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Anidi C, Abdulrazzak O, Jones G, Epperson MV, Ibrahim NI, Banakis Hartl RM. Auditory Localization Performance in Cochlear Implant Recipients With Single-Sided Deafness: The Challenges and Limitations of Current Outcome Metrics. Otol Neurotol 2024; 45:878-886. [PMID: 39066685 DOI: 10.1097/mao.0000000000004273] [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: 07/30/2024]
Abstract
HYPOTHESIS Acoustic localization accuracy metrics currently employed in clinical literature both overestimate and underestimate performance benefit of cochlear implantation (CI) for single-sided deafness (SSD). BACKGROUND Although localization in SSD with CI has been investigated, performance characterization has relied heavily on average error. Although attractively concise, this measure may misrepresent performance. Here, we characterize frequency-specific localization on a granular level in subjects with CI for SSD as a critical analysis of localization outcome metrics. METHODS Eight CI recipients with SSD were recruited. Stimuli of broadband (BBN) and narrowband noise (NBN) at low (500 Hz), mid (1000 Hz), and high (4000 Hz) frequencies were presented in a semianechoic chamber. Localization accuracy was quantified in mean angular error (MAE) and linear regression slope. RESULTS Use of a CI for SSD subjects improved localization performance by slope for all stimuli ( p ≤ 0.0033) to a level that was equal to normal-hearing controls at 1 and 4 kHz ( p ≥ 0.2281). MAE was also significantly improved for SSD subjects using CI for BBN stimuli ( p ≪ 0.0001); however, no statistically significant improvement in MAE was seen for NBN ( p ≥ 0.5773) with CI use. Descriptive analysis of individual subject performance highlights the reasons for contradictory results. CONCLUSION There is inherent challenge in characterizing localization benefit for individuals with CI for SSD. Our data demonstrate the limitations of utilization of average error as the sole metric for outcome benefit. We emphasize the importance of continued research investigating alternative outcome measures as we work toward a more refined understanding of the potential benefits and limitations of cochlear implantation for SSD.
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Affiliation(s)
- Chioma Anidi
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Obada Abdulrazzak
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Gerilyn Jones
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Madison V Epperson
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Nadine I Ibrahim
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Renee M Banakis Hartl
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
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2
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Kleinjung T, Peter N, Schecklmann M, Langguth B. The Current State of Tinnitus Diagnosis and Treatment: a Multidisciplinary Expert Perspective. J Assoc Res Otolaryngol 2024:10.1007/s10162-024-00960-3. [PMID: 39138756 DOI: 10.1007/s10162-024-00960-3] [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: 12/28/2023] [Accepted: 07/31/2024] [Indexed: 08/15/2024] Open
Abstract
Tinnitus, the perception of sound without an external source, affects 15% of the population, with 2.4% experiencing significant distress. In this review, we summarize the current state of knowledge about tinnitus management with a particular focus on the translation into clinical practice. In the first section, we analyze shortcomings, knowledge gaps, and challenges in the field of tinnitus research. Then, we highlight the relevance of the diagnostic process to account for tinnitus heterogeneity and to identify all relevant aspects of the tinnitus in an individual patient, such as etiological aspects, pathophysiological mechanisms, factors that contribute most to suffering, and comorbidities. In the next section, we review available treatment options, including counselling, cognitive-behavioral therapy (CBT), hearing aids and cochlear implants for patients with a relevant hearing loss, sound generators, novel auditory stimulation approaches, tinnitus retraining therapy (TRT), pharmacological treatment, neurofeedback, brain stimulation, bimodal stimulation, Internet- and app-based digital approaches, and alternative treatment approaches. The evidence for the effectiveness of the various treatment interventions varies considerably. We also discuss differences in current respective guideline recommendations and close with a discussion of how current pathophysiological knowledge, latest scientific evidence, and patient perspectives can be translated in patient-centered care.
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Affiliation(s)
- Tobias Kleinjung
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Nicole Peter
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Bezirksklinikum, Universitätsstr. 84, 93049, Regensburg, Germany
- Multidisciplinary Tinnitus Clinic, University of Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Bezirksklinikum, Universitätsstr. 84, 93049, Regensburg, Germany.
- Multidisciplinary Tinnitus Clinic, University of Regensburg, Regensburg, Germany.
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3
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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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Tang D, Tran Y, Lo C, Lee JN, Turner J, McAlpine D, McMahon C, Gopinath B. The Benefits of Cochlear Implantation for Adults: A Systematic Umbrella Review. Ear Hear 2024; 45:801-807. [PMID: 38233980 DOI: 10.1097/aud.0000000000001473] [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] [Indexed: 01/19/2024]
Abstract
OBJECTIVES The uptake of cochlear implants among adults who could benefit (based on pure-tone audiometry) in developed countries is estimated to be less than 10%. Concerns about potential surgical complications, fear of losing residual hearing, and limited awareness about the benefits of this intervention contribute to the low adoption rate. To enhance quality of life and improve the uptake of cochlear implants, it is essential to have a clear understanding of their benefits. DESIGN This umbrella review aims to summarize the major benefits of cochlear implant usage in adults, by synthesizing findings from published review articles. A comprehensive search of databases including MEDLINE, EMBASE, PsycINFO, and Google Scholar, was conducted. The search was limited to English-language review articles published between 1990 and 2022, focusing on cochlear implant outcomes in at least 5 adults (aged ≥18 years). Two independent reviewers screened titles, abstracts, and full-text articles, and conducted a quality assessment using the Joanna Briggs Checklist for Systematic Reviews and Research Syntheses. RESULTS Forty-two articles were included in this review. There were 15 systematic reviews with meta-analysis, 25 systematic reviews without meta-analysis, and 2 systematic scoping reviews. All 42 articles underwent quality assessment using the Joanna Briggs Institute Checklist for Systematic Reviews and Research Syntheses, of which 40% (n = 17) satisfied 9 out of 11 quality criteria. This umbrella review shows that cochlear implants are associated with improvements in speech perception and recognition as well as improved quality of life and cognition. These benefits are observed in a significant proportion of adults undergoing the procedure, highlighting its effectiveness as a viable intervention for individuals with severe to profound hearing loss. CONCLUSIONS The potential benefits of cochlear implantation appear to outweigh the risks and complications associated with the procedure. It is recommended that adults with severe to profound hearing loss in particular, engage in informed discussions with healthcare professionals to consider cochlear implantation as a viable treatment option.
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Affiliation(s)
- Diana Tang
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Yvonne Tran
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Charles Lo
- Department of Management, Australian College of Applied Professions, Sydney, New South Wales, Australia
| | - Jien Nien Lee
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Jessica Turner
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - David McAlpine
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Catherine McMahon
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Bamini Gopinath
- Macquarie University Hearing Research Centre, Faculty of Medicine Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
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Kang YJ, Zheng Y. Current understanding of subjective tinnitus in adults. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08633-w. [PMID: 38632112 DOI: 10.1007/s00405-024-08633-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 03/14/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE An up-to-date overview of epidemiology, etiology and pathophysiological mechanisms, diagnostic and evaluation methods, current treatment status and future directions of subjective tinnitus in adults. METHODS Review of current evidence-based literature on subjective tinnitus in adults. RESULTS The prevalence of subjective tinnitus in the adult population is estimated to be around 14%, and it tends to increase with age. Subjective tinnitus is a complex condition with multiple factors contributing to its origin. However, the exact causes and underlying mechanisms remain unknown. Potential causes may include hearing loss, dysfunction in the somatosensory system, and auditory cortical dysfunction, although severe underlying pathology is rare. Currently, diagnosis primarily relies on patient self-reported medical history and physician-based clinical assessment due to the lack of objective testing. Various treatment and management options have been proposed, but their effectiveness varies, and there is no universally agreed-upon treatment option. CONCLUSIONS Tinnitus is a complex and heterogeneous disease with a high incidence rate and a tendency to increase with age. A holistic perspective is needed to understand the generation, perception, and emotional responses to tinnitus. Diagnosis requires a comprehensive assessment based on medical history and relevant examinations, identification of concurrent psychosomatic comorbidities, and active pursuit of objective diagnostic methods. At the same time, on the basis of existing treatment plans and combining emerging technologies, we will develop new personalized, precise, and combined treatment plans.
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Affiliation(s)
- Yao-Jie Kang
- Hearing Center, Department of Otolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
- Department of Otolaryngology-Head and Neck Surgery, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Tujia and Miao Autonomous Prefecture, China
| | - Yun Zheng
- Hearing Center, Department of Otolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China.
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Colasacco CJ, Morgan S, Bornstein R, Drugge E, Stidham KR. Cochlear Implantation in Children With a Long Average Duration of Single Sided Deafness. Ann Otol Rhinol Laryngol 2024; 133:345-350. [PMID: 38047440 DOI: 10.1177/00034894231216288] [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: 12/05/2023]
Abstract
OBJECTIVES Previous research has shown the positive effects of cochlear implantation in children with a short duration of single sided deafness (SSD). This case series assessed the impact of cochlear implantation in a cohort of children with a longer average duration of SSD. METHODS A retrospective chart review of 6 children who received a cochlear implant for SSD. The mean age at time of cochlear implantation was 14.7 years old (median = 15.5, interquartile range (IQR) = 2.5) and mean duration of hearing loss before cochlear implantation was 10.8 years (median = 11.5, IQR = 5.3). Pre- and post-operative audiometric data for aided speech perception testing, sentence recognition in quiet, sentence recognition in noise, and word recognition scores were analyzed. RESULTS When compared to preoperative hearing aid scores a 24% significant increase in median word score and a 64% significant increase in median sentence recognition score in quiet was observed at 12 months post-op. CONCLUSION Cochlear implantation in children with a longer duration of SSD can provide benefit to speech recognition. LAY SUMMARY This retrospective case series of children with prolonged single sided deafness demonstrated an improvement in word and sentence recognition within 12 months of receiving a cochlear implant.
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Affiliation(s)
| | - Samantha Morgan
- Department of Otolaryngology, Westchester Medical Center, Valhalla, NY, USA
- Westchester Institute for Human Development, Valhalla, NY, USA
| | - Rivka Bornstein
- Department of Otolaryngology, Westchester Medical Center, Valhalla, NY, USA
- Westchester Institute for Human Development, Valhalla, NY, USA
| | | | - Katrina R Stidham
- Department of Otolaryngology, Westchester Medical Center, Valhalla, NY, USA
- Westchester Institute for Human Development, Valhalla, NY, USA
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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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8
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Fan S, Zhang C, Chen M, Mao J, Li S. The impact of cochlear implantation on quality of life and psychological status in single-sided deafness or asymmetric hearing loss with tinnitus and influencing factors of implantation intention: a preliminary study. Eur Arch Otorhinolaryngol 2024; 281:95-105. [PMID: 37378727 DOI: 10.1007/s00405-023-08086-7] [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: 03/25/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE The current study aims to explore the therapeutic effect of cochlear implants (CIs) on tinnitus in patients with single-sided deafness or asymmetric hearing loss (SSD/AHL) as well as the improvement of tinnitus-related quality of life and psychological status. In addition, we also explored whether the levels of quality of life and psychological status was related to the patient's implantation intention. METHODS Seven patients decided to receive cochlear implantation. Before and after implantation, they completed the Visual Analogue Scale (VAS) and the Tinnitus Questionnaire (TQ) to assess tinnitus severity, the Speech, Spatial and Qualities of Hearing Scale (SSQ), and the Medical Outcomes Study Short Form 36 Health Survey Questionnaire (SF-36) to assess the quality of life, the Simplified Coping Style Questionnaire (SCSQ) to assess psychological status. The other 8 SSD patients refused cochlear implantation. Their scores of the above questionnaires were compared with those of patients received implantation. RESULTS Six months after cochlear implantations, the tinnitus perception, loudness, and annoyance significantly decreased compared to that before implantation. In terms of quality of life and physiological status, no statistically significant changes were detected in SSQ, SF-36, and SCSQ measurements. The score of annoyance subcategory of VAS and all subcategories of SSQ of patients refused implantation were better than those of implanted patients before implantation. CONCLUSIONS These results suggest that CIs can significantly reduce tinnitus severity. Patients refused implantation had better status in the annoyance of VAS and all subcategories of SSQ scores than those received implantation.
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Affiliation(s)
- Shuwen Fan
- Department of Otolaryngology-Head and Neck Surgery, ENT Institute, Eye & ENT Hospital of Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 20031, China
| | - Chen Zhang
- Department of Otolaryngology-Head and Neck Surgery, ENT Institute, Eye & ENT Hospital of Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 20031, China
| | - Min Chen
- Department of Otolaryngology-Head and Neck Surgery, ENT Institute, Eye & ENT Hospital of Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 20031, China
| | - Jiabao Mao
- Department of Otolaryngology-Head and Neck Surgery, ENT Institute, Eye & ENT Hospital of Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 20031, China
| | - Shufeng Li
- Department of Otolaryngology-Head and Neck Surgery, ENT Institute, Eye & ENT Hospital of Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 20031, China.
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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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10
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Garcia A, Haleem A, Chari DA, Morse-Fortier C, Arenberg JG, Lee DJ. Influence of listening environment on usage patterns in cochlear implant patients with single-sided deafness. Cochlear Implants Int 2023; 24:335-341. [PMID: 36846887 DOI: 10.1080/14670100.2023.2176990] [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: 03/01/2023]
Abstract
OBJECTIVE To compare cochlear implant (CI) data logging of patients with single-sided deafness (SSD) and bilateral sensorineural hearing loss (biSNHL) in various acoustic environments and study the implications of data logging on auditory performance. STUDY DESIGN Retrospective case control study. METHODS Adult CI patients with SSD or biSNHL from 2010 to 2021 with usage data collected at 3-, 6-, and 12-months following device activation were identified. The CI listening environment was defined as speech in noise, speech in quiet, quiet, music or noise. Auditory performance was measured using the CNC word, AzBio sentence tests and the Tinnitus Handicap Index (THI). RESULTS 60 adults with SSD or biSNHL were included. CI patients with biSNHL wore their devices more than those with SSD at 3-months post-activation (11.18 versus 8.97 hours/day, p = 0.04), though there were no significant differences at 6-12 months. Device usage was highest in the speech in quiet environment. In SSD CI users, there was a positive correlation (p = 0.03) between device use and CNC scores at 12-months and an improvement in THI scores at 12-months (p = 0.0004). CONCLUSIONS CI users with SSD and biSNHL have comparable duration of device usage at longer follow-up periods with greatest device usage recorded in speech in quiet environments.
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Affiliation(s)
- Alejandro Garcia
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Afash Haleem
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Divya A Chari
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Charlotte Morse-Fortier
- Department of Audiology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Julie G Arenberg
- Department of Audiology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Daniel J Lee
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
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11
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Lee HY, Jung DJ. Recent Updates on Tinnitus Management. J Audiol Otol 2023; 27:181-192. [PMID: 37872753 PMCID: PMC10603282 DOI: 10.7874/jao.2023.00416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/25/2023] Open
Abstract
In this comprehensive review, we discuss recent updates on tinnitus evaluation and treatment. Tinnitus evaluation commences with comprehensive medical history taking and audiological evaluation, which can provide valuable insight into the nature and extent of auditory disturbances. Additionally, tinnitus evaluation includes investigation of psychosomatic comorbidities to determine the intricate interplay between psychological factors and tinnitus perception. Various therapeutic approaches are available to minimize the burden of tinnitus. Cognitive behavioral therapy reshapes negative thought patterns and behaviors that are closely associated with tinnitus-induced distress. Acceptance and commitment therapy fosters mindfulness and value-aligned actions to address emotional effects. Tinnitus retraining therapy combines counseling and sound therapy for habituation. Tailor-made notched music therapy offers customized auditory experiences for symptom relief. Hearing aids and cochlear implants compensate for hearing loss and associated stress. Both neuromodulation and neurofeedback may be potentially useful. The role of pharmacotherapy and dietary supplements remains uncertain. Physiotherapy and head-neck manipulation relieve tinnitus associated with orofacial factors. Virtual reality, smartphone applications, and photobiomodulation may serve as novel therapeutic avenues. Although promising interventions are available, further research is warranted to confirm their effectiveness and long-term effects.
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Affiliation(s)
- Ho Yun Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Ewha Womans University School of Medicine, Seoul, Korea
| | - Da Jung Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
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12
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Langguth B, Kleinjung T, Schlee W, Vanneste S, De Ridder D. Tinnitus Guidelines and Their Evidence Base. J Clin Med 2023; 12:jcm12093087. [PMID: 37176527 PMCID: PMC10178961 DOI: 10.3390/jcm12093087] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/17/2023] [Accepted: 04/22/2023] [Indexed: 05/15/2023] Open
Abstract
Evidence-based medicine (EBM) is generally accepted as the gold standard for high-quality medicine and, thus, for managing patients with tinnitus. EBM integrates the best available scientific information with clinical experience and patient values to guide decision-making about clinical management. To help health care providers and clinicians, the available evidence is commonly translated into medical or clinical guidelines based on a consensus. These involve a systematic review of the literature and meta-analytic aggregation of research findings followed by the formulation of clinical recommendations. However, this approach also has limitations, which include a lack of consideration of individual patient characteristics, the susceptibility of guideline recommendations to material and immaterial conflicts of interest of guideline authors and long latencies till new knowledge is implemented in guidelines. A further important aspect in interpreting the existing literature is that the absence of evidence is not evidence of absence. These circumstances could result in the decoupling of recommendations and their supporting evidence, which becomes evident when guidelines from different countries differ in their recommendations. This opinion paper will discuss how these weaknesses can be addressed in tinnitus.
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Affiliation(s)
- Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Clinic, University of Regensburg, 93053 Regensburg, Germany
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Clinic, University of Regensburg, 93053 Regensburg, Germany
- Institute for Information and Process Management, Eastern Switzerland University of Applied Sciences, 9001 St. Gallen, Switzerland
| | - Sven Vanneste
- Trinity Institute for Neuroscience, Trinity College Dublin, D02 PN40 Dublin, Ireland
- Global Brain Health Institute, Trinity College Dublin, D02 PN40 Dublin, Ireland
- School of Psychology, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin 9016, New Zealand
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13
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Olze H, Ketterer MC, Péus D, Häußler SM, Hildebrandt L, Gräbel S, Szczepek AJ. Effects of auditory rehabilitation with cochlear implant on tinnitus prevalence and distress, health-related quality of life, subjective hearing and psychological comorbidities: Comparative analysis of patients with asymmetric hearing loss (AHL), double-sided (bilateral) deafness (DSD), and single-sided (unilateral) deafness (SSD). Front Neurol 2023; 13:1089610. [PMID: 36712436 PMCID: PMC9877424 DOI: 10.3389/fneur.2022.1089610] [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: 11/04/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction Auditory rehabilitation with a cochlear implant (CI), in many cases, positively impacts tinnitus. However, it is unclear if the tinnitus-related benefit of CI is equal for patients with various indications for CI. Therefore, this study aimed to determine differences in tinnitus prevalence and distress, health-related quality of life, subjective hearing, perceived stress, and psychological comorbidities between patients diagnosed with asymmetric hearing loss (AHL), single-sided (unilateral) deafness (SSD), and double-sided (bilateral) deafness (DSD) before and six months after cochlear implantation. Methods One hundred-one CI candidates were included in this prospective study (39 AHL patients, 23 DSD patients, and 39 SSD patients). The patients completed questionnaires measuring tinnitus distress, health-related quality of life, subjective hearing, perceived stress, and psychological comorbidities before and 6 months after CI. Results The prevalence of tinnitus in the entire cohort (80.2% before CI) decreased 6 months after CI to 71.3%. The DSD group had the lowest tinnitus prevalence at both time points. The degree of tinnitus-induced distress decreased significantly in all three groups after CI. Differences in quality of life, subjective hearing, and psychological comorbidities between the groups at the study onset disappeared after CI. Significant correlations existed between anxiety, depression, and tinnitus distress in AHL and SSD but not in DSD patients before and after CI. Discussion Our results demonstrate significant differences between the three groups of CI candidates, which might affect the implantation outcome. These differences suggest a need for personalized psychological counseling during the auditory rehabilitation process, focusing on anxiety and depressive symptoms for SSD and AHL patients.
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Affiliation(s)
- Heidi Olze
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany,*Correspondence: Heidi Olze ✉
| | - Manuel Christoph Ketterer
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Dominik Péus
- Department of Otorhinolaryngology, University of Oldenburg, Oldenburg, Germany
| | - Sophia Marie Häußler
- Department of Otorhinolaryngology, Skull Base Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lynn Hildebrandt
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Stefan Gräbel
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Agnieszka J. Szczepek
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
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14
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Iwasaki S. Advances in auditory implants. Auris Nasus Larynx 2022; 50:321-326. [PMID: 36114071 DOI: 10.1016/j.anl.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/21/2022] [Accepted: 09/01/2022] [Indexed: 11/30/2022]
Abstract
Auditory implants are classified into bone conduction (BAHA and Bonebridge; BB) and active middle ear implants (Vibrant Soundbridge; VSB) that stimulate cochlear hair cells, and cochlear implants (CIs) that stimulate neural structures. CIs should be performed as early as possible, and bilateral CIs have become popular because sound localization and speech recognition can be improved. CI is also considered a desirable treatment option for patients with single-sided deafness. VSB provides a safe and effective option for patients with conductive or mixed hearing loss and moderate to severe sensorineural hearing loss (SNHL); however, it use in patients with conductive or mixed hearing loss have only been approved in Japan. BAHA and BB implants have been approved by national insurance in Japan as bone conduction implants for patients with conductive or mixed hearing loss. Two fully implantable devices (Cochlear Carina and Envoy Esteem) are provided for patients with SNHL.
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Affiliation(s)
- Satoshi Iwasaki
- Department of Otorhinolaryngology, International University of Health and Welfare Mita Hospital, 1-4-3, Mita, Minato-ku, Tokyo 108-8329, Japan.
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15
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Deliano M, Seidel P, Vorwerk U, Stadler B, Angenstein N. Effect of cochlear implant side on early speech processing in adults with single-sided deafness. Clin Neurophysiol 2022; 140:29-39. [DOI: 10.1016/j.clinph.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 04/22/2022] [Accepted: 05/04/2022] [Indexed: 11/03/2022]
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16
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Are Electrocochleographic Changes an Early Sign of Cochlear Synaptopathy? A Prospective Study in Tinnitus Patients with Normal Hearing. Diagnostics (Basel) 2022; 12:diagnostics12040802. [PMID: 35453851 PMCID: PMC9027360 DOI: 10.3390/diagnostics12040802] [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: 03/11/2022] [Revised: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 11/29/2022] Open
Abstract
The mechanism of tinnitus accompanied by a normal audiogram remains elusive. This study aimed to investigate evidence of primary neural degeneration, also known as cochlear synaptopathy, in tinnitus patients with normal hearing thresholds. We analyzed the differences in electrocochleography (ECochG) measurements between normal-hearing subjects with and without tinnitus. Forty-five subjects were enrolled in this study: 21 were in the tinnitus group, defined by chronic tinnitus of over two months’ duration with normal audiometric thresholds, and 24 were in the control group, defined by a lack of tinnitus complaints. Electrocochleograms were evoked by 1, 4, 6, and 8 kHz alternating-polarity tone bursts at sound pressure levels (SPLs) of 90−110 dB. The tinnitus group had smaller action potential (AP) amplitudes than the control group for 1, 4, 6, and 8 kHz tone bursts and showed significant amplitude reduction at 1 kHz 110 dB SPL (p < 0.01), 1 kHz 90 dB SPL (p < 0.05), and 4 kHz 110 dB SPL (p < 0.05). There were no significant differences in the summating potential/action potential (SP/AP) amplitude ratios across the four tested frequencies. A trend of reduced AP amplitudes was found in the tinnitus group, supporting the hypothesis that tinnitus might be associated with primary neural degeneration.
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