scholarly journals Long‐term outcomes of cochlear implantation in patients with high‐frequency hearing loss

2018 ◽  
Vol 128 (8) ◽  
pp. 1939-1945 ◽  
Author(s):  
J. Thomas Roland ◽  
Bruce J. Gantz ◽  
Susan B. Waltzman ◽  
Aaron J. Parkinson
2012 ◽  
Vol 23 (01) ◽  
pp. 005-017 ◽  
Author(s):  
Alyce I. Breneman ◽  
René H. Gifford ◽  
Melissa D. DeJong

Background: Best practices concerning the audiological management of the child diagnosed with auditory neuropathy spectrum disorder (ANSD) have not been definitively defined nor fully understood. One reason is that previous studies have demonstrated conflicting findings regarding the outcomes of cochlear implantation for children with ANSD. Thus, the question remains whether children with ANSD are able to achieve similar outcomes following cochlear implantation as those children with sensorineural hearing loss (SNHL). Purpose: To assess speech perception outcomes for children with cochlear implants who have a diagnosis of ANSD as well as their age-matched peers who have sensorineural hearing loss. Research Design: Retrospective study Study Sample: Thirty-five subject pairs (n = 70) ranging in age at implant activation from to 10 to 121 mo (mean 39.2 mo) were included in this retrospective study. Subjects were matched on variables including age at initial implant activation and months of implant use at postoperative test point. Data Collection and Analysis: Speech recognition scores for monosyllabic and multisyllabic stimuli were compared across the subject groups. For those not developmentally and/or linguistically ready for completion of open-set speech recognition testing with recorded stimuli, GASP (Glendonald Auditory Screening Procedure) word recognition and/or questionnaire data using either the LittlEARS or Meaningful Auditory Integration Scale were compared across the groups. Statistical analysis using a repeated-measures analysis of variance (ANOVA) evaluated the effects of etiology (ANSD or SNHL) on postoperative outcomes. Results: The results of this study demonstrate that children with ANSD can clearly benefit from cochlear implantation and that their long-term outcomes are similar to matched peers with SNHL on measures of speech recognition. There were no significant differences across the ANSD and SNHL groups on any of the tested measures. Conclusion: Cochlear implantation is a viable treatment option for children with a diagnosis of ANSD who are not making auditory progress with hearing aids that have been fit using the Desired Sensation Level method (DSL v5.0). Expected outcomes of cochlear implantation for children with ANSD, excluding children with cochlear nerve deficiency, are no different than for children with non-ANSD SNHL. These results are important for counseling families on the expected outcomes and realistic expectations following cochlear implantation for children with ANSD who demonstrate no evidence of cochlear nerve deficiency.


2013 ◽  
Vol 24 (08) ◽  
pp. 671-683 ◽  
Author(s):  
Ying-Hui Lai ◽  
Pei-Chun Li ◽  
Kuen-Shian Tsai ◽  
Woei-Chyn Chu ◽  
Shuenn-Tsong Young

Background: Multichannel wide-dynamic-range compression (WDRC) is a widely adopted amplification scheme in modern digital hearing aids. It attempts to provide individuals with loudness recruitment with superior speech intelligibility and greater listening comfort over a wider range of input levels. However, recent surveys have shown that compression processing (operating in the nonlinear regime) usually reduces the long-term signal-to-noise ratio (SNR). Purpose: The purpose of this study was to determine the long-term SNR in an adaptive compression-ratio (CR) amplification scheme called adaptive wide-dynamic-range compression (AWDRC), and to determine whether this concept is better than static WDRC amplification at improving the long-term SNR for speech in noise. Design and Study Sample: AWDRC uses the input short-term dynamic range to adjust the CR to maximize audibility and comfort. Various methods for evaluating the long-term SNR were used to observe the relationship between the CR and output SNR performance in AWDRC for seven typical audiograms, and to compare the results with those for static WDRC amplification. Results: The results showed that the variation of the CR in AWDRC amplification can maintain the comfort and audibility of the output sound. In addition, the average long-term SNR improved by 0.1–5.5 dB for a flat hearing loss, by 0.2–3.4 dB for a reverse sloping hearing loss, by 1.4–4.8 dB for a high-frequency hearing loss, and by 0.3–5.7 dB for a mild-to-moderate-sloping high-frequency hearing loss relative to static WDRC amplification. The output long-term SNR differed significantly (p < .001) between static WDRC and AWDRC amplification. Conclusions: The results of this study show that AWDRC, which uses the characteristics of the input signal to adaptively adjust the CR, provides better long-term SNR performance than static WDRC amplification.


1968 ◽  
Vol 11 (1) ◽  
pp. 204-218 ◽  
Author(s):  
Elizabeth Dodds ◽  
Earl Harford

Persons with a high frequency hearing loss are difficult cases for whom to find suitable amplification. We have experienced some success with this problem in our Hearing Clinics using a specially designed earmold with a hearing aid. Thirty-five cases with high frequency hearing losses were selected from our clinical files for analysis of test results using standard, vented, and open earpieces. A statistical analysis of test results revealed that PB scores in sound field, using an average conversational intensity level (70 dB SPL), were enhanced when utilizing any one of the three earmolds. This result was due undoubtedly to increased sensitivity provided by the hearing aid. Only the open earmold used with a CROS hearing aid resulted in a significant improvement in discrimination when compared with the group’s unaided PB score under earphones or when comparing inter-earmold scores. These findings suggest that the inclusion of the open earmold with a CROS aid in the audiologist’s armamentarium should increase his flexibility in selecting hearing aids for persons with a high frequency hearing loss.


Author(s):  
Wei Gong ◽  
Liangliang Zhao ◽  
Ling Li ◽  
Thais C. Morata ◽  
Wei Qiu ◽  
...  

A survey was administered to 385 noise-exposed workers from an auto parts factory and 1268 non-noise-exposed health department employees in China. Individual 8 h A-weighted equivalent sound levels (LAeq,8h), earplug personal attenuation ratings (PARs), and pure-tone audiometric tests were performed. The average LAeq,8h of noise-exposed workers was 87 dB (A) with a mean PAR of 7 dB. The prevalence of high-frequency hearing loss was 65% for noise-exposed workers and 33% for the non-noise-exposed employees. The use of earplugs had no observable effect on the prevalence of high-frequency hearing loss of the study participants (OR 0.964, 95% CI 0.925–1.005, p = 0.085). No significant relationship between the effectiveness offered by earplug use and high-frequency hearing thresholds at 3, 4, and 6 kHz was found (t = −1.54, p = 0.125). The mandatory requirement of earplug use without individualized training on how to wear HPDs correctly had no detectable effect on the prevention of hearing loss at the auto parts factory. The hearing conservation program at the surveyed factory was not effective. Periodic hearing tests, earplug fit testing, expanding the offer of different types of hearing protection, and employee education about the importance of protecting their hearing were recommended to the occupational health and safety program.


1998 ◽  
Vol 79 (5) ◽  
pp. 2603-2614 ◽  
Author(s):  
Stephanie Carlson ◽  
James F. Willott

Carlson, Stephanie and James F. Willott. Caudal pontine reticular formation of C57BL/6J mice: responses to startle stimuli, inhibition by tones, and plasticity. J. Neurophysiol. 79: 2603–2614, 1998. C57BL/6J (C57) mice were used to examine relationships between the behavioral acoustic startle response (ASR) and the responses of neurons in the caudal pontine reticular formation (PnC) in three contexts: 1) responses evoked by basic startle stimuli; 2) the prepulse inhibition (PPI) paradigm; and 3) the effects of high-frequency hearing loss and concomitant neural plasticity that occurs in middle-aged C57 mice. 1) Responses (evoked action potentials) of PnC neurons closely paralleled the ASR with respect to latency, threshold, and responses to rapidly presented stimuli. 2) “Neural PPI” (inhibition of responses evoked by a startle stimulus when preceded by a tone prepulse) was observed in all PnC neurons studied. 3) In PnC neurons of 6-mo-old mice with high-frequency (>20 kHz) hearing loss, neural PPI was enhanced with 12- and 4-kHz prepulses, as it is behaviorally. These are frequencies that have become “overrepresented” in the central auditory system of 6-mo-old C57 mice. Thus neural plasticity in the auditory system, induced by high-frequency hearing loss, is correlated with increased salience of the inhibiting tones in both behavioral and neural PPI paradigms.


PLoS ONE ◽  
2016 ◽  
Vol 11 (3) ◽  
pp. e0151467 ◽  
Author(s):  
Abhijit Dandapat ◽  
Benjamin J. Perrin ◽  
Christine Cabelka ◽  
Maria Razzoli ◽  
James M. Ervasti ◽  
...  

2017 ◽  
Vol 28 (10) ◽  
pp. 913-919 ◽  
Author(s):  
Margaret A. Meredith ◽  
Jay T. Rubinstein ◽  
Kathleen C. Y. Sie ◽  
Susan J. Norton

Background: Children with steeply sloping sensorineural hearing loss (SNHL) lack access to critical high-frequency cues despite the use of advanced hearing aid technology. In addition, their auditory-only aided speech perception abilities often meet Food and Drug Administration criteria for cochlear implantation. Purpose: The objective of this study was to describe hearing preservation and speech perception outcomes in a group of young children with steeply sloping SNHL who received a cochlear implant (CI). Research Design: Retrospective case series. Study Sample: Eight children with steeply sloping postlingual progressive SNHL who received a unilateral traditional CI at Seattle Children’s Hospital between 2009 and 2013 and had follow-up data available up to 24 mo postimplant were included. Data Collection and Analysis: A retrospective chart review was completed. Medical records were reviewed for demographic information, preoperative and postoperative behavioral hearing thresholds, and speech perception scores. Paired t tests were used to analyze speech perception data. Hearing preservation results are reported. Results: Rapid improvement of speech perception scores was observed within the first month postimplant for all participants. Mean monosyllabic word scores were 76% and mean phoneme scores were 86.7% at 1-mo postactivation compared to mean preimplant scores of 19.5% and 31.0%, respectively. Hearing preservation was observed in five participants out to 24-mo postactivation. Two participants lost hearing in both the implanted and unimplanted ear, and received a sequential bilateral CI in the other ear after progression of the hearing loss. One participant had a total loss of hearing in only the implanted ear. Results reported in this article are from the ear implanted first. Bilateral outcomes are not reported. Conclusions: CIs provided benefit for children with steeply sloping bilateral hearing loss for whom hearing aids did not provide adequate auditory access. In our cohort, significant improvements in speech understanding occurred rapidly postactivation. Preservation of residual hearing in children with a traditional CI electrode is possible.


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