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Shepherd R, Gantz B. Hearing preservation in cochlear implantation. Hear Res 2023; 434:108787. [PMID: 37167888 DOI: 10.1016/j.heares.2023.108787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Affiliation(s)
- Robert Shepherd
- Medical Bionics Department, University of Melbourne and the Bionics Institute.
| | - Bruce Gantz
- Department of Otolaryngology, University of Iowa
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Racca JM, Jones LL, Dwyer RT, Ferguson M, Sunderhaus L, Hood LJ, Gifford RH. Changes in Acoustic Absorbance Pre- and Post-Cochlear Implantation. Am J Audiol 2022; 31:380-391. [PMID: 35549520 PMCID: PMC9524757 DOI: 10.1044/2022_aja-21-00146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Until recently, there has been little investigation on the effects of cochlear implantation on the transmission of acoustic stimuli through the middle-ear system. Recent studies have shown that cochlear implantation decreases low-frequency acoustic absorbance, consistent with a stiffer middle-ear system postsurgery. The objectives of this study are (a) to investigate the time course of changes in acoustic absorbance post-cochlear implantation in the implanted ear and (b) to compare changes in acoustic absorbance between implanted and nonimplanted ears over time. METHOD Seventeen adult cochlear implant (CI) recipients within 6 months of device activation participated in this study. Wideband acoustic absorbance was measured in both ears at one to six different time points from pre-implantation up to 6-month postactivation. Analyses examined (a) changes in acoustic absorbance as compared to pre-implantation and (b) differences in acoustic absorbance between implanted and nonimplanted ears over time. RESULTS Acoustic absorbance in the implanted ear decreased postsurgery for frequencies lower than 1.5 kHz and persisted through at least 6-month postactivation. We also observed that the spectral range of decreased acoustic absorbance in the implanted ear decreased with longer time postsurgery. Differences in acoustic absorbance between implanted and nonimplanted ears occurred over a broad spectral range at the activation time point and persisted through at least 3-month postactivation, though for a narrower spectral range at the later time point. CONCLUSIONS Cochlear implantation increased middle-ear stiffness as indicated by decreased acoustic absorbance of low-frequency acoustic power. The findings of this study are consistent with those of previous studies and may have important implications toward understanding spatial hearing and programming of acoustic components for CI-combined electric and binaural acoustic stimulation patients.
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Affiliation(s)
- Jordan M. Racca
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN,Department of Radiology, Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN
| | - Laura L. Jones
- Department of Audiology, MedStar Georgetown University Hospital, Washington, DC
| | - Robert T. Dwyer
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN,Advanced Bionics LLC, Valencia, CA
| | - Mary Ferguson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Linsey Sunderhaus
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Linda J. Hood
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - René H. Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
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Dhanasingh A, Hochmair I. Bilateral cochlear implantation. Acta Otolaryngol 2021; 141:1-21. [PMID: 33818259 DOI: 10.1080/00016489.2021.1888193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Binaural hearing has certain benefits while listening in noisy environments. It provides the listeners with access to time, level and spectral differences between sound signals, perceived by the two ears. However, single sided deaf (SSD) or unilateral cochlear implant (CI) users cannot experience these binaural benefits due to the acoustic input coming from a single ear. The translational research on bilateral CIs started in the year 1998, initiated by J. Müller and J. Helms from Würzburg, Germany in association with MED-EL. Since then, several clinical studies were conducted by different research groups from across the world either independently or in collaboration with MED-EL. As a result, the bilateral CI has become the standard of care in many countries along with reimbursement by the health care systems. Recent data shows that children particularly, are given high priority for the bilateral CI implantation, most often performed simultaneously in a single surgery, as the binaural hearing has a positive effect on their language development. This article covers the milestones of translational research from the first concept to the widespread clinical use of bilateral CI.
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Affiliation(s)
| | - Ingeborg Hochmair
- MED-EL Elektromedizinische Geraete Gesellschaft m.b.H., Innsbruck, Austria
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Péus D, Pfluger A, Häussler SM, Knopke S, Ketterer MC, Szczepek AJ, Gräbel S, Olze H. Single-centre experience and practical considerations of the benefit of a second cochlear implant in bilaterally deaf adults. Eur Arch Otorhinolaryngol 2020; 278:2289-2296. [PMID: 32889623 PMCID: PMC8165073 DOI: 10.1007/s00405-020-06315-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/20/2020] [Indexed: 11/25/2022]
Abstract
Purpose Bilateral cochlear implant (CI) implantation is increasingly used in the auditory rehabilitation of bilaterally deafened adults. However, after successful unilateral implantation, objective patient counselling is essential. Methods We investigated the extra benefit of a second CI in adults in terms of health-related quality of life, tinnitus, stress, anxiety, depression, quality of hearing, and speech recognition. Hearing ability was assessed by using the Freiburg monosyllable speech discrimination test (FB MS) and the Oldenburg sentence test with azimuth variations. In a prospective patient cohort, we administered validated questionnaires before a CI, after a first CI and after a second CI implantation. Results The study included 29 patients, made up of nine women and 20 men. The median time between the first and the second implantation was 23 months. The mean total NCIQ score and TQ before a CI improved significantly after both implantations. Stress, anxiety, and depression were stable over time and were not significantly affected by CI implantations. Speech recognition with noise significantly improved after the first and again after the second CI. Correlation analysis showed a strong connection between auditory performance and HRQoL. Conclusion We demonstrated that a unilateral CI benefitted many fields and that the second sequential CI leads again to additional improvement. Bilateral CI implantation should, therefore, be the standard form of auditory rehabilitation in deafened adults.
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Affiliation(s)
- Dominik Péus
- Department of Otorhinolaryngology, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.,Department of Otorhinolaryngology, Kantonsspital Baselland, Liestal, Switzerland
| | - Andreas Pfluger
- Department of Otorhinolaryngology, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Sophia Marie Häussler
- Department of Otorhinolaryngology, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Steffen Knopke
- Department of Otorhinolaryngology, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Manuel Christoph Ketterer
- Department of Otorhinolaryngology, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Agnieszka J Szczepek
- Department of Otorhinolaryngology, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Stefan Gräbel
- Department of Otorhinolaryngology, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Heidi Olze
- Department of Otorhinolaryngology, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
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Usami SI, Nishio SY, Moteki H, Miyagawa M, Yoshimura H. Cochlear Implantation From the Perspective of Genetic Background. Anat Rec (Hoboken) 2020; 303:563-593. [PMID: 32027099 PMCID: PMC7064903 DOI: 10.1002/ar.24360] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 12/13/2019] [Indexed: 12/18/2022]
Abstract
While cochlear implantation (CI) technology has greatly improved over the past 40 years, one aspect of CI that continues to pose difficulties is the variability of outcomes due to numerous factors involved in postimplantation performance. The electric acoustic stimulation (EAS) system has expanded indications for CI to include patients with residual hearing, and is currently becoming a standard therapy for these patients. Genetic disorders are known to be the most common cause of congenital/early-onset sensorineural hearing loss, and are also involved in a considerable proportion of cases of late-onset hearing loss. There has been a great deal of progress in the identification of deafness genes over the last two decades. Currently, more than 100 genes have been reported to be associated with non-syndromic hearing loss. Patients possessing a variety of deafness gene mutations have achieved satisfactory auditory performance after CI/EAS, suggesting that identification of the genetic background facilitates prediction of post-CI/EAS performance. When the intra-cochlear etiology is associated with a specific genetic background, there is a potential for good CI performance. Thus, it is essential to determine which region of the cochlea is affected by identifying the responsible genes. This review summarizes the genetic background of the patients receiving CI/EAS, and introduces detailed clinical data and CI/EAS outcomes in representative examples. Anat Rec, 303:563-593, 2020. © 2020 The Authors. The Anatomical Record published by Wiley Periodicals, Inc. on behalf of American Association of Anatomists.
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Affiliation(s)
- Shin-Ichi Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan.,Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shin-Ya Nishio
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan.,Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hideaki Moteki
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Maiko Miyagawa
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hidekane Yoshimura
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan.,Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
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Gifford RH, Loiselle L, Natale S, Sheffield SW, Sunderhaus LW, S. Dietrich M, Dorman MF. Speech Understanding in Noise for Adults With Cochlear Implants: Effects of Hearing Configuration, Source Location Certainty, and Head Movement. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1306-1321. [PMID: 29800361 PMCID: PMC6195075 DOI: 10.1044/2018_jslhr-h-16-0444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 07/27/2017] [Accepted: 02/04/2018] [Indexed: 05/11/2023]
Abstract
Purpose The primary purpose of this study was to assess speech understanding in quiet and in diffuse noise for adult cochlear implant (CI) recipients utilizing bimodal hearing or bilateral CIs. Our primary hypothesis was that bilateral CI recipients would demonstrate less effect of source azimuth in the bilateral CI condition due to symmetric interaural head shadow. Method Sentence recognition was assessed for adult bilateral (n = 25) CI users and bimodal listeners (n = 12) in three conditions: (1) source location certainty regarding fixed target azimuth, (2) source location uncertainty regarding roving target azimuth, and (3) Condition 2 repeated, allowing listeners to turn their heads, as needed. Results (a) Bilateral CI users exhibited relatively similar performance regardless of source azimuth in the bilateral CI condition; (b) bimodal listeners exhibited higher performance for speech directed to the better hearing ear even in the bimodal condition; (c) the unilateral, better ear condition yielded higher performance for speech presented to the better ear versus speech to the front or to the poorer ear; (d) source location certainty did not affect speech understanding performance; and (e) head turns did not improve performance. The results confirmed our hypothesis that bilateral CI users exhibited less effect of source azimuth than bimodal listeners. That is, they exhibited similar performance for speech recognition irrespective of source azimuth, whereas bimodal listeners exhibited significantly poorer performance with speech originating from the poorer hearing ear (typically the nonimplanted ear). Conclusions Bilateral CI users overcame ear and source location effects observed for the bimodal listeners. Bilateral CI users have access to head shadow on both sides, whereas bimodal listeners generally have interaural asymmetry in both speech understanding and audible bandwidth limiting the head shadow benefit obtained from the poorer ear (generally the nonimplanted ear). In summary, we found that, in conditions with source location uncertainty and increased ecological validity, bilateral CI performance was superior to bimodal listening.
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Affiliation(s)
| | - Louise Loiselle
- Arizona State University, Tempe, AZ
- MED-EL Corporation, Durham, NC
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Hybrid cochlear implantation: quality of life, quality of hearing, and working performance compared to patients with conventional unilateral or bilateral cochlear implantation. Eur Arch Otorhinolaryngol 2017; 274:3599-3604. [DOI: 10.1007/s00405-017-4690-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/25/2017] [Indexed: 11/27/2022]
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Masking release with changing fundamental frequency: Electric acoustic stimulation resembles normal hearing subjects. Hear Res 2017; 350:226-234. [DOI: 10.1016/j.heares.2017.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/04/2017] [Accepted: 05/08/2017] [Indexed: 11/20/2022]
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