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Yang AW, Pillion EM, Riley CA, Tolisano AM. Differences in music appreciation between bilateral and single-sided cochlear implant recipients. Am J Otolaryngol 2024; 45:104331. [PMID: 38677147 DOI: 10.1016/j.amjoto.2024.104331] [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: 02/06/2024] [Accepted: 04/21/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE To compare changes in music appreciation after cochlear implant (CI) surgery for patients with bilateral and single-sided deafness (SSD). METHODS A retrospective cohort study was performed on all adult CI unilateral or bilateral recipients from November 2019 to March 2023. Musical questionnaire subset data from the Cochlear Implant Quality of Life (CIQOL) - 35 Profile Instrument Score (maximum raw score of 15) was collected. Functional CI assessment was measured with CI-alone speech-in-quiet (SIQ) scores (AzBio and CNC). RESULTS 22 adults underwent CI surgery for SSD and 21 adults for bilateral deafness (8 sequentially implanted). Every patient group had clinically significant improvements (p < 0.001) in mean SIQ scores in the most recently implanted ear (Azbio (% correct) SSD: 14.23 to 68.48, bilateral: 24.54 to 82.23, sequential: 6.25 to 82.57). SSD adults on average had higher music QOL scores at baseline (SSD: 11.05; bilateral: 7.86, p < 0.001). No group had significant increases in raw score at the first post-operative visit (SSD: 11.45, p = 0.86; bilateral: 8.15, p = 0.15). By the most recent post-implantation evaluation (median 12.8 months for SSD, 12.3 months for bilateral), SSD adults had a significant increase in raw score from baseline (11.05 to 12.45, p = 0.03), whereas bilaterally deafened (7.86 to 9.38, p = 0.12) adults had nonsignificant increases. CONCLUSIONS SSD patients demonstrate higher baseline music appreciation than bilaterally deafened individuals regardless of unilateral or bilateral implantation and are more likely to demonstrate continued improvement in subjective music appreciation at last follow-up even when speech perception outcomes are similar.
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Affiliation(s)
- Alex W Yang
- Department of Otolaryngology Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Elicia M Pillion
- Department of Audiology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Charles A Riley
- Department of Otolaryngology Head and 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 and 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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Bruschini L, Canzi P, Canale A, Covelli E, Laborai A, Monteforte M, Cinquini M, Barbara M, Beltrame MA, Bovo R, Castigliano B, De Filippis C, Della Volpe A, Dispenza F, Marsella P, Mainardi A, Orzan E, Piccirillo E, Ricci G, Quaranta N, Cuda D. Implantable hearing devices in clinical practice. Systematic review and consensus statements. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2024; 44:52-67. [PMID: 38165206 PMCID: PMC10914359 DOI: 10.14639/0392-100x-n2651] [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: 05/22/2023] [Accepted: 09/21/2023] [Indexed: 01/03/2024]
Abstract
Objective Implantable hearing devices represent a modern and innovative solution for hearing restoration. Over the years, these high-tech devices have increasingly evolved but their use in clinical practice is not universally agreed in the scientific literature. Congresses, meetings, conferences, and consensus statements to achieve international agreement have been made. This work follows this line and aims to answer unsolved questions regarding examinations, selection criteria and surgery for implantable hearing devices. Materials and methods A Consensus Working Group was established by the Italian Society of Otorhinolaryngology. A method group performed a systematic review for each single question to identify the current best evidence on the topic and to guide a multidisciplinary panel in developing the statements. Results Twenty-nine consensus statements were approved by the Italian Society of Otorhinolaryngology. These were associated with 4 key area subtopics regarding pre-operative tests, otological, audiological and surgical indications. Conclusions This consensus can be considered a further step forward to establish realistic guidelines on the debated topic of implantable hearing devices.
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Affiliation(s)
- Luca Bruschini
- Otolaryngology, ENT Audiology and Phoniatrics Unit, University Hospital of Pisa, Pisa, Italy
| | - Pietro Canzi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Canale
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Edoardo Covelli
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Andrea Laborai
- Department of Otolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Marta Monteforte
- Laboratory of systematic review methodology and guidelines production, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Michela Cinquini
- Laboratory of systematic review methodology and guidelines production, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maurizio Barbara
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Millo Achille Beltrame
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberto Bovo
- Department of Neuroscience DNS, Otolaryngology Section, Padua University, Padua, Italy
| | - Bruno Castigliano
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Cosimo De Filippis
- Department of Neuroscience, Audiology Section, University of Padua, Treviso, Italy
| | - Antonio Della Volpe
- Otology and Cochlear Implant Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - Francesco Dispenza
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Azienda Ospedaliera Universitaria Policlinico ‘’Paolo Giaccone’’, University of Palermo, Palermo, Italy
| | - Pasquale Marsella
- Audiology and Otosurgery Department, “Bambino Gesù” Children’s Hospital, Rome, Italy
| | - Anna Mainardi
- Department of Otolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Eva Orzan
- ENT and Audiology Unit, Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, Trieste, Italy
| | | | - Giampietro Ricci
- Department of Surgical and Biomedical Sciences, Section of Otorhinolaryngology, University of Perugia, Perugia, Italy
| | - Nicola Quaranta
- Translational Biomedicine and Neurosciences Department, University of Bari, Bari, Italy
| | - Domenico Cuda
- Department of Otolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
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Mecklenburg DJ, Graham PL, James CJ. Relationships Between Speech, Spatial and Qualities of Hearing Short Form SSQ12 Item Scores and their Use in Guiding Rehabilitation for Cochlear Implant Recipients. Trends Hear 2024; 28:23312165231224643. [PMID: 38361477 PMCID: PMC10874150 DOI: 10.1177/23312165231224643] [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: 04/21/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 02/17/2024] Open
Abstract
Cochlear implantation successfully improves hearing in most adult recipients. However, in rare cases, post-implant rehabilitation is required to maximize benefit. The primary aim of this investigation was to test if self-reports by cochlear implant users indicate the need for post-implant rehabilitation. Listening performance was assessed with the Speech, Spatial and Qualities short-form SSQ12, which was self-administered via a web-based survey. Subjects included over 2000 adult bilateral or unilateral cochlear implant users with at least one year of experience. A novel application of regression tree analysis identified core SSQ12 items that serve as first steps in establishing a plan for further rehabilitation: items 1, 8, and 11 dealing with single-talker situations, loudness perception, and clarity, respectively. Further regression and classification tree analyses revealed that SSQ12 item scores were weakly related to age, degree of tinnitus, and use of bilateral versus unilateral implants. Conversely, SSQ12 scores were strongly associated with self-rated satisfaction and confidence in using their cochlear implant. The SSQ12 total scores did not vary significantly over 1-9 or more years' experience. These findings suggest that the SSQ12 may be a useful tool to guide rehabilitation at any time after cochlear implantation. Identification of poor performance may have implications for timely management to improve the outcomes, through various techniques such as device fitting adjustments, counseling, active sound exposure, and training spatial hearing.
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Affiliation(s)
| | - Petra L. Graham
- School of Mathematical and Physical Sciences, Macquarie University, North Ryde, Australia
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Philips C, Jacquemin L, Lammers MJW, Mertens G, Gilles A, Vanderveken OM, Van Rompaey V. Listening effort and fatigue among cochlear implant users: a scoping review. Front Neurol 2023; 14:1278508. [PMID: 38020642 PMCID: PMC10656682 DOI: 10.3389/fneur.2023.1278508] [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: 08/16/2023] [Accepted: 09/18/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction In challenging listening situations, speech perception with a cochlear implant (CI) remains demanding and requires high levels of listening effort, which can lead to increased levels of listening-related fatigue. The body of literature on these topics increases as the number of CI users rises. This scoping review aims to provide an overview of the existing literature on listening effort, fatigue, and listening-related fatigue among CI users and the measurement techniques to evaluate them. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statements were used to conduct the scoping review. The search was performed on PubMed, Scopus, and Web of Science to identify all relevant studies. Results In total, 24 studies were included and suggests that CI users experience higher levels of listening effort when compared to normal hearing controls using scales, questionnaires and electroencephalogram measurements. However, executing dual-task paradigms did not reveal any difference in listening effort between both groups. Uncertainty exists regarding the difference in listening effort between unilateral, bilateral, and bimodal CI users with bilateral hearing loss due to ambiguous results. Only five studies were eligible for the research on fatigue and listening-related fatigue. Additionally, studies using objective measurement methods were lacking. Discussion This scoping review highlights the necessity for additional research on these topics. Moreover, there is a need for guidelines on how listening effort, fatigue, and listening-related fatigue should be measured to allow for study results that are comparable and support optimal rehabilitation strategies.
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Affiliation(s)
- Cato Philips
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology/Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Laure Jacquemin
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology/Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Marc J. W. Lammers
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology/Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Griet Mertens
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology/Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Annick Gilles
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology/Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
| | - Olivier M. Vanderveken
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology/Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Vincent Van Rompaey
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology/Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
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Myhrum M, Heldahl MG, Rødvik AK, Tvete OE, Jablonski GE. Validation of the Norwegian Version of the Speech, Spatial and Qualities of Hearing Scale (SSQ). Audiol Neurootol 2023; 29:124-135. [PMID: 37918367 PMCID: PMC10994583 DOI: 10.1159/000534197] [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: 10/24/2022] [Accepted: 09/06/2023] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION The main objective of the study was to validate the Norwegian translation of the Speech, Spatial and Qualities of Hearing Scale (SSQ) and investigate the SSQ disability profiles in a cochlear implant (CI) user population. METHODS The study involved 152 adult CI users. The mean age at implantation was 55 (standard deviation [SD] = 16), and the mean CI experience was 5 years (SD = 4.8). The cohort was split into three groups depending on the hearing modality: bilateral CIs (BCIs), a unilateral CI (UCI), and bimodal (CI plus contralateral hearing aid; HCI). The SSQ disability profiles of each group were compared with those observed in similar studies using the English version and other translations of the SSQ. Standard values, internal consistency, sensitivity, and floor and ceiling effects were investigated, and the missing-response rates to specific questions were calculated. Relationships to speech perception were measured using monosyllabic word scores and the Norwegian Hearing in Noise Test scores. RESULTS In the BCI group, the average scores were around 5.0 for the speech and spatial sections and 7.0 for the qualities section (SD ∼2). The average scores of the UCI and HCI groups were about one point lower than those of the BCI group. The SSQ disability profiles were comparable to the profiles in similar studies. The slopes of the linear regression lines measuring the relationships between the SSQ speech and monosyllabic word scores were 0.8 per 10% increase in the monosyllabic word score for the BCI group (explaining 35% of the variation) and 0.4 for the UCI and HCI groups (explaining 22-23% of the variation). CONCLUSION The Norwegian version of the SSQ measures hearing disability similar to the original English version, and the internal consistency is good. Differences in the recipients' pre-implantation variables could explain some variations we observed in the SSQ responses, and such predictors should be investigated. Data aggregation will be possible using the SSQ as a routine clinical assessment in global CI populations. Moreover, pre-implantation variables should be systematically registered so that they can be used in mixed-effects models.
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Affiliation(s)
- Marte Myhrum
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mariann Gjervik Heldahl
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Arne Kirkhorn Rødvik
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Ole Edvard Tvete
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Greg Eigner Jablonski
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Thompson NJ, Lopez EM, Dillon MT, Rooth MA, Richter ME, Pillsbury HC, Brown KD. Cochlear Implantation for Unilateral and Asymmetric Hearing Loss: Long-Term Subjective Benefit. Laryngoscope 2023; 133:2792-2797. [PMID: 36757052 DOI: 10.1002/lary.30608] [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: 08/24/2022] [Revised: 12/10/2022] [Accepted: 01/25/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVES Assess the long-term patterns of perceived tinnitus severity and subjective benefit for adult cochlear implant (CI) users with asymmetric or unilateral hearing loss (AHL or UHL). METHODS Forty adults underwent cochlear implantation as part of a prospective clinical trial assessing the outcomes of CI use in cases of AHL (n = 20) and UHL (n = 20). Subjective measures included the Tinnitus Handicap Inventory (THI), the Speech, Spatial, & Qualities of Hearing Scale (SSQ), and the Abbreviated Profile of Hearing Aid Benefit (APHAB). Responses were obtained preoperatively and at routine intervals out to 5 years post-activation. RESULTS For subjective benefit, participants with AHL and UHL reported a significant improvement as compared to preoperative abilities, which was maintained with long-term CI use. For perceived tinnitus severity, participants with AHL and UHL reported a significant reduction with CI use as compared to preoperative perceptions. The perceived tinnitus severity significantly differed for the AHL and UHL cohorts over time. This pattern of results is likely influenced by the worse perceived severity levels for the UHL cohort preoperatively and the fluctuating perceived severity levels for some participants in the AHL cohort post-activation. CONCLUSION Adults with AHL and UHL report an early, significant reduction in perceived tinnitus severity and improvement in quality of life with CI use that is generally maintained with long-term device use. Questionnaires such as the THI, SSQ, and APHAB may contribute to a more holistic assessment of the benefits of cochlear implantation in this population. LEVEL OF EVIDENCE 2 Laryngoscope, 133:2792-2797, 2023.
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Affiliation(s)
- Nicholas J Thompson
- Department of Otolaryngology/Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Erin M Lopez
- Department of Otolaryngology/Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Margaret T Dillon
- Department of Otolaryngology/Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Meredith A Rooth
- Department of Otolaryngology/Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Margaret E Richter
- Department of Otolaryngology/Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Harold C Pillsbury
- Department of Otolaryngology/Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kevin D Brown
- Department of Otolaryngology/Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Patel R, Hoare DJ, Willis KR, Tabraiz S, Bateman PK, Thornton SK. Characterisation of the treatment provided for children with unilateral hearing loss. Front Pediatr 2023; 11:1197713. [PMID: 37559951 PMCID: PMC10407268 DOI: 10.3389/fped.2023.1197713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/16/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Children with permanent unilateral hearing loss (UHL) are an understudied population, with limited data to inform the guidelines on clinical management. There is a funding gap in healthcare provision for the children with UHL in the United Kingdom, where genetic screening, support services, and devices are not consistently provided or fully funded in all areas. They are a disparate population with regard to aetiology and their degree of hearing loss, and hence their device choice and use. Despite having one "good ear", some children with UHL can have similar outcomes, socially, behaviourally, and academically, to children with bilateral hearing loss, highlighting the importance of understanding this population. In this longitudinal cohort study, we aimed to characterise the management of the children with UHL and the gaps in the support services that are provided for the children in Nottingham, United Kingdom. METHODS A cohort study was conducted collecting longitudinal data over 17 years (2002-2019) for 63 children with permanent congenital confirmed UHL in a large tertiary regional referral centre for hearing loss in Nottingham, United Kingdom. The cases of UHL include permanent congenital, conductive, mixed, or sensorineural hearing loss, and the degree of hearing loss ranges from mild to profound. The data were taken from their diagnostic auditory brainstem responses and their two most recent hearing assessments. Descriptors were recorded of the devices trialled and used and the diagnoses including aetiology of UHL, age of first fit, degree of hearing loss, when and which type of device was used, why a device was not used, the support services provided, concerns raised, and who raised them. RESULTS Most children (45/63; 71%) trialled a device, and the remaining 18 children had no device trial on record. Most children (20/45; 44%) trialled a bone-conduction device, followed by contralateral routing of signal aid (15/45; 33%) and conventional hearing aids (9/45; 20%). Most children (36/45; 80%) who had a device indicated that they wore their device "all day" or every day in school. Few children (8/45; 18%) reported that they wore their device rarely, and the reasons for this included bullying (3/8), feedback from the device (2/8), and discomfort from the device (2/8). Only one child reported that the device was not helping with their hearing. The age that the children were first fitted with their hearing device varied a median of 2.5 years for hearing aids and bone-conduction devices and 7 years for a contralateral routing of signal aid. The length of time that the children had the device also varied widely (median of 26 months, range 3-135 months); the children had their bone-conduction hearing aid for the longest period of time (median of 32.5 months). There was a significant trend where more recent device fittings were happening for children at a younger age. Fifty-one children were referred by the paediatric audiologist to a support service, 72.5% (37/51) were subsequently followed up by the referred service with no issue, whilst the remaining 27.5% (14/51) encountered an issue leading to an unsuccessful provision of support. Overall, most children (65%, 41/63) had no reported concerns, and 28.5% (18/63) of the children went on to have a documented concern at some point during their audiological care: five with hearing aid difficulties, five with speech issues, four with no improvement in hearing, three facing self-image or bullying issues, and one case of a child struggling to interact socially with friends. Three of these children had not trialled a device. We documented every concern reported from the parents, clinicians, teachers of the deaf, and from the children themselves. Where concerns were raised, more than half (58.6%, 10/18) were by schools and teachers, the remaining four concerns were raised by the family, and further four concerns were raised by the children themselves. CONCLUSION To discover what management will most benefit which children with permanent UHL, we first must characterise their treatment, their concerns, and the support services available for them. Despite the children with UHL being a highly disparate population-in terms of their aetiology, their device use, the degree of hearing loss, and the age at which they trial a device-the majority report they use their device mostly in school. In lieu of available data and in consideration of the devices that are available to them, it could be useful to support families and clinicians in understanding the devices which are most used and where they are used. Considering the reasons for cessation of regular device use counselling and support services would be vital to support the children with UHL.
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Affiliation(s)
- Roshni Patel
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, The University of Nottingham, Nottingham, United Kingdom
| | - Derek J. Hoare
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, The University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Karen R. Willis
- Children’s Audiology, Ropewalk House, Nottingham, United Kingdom
| | - Shammas Tabraiz
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, The University of Nottingham, Nottingham, United Kingdom
| | - Paul K. Bateman
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, The University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Sally K. Thornton
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, The University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
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Saxena U, Mishra SK, Rodrigo H, Choudhury M. Functional consequences of extended high frequency hearing impairment: Evidence from the speech, spatial, and qualities of hearing scale. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:2946. [PMID: 36456291 DOI: 10.1121/10.0015200] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/01/2022] [Indexed: 06/17/2023]
Abstract
Hearing loss in the extended high frequencies, despite a normal audiogram, could affect speech-in-noise recognition. However, it is not known if extended high frequency (EHF) hearing loss is associated with everyday listening and communication deficits. The present study aimed to determine the functional effects of impaired EHF hearing among adults using the Speech, Spatial, and Qualities of Hearing Scale (SSQ). A secondary objective was to evaluate the relationship between objective (speech-in-noise recognition) and subjective (SSQ) measures of hearing function. Listeners with EHF hearing loss provided lower SSQ ratings compared with their EHF-normal counterparts. The lower ratings could not be attributed to the age or standard audiogram of the listeners. Ratings from more than 50% of EHF-impaired listeners were below the 2 SD cutoff point obtained from EHF-normal listeners. The mean speech recognition threshold was poorer for EHF-impaired listeners, and a poorer speech recognition threshold was associated with lower SSQ ratings, i.e., poorer self-reported hearing ability. For some listeners, EHF hearing loss could be the missing link between self-reported hearing difficulty in the presence of a normal audiogram. These findings provide evidence for the functional deficits associated with EHF hearing loss and invoke the need for future investigations into the management of EHF loss.
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Affiliation(s)
- Udit Saxena
- Department of Audiology & Speech Language Pathology, GMERS Medical College & Hospital, Ahmedabad 380060, India
| | - Srikanta K Mishra
- Department of Speech, Language and Hearing Sciences, The University of Texas at Austin, Austin, Texas 78712, USA
| | - Hansapani Rodrigo
- School of Mathematical and Statistical Sciences, The University of Texas Rio Grande Valley, Edinburg, Texas 78539, USA
| | - Moumita Choudhury
- Department of Speech, Language and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, Texas 79430, USA
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Patro A, Lindquist NR, Holder JT, Tawfik KO, O’Malley MR, Bennett ML, Haynes DS, Gifford R, Perkins EL. Further Evidence for Individual Ear Consideration in Cochlear Implant Candidacy Evaluation. Otol Neurotol 2022; 43:1033-1040. [PMID: 36075098 PMCID: PMC9481725 DOI: 10.1097/mao.0000000000003677] [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] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To report speech outcomes after cochlear implantation (CI) for asymmetric hearing loss (AHL) and assess the influence of contralateral hearing. STUDY DESIGN Retrospective review. SETTING Tertiary referral center. PATIENTS One hundred eighty-eight adults (mean age, 70 yr) undergoing CI for AHL from 2015 to 2020. Candidacy included pure-tone average (PTA) at least 70 dB hearing level and AzBio in quiet 60% or less in the implanted ear and AzBio in quiet greater than 40% in the contralateral ear. MAIN OUTCOME MEASURES PTA; Consonant-Nucleus-Consonant (CNC) word, AzBio sentences scores; Speech, Spatial, and Qualities of Hearing Scale (SSQ). RESULTS Mean preoperative PTA and AzBio in the implanted and contralateral ears were 85.2 and 68.1 dB hearing level and 24.7% and 69.2%, respectively. Mean CNC in the implanted ear increased from 18.3% preoperatively to 44.4% ( p < 0.0001) at 6 months and 49.3% ( p < 0.0001) at 12 months. Mean AzBio in the implanted ear improved from 24.7% preoperatively to 60.3% ( p < 0.0001) at 6 months and 64.3% ( p < 0.0001) at 12 months. Patients demonstrated significant improvement in all SSQ domains at 6 and 12 months. When comparing patients with preoperative contralateral AzBio greater than 60% versus 41% to 60%, no significant differences existed in postoperative CNC scores (6-mo: 47% versus 41%, p = 0.276; 12-mo: 51% versus 47%, p = 0.543). There were no significant differences in 6-month ( p = 0.936) or 12-month ( p = 0.792) CNC scores between patients with AHL (contralateral ear AzBio >40%) and 169 unilateral CI patients meeting the traditional Medicare criteria (contralateral ear AzBio ≤40%). CONCLUSION CI recipients with AHL derive significant speech improvements, supporting individual ear consideration for CI candidacy and patient benefit outside of current Medicare criteria.
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Affiliation(s)
- Ankita Patro
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Nathan R. Lindquist
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jourdan T. Holder
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kareem O. Tawfik
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Matthew R. O’Malley
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Marc L. Bennett
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - David S. Haynes
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - René Gifford
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Elizabeth L. Perkins
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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Cochlear implantation in patients with asymmetric hearing loss: reporting and discussing the benefits in speech perception, speech reception threshold, squelch abilities, and patients’ reported outcomes. The Journal of Laryngology & Otology 2022; 136:964-969. [DOI: 10.1017/s0022215121004333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectivesThis study presents the results obtained in a group of patients with asymmetric hearing loss undergoing cochlear implantation at our institution. Prognostic factors are discussed in relation to different rehabilitative approaches for asymmetric hearing loss remediation. The current literature is also discussed.MethodsNineteen adult patients with post-verbal asymmetric hearing loss were enrolled. The results were assessed by means of a speech perception test, completed in silence and with background noise, and a speech reception threshold test (Oldenburg Sentence Test). The subjectively perceived benefits were assessed using the Speech, Spatial and Qualities of Hearing Scale.ResultsStatistically significant improvements were achieved by all patients in terms of speech perception and speech reception threshold, and in subjective benefits.ConclusionThe results confirm the literature findings which suggest that patients with asymmetric hearing loss generally gain substantial benefit from cochlear implantation because of the binaural input, with significant improvement in speech perception abilities in noise, speech reception threshold, and squelch abilities.
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11
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Cochlear implantation for paediatric and adult cases of unilateral and asymmetric hearing loss. Curr Opin Otolaryngol Head Neck Surg 2022; 30:303-308. [PMID: 36004791 DOI: 10.1097/moo.0000000000000838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Children and adults with unilateral or asymmetric hearing loss (UHL/AHL) have poorer spatial hearing (e.g. speech understanding in complex maskers and localization) and quality of life compared with peers with normal hearing bilaterally. Patients with UHL/AHL experience limited benefits with contralateral-routing technologies (e.g. bone conduction, CROS hearing aid systems). Cochlear implantation allows for stimulation of the auditory pathway for the poorer hearing ear. The present study reviews the recent literature on outcomes of cochlear implant use for recipients with UHL/AHL. RECENT FINDINGS Recent research corroborates previous investigations of the significant benefits on measures of spatial hearing, tinnitus severity and quality of life for adult cochlear implant recipients. These benefits are also observed in pediatric cochlear implant recipients, with an association of better outcomes with younger ages at implantation for congenital cases and shorter durations of UHL/AHL for acquired cases. In addition, randomized trials demonstrate better outcomes with cochlear implant use versus contralateral-routing technologies. SUMMARY Cochlear implantation supports better spatial hearing and quality of life in children and adults with UHL/AHL as compared to alternative listening conditions. Current research supports the expansion of candidacy criteria and insurance coverage for cochlear implantation for patients with UHL/AHL to improve their binaural hearing.
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12
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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: 8] [Impact Index Per Article: 4.0] [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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孙 进, 朱 笛, 王 璐, 梅 玲, 陈 建, 汪 玮, 沈 佳, 马 孝, 陈 向, 杨 军. [Compensation effect of hearing aid on speech recognition in noise in patients with unilateral hearing loss]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:571-575. [PMID: 35959572 PMCID: PMC10128199 DOI: 10.13201/j.issn.2096-7993.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Indexed: 06/15/2023]
Abstract
Objective:The aim of this study was to investigate the speech recognition in noise in patients with unilateral hearing loss(UHL), and explore the compensation effect of behind-the-ear(BTE) hearing aid on speech recognition in patients with varied degrees of UHL. Methods:Twenty-five participants with UHL were divided into two groups according to the degree of hearing loss: one group included subjects with unilateral moderate and moderately severe hearing loss and another one included subjects with unilateral severe and profound hearing loss. Fifteen healthy subjects with normal hearing were enrolled as the control group. The speech recognition thresholds and speech recognition scores at fixed signal noise ratio(SNR) in UHL participants with and without BTE hearing aid were tested in the sound field and compared with those in the control group. One-way ANOVA was used to examine the significance of the difference between UHL participants and control group, and paired t-test was used to analyze the compensation effect of hearing aid on speech recognition in noise in UHL participants. Results:The speech recognition thresholds were significantly higher in both UHL groups(P<0.01) compared with the control group, there was no significant difference between two UHL groups. And the speech recognition scores were significantly lower when the SNR was fixed(P<0.01), and there were no significant differences between two UHL groups. When fitting BTE hearing aid, the speech recognition thresholds of the two groups significantly decreased(P<0.01), and the speech recognition scores significantly improved(P<0.01). Conclusion:Patients with above moderate UHL presented a significant decrease in performance of speech recognition in noise, and fitting BTE hearing aid on the affected ear had a positive compensation effect.
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Affiliation(s)
- 进 孙
- 上海交通大学医学院附属新华医院耳鼻咽喉头颈外科 听力障碍及眩晕诊治中心 上海交通大学医学院耳科学研究所 上海市耳鼻疾病转化医学重点实验室(上海,200092)Diagnosis and Treatment Center of Hearing Impairment and Vertigo, Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine; Ear Institute, Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, 200092, China
| | - 笛 朱
- 上海中医药大学康复医学院School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine
| | - 璐 王
- 上海交通大学医学院附属新华医院耳鼻咽喉头颈外科 听力障碍及眩晕诊治中心 上海交通大学医学院耳科学研究所 上海市耳鼻疾病转化医学重点实验室(上海,200092)Diagnosis and Treatment Center of Hearing Impairment and Vertigo, Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine; Ear Institute, Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, 200092, China
| | - 玲 梅
- 上海交通大学医学院附属新华医院耳鼻咽喉头颈外科 听力障碍及眩晕诊治中心 上海交通大学医学院耳科学研究所 上海市耳鼻疾病转化医学重点实验室(上海,200092)Diagnosis and Treatment Center of Hearing Impairment and Vertigo, Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine; Ear Institute, Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, 200092, China
| | - 建勇 陈
- 上海交通大学医学院附属新华医院耳鼻咽喉头颈外科 听力障碍及眩晕诊治中心 上海交通大学医学院耳科学研究所 上海市耳鼻疾病转化医学重点实验室(上海,200092)Diagnosis and Treatment Center of Hearing Impairment and Vertigo, Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine; Ear Institute, Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, 200092, China
| | - 玮 汪
- 上海交通大学医学院附属新华医院耳鼻咽喉头颈外科 听力障碍及眩晕诊治中心 上海交通大学医学院耳科学研究所 上海市耳鼻疾病转化医学重点实验室(上海,200092)Diagnosis and Treatment Center of Hearing Impairment and Vertigo, Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine; Ear Institute, Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, 200092, China
| | - 佳丽 沈
- 上海交通大学医学院附属新华医院耳鼻咽喉头颈外科 听力障碍及眩晕诊治中心 上海交通大学医学院耳科学研究所 上海市耳鼻疾病转化医学重点实验室(上海,200092)Diagnosis and Treatment Center of Hearing Impairment and Vertigo, Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine; Ear Institute, Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, 200092, China
| | - 孝宝 马
- 上海交通大学医学院附属新华医院耳鼻咽喉头颈外科 听力障碍及眩晕诊治中心 上海交通大学医学院耳科学研究所 上海市耳鼻疾病转化医学重点实验室(上海,200092)Diagnosis and Treatment Center of Hearing Impairment and Vertigo, Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine; Ear Institute, Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, 200092, China
| | - 向平 陈
- 上海交通大学医学院附属新华医院耳鼻咽喉头颈外科 听力障碍及眩晕诊治中心 上海交通大学医学院耳科学研究所 上海市耳鼻疾病转化医学重点实验室(上海,200092)Diagnosis and Treatment Center of Hearing Impairment and Vertigo, Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine; Ear Institute, Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, 200092, China
| | - 军 杨
- 上海交通大学医学院附属新华医院耳鼻咽喉头颈外科 听力障碍及眩晕诊治中心 上海交通大学医学院耳科学研究所 上海市耳鼻疾病转化医学重点实验室(上海,200092)Diagnosis and Treatment Center of Hearing Impairment and Vertigo, Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine; Ear Institute, Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, 200092, China
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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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15
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Sherafati A, Dwyer N, Bajracharya A, Hassanpour MS, Eggebrecht AT, Firszt JB, Culver JP, Peelle JE. Prefrontal cortex supports speech perception in listeners with cochlear implants. eLife 2022; 11:e75323. [PMID: 35666138 PMCID: PMC9225001 DOI: 10.7554/elife.75323] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 06/04/2022] [Indexed: 12/14/2022] Open
Abstract
Cochlear implants are neuroprosthetic devices that can restore hearing in people with severe to profound hearing loss by electrically stimulating the auditory nerve. Because of physical limitations on the precision of this stimulation, the acoustic information delivered by a cochlear implant does not convey the same level of acoustic detail as that conveyed by normal hearing. As a result, speech understanding in listeners with cochlear implants is typically poorer and more effortful than in listeners with normal hearing. The brain networks supporting speech understanding in listeners with cochlear implants are not well understood, partly due to difficulties obtaining functional neuroimaging data in this population. In the current study, we assessed the brain regions supporting spoken word understanding in adult listeners with right unilateral cochlear implants (n=20) and matched controls (n=18) using high-density diffuse optical tomography (HD-DOT), a quiet and non-invasive imaging modality with spatial resolution comparable to that of functional MRI. We found that while listening to spoken words in quiet, listeners with cochlear implants showed greater activity in the left prefrontal cortex than listeners with normal hearing, specifically in a region engaged in a separate spatial working memory task. These results suggest that listeners with cochlear implants require greater cognitive processing during speech understanding than listeners with normal hearing, supported by compensatory recruitment of the left prefrontal cortex.
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Affiliation(s)
- Arefeh Sherafati
- Department of Radiology, Washington University in St. LouisSt. LouisUnited States
| | - Noel Dwyer
- Department of Otolaryngology, Washington University in St. LouisSt. LouisUnited States
| | - Aahana Bajracharya
- Department of Otolaryngology, Washington University in St. LouisSt. LouisUnited States
| | | | - Adam T Eggebrecht
- Department of Radiology, Washington University in St. LouisSt. LouisUnited States
- Department of Electrical & Systems Engineering, Washington University in St. LouisSt. LouisUnited States
- Department of Biomedical Engineering, Washington University in St. LouisSt. LouisUnited States
- Division of Biology and Biomedical Sciences, Washington University in St. LouisSt. LouisUnited States
| | - Jill B Firszt
- Department of Otolaryngology, Washington University in St. LouisSt. LouisUnited States
| | - Joseph P Culver
- Department of Radiology, Washington University in St. LouisSt. LouisUnited States
- Department of Biomedical Engineering, Washington University in St. LouisSt. LouisUnited States
- Division of Biology and Biomedical Sciences, Washington University in St. LouisSt. LouisUnited States
- Department of Physics, Washington University in St. LouisSt. LouisUnited States
| | - Jonathan E Peelle
- Department of Otolaryngology, Washington University in St. LouisSt. LouisUnited States
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Russo FY, De Seta D, Orlando MP, Ralli M, Cammeresi MG, Greco A, de Vincentiis M, Ruoppolo G, Mancini P, Turchetta R. Hearing attention and quality of listening in children with unilateral hearing loss with and without hearing aid. ACTA OTORHINOLARYNGOLOGICA ITALICA 2022; 42:169-175. [PMID: 35612509 PMCID: PMC9131998 DOI: 10.14639/0392-100x-n1746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/18/2021] [Indexed: 11/23/2022]
Abstract
Objective Methods Results Conclusions
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17
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Ha J, Kim H, Lee JH, Park HY. Sound localization in patients with a unilateral hearing aid: Discordance between the right and left ears. Laryngoscope Investig Otolaryngol 2022; 7:599-603. [PMID: 35434348 PMCID: PMC9008160 DOI: 10.1002/lio2.769] [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: 08/12/2021] [Revised: 01/15/2022] [Accepted: 02/16/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives Patients with unilateral hearing loss (UHL) have difficulty in recognizing the direction of a sound. Previous studies have shown that hearing aids (HAs) could improve the directional perception of sound. In this study, we analyzed the results of sound localization tests in patients using a unilateral HA. Methods All patients with UHL who had performed sound localization tests since 2018 were included in this study. Sound localization tests, functional gain tests, and the speech discrimination scores (SDSs) were analyzed. The tests were obtained at 1‐, 3‐, and 6‐month after fitting the HA. Results Of the 32 patients with UHL, 13 were right‐sided and 19 were left‐sided. After 6 months of using a HA, the results of the sound localization test were significantly better in patients with right than left UHL (percent correct [PCT], 61.9 ± 24.0% vs. 37.9 ± 24.6%, p = .011; mean absolute error (MAE), 41.4 ± 23.9° vs. 65.5 ± 28.6°, p = .018; root‐mean‐square error (RMS), 25.8 ± 17.6° vs. 48.8 ± 24.5°, p = .007]. The aided SDSs were not different between the two groups (78.7 ± 16.5% vs. 77.2 ± 18.5%, p = .825). Conclusion The side of the hearing loss could have a substantial effect on sound localization in UHL patients using a HA. Sound localization test results should be interpreted with the consideration of this discordance. Level of Evidence 4
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Affiliation(s)
- Jungho Ha
- Department of Otolaryngology Ajou University School of Medicine Suwon South Korea
| | - Hantai Kim
- Department of Otorhinolaryngology–Head and Neck Surgery Konyang University College of Medicine Daejeon South Korea
| | - Ju Ho Lee
- Department of Otolaryngology Ajou University School of Medicine Suwon South Korea
| | - Hun Yi Park
- Department of Otolaryngology Ajou University School of Medicine Suwon South Korea
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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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Falcón Benítez N, Falcón González JC, Ramos Macías Á, Borkoski Barreiro S, Ramos de Miguel Á. Cochlear Implants in Single-Sided Deafness. Comparison Between Children and Adult Populations With Post-lingually Acquired Severe to Profound Hearing Loss. Front Neurol 2021; 12:760831. [PMID: 34803893 PMCID: PMC8599284 DOI: 10.3389/fneur.2021.760831] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To determine audiological and clinical results of cochlear implantation (CI) comparing two populations with single-sided deafness (SSD): post-lingually deaf children between 6 and 12 years of age, and post-lingually deaf adults, in order to evaluate the effect of CI in different age groups. Design: Retrospective case review. Setting: Tertiary clinic. Patients and Method: Twenty-three children and twenty-one adult patients that were candidates for CI with single-side deafness were included. In all cases we evaluate: Speech perception thresholds; disyllabic words test (65 dB SPL) were performed in the modalities S0-SCI-SNH and Auditory Lateralization Test. The Speech, Spatial, and Qualities of Hearing Scale (SSQ) questionnaire was also used. All results were obtained after 12 months of CI activation. Results: In children, the most common etiology was idiopathic sensory-neural hearing loss. They showed positive results in the Auditory Lateralization Test. In the Speech Test, word recognition in noise improved from 2% preoperatively to 61.1% at a mean follow-up of 1 year (S0 condition) in children [test with signal in CI side 60% and signal normal hearing side (plugged) 31%]. The processor was used for >12 h in all cases. With respect to the SSQ questionnaire, parents were more satisfied within the postoperative period than within the preoperative period. For adults, the most common etiology was idiopathic sudden sensorineural hearing loss (SNHL). Positive results in the Auditory Lateralization Test were found. With respect to the Speech Test in quiet conditions: Word recognition in noise improved from 5.7% preoperatively to 71.8% at a mean follow-up of 1 year [test with signal in CI side 68% and signal normal hearing side (plugged) 41%]. The processor was used for >12 h. In the SSQ questionnaire, the post-operative results showed a beneficial effect of the CI. No adverse events were reported during the study period. No differences were found between children and adults in all tests in this study. Conclusions: Cochlear implantation in post-lingually deaf adults and children with SSD can achieve a speech perception outcome comparable with CI in conventional candidates. Improvements in spatial hearing were also observed. Careful patient selection and counseling regarding potential benefits are important to optimize outcomes.
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Affiliation(s)
- Nadia Falcón Benítez
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Juan Carlos Falcón González
- Department of Otolaryngology, Head and Neck Surgery, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Las Palmas, Spain
| | - Ángel Ramos Macías
- Department of Otolaryngology, Head and Neck Surgery, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Las Palmas, Spain
| | - Silvia Borkoski Barreiro
- Department of Otolaryngology, Head and Neck Surgery, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Las Palmas, Spain
| | - Ángel Ramos de Miguel
- Hearing and Balance Laboratory, Las Palmas de Gran Canaria University Institute of Intelligent System and Numeric Application in Engineering, Las Palmas, Spain
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20
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Corbin NE, Buss E, Leibold LJ. Spatial Hearing and Functional Auditory Skills in Children With Unilateral Hearing Loss. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4495-4512. [PMID: 34609204 PMCID: PMC9132156 DOI: 10.1044/2021_jslhr-20-00081] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/03/2021] [Accepted: 06/30/2021] [Indexed: 06/13/2023]
Abstract
Purpose The purpose of this study was to characterize spatial hearing abilities of children with longstanding unilateral hearing loss (UHL). UHL was expected to negatively impact children's sound source localization and masked speech recognition, particularly when the target and masker were separated in space. Spatial release from masking (SRM) in the presence of a two-talker speech masker was expected to predict functional auditory performance as assessed by parent report. Method Participants were 5- to 14-year-olds with sensorineural or mixed UHL, age-matched children with normal hearing (NH), and adults with NH. Sound source localization was assessed on the horizontal plane (-90° to 90°), with noise that was either all-pass, low-pass, high-pass, or an unpredictable mixture. Speech recognition thresholds were measured in the sound field for sentences presented in two-talker speech or speech-shaped noise. Target speech was always presented from 0°; the masker was either colocated with the target or spatially separated at ±90°. Parents of children with UHL rated their children's functional auditory performance in everyday environments via questionnaire. Results Sound source localization was poorer for children with UHL than those with NH. Children with UHL also derived less SRM than those with NH, with increased masking for some conditions. Effects of UHL were larger in the two-talker than the noise masker, and SRM in two-talker speech increased with age for both groups of children. Children with UHL whose parents reported greater functional difficulties achieved less SRM when either masker was on the side of the better-hearing ear. Conclusions Children with UHL are clearly at a disadvantage compared with children with NH for both sound source localization and masked speech recognition with spatial separation. Parents' report of their children's real-world communication abilities suggests that spatial hearing plays an important role in outcomes for children with UHL.
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Affiliation(s)
- Nicole E. Corbin
- Department of Communication Science and Disorders, University of Pittsburgh, PA
| | - Emily Buss
- Department of Otolaryngology—Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill
| | - Lori J. Leibold
- Center for Hearing Research, Boys Town National Research Hospital, Omaha, NE
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21
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Lopez EM, Dillon MT, Park LR, Rooth MA, Richter ME, Thompson NJ, O'Connell BP, Pillsbury HC, Brown KD. Influence of Cochlear Implant Use on Perceived Listening Effort in Adult and Pediatric Cases of Unilateral and Asymmetric Hearing Loss. Otol Neurotol 2021; 42:e1234-e1241. [PMID: 34224547 PMCID: PMC8448920 DOI: 10.1097/mao.0000000000003261] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Assess the influence of cochlear implant (CI) use on the perceived listening effort of adult and pediatric subjects with unilateral hearing loss (UHL) or asymmetric hearing loss (AHL). STUDY DESIGN Prospective cohort. SETTING Tertiary referral center. PATIENTS Adults and children with UHL or AHL. INTERVENTION Cochlear implantation. Subjects received their CI as part of a clinical trial assessing the effectiveness of cochlear implantation in cases of UHL and AHL. MAIN OUTCOME MEASURES Responses to the Listening Effort pragmatic subscale on the Speech, Spatial, and Qualities of Hearing Scale (SSQ) or SSQ for Children with Impaired Hearing (SSQ-C) were compared over the study period. Subjects or their parents completed the questionnaires preoperatively and at predetermined postactivation intervals. For the adult subjects, responses were compared to word recognition in quiet and sentence recognition in noise. RESULTS Forty adult subjects (n = 20 UHL, n = 20 AHL) and 16 pediatric subjects with UHL enrolled and underwent cochlear implantation. Subjects in all three groups reported a significant reduction in perceived listening effort within the initial months of CI use (p < 0.001; η2 ≥ 0.351). The perceived benefit was significantly correlated with speech recognition in noise for the adult subjects with UHL at the 12-month interval (r(20) = .59, p = 0.006). CONCLUSIONS Adult and pediatric CI recipients with UHL or AHL report a reduction in listening effort with CI use as compared to their preoperative experiences. Use of the SSQ and SSQ-C Listening Effort pragmatic subscale may provide additional information about a CI recipient's experience beyond the abilities measured in the sound booth.
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Affiliation(s)
- Erin M Lopez
- Department of Otolaryngology/Head & Neck Surgery
| | | | - Lisa R Park
- Department of Otolaryngology/Head & Neck Surgery
| | | | - Margaret E Richter
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, North Carolina
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22
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Effects of Simulated and Profound Unilateral Sensorineural Hearing Loss on Recognition of Speech in Competing Speech. Ear Hear 2021; 41:411-419. [PMID: 31356386 DOI: 10.1097/aud.0000000000000764] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Unilateral hearing loss (UHL) is a condition as common as bilateral hearing loss in adults. Because of the unilaterally reduced audibility associated with UHL, binaural processing of sounds may be disrupted. As a consequence, daily tasks such as listening to speech in a background of spatially distinct competing sounds may be challenging. A growing body of subjective and objective data suggests that spatial hearing is negatively affected by UHL. However, the type and degree of UHL vary considerably in previous studies. The aim here was to determine the effect of a profound sensorineural UHL, and of a simulated UHL, on recognition of speech in competing speech, and the binaural and monaural contributions to spatial release from masking, in a demanding multisource listening environment. DESIGN Nine subjects (25 to 61 years) with profound sensorineural UHL [mean pure-tone average (PTA) across 0.5, 1, 2, and 4 kHz = 105 dB HL] and normal contralateral hearing (mean PTA = 7.2 dB HL) were included based on the criterion that the target and competing speech were inaudible in the ear with hearing loss. Thirteen subjects with normal hearing (19 to 60 years; mean left PTA = 4.1 dB HL; mean right PTA = 5.5 dB HL) contributed data in normal and simulated "mild-to-moderate" UHL conditions (PTA = 38.6 dB HL). The main outcome measure was the threshold for 40% correct speech recognition in colocated (0°) and spatially and symmetrically separated (±30° and ±150°) competing speech conditions. Spatial release from masking was quantified as the threshold difference between colocated and separated conditions. RESULTS Thresholds in profound UHL were higher (worse) than normal hearing in separated and colocated conditions, and comparable to simulated UHL. Monaural spatial release from masking, that is, the spatial release achieved by subjects with profound UHL, was significantly different from zero and 49% of the magnitude of the spatial release from masking achieved by subjects with normal hearing. There were subjects with profound UHL who showed negative spatial release, whereas subjects with normal hearing consistently showed positive spatial release from masking in the normal condition. The simulated UHL had a larger effect on the speech recognition threshold for separated than for colocated conditions, resulting in decreased spatial release from masking. The difference in spatial release between normal-hearing and simulated UHL conditions increased with age. CONCLUSIONS The results demonstrate that while recognition of speech in colocated and separated competing speech is impaired for profound sensorineural UHL, spatial release from masking may be possible when competing speech is symmetrically distributed around the listener. A "mild-to-moderate" simulated UHL decreases spatial release from masking compared with normal-hearing conditions and interacts with age, indicating that small amounts of residual hearing in the UHL ear may be more beneficial for separated than for colocated interferer conditions for young listeners.
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Abstract
OBJECTIVE To describe our experience with adults undergoing cochlear implantation (CI) for treatment of single-sided deafness (SSD). STUDY DESIGN Retrospective case review. SETTING Tertiary referral center. PATIENTS Fifty-three adults with SSD. INTERVENTIONS Unilateral CI. MAIN OUTCOME MEASURES Speech perception testing in quiet and noise, tinnitus suppression, and device usage from datalogs. RESULTS The mean age at CI was 53.2 years (SD 11.9). The mean duration of deafness was 4.0 years (SD 7.8). The most common etiology was idiopathic sudden SNHL (50%). Word recognition improved from 8.7% (SD 15) preoperatively to 61.8% (SD 20) at a mean follow-up of 3.3 years (SD 1.8) (p < 0.0001). Adaptive speech recognition testing in the "binaural with CI" condition (speech directed toward the front and noise toward the normal hearing ear) revealed a significant improvement by 2.6-dB SNR compared to the preoperative unaided condition (p = 0.0002) and by 3.6-dB SNR compared to when a device to route sound to the contralateral side was used (p < 0.0001). Tinnitus suppression was reported to be complete in 23 patients (43%) and improved in 20 patients (38%) while the device was on. The addition of the CI did not lead to a decrement in hearing performance in any spatial configuration. Device usage averaged 8.7 (SD 3.7) hours/day. CONCLUSIONS Cochlear implantation in adult SSD patients can suppress tinnitus and achieve speech perception outcomes comparable with CI in conventional candidates. Modest improvements in spatial hearing were also observed and primarily attributable to the head shadow effect. Careful patient selection and counseling regarding potential benefits are important to optimize outcomes.
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24
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Abstract
Posterior fossa meningiomas that impinge on structures of the temporal bone or clivus may be difficult to access for optimal resection that maximizes tumor control and minimizes short- and long-term morbidities. To address this challenge, the contemporary neurosurgery-neurotology team works collaboratively by managing patients jointly at every stage of care: preoperative evaluation, intraoperative intervention, and postoperative treatment. The neurotologist is important at all stages of posterior fossa meningioma surgery. First, detailed preoperative evaluation of auditory, facial, vestibular, and lower cranial nerve integrity enables assessment of new neurologic deficit risk, prognosis of functional recovery, and pros and cons of candidate surgical approaches. Second, intraoperative partitioning of surgical steps by provider and adopting an overlapping tumor resection philosophy creates an efficient and confident surgical team built on trust. Third, postoperative closure of cerebrospinal fluid leak and treatment of facial weakness, audiovestibular dysfunction, and voicing and swallowing impairments organized by the neurotologist reduces the impact of negative outcomes. The role of the neurotologist in posterior fossa meningioma surgery is to deliver nuanced evaluative metrics, facilitate shared decision making, perform precise bone and soft tissue microsurgery, and mitigate perioperative morbidities.
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25
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Unilateral auditory deprivation in humans: Effects on frequency discrimination and auditory memory span in the normal ear. Hear Res 2021; 405:108245. [PMID: 33887536 DOI: 10.1016/j.heares.2021.108245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 11/22/2022]
Abstract
Hearing with one ear is associated with auditory deprivation leading to cortical neuronal reorganization. Despite evidence for substantial effects of unilateral input on cortical and sub-cortical structures, the functional consequences of such alterations on human hearing is underexplored. Unilateral hearing impairment offers a unique model to study the perceptual consequences of cortical reorganization. The present study provides evidence for larger (poorer) difference limens for frequency for sounds heard by the normal ear of listeners with unilateral hearing loss relative to bilaterally normal-hearing controls. This difference in frequency discrimination ability was observed for the low (250 Hz), but not for the high-frequency tone (4000 Hz). Besides auditory perceptual effects, we also found reduced working memory capacity as revealed by forward and backward digit span measures. Contrary to the expectation, there was no significant association between frequency discrimination and working memory capacity in listeners with unilateral hearing loss. Auditory deprivation associated with unilateral hearing impairment affects low-frequency (pitch) discrimination and working memory capacity despite normal hearing in the intact ear. Such deficits in basic auditory processes and memory span for sounds heard by the normal ear may contribute to the hearing and communication difficulties experienced by listeners with unilateral or single-sided deafness.
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26
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Behavioural performance and self-report measures in children with unilateral hearing loss due to congenital aural atresia. Auris Nasus Larynx 2021; 48:65-74. [DOI: 10.1016/j.anl.2020.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/28/2020] [Accepted: 07/13/2020] [Indexed: 11/20/2022]
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27
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Islamoglu Y, Kesici GG, Ercan K, Babademez MA. Single-sided deafness after sudden hearıng loss: late effect on cochlear nerve size. Eur Arch Otorhinolaryngol 2020; 277:2423-2426. [PMID: 32314048 DOI: 10.1007/s00405-020-05977-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Single-sided deafness (SSD) is a condition where an individual has non-functional hearing in one ear and receives no clinical benefit from amplification in that ear, with the contralateral ear possessing normal audiometric function. Cochlear implant presents a good choice in rehabilitation of SSD. The presence of a deficient cochlear nerve (CN) has been linked to poor performance with cochlear implants. CN can be measured by imaging techniques. The objective of this study was to compare CN diameter in patients who had a history of single-sided deafness because of sudden hearing loss. METHODS Retrospective study where radiologist was blind designed. 53 SSD patients who had a history of sudden hearing loss and MRI at least 5 years after the sudden hearing loss were included in this retrospective study. High-resolution 3-D constructive interference in steady state (CISS)-sequence magnetic resonance (MRI) images was review by the neurotology-experienced blind radiologist. Vertical, horizontal and area measurements of cochlear nerve between the deaf and the normal ear were made. RESULTS There was no statistically significant difference between the normal ear and deaf ear of the subjects in terms of cochlear nerve vertical diameter, horizontal diameter and area. (respectively, p = 0.250; p = 0.183; p = 0.874) CONCLUSION: The numbers of remaining cochlear neurons and spiral ganglion cells in the implanted deaf ears are critical and evidence was not found for spiral ganglion cell loss in the sudden hearing loss deaf ear with SSD in MRI. In the light of all these findings, implantation would be a good choice for rehabilitation in postlingual SSD regardless of auditory deprivation duration.
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Affiliation(s)
- Yuce Islamoglu
- Department of Otolaryngology-Head and Neck Surgery, Ankara City Hospital, Ankara, Turkey.
| | - Gulin Gokcen Kesici
- Department of Otolaryngology-Head and Neck Surgery, Ankara City Hospital, Ankara, Turkey
| | - Karabekir Ercan
- Department of Radiology, Ankara City Hospital, Ankara, Turkey
| | - Mehmet Ali Babademez
- Department of Otolaryngology-Head and Neck Surgery, Yıldırım Beyazıt Medical School, Ankara, Turkey
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28
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Single-Sided Deafness—Outcomes of Three Interventions for Profound Unilateral Sensorineural Hearing Loss: A Randomized Clinical Trial. Otol Neurotol 2020; 41:736-744. [DOI: 10.1097/mao.0000000000002633] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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Thompson NJ, Dillon MT, Buss E, Rooth MA, King ER, Bucker AL, McCarthy SA, Deres EJ, O'Connell BP, Pillsbury HC, Brown KD. Subjective Benefits of Bimodal Listening in Cochlear Implant Recipients with Asymmetric Hearing Loss. Otolaryngol Head Neck Surg 2020; 162:933-941. [PMID: 32182164 PMCID: PMC7268952 DOI: 10.1177/0194599820911716] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the influence of cochlear implant (CI) use on subjective benefits in quality of life in cases of asymmetric hearing loss (AHL). STUDY DESIGN Prospective clinical trial. SETTING Tertiary academic center. SUBJECTS AND METHODS Subjects included CI recipients with AHL (n = 20), defined as moderate-to-profound hearing loss in the affected ear and mild-to-moderate hearing loss in the contralateral ear. Quality of life was assessed with the Speech, Spatial, and Qualities of Hearing Scale (SSQ) pragmatic subscales, which assess binaural benefits. Subjective benefit on the pragmatic subscales was compared to word recognition in quiet and spatial hearing abilities (ie, masked sentence recognition and localization). RESULTS Subjects demonstrated an early, significant improvement (P < .01) in abilities with the CI as compared to preoperative abilities on the SSQ pragmatic subscales by the 1-month interval. Perceived abilities were either maintained or continued to improve over the study period. There were no significant correlations between results on the Speech in Quiet subscale and word recognition in quiet, the Speech in Speech Contexts subscale and masked sentence recognition, or the Localization subscale and sound field localization. CONCLUSIONS CI recipients with AHL report a significant improvement in quality of life as measured by the SSQ pragmatic subscales over preoperative abilities. Reported improvements are observed as early as 1 month postactivation, which likely reflect the binaural benefits of listening with bimodal stimulation (CI and contralateral hearing aid). The SSQ pragmatic subscales may provide a more in-depth insight into CI recipient experience as compared to behavioral sound field measures alone.
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Affiliation(s)
- Nicholas J Thompson
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Margaret T Dillon
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Emily Buss
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Meredith A Rooth
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - English R King
- Department of Audiology, University of North Carolina Health Chapel Hill, North Carolina, USA
| | - Andrea L Bucker
- Department of Audiology, University of North Carolina Health Chapel Hill, North Carolina, USA
| | - Sarah A McCarthy
- Department of Audiology, University of North Carolina Health Chapel Hill, North Carolina, USA
| | - Ellen J Deres
- Department of Audiology, University of North Carolina Health Chapel Hill, North Carolina, USA
| | - Brendan P O'Connell
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Harold C Pillsbury
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kevin D Brown
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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30
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Katiri R, Hall DA, Buggy N, Hogan N, Horobin A, van de Heyning P, Firszt JB, Bruce IA, Kitterick PT. Core Rehabilitation Outcome Set for Single Sided Deafness (CROSSSD) study: protocol for an international consensus on outcome measures for single sided deafness interventions using a modified Delphi survey. Trials 2020; 21:238. [PMID: 32131880 PMCID: PMC7057560 DOI: 10.1186/s13063-020-4094-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 01/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Single-sided deafness (SSD) describes the presence of a unilateral severe to profound sensorineural hearing loss. SSD disrupts spatial hearing and understanding speech in background noise. It has functional, psychological and social consequences. Potential options for rehabilitation include hearing aids and auditory implants. Benefits and harms of these interventions are documented inconsistently in the literature, using a variety of outcomes ranging from tests of speech perception to quality of life questionnaires. It is therefore difficult to compare interventions when rehabilitating SSD. The Core Rehabilitation Outcome Set for Single Sided Deafness (CROSSSD) study is an international initiative that aims to develop a minimum set of core outcomes for use in future trials of SSD interventions. METHODS/DESIGN The CROSSSD study adopts an international two-round online modified Delphi survey followed by a stakeholder consensus meeting to identify a patient-centred core outcome domain set for SSD based on what is considered critical and important for assessing whether an intervention for SSD has worked. DISCUSSION The resulting core outcome domain set will act as a minimum standard for reporting in future clinical trials and could have further applications in guiding the use of outcome measures in clinical practice. Standardisation will facilitate comparison of research findings.
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Affiliation(s)
- Roulla Katiri
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom
- Department of Audiology, Mater Misericordiae University Hospital, Dublin, D07 R2WY, Ireland
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, United Kingdom
| | - Deborah A Hall
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, United Kingdom
- University of Nottingham Malaysia, Jalan Broga, 43500, Semenyih, Selangor Darul Ehsan, Malaysia
| | - Nora Buggy
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom
| | - Nicholas Hogan
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom
| | - Adele Horobin
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, United Kingdom
| | - Paul van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Jill B Firszt
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Iain A Bruce
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, United Kingdom
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - Pádraig T Kitterick
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom.
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, United Kingdom.
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, United Kingdom.
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Dingemanse G, Goedegebure A. The relation of hearing-specific patient-reported outcome measures with speech perception measures and acceptable noise levels in cochlear implant users. Int J Audiol 2020; 59:416-426. [PMID: 32091274 DOI: 10.1080/14992027.2020.1727033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: To investigate the relation of a hearing-specific patient-reported outcome measure (PROM) with speech perception and noise tolerance measurements. It was hypothesised that speech intelligibility in noise and noise tolerance may explain a larger part of the variance in PROM scores than speech intelligibility in quiet.Design: This cross-sectional study used the Speech, Spatial, Qualities (SSQ) questionnaire as a PROM. Speech recognition in quiet, the Speech Reception Threshold in noise and noise tolerance as measured with the acceptable noise level (ANL) were measured with sentences.Study sample: A group of 48 unilateral post-lingual deafened cochlear implant (CI) users.Results: SSQ scores were moderately correlated with speech scores in quiet and noise, and also with ANLs. Speech scores in quiet and noise were strongly correlated. The combination of speech scores and ANL explained 10-30% of the variances in SSQ scores, with ANLs adding only 0-9%.Conclusions: The variance in the SSQ as hearing-specific PROM in CI users was not better explained by speech intelligibility in noise than by speech intelligibility in quiet, because of the remarkably strong correlation between both measures. ANLs made only a small contribution to explain the variance of the SSQ. ANLs seem to measure other aspects than the SSQ.
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Affiliation(s)
- Gertjan Dingemanse
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
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32
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Morselli C, Boari N, Artico M, Bailo M, Piccioni LO, Giallini I, de Vincentiis M, Mortini P, Mancini P. The emerging role of hearing loss rehabilitation in patients with vestibular schwannoma treated with Gamma Knife radiosurgery: literature review. Neurosurg Rev 2020; 44:223-238. [PMID: 32030543 DOI: 10.1007/s10143-020-01257-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 01/20/2020] [Accepted: 01/30/2020] [Indexed: 12/19/2022]
Abstract
Stereotactic radiosurgery (SRS) is currently the most common treatment for small- to medium-size vestibular schwannoma (VS). Despite favorable outcome, hearing deterioration still remains an underestimated problem, and the role of hearing rehabilitation is an underinvestigated topic. Among available technologies, cochlear implant (CI) should represent a valid alternative in sporadic VS with single-sided deafness and in neurofibromatosis (NF2) with bilateral profound hearing loss. A literature review of the current clinical data was performed searching scientific literature databases. From all of the articles found, 16 papers were selected. Forty-four subjects treated with radiosurgery (18 male, 19 female, and in 7 cases, sex were not specified; 43 NF2 and 1 sporadic VS) were included in the analysis. Epidemiological, clinical, tumor, treatment, and audiological data were collected. Clinical outcome at last follow-up showed an audiological improvement in 25 of the 44 patients. The audiological outcome was unchanged in 16 cases. Audiological deterioration was recorded in 3 cases. Severity of NF2 phenotype, long history of ipsilateral profound deafness before implantation, progressive tumor growth, and high radiation dose (20 and 40 Gy) were found in patients with a worst audiological outcome. Hearing rehabilitation can improve audiological results for VS patients following SRS in selected cases. Hearing rehabilitation with cochlear implant (CI) in SSD leads to partial restoration of binaural hearing with an improvement in speech comprehension in noise and in sound localization, and partial suppression of subjective incapacitating tinnitus. SRS followed by CI may represent in selected cases a potential emerging option in the management of these patients, aimed at improving their quality of life. Possible implications for the follow-up of these patients are still present, although partially resolved.
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Affiliation(s)
- Carlotta Morselli
- Department of Human Neurosciences, Spienza University of Rome, Rome, Italy.
| | - N Boari
- Department of Neurosurgery and Radiosurgery Units, San Raffaele University Health Institute, Milan, Italy
| | - M Artico
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - M Bailo
- Department of Neurosurgery and Radiosurgery Units, San Raffaele University Health Institute, Milan, Italy
| | - L O Piccioni
- Department of Neurosurgery and Radiosurgery Units, San Raffaele University Health Institute, Milan, Italy
| | - I Giallini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - M de Vincentiis
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - P Mortini
- Department of Neurosurgery and Radiosurgery Units, San Raffaele University Health Institute, Milan, Italy
| | - P Mancini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
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Abstract
OBJECTIVES A positive relation between audibility and speech understanding has been established for cochlear implant (CI) recipients. Sound field thresholds of 20 dB HL across the frequency range provide CI users the opportunity to understand soft and very soft speech. However, programming the sound processor to attain good audibility can be time-consuming and difficult for some patients. To address these issues, Advanced Bionics (AB) developed the SoftVoice algorithm designed to remove system noise and thereby improve audibility of soft speech. The present study aimed to evaluate the efficacy of SoftVoice in optimizing AB CI recipients' soft-speech perception. DESIGN Two studies were conducted. Study 1 had two phases, 1A and 1B. Sixteen adult, AB CI recipients participated in Study 1A. Acute testing was performed in the unilateral CI condition using a Harmony processor programmed with participants' everyday-use program (Everyday) and that same program but with SoftVoice implemented. Speech recognition measures were administered at several presentation levels in quiet (35 to 60 dB SPL) and in noise (60 dB SPL). In Study 1B, 10 of the participants compared Everyday and SoftVoice at home to obtain feedback regarding the use of SoftVoice in various environments. During Study 2, soft-speech perception was acutely measured with Everyday and SoftVoice for 10 participants using the Naida CI Q70 processor. Results with the Harmony (Study 1A) and Naida processors were compared. Additionally, Study 2 evaluated programming options for setting electrode threshold levels (T-levels or Ts) to improve the usability of SoftVoice in daily life. RESULTS Study 1A showed significantly higher scores with SoftVoice than Everyday at soft presentation levels (35, 40, 45, and 50 dB SPL) and no significant differences between programs at a conversational level (60 dB SPL) in quiet or in noise. After take-home experience with SoftVoice and Everyday (Study 1B), 5 of 10 participants reported preferring SoftVoice over Everyday; however, 6 reported bothersome environmental sound when listening with SoftVoice at home. Results of Study 2 indicated similar soft-speech perception between Harmony and Naida processors. Additionally, implementing SoftVoice with Ts at the manufacturer's default setting of 10% of Ms reduced reports of bothersome environmental sound during take-home experience; however, soft-speech perception was best with SoftVoice when Ts were behaviorally set above 10% of Ms. CONCLUSIONS Results indicate that SoftVoice may be a potential tool for optimizing AB users' audibility and, in turn, soft-speech perception. To achieve optimal performance at soft levels and comfortable use in daily environments, setting Ts must be considered with SoftVoice. Future research should examine program parameters that may benefit soft-speech perception when used in combination with SoftVoice (e.g., increased input dynamic range).
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Sanhueza I, Manrique-Huarte R, Calavia D, Huarte A, Manrique M. Hearing Impairment and Quality of Life in Adults with Asymmetric Hearing Loss: Benefits of Bimodal Stimulation. J Int Adv Otol 2020; 15:62-69. [PMID: 31058597 DOI: 10.5152/iao.2019.6224] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Bimodal stimulation for asymmetric hearing loss is an emerging treatment with proven audiometric outcomes. Our objectives are to assess the changes of the hearing impairment and the quality of life of patients treated with this type of stimulation, when compared to a unilateral Cochlear Implant (CI) stimulated condition. MATERIALS AND METHODS 31 patients with asymmetric hearing loss (Group 1) were recruited for the study. They were divided into three groups, based on their hearing loss in the ear treated with the hearing aid: Group 1A (Pure Tone Audiometry (PTA) between 41 and 70 decibels (dB)); Group 1B, (PTA between 71 and 80 dB) and Group 1C (PTA between 81 and 90 dB). 30 patients had profound, bilateral hearing loss. Then, users of a unilateral cochlear implant were recruited for the control group. Their hearing impairment and quality of life were analyzed with questionnaires Abbreviated Profile of Hearing Aid Benefit (APHAB), Speech, Spatial and Qualities of Hearing Scale (SSQ) and the Health Utilities Index (HUI). They were followed up for at least 2 years. RESULTS The group with the asymmetric hearing loss obtains a statistically significant clinical improvement in the APHAB under category "with hearing aid" compared to "without hearing aid". The group with the asymmetric hearing loss benefits more across basically all variables compared with the control group in the SSQ. Group 1A obtains the best outcome of the sample in the HUI. CONCLUSION Bimodal stimulation and better hearing in the ear treated with the hearing aid reduce hearing impairment and improve the quality of life.
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Affiliation(s)
- Ignacio Sanhueza
- Department of ENT, Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | - Diego Calavia
- Department of ENT, Clinica Universidad de Navarra, Pamplona, Spain
| | - Alicia Huarte
- Department of ENT, Clinica Universidad de Navarra, Pamplona, Spain
| | - Manuel Manrique
- Department of ENT, Clinica Universidad de Navarra, Pamplona, Spain
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Aguiar RGR, Almeida KD, Miranda-Gonsalez ECD. Test-Retest Reliability of the Speech, Spatial and Qualities of Hearing Scale (SSQ) in Brazilian Portuguese. Int Arch Otorhinolaryngol 2019; 23:e380-e383. [PMID: 31649755 PMCID: PMC6805206 DOI: 10.1055/s-0039-1677754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 12/02/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction
The Speech, Spatial and Qualities of Hearing Scale (SSQ) is a questionnaire designed to assess the auditory experience and quantify hearing disabilities in realistic communication situations, with particular attention to binaural hearing.
Objective
To determine the test-retest reliability of the SSQ in Brazilian Portuguese.
Method
A total of 35 individuals with mean age of 61 years and mean education of 7 years were interviewed. The mean auditory threshold was 44.29 dBNA in the best ear and 58.04 dBNA in the worst ear. The SSQ in Portuguese was applied at two time points, test and retest. An interval of 7 to 20 days between interviews was established. The level of significance adopted was 0.05, or 5%.
Results
The analysis revealed a high Cronbach α coefficient for the three domains and for the general component of the scale, demonstrating good internal consistency between the items. In addition, a significant strong correlation was detected between test and retest of the SSQ on the analysis by domain and for the general component of the scale. A significant moderate-to-strong correlation between test and retest by question was found, except for question 2 of Part I.
Conclusion
The test-retest reliability indicators showed good stability of the Portuguese version of the SSQ, indicating that the scale is suitable for use in the hearing-impaired population in Brazil.
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Affiliation(s)
- Raiza Gorbachev Ribeiro Aguiar
- Faculty of Medical Sciences, School of Speech-Language Pathology and Audiology, Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Katia de Almeida
- Faculty of Medical Sciences, School of Speech-Language Pathology and Audiology, Santa Casa de São Paulo, São Paulo, SP, Brasil
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Au A, Dowell RC. Evidence-Based Recommendation for Bilateral Cochlear Implantation in Adults. Am J Audiol 2019; 28:775-782. [PMID: 32271119 DOI: 10.1044/2019_aja-heal18-18-0183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Most adult cochlear implant (CI) users in developed countries benefit from the use of a hearing aid in conjunction with their implant device (bimodal hearing). Benefits have also been documented for the use of bilateral CIs for speech perception in quiet, localization, and speech perception in noise. This study attempted to quantify speech perception results for bimodal and bilateral CIs in adults and provide a guide for those considering a 2nd CI. Method Speech perception outcomes were reviewed for 1,394 adults with acquired hearing loss who received a CI at the Melbourne Cochlear Implant Clinic between 2000 and 2015. Results Bimodal and bilateral users significantly outperformed unilateral CI users on consonant-vowel-consonant word recognition in quiet. For the bilateral group, word recognition scores with the 1st CI were predictive of 2nd CI word scores. The analysis suggested that bimodal users who were gaining less than 19% benefit from the nonimplanted ear were likely to perform better with a 2nd implant. Conclusions CI users who score less than 19% on consonant-vowel-consonant words in the nonimplanted ear have a good chance of benefiting from a 2nd implant. Consideration of many other factors including age, hearing goals, medical factors, and the risk to residual hearing also needs to play a part in recommending a 2nd CI.
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Affiliation(s)
- Agnes Au
- The HEARing Cooperative Research Center, Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, The University of Melbourne, Victoria, Australia
| | - Richard C. Dowell
- The HEARing Cooperative Research Center, Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, The University of Melbourne, Victoria, Australia
- Cochlear Implant Clinic, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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A New Speech, Spatial, and Qualities of Hearing Scale Short-Form: Factor, Cluster, and Comparative Analyses. Ear Hear 2019; 40:938-950. [DOI: 10.1097/aud.0000000000000675] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lau MK, Hicks C, Kroll T, Zupancic S. Effect of Auditory Task Type on Physiological and Subjective Measures of Listening Effort in Individuals With Normal Hearing. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:1549-1560. [PMID: 31063438 DOI: 10.1044/2018_jslhr-h-17-0473] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose Listening effort has traditionally been measured using subjective rating scales and behavioral measures. Recent physiological measures of listening effort have utilized pupil dilation. Using a combination of physiological and subjective measures of listening effort, this study aimed to identify differences in listening effort during 2 auditory tasks: sentence recognition and word recognition. Method Pupil dilation and subjective ratings of listening effort were obtained for auditory tasks utilizing AzBio sentences recognition and Northwestern University Auditory Test No. 6 words recognition, across 3 listening situations: in quiet, at +6 dB signal-to-noise ratio, and at 0 dB signal-to-noise ratio. Task accuracy was recorded for each of the 6 conditions, as well as peak pupil dilation and a subjective rating of listening effort. Results A significant impact of listening situation (quiet vs. noise) and task type (sentence recognition vs. word recognition) on both physiological and subjective measures was found. There was a significant interaction between listening situation and task type, suggesting that contextual cues may only be beneficial when audibility is uncompromised. The current study found no correlation between the physiological and subjective measures, possibly suggesting that these measures analyze different aspects of cognitive effort in a listening task.
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Affiliation(s)
- Marcy K Lau
- Department of Audiology & Speech Pathology, East Tennessee State University, Johnson City
| | - Candace Hicks
- Department of Speech, Language, & Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock
| | - Tobias Kroll
- Department of Speech, Language, & Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock
| | - Steven Zupancic
- Department of Speech, Language, & Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock
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Abstract
Objective: Hearing impairment is linked to increased fatigue, yet little is known about the real-world impact of this fatigue. This qualitative study investigated the experience of daily-life fatigue in people with a hearing impairment. Design: Individual face-to-face semi-structured interviews were conducted. Thematic analysis was then used to analyse the data. Study sample: Fourteen hearing impaired participants (aged 44-70 years) who varied in terms of hearing loss, hearing aid status, age and gender. Results: The themes and sub-themes that emerged from the transcripts were: Fatigue (effort-driven fatigue, emotion-driven fatigue, breaks and recovery, the perceived relationship between hearing impairment and fatigue, and sleep), Effort (cognitive effort and physical effort), Coping Strategies (withdrawal, avoidance and planning), Relationships and Emotions, Hearing Aid Impact. Conclusions: The study highlights that hearing impairment-related fatigue is experienced by many but not all, and to different extents. Hearing aids were weakly linked to a beneficial effect on fatigue. In addition to the more widely researched effort-driven fatigue, participants described fatigue linked to the negative emotions related to having a hearing impairment. These findings, in conjunction with the widespread utilisation of different coping strategies, demonstrate that the experience of fatigue is varied and likely dependent on personal factors and lifestyle.
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Affiliation(s)
- Jack A Holman
- a Hearing Sciences (Scottish Section), Division of Clinical Neuroscience , School of Medicine, University of Nottingham , Glasgow , UK
| | - Avril Drummond
- b School of Health Sciences, University of Nottingham , Nottingham , UK
| | - Sarah E Hughes
- c School of Medicine, Swansea University , Swansea , UK.,d South Wales Cochlear Implant Programme , Bridgend , UK
| | - Graham Naylor
- a Hearing Sciences (Scottish Section), Division of Clinical Neuroscience , School of Medicine, University of Nottingham , Glasgow , UK
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Liu YW, Cheng X, Chen B, Peng K, Ishiyama A, Fu QJ. Effect of Tinnitus and Duration of Deafness on Sound Localization and Speech Recognition in Noise in Patients With Single-Sided Deafness. Trends Hear 2019; 22:2331216518813802. [PMID: 30509148 PMCID: PMC6291880 DOI: 10.1177/2331216518813802] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patients with single-sided deafness (SSD) often experience poor sound localization, reduced speech understanding in noise, reduced quality of life, and tinnitus. The present study aims to evaluate effects of tinnitus and duration of deafness on sound localization and speech recognition in noise by SSD subjects. Sound localization and speech recognition in noise were measured in 26 SSD and 10 normal-hearing (NH) subjects. Speech was always presented directly in front of the listener. Noise was presented to the deaf ear, in front of the listener, or to the better hearing ear. Tinnitus severity was measured using visual analog scale and Tinnitus Handicap Inventory. Relative to NH subjects, SSD subjects had significant deficits in sound localization and speech recognition in all listening conditions (p < .001). For SSD subjects, speech recognition in noise was correlated with mean hearing thresholds in the better hearing ear (p < .001) but not in the deaf ear. SSD subjects with tinnitus performed poorer in sound localization and speech recognition in noise than those without tinnitus. Shorter duration of deafness was associated with greater tinnitus and sound localization difficulty. Tinnitus visual analog scale and Tinnitus Handicap Inventory were highly correlated; the degree of tinnitus was negatively correlated with sound localization and speech recognition in noise. Those experiencing noticeable tinnitus may benefit more from cochlear implantation than those without; subjective tinnitus reduction may be correlated with improved sound localization and speech recognition in noise. Subjects with longer duration of deafness demonstrated better sound localization, suggesting long-term compensation for loss of binaural cues.
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Affiliation(s)
- Yang-Wenyi Liu
- 1 Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.,2 NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Xiaoting Cheng
- 1 Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.,2 NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Bing Chen
- 1 Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.,2 NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Kevin Peng
- 3 House Clinic, Los Angeles, CA, USA.,4 Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Akira Ishiyama
- 4 Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Qian-Jie Fu
- 4 Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Results in Adult Cochlear Implant Recipients With Varied Asymmetric Hearing: A Prospective Longitudinal Study of Speech Recognition, Localization, and Participant Report. Ear Hear 2019; 39:845-862. [PMID: 29373326 DOI: 10.1097/aud.0000000000000548] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Asymmetric hearing with severe to profound hearing loss (SPHL) in one ear and better hearing in the other requires increased listening effort and is detrimental for understanding speech in noise and sound localization. Although a cochlear implant (CI) is the only treatment that can restore hearing to an ear with SPHL, current candidacy criteria often disallows this option for patients with asymmetric hearing. The present study aimed to evaluate longitudinal performance outcomes in a relatively large group of adults with asymmetric hearing who received a CI in the poor ear. DESIGN Forty-seven adults with postlingual hearing loss participated. Test materials included objective and subjective measures meant to elucidate communication challenges encountered by those with asymmetric hearing. Test intervals included preimplant and 6 and 12 months postimplant. Preimplant testing was completed in participants' everyday listening condition: bilateral hearing aids (HAs) n = 9, better ear HA n = 29, and no HA n = 9; postimplant, each ear was tested separately and in the bimodal condition. RESULTS Group mean longitudinal results in the bimodal condition postimplant compared with the preimplant everyday listening condition indicated significantly improved sentence scores at soft levels and in noise, improved localization, and higher ratings of communication function by 6 months postimplant. Group mean, 6-month postimplant results were significantly better in the bimodal condition compared with either ear alone. Audibility and speech recognition for the poor ear alone improved significantly with a CI compared with preimplant. Most participants had clinically meaningful benefit on most measures. Contributory factors reported for traditional CI candidates also impacted results for this population. In general, older participants had poorer bimodal speech recognition in noise and localization abilities than younger participants. Participants with early SPHL onset had better bimodal localization than those with later SPHL onset, and participants with longer SPHL duration had poorer CI alone speech understanding in noise but not in quiet. Better ear pure-tone average (PTA) correlated with all speech recognition measures in the bimodal condition. To understand the impact of better ear hearing on bimodal performance, participants were grouped by better ear PTA: group 1 PTA ≤40 dB HL (n = 19), group 2 PTA = 41 to 55 dB HL (n = 14), and group 3 PTA = 56 to 70 dB HL (n = 14). All groups showed bimodal benefit on speech recognition measures in quiet and in noise; however, only group 3 obtained benefit when noise was toward the CI ear. All groups showed improved localization and ratings of perceived communication. CONCLUSIONS Receiving a CI for the poor ear was an effective treatment for this population. Improved audibility and speech recognition were evident by 6 months postimplant. Improvements in sound localization and self-reports of communication benefit were significant and not related to better ear hearing. Participants with more hearing in the better ear (group 1) showed less bimodal benefit but greater bimodal performance for speech recognition than groups 2 and 3. Test batteries for this population should include quality of life measures, sound localization, and adaptive speech recognition measures with spatially separated noise to capture the hearing loss deficits and treatment benefits reported by this patient population.
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Relations Between Self-Reported Daily-Life Fatigue, Hearing Status, and Pupil Dilation During a Speech Perception in Noise Task. Ear Hear 2019; 39:573-582. [PMID: 29117062 PMCID: PMC7664454 DOI: 10.1097/aud.0000000000000512] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Supplemental Digital Content is available in the text. Objective: People with hearing impairment are likely to experience higher levels of fatigue because of effortful listening in daily communication. This hearing-related fatigue might not only constrain their work performance but also result in withdrawal from major social roles. Therefore, it is important to understand the relationships between fatigue, listening effort, and hearing impairment by examining the evidence from both subjective and objective measurements. The aim of the present study was to investigate these relationships by assessing subjectively measured daily-life fatigue (self-report questionnaires) and objectively measured listening effort (pupillometry) in both normally hearing and hearing-impaired participants. Design: Twenty-seven normally hearing and 19 age-matched participants with hearing impairment were included in this study. Two self-report fatigue questionnaires Need For Recovery and Checklist Individual Strength were given to the participants before the test session to evaluate the subjectively measured daily fatigue. Participants were asked to perform a speech reception threshold test with single-talker masker targeting a 50% correct response criterion. The pupil diameter was recorded during the speech processing, and we used peak pupil dilation (PPD) as the main outcome measure of the pupillometry. Results: No correlation was found between subjectively measured fatigue and hearing acuity, nor was a group difference found between the normally hearing and the hearing-impaired participants on the fatigue scores. A significant negative correlation was found between self-reported fatigue and PPD. A similar correlation was also found between Speech Intelligibility Index required for 50% correct and PPD. Multiple regression analysis showed that factors representing “hearing acuity” and “self-reported fatigue” had equal and independent associations with the PPD during the speech in noise test. Less fatigue and better hearing acuity were associated with a larger pupil dilation. Conclusions: To the best of our knowledge, this is the first study to investigate the relationship between a subjective measure of daily-life fatigue and an objective measure of pupil dilation, as an indicator of listening effort. These findings help to provide an empirical link between pupil responses, as observed in the laboratory, and daily-life fatigue.
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von Gablenz P, Otto-Sobotka F, Holube I. Adjusting Expectations: Hearing Abilities in a Population-Based Sample Using an SSQ Short Form. Trends Hear 2019; 22:2331216518784837. [PMID: 30022731 PMCID: PMC6053860 DOI: 10.1177/2331216518784837] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The German short form of the Speech, Spatial, and Qualities of Hearing Scale (SSQ) was administered in a cross-sectional study based on stratified random samples complemented by audiometric tests and a general interview. Data from 1,711 unaided adults aged 18 to 97 years were analyzed in order to determine a distribution of hearing abilities considered as normal and the main factors that impact self-assessments. An innovative mathematical approach was used to overcome the constraints of statistics based on the mean. Quantile regression analysis yielded a benchmark distribution of SSQ scores that might support audiologists in setting realistic SSQ score targets and estimated how the effect of auditory and nonauditory factors changes across the distribution of SSQ scores. Regression models showed significant effects for nonauditory factors on SSQ ratings when controlled for pure-tone hearing and interaural asymmetry. Self-reporting of hearing difficulties, when asked in general terms, was substantially related to SSQ ratings. This effect was observed in both high and low scoring participants and led to a considerable score decrease in all SSQ subscales. Gender, educational level, and self-reporting of health issues also were significantly related to SSQ ratings, but the corresponding effects were regularly unbalanced across the score distribution and particularly large at lower quantiles. The estimated effects of age, however, were mostly small in size, inconsistent regarding the direction, and failed significance for all SSQ items. Overall, the results suggest that nonauditory factors and cumulative effects must be considered when evaluating rehabilitative interventions against an ideal outcome.
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Affiliation(s)
- Petra von Gablenz
- 1 Institute of Hearing Technology and Audiology, Jade University of Applied Sciences, Oldenburg, Germany.,2 Cluster of Excellence Hearing4all, Oldenburg, Germany
| | - Fabian Otto-Sobotka
- 3 Division of Epidemiology and Biometry, School for Medicine and Health Sciences, Carl von Ossietzky University, Oldenburg, Germany
| | - Inga Holube
- 1 Institute of Hearing Technology and Audiology, Jade University of Applied Sciences, Oldenburg, Germany.,2 Cluster of Excellence Hearing4all, Oldenburg, Germany
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Buss E, Dillon MT, Rooth MA, King ER, Deres EJ, Buchman CA, Pillsbury HC, Brown KD. Effects of Cochlear Implantation on Binaural Hearing in Adults With Unilateral Hearing Loss. Trends Hear 2019; 22:2331216518771173. [PMID: 29732951 PMCID: PMC5950506 DOI: 10.1177/2331216518771173] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A FDA clinical trial was carried out to evaluate the potential benefit of cochlear implant (CI) use for adults with unilateral moderate-to-profound sensorineural hearing loss. Subjects were 20 adults with moderate-to-profound unilateral sensorineural hearing loss and normal or near-normal hearing on the other side. A MED-EL standard electrode was implanted in the impaired ear. Outcome measures included: (a) sound localization on the horizontal plane (11 positions, -90° to 90°), (b) word recognition in quiet with the CI alone, and (c) masked sentence recognition with the target at 0° and the masker at -90°, 0°, or 90°. This battery was completed preoperatively and at 1, 3, 6, 9, and 12 months after CI activation. Normative data were also collected for 20 age-matched control subjects with normal or near-normal hearing bilaterally. The CI improved localization accuracy and reduced side bias. Word recognition with the CI alone was similar to performance of traditional CI recipients. The CI improved masked sentence recognition when the masker was presented from the front or from the side of normal or near-normal hearing. The binaural benefits observed with the CI increased between the 1- and 3-month intervals but appeared stable thereafter. In contrast to previous reports on localization and speech perception in patients with unilateral sensorineural hearing loss, CI benefits were consistently observed across individual subjects, and performance was at asymptote by the 3-month test interval. Cochlear implant settings, consistent CI use, and short duration of deafness could play a role in this result.
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Affiliation(s)
- Emily Buss
- 1 Department of Otolaryngology/Head and Neck Surgery, 2331 University of North Carolina School of Medicine , Chapel Hill, NC, USA
| | - Margaret T Dillon
- 1 Department of Otolaryngology/Head and Neck Surgery, 2331 University of North Carolina School of Medicine , Chapel Hill, NC, USA
| | - Meredith A Rooth
- 1 Department of Otolaryngology/Head and Neck Surgery, 2331 University of North Carolina School of Medicine , Chapel Hill, NC, USA
| | - English R King
- 2 Department of Audiology, 2334 UNC Health Care , Chapel Hill, NC, USA
| | - Ellen J Deres
- 2 Department of Audiology, 2334 UNC Health Care , Chapel Hill, NC, USA
| | - Craig A Buchman
- 3 Department of Otolaryngology/Head and Neck Surgery, 12275 Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Harold C Pillsbury
- 1 Department of Otolaryngology/Head and Neck Surgery, 2331 University of North Carolina School of Medicine , Chapel Hill, NC, USA
| | - Kevin D Brown
- 1 Department of Otolaryngology/Head and Neck Surgery, 2331 University of North Carolina School of Medicine , Chapel Hill, NC, USA
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Costa LD, Santos SND, Costa MJ. Unilateral hearing loss and the use of hearing aid: speech recognition, benefit, self-perception of functional performance and satisfaction. REVISTA CEFAC 2019. [DOI: 10.1590/1982-0216/201921113918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Purpose: to investigate speech recognition in silence and in noise in subjects with unilateral hearing loss with and without hearing aids, and to analyze the benefit, self-perception of functional performance, satisfaction and the use of hearing aids in these subjects. Methods: eleven adults with unilateral, mixed and sensorineural, mild to severe hearing loss participated in this study. Speech recognition was evaluated by the Brazilian Portuguese sentences lists test; functional performance of the hearing was assessed by using the Speech Spatial and Qualities of Hearing Scale questionnaire; satisfaction was assessed by the Satisfaction with Amplification in Daily Life questionnaire, both in Brazilian Portuguese; and to assess the use of hearing aids, the patient's report was analyzed. Results: the adaptation of hearing aids provided benefits in speech recognition in all positions evaluated, both in silence and in noise. The subjects did not report major limitations in communication activities with the use of hearing aids. They were satisfied with the use of sound amplification. Most of the subjects did not use hearing aids, effectively. The discontinuity of hearing aids use can be justified by the difficulty on perceiving participation’s restriction caused by hearing loss, as well as the benefit of the hearing aid, besides the concern with batteries’ costs and aesthetic aspects. Conclusion: although showing benefits in speech recognition, in silence and in noise, and satisfaction with sound amplification, most subjects with unilateral hearing loss do not effectively use hearing aids.
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Van Eeckhoutte M, Spirrov D, Wouters J, Francart T. Objective Binaural Loudness Balancing Based on 40-Hz Auditory Steady-State Responses. Part II: Asymmetric and Bimodal Hearing. Trends Hear 2018; 22:2331216518805363. [PMID: 30334496 PMCID: PMC6196612 DOI: 10.1177/2331216518805363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In Part I, we investigated 40-Hz auditory steady-state response (ASSR) amplitudes for the use of objective loudness balancing across the ears for normal-hearing participants and found median across-ear ratios in ASSR amplitudes close to 1. In this part, we further investigated whether the ASSR can be used to estimate binaural loudness balance for listeners with asymmetric hearing, for whom binaural loudness balancing is of particular interest. We tested participants with asymmetric hearing and participants with bimodal hearing, who hear with electrical stimulation through a cochlear implant (CI) in one ear and with acoustical stimulation in the other ear. Behavioral loudness balancing was performed at different percentages of the dynamic range. Acoustical carrier frequencies were 500, 1000, or 2000 Hz, and CI channels were stimulated in apical or middle regions in the cochlea. For both groups, the ASSR amplitudes at balanced loudness levels were similar for the two ears, with median ratios between left and right ear stimulation close to 1. However, individual variability was observed. For participants with asymmetric hearing loss, the difference between the behavioral balanced levels and the ASSR-predicted balanced levels was smaller than 10 dB in 50% and 56% of cases, for 500 Hz and 2000 Hz, respectively. For bimodal listeners, these percentages were 89% and 60%. Apical CI channels yielded significantly better results (median difference near 0 dB) than middle CI channels, which had a median difference of −7.25 dB.
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Affiliation(s)
| | | | - Jan Wouters
- 1 ExpORL, Department of Neurosciences, KU Leuven, Belgium
| | - Tom Francart
- 1 ExpORL, Department of Neurosciences, KU Leuven, Belgium
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Perkins E, Rooth M, Dillon M, Brown K. Simultaneous labyrinthectomy and cochlear implantation in unilateral meniere's disease. Laryngoscope Investig Otolaryngol 2018; 3:225-230. [PMID: 30062139 PMCID: PMC6057226 DOI: 10.1002/lio2.163] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 03/30/2018] [Indexed: 11/10/2022] Open
Abstract
Objective In a single‐institution, FDA‐approved IDE study, subjects with unilateral Meniere's disease and intractable vertigo underwent concurrent labyrinthectomy and cochlear implantation to determine speech perception, localization, and quality of life outcomes. Methods Three subjects with unilateral Meniere's disease with normal or near‐normal hearing in the contralateral ear underwent simultaneous labyrinthectomy and cochlear implantation. Sound localization, speech perception in noise and quiet, tinnitus handicap index, and quality of life measures were evaluated at 1, 3, and 6 months after implant activation. Results Sound localization testing demonstrated immediate benefit postimplantation with the cochlear implant (CI). RMS error with CI on was 22 degrees (±2) and with CI off was 63 (±15) at 6 months. Mean CI alone scores were 22% (±20) at 1 month and improved to 43% (±20) and 49% (±11) at the 3‐ and 6‐month intervals, respectively. AzBio sentences in babble (0 dB SNR) scores presented in the most challenging listening condition (S0NContra) were 28% (±20) at 1 month, 38% (±18) at 3 months, and 45% (±24) at 6 months. Tinnitus Handicap Inventory (THI) significantly improved from an average preoperative score of 42 (±26) to 0 at 6 months. Quality of life measures improved overall over the postimplantation follow‐up intervals. Conclusions Subjects with unilateral Meniere's Disease who underwent simultaneous labyrinthectomy and cochlear implantation experienced improvements in sound localization, speech understanding, tinnitus severity, and quality of life with device use. There was a trend for better performance over the postoperative intervals. Level of Evidence 2b.
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Affiliation(s)
- Elizabeth Perkins
- Department of Otolaryngology-Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A
| | - Meredith Rooth
- Department of Otolaryngology-Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A
| | - Margaret Dillon
- Department of Otolaryngology-Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A
| | - Kevin Brown
- Department of Otolaryngology-Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A
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Abstract
OBJECTIVES To undertake a systematic review of available evidence on the effect of hearing impairment and hearing aid amplification on listening effort. Two research questions were addressed: Q1) does hearing impairment affect listening effort? and Q2) can hearing aid amplification affect listening effort during speech comprehension? DESIGN English language articles were identified through systematic searches in PubMed, EMBASE, Cinahl, the Cochrane Library, and PsycINFO from inception to August 2014. References of eligible studies were checked. The Population, Intervention, Control, Outcomes, and Study design strategy was used to create inclusion criteria for relevance. It was not feasible to apply a meta-analysis of the results from comparable studies. For the articles identified as relevant, a quality rating, based on the 2011 Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines, was carried out to judge the reliability and confidence of the estimated effects. RESULTS The primary search produced 7017 unique hits using the keywords: hearing aids OR hearing impairment AND listening effort OR perceptual effort OR ease of listening. Of these, 41 articles fulfilled the Population, Intervention, Control, Outcomes, and Study design selection criteria of: experimental work on hearing impairment OR hearing aid technologies AND listening effort OR fatigue during speech perception. The methods applied in those articles were categorized into subjective, behavioral, and physiological assessment of listening effort. For each study, the statistical analysis addressing research question Q1 and/or Q2 was extracted. In seven articles more than one measure of listening effort was provided. Evidence relating to Q1 was provided by 21 articles that reported 41 relevant findings. Evidence relating to Q2 was provided by 27 articles that reported 56 relevant findings. The quality of evidence on both research questions (Q1 and Q2) was very low, according to the Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines. We tested the statistical evidence across studies with nonparametric tests. The testing revealed only one consistent effect across studies, namely that listening effort was higher for hearing-impaired listeners compared with normal-hearing listeners (Q1) as measured by electroencephalographic measures. For all other studies, the evidence across studies failed to reveal consistent effects on listening effort. CONCLUSION In summary, we could only identify scientific evidence from physiological measurement methods, suggesting that hearing impairment increases listening effort during speech perception (Q1). There was no scientific, finding across studies indicating that hearing aid amplification decreases listening effort (Q2). In general, there were large differences in the study population, the control groups and conditions, and the outcome measures applied between the studies included in this review. The results of this review indicate that published listening effort studies lack consistency, lack standardization across studies, and have insufficient statistical power. The findings underline the need for a common conceptual framework for listening effort to address the current shortcomings.
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Abstract
BACKGROUND Cochlear implants (CIs) can improve speech-in-noise performance for listeners with unilateral sensorineural deafness. But these benefits are modest and in most cases are limited to head-shadow advantages, with little evidence of binaural squelch. HYPOTHESIS The goal of the investigation was to determine whether CI listeners with normal hearing or moderate hearing loss in the contralateral ear would receive a larger head-shadow benefit for target speech and noise originating from opposite sides of the head, and whether listeners would experience binaural squelch in the free field in a test involving interfering talkers. METHODS Eleven CI listeners performed a speech-identification task in the presence of interfering noise or speech. Six listeners had single-sided deafness (normal or near-normal audiometric thresholds in the acoustic ear) and five had asymmetric hearing loss (hearing loss in the acoustic ear treated with a hearing aid). Listeners were tested with the acoustic ear only and bilaterally with the CI turned on. One set of conditions examined head-shadow effects with target speech and masking noise presented from azimuths of 0 or ±108 degrees. A second set of conditions examined binaural squelch, with target speech presented from the front and interfering talkers symmetrically placed on both sides. RESULTS On average, the largest head-shadow benefit (5 dB) occurred when the target and masking noise were presented on opposite sides of the head. Listeners also showed an average of 2 dB of squelch, but only when the target speech was masked by interfering talkers of the same sex as the target. CONCLUSIONS CIs provide listeners with unilateral deafness important benefits for speech perception in complex spatial environments, including a larger head-shadow benefit when speech and noise originate on opposite sides of the head, and an improved ability to perceptually organize an auditory scene with multiple competing voices.The views expressed in this abstract are those of the authors and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or US Government.
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Firszt JB, Reeder RM, Holden LK. Unilateral Hearing Loss: Understanding Speech Recognition and Localization Variability-Implications for Cochlear Implant Candidacy. Ear Hear 2018; 38:159-173. [PMID: 28067750 PMCID: PMC5321788 DOI: 10.1097/aud.0000000000000380] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES At a minimum, unilateral hearing loss (UHL) impairs sound localization ability and understanding speech in noisy environments, particularly if the loss is severe to profound. Accompanying the numerous negative consequences of UHL is considerable unexplained individual variability in the magnitude of its effects. Identification of covariables that affect outcome and contribute to variability in UHLs could augment counseling, treatment options, and rehabilitation. Cochlear implantation as a treatment for UHL is on the rise yet little is known about factors that could impact performance or whether there is a group at risk for poor cochlear implant outcomes when hearing is near-normal in one ear. The overall goal of our research is to investigate the range and source of variability in speech recognition in noise and localization among individuals with severe to profound UHL and thereby help determine factors relevant to decisions regarding cochlear implantation in this population. DESIGN The present study evaluated adults with severe to profound UHL and adults with bilateral normal hearing. Measures included adaptive sentence understanding in diffuse restaurant noise, localization, roving-source speech recognition (words from 1 of 15 speakers in a 140° arc), and an adaptive speech-reception threshold psychoacoustic task with varied noise types and noise-source locations. There were three age-sex-matched groups: UHL (severe to profound hearing loss in one ear and normal hearing in the contralateral ear), normal hearing listening bilaterally, and normal hearing listening unilaterally. RESULTS Although the normal-hearing-bilateral group scored significantly better and had less performance variability than UHLs on all measures, some UHL participants scored within the range of the normal-hearing-bilateral group on all measures. The normal-hearing participants listening unilaterally had better monosyllabic word understanding than UHLs for words presented on the blocked/deaf side but not the open/hearing side. In contrast, UHLs localized better than the normal-hearing unilateral listeners for stimuli on the open/hearing side but not the blocked/deaf side. This suggests that UHLs had learned strategies for improved localization on the side of the intact ear. The UHL and unilateral normal-hearing participant groups were not significantly different for speech in noise measures. UHL participants with childhood rather than recent hearing loss onset localized significantly better; however, these two groups did not differ for speech recognition in noise. Age at onset in UHL adults appears to affect localization ability differently than understanding speech in noise. Hearing thresholds were significantly correlated with speech recognition for UHL participants but not the other two groups. CONCLUSIONS Auditory abilities of UHLs varied widely and could be explained only in part by hearing threshold levels. Age at onset and length of hearing loss influenced performance on some, but not all measures. Results support the need for a revised and diverse set of clinical measures, including sound localization, understanding speech in varied environments, and careful consideration of functional abilities as individuals with severe to profound UHL are being considered potential cochlear implant candidates.
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Affiliation(s)
- Jill B Firszt
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
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