantai Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Shi Nae Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyong-Ho Cho
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, Korea
| | - Jae Young Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Chi Kyou Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Korea
| | - Il-Woo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University College of Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Il Joon Moon
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Yun Jung
- Department of Otolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
| | - Jinsei Jung
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Kyu-Yup Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jeong-Hoon Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Hong Ju Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Hyun Seo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jungho Ha
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Jeong Hun Jang
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Yun-Hoon Choung
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
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Peter N, Treyer V, Probst R, Kleinjung T. Auditory Cortical Plasticity in Patients with Single-Sided Deafness Before and After Cochlear Implantation. J Assoc Res Otolaryngol 2024; 25:79-88. [PMID: 38253897 PMCID: PMC10907329 DOI: 10.1007/s10162-024-00928-3] [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: 03/29/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
PURPOSE This study investigated neuroplastic changes induced by postlingual single-sided deafness (SSD) and the effects of a cochlear implantation for the deaf ear. Neural processing of acoustic signals from the normal hearing ear to the brain was studied before and after implantation using a positron emission tomography (PET)/CT scanner. METHODS Eight patients with postlingual SSD received a cochlear implant (CI) in a prospective clinical trial. Dynamic imaging was performed in a PET/CT scanner using radioactively labeled water ([15O]H2O) to localize changes in the regional cerebral blood flow (rCBF) with and without an auditory task of logatomes containing speech-like elements without meaningful context. The normal hearing ear was stimulated before implantation and after the use of the cochlear implant for at least 8 months (mean 13.5, range 8.1-26.6). Eight age- and gender-matched subjects with normal hearing on both sides served as healthy control subjects (HCS). RESULTS When the normal hearing ear of SSD patients was stimulated before CI implantation, the [15O]H2O-PET showed a more symmetrical rCBF in the auditory regions of both hemispheres in comparison to the HCS. The use of CI increased the asymmetry index (AI) in six of eight patients indicating an increase of activity of the contralateral hemisphere. Non-parametric statistics revealed a significant difference in the AI between patients before CI implantation and HCS (p < .01), which disappeared after CI implantation (p = .195). CONCLUSION The functional neuroimaging data showed a tendency towards normalization of neuronal activity after CI implantation, which supports the effectiveness of CI in SSD patients. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01749592, December 13, 2012.
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Affiliation(s)
- Nicole Peter
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Zurich, University of Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
| | - Valerie Treyer
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
| | - Rudolf Probst
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Zurich, University of Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Zurich, University of Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
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Pantaleo A, Murri A, Cavallaro G, Pontillo V, Auricchio D, Quaranta N. Single-Sided Deafness and Hearing Rehabilitation Modalities: Contralateral Routing of Signal Devices, Bone Conduction Devices, and Cochlear Implants. Brain Sci 2024; 14:99. [PMID: 38275519 PMCID: PMC10814000 DOI: 10.3390/brainsci14010099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Single sided deafness (SSD) is characterized by significant sensorineural hearing loss, severe or profound, in only one ear. SSD adversely affects various aspects of auditory perception, including causing impairment in sound localization, difficulties with speech comprehension in noisy environments, and decreased spatial awareness, resulting in a significant decline in overall quality of life (QoL). Several treatment options are available for SSD, including cochlear implants (CI), contralateral routing of signal (CROS), and bone conduction devices (BCD). The lack of consensus on outcome domains and measurement tools complicates treatment comparisons and decision-making. This narrative overview aims to summarize the treatment options available for SSD in adult and pediatric populations, discussing their respective advantages and disadvantages. Rerouting devices (CROS and BCD) attenuate the effects of head shadow and improve sound awareness and signal-to-noise ratio in the affected ear; however, they cannot restore binaural hearing. CROS devices, being non-implantable, are the least invasive option. Cochlear implantation is the only strategy that can restore binaural hearing, delivering significant improvements in speech perception, spatial localization, tinnitus control, and overall QoL. Comprehensive preoperative counseling, including a discussion of alternative technologies, implications of no treatment, expectations, and auditory training, is critical to optimizing therapeutic outcomes.
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Affiliation(s)
- Alessandra Pantaleo
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
| | - Alessandra Murri
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
| | - Giada Cavallaro
- Otolaryngology Unit, Madonna delle Grazie Hospital, 75100 Matera, Italy;
| | - Vito Pontillo
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
| | - Debora Auricchio
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
| | - Nicola Quaranta
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
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Muck S, Magele A, Wirthner B, Schoerg P, Sprinzl GM. Effects of Auditory Training on Speech Recognition in Children with Single-Sided Deafness and Cochlea Implants Using a Direct Streaming Device: A Pilot Study. J Pers Med 2023; 13:1688. [PMID: 38138915 PMCID: PMC10744358 DOI: 10.3390/jpm13121688] [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: 10/25/2023] [Revised: 11/24/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
Treating individuals with single-sided deafness (SSD) with a cochlear implant (CI) offers significant benefits for speech perception in complex spatial listening environments. After implantation, training without involvement of the normal-hearing ear is essential. Therefore, the AudioLink streaming device (MED-EL GmbH, Austria) can be used to connect the externally worn audio processor to media devices; thus, the auditory stimuli are directly streamed to the implanted ear. The aim was to test whether children with SSD, aged 5-12 years, accept this training method and whether auditory training, streamed directly via AudioLink using the Tiptoi device (Ravensburger GmbH., Ravensburg, Germany), improves speech recognition. A total of 12 children with SSD and implanted with a CI received Tiptoi training via AudioLink and were asked to practice daily for 10 min over a period of one month. All participants completed the training. The measurements employed to assess improvement included speech audiometry, speech, spatial, and quality of hearing scale for parents (SSQ P), and specially designed tasks crafted for this study. Daily training of 9.93 min was reported. The word recognition score (WRS) at 65 dB and 80 dB in aided condition significantly improved and the WRS streamed via AudioLink was significantly better after training. The speech, spatial, and qualities of hearing scale for parents (SSQ P questionnaire) showed significant improvement in the dimension of quality of hearing and overall gain. The outcomes of the Tiptoi tasks resulted in a significant benefit in both categories of the "recognition of sounds" and "understanding of sentences". The results are very encouraging and do not only show the positive uptake of daily training at home but also how this resulted in a significant improvement in subjective and objective measures for this rather short training period of one month only.
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Affiliation(s)
- Stefanie Muck
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, 3100 St. Poelten, Austria; (S.M.); (A.M.); (B.W.); (P.S.)
| | - Astrid Magele
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, 3100 St. Poelten, Austria; (S.M.); (A.M.); (B.W.); (P.S.)
- Karl Landsteiner Institute of Implantable Hearing Devices, 3100 St. Poelten, Austria
| | - Bianca Wirthner
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, 3100 St. Poelten, Austria; (S.M.); (A.M.); (B.W.); (P.S.)
| | - Philipp Schoerg
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, 3100 St. Poelten, Austria; (S.M.); (A.M.); (B.W.); (P.S.)
| | - Georg Mathias Sprinzl
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, 3100 St. Poelten, Austria; (S.M.); (A.M.); (B.W.); (P.S.)
- Karl Landsteiner Institute of Implantable Hearing Devices, 3100 St. Poelten, Austria
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Lee SW, Yuen HW, Low D, Kamath S, Chua KWD. The functional impact of implantable hearing devices in patients with single-sided deafness. PROCEEDINGS OF SINGAPORE HEALTHCARE 2023. [DOI: 10.1177/20101058231160604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Introduction Single-sided deafness (SSD) is associated with significant functional impairment such as listening speech in noise and localizing sound. To date, studies on the efficacy of CI and BCI for single-sided deafness are conflicting. Objective Thus, the objective of our study was to describe and compare the functional outcomes between these devices. Methods Thirteen subjects with SSD were prospectively recruited for our study. Six underwent CI and seven received BCI. Word recognition scores (WRS) and disease specific outcome measures were obtained pre-implantation, at 6, and 12 months. Results WRS improved both in quiet and in noise for CI and BCI recipients. On the contrary, CI recipients displayed improvement in Speech Spatial Quality (SSQ) scores. A decreasing trend of improvement in APHAB scores were observed for the BCI group. Conclusion BCI recipients showed a significant improvement in WRS (in noise). Conversely, CI recipients showed a great improvement in SSQ scores. These preliminary findings suggest that true binaural hearing can only be restored with CI for better SSQ performance. However, BCIs could be recommended to a sub-group of patients, if listening to speech in noise is a priority.
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Affiliation(s)
- Sin Wai Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
| | - Heng Wai Yuen
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
| | - David Low
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
| | - Savitha Kamath
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
| | - Kenneth Wei De Chua
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
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Tropitzsch A, Schade-Mann T, Gamerdinger P, Dofek S, Schulte B, Schulze M, Fehr S, Biskup S, Haack TB, Stöbe P, Heyd A, Harre J, Lesinski-Schiedat A, Büchner A, Lenarz T, Warnecke A, Müller M, Vona B, Dahlhoff E, Löwenheim H, Holderried M. Variability in Cochlear Implantation Outcomes in a Large German Cohort With a Genetic Etiology of Hearing Loss. Ear Hear 2023; 44:1464-1484. [PMID: 37438890 PMCID: PMC10583923 DOI: 10.1097/aud.0000000000001386] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/04/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVES The variability in outcomes of cochlear implantation is largely unexplained, and clinical factors are not sufficient for predicting performance. Genetic factors have been suggested to impact outcomes, but the clinical and genetic heterogeneity of hereditary hearing loss makes it difficult to determine and interpret postoperative performance. It is hypothesized that genetic mutations that affect the neuronal components of the cochlea and auditory pathway, targeted by the cochlear implant (CI), may lead to poor performance. A large cohort of CI recipients was studied to verify this hypothesis. DESIGN This study included a large German cohort of CI recipients (n = 123 implanted ears; n = 76 probands) with a definitive genetic etiology of hearing loss according to the American College of Medical Genetics (ACMG)/Association for Molecular Pathology (AMP) guidelines and documented postoperative audiological outcomes. All patients underwent preoperative clinical and audiological examinations. Postoperative CI outcome measures were based on at least 1 year of postoperative audiological follow-up for patients with postlingual hearing loss onset (>6 years) and 5 years for children with congenital or pre/perilingual hearing loss onset (≤6 years). Genetic analysis was performed based on three different methods that included single-gene screening, custom-designed hearing loss gene panel sequencing, targeting known syndromic and nonsyndromic hearing loss genes, and whole-genome sequencing. RESULTS The genetic diagnosis of the 76 probands in the genetic cohort involved 35 genes and 61 different clinically relevant (pathogenic, likely pathogenic) variants. With regard to implanted ears (n = 123), the six most frequently affected genes affecting nearly one-half of implanted ears were GJB2 (21%; n = 26), TMPRSS3 (7%; n = 9), MYO15A (7%; n = 8), SLC26A4 (5%; n = 6), and LOXHD1 and USH2A (each 4%; n = 5). CI recipients with pathogenic variants that influence the sensory nonneural structures performed at or above the median level of speech performance of all ears at 70% [monosyllable word recognition score in quiet at 65 decibels sound pressure level (SPL)]. When gene expression categories were compared to demographic and clinical categories (total number of compared categories: n = 30), mutations in genes expressed in the spiral ganglion emerged as a significant factor more negatively affecting cochlear implantation outcomes than all clinical parameters. An ANOVA of a reduced set of genetic and clinical categories (n = 10) identified five detrimental factors leading to poorer performance with highly significant effects ( p < 0.001), accounting for a total of 11.8% of the observed variance. The single strongest category was neural gene expression accounting for 3.1% of the variance. CONCLUSIONS The analysis of the relationship between the molecular genetic diagnoses of a hereditary etiology of hearing loss and cochlear implantation outcomes in a large German cohort of CI recipients revealed significant variabilities. Poor performance was observed with genetic mutations that affected the neural components of the cochlea, supporting the "spiral ganglion hypothesis."
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Affiliation(s)
- Anke Tropitzsch
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Hearing Center, Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Center for Rare Hearing Disorders, Centre for Rare Diseases, University of Tübingen, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Thore Schade-Mann
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Hearing Center, Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
| | - Philipp Gamerdinger
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Hearing Center, Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
| | - Saskia Dofek
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
| | - Björn Schulte
- CeGaT GmbH und Praxis für Humangenetik Tübingen, Tübingen, Germany
| | - Martin Schulze
- CeGaT GmbH und Praxis für Humangenetik Tübingen, Tübingen, Germany
| | - Sarah Fehr
- CeGaT GmbH und Praxis für Humangenetik Tübingen, Tübingen, Germany
| | - Saskia Biskup
- CeGaT GmbH und Praxis für Humangenetik Tübingen, Tübingen, Germany
| | - Tobias B. Haack
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Petra Stöbe
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Andreas Heyd
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
| | - Jennifer Harre
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Anke Lesinski-Schiedat
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Andreas Büchner
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Thomas Lenarz
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Athanasia Warnecke
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Marcus Müller
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Barbara Vona
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Ernst Dahlhoff
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Hubert Löwenheim
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Martin Holderried
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Department of Medical Development and Quality Management, University Hospital Tübingen, Tübingen, Germany
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20
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Andren KG, Duffin K, Ryan MT, Riley CA, Tolisano AM. Postoperative optimization of cochlear implantation for single sided deafness and asymmetric hearing loss: a systematic review. Cochlear Implants Int 2023; 24:342-353. [PMID: 37490782 DOI: 10.1080/14670100.2023.2239512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
OBJECTIVE Identify and evaluate the effectiveness of methods for improving postoperative cochlear implant (CI) hearing performance in subjects with single-sided deafness (SSD) and asymmetric hearing loss (AHL). DATA SOURCES Embase, PubMed, Scopus. REVIEW METHODS Systematic review and narrative synthesis. English language studies of adult CI recipients with SSD and AHL reporting a postoperative intervention and comparative audiometric data pertaining to speech in noise, speech in quiet and sound localization were included. RESULTS 32 studies met criteria for full text review and 6 (n = 81) met final inclusion criteria. Interventions were categorized as: formal auditory training, programming techniques, or hardware optimization. Formal auditory training (n = 10) found no objective improvement in hearing outcomes. Experimental CI maps did not improve audiologic outcomes (n = 9). Programed CI signal delays to improve synchronization demonstrated improved sound localization (n = 12). Hardware optimization, including multidirectional (n = 29) and remote (n = 11) microphones, improved sound localization and speech in noise, respectively. CONCLUSION Few studies meeting inclusion criteria and small sample sizes highlight the need for further study. Formal auditory training did not appear to improve hearing outcomes. Programming techniques, such as CI signal delay, and hardware optimization, such as multidirectional and remote microphones, show promise to improve outcomes for SSD and AHL CI users.
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Affiliation(s)
- Kristofer G Andren
- Department of Otolaryngology - Head & Neck Surgery, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX, USA
| | - Kevin Duffin
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Matthew T Ryan
- Department of Otolaryngology - Head & Neck Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Charles A Riley
- Department of Otolaryngology - Head & Neck Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Anthony M Tolisano
- Department of Otolaryngology - Head & Neck Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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21
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Tessler I, Gecel NA, Glicksberg BS, Shivatzki S, Shapira Y, Zimlichman E, Alon EE, Klang E, Wolfovitz A. A Five-Decade Text Mining Analysis of Cochlear Implant Research: Where We Started and Where We Are Heading. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1891. [PMID: 38003940 PMCID: PMC10673015 DOI: 10.3390/medicina59111891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/09/2023] [Accepted: 10/19/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Since its invention in the 1970s, the cochlear implant (CI) has been substantially developed. We aimed to assess the trends in the published literature to characterize CI. Materials and Methods: We queried PubMed for all CI-related entries published during 1970-2022. The following data were extracted: year of publication, publishing journal, title, keywords, and abstract text. Search terms belonged to the patient's age group, etiology for hearing loss, indications for CI, and surgical methodological advancement. Annual trends of publications were plotted. The slopes of publication trends were calculated by fitting regression lines to the yearly number of publications. Results: Overall, 19,428 CIs articles were identified. Pediatric-related CI was the most dominant sub-population among the age groups, with the highest rate and slope during the years (slope 5.2 ± 0.3, p < 0.001), while elderly-related CIs had significantly fewer publications. Entries concerning hearing preservation showed the sharpest rise among the methods, from no entries in 1980 to 46 entries in 2021 (slope 1.7 ± 0.2, p < 0.001). Entries concerning robotic surgery emerged in 2000, with a sharp increase in recent years (slope 0.5 ± 0.1, p < 0.001). Drug-eluting electrodes and CI under local-anesthesia have been reported only in the past five years, with a gradual rise. Conclusions: Publications regarding CI among pediatrics outnumbered all other indications, supporting the rising, pivotal role of CI in the rehabilitation of children with sensorineural hearing loss. Hearing-preservation publications have recently rapidly risen, identified as the primary trend of the current era, followed by a sharp rise of robotic surgery that is evolving and could define the next revolution.
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Affiliation(s)
- Idit Tessler
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Ramat Gan 52621, Israel (S.S.); (Y.S.); (E.E.A.); (A.W.)
- ARC Innovation Center, Sheba Medical Center, Ramat Gan 52621, Israel; (E.Z.); (E.K.)
| | - Nir A. Gecel
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Ramat Gan 52621, Israel (S.S.); (Y.S.); (E.E.A.); (A.W.)
| | - Benjamin S. Glicksberg
- Hasso Plattner Institute for Digital Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Shaked Shivatzki
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Ramat Gan 52621, Israel (S.S.); (Y.S.); (E.E.A.); (A.W.)
| | - Yisgav Shapira
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Ramat Gan 52621, Israel (S.S.); (Y.S.); (E.E.A.); (A.W.)
| | - Eyal Zimlichman
- ARC Innovation Center, Sheba Medical Center, Ramat Gan 52621, Israel; (E.Z.); (E.K.)
| | - Eran E. Alon
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Ramat Gan 52621, Israel (S.S.); (Y.S.); (E.E.A.); (A.W.)
| | - Eyal Klang
- ARC Innovation Center, Sheba Medical Center, Ramat Gan 52621, Israel; (E.Z.); (E.K.)
- Hasso Plattner Institute for Digital Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Amit Wolfovitz
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Ramat Gan 52621, Israel (S.S.); (Y.S.); (E.E.A.); (A.W.)
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Liu Y, Wu W, Li S, Zhang Q, He J, Duan M, Yang J. Clinical characteristics and prognosis of sudden sensorineural hearing loss in single-sided deafness patients. Front Neurol 2023; 14:1230340. [PMID: 37830094 PMCID: PMC10565856 DOI: 10.3389/fneur.2023.1230340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
Background Sudden sensorineural hearing loss (SSNHL) in patients with single-sided deafness (SSD) is rare. The prognosis of the sole serviceable hearing ear is very important for these patients. However, the clinical characteristics and prognosis of SSNHL in SSD patients are not well-documented. Objective This study aimed to investigate the clinical features and treatment outcomes of SSNHL in SSD patients. Methods Clinical data of 36 SSD patients and 116 non-SSD patients with unilateral SSNHL from January 2013 to December 2022 were retrospectively investigated. The clinical characteristics of the SSD patients were analyzed. All SSD patients were treated with intratympanic steroids plus intravenous steroids. Pure-tone average (PTA) and word recognition score (WRS) before and after treatment were recorded. The hearing recovery of SSNHL in SSD patients in comparison with non-SSD patients was explored. Auditory outcomes in SSD patients with different etiologies were also compared. Results Initial hearing threshold showed no significant differences between the SSD group and the non-SSD group (66.41 ± 24.64 dB HL vs. 69.21 ± 31.48 dB HL, p = 0.625). The SSD group had a higher post-treatment hearing threshold (median (interquartile range, IQR) 53.13(36.56) dB HL) than the non-SSD group (median 32.50(47.5) dB HL, p < 0.01). Hearing gains (median 8.75(13.00) dB) and the rate of significant recovery (13.89%) were lower in the SSD group than in the non-SSD group (median 23.75(34.69) dB, 45.69%). The etiology of SSD was classified as SSNHL, special types of infection, chronic otitis media, and unknown causes. SSNHL accounted for the maximum proportion (38.9%) of causes of SSD in the SSD group. Hearing gains were lower in the SSNHL-SSD group than in other causes of the SSD group. A binary logistic regression analysis demonstrated that SSD serves as an indicator of unfavorable hearing recovery outcomes (OR = 5.264, p < 0.01). Conclusion The prognosis of SSNHL in SSD patients is unsatisfactory. SSNHL accounts for the maximum proportion of causes of SSD in this group of patients. For SSD patients caused by SSNHL, less hearing improvement after treatment was expected when SSNHL occurred in the contralateral ear in comparison with SSD patients with other causes.
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Affiliation(s)
- Yupeng Liu
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Wenjin Wu
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Shuna Li
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Qing Zhang
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jingchun He
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Maoli Duan
- Ear Nose and Throat Patient Area, Trauma and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden
- Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Jun Yang
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
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23
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Lindquist NR, Holder JT, Patro A, Cass ND, Tawfik KO, O'Malley MR, Bennett ML, Haynes DS, Gifford RH, Perkins EL. Cochlear Implants for Single-Sided Deafness: Quality of Life, Daily Usage, and Duration of Deafness. Laryngoscope 2023; 133:2362-2370. [PMID: 36254870 DOI: 10.1002/lary.30452] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/22/2022] [Accepted: 09/15/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To report our experience for adults undergoing cochlear implantation (CI) for single-sided deafness (SSD). METHODS This is a retrospective case series for adults with SSD who underwent CI between January 2013 and May 2021 at our institution. CNC and AzBio speech recognition scores, Tinnitus Handicap Inventory (THI), Speech, Spatial, and Qualities of Hearing Scale (SSQ12), datalogging, and the Cochlear Implant Quality of Life (CIQOL)-10 Global measure were utilized. RESULTS Sixty-six adults underwent CI for SSD (median 51.3 years, range 20.0-74.3 years), and 57 (86.4%) remained device users at last follow-up. Compared to pre-operative performance, device users demonstrated significant improvement in speech recognition scores and achieved peak performance at six months post-activation for CNC (8.0% increased to 45.6%, p < 0.0001) and AzBio in quiet (12.2% increased to 59.5%, p < 0.0001). THI was decreased at 6 months post-implantation (58.1-14.6, p < 0.0001), with 77% of patients reporting improved or resolved tinnitus. Patients demonstrated improved SSQ12 scores as well as the disease-specific CIQOL-10 Global questionnaire. Duration of deafness was not associated with significant differences in speech recognition performance. Average daily wear time was positively associated with CNC and AzBio scores as well as post-operative CIQOL-10 scores. CONCLUSIONS Herein we present the largest cohort of adult CI recipients with SSD with data on speech recognition scores, tinnitus measures, and SSQ12. Novel insights regarding the correlation of datalogging, duration of deafness, and CI-specific quality of life (CIQOL-10) metrics are discussed. Data continue to support CI as an efficacious treatment option for SSD. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2362-2370, 2023.
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Affiliation(s)
- Nathan R Lindquist
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jourdan T Holder
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ankita Patro
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Nathan D Cass
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kareem O Tawfik
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Matthew R O'Malley
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Marc L Bennett
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David S Haynes
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - René H Gifford
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Elizabeth L Perkins
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Shim L, Lee J, Han JH, Jeon H, Hong SK, Lee HJ. Feasibility of Virtual Reality-Based Auditory Localization Training With Binaurally Recorded Auditory Stimuli for Patients With Single-Sided Deafness. Clin Exp Otorhinolaryngol 2023; 16:217-224. [PMID: 37080730 PMCID: PMC10471910 DOI: 10.21053/ceo.2023.00206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/08/2023] [Accepted: 04/15/2023] [Indexed: 04/22/2023] Open
Abstract
OBJECTIVES To train participants to localize sound using virtual reality (VR) technology, appropriate auditory stimuli that contain accurate spatial cues are essential. The generic head-related transfer function that grounds the programmed spatial audio in VR does not reflect individual variation in monaural spatial cues, which is critical for auditory spatial perception in patients with single-sided deafness (SSD). As binaural difference cues are unavailable, auditory spatial perception is a typical problem in the SSD population and warrants intervention. This study assessed the applicability of binaurally recorded auditory stimuli in VR-based training for sound localization in SSD patients. METHODS Sixteen subjects with SSD and 38 normal-hearing (NH) controls underwent VR-based training for sound localization and were assessed 3 weeks after completing training. The VR program incorporated prerecorded auditory stimuli created individually in the SSD group and over an anthropometric model in the NH group. RESULTS Sound localization performance revealed significant improvements in both groups after training, with retained benefits lasting for an additional 3 weeks. Subjective improvements in spatial hearing were confirmed in the SSD group. CONCLUSION By examining individuals with SSD and NH, VR-based training for sound localization that used binaurally recorded stimuli, measured individually, was found to be effective and beneficial. Furthermore, VR-based training does not require sophisticated instruments or setups. These. RESULTS suggest that this technique represents a new therapeutic treatment for impaired sound localization.
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Affiliation(s)
- Leeseul Shim
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, Korea
- Ear and Interaction Center, Doheun Institute for Digital Innovation in Medicine (D.I.D.I.M.), Hallym University Medical Center, Anyang, Korea
| | - Jihyun Lee
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, Korea
- Ear and Interaction Center, Doheun Institute for Digital Innovation in Medicine (D.I.D.I.M.), Hallym University Medical Center, Anyang, Korea
| | - Ji-Hye Han
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, Korea
- Ear and Interaction Center, Doheun Institute for Digital Innovation in Medicine (D.I.D.I.M.), Hallym University Medical Center, Anyang, Korea
| | - Hanjae Jeon
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, Korea
| | - Sung-Kwang Hong
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, Korea
| | - Hyo-Jeong Lee
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, Korea
- Ear and Interaction Center, Doheun Institute for Digital Innovation in Medicine (D.I.D.I.M.), Hallym University Medical Center, Anyang, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, Korea
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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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Predictable Factors of People with Asymmetrical Hearing Loss Wearing a Hearing Aid in the Worse Ear Only. J Clin Med 2023; 12:jcm12062251. [PMID: 36983249 PMCID: PMC10059651 DOI: 10.3390/jcm12062251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
In patients with bilateral asymmetrical hearing loss (AHL), where only one hearing aid is available, it is difficult to decide which ear to amplify. The aim of this study was to evaluate the outcomes of hearing aid use for AHL patients fitted with a hearing aid in their worse ear only. One-hundred-two adults with asymmetrical-mixed or sensorineural hearing loss were retrospectively included. AHL was classified into three subgroups: unilateral hearing loss (UHL) and AHL type 1 (AHL1) and type 2 (AHL2). The main outcome measures were (1) the time spent wearing a hearing aid, (2) the hearing in a noise test (HINT), (3) the sound localization test and (4) the Korean version of the International Outcome Inventory for Hearing Aids (IOI-HA). The 1 kHz-hearing threshold of the better ear was significantly better in the successful users than in the intermittent users for UHL. Younger age was associated with significantly better outcomes than older for AHL1 and AHL2. Among the etiologies of AHL, sudden hearing loss was associated with significantly better outcomes of hearing aid use for AHL, UHL and AHL1 patients. In this study, the success rate and usage rates were 43.1% and 67.6% in AHL patients wearing a hearing aid in the worse ear. This study identified the hearing threshold of 1 kHz from the better ear, age and etiology of sudden hearing loss as audiometric and non-audiometric factors that affected the outcomes of hearing aid use.
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Yaar-Soffer Y, Kaplan-Neeman R, Greenbom T, Habiballah S, Shapira Y, Henkin Y. A cortical biomarker of audibility and processing efficacy in children with single-sided deafness using a cochlear implant. Sci Rep 2023; 13:3533. [PMID: 36864095 PMCID: PMC9981742 DOI: 10.1038/s41598-023-30399-0] [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: 10/24/2022] [Accepted: 02/22/2023] [Indexed: 03/04/2023] Open
Abstract
The goals of the current study were to evaluate audibility and cortical speech processing, and to provide insight into binaural processing in children with single-sided deafness (CHwSSD) using a cochlear implant (CI). The P1 potential to acoustically-presented speech stimuli (/m/, /g/, /t/) was recorded during monaural [Normal hearing (NH), CI], and bilateral (BIL, NH + CI) listening conditions within a clinical setting in 22 CHwSSD (mean age at CI/testing 4.7, 5.7 years). Robust P1 potentials were elicited in all children in the NH and BIL conditions. In the CI condition: (1) P1 prevalence was reduced yet was elicited in all but one child to at least one stimulus; (2) P1 latency was prolonged and amplitude was reduced, consequently leading to absence of binaural processing manifestations; (3) Correlation between P1 latency and age at CI/testing was weak and not significant; (4) P1 prevalence for /m/ was reduced and associated with CI manufacturer and duration of CI use. Results indicate that recording CAEPs to speech stimuli in clinical settings is feasible and valuable for the management of CHwSSD. While CAEPs provided evidence for effective audibility, a substantial mismatch in timing and synchrony of early-stage cortical processing between the CI and NH ear remains a barrier for the development of binaural interaction components.
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Affiliation(s)
- Y. Yaar-Soffer
- grid.413795.d0000 0001 2107 2845Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer, 52621 Ramat Gan, Israel ,grid.12136.370000 0004 1937 0546Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R. Kaplan-Neeman
- grid.413795.d0000 0001 2107 2845Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer, 52621 Ramat Gan, Israel ,grid.12136.370000 0004 1937 0546Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - T. Greenbom
- grid.413795.d0000 0001 2107 2845Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer, 52621 Ramat Gan, Israel ,grid.12136.370000 0004 1937 0546Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S. Habiballah
- grid.18098.380000 0004 1937 0562Department of Communication Disorders, Haifa University, Haifa, Israel ,grid.471000.2Alango Technologies LTD, Tirat Carmel, Israel
| | - Y. Shapira
- grid.413795.d0000 0001 2107 2845Department of Otolaryngology Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel
| | - Y. Henkin
- grid.413795.d0000 0001 2107 2845Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer, 52621 Ramat Gan, Israel ,grid.12136.370000 0004 1937 0546Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Tolisano AM, Pillion EM, Dirks CE, Ryan MT, Bernstein JGW. Quality of Life Impact of Cochlear Implantation for Single-Sided Deafness: Assessing the Interrelationship of Objective and Subjective Measures. Otol Neurotol 2023; 44:e125-e132. [PMID: 36728614 DOI: 10.1097/mao.0000000000003783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine the effect on quality of life (QOL) of cochlear implantation (CI) for single-sided deafness (SSD) and asymmetric hearing loss (AHL) using the first psychometrically developed CI-specific QOL tool for English-speaking patients and to assess its relationship to objective perceptual measures. STUDY DESIGN Retrospective cohort study. SETTING Tertiary-care medical center. PATIENTS English-speaking adults with SSD or AHL. INTERVENTIONS Unilateral CI. MAIN OUTCOME MEASURES Cochlear Implant Quality of Life (CIQOL) score, CI-alone speech-in-quiet (SIQ) score (CNC and AzBio), binaural speech-in-noise (SIN) threshold, binaural azimuthal sound localization (SL) error. RESULTS At the most recent postoperative evaluation (median, 9.3 months postimplantation), 25 of 28 subjects (89%) had a CIQOL improvement, with the improvement considered clinically beneficial (>3 points) for 18 of 28 subjects (64%). Group-mean CIQOL improvement was observed at the first postoperative visit and did not change significantly thereafter. Objective perceptual measures (SL, SIQ, SIN) continued to improve over 12 months after implantation. Linear mixed-model regression analyses showed a moderate positive correlation between SIN and SIQ improvements (r = 0.50 to 0.59, p < 0.0001) and a strong positive correlation between the improvement in the two SIQ measures (r = 0.89, p < 0.0001). No significant relationships were observed ( p > 0.05) among QOL or the objective perceptual measures. CONCLUSIONS QOL improved for the majority of subjects implanted for SSD and AHL. Different time courses for improvement in QOL and audiologic tests, combined with the lack of significant relationships among them, suggest that QOL outcomes reflect different aspects of the CI experience than those captured by speech-understanding and localization measures. SIQ may substitute for SIN when clinical constraints exist.
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Affiliation(s)
| | - Elicia M Pillion
- Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Coral E Dirks
- Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Matthew T Ryan
- Department of Otolaryngology-Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
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Seebacher J, Franke-Trieger A, Weichbold V, Galvan O, Schmutzhard J, Zorowka P, Stephan K. Sound localisation of low- and high-frequency sounds in cochlear implant users with single-sided deafness. Int J Audiol 2023; 62:71-78. [PMID: 35103553 DOI: 10.1080/14992027.2022.2030496] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Localisation of low- and high-frequency sounds in single-sided deaf cochlear implant users was investigated using noise stimuli designed to mitigate monaural localisation cues. DESIGN Within subject design. Sound source localisation was tested in the horizontal plane using an array of seven loudspeakers along the azimuthal angle span from -90° to +90°. Stimuli were broadband noise and high- and low-frequency noise. STUDY SAMPLE Twelve adult subjects with single-sided deafness participated in the study. All had normal hearing in the healthy ear and were supplied with a cochlear implant (CI) in their deaf ear. RESULTS With broadband noise, the mean angular localisation error was 39° in aided condition as compared to a median angular error of 83.6° when the speech processor was not worn. For high-frequency noise, the median angular error was 30° and for low-frequency noise, it was 46° in the CI-aided condition. CONCLUSIONS Single-sided deaf CI users show the best sound localisation for high-frequency sounds. This supports the view that interaural level differences are dominant for sound localisation in these listeners. Nonetheless, a limited ability to localise low-frequency sounds was observed, which may be based on the supportive perception of interaural time differences.
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Affiliation(s)
- J Seebacher
- Department for Hearing, Speech and Voice Disorders, Medical University of Innsbruck, Innsbruck, Austria
| | - A Franke-Trieger
- Saxonian Cochlear Implant Center, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany
| | - V Weichbold
- Department for Hearing, Speech and Voice Disorders, Medical University of Innsbruck, Innsbruck, Austria
| | - O Galvan
- Department for Hearing, Speech and Voice Disorders, Medical University of Innsbruck, Innsbruck, Austria
| | - J Schmutzhard
- Department of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, Austria
| | - P Zorowka
- Department for Hearing, Speech and Voice Disorders, Medical University of Innsbruck, Innsbruck, Austria
| | - K Stephan
- Department for Hearing, Speech and Voice Disorders, Medical University of Innsbruck, Innsbruck, Austria
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Cochlear Implant Facilitates the Use of Talker Sex and Spatial Cues to Segregate Competing Speech in Unilaterally Deaf Listeners. Ear Hear 2023; 44:77-91. [PMID: 35733275 DOI: 10.1097/aud.0000000000001254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Talker sex and spatial cues can facilitate segregation of competing speech. However, the spectrotemporal degradation associated with cochlear implants (CIs) can limit the benefit of talker sex and spatial cues. Acoustic hearing in the nonimplanted ear can improve access to talker sex cues in CI users. However, it's unclear whether the CI can improve segregation of competing speech when maskers are symmetrically placed around the target (i.e., when spatial cues are available), compared with acoustic hearing alone. The aim of this study was to investigate whether a CI can improve segregation of competing speech by individuals with unilateral hearing loss. DESIGN Speech recognition thresholds (SRTs) for competing speech were measured in 16 normal-hearing (NH) adults and 16 unilaterally deaf CI users. All participants were native speakers of Mandarin Chinese. CI users were divided into two groups according to thresholds in the nonimplanted ear: (1) single-sided deaf (SSD); pure-tone thresholds <25 dB HL at all audiometric frequencies, and (2) Asymmetric hearing loss (AHL; one or more thresholds > 25 dB HL). SRTs were measured for target sentences produced by a male talker in the presence of two masker talkers (different male or female talkers). The target sentence was always presented via loudspeaker directly in front of the listener (0°), and the maskers were either colocated with the target (0°) or spatially separated from the target at ±90°. Three segregation cue conditions were tested to measure masking release (MR) relative to the baseline condition: (1) Talker sex, (2) Spatial, and (3) Talker sex + Spatial. For CI users, SRTs were measured with the CI on or off. RESULTS Binaural MR was significantly better for the NH group than for the AHL or SSD groups ( P < 0.001 in all cases). For the NH group, mean MR was largest with the Talker sex + spatial cues (18.8 dB) and smallest for the Talker sex cues (10.7 dB). In contrast, mean MR for the SSD group was largest with the Talker sex + spatial cues (14.7 dB), and smallest with the Spatial cues (4.8 dB). For the AHL group, mean MR was largest with the Talker sex + spatial cues (7.8 dB) and smallest with the Talker sex (4.8 dB) and the Spatial cues (4.8 dB). MR was significantly better with the CI on than off for both the AHL ( P = 0.014) and SSD groups ( P < 0.001). Across all unilaterally deaf CI users, monaural (acoustic ear alone) and binaural MR were significantly correlated with unaided pure-tone average thresholds in the nonimplanted ear for the Talker sex and Talker sex + spatial conditions ( P < 0.001 in both cases) but not for the Spatial condition. CONCLUSION Although the CI benefitted unilaterally deaf listeners' segregation of competing speech, MR was much poorer than that observed in NH listeners. Different from previous findings with steady noise maskers, the CI benefit for segregation of competing speech from a different talker sex was greater in the SSD group than in the AHL group.
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Wendrich AW, van Heteren JAA, Peters JPM, Cattani G, Stokroos RJ, Versnel H, Smit AL. Choice of treatment evaluated after trial periods with bone conduction devices and contralateral routing of sound systems in patients with single-sided deafness. Laryngoscope Investig Otolaryngol 2022; 8:192-200. [PMID: 36846432 PMCID: PMC9948587 DOI: 10.1002/lio2.1002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/14/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022] Open
Abstract
Objectives Patients with single-sided deafness (SSD) may experience difficulties with speech perception in noise, sound localization, have tinnitus and experience a reduced quality of life (QoL). contralateral routing of sound hearing aids (CROS) or bone conduction devices (BCD) may partly improve subjective speech communication and QoL in SSD patients. A trial period with these devices can help in making a well-informed choice of treatment. Our aim was to evaluate factors influencing the choice of treatment made after a BCD and CROS trial period in adult SSD patients. Methods Patients were randomized in the: "first BCD, then CROS" or "first CROS, then BCD" trial period group. After the BCD on headband and CROS were tested for 6 weeks each, patients choose for BCD, CROS or no treatment. Primary outcome was the distribution of choice of treatment. Secondary outcomes included the association between the choice of treatment and patient characteristics, reasons for treatment acceptance or rejection, device usage during the trial periods, and disease-specific QoL outcomes. Results Of 91 patients randomized, 84 completed both trial periods and made their choice of treatment: 25 (30%) BCD, 34 (40%) CROS, and 25 (30%) no treatment. No characteristics were found to be related to choice of treatment. Top three reasons for acceptance or rejection were: device (dis)comfort, sound quality and (dis)advantage of subjective hearing. Average daily device use during the trial periods was higher for CROS than for BCD. Choice of treatment was significantly related with both duration of device usage and greater improvement of QoL after the corresponding trial period. Conclusion The majority of SSD patients preferred BCD or CROS over no treatment. Evaluating device usage, discussing treatment (dis)advantages and disease-specific QoL outcomes after trial periods are to be considered during patient counseling and could facilitate whether to choose one of these treatments. Level of evidence 1B.
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Affiliation(s)
- Anne W. Wendrich
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands,UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Jan A. A. van Heteren
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands,UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Jeroen P. M. Peters
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands,UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Guido Cattani
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands,Adelante Center of Expertise in rehabilitation and AudiologyHoensbroekNetherlands
| | - Robert J. Stokroos
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands,UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Huib Versnel
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands,UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Adriana L. Smit
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands,UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
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Távora-Vieira D, Wedekind A. Single-Sided Deafness: Emotional and Social Handicap, Impact on Health Status and Quality of Life, Functional Hearing, and the Effects of Cochlear Implantation. Otol Neurotol 2022; 43:1116-1124. [PMID: 36351222 DOI: 10.1097/mao.0000000000003725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To evaluate the functional and subjective outcomes in individuals with single-sided deafness (SSD) treated with a cochlear implant (CI). METHODS Eighty-one adult CI users with SSD participated in this study. Functional assessments consisted of speech in noise testing and localization. Subjective assessments consisted of the Speech Spatial Quality of Hearing Scale, the Tinnitus Reaction Questionnaire, the Abbreviated Profile of Hearing Aid Benefit questionnaire, the Hearing Handicap Inventory for Adults questionnaire, and the Glasgow Health Status Inventory and the Glasgow Benefit Inventory questionnaires. RESULTS SSD has remarkable consequences on quality of life (QoL) and imposes a substantial emotional and social handicap on the individuals. Self-reported QoL improved after CI with tinnitus intrusion significantly reduced as early as 3 months post-CI. A significant improvement was seen in all speech understanding in noise configurations. Localization ability significantly improved with CI on. CONCLUSION Our findings demonstrate that SSD reduces social and psychological QoL and imposes a remarkable level of handicap as per general and specific self-assessments tool. CI provided a significant improvement in function including speech understanding in noise and localization ability, as well as improved QoL and reduced tinnitus significantly in both the early and long terms.
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Towards a Consensus on an ICF-Based Classification System for Horizontal Sound-Source Localization. J Pers Med 2022; 12:jpm12121971. [PMID: 36556192 PMCID: PMC9786639 DOI: 10.3390/jpm12121971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/15/2022] [Accepted: 11/18/2022] [Indexed: 12/05/2022] Open
Abstract
The study aimed to develop a consensus classification system for the reporting of sound localization testing results, especially in the field of cochlear implantation. Against the background of an overview of the wide variations present in localization testing procedures and reporting metrics, a novel classification system was proposed to report localization errors according to the widely accepted International Classification of Functioning, Disability and Health (ICF) framework. The obtained HEARRING_LOC_ICF scale includes the ICF graded scale: 0 (no impairment), 1 (mild impairment), 2 (moderate impairment), 3 (severe impairment), and 4 (complete impairment). Improvement of comparability of localization results across institutes, localization testing setups, and listeners was demonstrated by applying the classification system retrospectively to data obtained from cohorts of normal-hearing and cochlear implant listeners at our institutes. The application of our classification system will help to facilitate multi-center studies, as well as allowing better meta-analyses of data, resulting in improved evidence-based practice in the field.
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Single-Sided Deafness: Using Cortical Auditory Evoked Potential to Improve Cochlear Implant Fitting. Otol Neurotol 2022; 43:e976-e983. [PMID: 36040051 DOI: 10.1097/mao.0000000000003659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To investigate if acoustic cortical auditory evoked potential (aCAEP) measures can be used to verify the cochlear implant (CI) map and consequently improve auditory outcomes in adults with single-sided deafness (SSD). DESIGN aCAEPs were measured in SSD-CI recipients using speech tokens /m/, /g/, /t/, and /s/. If aCAEP responses were present for all speech tokens at the outset, no map adjustments were implemented. If aCAEP responses were absent for one or more tokens, the map was adjusted until aCAEPs were observed for all four tokens. Speech in noise testing using BKB-SiN was performed before and after aCAEP recording. The results of the speech testing results at presurgery, 6, 12, and 24 months post-CI were also analyzed. RESULTS Sixty-seven CI users with SSD participated in this study. All CIs had been mapped according to the conventional subjective loudness perception method. Twenty-three SSD-CI users exhibited an aCAEP response for all four speech tokens and were therefore considered optimized at outset. Forty-four participants lacked an aCAEP response from at least one speech token and had their most comfortable levels adjusted accordingly. Of these, map adjustments allowed aCAEPs to be elicited for all four speech tokens in 23 individuals. Speech in noise testing significantly improved pre- to post-aCAEP-based adjustment. CONCLUSION aCAEP recordings were successfully used to verify CI mapping and improve resultant speech outcomes in SSD-CI users.
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Katiri R, Hall DA, Hoare DJ, Fackrell K, Horobin A, Hogan N, Buggy N, Van de Heyning PH, Firszt JB, Bruce IA, Kitterick PT. The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) study: International consensus on outcome measures for trials of interventions for adults with single-sided deafness. Trials 2022; 23:764. [PMID: 36076299 PMCID: PMC9454406 DOI: 10.1186/s13063-022-06702-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 09/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background Single-sided deafness (SSD) has functional, psychological, and social consequences. Interventions for adults with SSD include hearing aids and auditory implants. Benefits and harms (outcome domains) of these interventions are until now reported inconsistently in clinical trials. Inconsistency in reporting outcome measures prevents meaningful comparisons or syntheses of trial results. The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) international initiative used structured communication techniques to achieve consensus among healthcare users and professionals working in the field of SSD. The novel contribution is a set of core outcome domains that experts agree are critically important to assess in all clinical trials of SSD interventions. Methods A long list of candidate outcome domains compiled from a systematic review and published qualitative data, informed the content of a two-round online Delphi survey. Overall, 308 participants from 29 countries were enrolled. Of those, 233 participants completed both rounds of the survey and scored each outcome domain on a 9-point scale. The set of core outcome domains was finalised via a web-based consensus meeting with 12 participants. Votes involved all stakeholder groups, with an approximate 2:1 ratio of professionals to healthcare users participating in the Delphi survey, and a 1:1 ratio participating in the consensus meeting. Results The first round of the survey listed 44 potential outcome domains, organised thematically. A further five outcome domains were included in Round 2 based on participant feedback. The structured voting at round 2 identified 17 candidate outcome domains which were voted on at the consensus meeting. Consensus was reached for a core outcome domain set including three outcome domains: spatial orientation, group conversations in noisy social situations, and impact on social situations. Seventy-seven percent of the remaining Delphi participants agreed with this core outcome domain set. Conclusions Adoption of the internationally agreed core outcome domain set would promote consistent assessment and reporting of outcomes that are meaningful and important to all relevant stakeholders. This consistency will in turn enable comparison of outcomes reported across clinical trials comparing SSD interventions in adults and reduce research waste. Further research will determine how those outcome domains should best be measured. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06702-1.
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Affiliation(s)
- Roulla Katiri
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK. .,National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK. .,Audiology Department, Mater Misericordiae University Hospital, North Circular Road, Dublin, D07 R2WY, Ireland.
| | - Deborah A Hall
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.,Department of Psychology, School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
| | - Derek J Hoare
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.,National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - Kathryn Fackrell
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.,National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK.,Wessex Institute, University of Southampton, University Road, Southampton, SO17 1BJ, UK
| | - Adele Horobin
- National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK.,Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, UK
| | - Nicholas Hogan
- National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - Nóra Buggy
- National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - Paul H Van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), 2650, Edegem, Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610, Antwerp, Belgium
| | - Jill B Firszt
- Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1010, USA
| | - Iain A Bruce
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, UK.,Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Pádraig T Kitterick
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.,National Acoustic Laboratories, Australian Hearing Hub, Macquarie University, Sydney, NSW, 2109, Australia
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American Cochlear Implant Alliance Task Force Guidelines for Clinical Assessment and Management of Adult Cochlear Implantation for Single-Sided Deafness. Ear Hear 2022; 43:1605-1619. [PMID: 35994570 PMCID: PMC9592177 DOI: 10.1097/aud.0000000000001260] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The indications for cochlear implantation have expanded to include individuals with profound sensorineural hearing loss in the impaired ear and normal hearing (NH) in the contralateral ear, known as single-sided deafness (SSD). There are additional considerations for the clinical assessment and management of adult cochlear implant candidates and recipients with SSD as compared to conventional cochlear implant candidates with bilateral moderate to profound sensorineural hearing loss. The present report reviews the current evidence relevant to the assessment and management of adults with SSD. A systematic review was also conducted on published studies that investigated outcomes of cochlear implant use on measures of speech recognition in quiet and noise, sound source localization, tinnitus perception, and quality of life for this patient population. Expert consensus and systematic review of the current literature were combined to provide guidance for the clinical assessment and management of adults with SSD.
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Anderson KM, Buss E, Rooth MA, Richter ME, Overton AB, Brown KD, Dillon MT. Masked Speech Recognition as a Function of Masker Location for Cochlear Implant Users With Single-Sided Deafness. Am J Audiol 2022; 31:757-763. [PMID: 35877957 DOI: 10.1044/2022_aja-21-00268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Cochlear implant (CI) recipients with normal or near normal hearing (NH) in the contralateral ear, referred to as single-sided deafness (SSD), experience significantly better speech recognition in noise with their CI than without it, although reported outcomes vary. One possible explanation for differences in outcomes across studies could be differences in the spatial configurations used to assess performance. This study compared speech recognition for different spatial configurations of the target and masker, with test materials used clinically. METHOD Sixteen CI users with SSD completed tasks of masked speech recognition presented in five spatial configurations. The target speech was presented from the front speaker (0° azimuth). The masker was located either 90° or 45° toward the CI-ear or NH-ear or colocated with the target. Materials were the AzBio sentences in a 10-talker masker and the Bamford-Kowal-Bench Speech-in-Noise test (BKB-SIN; four-talker masker). Spatial release from masking (SRM) was computed as the benefit associated with spatial separation relative to the colocated condition. RESULTS Performance was significantly better when the masker was separated toward the CI-ear as compared to colocated. No benefit was observed for spatial separations toward the NH-ear. The magnitude of SRM for spatial separations toward the CI-ear was similar for 45° and 90° when tested with the AzBio sentences, but a larger benefit was observed for 90° as compared to 45° for the BKB-SIN. CONCLUSIONS Masked speech recognition in CI users with SSD varies as a function of the spatial configuration of the target and masker. Results supported an expansion of the clinical test battery at the study site to assess binaural hearing abilities for CI candidates and recipients with SSD. The revised test battery presents the target from the front speaker and the masker colocated with the target, 90° toward the CI-ear, or 90° toward the NH-ear.
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Affiliation(s)
- Kelly M Anderson
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill.,Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill
| | - Emily Buss
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Meredith A Rooth
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Margaret E Richter
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | | | - Kevin D Brown
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill
| | - Margaret T Dillon
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill.,Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill
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Auinger AB, Liepins R, Brkic FF, Vyskocil E, Arnoldner C. The Functional Hearing Gain with an Active Transcutaneous Bone Conduction Implant Does Not Correlate with the Subjective Hearing Performance. J Pers Med 2022; 12:jpm12071064. [PMID: 35887561 PMCID: PMC9321828 DOI: 10.3390/jpm12071064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/21/2022] [Accepted: 06/25/2022] [Indexed: 11/24/2022] Open
Abstract
The functional hearing outcome with hearing implants does not always properly reflect the subjective benefit in everyday listening situations. In this study, the functional hearing gain and the impact on the subjective hearing ability and quality of life were assessed in patients with a Bonebridge. A chart review was performed on 45 patients with a Bonebridge who were provided with questionnaires regarding the hearing quality and health-related quality of life during their last clinical visit. The questionnaires consisted of the Speech, Spatial and Qualities (SSQ) and the Health Utility Index Mark 3 (HUI3). Eleven patients had to be excluded due to missing data. A total of 34 patients (37 ears) were included in the study. Aided hearing thresholds were significantly lower compared with the unaided condition, with a mean functional gain of 26.87 dB for patients with mixed/conductive hearing loss (MHL/CHL). Although patients with single-sided deafness (SSD) scored slightly lower on the SSQ compared with patients with MHL/CHL, all included patients reported improved subjective hearing quality with the BB compared with the hearing situation before implantation. No correlation was found between the functional hearing gain and the subdomains of the SSQ. SSD patients scored the HUI3 subdomain “hearing” slightly lower compared with MHL/CHL patients. Although not significant, a relationship was found between the functional gain and the “hearing” subdomain. No correlation was found for the other subdomains of the HUI3. Audiological measurements showed significantly improved hearing thresholds with the Bonebridge. Most importantly, the subjective benefit achieved in everyday listening situations was superior compared with the previous hearing condition. The lack of correlation between subjective questionnaire results and the functional hearing gain shows the importance of assessing both audiological and subjective hearing quality parameters in clinical routine.
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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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Longitudinal auditory data of children with prelingual single-sided deafness managed with early cochlear implantation. Sci Rep 2022; 12:9376. [PMID: 35672363 PMCID: PMC9174487 DOI: 10.1038/s41598-022-13247-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 05/23/2022] [Indexed: 11/09/2022] Open
Abstract
Individuals with single-sided deafness (SSD) have no access to binaural hearing, which limits their ability to localize sounds and understand speech in noisy environments. In addition, children with prelingual SSD are at risk for neurocognitive and academic difficulties. Early cochlear implantation may lead to improved hearing outcomes by restoring bilateral hearing. However, its longitudinal impact on the development of children with SSD remains unclear. In the current study, a group of young children with prelingual SSD received a cochlear implant at an early age. From the age of four, the children’s spatial hearing skills could be assessed using a spatial speech perception in noise test and a sound localization test. The results are compared to those of two control groups: children with SSD without a cochlear implant and children with bilateral normal hearing. Overall, the implanted group exhibited improved speech perception in noise abilities and better sound localization skills, compared to their non-implanted peers. On average, the children wore their device approximately nine hours a day. Given the large contribution of maturation to the development of spatial hearing skills, further follow-up is important to understand the long-term benefit of a cochlear implant for children with prelingual SSD.
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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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Fritz CG, Dwyer SM, Renker JM, Luryi AL, Doerfer KW, Bojrab DI, Hong RS, Babu SC. Patient Sentiments Influencing Management Strategy for Single-sided Deafness. Otol Neurotol 2022; 43:e399-e407. [PMID: 35213474 DOI: 10.1097/mao.0000000000003492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Assess opinions that influence treatment choice for single sided deafness (SSD). STUDY DESIGN Retrospective chart review. SETTING Tertiary neurotology referral center. PATIENTS Patients with SSD were recruited between December 2020 and February 2021. Included patients were self-selected by voluntary completion of the study questionnaire. MAIN OUTCOME MEASURES Tinnitus Handicap Inventory (THI), Hearing Handicap Inventory for Adults (HHIA), and a questionnaire containing 25 areas of inquiry relevant to management strategy decision making. RESULTS In comparison to the surgical management group, patients opting for nonsurgical amplification were significantly more concerned about device visibility (p = 0.005, 1.32 ± 0.22 versus 2.67 ± 0.37), undergoing surgery (p = 0.017, 1.64 ± 0.23 versus 2.89 ± 0.51), and the thought of harboring an implanted device (p = 0.003, 1.46 ± 0.22 versus 2.82 ± 0.35). Patients with a major hearing handicap (grade 2-4) placed significantly less emphasis on out-of-pocket costs (p = 0.049, 2.38 ± 0.17 versus 2.94 ± 0.21) and were less concerned about experiencing discomfort from the device (p = 0.033, 3.13 ± 0.11 versus 3.56 ± 0.16) or ease of device use (p = 0.040, 3.20 ± 0.13 versus 3.63 ± 0.13) when compared with the minor handicap group. CONCLUSIONS Lingering concerns about device visibility, undergoing surgery, and harboring an implanted device underscore the need for thorough patient counseling during SSD device selection consultations. These efforts should aim to address esthetic and surgical risk concerns while emphasizing the potential for improvements in quality of life.
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Affiliation(s)
- Christian G Fritz
- Michigan Ear Institute, Farmington Hills
- Oakland University William Beaumont School of Medicine
| | | | | | | | | | | | - Robert S Hong
- Michigan Ear Institute, Farmington Hills
- Neurotology Division, St John Providence Health System, Novi
- Department of Surgery, William Beaumont School of Medicine, Oakland University, Rochester
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University, Detroit, Michigan
| | - Seilesh C Babu
- Michigan Ear Institute, Farmington Hills
- Neurotology Division, St John Providence Health System, Novi
- Department of Surgery, William Beaumont School of Medicine, Oakland University, Rochester
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University, Detroit, Michigan
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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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Potier M, Seldran F, Sonthonnax M, Péan V, Berger P, Norena A, Gallégo S. Evaluation of a New Bone Conduction Device for the Rehabilitation of Single-Sided Deafness: Effects on Speech Understanding in Noise. Otol Neurotol 2022; 43:105-112. [PMID: 34699396 DOI: 10.1097/mao.0000000000003364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION A new external, adhesive, no-pressure bone-conduction device provides rehabilitation for conductive hearing loss and single-sided deafness (SSD). The purpose of the study is to evaluate speech recognition performance with the bone-conduction contralateral routing of signal (aBC-CROS) and compare it to an air-conduction CROS (AC-CROS) used by subjects for at least 1 year. METHODS Ten SSD patients underwent speech understanding in noise tests with their AC-CROS, the aBC-CROS, and unaided. The 1st test session took place the day the aBC-CROS was fitted, with the second session after 2 weeks of aBC-CROS use. Two configurations were used: speech presented on the deaf side and noise on the normal side and the reverse. RESULTS The speech recognition threshold (SRT) improved with both devices when speech was presented to the deaf side. Nine patients showed significant improvement (p < 0.016) with the AC-CROS (mean: 2.8 dB) and the aBC-CROS (mean: 3.0 dB). Mean difference of improvement was significant between unaided and aBC-CROS (p = 0.001) or AC-CROS (p = 0.006). The SRT deteriorated by an average of 2.3 dB with the AC-CROS with noise presented on the deaf side, with significance found for six patients (p < 0.016). The aBC-CROS did not affect performance in this configuration (mean improvement: 0.3 dB) and only one patient had a significant SRT degradation (p < 0.016). Mean difference of improvement was significant between the AC-CROS and aBC-CROS (p = 0.021) or unaided (p = 0.05). DISCUSSION The aBC-CROS is a good alternative to the existing CROS devices for SSD rehabilitation, as it offers the same benefit with none of the drawbacks when noise is on the patient's deaf side.
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Affiliation(s)
- Morgan Potier
- Sensory and Cognitive Neuroscience Laboratory (LNSC), Marseille
| | | | | | | | | | - Arnaud Norena
- Sensory and Cognitive Neuroscience Laboratory (LNSC), Marseille
| | - Stéphane Gallégo
- Sensory and Cognitive Neuroscience Laboratory (LNSC), Marseille
- Institute of Sciences and Technologies of Rehabilitation (ISTR), University of Lyon, Lyon, France
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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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Pieper SH, Hamze N, Brill S, Hochmuth S, Exter M, Polak M, Radeloff A, Buschermöhle M, Dietz M. Considerations for Fitting Cochlear Implants Bimodally and to the Single-Sided Deaf. Trends Hear 2022; 26:23312165221108259. [PMID: 35726211 PMCID: PMC9218456 DOI: 10.1177/23312165221108259] [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] [Indexed: 11/16/2022] Open
Abstract
When listening with a cochlear implant through one ear and acoustically through the other, binaural benefits and spatial hearing abilities are generally poorer than in other bilaterally stimulated configurations. With the working hypothesis that binaural neurons require interaurally matched inputs, we review causes for mismatch, their perceptual consequences, and experimental methods for mismatch measurements. The focus is on the three primary interaural dimensions of latency, frequency, and level. Often, the mismatch is not constant, but rather highly stimulus-dependent. We report on mismatch compensation strategies, taking into consideration the specific needs of the respective patient groups. Practical challenges typically faced by audiologists in the proposed fitting procedure are discussed. While improvement in certain areas (e.g., speaker localization) is definitely achievable, a more comprehensive mismatch compensation is a very ambitious endeavor. Even in the hypothetical ideal fitting case, performance is not expected to exceed that of a good bilateral cochlear implant user.
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Affiliation(s)
- Sabrina H Pieper
- Department of Medical Physics and Acoustic, University of Oldenburg, Oldenburg, Germany.,Cluster of Excellence Hearing4all, University of Oldenburg, Oldenburg, Germany
| | - Noura Hamze
- MED-EL Medical Electronics GmbH, Innsbruck, Austria
| | - Stefan Brill
- MED-EL Medical Electronics Germany GmbH, Starnberg, Germany
| | - Sabine Hochmuth
- Division of Otorhinolaryngology, University of Oldenburg, Oldenburg, Germany
| | - Mats Exter
- Cluster of Excellence Hearing4all, University of Oldenburg, Oldenburg, Germany.,Hörzentrum Oldenburg gGmbH, Oldenburg, Germany
| | - Marek Polak
- MED-EL Medical Electronics GmbH, Innsbruck, Austria
| | - Andreas Radeloff
- Cluster of Excellence Hearing4all, University of Oldenburg, Oldenburg, Germany.,Division of Otorhinolaryngology, University of Oldenburg, Oldenburg, Germany.,Research Center Neurosensory Science, University of Oldenburg, Oldenburg, Germany
| | | | - Mathias Dietz
- Department of Medical Physics and Acoustic, University of Oldenburg, Oldenburg, Germany.,Cluster of Excellence Hearing4all, University of Oldenburg, Oldenburg, Germany.,Research Center Neurosensory Science, University of Oldenburg, Oldenburg, Germany
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Liu Y, Zhao C, Yang J, Chen P, Gao M, Wang D, Zhao S. Audiological and subjective benefit with a new adhesive bone conduction hearing aid in children with congenital unilateral microtia and atresia. Eur Arch Otorhinolaryngol 2021; 279:4289-4301. [PMID: 34816297 DOI: 10.1007/s00405-021-07168-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 11/02/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to evaluate the audiological benefits and subjective satisfaction in using a new adhesive bone conduction hearing aid in children with congenital unilateral microtia and atresia. METHODS We evaluated the effectiveness of the hearing aid using the sound field hearing threshold, speech recognition ability under quiet and noise, and subjective questionnaires in 13 children (5-15 years old). RESULTS The mean sound field hearing threshold significantly improved with a gain of 25.4 ± 4.9 dB HL. Mean word recognition scores were ameliorated in quiet and noise by 1.9 ± 2.5% and 7.3 ± 5.3%, respectively. Speech recognition ability results in noise varied; when the speech signal and noise were presented from the front, the mean speech recognition ability improved by 2.5 ± 1.6 dB signal-to-noise ratios (SNR). When noise was presented towards the normal hearing side, speech understanding was improved by 2.9 ± 1.6 dB SNR. When the speech signal was presented from the atretic side with noise from the normal hearing side, an improvement of 5.7 ± 3.4 dB SNR (p < 0.001) was noted. However, when noise was presented towards the newly aided atretic ear, no statistical significance was found. The questionnaire results indicated that the hearing device provided benefits in speech recognition ability in different complex situations, with high satisfaction rates. CONCLUSION The adhesive bone conduction hearing aid investigated here offers a concealed and aesthetic method to improve hearing in children with congenital unilateral microtia and atresia during their early years, with high subjective satisfaction.
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Affiliation(s)
- Yujie Liu
- Department of Otolaryngology Head and Neck Surgery, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Chunli Zhao
- Department of Otolaryngology Head and Neck Surgery, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Jinsong Yang
- Department of Otolaryngology Head and Neck Surgery, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Peiwei Chen
- Department of Otolaryngology Head and Neck Surgery, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Mengdie Gao
- Department of Otolaryngology Head and Neck Surgery, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Danni Wang
- Department of Otolaryngology Head and Neck Surgery, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Shouqin Zhao
- Department of Otolaryngology Head and Neck Surgery, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
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Diagnostic Yield of Targeted Hearing Loss Gene Panel Sequencing in a Large German Cohort With a Balanced Age Distribution from a Single Diagnostic Center: An Eight-year Study. Ear Hear 2021; 43:1049-1066. [PMID: 34753855 PMCID: PMC9007094 DOI: 10.1097/aud.0000000000001159] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives: Hereditary hearing loss exhibits high degrees of genetic and clinical heterogeneity. To elucidate the population-specific and age-related genetic and clinical spectra of hereditary hearing loss, we investigated the sequencing data of causally associated hearing loss genes in a large cohort of hearing-impaired probands with a balanced age distribution from a single center in Southwest Germany. Design: Genetic testing was applied to 305 hearing-impaired probands/families with a suspected genetic hearing loss etiology and a balanced age distribution over a period of 8 years (2011–2018). These individuals were representative of the regional population according to age and sex distributions. The genetic testing workflow consisted of single-gene screening (n = 21) and custom-designed hearing loss gene panel sequencing (n = 284) targeting known nonsyndromic and syndromic hearing loss genes in a diagnostic setup. Retrospective reanalysis of sequencing data was conducted by applying the current American College of Medical Genetics and Genomics/Association for Molecular Pathology guidelines. Results: A genetic diagnosis was established for 75 (25%) of the probands that involved 75 causal variants in 35 genes, including 16 novel causal variants and 9 medically significant variant reclassifications. Nearly half of the solved cases (47%; n = 35) were related to variants in the five most frequently affected genes: GJB2 (25%), MYO15A, WFS1, SLC26A4, and COL11A1 (all 5%). Nearly one-quarter of the cases (23%; n = 17) were associated with variants in seven additional genes (TMPRSS3, COL4A3, LOXHD1, EDNRB, MYO6, TECTA, and USH2A). The remaining one-third of single cases (33%; n = 25) were linked to variants in 25 distinct genes. Diagnostic rates and gene distribution were highly dependent on phenotypic characteristics. A positive family history of autosomal-recessive inheritance in combination with early onset and higher grades of hearing loss significantly increased the solve rate up to 60%, while late onset and lower grades of hearing loss yielded significantly fewer diagnoses. Regarding genetic diagnoses, autosomal-dominant genes accounted for 37%, autosomal-recessive genes for 60%, and X-linked genes for 3% of the solved cases. Syndromic/nonsyndromic hearing loss mimic genes were affected in 27% of the genetic diagnoses. Conclusions: The genetic epidemiology of the largest German cohort subjected to comprehensive targeted sequencing for hereditary hearing loss to date revealed broad causal gene and variant spectra in this population. Targeted hearing loss gene panel analysis proved to be an effective tool for ensuring an appropriate diagnostic yield in a routine clinical setting including the identification of novel variants and medically significant reclassifications. Solve rates were highly sensitive to phenotypic characteristics. The unique population-adapted and balanced age distribution of the cohort favoring late hearing loss onset uncovered a markedly large contribution of autosomal-dominant genes to the diagnoses which may be a representative for other age balanced cohorts in other populations.
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Ellsperman SE, Zwolan TA, Telian SA. Rehabilitation for unilateral deafness - Narrative review comparing a novel bone conduction solution with existing options. Am J Otolaryngol 2021; 42:103060. [PMID: 33932625 DOI: 10.1016/j.amjoto.2021.103060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/11/2021] [Indexed: 12/17/2022]
Abstract
Patients with single sided deafness (SSD) struggle with sound localization and speech in noise. Existing treatment options include contralateral routing of signal (CROS) systems, percutaneous bone conduction hearing devices (BCHDs), passive transcutaneous BCHDs, active BCHDs, and cochlear implants. Implanted devices provide benefits in speech in noise compared to CROS devices. Percutaneous BCHDs transmit sound efficiently but have aesthetic drawbacks and skin complications. Scalp attenuation impacts passive transcutaneous BCHD performance. Active BCHDs overcome these issues and provide benefits for speech in noise. Cochlear implantation is the only existing option that restores binaural input but introduces electrical rather than acoustic stimuli to the deaf ear. Active BCHDs have been designed to maintain efficient sound transmission and avoid chronic skin irritation and cosmetic concerns that may occur with percutaneous BCHDs. Cochlear implantation may be a superior option for recently deafened SSD patients, though this requires further study. The duration of deafness, patient age and comorbidities, and a shared decision-making model among patients, surgeons, and audiologists should be considered in device selection. The aim of this manuscript is to review available devices, discuss surgical considerations for implantable devices, review available published results for speech in noise and sound quality with each device, and provide an overview to guide shared decision making for patients and providers. This review consolidates available literature and reviews experience with a newer active transcutaneous active BCHD available for use in the SSD population.
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Affiliation(s)
- Susan E Ellsperman
- Department of Otolaryngology-Head and Neck Surgery University of Michigan Ann Arbor Michigan, United States of America.
| | - Terry A Zwolan
- Department of Otolaryngology-Head and Neck Surgery University of Michigan Ann Arbor Michigan, United States of America.
| | - Steven A Telian
- Department of Otolaryngology-Head and Neck Surgery University of Michigan Ann Arbor Michigan, United States of America.
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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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