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Choi JW, Lee YJ, Kang WS, Ahn JH, Park HJ, Chung JW. The Role of Measuring Preoperative Social Maturation Score in Children With Additional Needs Who Underwent Cochlear Implantation. J Audiol Otol 2024; 28:107-113. [PMID: 38695056 PMCID: PMC11065552 DOI: 10.7874/jao.2024.00101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Additional needs refer to specific requirements or support for individuals with disabilities or syndromes. Intellectual ability is a crucial outcome determinant of a cochlear implant. The social quotient (SQ) is an indirect predictor of intellectual capacity and social skills. This study aimed to investigate the clinical significance of the SQ on children with additional needs who received cochlear implants. Subjects and. METHODS This study included 24 patients with diagnosed developmental delays and syndromes, who demonstrated SQ scores of <70. Preoperative social skills were evaluated using the SQ. All patients underwent cochlear implantation (CI) surgery before 7 years of age. Outcomes were evaluated using the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) and Categories of Auditory Performance (CAP) scores. Data were collected through a retrospective chart review. RESULTS Children were categorized into three groups based on their SQ. There were no correlations between the preoperative SQ and IT-MAIS or CAP scores at 2 and 5 years of follow-up postoperatively. The CI outcomes of children with low SQ (<70) differed from those with normal development (SQ>70). In the low-SQ group, inner ear anomalies were observed in 10 (41.7%) patients. Although not statistically significant, these children exhibited a trend of lower average outcomes than children without inner ear anomalies. CONCLUSIONS CI outcomes in children with additional needs positively affected auditory performance. Postoperative auditory and language skills tended to improve slowly in children with additional needs and a lower SQ. Over time, development gradually became more comparable to the other groups of children. However, this improvement was less than that observed in children without additional needs. Our findings support CI for children with additional needs as part of long-term auditory rehabilitation following surgery.
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Affiliation(s)
- Ji Won Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Ji Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Seok Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joong Ho Ahn
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong Ju Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Woo Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Singhal K, Singhal J, Muzaffar J, Monksfield P, Bance M. Outcomes of Cochlear Implantation in Patients with Post-Meningitis Deafness: A Systematic Review and Narrative Synthesis. J Int Adv Otol 2020; 16:395-410. [PMID: 33136024 DOI: 10.5152/iao.2020.9040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Summarise outcomes following cochlear implantation (CI) in patients with post-meningitis deafness. Systematic review and narrative synthesis. Databases searched: Medline, Pubmed, Embase, Web of Science, Cochrane Collection and ClinicalTrials.gov. No limits placed on language or year of publication. Studies with a minimum of 20 individuals with post-meningitis deafness were included. Review conducted in accordance with the PRISMA statement. Searches identified 906 abstracts and 291 full texts. Of these, 19 studies met the inclusion criteria, reporting outcomes in 610 patients with 650 implants. Audiological outcomes improved across all studies following cochlear implantation. 7 studies demonstrated a statistically significant difference between pre and post-CI outcomes. Patients with no cochlear ossification, full electrode insertion, shorter duration of deafness and no neurological sequelae generally appeared to perform best. A total of 31 minor and 19 major complications were reported, with 15 cases of reimplantation. The methodological quality of the included studies was sufficient, predominantly consisting of cohort studies. 15 studies were OCEBM grade III and 4 studies were OCEBM grade IV. All studies had a minimum of 20 individuals with post-meningitic deafness and used multi-channel cochlear implant devices. Audiological outcomes following cochlear implantation in meningitis are satisfactory, providing functional levels of speech perception and intelligibility. Improvement in hearing is dependent on the amount of cochlear ossification, duration of deafness prior to implantation, electrode insertion depth and presence of neurological sequalae. Cochlear implantation in meningitis patients can be challenging due to the presence of ossification and inaccuracies of pre-operative imaging. Therefore, early and bilateral implantation is recommended in all patients with post-meningitis hearing loss to improve the likelihood of full electrode insertion.
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Affiliation(s)
- Kaajal Singhal
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Juhi Singhal
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Bigmingham, UK
| | - Jameel Muzaffar
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Bigmingham, UK
| | - Peter Monksfield
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Bigmingham, UK
| | - Manohar Bance
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Helmstaedter V, Buechner A, Stolle S, Goetz F, Lenarz T, Durisin M. Cochlear implantation in children with meningitis related deafness: The influence of electrode impedance and implant charge on auditory performance - A case control study. Int J Pediatr Otorhinolaryngol 2018; 113:102-109. [PMID: 30173965 DOI: 10.1016/j.ijporl.2018.07.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Bacterial meningitis can cause a labyrinthitis. Consequences often are intracochlear soft tissue neoformation (cochlear obliteration) or intracochlear osteoneogenesis (cochlear ossification) and deafness. Cochlear implantation becomes challenging and hearing rehabilitation is complicated. This retrospective case-control-study aimed to find correlations between morphologic, electric and functional parameters. METHODS The study group included children, who lost hearing due to a bacterial meningitis (n = 35 cases). Using preoperative computed tomography and intraoperative findings we grouped into 'unaltered cochleae', 'obliterated cochleae' and 'ossified cochleae'. Control group children suffered from deafness (n = 16) of other aetiology and presented with radiologically unchanged cochleae. Postoperative routine controls documented impedances, stimulation charge and hearing tests a various time points, which all were analysed. RESULTS Control group patients showed a mean impedance of 6.3 kΩ and the mean charge applied was 19 nC. The study group averaged at 7.9 kΩ and 24.6 nC respectively. Patients with ossified cochleae had increased values of 8.6 kΩ and 29.7 nC. The control group reached a monosyllabic word understanding of 74% and the study group of 58%. Patients with ossified cochleae reached 36%. CONCLUSIONS Impedances and stimulation charge influence each other. Increased charge is necessary for higher cochlear implant output. Despite higher charges, patients with obliterated and patients with ossified cochleae significantly perform worse in hearing rehabilitation. Reduced audiological outcome in study group patients without morphologic cochlear changes furthermore hints at additional factors besides cochlear tissue neogenesis like postinflammational changes at the neural pathway.
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Affiliation(s)
- Victor Helmstaedter
- Department of Otorhinolaryngology, Hannover Medical University, Carl-Neuberg-Straße 1, 30625, Hannover, Germany; German Hearing Center, Hannover Medical University, Karl-Wiechert-Allee 3, 30625, Hannover, Germany.
| | - Andreas Buechner
- German Hearing Center, Hannover Medical University, Karl-Wiechert-Allee 3, 30625, Hannover, Germany
| | - Stefan Stolle
- Department of Otorhinolaryngology, Hannover Medical University, Carl-Neuberg-Straße 1, 30625, Hannover, Germany; German Hearing Center, Hannover Medical University, Karl-Wiechert-Allee 3, 30625, Hannover, Germany
| | - Friedrich Goetz
- Department of Neuroradiology, Hannover Medical University, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Thomas Lenarz
- Department of Otorhinolaryngology, Hannover Medical University, Carl-Neuberg-Straße 1, 30625, Hannover, Germany; German Hearing Center, Hannover Medical University, Karl-Wiechert-Allee 3, 30625, Hannover, Germany
| | - Martin Durisin
- Department of Otorhinolaryngology, Hannover Medical University, Carl-Neuberg-Straße 1, 30625, Hannover, Germany; German Hearing Center, Hannover Medical University, Karl-Wiechert-Allee 3, 30625, Hannover, Germany
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The Impact of Postmeningitic Labyrinthitis Ossificans on Speech Performance After Pediatric Cochlear Implantation. Otol Neurotol 2015; 36:1633-7. [DOI: 10.1097/mao.0000000000000877] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lesinski-Schiedat A, Illg A, Heermann R, Bertram B, Lenarz T. Paediatric cochlear implantation in the first and in the second year of life: a comparative study. Cochlear Implants Int 2013; 5:146-59. [DOI: 10.1179/cim.2004.5.4.146] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Hasanalifard M, Ajalloueyan M, Amirsalari S, Saburi A. Outcome of cochlear implantation in post-meningitis deaf children. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:15-7. [PMID: 23486288 PMCID: PMC3589772 DOI: 10.5812/ircmj.3394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 03/10/2012] [Accepted: 04/06/2012] [Indexed: 11/16/2022]
Affiliation(s)
- Mahdiyeh Hasanalifard
- New Hearing Technologies Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Ajalloueyan
- New Hearing Technologies Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Susan Amirsalari
- New Hearing Technologies Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Susan Amirsalari, New Hearing Technologies Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel.: +98-2188600067, E-mail:
| | - Amin Saburi
- New Hearing Technologies Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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Mosnier I, Felice A, Esquia G, Borel S, Bouccara D, Ambert-Dahan E, Smadja M, Ferrary E, Sterkers O. New cochlear implant technologies improve performance in post-meningitic deaf patients. Eur Arch Otorhinolaryngol 2012; 270:53-9. [PMID: 22237762 DOI: 10.1007/s00405-011-1918-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 12/28/2011] [Indexed: 10/14/2022]
Abstract
The objective of the study was to compare the performance of cochlear implantation between post-meningitic and non-meningitic patients, and to evaluate the impact on hearing outcome of technical advances in cochlear implant technology. Retrospective chart review was used as the study design. Twenty adults with post-meningitic profound hearing loss receiving unilateral or bilateral cochlear implants between 1990 and 2008 were tested. Results were compared to a control group of 46 adults implanted for a non-meningitic hearing loss, with the same pre-operative speech scores. Speech scores were poorer in post-meningitic patients compared to those of control group, whatever the duration after implantation (p < 0.0001). Speech scores of subjects implanted and fitted before 2001 were compared to those of subjects implanted after 2001, with the same duration of hearing loss. Performance improved with implants and processors available after 2001, with a magnitude of improvement higher in post-meningitic patients (p < 0.0001 and p < 0.05 in post-meningitic and control groups, respectively, two-way ANOVA). Consequently, speech scores of post-meningitic patients implanted after 2001 achieved those of control subjects (two-way ANOVA). Advances in cochlear implant technology and coding strategy improve hearing outcome in post-meningitic adult patients, who now achieve similar performance as those of non-meningitic patients.
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Affiliation(s)
- Isabelle Mosnier
- Service d'ORL et de Chirurgie cervico-faciale, AP-HP, Hôpital Beaujon, 100 Boulevard du Général Leclerc, 92118, Clichy, France.
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Abstract
OBJECTIVES The study was carried out to assess the role that five hearing history variables (chronological age, age at onset of deafness, age of first cochlear implant [CI] activation, duration of CI use, and duration of known deafness) play in the ability of CI users to identify speaker gender. DESIGN Forty-one juvenile CI users participated in two voice gender identification tasks. In a fixed, single-interval task, subjects listened to a single speech item from one of 20 adult male or 20 adult female speakers and had to identify speaker gender. In an adaptive speech-based voice gender discrimination task with the fundamental frequency difference between the voices as the adaptive parameter, subjects listened to a pair of speech items presented in sequential order, one of which was always spoken by an adult female and the other by an adult male. Subjects had to identify the speech item spoken by the female voice. Correlation and regression analyses between perceptual scores in the two tasks and the hearing history variables were performed. RESULTS Subjects fell into three performance groups: (1) those who could distinguish voice gender in both tasks, (2) those who could distinguish voice gender in the adaptive but not the fixed task, and (3) those who could not distinguish voice gender in either task. Gender identification performance for single voices in the fixed task was significantly and negatively related to the duration of deafness before cochlear implantation (shorter deafness yielded better performance), whereas performance in the adaptive task was weakly but significantly related to age at first activation of the CI device, with earlier activations yielding better scores. CONCLUSIONS The existence of a group of subjects able to perform adaptive discrimination but unable to identify the gender of singly presented voices demonstrates the potential dissociability of the skills required for these two tasks, suggesting that duration of deafness and age of cochlear implantation could have dissociable effects on the development of different skills required by CI users to identify speaker gender.
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Rotteveel L, Snik A, Vermeulen A, Cremers C, Mylanus E. Speech perception in congenitally, pre-lingually and post-lingually deaf children expressed in an equivalent hearing loss value. Clin Otolaryngol 2008; 33:560-9. [DOI: 10.1111/j.1749-4486.2008.01833.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nicholas JG, Geers AE. Expected test scores for preschoolers with a cochlear implant who use spoken language. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2008; 17:121-38. [PMID: 18448600 PMCID: PMC2515171 DOI: 10.1044/1058-0360(2008/013)] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
PURPOSE The major purpose of this study was to provide information about expected spoken language skills of preschool-age children who are deaf and who use a cochlear implant. A goal was to provide "benchmarks" against which those skills could be compared, for a given age at implantation. We also examined whether parent-completed checklists of children's language were correlated with results of standardized language tests and whether scores increased linearly with decreasing age of implantation and increasing duration of cochlear implant use. METHOD Participants were a nationwide sample of 76 children who were deaf and orally educated and who received an implant by 38 months of age. Formal language tests were administered at age 4.5 years. The MacArthur-Bates Communicative Development Inventories (CDI) instrument was completed by parents when children were ages 3.5 and 4.5 years. RESULTS Based on regression analyses, expected scores for each age at implant were provided for 2 commonly administered language tests at 4.5 years of age and CDI subscale scores at 3.5 and 4.5 years. Concurrent test scores were significantly correlated on all measures. A linear relation was found that predicted increasing test scores with younger ages at implantation for all scales administered. CONCLUSIONS While the expected scores reported here should not be considered as normative data, they are benchmarks that may be useful for evaluating spoken language progress of children with cochlear implants who are enrolled in spoken language-based programs.
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Affiliation(s)
- Johanna G Nicholas
- Department of Otolaryngology - Head and Neck Surgery, Box 8115, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, MO 63110, USA.
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Audiological performance in cochlear implanted patients deafened by meningitis depending on duration of deafness. Eur Arch Otorhinolaryngol 2008; 265:381-8. [PMID: 18246365 DOI: 10.1007/s00405-008-0584-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2007] [Accepted: 01/14/2008] [Indexed: 10/22/2022]
Abstract
The objective of our study was to evaluate audiological outcome in cochlear implanted children deafened by meningitis and its correlation with duration of deafness from meningitis in a retrospective clinical study at an academic tertiary referral center. Sixty patients profoundly deafened by meningitis were evaluated. Two groups of children depending on duration of deafness--group 1 defined by duration of deafness less than 6 months and group 2 defined by duration of deafness over 6 months were evaluated. The control group A (duration of deafness <6 months) and group B (duration of deafness >6 months) with similar demographics data and a non-meningitis-related cause of deafness were evaluated. Patient history, cochlear implantation and audiological findings (MAIS, MUSS and open set tests questionnaire) were investigated. Standardized diagnostic and therapeutic procedure was performed in all patients. Our results showed better auditory performance and language control in children implanted within 6 months after meningitis. Over the period of 36 months group 2 was able to catch up with the group 1 in the MUSS and MAIS tests. However, the results of the common phrases test remain significantly better in group 1 over this time period (P=0.0188). In case of meningitis, audiological and radiological assessment should be performed within 4 weeks after the onset of disease. We see a clear indication for immediate implantation in patients with profound SNHL caused by meningitis. The aim should be bilateral implantation in this population to achieve the best possible performance by implantation before obliteration occurs. Premeningetic auditory experience is an important advantage which should be used. Frequent bilateral and sometimes late obliteration should be taken into consideration in the decision-making process as well.
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Nikolopoulos TP, Archbold SM, O'Donoghue GM. Does cause of deafness influence outcome after cochlear implantation in children? Pediatrics 2006; 118:1350-6. [PMID: 17015523 DOI: 10.1542/peds.2006-0502] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The objective of this study was to evaluate long-term speech perception abilities of comparable groups of postmeningitic and congenitally deaf children after cochlear implantation. METHODS This prospective longitudinal study comprised 46 postmeningitic deaf children and 83 congenitally deaf children with age at implantation of < or = 5.6 years. Both groups were comparable with respect to educational setting and mode of communication and included children with additional disabilities. RESULTS Both postmeningitic and congenitally deaf children showed significant progress after implantation. Most (73% and 77%, respectively) could understand conversation without lip-reading or use the telephone with a known speaker 5 years after implantation, whereas none could do so before implantation. At the same interval, the postmeningitic and congenitally deaf children scored a mean open-set speech perception score of 47 (range: 0-91) and 46 (range: 0-107) words per minute, respectively, on connected discourse tracking. The respective mean scores at the 3-year interval were 22 and 29 correct words per minute, respectively. None of these children could score a single correct word per minute before implantation. The progress in both groups was statistically significant. When the 2 groups were compared, there was no statistically significant difference. CONCLUSION Postmeningitic and congenitally deaf children showed significant improvement in their auditory receptive abilities at the 3- and 5-year intervals after cochlear implantation. There was no statistically significant difference between the outcomes of the 2 groups, suggesting that, provided that children receive an implant early, cause of deafness has little influence on outcome. Although the prevalence of other disabilities was similar in both groups, for individual children, their presence may have profound impact. The study supports the concept of implantation early in life, irrespective of the cause of deafness.
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Affiliation(s)
- Thomas P Nikolopoulos
- Department of Otorhinolaryngology, Athens University, Hippokration Hospital, Athens, Greece.
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Lesinski-Schiedat A, Illg A, Warnecke A, Heermann R, Bertram B, Lenarz T. Kochleaimplantation bei Kindern im 1. Lebensjahr. HNO 2006; 54:565-72. [PMID: 15841407 DOI: 10.1007/s00106-005-1260-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The success of cochlear implants in children was followed by a stepwise reduction in age at time of surgery. As a result of newborn hearing-screening (NHS) and the reliable audiologic diagnostic procedure, the question is raised as to whether an implantation before the age of 1 year is effective and safe in terms of surgery and rehabilitation. METHOD AND PATIENTS This retrospective study included 27 children implanted before the age of 1 year (Gr. 1) and 89 children implanted between the age of 1 and 2 years (Gr. 2). Patient related data were analysed for individual history, surgery, rehabilitation and speech understanding. RESULTS The incidence of complications was not increased in Gr. 1. The fitting of a speech processor was effective and uneventful in all children. The development of hearing and speech understanding showed better results after 2 years in Gr. 1. This development is more obvious for absolute age and not to rehabilitation time. CONCLUSION In order to achieve an optimal timing for the development of speech understanding, cochlear implantation should be performed before the age of 2 years. This study revealed no additional risks for children in Gr. 1, but the development of speech understanding was better. As a consequence, cochlear implantation should be considered for very young children with an identified bilateral profound hearing loss.
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Rotteveel LJC, Snik AFM, Vermeulen AM, Mylanus EAM. Three-year follow-up of children with postmeningitic deafness and partial cochlear implant insertion. Clin Otolaryngol 2005; 30:242-8. [PMID: 16111420 DOI: 10.1111/j.1365-2273.2005.00958.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the long-term outcome of children with postmeningitic deafness and partial insertion of the Nucleus electrode array, and to compare their speech perception performance with that of children with full insertion of the electrode array. DESIGN A battery of seven speech perception tests was administered to 25 children with a cochlear implant (CI). Results were reduced into one score: equivalent hearing loss (EHL). SETTING Tertiary referral centre. PARTICIPANTS The partial insertion group comprised seven children, mean age at implantation 5.5 years, mean duration of deafness 3.6 years. The full-insertion control group comprised 18 children. Mean age at implantation: 4.4 years; mean duration of deafness: 2.9 years. All the children became deaf between 0 and 3 years of age. MAIN OUTCOME MEASURES Over a 3-year follow-up period, the children with partial insertion showed continuing progress, although there was wide variation in performance and the rate of progression. Some open-set comprehension could even be achieved with the insertion of only eight electrodes of a nucleus device. RESULTS Three years after implantation, speech perception in the partial insertion children was poorer than that in the control groups with long (P < 0.01; 95% confidence interval 7-43 dB EHL) and short duration of deafness (P < 0.0001; 95% confidence interval 28-53 dB EHL). They showed slower progress and reached a poorer EHL plateau. Four of the seven children acquired open-set word recognition. CONCLUSIONS Patients with partial insertion of the electrode array benefit from a CI, although less than patients with complete insertion.
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Affiliation(s)
- L J C Rotteveel
- Department of Otorhinolaryngology, University Medical Centre Nijmegen, The Netherlands.
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Bevilacqua MC, Moret ALM, Costa Filho OA, Nascimento LT, Banhara MR. Implantes cocleares em crianças portadoras de deficiência auditiva decorrente de meningite. ACTA ACUST UNITED AC 2003. [DOI: 10.1590/s0034-72992003000600006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A meningite é a principal causa de deficiência auditiva neurossensorial adquirida, o paciente pode apresentar ao mesmo tempo déficit motor, distúrbio visual, distúrbio de linguagem, déficit vestibular, déficit de atenção e incapacidade para a aprendizagem. Caracteristicamente a deficiência auditiva pós-meningite é sensorioneural, profunda, bilateral, simétrica e descendente, mais comum no sexo masculino e em crianças abaixo de 5 anos e traz não só graves implicações quanto ao desenvolvimento social e emocional dos sujeitos por ela afetados, como também sérias alterações na linguagem oral já adquirida e/ou em estágio de aquisição. OBJETIVO: O trabalho objetiva realizar um estudo comparativo de um grupo de crianças com deficiência auditiva sensorioneural devido a meningite e um grupo de crianças com deficiência auditiva sensorioneural de etiologias diversas, implantadas no período pré-lingual, na faixa etária de 1 ano e 10 meses a 6 anos. FORMA DE ESTUDO: Coorte transversal. MATERIAL E MÉTODO: Foram avaliadas 63 crianças com deficiência auditiva neurossensorial profunda bilateral pré-lingual, usuárias de implante coclear multicanal, sendo 25 (40%) do sexo masculino 38 (60%) do sexo feminino. Em 12 casos (19%) a deficiência auditiva foi decorrente da meningite e em 51 casos (81%) de outras etiologias. Todos os indivíduos selecionados foram submetidos a avaliações otorrinolaringológicas e audiológicas clínicas e objetivas. CONCLUSÕES: A ocorrência de inserção parcial dos eletrodos foi maior no grupo com deficiência auditiva pós-meningite. Não houve diferenças estatisticamente significantes quanto ao reconhecimento de palavras e fonemas e nos questionários de avaliação das habilidades auditivas (MAIS) e de linguagem (MUSS) entre os grupos estudados.
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Matsushiro N, Doi K, Fuse Y, Nagai K, Yamamoto K, Iwaki T, Kawashima T, Sawada A, Hibino H, Kubo T. Successful cochlear implantation in prelingual profound deafness resulting from the common 233delC mutation of the GJB2 gene in the Japanese. Laryngoscope 2002; 112:255-61. [PMID: 11889380 DOI: 10.1097/00005537-200202000-00011] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Recently, we identified three novel mutations of the GJB2 gene in Japanese families with autosomal-recessive non-syndromic deafness.1 Seven of 11 mutated chromosomes (63.6%) contained a 233delC allele, suggesting that the 233delC mutation is the most common mutation of the GJB2 gene in the Japanese population. After it was recognized that cochlear implantation (CI) is of benefit to children with prelingual deafness, we have had a number of prelingual pediatric CI patients. Because children carrying the homozygous 233delC mutation show bilateral prelingual profound deafness, they could be enrolled in the CI program at Osaka University Graduate School of Medicine. The purposes of this study were 1) to analyze the occurrence of the GJB2 mutations in our 15 prelingual pediatric CI patients in whom the cause of non-syndromic deafness was unknown, and 2) to evaluate the auditory function and postoperative speech perception with CI of those GJB2-related deaf subjects. STUDY DESIGN Retrospective analysis. METHODS Mutation analysis of the GJB2 gene by direct sequencing was performed with genomic DNA from 15 children born profoundly deaf as a result of unknown causes and implanted with CI. Intraoperative electrically evoked auditory brainstem response (EABR) and intra-/postoperative EAP were measured. The speech perception was evaluated with Infants and Toddlers Meaningful Auditory Integration Scale (IT-MAIS). RESULTS AND CONCLUSIONS We identified 4 CI patients (26.7%) out of 15 children carrying the homozygous 233delC mutation. Intra- and postoperative evaluation of the auditory system revealed almost intact cochlear and retrocochlear auditory function in these 4 patients. Postoperative auditory testing indicates that their speech perception had become significantly higher in comparison with that of other prelingual CI patients. These results suggest that prelingual deaf children carrying the homozygous 233delC mutation of the GJB2 gene can benefit from CI.
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Affiliation(s)
- Naoki Matsushiro
- Department of Otolaryngology and Sensory Organ Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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