Effect of Increased Daily Cochlear Implant Use on Auditory Perception in Adults

Author(s):  
Jourdan T. Holder ◽  
René H. Gifford

Purpose Despite the recommendation for cochlear implant (CI) processor use during all waking hours, variability in average daily wear time remains high. Previous work has shown that objective wear time is significantly correlated with speech recognition outcomes. We aimed to investigate the causal link between daily wear time and speech recognition outcomes and assess one potential underlying mechanism, spectral processing, driving the causal link. We hypothesized that increased CI use would result in improved speech recognition via improved spectral processing. Method Twenty adult CI recipients completed two study visits. The baseline visit included auditory perception testing (speech recognition and spectral processing measures), questionnaire administration, and documentation of data logging from the CI software. Participants watched an educational video, and they were informed of the compensation schedule. Participants were then asked to increase their daily CI use over a 4-week period during everyday life. Baseline measures were reassessed following the 4-week period. Results Seventeen out of 20 participants increased their daily CI use. On average, participants’ speech recognition improved by 3.0, 2.4, and 7.0 percentage points per hour of increased average daily CI use for consonant–nucleus–consonant words, AzBio sentences, and AzBio sentences in noise, respectively. Questionnaire scores were similar between visits. Spectral processing showed significant improvement and accounted for a small amount of variance in the change in speech recognition values. Conclusions Improved consistency of processor use over a 4-week period yielded significant improvements in speech recognition scores. Though a significant factor, spectral processing is likely not the only mechanism driving improvement in speech recognition; further research is warranted.

2021 ◽  
pp. 1-11
Author(s):  
Stefanie Bruschke ◽  
Uwe Baumann ◽  
Timo Stöver

Background: The cochlear implant (CI) is a standard procedure for the treatment of patients with severe to profound hearing loss. In the past, a standard healing period of 3–6 weeks occurred after CI surgery before the sound processor was initially activated. Advancements of surgical techniques and instruments allow an earlier initial activation of the processor within 14 days after surgery. Objective: Evaluation of the early CI device activation after CI surgery within 14 days, comparison to the first activation after 4–6 weeks, and assessment of the feasibility and safety of the early fitting over a 12 month observation period were the objectives of this study. Method: In a prospective study, 127 patients scheduled for CI surgery were divided into early fitting group (EF, n = 67) and control group (CG, n = 60). Individual questionnaires were used to evaluate medical and technical outcomes of the EF. Medical side effects, speech recognition, and follow-up effort were compared with the CG within the first year after CI surgery. Results: The early fitting was feasible in 97% of the EF patients. In the EF, the processor was activated 25 days earlier than in the CG. No major complications were observed in either group. At the follow-up appointments, side effects such as pain and balance problems occurred with comparable frequency in both groups. At initial fitting, the EF showed a significantly higher incidence of medical minor complications (p < 0.05). When developing speech recognition within the first year of CI use, no difference was observed. Furthermore, the follow-up effort within the first year after CI surgery was comparable in both groups. Conclusions: Early fitting of the sound processor is a feasible and safe procedure with comparable follow-up effort. Although more early minor complications were observed in the EF, there were no long-term wound healing problems caused by the early fitting. Regular inspection of the magnet strength is recommended as part of the CI follow-up since postoperative wound swelling must be expected. The early fitting procedure enabled a clear reduction in the waiting time between CI surgery and initial sound processor activation.


2021 ◽  
Vol 404 ◽  
pp. 108206
Author(s):  
Kelly Vasconcelos Chaves Martins ◽  
Maria Valéria Schmidt Goffi-Gomez ◽  
Robinson Koji Tsuji ◽  
Ricardo Ferreira Bento

Author(s):  
Claire Marcus Bernstein ◽  
Diane Majerus Brewer ◽  
Matthew H. Bakke ◽  
Anne D. Olson ◽  
Elizabeth Jackson Machmer ◽  
...  

Abstract Background Increasing numbers of adults are receiving cochlear implants (CIs) and many achieve high levels of speech perception and improved quality of life. However, a proportion of implant recipients still struggle due to limited speech recognition and/or greater communication demands in their daily lives. For these individuals a program of aural rehabilitation (AR) has the potential to improve outcomes. Purpose The study investigated the effects of a short-term AR intervention on speech recognition, functional communication, and psychosocial outcomes in post lingually deafened adult CI users. Research Design The experimental design was a multisite clinical study with participants randomized to either an AR treatment or active control group. Each group completed 6 weekly 90-minute individual treatment sessions. Assessments were completed pretreatment, 1 week and 2 months post-treatment. Study Sample Twenty-five post lingually deafened adult CI recipients participated. AR group: mean age 66.2 (48–80); nine females, four males; months postactivation 7.7 (3–16); mean years severe to profound deafness 18.4 (2–40). Active control group: mean age 62.8 (47–85); eight females, four males; months postactivation 7.0 (3–13); mean years severe to profound deafness 18.8 (1–55). Intervention The AR protocol consisted of auditory training (words, sentences, speech tracking), and psychosocial counseling (informational and communication strategies). Active control group participants engaged in cognitive stimulation activities (e.g., crosswords, sudoku, etc.). Data Collection and Analysis Repeated measures ANOVA or analysis of variance, MANOVA or multivariate analysis of variance, and planned contrasts were used to compare group performance on the following measures: CasperSent; Hearing Handicap Inventory; Nijmegen Cochlear Implant Questionnaire; Client Oriented Scale of Improvement; Glasgow Benefit Inventory. Results The AR group showed statistically significant improvements on speech recognition performance, psychosocial function, and communication goals with no significant improvement seen in the control group. The two groups were statistically equivalent on all outcome measures at preassessment. The robust improvements for the AR group were maintained at 2 months post-treatment. Conclusion Results of this clinical study provide evidence that a short-term AR intervention protocol can maximize outcomes for adult post lingually deafened CI users. The impact of this brief multidimensional AR intervention to extend CI benefit is compelling, and may serve as a template for best practices with adult CI users.


2021 ◽  
Author(s):  
Alexander T. Murr ◽  
Michael W. Canfarotta ◽  
Brendan P. O'Connell ◽  
Emily Buss ◽  
English R. King ◽  
...  

2019 ◽  
Vol 40 (3) ◽  
pp. 621-635 ◽  
Author(s):  
Arlene C. Neuman ◽  
Annette Zeman ◽  
Jonathan Neukam ◽  
Binhuan Wang ◽  
Mario A. Svirsky

2008 ◽  
Vol 19 (02) ◽  
pp. 120-134 ◽  
Author(s):  
Kate Gfeller ◽  
Jacob Oleson ◽  
John F. Knutson ◽  
Patrick Breheny ◽  
Virginia Driscoll ◽  
...  

The research examined whether performance by adult cochlear implant recipients on a variety of recognition and appraisal tests derived from real-world music could be predicted from technological, demographic, and life experience variables, as well as speech recognition scores. A representative sample of 209 adults implanted between 1985 and 2006 participated. Using multiple linear regression models and generalized linear mixed models, sets of optimal predictor variables were selected that effectively predicted performance on a test battery that assessed different aspects of music listening. These analyses established the importance of distinguishing between the accuracy of music perception and the appraisal of musical stimuli when using music listening as an index of implant success. Importantly, neither device type nor processing strategy predicted music perception or music appraisal. Speech recognition performance was not a strong predictor of music perception, and primarily predicted music perception when the test stimuli included lyrics. Additionally, limitations in the utility of speech perception in predicting musical perception and appraisal underscore the utility of music perception as an alternative outcome measure for evaluating implant outcomes. Music listening background, residual hearing (i.e., hearing aid use), cognitive factors, and some demographic factors predicted several indices of perceptual accuracy or appraisal of music. La investigación examinó si el desempeño, por parte de adultos receptores de un implante coclear, sobre una variedad de pruebas de reconocimiento y evaluación derivadas de la música del mundo real, podrían predecirse a partir de variables tecnológicas, demográficas y de experiencias de vida, así como de puntajes de reconocimiento del lenguaje. Participó una muestra representativa de 209 adultos implantados entre 1965 y el 2006. Usando múltiples modelos de regresión lineal y modelos mixtos lineales generalizados, se seleccionaron grupos de variables óptimas de predicción, que pudieran predecir efectivamente el desempeño por medio de una batería de pruebas que permitiera evaluar diferentes aspectos de la apreciación musical. Estos análisis establecieron la importancia de distinguir entre la exactitud en la percepción musical y la evaluación de estímulos musicales cuando se utiliza la apreciación musical como un índice de éxito en la implantación. Importantemente, ningún tipo de dispositivo o estrategia de procesamiento predijo la percepción o la evaluación musical. El desempeño en el reconocimiento del lenguaje no fue un elemento fuerte de predicción, y llegó a predecir primariamente la percepción musical cuando los estímulos de prueba incluyeron las letras. Adicionalmente, las limitaciones en la utilidad de la percepción del lenguaje a la hora de predecir la percepción y la evaluación musical, subrayan la utilidad de la percepción de la música como una medida alternativa de resultado para evaluar la implantación coclear. La música de fondo, la audición residual (p.e., el uso de auxiliares auditivos), los factores cognitivos, y algunos factores demográficos predijeron varios índices de exactitud y evaluación perceptual de la música.


2017 ◽  
Vol 18 (6) ◽  
pp. 324-334 ◽  
Author(s):  
Kara C. Schvartz-Leyzac ◽  
Teresa A. Zwolan ◽  
Bryan E. Pfingst

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