Speech perception and auditory performance in finnish adult cochlear implant users

Improving quality of life in the elderly: hearing loss treatment with cochlear implants

BACKGROUND

Hearing loss impacts health-related quality of life and general well-being and was identified in a Lancet report as one of the largest potentially modifiable factors for the prevention of age-related dementia. There is a lack of robust data on how cochlear implant treatment in the elderly impacts quality of life. The primary objective was to measure the change in health utility following cochlear implantation in individuals aged ≥ 60 years.

METHODS

This study uniquely prospectively recruited a large multinational sample of 100 older adults (mean age 71.7 (SD7.6) range 60-91 years) with severe to profound hearing loss. In a repeated-measures design, pre and post implant outcome measures were analysed using mixed-effect models. Health utility was assessed with the Health Utilities Index Mark III (HUI3). Subjects were divided into groups of 60-64, 65-74 and 75 + years.

RESULTS

At 18 months post implant, the mean HUI3 score improved by 0.13 (95%CI: 0.07-0.18 p < 0.001). There was no statistically significant difference in the HUI3 between age groups (F[2,9228] = 0.53, p = 0.59). The De Jong Loneliness scale reduced by an average of 0.61 (95%CI: 0.25-0.97 p < 0.014) and the Lawton Instrumental Activities of Daily Living Scale improved on average (1.25, 95%CI: 0.85-1.65 p < 0.001). Hearing Handicap Inventory for the Elderly Screening reduced by an average of 8.7 (95%CI: 6.7-10.8, p < 0.001) from a significant to mild-moderate hearing handicap. Age was not a statistically significant factor for any of the other measures (p > 0.20). At baseline 90% of participants had no or mild depression and there was no change in mean depression scores after implant. Categories of Auditory perception scale showed that all subjects achieved a level of speech sound discrimination without lip reading post implantation (level 4) and at least 50% could use the telephone with a known speaker.

CONCLUSIONS

Better hearing improved individuals' quality of life, ability to communicate verbally and their ability to function independently. They felt less lonely and less handicapped by their hearing loss. Benefits were independent of age group. Cochlear implants should be considered as a routine treatment option for those over 60 years with bilateral severe to profound hearing loss.

TRIAL REGISTRATION

ClinicalTrials.gov ( http://www.

CLINICALTRIALS

gov/ ), 7 March 2017, NCT03072862.

Vowel confusion patterns in adults during initial 4 years of implant use

This study investigated adult cochlear implant users' (n = 39) vowel recognition and confusions by an open-set syllable test during 4 years of implant use, in a prospective repeated-measures design. Subjects' responses were coded for phoneme errors and estimated by the generalized mixed model. Improvement in overall vowel recognition was highest during the first 6 months, showing statistically significant change until 4 years, especially for the mediocre performers. The best performers improved statistically significantly until 18 months. The poorest performers improved until 12 months and exhibited more vowel confusions. No differences were found in overall vowel recognition between Nucleus24M/24R and Med-ElC40+ device users (matched comparison), but certain vowels showed statistically significant differences. Vowel confusions between adjacent vowels were evident, probably due to the implant users' inability to discriminate formant frequencies. Vowel confusions were also dominated by vowels whose average F1 and/or F2 frequencies were higher than the target vowel, indicating a basalward shift in the confusions.

Comparison of the body-worn CIS-PRO + and the behind-the-ear-worn TEMPO + cochlear implant systems in Finnish-speaking adult CI users: any differences in results with experienced listeners?

CONCLUSION

The results indicate that the need for upgrading the processor and/or speech coding strategy should be considered individually, if the processor and coding strategy are functioning properly and a good level of speech perception has been achieved.

OBJECTIVES

Our aim was to study the intra-individual differences of the body-worn CIS-PRO + and the behind-the-ear-worn TEMPO + cochlear implant systems used in the MED-EL Combi40/Combi40 + implants.

SUBJECTS AND METHODS

The hearing level, sentence, word and phoneme recognition of eight adult subjects were determined in an ABA study design. Additionally, a self-assessment questionnaire was used. Mean scores and 95% confidence intervals, and individual scores were analysed.

RESULTS

The subjects tended to score slightly better on word and phoneme recognition with CIS-PRO+ and CIS strategy than with TEMPO+ and CIS+, but there were no statistically significant differences. Subjectively the participants ranked speech perception and discussion in noise to be slightly easier with TEMPO+ and CIS+. Six of the eight subjects preferred TEMPO+ and CIS+ and two of eight preferred CIS-PRO+ with CIS or number-of-maxima.