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Hoppe U, Hocke T, Hast A. Impact of unilateral vs. bilateral evaluation on cochlear implant candidacy. Acta Otolaryngol 2024; 144:207-218. [PMID: 38648394 DOI: 10.1080/00016489.2024.2336562] [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: 03/04/2024] [Accepted: 03/25/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND The indication criteria for cochlear implantation differ considerably across regions. OBJECTIVES To estimate the effects of different candidacy criteria on the number of cochlear implant (CI) candidates. METHODS We analysed a very large clinical audiological database comprising pure-tone thresholds and speech-audiometric data in order to identify CI candidates on the basis of different audiometric candidacy criteria. In particular, we simulated the effects of three different CI candidacy criteria. RESULTS The bilateral evaluation of CI candidacy has the strongest influence on the number of potential CI candidates. Additionally, the cut-off criteria for middle-ear implants have a large effect on numbers of candidates when air conduction has deteriorated.Conclusions and Significance: Expanding the indication criteria opens up the possibility of improving the accurate identification of individual cases suitable for cochlear-implant provision.
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Affiliation(s)
- Ulrich Hoppe
- Cochlear Implant Center CICERO, Department of Otorhinolaryngology - Head and Neck Surgery, Uniklinikum Erlangen, Erlangen, Germany
| | - Thomas Hocke
- Cochlear Deutschland GmbH & Co. KG, Hannover, Germany
| | - Anne Hast
- Cochlear Implant Center CICERO, Department of Otorhinolaryngology - Head and Neck Surgery, Uniklinikum Erlangen, Erlangen, Germany
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2
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van der Straaten TFK, Burger AVM, Briaire JJ, Boermans PPBM, Vickers D, Frijns JHM. Diagnostic value of preoperative measures in selecting post-lingually deafened candidates for cochlear implantation - a different approach. Int J Audiol 2023; 62:983-991. [PMID: 35997570 DOI: 10.1080/14992027.2022.2106453] [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: 09/29/2021] [Accepted: 07/21/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES We examined which preoperative diagnostic measure is most suited to serve as a selection criterion to determine adult cochlear implantation (CI) candidacy. DESIGN Preoperative diagnostic measures included pure tone audiometry (PTA; 0.5, 1, 2, 4 kHz), speech perception tests (SPT) unaided with headphones and with best-aided hearing aids (in quiet and in noise). Gain in speech perception was used as outcome measure. Performance of preoperative measures was analysed using the area under the curve (AUC) of receiver operating characteristic (ROC) curves. STUDY SAMPLE This retrospective longitudinal cohort study included 552 post-lingually deafened adults with CI in a tertiary referral centre in the Netherlands. RESULTS Best-aided SPT in quiet was the most accurate in defining which CI candidates improved their speech perception in quiet postoperatively. For an improvement in speech perception in noise, the best-aided SPT in noise was the most accurate in defining which adult would benefit from CI. PTA measures performed lower compared to the SPT measures. CONCLUSIONS SPT is better than PTA for selecting CI candidates who will benefit in terms of speech perception. Best-aided SPT in noise was the most accurate for indicating an improvement of speech perception in noise but was only evaluated in high performers with residual hearing. These insights will assist in formulating more effective selection criteria for CI.
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Affiliation(s)
- Tirza F K van der Straaten
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Anouk V M Burger
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeroen J Briaire
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter Paul B M Boermans
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Deborah Vickers
- Clinical Neurosciences, University of Cambridge, Cambridge, The United Kingdom
| | - Johan H M Frijns
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
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Hey M, Hersbach AA, Hocke T, Mauger SJ, Böhnke B, Mewes A. Ecological Momentary Assessment to Obtain Signal Processing Technology Preference in Cochlear Implant Users. J Clin Med 2022; 11:jcm11102941. [PMID: 35629065 PMCID: PMC9147494 DOI: 10.3390/jcm11102941] [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: 04/05/2022] [Revised: 05/13/2022] [Accepted: 05/20/2022] [Indexed: 02/01/2023] Open
Abstract
Background: To assess the performance of cochlear implant users, speech comprehension benefits are generally measured in controlled sound room environments of the laboratory. For field-based assessment of preference, questionnaires are generally used. Since questionnaires are typically administered at the end of an experimental period, they can be inaccurate due to retrospective recall. An alternative known as ecological momentary assessment (EMA) has begun to be used for clinical research. The objective of this study was to determine the feasibility of using EMA to obtain in-the-moment responses from cochlear implant users describing their technology preference in specific acoustic listening situations. Methods: Over a two-week period, eleven adult cochlear implant users compared two listening programs containing different sound processing technologies during everyday take-home use. Their task was to compare and vote for their preferred program. Results: A total of 205 votes were collected from acoustic environments that were classified into six listening scenes. The analysis yielded different patterns of voting among the subjects. Two subjects had a consistent preference for one sound processing technology across all acoustic scenes, three subjects changed their preference based on the acoustic scene, and six subjects had no conclusive preference for either technology. Conclusion: Results show that EMA is suitable for quantifying real-world self-reported preference, showing inter-subject variability in different listening environments. However, there is uncertainty that patients will not provide sufficient spontaneous feedback. One improvement for future research is a participant forced prompt to improve response rates.
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Affiliation(s)
- Matthias Hey
- Audiology, ENT Clinic, UKSH, 24105 Kiel, Germany; (B.B.); (A.M.)
- Correspondence: ; Tel.: +49-431-500-21857
| | - Adam A. Hersbach
- Research and Development, Cochlear Limited, Melbourne, VIC 3000, Australia;
| | - Thomas Hocke
- Research, Cochlear Deutschland, 30625 Hannover, Germany;
| | | | - Britta Böhnke
- Audiology, ENT Clinic, UKSH, 24105 Kiel, Germany; (B.B.); (A.M.)
| | - Alexander Mewes
- Audiology, ENT Clinic, UKSH, 24105 Kiel, Germany; (B.B.); (A.M.)
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Ngombu SJ, Ray C, Vasil K, Moberly AC, Varadarajan VV. Development of a novel screening tool for predicting Cochlear implant candidacy. Laryngoscope Investig Otolaryngol 2021; 6:1406-1413. [PMID: 34938881 PMCID: PMC8665459 DOI: 10.1002/lio2.673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/21/2021] [Accepted: 09/15/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Cochlear implantation (CI) is a well-established treatment for sensorineural hearing loss. Due in part to a lack of referral guidelines, CI technology remains underutilized, and many patients who could benefit from CI may not be referred for evaluation. This study aimed to develop a model for predicting CI candidacy using routine audiometric measures, with the goal of providing guidance to clinicians regarding when to refer a patient for CI evaluation. METHODS Unaided three-frequency pure tone average (PTA), unaided speech discrimination score (SDS), and best-aided sentence recognition testing with AZBio sentence lists were collected from 252 subjects undergoing CIE. Candidacy was defined by meeting traditional (AZBio score ≤ 60%), or Medicare criteria (≤40%). A logistic regression model was developed to predict candidacy. Confusion matrices were plotted to determine the sensitivity and specificity at various probability thresholds. RESULTS Logistic regression models were capable of predicting probability of candidacy for traditional criteria (P < .001) and Medicare criteria (P < .001). PTA and SDS were significant predictors (P < .001). Using a probability cutoff of .5, the models yielded a sensitivity rate of 91% and 78% for traditional and Medicare criteria, respectively. CONCLUSION Probability of CI candidacy may be determined using a novel screening tool for referral. This tool supports individualized counseling, serves as a proof of concept for candidacy prediction, and could be modified based on an institution's philosophy regarding an acceptable false positive rate of referral. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Stephany J. Ngombu
- Department of Otolaryngology – Head & Neck SurgeryWexner Medical Center at The Ohio State UniversityColumbusOhioUSA
| | - Christin Ray
- Department of Otolaryngology – Head & Neck SurgeryWexner Medical Center at The Ohio State UniversityColumbusOhioUSA
| | - Kara Vasil
- Department of Otolaryngology – Head & Neck SurgeryWexner Medical Center at The Ohio State UniversityColumbusOhioUSA
| | - Aaron C. Moberly
- Department of Otolaryngology – Head & Neck SurgeryWexner Medical Center at The Ohio State UniversityColumbusOhioUSA
| | - Varun V. Varadarajan
- Department of Otolaryngology – Head & Neck SurgeryWexner Medical Center at The Ohio State UniversityColumbusOhioUSA
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5
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Ernst R, Linxweiler M, Rink KA, Rothe H, Lecomte G, Bozzato A, Hecker D. [Neurophysiological parameters for speech recognition in patients with cochlear implants]. Laryngorhinootologie 2021; 101:216-227. [PMID: 33836549 DOI: 10.1055/a-1399-9540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Cochlea Implants (CI) are the preferred treatment for deaf and highly hearing imparied people. While deaf people already profit enormously from any regained hearing perception, it is not as easy to predict a profitable outcome for people with a remaining sense of hearing. To provide patients the best possible outcome in speech understanding, a lot of parameters have to be identified and adjusted. The aim of this study is to show the influence of objective parameters on classified speech understanding using collected data. MATERIAL AND METHODS A total of 52 patients and 65 ears aged between 18 and 80 years were included in this study. ECAP-thresholds from intraoperative measurements and impedance were used as objective parameters. T- and C/M-levels were defined as subjective parameters. To classify the performance the value of speech understanding was used. RESULTS Differences between both groups (age, time after implantation) were not significant. The gained word scores at 500 Hz correlated significantly with the results of the speech perception threshold on two-digit numbers. The electrode impedances correlated on average with speech understanding with constant variability. The distributions of objective and subjective parameters showed partially significant differences. Many distributions showed significant differences to the normal distribution. Accordingly, the overlapping areas of the significance levels are very narrow. CONCLUSION Higher impedances and incorrectly adjusted T-levels resulted in a worse speech understanding. Relation of C/M-levels to ECAP thresholds seem to be crucial for good speech understanding.
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Affiliation(s)
- Robert Ernst
- Hals-, Nasen- und Ohrenklinik, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Maximilian Linxweiler
- Hals-, Nasen- und Ohrenklinik, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Katharina Anna Rink
- Hals-, Nasen- und Ohrenklinik, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Heike Rothe
- Hals-, Nasen- und Ohrenklinik, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Gregory Lecomte
- Hals-, Nasen- und Ohrenklinik, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Alessandro Bozzato
- Hals-, Nasen- und Ohrenklinik, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Dietmar Hecker
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Germany
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Na E, Toupin-April K, Olds J, Whittingham J, Fitzpatrick EM. Clinical characteristics and outcomes of children with cochlear implants who had preoperative residual hearing. Int J Audiol 2021; 61:108-118. [PMID: 33761807 DOI: 10.1080/14992027.2021.1893841] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Cochlear implants (CI) candidacy criteria have expanded to include children with more residual hearing. This study explored the clinical profiles and outcomes of children with CIs who had preoperative residual hearing in at least one ear. DESIGN A retrospective chart review was conducted to collect clinical characteristics and speech perception data. Pre- and post-CI auditory and speech perception data were analysed using a modified version of the Pediatric Ranked Order Speech Perception (PROSPER) score. STUDY SAMPLE This study included all children with residual hearing who received CIs in one Canadian paediatric centre from 1992 to 2018. RESULTS A total of 100 of 389 (25.7%) children with CIs had residual hearing (median 77.6 dB HL, better ear). The proportion of children with residual hearing increased from 1992 to 2018. Children who had auditory behaviour and speech perception tests (n = 83) showed higher modified PROSPER scores post-CI compared to pre-CI. Phonologically Balanced Kindergarten (PBK) test scores were available for 71 children post-CI; 81.7% (58/71) of children achieved > 80% on the PBK. CONCLUSIONS One in four children who received CIs had residual hearing, and most of them had severe hearing loss at pre-CI. These children showed a high level of speech perception with CIs.
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Affiliation(s)
- Eunjung Na
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Karine Toupin-April
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.,Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Janet Olds
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.,Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - JoAnne Whittingham
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Elizabeth M Fitzpatrick
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
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Hoppe U, Hocke T, Hast A, Iro H. Cochlear Implantation in Candidates With Moderate-to-Severe Hearing Loss and Poor Speech Perception. Laryngoscope 2021; 131:E940-E945. [PMID: 32484949 DOI: 10.1002/lary.28771] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine the improvement in word recognition score (WRS65 ) after cochlear implant (CI) surgery in hearing aid (HA) users with preoperative hearing threshold ≤80 dB HL and inadequate speech recognition scores with HA. Secondarily, to identify predictive factors for WRS65 with a CI (WRS65 [CI]) 6 months after surgery, derived from the standard German CI preoperative assessment. STUDY DESIGN Retrospective chart review. METHODS Retrospective review of all adult patients who received a Nucleus cochlear implant in the ear, nose, and throat department of the University Hospital of Erlangen between January 2010 and April 2019. The inclusion criteria were a preoperative hearing threshold ≤80 dB HL in the ear to receive the implantation, German as the native language, and at least 6 months postimplantation care at our center. RESULTS The inclusion criteria were met by 128 patients. All but two patients (98.4%) showed a significant improvement, WRS65 (CI) versus WRS65 with an (HA) (WRS65 [HA]), of at least 15 percentage points (pp). The median improvement was 55 pp with a median WRS65 (CI) of 70%. Three preoperative audiometric measures, the maximum word recognition score, age at implantation, and WRS65 (HA) were identified as predictive factors for WRS65 (CI). For three-quarters of the CI recipients, the score was not poorer than 12 pp below the predicted WRS65 (CI). CONCLUSIONS For patients with a hearing loss ≤80 dB HL, cochlear implantation should be considered when speech perception with an HA is insufficient. The prediction model can support counseling in this patient group. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E940-E945, 2021.
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Affiliation(s)
- Ulrich Hoppe
- ENT Department, University Hospital Erlangen, Erlangen, Germany
| | - Thomas Hocke
- Cochlear Deutschland GmbH and Co. KG, Hannover, Germany
| | - Anne Hast
- ENT Department, University Hospital Erlangen, Erlangen, Germany
| | - Heinrich Iro
- ENT Department, University Hospital Erlangen, Erlangen, Germany
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8
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Grounds R, Miachi E, Beckham T, Neumann C, Wasson J. How many patients will be eligible for cochlear implantation (CI) on audiological grounds, once the new 2019 NICE guidance takes effect? Clin Otolaryngol 2020; 46:619-623. [PMID: 33277800 DOI: 10.1111/coa.13684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/04/2020] [Accepted: 11/15/2020] [Indexed: 11/27/2022]
Affiliation(s)
| | | | - Tina Beckham
- William Harvey Hospital, Ashford, Northern Ireland
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9
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How many patients will be eligible for cochlear implantation (CI) on audiological grounds, once the new 2019 NICE guidance takes effect? Evaluation of audiological data for the population of East Kent to estimate cochlear implantation eligibility based on NICE 2019 guidance (TA566) and NICE 2009 guidance (TA166). Clin Otolaryngol 2020; 45:932-937. [DOI: 10.1111/coa.13605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 05/28/2020] [Accepted: 06/14/2020] [Indexed: 11/26/2022]
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10
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Cognitive Improvement After Cochlear Implantation in Older Adults With Severe or Profound Hearing Impairment: A Prospective, Longitudinal, Controlled, Multicenter Study. Ear Hear 2020; 42:606-614. [PMID: 33055579 PMCID: PMC8088820 DOI: 10.1097/aud.0000000000000962] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objective: To compare the cognitive evolution of older adults with severe or profound hearing impairment after cochlear implantation with that of a matched group of older adults with severe hearing impairment who do not receive a cochlear implant (CI). Design: In this prospective, longitudinal, controlled, and multicenter study, 24 older CI users were included in the intervention group and 24 adults without a CI in the control group. The control group matched the intervention group in terms of gender, age, formal education, cognitive functioning, and residual hearing. Assessments were made at baseline and 14 months later. Primary outcome measurements included the change in the total score on the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing impaired individuals score and on its subdomain score to assess cognitive evolution in both groups. Secondary outcome measurements included self-reported changes in sound quality (Hearing Implant Sound Quality Index), self-perceived hearing disability (Speech, Spatial, and Qualities of Hearing Scale), states of anxiety and depression (Hospital Anxiety and Depression Scale), and level of negative affectivity and social inhibition (Type D questionnaire). Results: Improvements of the overall cognitive functioning (p = 0.05) and the subdomain “Attention” (p = 0.02) were observed after cochlear implantation in the intervention group; their scores were compared to the corresponding scores in the control group. Significant positive effects of cochlear implantation on sound quality and self-perceived hearing outcomes were found in the intervention group. Notably, 20% fewer traits of Type D personalities were measured in the intervention group after cochlear implantation. In the control group, traits of Type D personalities increased by 13%. Conclusion: Intervention with a CI improved cognitive functioning (domain Attention in particular) in older adults with severe hearing impairment compared to that of the matched controls with hearing impairment without a CI. However, older CI users did not, in terms of cognition, bridge the performance gap with adults with normal hearing after 1 year of CI use. The fact that experienced, older CI users still present subnormal cognitive functioning may highlight the need for additional cognitive rehabilitation in the long term after implantation.
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Selection Criteria for Cochlear Implantation in the United Kingdom and Flanders: Toward a Less Restrictive Standard. Ear Hear 2020; 42:68-75. [PMID: 32590629 PMCID: PMC7757743 DOI: 10.1097/aud.0000000000000901] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The impact of the newly introduced cochlear implantation criteria of the United Kingdom and Flanders (Dutch speaking part of Belgium) was examined in the patient population of a tertiary referral center in the Netherlands. We compared the patients who would be included/excluded under the new versus old criteria in relation to the actual improvement in speech understanding after implantation in our center. We also performed a sensitivity analysis to examine the effectiveness of the different preoperative assessment approaches used in the United Kingdom and Flanders.
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12
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De Raeve L, Archbold S, Lehnhardt-Goriany M, Kemp T. Prevalence of cochlear implants in Europe: trend between 2010 and 2016. Cochlear Implants Int 2020; 21:275-280. [PMID: 32476613 DOI: 10.1080/14670100.2020.1771829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: To collect figures on the numbers of children and adults receiving cochlear implants across Europe, compare the figures for 2016 with those for 2010, and identify any trends. Materials and methods: In 2018 EURO-CIU invited their 23 member countries to conduct a survey collecting data on the number of CI recipients in 2016 and 2017. Data were received from 15 countries, representing more than 100 000 CI recipients in Europe. Results: For paediatric CI, there was an increase in nearly all European countries (except Denmark, the UK and Luxembourg) between 2010 and 2016. We found an annual figure of one CI per 1000 newborns common in most countries where reimbursement of paediatric CI's is available. Conversely the adult data reveals no increase between 2010 and 2016 and the data is less homogeneous than the paediatric data with huge differences across countries. Conclusion: There is little agreement on data on numbers of CI across Europe, which makes it difficult to plan public health policy, funding or services. In all European countries included in this study (except Germany) there needs to be work on raising more awareness of adult hearing loss and adult cochlear implantation to improve access.
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Affiliation(s)
- Leo De Raeve
- Independent Information and Research Centre on Cochlear Implants, Zonhoven, Belgium
| | - Sue Archbold
- Independent Consultant on Deafness and Hearing Care, Nottingham, UK
| | | | - Tricia Kemp
- Cochlear Implanted Children's Support Group, London, UK
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13
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Bruijnzeel H, Bezdjian A, Lesinski-Schiedat A, Illg A, Tzifa K, Monteiro L, Volpe AD, Grolman W, Topsakal V. Evaluation of pediatric cochlear implant care throughout Europe: Is European pediatric cochlear implant care performed according to guidelines? Cochlear Implants Int 2017; 18:287-296. [DOI: 10.1080/14670100.2017.1375238] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Hanneke Bruijnzeel
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University of Utrecht, Utrecht, The Netherlands
| | - Aren Bezdjian
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University of Utrecht, Utrecht, The Netherlands
- Department of Experimental Surgery, McGill University, Montreal, Quebec, Canada
| | - Anke Lesinski-Schiedat
- Medizinische Hochschule Hannover, Deutsches HörZentrum Hannover der HNO-Klinik, Hannover, Germany
| | - Angelika Illg
- Medizinische Hochschule Hannover, Deutsches HörZentrum Hannover der HNO-Klinik, Hannover, Germany
| | - Konstance Tzifa
- The Midlands Hearing Implant Program – Children’s Service, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, UK
| | - Luisa Monteiro
- Pediatric Otolaryngology and Cochlear Implantation, Dona Estefânia Children’s Hospital, Lisbon, Portugal
| | - Antonio della Volpe
- Otology and Cochlear Implant Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - Wilko Grolman
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University of Utrecht, Utrecht, The Netherlands
| | - Vedat Topsakal
- Brain Center Rudolf Magnus, University of Utrecht, Utrecht, The Netherlands
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- University of Antwerp, Antwerp, Belgium
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14
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Raine C, Atkinson H, Strachan DR, Martin JM. Access to cochlear implants: Time to reflect. Cochlear Implants Int 2017; 17 Suppl 1:42-6. [PMID: 27099110 DOI: 10.1080/14670100.2016.1155808] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cochlear implant (CI) intervention is expensive and accessed mainly by developed countries. The introduction of Universal Newborn Hearing Screening and funding via a public health service give children better access to CIs. However for adults large disparities exist between utilization and estimated prevalence. In the UK CI selection criteria are restrictive compared with many other countries. Improved audiological awareness and screening programmes for adults would improve access to hearing technologies that would improve health and quality of life. Hearing loss itself has significant medical and financial burdens on society and by investing in early intervention and using best technology this would mitigate some of the rising associated medical costs.
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Affiliation(s)
- Christopher Raine
- a Yorkshire Auditory Implant Service, Bradford Royal Infirmary , Duckworth Lane, Bradford BD9 6RJ , UK
| | - Helen Atkinson
- a Yorkshire Auditory Implant Service, Bradford Royal Infirmary , Duckworth Lane, Bradford BD9 6RJ , UK
| | - David R Strachan
- a Yorkshire Auditory Implant Service, Bradford Royal Infirmary , Duckworth Lane, Bradford BD9 6RJ , UK
| | - Jane M Martin
- a Yorkshire Auditory Implant Service, Bradford Royal Infirmary , Duckworth Lane, Bradford BD9 6RJ , UK
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15
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Vickers D, De Raeve L, Graham J. International survey of cochlear implant candidacy. Cochlear Implants Int 2016; 17 Suppl 1:36-41. [DOI: 10.1080/14670100.2016.1155809] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
OBJECTIVE This study defines a screening procedure for cochlear implant (CI) candidacy in hearing aid users by using simple audiometric measures. METHODS Within this retrospective study, hearing aid performance and audiometric measures in 185 subjects (318 ears) were analyzed. By means of a linear Naive Bayes classifier, the pure-tone average and the maximum monosyllabic score (PB(max)) were used to predict the aided monosyllabic word score and CI candidacy. RESULTS The two parameters PB(max) and four-frequency hearing threshold average can be used to predict speech perception with hearing aids with reasonable accuracy for screening purposes. The classification has a sensitivity of 87% and a specificity of 91%. The classification can be represented by a simple linear formula. CONCLUSION CI candidacy can be predicted based on commonly used audiometric measures.Cochlear implant candidacy may be considered if the difference between the average pure-tone threshold (in decibels) and PBmax (in percent) exceeds 8.
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Hutter E, Argstatter H, Grapp M, Plinkert PK. Music therapy as specific and complementary training for adults after cochlear implantation: A pilot study. Cochlear Implants Int 2015; 16 Suppl 3:S13-21. [PMID: 26047068 DOI: 10.1179/1467010015z.000000000261] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES Although cochlear implant (CI) users achieve good speech comprehension, they experience difficulty perceiving music and prosody in speech. As the provision of music training in rehabilitation is limited, a novel concept of music therapy for rehabilitation of adult CI users was developed and evaluated in this pilot study. METHODS Twelve unilaterally implanted, postlingually deafened CI users attended ten sessions of individualized and standardized training. The training started about 6 weeks after the initial activation of the speech processor. Before and after therapy, psychological and musical tests were applied in order to evaluate the effects of music therapy. CI users completed the musical tests in two conditions: bilateral (CI + contralateral, unimplanted ear) and unilateral (CI only). RESULTS After therapy, improvements were observed in the subjective sound quality (Hearing Implant Sound Quality Index) and the global score on the self-concept questionnaire (Multidimensional Self-Concept Scales) as well as in the musical subtests for melody recognition and for timbre identification in the unilateral condition. Discussion Preliminary results suggest improvements in subjective hearing and music perception, with an additional increase in global self-concept and enhanced daily listening capacities. CONCLUSIONS The novel concept of individualized music therapy seems to provide an effective treatment option in the rehabilitation of adult CI users. Further investigations are necessary to evaluate effects in the area of prosody perception and to separate therapy effects from general learning effects in CI rehabilitation.
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Athalye S, Archbold S, Mulla I, Lutman M, Nikolopoulous T. Exploring views on current and future cochlear implant service delivery: the perspectives of users, parents and professionals at cochlear implant centres and in the community. Cochlear Implants Int 2015; 16:241-53. [DOI: 10.1179/1754762815y.0000000003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
OBJECTIVE AND IMPORTANCE The candidacy for cochlear implant has changed over time and includes people with lesser degrees of hearing loss. Candidacy is based on the pure-tone audiometry thresholds and aided speech testing. The audiogram does not reflect the actual problems faced by an individual with and without hearing aids. The variability in the actual functional hearing and the pure-tone thresholds makes it difficult for the patients whose audiogram is borderline for cochlear implantation and they are not deriving enough benefit from hearing aids. CASE PRESENTATION Retrospective report of the audiological findings of two patients whose cochlear implant funding was refused based on their audiogram. In both instances, they were not deriving benefit from hearing aids and the pure-tone audiometry results were just outside the National Institute for Health and Care Excellence guidelines at 4 kHz. CONCLUSIONS Cochlear implant candidacy should be individually based and needs to take into account other factors such as work, quality of life, and social impact rather than just adhering to the pure-tone audiometry guidelines. These guidelines should not be considered as strict criteria nor used to deny the benefit of a cochlear implant at the earliest possible opportunity.
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