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Ho PH, Huang PK, Chen PY, Chu CH, Hsu HM, Chen XX, Lin HC. Speech Perception and Quality-of-Life Outcomes in Mandarin-Speaking Postlingual Deaf Adults With Cochlear Implant: Any Difference With the Intonation Language Users? Otol Neurotol 2024; 45:e483-e489. [PMID: 38865725 DOI: 10.1097/mao.0000000000004209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
OBJECTIVE To evaluate the effects of related factors on long-term speech perception and quality-of-life (QoL) outcomes in postlingual deaf Mandarin-speaking adult cochlear implant (CI) recipients and to assess any differences between tone language and other intonation language CI adult users. STUDY DESIGN Retrospective cases review. SETTING Tertiary referral center. PATIENTS Forty-five adult CI recipients (48 implanted ears). MAIN OUTCOME MEASURES Post-CI outcomes were evaluated after follow-ups of more than 24 months using speech perception tests and QoL questionnaires. We analyzed the related factors affecting CI outcomes. RESULTS A shorter duration of profound deafness was predictive factors for better post-CI speech perception. Earlier implantation and better performance of vowel scores were predictive of better subjective improvements in social and emotional life. Post-CI vowel scores of over 56% indicated promising improvements in QoL. CONCLUSION Shorter duration of deafness could have better post-CI speech perception. Post-CI vowel scores instead of monosyllable words have the more potential to predict the QoL in Mandarin-speaking adult CI recipients.
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Affiliation(s)
| | - Po-Kai Huang
- Department of Otolaryngology and Head Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan
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Huang PK, Ho PH, Chu CH, Chen PY, Lin HC. Can Mandarin-speaking prelingual deaf adults benefit from cochlear implant? Acta Otolaryngol 2024; 144:44-51. [PMID: 38400594 DOI: 10.1080/00016489.2024.2315299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND With advances in cochlear implant (CI) technology, prelingual deaf adults may experience improved speech perception and quality of life (QoL). It is still a challenge for Mandarin-speaking CI user with tone recognition due to CI technology focused on intonation language. OBJECTIVES To evaluate the long-term post-CI auditory performance and social-emotional benefits in prelingual deaf Mandarin-speaking adults and the difference between them and post-lingual deaf adults. MATERIAL AND METHODS Fifty-five adult implanted ears were included (forty-six postlingual deaf group; nine prelingual deaf group). Post-CI long-term outcomes were using vowels, consonants, disyllabic words, Mandarin monosyllable words, categories of audiology performance, speech intelligibility rating, subjective social-emotional questionnaires. RESULTS Post-CI auditory performance and speech intelligibility of prelingual deafness adults was significantly inferior to that of those with postlingual deafness. However, both groups presented improved social-emotional benefits, with no significant difference between both groups. CONCLUSIONS Adult CI recipients who deaf before the age of 4 can experience benefits in social-emotional life functioning, regardless of their limited auditory performance and speech intelligibility. Therefore, prelingual Mandarin-speaking deaf adults, especially those using oral communication, can be considered as relative indications for cochlear implantation. SIGNIFICANCE To clarify and validate the benefits among Mandarin-speaking prelingual deaf adult recipients.
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Affiliation(s)
- Po-Kai Huang
- Department of Otolaryngology and Head Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan
| | - Pei-Hsuan Ho
- Department of Otolaryngology and Head Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Audiology and Speech Language Pathology, MacKay Medical College, New Taipei City, Taiwan
| | - Chia-Huei Chu
- Department of Otolaryngology and Head Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Audiology and Speech Language Pathology, MacKay Medical College, New Taipei City, Taiwan
| | - Pey-Yu Chen
- Department of Otolaryngology and Head Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Audiology and Speech Language Pathology, MacKay Medical College, New Taipei City, Taiwan
| | - Hung-Ching Lin
- Department of Otolaryngology and Head Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Audiology and Speech Language Pathology, MacKay Medical College, New Taipei City, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
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3
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Kashani A, Shariatpanahi E, Ayubi E, Emami SF. The Best Users of Cochlear Implants. Indian J Otolaryngol Head Neck Surg 2023; 75:3639-3644. [PMID: 37974846 PMCID: PMC10646021 DOI: 10.1007/s12070-023-04073-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/10/2023] [Indexed: 11/19/2023] Open
Abstract
The aim of this descriptive-analytical study was to compare the categories of auditory performance (CAP) and speech intelligibility rating (SIR) in people with cochlear implants (CI) based on the implanted ear. CAP and SIR were evaluated in 184 people with CI of right (110) and left (74) ears every 6 to 24 months (6,12,18,24). The significance level was less than 0.05. People with CI in the right-ears had better mean CAP and SIR scores than the left-ears (P values6,12,18, 24= 0.001, 0.004, 0.004, 0.002, and 0.001, 0.010, 0.010, 0.006). There were the relationship between the means of language acquisition status at the time of surgery and the means of CAP and SIR scores (P values6,12,18, 24= 0.005, 0.031, 0.006, 0.019, and 0.000, 0.000, 0.000, 0.002). The highest mean SIR scores were found in people with high school education (P values6,12,18, 24= 0.000, 0.000, 0.000, 0.008). The means of CAP scores did not show a relationship with the level of education (P values6, 12, 18, 24= 0.388, 0.217, 0.297, 0.213). Mean SIR and CAP scores were not related to gender. People who received right ear prostheses after the language learning age and have a higher level of education are the best users of cochlear implants. Compared to others who do not have these facilities, they gain more ability in auditory-speech skills. Gender, does not affect these capabilities.
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Affiliation(s)
- Amin Kashani
- Department of Otorhinolaryngology, School of Medicine, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Elnaz Shariatpanahi
- Department of Otorhinolaryngology, School of Medicine, Hearing Disorder Research Center, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Erfan Ayubi
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Seyede Faranak Emami
- Department of Audiology, School of Rehabilitation Sciences, Hearing Disorder Research Center, Hamadan University of Medical Sciences, Hamedan, Iran
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Yoshida H, Kanda Y, Satoh C, Kumai Y, Takahashi H. Long-term speech perception performance in prelingually deafened adult cochlear implant recipients. Cochlear Implants Int 2023:1-7. [PMID: 37440720 DOI: 10.1080/14670100.2023.2228031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
To investigate the postoperative long-term outcomes after an average of 9.2 years following cochlear implantation (CI) in prelingually deafened adults, along with preimplantation factors predicting postoperative outcomes. Twenty-six prelingually deafened adults who underwent CI at >18 years were compared with those who had undergone CI in childhood (<9 years) and were >10 years old. Outcome measures includedhearing thresholds, preoperative and postoperative aided hearing level (HL), speech discrimination score (SDS), and Categories of Auditory Performance (CAP) scores. Correlation analyses were performed on the following: SDS results, aided HL, school attendant status, implant manufacturers, and speech processor models. Improvement was achieved in the aided HL and SDS results, although these results were not better than those of the child group. CAP score was also statistically significantly improved after CI. Statistically significant correlation between the preoperative SDS and postoperative HL with CI results was observed. In other words, the better the preoperative SDS results, the better the postoperative SDS results. Prelingually deafened adults achieved considerable improvement through CI. It is important to understand that patients achieving better hearing with a well-fitted hearing aid and good SDS performance before surgery may be good candidates for CI.
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Affiliation(s)
- Haruo Yoshida
- Department of Otolaryngology: Head and Neck Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Yukihiko Kanda
- Nagasaki Bell Hearing Center, Nagasaki, Japan
- Department of Otolaryngology: Head and Neck Surgery, Nagasaki University, Nagasaki, Japan
| | - Chisei Satoh
- Department of Otolaryngology: Head and Neck Surgery, Nagasaki University, Nagasaki, Japan
| | - Yoshihiko Kumai
- Department of Otolaryngology: Head and Neck Surgery, Nagasaki University, Nagasaki, Japan
| | - Haruo Takahashi
- Department of Otolaryngology: Head and Neck Surgery, Nagasaki University, Nagasaki, Japan
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Alam N, Munjal SK, Panda NK, Kaur R. Translation and Adaptation of the Nijmegen Cochlear Implant Questionnaire in Hindi: A Health-Related Quality of Life Questionnaire for Adults with Cochlear Implants. Indian J Otolaryngol Head Neck Surg 2023; 75:121-126. [PMID: 37206733 PMCID: PMC10188667 DOI: 10.1007/s12070-022-03306-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
Nijmegen Cochlear Implant Questionnaire is an HRQoL tool that was developed by Dutch researchers to assess the QoL in adult CI users in the English language. It is used to measure the impact of the use of CI on the daily life situations of its users, on the perception of speech sounds, and on the cost-benefit assessment CI in adult CI users. There is no specific instrument available to assess the QoL in adult CI users in India, hence there was a need to take up this study. The primary aim of the study was to adapt and translate NCIQ into Hindi with a secondary aim to describe the effect of CI on quality of life in adult CI users. For translation, permission was taken from the authors of the original tool. The Forward-backward translation method was utilized for translation. The final version of the NCIQ-H was administered to the study participants (25 no.) 25, aged 18-60 years; High School as the minimum level of education; post-lingual hearing impairment, and CI use ≥ 12 months. The Cronbach's α coefficient was calculated for all domains and subdomains in the NCIQ-H showed the overall reliability of the questionnaire (0.82), showing good internal consistency. The CI users reported high scores across all the domains indicating improved quality of life. No significant correlation was found between the CI usage time and NCIQ scores on Spearman's correlation test. Also, there was no significant difference in NCIQ-H scores between genders on the Kruskal-Wallis test. The NCIQ (H) can be used to assess QoL in adults with cochlear implants. The scores suggest improvement in physical, social and psychological domains of life. No correlation was observed between the NCIQ-H scores and duration of CI usage as well as with gender differences.
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Affiliation(s)
| | | | | | - Ramandeep Kaur
- Dr. B.R. Ambedkar State Institute of Medical Sciences, Sahibzada, Mohali India
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6
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Dixon PR, Shapiro J, Tomlinson G, Cottrell J, Lui JT, Falk L, Chen JM. Health State Utility Values Associated with Cochlear Implants in Adults: A Systematic Review and Network Meta-Analysis. Ear Hear 2023; 44:244-253. [PMID: 36303282 DOI: 10.1097/aud.0000000000001287] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The cost-effectiveness of bilateral cochlear implants in adults remains uncertain despite established clinical benefits. In cost-effectiveness studies, benefit is often measured by change in health state utility value (HSUV), a single number summary of health-related quality of life anchored at 0 (state of being dead) and 1 (perfect health). Small differences in bilateral cochlear implant HSUV change conclusions of published models, and invalid estimates can therefore mislead policy and funding decisions. As such, we aimed to review and synthesize published HSUV estimates associated with cochlear implants. DESIGN We included observational or experimental studies reporting HSUV for adult patients (age ≥18 years) with at least moderate-profound sensorineural hearing loss in both ears who received unilateral or bilateral cochlear implants. We searched MEDLINE, EMBASE, PsycINFO, and Cochrane Library databases up to May 1, 2021. Study and participant characteristics and HSUV outcomes were extracted. Narrative synthesis is reported for all studies. A Bayesian network meta-analysis was conducted to generate pooled estimates for the mean difference in HSUV for three comparisons: (1) unilateral cochlear implant versus preimplant, (2) bilateral cochlear implants versus preimplant, (3) bilateral versus unilateral cochlear implants. Our principal measure was pooled mean difference in HSUV. RESULTS Thirty-six studies reporting unique patient cohorts were identified. Health Utilities Index, 3 (HUI-3) was the most common HSUV elicitation method. HSUV from 19 preimplant mean estimates (1402 patients), 19 unilateral cochlear implant mean estimates (1701 patients), and 5 bilateral cochlear implants mean estimates (83 patients) were pooled to estimate mean differences in HUI-3 HSUV by network meta-analysis. Compared with preimplant, a unilateral cochlear implant was associated with a mean change in HSUV of +0.17 (95% credible interval [CrI] +0.12 to +0.23) and bilateral cochlear implants were associated with a mean change of +0.25 (95% CrI +0.12 to +0.37). No significant difference in HSUV was detected for bilateral compared with unilateral cochlear implants (+0.08 [95% CrI -0.06 to +0.21]). Overall study quality was moderate. CONCLUSIONS The findings of this review and network meta-analysis comprise the best-available resource for parameterization of cost-utility models of cochlear implantation in adults and highlight the need to critically evaluate the validity of available HSUV instruments for bilateral cochlear implant populations.Protocol registration: PROSPERO (CRD42018091838).
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Affiliation(s)
- Peter R Dixon
- Department of Otolaryngology-Head & Neck Surgery, University of California San Diego, San Diego, California
| | - Justin Shapiro
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Canada
- Temerty Faculty of Medicine, University of Toronto
| | - George Tomlinson
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Canada
- Toronto Health Economics and Technology Assessment Collaborative, Toronto, Canada
| | - Justin Cottrell
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, Canada
| | - Justin T Lui
- Section of Otolaryngology-Head & Neck Surgery, Department of Surgery, University of Calgary, Calgary, Canada
| | - Lindsey Falk
- Evidence, Development and Standards, Health Quality Ontario
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada
| | - Joseph M Chen
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, Canada
- Department of Otolaryngology-Head & Neck Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada
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Candidacy for Cochlear Implantation in Prelingual Profoundly Deaf Adult Patients. J Clin Med 2022; 11:jcm11071874. [PMID: 35407482 PMCID: PMC8999851 DOI: 10.3390/jcm11071874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/14/2022] [Accepted: 03/21/2022] [Indexed: 12/04/2022] Open
Abstract
Cochlear implantation is usually not recommended for prelingual profoundly deaf adults, although some of these patients might benefit from it. This study aims to define the candidates for cochlear implantation in this population. This retrospective study reviewed 34 prelingual profoundly deaf patients who had received a cochlear implant at 32 ± 1.7 years old (16−55), with at least 1 year of follow-up. Speech perception and quality of life were assessed before and 3, 6, and 12 months after cochlear implantation, then every year thereafter. According to the word speech intelligibility in quiet (WSI) 1 year after implantation, two groups were identified: good performer (GP) with WSI ≥ 50% (n = 15), and poor performer (PP) with WSI ≤ 40% (n = 19). At the 1 year mark, mean WSI improved by 28 ± 4.6% (−20−100) (p < 0.0001). In GP, the intelligibility for words and sentences, communication and quality of life scales improved. In PP, the communication scale improved, but not auditory performance or quality of life. GP and PP differed pre-operatively in speech production, communication abilities, and WSI in best-aided conditions. In prelingual profoundly deaf adults, a dramatic auditory performance benefit could be expected after cochlear implantation if the patients have some degree of speech intelligibility in aided conditions and have developed oral communication and speech production.
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Alnıaçık A, Çakmak E, Öz O. Cross-cultural adaptation of the Nijmegen cochlear implant questionnaire into Turkish language: validity, reliability and effects of demographic variables. Eur Arch Otorhinolaryngol 2021; 279:2175-2182. [PMID: 34837517 PMCID: PMC8627160 DOI: 10.1007/s00405-021-07191-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/15/2021] [Indexed: 11/12/2022]
Abstract
Purpose The purpose of this study was to evaluate the validity and reliability of the Turkish version of the Nijmegen Cochlear Implant Questionnaire (Tr-NCIQ) and reveal the demographic factors contributing to the outcomes. Methods A group of 118 cochlear implant users aged between 18 and 70 years filled the Tr-NCIQ and the Turkish Hearing Handicapped Inventory for Adults (the Tr-HHI-Adult) via electronic survey. Cross-cultural adaptation of the Tr-NCIQ was performed. The reliability and validity of the questionnaire were evaluated utilizing internal consistency coefficient, split-half method, and predictive validity. Results The overall Cronbach’s alpha coefficient of the scale was 0.91, and the Spearman-Brown coefficient was 0.91. A moderately significant and negative correlation was present between the basic sound perception, speech production, self-esteem, activity, and social interactions subdomain scores and the HHI-Adult scores. Patients with post-lingual onset of hearing loss had significantly better results than those with pre-lingual onset, in the advanced sound perception subdomain. In addition, bilateral cochlear implant users had better results than the unilateral and bimodal users in the speech production subdomain and then the bimodal users in the self-esteem subdomain. There was no effect of age, duration of implant use, age at implantation, and the daily usage of cochlear implant (CI) on the quality-of-life outcomes. Conclusion The Tr-NCIQ is a reliable and valid tool to evaluate the subjective quality of life in CI users. In addition, as a standardized instrument, it can be easily self-administered both in clinical practice and for research purposes.
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Affiliation(s)
- Asuman Alnıaçık
- Department of Audiology, Faculty of Health Sciences, Başkent University, Bağlıca Campus, Eskişehir Road, 18. km, 06790, Ankara, Turkey.
| | - Eda Çakmak
- Department of Audiology, Faculty of Health Sciences, Başkent University, Bağlıca Campus, Eskişehir Road, 18. km, 06790, Ankara, Turkey
| | - Okan Öz
- The Eargroup, Antwerp, Belgium
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Harrison SC, Lawrence R, Hoare DJ, Wiggins IM, Hartley DEH. Use of Functional Near-Infrared Spectroscopy to Predict and Measure Cochlear Implant Outcomes: A Scoping Review. Brain Sci 2021; 11:brainsci11111439. [PMID: 34827438 PMCID: PMC8615917 DOI: 10.3390/brainsci11111439] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/15/2021] [Accepted: 10/25/2021] [Indexed: 11/21/2022] Open
Abstract
Outcomes following cochlear implantation vary widely for both adults and children, and behavioral tests are currently relied upon to assess this. However, these behavioral tests rely on subjective judgements that can be unreliable, particularly for infants and young children. The addition of an objective test of outcome following cochlear implantation is therefore desirable. The aim of this scoping review was to comprehensively catalogue the evidence for the potential of functional near infrared spectroscopy (fNIRS) to be used as a tool to objectively predict and measure cochlear implant outcomes. A scoping review of the literature was conducted following the PRISMA extension for scoping review framework. Searches were conducted in the MEDLINE, EMBASE, PubMed, CINAHL, SCOPUS, and Web of Science electronic databases, with a hand search conducted in Google Scholar. Key terms relating to near infrared spectroscopy and cochlear implants were used to identify relevant publications. Eight records met the criteria for inclusion. Seven records reported on adult populations, with five records only including post-lingually deaf individuals and two including both pre- and post-lingually deaf individuals. Studies were either longitudinal or cross-sectional, and all studies compared fNIRS measurements with receptive speech outcomes. This review identified and collated key work in this field. The homogeneity of the populations studied so far identifies key gaps for future research, including the use of fNIRS in infants. By mapping the literature on this important topic, this review contributes knowledge towards the improvement of outcomes following cochlear implantation.
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Affiliation(s)
- Samantha C. Harrison
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
- Correspondence: ; Tel.: +44-115-823-2640
| | - Rachael Lawrence
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
- Nottingham University Hospitals National Health Service Trust, Nottingham NG5 1PB, UK
| | - Derek J. Hoare
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
| | - Ian M. Wiggins
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
| | - Douglas E. H. Hartley
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
- Nottingham University Hospitals National Health Service Trust, Nottingham NG5 1PB, UK
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Forli F, Lazzerini F, Montecchiari V, Morganti R, Bruschini L, Berrettini S. Cochlear implant in prelingually hearing-impaired adults: prognostic factors and results. ACTA ACUST UNITED AC 2021; 41:173-179. [PMID: 34028463 PMCID: PMC8142735 DOI: 10.14639/0392-100x-n1146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/27/2020] [Indexed: 11/23/2022]
Abstract
Objectives The aim of present study is to evaluate the impact of prognostic factors on the outcome in a group of prelingually hearing-impaired patients submitted to cochlear implantation (CI) at an adult age. Methods This is a retrospective study on a cohort of prelingually severe-to-profound hearing-impaired patients cochlear implanted in adulthood and followed by a single audiology centre. We correlated post-CI results in term of speech perception with patients’ speech perception with hearing aids before implantation, history of progression of hearing loss (HL), and levels of education and cognition. The study group was composed of 49 patients. Results Post-CI open-set recognition score in silence and noise was significantly correlated with pre-CI open-set recognition score in silence and with background noise. Patients with a history of progression of HL gained significantly better results. Furthermore, we found higher improvements in patients with a higher level of education. Conclusions Prelingually deafened patients implanted in adulthood achieved satisfactory results. Significantly better results were achieved by patients with better pre-operative speech perception scores, progressive HL and higher level of education.
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Affiliation(s)
- Francesca Forli
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy
| | - Francesco Lazzerini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy
| | | | | | - Luca Bruschini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy
| | - Stefano Berrettini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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11
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Debruyne JA, Janssen AM, Brokx JPL. Systematic Review on Late Cochlear Implantation in Early-Deafened Adults and Adolescents: Predictors of Performance. Ear Hear 2021; 41:1431-1441. [PMID: 33136620 DOI: 10.1097/aud.0000000000000889] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Early-deafened, late-implanted adolescents and adults constitute a unique group of cochlear implant (CI) users, showing a large variability in outcomes. The current systematic review aimed to determine which preimplantation factors are relevant in predicting postoperative outcomes in this patient group. DESIGN A systematic search for studies published between 2000 and September 2017 was performed in five electronic databases (PubMed, Embase, the Cochrane library, CINAHL, and PsycInfo). Prognostic studies that assessed the relation between patient-related factors and CI outcomes in early-deafened but late-implanted adolescent and adult CI users were included. Study quality was assessed with the Quality In Prognosis Studies (QUIPS) tool. RESULTS The systematic search and subsequent full-text evaluation identified 13 studies that had a clear prognostic study goal. Eight out of these 13 studies had a high risk of bias for at least one of the five QUIPS domains. Analysis of the outcomes identified that communication mode (in childhood), preoperative speech intelligibility, and preoperative speech recognition scores were significantly related to speech perception outcomes for this group of CI users. A number of additional factors considered worth for further investigation were also identified. CONCLUSIONS The analysis of the studies assessing the effect of a number of patient-related factors on outcome with CI in early-deafened adolescents and adults identified three potential prognostic factors and a number of additional factors to be incorporated in future research. More high-quality prognosis studies in the investigated patient population are still needed.
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Affiliation(s)
- Joke A Debruyne
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - A Miranda Janssen
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jan P L Brokx
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
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12
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Debruyne JA, Janssen AM, Brokx JPL. Systematic Review on Late Cochlear Implantation in Early-Deafened Adults and Adolescents: Clinical Effectiveness. Ear Hear 2021; 41:1417-1430. [PMID: 33136619 DOI: 10.1097/aud.0000000000000884] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Cochlear implantation in early-deafened patients, implanted as adolescents or adults, is not always advised due to poor expected outcomes. In order to judge whether such reluctance is justified, the current systematic review aimed to gather all available evidence on postoperative outcomes obtained by early-deafened patients using a state-of-the art cochlear implant (CI). DESIGN Five electronic databases (PubMed, Embase, the Cochrane library, CINAHL, and PsycInfo) were systematically searched for studies in English, French, German, or Dutch, published between 2000 and September 2017. Studies that reported pre- and postoperative outcomes on any measure of speech or sound perception, audiovisual or subjective benefit (quality of life) were included. Study quality was assessed with the Institute of Health Economics quality appraisal tool for case series studies. RESULTS The systematic search and subsequent full-text evaluation identified 38 studies meeting the inclusion criteria. Only a limited number of studies were judged to be of high quality according to the Institute of Health Economics tool, with lack of (clear) presentation of relevant study information being a recurring problem. Twenty-five studies presented viable outcomes on open-set speech understanding in quiet: mean postoperative scores obtained with CI remained below 50% for the vast majority of studies; significant postoperative improvements were found in 16 studies, although this number might have been higher if appropriate statistical testing had been performed in all studies. Eight studies observed increased audiovisual performance after implantation, which was statistically significant in six studies. A validated measure of hearing-related quality of life was used in only 5 of the 16 studies assessing subjective outcomes, showing significant postoperative improvements for most questionnaire domains. The relation between auditory and subjective outcomes was assessed in two studies, with contradictory results. CONCLUSIONS The current review showed that late cochlear implantation in early-deafened subjects resulted in significantly improved open-set speech perception, audiovisual speech perception, and (hearing-related) quality of life in the majority of the studies involved. Nonetheless, more and especially higher-quality research is needed in order to gain a more detailed understanding of the outcomes of cochlear implantation in this population.
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Affiliation(s)
- Joke A Debruyne
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - A Miranda Janssen
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jan P L Brokx
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
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SoftVoice Improves Speech Recognition and Reduces Listening Effort in Cochlear Implant Users. Ear Hear 2020; 42:381-392. [PMID: 32796352 DOI: 10.1097/aud.0000000000000928] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The ability to perceive soft speech by cochlear implant (CI) users is restricted in part by the inherent system noise produced by the speech processor, and in particular by the microphone(s). The algorithm "SoftVoice" (SV) was developed by Advanced Bionics to enhance the perception of soft speech by reducing the system noise in speech processors. The aim of this study was to examine the effects of SV on speech recognition and listening effort. DESIGN Seventeen adult Advanced Bionics CI recipients were recruited and tested in two sessions. The effect of SV on speech recognition was tested by determining the SRT in quiet using the Matrix test. Based on the individual subjects' SRTs, we investigated speech-recognition scores at fixed speech levels, namely SRT -5 dB, SRT +0 dB, SRT +5 dB, and SRT +10 dB, again in quiet and using the Matrix test. Listening effort was measured at each of these speech levels subjectively by using a rating scale, and objectively by determining pupil dilation with pupillometry. To verify whether SoftVoice had any negative effects on speech perception in noise, we determined the SRT in steady state, speech-weighted noise of 60 dBA. RESULTS Our results revealed a significant improvement of 2.0 dB on the SRT in quiet with SoftVoice. The average SRT in quiet without SoftVoice was 38 dBA. SoftVoice did not affect the SRT in steady state, speech-weighted noise of 60 dB. At an average speech level of 33 dBA (SRT -5 dB) and 38 dBA (SRT +0 dB) in quiet, significant improvements of 17% and 9% on speech-recognition scores were found with SoftVoice, respectively. At higher speech levels, SoftVoice did not significantly affect speech recognition. Pupillometry did not show significant effects of SoftVoice at any speech level. However, subjective ratings of listening effort indicated a decrease of listening effort with SoftVoice at a speech level of 33 dBA. CONCLUSIONS We conclude that SoftVoice substantially improves recognition of soft speech and lowers subjective listening effort at low speech levels in quiet. However, no significant effect of SoftVoice was found on pupil dilation. As SRTs in noise were not statistically significantly affected by SoftVoice, we conclude that SoftVoice can be used in noisy listening conditions with little negative impact on speech recognition, if any. The increased power demands of the algorithm are considered to be negligible. It is expected that SoftVoice will reduce power consumption at low ambient sound levels. These results support the use of SoftVoice as a standard feature of Advanced Bionics CI fittings for everyday use.
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Data logging variables and speech perception in prelingually deafened pediatric cochlear implant users. Int J Pediatr Otorhinolaryngol 2020; 133:110003. [PMID: 32203760 DOI: 10.1016/j.ijporl.2020.110003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/11/2020] [Accepted: 03/11/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To investigate the relationship among objectively gathered data logging measurements, patient-related variables, and speech recognition performance of pediatric CI users. METHODS AND MATERIALS Thirty-two prelingually implanted children who have the ability to perform word discrimination test were included in this study. To reveal the relationship between speech perception abilities and auditory exposure, seven data logging variables were analyzed: "on-air," "off-air," "coil-off," "speech," "speech in noise," "music" and "noise. In addition, implantation age (months) and CI usage duration (months) were taken into account. Finally, it was investigated the differences between unilateral, sequential bilateral, and simultaneous bilateral CI users in terms of all study variables. RESULTS The average on-air time ranged between 10.52 and 12.30 in the groups. In the case of sequential implantation, smaller on-air and higher coil off values were observed with the second CI. In the case of simultaneous bilateral implantation, data logging measurements were almost the same in both implants. WRS was significantly correlated (p < 0.05) with on-air time (r = 0.62), coil-off count (r = -0.48), chronological age (r = 0.48), and CI duration (r = 0.44). Multiple linear regression model was fit to predict the WRS, with on-air time, CI duration, and chronological age as predictors. CONCLUSIONS The critical importance of early intervention and long-term use of CI is well-established in the literature and is also corroborated by our findings. However, the key findings of the present study are that consistent CI use and the quality of daily listening environment also exerted a major and positive effect on the speech recognition performance of pediatric CI users. Therefore, during the monitoring of pediatric CI recipients, it is important to know the device usage data in order to detect problems in the early stages after CI.
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Boisvert I, Reis M, Au A, Cowan R, Dowell RC. Cochlear implantation outcomes in adults: A scoping review. PLoS One 2020; 15:e0232421. [PMID: 32369519 PMCID: PMC7199932 DOI: 10.1371/journal.pone.0232421] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 04/14/2020] [Indexed: 12/20/2022] Open
Abstract
Cochlear implantation has become known as “the treatment of choice” for adults with severe to profound hearing loss. Wide variability exists, however, in the way hearing loss severity is measured and in the candidacy criteria used to recommend cochlear implantation.
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Affiliation(s)
- Isabelle Boisvert
- The HEARing Cooperative Research Centre, Melbourne, Australia
- Faculty of Human Sciences, Audiology, H:EAR, Macquarie University, Sydney, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- * E-mail: (IB); rcd.@unimelb.edu.au (RCD)
| | - Mariana Reis
- The HEARing Cooperative Research Centre, Melbourne, Australia
- Faculty of Human Sciences, Audiology, H:EAR, Macquarie University, Sydney, Australia
| | - Agnes Au
- The HEARing Cooperative Research Centre, Melbourne, Australia
- Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia
| | - Robert Cowan
- The HEARing Cooperative Research Centre, Melbourne, Australia
- Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia
| | - Richard C. Dowell
- The HEARing Cooperative Research Centre, Melbourne, Australia
- Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia
- Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- * E-mail: (IB); rcd.@unimelb.edu.au (RCD)
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Predicting Performance and Non-Use in Prelingually Deaf and Late-Implanted Cochlear Implant Users. Otol Neurotol 2019; 39:e436-e442. [PMID: 29794686 DOI: 10.1097/mao.0000000000001828] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To analyze postoperative hearing performance and independent predictors of speech perception and to assess cochlear implant nonuse in adults with prelingual deafness who received an implant during adulthood. DESIGN Retrospective cohort study including all prelingually deaf adults who received a cochlear implant at the University Medical Center Utrecht between 2000 and 2013. SETTING Tertiary referral center. PATIENTS Included were a total of 48 prelingually deaf patients diagnosed with severe to profound sensorineural hearing loss before the age of 2 years who received their implants during adulthood. MAIN OUTCOME MEASURES Postoperative monosyllabic word and sentence recognition scores. RESULTS The average maximum postoperative monosyllabic word score for all subjects was 25% correct. Preoperative speech perception and the extent of preoperative residual hearing were both positive independent predictors of postoperative speech recognition, explaining 47% of the variance. Almost half of the population experienced only little (27%) or no benefit (21%) of their implants in daily communication. These patients were more likely to have either no or only low-frequency residual hearing. Eventually, all subjects without any benefit became non-user. CONCLUSIONS Postoperative performance of adult, prelingually deaf cochlear implant candidates, with long-term deafness is dependent on their preoperative speech perception and residual hearing. Candidates who have negligible residual hearing are expected to have no or only limited postoperative benefit of their implants and are at risk of becoming nonusers.
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Albalawi Y, Nidami M, Almohawas F, Hagr A, Garadat SN. Categories of Auditory Performance and Speech Intelligibility Ratings in Prelingually Deaf Children With Bilateral Implantation. Am J Audiol 2019; 28:62-68. [PMID: 30938557 DOI: 10.1044/2018_aja-17-0112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The aim of the current study was to review all pediatric cases with congenital deafness who underwent bilateral implantation in our center. Specifically, auditory performance and speech intelligibility ratings were compared across children based on their mode of bilateral stimulation (simultaneous or sequential implantation). Method A retrospective chart review design was used in this study. A total of 46 congenitally deaf children were included. Children ranged in age between 2 and 8 years, with a mean of 3 years 7 months. Participants were divided into 2 groups: those who received their bilateral implant simultaneously and those who received them sequentially. Categories of Auditory Performance (CAP; Archbold, Lutman, & Marshall, 1995 ) scores and Speech Intelligibility Rating (SIR; M. C. Allen, Nikolopoulos, & O'Donoghue, 1998 ) scores were used to measure their performance. Results Children scored an average of 4.1 (±1.6) on the CAP Scale and 1.6 (±1) on the SIR Scale. Results showed that children who received their implants simultaneously scored relatively higher on the CAP Scale than those with sequential implants. However, there were no differences between the 2 groups in SIR scores. These 2 outcome measures were not correlated with age at implantation. Conclusion The current study demonstrated that simultaneous implantation could potentially improve audiologic outcome.
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Affiliation(s)
| | - Mohamad Nidami
- Department of Communication and Swallowing Disorder, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Fida Almohawas
- King Abdullah Ear Specialist Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Soha N. Garadat
- Medical Audiology Sciences Program, American University of Beirut, Lebanon
- Department of Hearing and Speech Sciences, The University of Jordan, Amman
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Vieira SDS, Dupas G, Chiari BM. Effects of cochlear implantation on adulthood. Codas 2018; 30:e20180001. [PMID: 30517268 DOI: 10.1590/2317-1782/20182018001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 05/16/2018] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To understand the benefits of cochlear implantation in adulthood under the perspective of users. METHODS Qualitative study using Symbolic Interactionism and Straussian Grounded Theory as theoretical and methodological frameworks, respectively. The project was approved by the Research Ethics Committee of the aforementioned Institution (Opinion no. 482,019). Sixteen adult cochlear implant (CI) users aged 28-58 years participated in the study. The data collection instrument was a semi-structured interview with questions about changes caused by CI in the social relations, communication, family system, and personal, academic and professional spheres of life of users. RESULTS The category Cochlear Implant Effects on Adulthood is part of a more comprehensive theoretical study that addresses how adult CI users cope with deafness. Together with its subcategories, it shows that CI intervenes in a revolutionary way in the lives of its users, because it increases their sense of security, enables them to see life from a new perspective, rescues self-confidence and self-esteem, enables them to communicate and interact more effectively, enjoy music and other entertainment, rescue old projects, and make plans for the future; thus assisting with the process of recovering independence in adult life. CONCLUSION Subjective impressions of the users showed that cochlear implants not only improve their auditory performance, but also bring several positive changes to their social insertion and quality of life. Therefore, this intervention is highly beneficial to deaf adults.
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Affiliation(s)
- Sheila de Souza Vieira
- Departamento de Fonoaudiologia, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brasil
| | - Giselle Dupas
- Departamento de Enfermagem, Universidade Federal de São Carlos - UFSCar - São Carlos (SP), Brasil
| | - Brasilia Maria Chiari
- Departamento de Fonoaudiologia, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brasil
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Forli F, Turchetti G, Giuntini G, Bellelli S, Fortunato S, Bruschini L, Barillari MR, Berrettini S. Cochlear implant in prelingually deafened oralist adults: speech perception outcomes, subjective benefits and quality of life improvement. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 37:416-422. [PMID: 29165436 PMCID: PMC5720870 DOI: 10.14639/0392-100x-1493] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 03/11/2017] [Indexed: 11/23/2022]
Abstract
The aim of this study is to report our results in a group of prelingually deafened adults, who followed an oralist rehabilitation programme, and submitted to cochlear implant at our institution. We evaluated 30 prelingually deafened adult patients, 18 males and 12 females, median age 35 years, of a group of 36 prelingually deafened adult patients consecutively submitted to unilateral cochlear implantation at the ENT Unit of the University of Pisa. After implantation, patients achieved significant benefits in terms of speech perception skills, including the ability to have telephone conversations in some cases, quality of life and their own perception of disability. According to literature data, the results herein reported are quite variable but generally satisfactory. Procedures other than traditional speech perception measures should be used to evaluate the benefits of cochlear implant in such patients, to compressively evaluate the global benefits, not only in terms of speech perception, but also in terms of quality of life and daily life.
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Affiliation(s)
- F Forli
- ENT, Audiology and Phoniatric Unit, University of Pisa, Italy
| | - G Turchetti
- Istituto di Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - G Giuntini
- ENT, Audiology and Phoniatric Unit, University of Pisa, Italy
| | - S Bellelli
- Istituto di Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - S Fortunato
- ENT, Audiology and Phoniatric Unit, University of Pisa, Italy
| | - L Bruschini
- ENT, Audiology and Phoniatric Unit, University of Pisa, Italy
| | - M R Barillari
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Divisione di Audiologia e Foniatria, II Università di Napoli, Italy
| | - S Berrettini
- ENT, Audiology and Phoniatric Unit, University of Pisa, Italy.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 17177, Stockholm, Sweden
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Debruyne J, Janssen M, Brokx J. Late Cochlear Implantation in Early-Deafened Adults: A Detailed Analysis of Auditory and Self-Perceived Benefits. Audiol Neurootol 2018; 22:364-376. [PMID: 29953973 DOI: 10.1159/000488023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 02/26/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES It is known that early-deafened cochlear implant (CI) users are a very heterogeneously performing group. To gain more insight into this population, this study investigated (1) postoperative changes in auditory performance over time based on various outcome measures, focusing on poor performers, (2) self-perceived outcomes, (3) relations between auditory and self-perceived outcomes, and (4) preimplantation factors predicting postoperative outcomes. METHODS Outcomes were assessed prospectively in a group of 27 early-deafened, late-implanted CI users, up to 3 years after implantation. Outcome measures included open-set word and sentence recognition, closed-set word recognition, speech tracking and a questionnaire on self-perceived outcomes. Additionally, the relative influence of 8 preimplantation factors on CI outcome was assessed with linear regression analyses. RESULTS Significant improvements were found for auditory performance measures and most of the questionnaire domains. Significant changes of the closed-set word test, speech tracking and questionnaire were also found for a subgroup of poor performers. Correlations between auditory and self-perceived outcomes were weak and nonsignificant. Preoperative word recognition and preoperative hearing thresholds, both for the implanted ear, were significant predictors of postoperative outcome in the multivariable regression model, explaining 63.5% of the variation. CONCLUSIONS Outcome measurement in this population should be adjusted to the patients' individual performance level and include self-perceived benefit. There is still a need for more knowledge regarding predictors of CI outcomes in this group, but the current study suggests the importance of the preoperative performance of the ear to be implanted.
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Affiliation(s)
- Joke Debruyne
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.,School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Miranda Janssen
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.,Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Jan Brokx
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.,School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
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Intelligibility of the Patient's Speech Predicts the Likelihood of Cochlear Implant Success in Prelingually Deaf Adults. Ear Hear 2018; 37:e302-10. [PMID: 26928004 DOI: 10.1097/aud.0000000000000286] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The objective of this study was to determine the validity and clinical applicability of intelligibility of the patient's own speech, measured via a Vowel Identification Test (VOW), as a predictor of speech perception for prelingually deafened adults after 1 year of cochlear implant use. Specifically, the objective was to investigate the probability that a prelingually deaf patient, given a VOW score above (or below) a chosen cutoff point, reaches a postimplant speech perception score above (or below) a critical value. High predictive values for VOW could support preimplant counseling and implant candidacy decisions in individual patients. DESIGN One hundred and fifty-two adult cochlear implant candidates with prelingual hearing impairment or deafness took part as speakers in a VOW; 149 speakers completed the test successfully. Recordings of the speech stimuli, consisting of nonsense words of the form [h]-V-[t], where V represents one of 15 vowels/diphthongs ([(Equation is included in full-text article.)]), were presented to two normal-hearing listeners. VOW score was expressed as the percentage of vowels identified correctly (averaged over the 2 listeners). Subsequently, the 149 participants enrolled in the cochlear implant selection procedure. Extremely poor speakers were excluded from implantation, as well as patients who did not meet regular selection criteria as developed for postlingually deafened patients. From the 149 participants, 92 were selected for implantation. For the implanted group, speech perception data were collected at 1-year postimplantation. RESULTS Speech perception score at 1-year postimplantation (available for 77 of the 92 implanted participants) correlated positively with preimplant intelligibility of the patient's speech, as represented by VOW (r = 0.79, p < 0.00001): the more intelligible the patient's speech, the higher the predicted postimplant speech perception score. This correlation is explained by the hypothesis that the two variables have a common driving force, i.e., (in)adequacy of auditory speech input in the earliest years of life. With a 60% cutoff point, VOW can discriminate between individuals with "above-chance" postimplant speech perception and those with "chance level" postimplant speech perception with sensitivity and specificity of 0.84 and 0.86, respectively. The probability that a patient with a VOW score ≥ 60% achieves "above-chance" speech perception after implantation is 0.91. Conversely, the probability that a patient with VOW < 60% reaches "above-chance" speech perception is 0.25. CONCLUSIONS For prelingually deaf adults, intelligibility of the patient's speech-as represented by VOW-is a valid predictor of postimplant speech perception. A patient with a VOW score above a preset cutoff is much more likely to develop acceptable speech perception after implantation than a patient with a VOW score below that cutoff. The binary classification based on VOW and the associated probabilities of cochlear implant success in terms of speech perception can be used-in addition to existing criteria-to support the clinician in guiding patient expectations and in considering implant candidacy for individual patients.
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Crowson MG, Semenov YR, Tucci DL, Niparko JK. Quality of Life and Cost-Effectiveness of Cochlear Implants: A Narrative Review. Audiol Neurootol 2017; 22:236-258. [PMID: 29262414 DOI: 10.1159/000481767] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 09/21/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To review evidence regarding the health-related quality of life (HRQoL) and cost-effectiveness of unilateral and bilateral cochlear implantation (CI) among children and adults with severe-to-profound hearing loss. STUDY DESIGN Narrative review. METHODS Publications related to quality of life (QoL) and costs of care in CI were acquired through searches in English-language databases. Studies were included if they had identified the HRQoL attainment, cost of care, cost-utility, or cost-effectiveness associated with CI. RESULTS 57 studies were critically reviewed. The QoL outcome metrics used in these articles were divided into 2 categories - generic and condition specific. In studies investigating children, many reported no significant difference in QoL attainment between CI recipients and normal-hearing peers. In adults, significant improvements in QoL after implantation and higher QoL than in their nonimplanted (hearing-aided) peers were frequently reported. Studies involving an older adult cohort reported significant improvement in QoL after implantation, which was often independent of audiological performance. Overall, the calculated cost-utility ratios consistently met the threshold of cost acceptance, indicating acceptable values for expenditures on CI. CONCLUSIONS Considerable work has been done on the QoL attainment and health economic implications of CI. Unilateral CI across all age groups leads to reported sustained benefits in the recipients' overall and disease-specific QoL. With increased cost associated with bilateral CI, further study is needed to characterize its costs and benefits with respect to the recipients' health, well-being, and contributions to society.
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Affiliation(s)
- Matthew G Crowson
- Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Santos NPD, Couto MIV, Martinho-Carvalho AC. Nijmegen Cochlear Implant Questionnaire (NCIQ): translation, cultural adaptation, and application in adults with cochlear implants. Codas 2017; 29:e20170007. [PMID: 29236905 DOI: 10.1590/2317-1782/20172017007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 07/08/2017] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Cross-cultural adaptation and translation of the Nijmegen Cochlear Implant Questionnaire (NCIQ) into Brazilian Portuguese and analysis of quality of life (QoL) results in adults with cochlear implant (CI). METHODS The NCIQ instrument was translated into Brazilian Portuguese and culturally adapted. After that, a cross-sectional and clinical QoL evaluation was conducted with a group of 24 adults with CI. RESULTS The questionnaire title in Brazilian Portuguese is 'Questionário Nijmegen de Implantes Cocleares' (NCIQ-P). The version of the NCIQ questionnaire translated into Brazilian Portuguese presented good internal consistency (0.78). The social and physical domains presented the highest scores, with the basic and advanced sound perception subdomains achieving the highest scores. No correlation between gender and time of device use was found for the questionnaire domains and subdomains. CONCLUSION The cross-cultural adaptation and translation of the NCIQ into Brazilian Portuguese suggests that this instrument is reliable and useful for clinical and research purposes in Brazilian adults with CI.
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Affiliation(s)
- Nathália Porfírio Dos Santos
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - FM, Universidade de São Paulo - USP - São Paulo (SP), Brasil
| | - Maria Inês Vieira Couto
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - FM, Universidade de São Paulo - USP - São Paulo (SP), Brasil
| | - Ana Claudia Martinho-Carvalho
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - FM, Universidade de São Paulo - USP - São Paulo (SP), Brasil
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Liang M, Zhang J, Liu J, Chen Y, Cai Y, Wang X, Wang J, Zhang X, Chen S, Li X, Chen L, Zheng Y. Visually Evoked Visual-Auditory Changes Associated with Auditory Performance in Children with Cochlear Implants. Front Hum Neurosci 2017; 11:510. [PMID: 29114213 PMCID: PMC5660683 DOI: 10.3389/fnhum.2017.00510] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 10/06/2017] [Indexed: 11/18/2022] Open
Abstract
Activation of the auditory cortex by visual stimuli has been reported in deaf children. In cochlear implant (CI) patients, a residual, more intense cortical activation in the frontotemporal areas in response to photo stimuli was found to be positively associated with poor auditory performance. Our study aimed to investigate the mechanism by which visual processing in CI users activates the auditory-associated cortex during the period after cochlear implantation as well as its relation to CI outcomes. Twenty prelingually deaf children with CI were recruited. Ten children were good CI performers (GCP) and ten were poor (PCP). Ten age- and sex- matched normal-hearing children were recruited as controls, and visual evoked potentials (VEPs) were recorded. The characteristics of the right frontotemporal N1 component were analyzed. In the prelingually deaf children, higher N1 amplitude was observed compared to normal controls. While the GCP group showed significant decreases in N1 amplitude, and source analysis showed the most significant decrease in brain activity was observed in the primary visual cortex (PVC), with a downward trend in the primary auditory cortex (PAC) activity, but these did not occur in the PCP group. Meanwhile, higher PVC activation (comparing to controls) before CI use (0M) and a significant decrease in source energy after CI use were found to be related to good CI outcomes. In the GCP group, source energy decreased in the visual-auditory cortex with CI use. However, no significant cerebral hemispheric dominance was found. We supposed that intra- or cross-modal reorganization and higher PVC activation in prelingually deaf children may reflect a stronger potential ability of cortical plasticity. Brain activity evolution appears to be related to CI auditory outcomes.
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Affiliation(s)
- Maojin Liang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Hearing and Speech Science, Xin Hua College of Sun Yat-sen University, Guangzhou, China
| | - Junpeng Zhang
- Department of Biomedical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, China
| | - Jiahao Liu
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Hearing and Speech Science, Xin Hua College of Sun Yat-sen University, Guangzhou, China
| | - Yuebo Chen
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Hearing and Speech Science, Xin Hua College of Sun Yat-sen University, Guangzhou, China
| | - Yuexin Cai
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Hearing and Speech Science, Xin Hua College of Sun Yat-sen University, Guangzhou, China
| | - Xianjun Wang
- Department of Biomedical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, China
| | - Junbo Wang
- Department of Clinical Medicine, Sun Yat-sen University, Guangzhou, China
| | - Xueyuan Zhang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Hearing and Speech Science, Xin Hua College of Sun Yat-sen University, Guangzhou, China
| | - Suijun Chen
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Hearing and Speech Science, Xin Hua College of Sun Yat-sen University, Guangzhou, China
| | - Xianghui Li
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Hearing and Speech Science, Xin Hua College of Sun Yat-sen University, Guangzhou, China
| | - Ling Chen
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Hearing and Speech Science, Xin Hua College of Sun Yat-sen University, Guangzhou, China
| | - Yiqing Zheng
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Hearing and Speech Science, Xin Hua College of Sun Yat-sen University, Guangzhou, China
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Sladen DP, Peterson A, Schmitt M, Olund A, Teece K, Dowling B, DeJong M, Breneman A, Beatty CW, Carlson ML, Neff BA, Hughes-Borst B, Driscoll CL. Health-related quality of life outcomes following adult cochlear implantation: A prospective cohort study. Cochlear Implants Int 2017; 18:130-135. [DOI: 10.1080/14670100.2017.1293203] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Ann Peterson
- Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA
| | - Matt Schmitt
- Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA
| | - Amy Olund
- Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA
| | - Katherine Teece
- Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA
| | | | - Melissa DeJong
- Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA
| | - Alyce Breneman
- Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Brian A. Neff
- Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA
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26
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Duchesne L, Millette I, Bhérer M, Gobeil S. Auditory performance and subjective benefits in adults with congenital or prelinguistic deafness who receive cochlear implants during adulthood. Cochlear Implants Int 2017; 18:143-152. [DOI: 10.1080/14670100.2017.1290925] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Louise Duchesne
- Département d'orthophonie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Isabelle Millette
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - Maurice Bhérer
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - Suzie Gobeil
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
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Anderson CA, Lazard DS, Hartley DEH. Plasticity in bilateral superior temporal cortex: Effects of deafness and cochlear implantation on auditory and visual speech processing. Hear Res 2017; 343:138-149. [PMID: 27473501 DOI: 10.1016/j.heares.2016.07.013] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 07/20/2016] [Accepted: 07/25/2016] [Indexed: 12/01/2022]
Abstract
While many individuals can benefit substantially from cochlear implantation, the ability to perceive and understand auditory speech with a cochlear implant (CI) remains highly variable amongst adult recipients. Importantly, auditory performance with a CI cannot be reliably predicted based solely on routinely obtained information regarding clinical characteristics of the CI candidate. This review argues that central factors, notably cortical function and plasticity, should also be considered as important contributors to the observed individual variability in CI outcome. Superior temporal cortex (STC), including auditory association areas, plays a crucial role in the processing of auditory and visual speech information. The current review considers evidence of cortical plasticity within bilateral STC, and how these effects may explain variability in CI outcome. Furthermore, evidence of audio-visual interactions in temporal and occipital cortices is examined, and relation to CI outcome is discussed. To date, longitudinal examination of changes in cortical function and plasticity over the period of rehabilitation with a CI has been restricted by methodological challenges. The application of functional near-infrared spectroscopy (fNIRS) in studying cortical function in CI users is becoming increasingly recognised as a potential solution to these problems. Here we suggest that fNIRS offers a powerful neuroimaging tool to elucidate the relationship between audio-visual interactions, cortical plasticity during deafness and following cochlear implantation, and individual variability in auditory performance with a CI.
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Affiliation(s)
- Carly A Anderson
- National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, United Kingdom.
| | - Diane S Lazard
- Institut Arthur Vernes, ENT Surgery, Paris, 75006, France; Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, United Kingdom.
| | - Douglas E H Hartley
- National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, United Kingdom; Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, United Kingdom; Medical Research Council (MRC) Institute of Hearing Research, The University of Nottingham, University Park, Nottingham, NG7 2RD, United Kingdom.
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Factors Affecting Speech Perception Improvement Post Implantation in Congenitally Deaf Adults. Ear Hear 2016; 37:671-679. [PMID: 27779517 DOI: 10.1097/aud.0000000000000331] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To identify factors preimplantation associated with postimplantation speech perception improvement in the adult congenitally deaf population. DESIGN Forty-four adult cochlear implant (CI) patients who had a severe to profound hearing loss from birth were identified from this centre's database. Eight preimplantation factors, speech intelligibility, preimplantation hearing levels, communication mode, preimplantation speech perception scores, progression of hearing loss, age at implantation, hearing aid use preimplantation, and gender, were recorded during the CI assessment process. These factors were investigated to determine their effect on speech perception improvement postimplantation. The outcome measures were the improvement in scores for the BKB Sentence test and CUNY Sentence test with lipreading after implantation. In the final analysis, 26 patients were included in the CUNY analysis, and 30 patients were included in the BKB analysis. RESULTS Speech intelligibility rating, preimplantation hearing levels, and communication mode were shown to be significantly associated with improvements in speech perception postimplantation. CONCLUSION Three factors were identified that affected speech perception improvement postimplantation: speech intelligibility, preimplantation hearing levels, and communication mode. These factors can be used to counsel CI patients regarding potential speech perception improvements from cochlear implantation, although these are based on average data and may not reflect individual performance.
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Vollmer M, Beitel RE, Schreiner CE, Leake PA. Passive stimulation and behavioral training differentially transform temporal processing in the inferior colliculus and primary auditory cortex. J Neurophysiol 2016; 117:47-64. [PMID: 27733594 DOI: 10.1152/jn.00392.2016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 10/05/2016] [Indexed: 11/22/2022] Open
Abstract
In profoundly deaf cats, behavioral training with intracochlear electric stimulation (ICES) can improve temporal processing in the primary auditory cortex (AI). To investigate whether similar effects are manifest in the auditory midbrain, ICES was initiated in neonatally deafened cats either during development after short durations of deafness (8 wk of age) or in adulthood after long durations of deafness (≥3.5 yr). All of these animals received behaviorally meaningless, "passive" ICES. Some animals also received behavioral training with ICES. Two long-deaf cats received no ICES prior to acute electrophysiological recording. After several months of passive ICES and behavioral training, animals were anesthetized, and neuronal responses to pulse trains of increasing rates were recorded in the central (ICC) and external (ICX) nuclei of the inferior colliculus. Neuronal temporal response patterns (repetition rate coding, minimum latencies, response precision) were compared with results from recordings made in the AI of the same animals (Beitel RE, Vollmer M, Raggio MW, Schreiner CE. J Neurophysiol 106: 944-959, 2011; Vollmer M, Beitel RE. J Neurophysiol 106: 2423-2436, 2011). Passive ICES in long-deaf cats remediated severely degraded temporal processing in the ICC and had no effects in the ICX. In contrast to observations in the AI, behaviorally relevant ICES had no effects on temporal processing in the ICC or ICX, with the single exception of shorter latencies in the ICC in short-deaf cats. The results suggest that independent of deafness duration passive stimulation and behavioral training differentially transform temporal processing in auditory midbrain and cortex, and primary auditory cortex emerges as a pivotal site for behaviorally driven neuronal temporal plasticity in the deaf cat. NEW & NOTEWORTHY Behaviorally relevant vs. passive electric stimulation of the auditory nerve differentially affects neuronal temporal processing in the central nucleus of the inferior colliculus (ICC) and the primary auditory cortex (AI) in profoundly short-deaf and long-deaf cats. Temporal plasticity in the ICC depends on a critical amount of electric stimulation, independent of its behavioral relevance. In contrast, the AI emerges as a pivotal site for behaviorally driven neuronal temporal plasticity in the deaf auditory system.
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Affiliation(s)
- Maike Vollmer
- Comprehensive Hearing Center, University Hospital Wuerzburg, Wuerzburg, Germany;
| | - Ralph E Beitel
- Coleman Memorial Laboratory, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California
| | - Christoph E Schreiner
- Center for Integrative Neuroscience, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California; and
| | - Patricia A Leake
- Epstein Laboratory, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California
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le Roux T, Vinck B, Butler I, Louw L, Nauta L, Schlesinger D, Swanepoel DW. Predictors of health-related quality of life in adult cochlear implant recipients in South Africa. Int J Audiol 2016; 56:16-23. [DOI: 10.1080/14992027.2016.1227482] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Talita le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa,
| | - Bart Vinck
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa,
- Speech-Language Audiology Department, Ghent University, Gent, Belgium,
| | - Iain Butler
- Department of Otorhinolaryngology, University of the Free State, Bloemfontein, South Africa,
| | - Liebie Louw
- Department of Statistics, University of Pretoria, Pretoria, South Africa,
| | - Leone Nauta
- Johannesburg Cochlear Implant Program, Johannesburg, South Africa,
| | - Dani Schlesinger
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Soweto, South Africa,
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa,
- Ear Sciences Centre, School of Surgery, University of Western Australia, Nedlands, Australia, and
- Ear Science Institute Australia, Subiaco, Australia
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Evaluation on health-related quality of life in deaf children with cochlear implant in China. Int J Pediatr Otorhinolaryngol 2016; 88:136-41. [PMID: 27497401 DOI: 10.1016/j.ijporl.2016.06.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/06/2016] [Accepted: 06/08/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Previous studies have shown that deaf children benefit considerably from cochlear implants. These improvements are found in areas such as speech perception, speech production, and audiology-verbal performance. Despite the increasing prevalence of cochlear implants in China, few studies have reported on health-related quality of life in children with cochlear implants. The main objective of this study was to explore health-related quality of life on children with cochlear implants in South-west China. STUDY DESIGN A retrospective observational study of 213 CI users in Southwest China between 2010 and 2013. METHODS Participants were 213 individuals with bilateral severe-to-profound hearing loss who wore unilateral cochlear implants. The Nijmegen Cochlear Implant Questionnaire and Health Utility Index Mark III were used pre-implantation and 1 year post-implantation. Additionally, 1-year postoperative scores for Mandarin speech perception were compared with preoperative scores. RESULTS Health-related quality of life improved post-operation with scores on the Nijmegen Cochlear Implant Questionnaire improving significantly in all subdomains, and the Health Utility Index 3 showing a significant improvement in the utility score and the subdomains of ''hearing," ''speech," and "emotion". Additionally, a significant improvement in speech recognition scores was found. No significant correlation was found between increased in quality of life and speech perception scores. CONCLUSION Health-related quality of life and speech recognition in prelingual deaf children significantly improved post-operation. The lack of correlation between quality of life and speech perception suggests that when evaluating performance post-implantation in prelingual deaf children and adolescents, measures of both speech perception and quality of life should be used.
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Results of Postoperative, CT-based, Electrode Deactivation on Hearing in Prelingually Deafened Adult Cochlear Implant Recipients. Otol Neurotol 2016; 37:137-45. [PMID: 26719955 DOI: 10.1097/mao.0000000000000926] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To test the use of a novel, image-guided cochlear implant (CI) programming (IGCIP) technique on prelingually deafened, adult CI recipients. STUDY DESIGN Prospective unblinded study. SETTING Tertiary referral center. PATIENTS Twenty-six prelingually deafened adult CI recipients with 29 CIs (3 bilateral). INTERVENTION(S) Temporal-bone CT scans were used as input to a series of semiautomated computer algorithms which estimate the location of electrodes in reference to the modiolus. This information was used to selectively deactivate suboptimally located electrodes, i.e., those for which the distance from the electrode to the modiolus was further than a neighboring electrode to the same site. Patients used the new IGCIP program exclusively for 3-5 weeks. MAIN OUTCOME MEASURE(S) Minimum Speech Test Battery (MSTB), quality of life (QOL), and spectral modulation detection (SMD). RESULTS On average one-third of electrodes were deactivated. At the group level, no significant differences were noted for MSTB measures nor for QOL estimates. Average SMD significantly improved after IGCIP reprogramming, which is consistent with improved spatial selectivity. Using 95% confidence interval data for CNC, AzBio, and BKB-SIN at the individual level, 76 to 90% of subjects demonstrated equivocal or significant improvement. Ultimately 21 of 29 (72.41%) elected to keep the IGCIP map because of perceived benefit often substantiated by improvement on either MSTB, QOL, and/or SMD. CONCLUSIONS Knowledge of the geometric relationship between CI electrodes and the modiolus appears to be useful in adjusting CI maps in prelingually deafened adults. Long-term improvements may be observed resulting from improved spatial selectivity and spectral resolution.
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Harris MS, Capretta NR, Henning SC, Feeney L, Pitt MA, Moberly AC. Postoperative Rehabilitation Strategies Used by Adults With Cochlear Implants: A Pilot Study. Laryngoscope Investig Otolaryngol 2016; 1:42-48. [PMID: 28894803 PMCID: PMC5510267 DOI: 10.1002/lio2.20] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 04/12/2016] [Accepted: 05/07/2016] [Indexed: 11/09/2022] Open
Abstract
Objectives/Hypothesis Aural rehabilitation is not standardized for adults after cochlear implantation. Most cochlear implant (CI) centers in the United States do not routinely enroll adult CI users in focused postoperative rehabilitation programs due to poor reimbursement and lack of data supporting (or refuting) the efficacy of any one specific approach. Consequently, patients generally assume a self‐driven approach toward rehabilitation. This exploratory pilot study examined rehabilitation strategies pursued by adults with CIs and associated these strategies with speech recognition and CI‐specific quality of life (QOL). Study Design Cross‐sectional study of 23 postlingually deafened adults with CIs. Methods Participants responded to an open‐ended questionnaire regarding rehabilitation strategies. A subset underwent in‐depth interviews. Thematic content analysis was applied to the questionnaires and interview transcripts. Participants also underwent word recognition testing and completed a CI‐related QOL measure. Participants were classified as having good or poor performance (upper or lower quartile for speech recognition) and high or low QOL (upper or lower quartile for QOL). Rehabilitation themes were compared and contrasted among groups. Results Five rehabilitation themes were identified: 1) Preimplant expectations of postoperative performance, 2) personal motivation, 3) social support, 4) specific rehabilitation strategies, and 5) patient‐perceived role of the audiologist. Patients with good speech recognition and high QOL tended to pursue more active rehabilitation and had greater social support. Patient expectations and motivation played significant roles in postoperative QOL. Conclusion Postoperative patient‐driven rehabilitation strategies are highly variable but appear to relate to outcomes. Larger‐scale extensions of this pilot study are needed.
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Affiliation(s)
- Michael S Harris
- Department of Otolaryngology-Head and Neck Surgery The Ohio State University Wexner Medical Center Columbus Ohio
| | - Natalie R Capretta
- Department of Otolaryngology-Head and Neck Surgery The Ohio State University Wexner Medical Center Columbus Ohio
| | - Shirley C Henning
- DeVault Otologic Research Laboratory Indiana University School of Medicine Indianapolis Indiana U.S.A
| | - Laura Feeney
- Department of Otolaryngology-Head and Neck Surgery The Ohio State University Wexner Medical Center Columbus Ohio
| | - Mark A Pitt
- the Department of Psychology The Ohio State University Columbus Ohio
| | - Aaron C Moberly
- Department of Otolaryngology-Head and Neck Surgery The Ohio State University Wexner Medical Center Columbus Ohio
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Rousset A, Dowell R, Leigh J. Receptive language as a predictor of cochlear implant outcome for prelingually deaf adults. Int J Audiol 2016; 55 Suppl 2:S24-30. [PMID: 27160793 DOI: 10.3109/14992027.2016.1157269] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study investigated outcomes and predictive factors, specifically language skills, for a group of prelingually hearing-impaired adults who received a cochlear implant. DESIGN Speech perception data, demographic information, and other related variables such as communication mode, residual hearing, and receptive language abilities were explored. Pre- and post-implant speech perception scores were compared and multiple regression analysis was used to identify significant predictive relationships. STUDY SAMPLE The study included 43 adults with a prelingual onset of hearing loss, who proceeded with cochlear implantation at the Royal Victorian Eye and Ear Hospital in Melbourne, Australia. RESULTS The majority of patients experienced benefit from their cochlear implants, with 88% demonstrating significant improvement in speech perception performance. Volunteers achieved better post-operative speech perception scores if they had a shorter duration of severe-to-profound hearing loss, better language skills, and used an exclusively oral communication mode. CONCLUSIONS Although post-operative speech perception performance is significantly poorer for prelingually hearing-impaired adults compared to postlingually hearing-impaired patients, the study group demonstrated significant benefit from their cochlear implants. The variability in post-operative outcomes can be predicted to some extent from the hearing history and language abilities of the individual patient.
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Affiliation(s)
- Alexandra Rousset
- a Cochlear Implant Clinic, Royal Victorian Eye and Ear Hospital , Melbourne , Australia .,b The University of Melbourne , Australia , and.,c The Cooperative Research Centre for Cochlear Implant and Hearing Aid Innovation , Melbourne , Australia
| | - Richard Dowell
- a Cochlear Implant Clinic, Royal Victorian Eye and Ear Hospital , Melbourne , Australia .,b The University of Melbourne , Australia , and.,c The Cooperative Research Centre for Cochlear Implant and Hearing Aid Innovation , Melbourne , Australia
| | - Jaime Leigh
- a Cochlear Implant Clinic, Royal Victorian Eye and Ear Hospital , Melbourne , Australia .,b The University of Melbourne , Australia , and.,c The Cooperative Research Centre for Cochlear Implant and Hearing Aid Innovation , Melbourne , Australia
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Kraaijenga V, Smit A, Stegeman I, Smilde J, van Zanten G, Grolman W. Factors that influence outcomes in cochlear implantation in adults, based on patient-related characteristics - a retrospective study. Clin Otolaryngol 2016; 41:585-92. [DOI: 10.1111/coa.12571] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2015] [Indexed: 11/29/2022]
Affiliation(s)
- V.J.C. Kraaijenga
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
- Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht the Netherlands
| | - A.L. Smit
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
- Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht the Netherlands
| | - I. Stegeman
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
- Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht the Netherlands
| | - J.J.M. Smilde
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
| | - G.A. van Zanten
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
- Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht the Netherlands
| | - W. Grolman
- Department of Otorhinolaryngology - Head and Neck Surgery; University Medical Center Utrecht; Utrecht the Netherlands
- Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht the Netherlands
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van der Marel KS, Briaire JJ, Verbist BM, Muurling TJ, Frijns JH. The Influence of Cochlear Implant Electrode Position on Performance. Audiol Neurootol 2015; 20:202-11. [DOI: 10.1159/000377616] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 02/01/2015] [Indexed: 11/19/2022] Open
Abstract
Objectives: To study the relation between variables related to cochlear implant electrode position and speech perception performance scores in a large patient population. Design: The study sample consisted of 203 patients implanted with a CII or HiRes90K implant with a HiFocus 1 or 1J electrode of Advanced Bionics. Phoneme and word score averages for the 1- and 2-year follow-up were calculated for 41 prelingually deaf and 162 postlingually deaf patients. Analyses to reveal correlations between these performance outcomes and 6 position-related variables (angle of most basal electrode contact, surgical insertion angle, surgical insertion, wrapping factor, angular insertion depth, linear insertion depth) were executed. The scalar location, as an indication for the presence of intracochlear trauma, and modiolus proximity beyond the basal turn were not evaluated in this study. In addition, different patient-specific variables (age at implantation, age at onset of hearing loss, duration of deafness, preoperative phoneme and word scores) were tested for correlation with performance. Results: The performance scores of prelingual patients were correlated with age at onset of hearing loss, duration of deafness and preoperative scores. For the postlingual patients, performance showed correlations with all 5 patient-specific variables. None of the 6 position-related variables influenced speech perception in cochlear implant patients. Conclusions: Although several patient-specific variables showed correlations with speech perception outcomes, not one of the studied angular and linear position-related variables turned out to have a demonstrable influence on performance.
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Lammers MJW, Versnel H, van Zanten GA, Grolman W. Altered cortical activity in prelingually deafened cochlear implant users following long periods of auditory deprivation. J Assoc Res Otolaryngol 2014; 16:159-70. [PMID: 25315357 DOI: 10.1007/s10162-014-0490-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 09/16/2014] [Indexed: 11/26/2022] Open
Abstract
Auditory stimulation during childhood is critical for the development of the auditory cortex in humans and with that for hearing in adulthood. Age-related changes in morphology and peak latencies of the cortical auditory evoked potential (CAEP) have led to the use of this cortical response as a biomarker of auditory cortical maturation including studies of cortical development after deafness and subsequent cochlear implantation. To date, it is unknown whether prelingually deaf adults, with early onset deafness (before the age of 2 years) and who received a cochlear implant (CI) only during adulthood, would display absent or aberrant CAEP waveforms as predicted from CAEP studies in late implanted prelingually deaf children. In the current study, CAEP waveforms were recorded in response to electric stimuli in prelingually deaf adults, who received their CI after the age of 21 years. Waveform morphology and peak latencies were compared to the CAEP responses obtained in postlingually deaf adults, who became deaf after the age of 16. Unexpectedly, typical CAEP waveforms with adult-like P1-N1-P2 morphology could be recorded in the prelingually deaf adult CI users. On visual inspection, waveform morphology was comparable to the CAEP waveforms recorded in the postlingually deaf CI users. Interestingly, however, latencies of the N1 peak were significantly shorter and amplitudes were significantly larger in the prelingual group than in the postlingual group. The presence of the CAEP together with an early and large N1 peak might represent activation of the more innate and less complex components of the auditory cortex of the prelingually deaf CI user, whereas the CAEP in postlingually deaf CI users might reflect activation of the mature neural network still present in these patients. The CAEPs may therefore be helpful in the assessment of developmental state of the auditory cortex.
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Affiliation(s)
- Marc J W Lammers
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Room G.02.531, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands,
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Cochlear implantation in late-implanted prelingually deafened adults: changes in quality of life. Otol Neurotol 2014; 35:253-9. [PMID: 24448285 DOI: 10.1097/mao.0b013e3182a4758e] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND With expanding inclusion criteria for cochlear implantation, the number of prelingually deafened persons who are implanted as adults increases. Compared with postlingually deafened adults, this group shows limited improvement in speech recognition. In this study, the changes in health-related quality of life in late-implanted prelingually deafened adults are evaluated and related to speech recognition. METHODS Quality of life was measured before implantation and 1 year after implantation in a group of 28 prelingually deafened adults, who had residual hearing and who used primarily oral communication. Patients completed 3 questionnaires (Nijmegen Cochlear Implant Questionnaire, Glasgow Benefit Inventory, and Health Utility Index 3). Postoperative scores were compared with preoperative scores. Additionally, phoneme recognition scores were obtained preimplantation and 1 year postimplantation. RESULTS Quality of life improved after implantation: scores on the Nijmegen Cochlear Implant Questionnaire improved significantly in all subdomains (basic speech perception, advanced speech perception, speech production, self-esteem, activity, and social interaction), the total Glasgow Benefit Inventory score improved significantly, and the Health Utility Index 3 showed a significant improvement in the utility score and in the subdomains "hearing" and "emotion." Additionally, a significant improvement in speech recognition scores was found. No significant correlations were found between gain in quality of life and speech perception scores. CONCLUSION The results suggest that quality of life and speech recognition in prelingually deafened adults significantly improved as a result of cochlear implantation. Lack of correlation between quality of life and speech recognition suggests that in evaluating performance after implantation in prelingually deafened adults, measures of both speech recognition and quality of life should be used.
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Athalye S, Mulla I, Archbold S. The experiences of adults assessed for cochlear implantation who did not proceed. Cochlear Implants Int 2014; 15:301-11. [DOI: 10.1179/1754762814y.0000000067] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Reliability and validity of the Nijmegen Cochlear Implant Questionnaire in Spanish. Eur Arch Otorhinolaryngol 2014; 272:1621-5. [PMID: 24609736 DOI: 10.1007/s00405-014-2983-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 02/22/2014] [Indexed: 10/25/2022]
Abstract
The Nijmegen Cochlear Implant Questionnaire (NCIQ) is a specific and quantifiable self-assessment health-related quality of life (QoL) questionnaire. It was developed to determine the subjective benefits of a cochlear implant (CI). The present study aimed to determine the validity and reliability of the NCIQ in Spanish. Seventy-six adult, Spanish speaking, CI users and 28 control subjects answered the NCIQ. Reliability of the questionnaire was determined using Cronbach's α coefficient and the validity established using Pearson's correlation coefficient. All questionnaire respondents performed significantly better in all sub-domains with a cochlear implant than before cochlear implantation. The Cronbach's α score exceeded 0.70 in most sub-domains and the total score. The objective measures: bisyllables tested without lip-reading and with masking; and bisyllables, tested without lip-reading and without masking were correlated with the sub-domain 'advanced sound perception'. To determine health-related QoL the NCIQ in Spanish is a reliable self-assessment questionnaire and a valuable instrument in determining the subjective benefit of a CI.
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Mcneill C, Sharma M, Purdy SC. Are cortical auditory evoked potentials useful in the clinical assessment of adults with cochlear implants? Cochlear Implants Int 2013; 10 Suppl 1:78-84. [DOI: 10.1179/cim.2009.10.supplement-1.78] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Mistry D, Ryan J, Maessen H, Bance M. Differences in perception of hearing handicap between cochlear implant users and their spouses. Laryngoscope 2013; 124:1199-203. [PMID: 24114999 DOI: 10.1002/lary.24404] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 07/19/2013] [Accepted: 08/26/2013] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS To examine the relationship between patient and proxy ratings of health-related quality of life (HRQL) in patients with cochlear implants. STUDY DESIGN Prospective survey. METHODS Eighty-two adult cochlear implant recipients and their spouses/partners were asked to complete the Nijmegen Cochlear Implant Questionnaire (NCIQ) and the Hearing Participation Scale (HPS) that were mailed to them. RESULTS For the NCIQ, there were 38 useable responses from recipients and 31 useable responses from the partners. There were 27 paired and useable questionnaires (i.e., from both the recipient and his/her partner). For the HPS, there were 42 useable responses from recipients and 36 useable responses from the partners. Of these, there were 35 paired questionnaires. There was good agreement between partners and patients with both the HPS (r = 0.62) and the NCIQ (r = 0.80). There was a significant statistical difference in the scoring of the Basic Sound Perception subscale between the two groups (P = .039), with spouses under-rating performance in this subscale. CONCLUSIONS For patients with cochlear implants, patients' partners corroborate patients' self-reported HRQL. In cases in which patients have sensory impairment, there may be an additional role for proxy ratings of HRQL to give a more complete assessment of functional limitations.
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Affiliation(s)
- Dipan Mistry
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia
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Music and Quality of Life in Early-Deafened Late-Implanted Adult Cochlear Implant Users. Otol Neurotol 2013; 34:1041-7. [DOI: 10.1097/mao.0b013e31828f47dd] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rembar S, Lind O, Arnesen H, Helvik AS. Effects of cochlear implants: a qualitative study. Cochlear Implants Int 2013; 10:179-97. [DOI: 10.1179/cim.2009.10.4.179] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Bosco E, Nicastri M, Ballantyne D, Viccaro M, Ruoppolo G, Ionescu Maddalena A, Mancini P. Long term results in late implanted adolescent and adult CI recipients. Eur Arch Otorhinolaryngol 2012. [PMID: 23179930 DOI: 10.1007/s00405-012-2264-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of the present study is to assess long-term outcomes of CI in prelingual deafened adolescents and adults, describing, where present, differences in performance, self perceived benefit and highlighting specific characteristics. Twenty-three patients were enrolled: 10 adolescents, 13 young adults. Each patient underwent speech perception/language development, psychological evaluation and structured interviews on self perception concerning CI. 70 % adolescents and 100 % adults used their cochlear implant for most of the day; two adolescents were partial users and one was a non-user. Adolescents' average word recognition and comprehension scores improved respectively from 7 to 29.8 % (p = 0.01) and 3 to 26 % (p = 0.1). Adults' average scores improved significantly from 1.5 to 41.9 % (p = 0.01) and from 18.5 to 52.7% (p = 0.001), respectively. None of the subjects showed a linguistic age adequate to the chronological one: average linguistic age was 7.6 years for adolescents and 19.3 for adults. Structured interviews showed improvement in self-esteem. Adults and most adolescents were fully or moderately satisfied with their implant. Cochlear implantation can be considered a valid option for the rehabilitation of highly motivated and well-selected pre-lingual deafened adolescents and adults. Although there is a substantial variability in both groups of patients and language skills are only marginally influenced by CI, there is still a significant improvement in speech perception. CI was described by both groups as having had a positive impact on their lives; nevertheless adolescents were the ones with a tendency to under-use CI, even those with better hearing outcomes.
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Affiliation(s)
- Ersilia Bosco
- Department of Sensorial Organs, University Sapienza of Rome, Policlinico Umberto I Viale del Policlinico, 00161 Rome, Italy
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de Carvalho GM, Guimarães AC, Danieli F, Onuki LCB, Paschoal JR, Bianchini WA, Castilho AM. Evaluation of the Digisonic® SP cochlear implant: patient outcomes and fixation system with titanium screws. Braz J Otorhinolaryngol 2012; 78:56-62. [PMID: 23306569 PMCID: PMC9446367 DOI: 10.5935/1808-8694.20120034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 10/02/2012] [Indexed: 11/20/2022] Open
Abstract
Cochlear implants have revolutionized the way patients affected by severe hearing loss experience the world. Neurelec developed a fixation system with two titanium screws that requires no skull bone drilling. Objective To describe the outcomes and procedure-related details of a series of patients implanted with the Digisonic® SP cochlear implant. Method This retrospective study analyzed patients submitted to cochlear implant placement within a period of 18 months. All patients had postlingual hearing impairment. Data was collected from patient charts and standard questionnaires answered by the surgeons in charge of carrying out the procedures. Results The six patients offered the Digisonic® SP cochlear implants were operated by experienced surgeons. The procedures took 95 to 203 minutes (mean = 135') to be completed, which is less time than what has been described for other fixation approaches. No complications were recorded and hearing improvement was satisfactory. Conclusion The Digisonic® SP cochlear implant developed by Neurelec offered good audiological results for adult patients, shorter surgery time, and no surgical or postoperative complications.
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Affiliation(s)
- Guilherme Machado de Carvalho
- MSc in Medicine, MD, ENT (Fellow in Otology. UNICAMP)
- Send correspondence to: Dr. Guilherme Machado de Carvalho. Disciplina de Otorrinolaringologia - UNICAMP. Faculdade de Ciências Médicas. Universidade de Campinas - UNICAMP. Campinas - SP. Brasil. CEP: 13083-970. Caixa Postal: 6111. Tel: +55 (19) 3521-7523. Fax: +55 (19) 3521-7563
| | | | | | | | | | - Walter Adriano Bianchini
- MSc in Medicine. MD, ENT. (Head and Coordinator of the Otology, Audiology, Cochlear Implant, and Implantable Hearing Aid Service. UNICAMP)
| | - Arthur Menino Castilho
- MD, PhD, ENT. (Head and Coordinator of the Otology, Audiology, Cochlear Implant, and Implantable Hearing Aid Service. UNICAMP)
- Otology, Audiology and Implantable Ear Prostheses Ear, Nose, Throat and Head & Neck Surgery Department
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Unilateral multi-channel cochlear implantation results in significant improvement in quality of life. Otol Neurotol 2012; 33:566-71. [PMID: 22569148 DOI: 10.1097/mao.0b013e3182536dc2] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To investigate the effects of unilateral multi-channel cochlear implant surgery on health-related quality of life and to determine if there is an age-related impact of cochlear implantation on these effects. DESIGN Prospective study. SETTING Tertiary health-care center. METHODS The Short Form-36 survey (SF-36) was administered to determine the health-related quality of life of 283 age-stratified patients before and after cochlear implant surgery. MAIN OUTCOMES Precochlear to postcochlear implantation changes in health-related quality of life as determined by the SF-36 questionnaire. RESULTS There were significant increases in precochlear and postcochlear implantation scores for 5 of the 8 SF-36 survey domains: vitality, physical role functioning, mental health, emotional role functioning, and social functioning. Significant differences were found between age groups in the domains of social functioning, emotion role functioning, and mental health. CONCLUSION Cochlear implant surgery significantly improves health-related quality of life as categorically stratified by the SF-36 questionnaire. These improvements were most evident in the mental health, emotional and social functioning, and physical functioning at work questions of the survey. Cochlear implant recipients younger than 65 years perceive a greater improvement in their level of energy, mental health, and social function compared with those older than 65 years.
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Abstract
OBJECTIVES The aims of the study were to investigate (1) speech perception outcomes in people with an early-onset hearing loss (HL) who received a cochlear implant as an adolescent or adult, (2) prognostic factors associated with positive speech perception outcomes, and (3) self-report outcomes in these participants. DESIGN Outcomes for 38 implant recipients with a Nucleus device were investigated retrospectively. All participants were diagnosed with a bilateral HL at age #3 yr and were implanted at age 14 yr or older. Nineteen participants had confirmed bilateral, severe to profound HL at age #12 mo (prelingual); nine had confirmed bilateral, severe to profound HL at age.12 mo and #3 yr (perilingual); and the remaining 10 had a diagnosis of bilateral sensorineural HL at age #3 yr which progressed to severe to profound HL after 3 yrs of age (progressive). There were 24 females and 14 males, and the average age at implantation was 33 yr (range 5 14-65 yr). Closed-set and open-set speech perception tests administered pre- and postimplant were analyzed for all participants, in addition to self-report survey measures of benefit, satisfaction, and implant usage. RESULTS Participants were placed into one of five hierarchic categories of speech perception performance preimplantation and at 12 mo postimplantation. The categories ranged from sound detection only (category 1) to excellent open-set speech perception (category 5). To be in category 4 or 5, the participant had to score.30% words correct on a recorded version of either the Central Institute for the Deaf Everyday Sentence Lists or the City University of New York Sentences. Before implantation, two recipients (5%) were in category 4 or 5 compared with 20 (53%) at 12 mo postimplant. Consistent with previous studies, there was large intersubject variability in speech scores. Three factors accounted for 63% of the variance on open-set sentence test scores, postimplant: mode of communication in childhood (oral versus total communication/sign), stable as opposed to progressive loss, and time without a hearing aid on the implant ear. More than 80% of survey respondents used their device.8 hr a day, and 90% reported that their ability to understand speech with visual cues was "much better" with the implant. In addition, all reported being satisfied with the device. CONCLUSION These results indicate that a cochlear implant should be considered as an option for adults and adolescents with early-onset HL. The majority of participants gained benefit from the device and were satisfied with it. In addition, a substantial number gained good open-set speech perception ability, postimplant. Recipients who used oral communication in childhood, had a progressive loss, and wore a hearing aid on the implant ear up to the time of surgery were more likely to obtain better speech perception outcomes.
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Preoperative voice parameters affect the postoperative speech intelligibility in patients with cochlear implantation. Clin Exp Otorhinolaryngol 2012; 5 Suppl 1:S69-72. [PMID: 22701152 PMCID: PMC3369987 DOI: 10.3342/ceo.2012.5.s1.s69] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 12/06/2011] [Accepted: 01/19/2012] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Verbal communication depends on a good function of voice and speech organs. Some of the voice characteristics of deaf people differ considerably from those of speakers with normal hearing. After cochlear implantation (CI), auditory control of voice production is possible and the quality of the voice is improved. CI improves quality of voice, speech and hearing with deafness. The aim of our study was to investigate the relationship between acoustic analysis before CI and the speech intelligibility before and after CI. METHODS Twelve prelingually deafened children implanted unilaterally at the age of 3.4-9 years were included in the study. For all of the children an acoustic analysis of the Slovene vowel 'a' was performed before CI. The fundamental frequency (F0), jitter, shimmer and noise-to-harmonic ratio (NHR) were studied before the implantation. For all of the children the speech intelligibility was performed before and 12 months after CI. Preoperative hearing was divided on existing residual hearing. The results of the acoustic analyses and speech intelligibility before and after CI were compared for preoperative hearing. The results of the speech intelligibility were compared for the age of operation and preoperative acoustic analysis (F0, jitter, shimmer, NHR). RESULTS Preoperative hearing had no influence on preoperative voice analysis. The children with residual hearing had a high grade of speech intelligibility before and after CI. The preoperative shimmer had positive correlation with postoperative 12 month speech intelligibility (r=0.618, P=0.032). The preoperative jitter had positive correlation with postoperative 12 month speech intelligibility, but was not statistically significant (r=0.479, P=0.116). CONCLUSION Shimmer on preoperative voice analyses had influence on speech intelligibility after CI.
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Speech intelligibility as a predictor of cochlear implant outcome in prelingually deafened adults. Ear Hear 2011; 32:445-58. [PMID: 21258238 DOI: 10.1097/aud.0b013e31820510b7] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Among adult patients with prelingual deafness, interindividual variability in speech perception outcome after cochlear implantation is generally large. It was hypothesized that the intelligibility of the patient's own speech may be predictive of speech perception with a cochlear implant. The objectives were (1) to provide a validation of a new test battery as a measurement tool for intelligibility using a group of prelingually deafened patients; (2) to investigate the validity of the test battery as a predictor of postimplant speech perception, based on preliminary data with a cochlear implant from a subgroup of patients; and (3) to investigate the validity of the test battery as a predictor of postimplant health-related quality of life (HRQoL) for the same subgroup of patients. DESIGN Twenty-five adult cochlear implant candidates with prelingual deafness participated in this study. Average age at onset of deafness was 8 mos (range 0 to 4 yrs). Speech samples from the participants were recorded and presented to two normal-hearing listeners. Results from the seven intelligibility tests in the battery were subjected to analyses of reliability and validity. Furthermore, the multiple test outcomes were submitted to a Principal Component Analysis to investigate the possibility of summarizing the data. Subsequently, from the group of 25 participants, 9 participants with above-average intelligibility were selected for implantation. Speech perception data with a cochlear implant from the nine implantees were collected at 12 mos postimplantation, as well as HRQoL data. Predictive validity of the intelligibility test battery was determined, using the postimplant data as the criterion. RESULTS Results from the 25 participants averaged over listeners showed that all tests in the battery had good reliability and validity as measures of intelligibility. Principal Component Analysis showed that the multiple test outcomes could be summarized by a single underlying variable. Despite the early age at onset of deafness, the subgroup of nine participants who received a cochlear implant included several good performers in terms of speech perception with the implant. The intelligibility test battery summary score had good validity as a predictor of postimplant outcome: the more intelligible the participant's speech, the better his or her speech perception outcome with the cochlear implant. Availability of effective auditory input in early life may be the fundamental factor underlying the potential for speech perception with a cochlear implant in later life. The intelligibility test battery can be reduced to a single test to minimize testing time without negatively affecting its predictive validity. Predictive validity of the intelligibility test battery can be generalized to HRQoL outcomes of cochlear implantation, provided these outcomes are concerned with speech processing abilities. CONCLUSIONS The new test battery (or its reduced version), used as a measure of intelligibility, is a promising tool for guiding cochlear implant candidacy decisions and counseling for individual patients with prelingual deafness. Because intelligibility has superior predictive power in comparison to age at onset of deafness, the latter should be discarded as an exclusion criterion for cochlear implantation.
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