scholarly journals Electric and Acoustic Stimulation in Cochlear Implant Recipients with Hearing Preservation

2018 ◽  
Vol 39 (04) ◽  
pp. 414-427 ◽  
Author(s):  
Christopher Welch ◽  
Margaret Dillon ◽  
Harold Pillsbury
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Cochlear Implant ◽  
Hearing Aids ◽  
High Frequency ◽  
Low Frequency ◽  
Hearing Preservation ◽  
The United States ◽  
Acoustic Stimulation ◽  
Electric Hearing

AbstractHearing loss affects 30 million people in the United States, and a subset of these patients have normal low-frequency hearing and ski-sloped high-frequency hearing loss. For these patients, hearing aids alone may not provide adequate benefit. Cochlear implantation alone has been utilized to improve speech perception. The addition of high-frequency electric hearing to low-frequency acoustic hearing in these patients is beneficial. Technical improvements have allowed preservation of low-frequency hearing in cochlear implant recipients, allowing for electric and acoustic stimulation in the same ear with significant improvements in speech perception, sound localization, music appreciation, and quality of life.

Cochlear Implantation in Children with Postlingual Progressive Steeply Sloping High-Frequency Hearing Loss

2017 ◽  
Vol 28 (10) ◽  
pp. 913-919 ◽  
Author(s):  
Margaret A. Meredith ◽  
Jay T. Rubinstein ◽  
Kathleen C. Y. Sie ◽  
Susan J. Norton
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Aids ◽  
Cochlear Implantation ◽  
High Frequency ◽  
Case Series ◽  
Hearing Preservation ◽  
Rapid Improvement ◽  
Retrospective Case ◽  
Monosyllabic Word

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.

Hearing Preservation Cochlear Implants: A Review of Potential Mechanisms of Hearing Loss After Implantation

2017 ◽  
Vol 2 (6) ◽  
pp. 54-63
Author(s):  
Conor Kelly ◽  
Lina A. J. Reiss
Keyword(s):  
Hearing Loss ◽  
Cochlear Implants ◽  
High Frequency ◽  
Music Perception ◽  
Low Frequency ◽  
Lateral Wall ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
Residual Hearing ◽  
Wide Range

Hearing preservation cochlear implants (CIs) are specifically designed to preserve residual low-frequency acoustic hearing for use together with electrically stimulated high-frequency hearing. This combined electro-acoustic stimulation (EAS) provides a promising treatment option for patients with severe high-frequency hearing loss, but with some residual low-frequency hearing, and has been shown to improve speech perception, especially in background noise, music perception, and sound source localization. Thus, preservation of residual hearing should be a priority in treatment. Although residual low-frequency hearing is successfully preserved to varying degrees in many patients, some patients experience a loss of residual hearing following implantation. A wide range of potential causes of, or contributors to, loss of residual hearing in EAS CI users have been proposed. In this paper, we review the evidence for several of the proposed causes of hearing loss with EAS CI. We conclude that its etiology is likely a multifactorial, heterogeneous phenomenon. Furthermore, we suggest that studies to further elucidate effects of ischemia on lateral wall function and maintenance of endocochlear potential in the context of EAS CI implantation and use are needed.

Evaluation of Special Hearing Aids for Deaf Children

1971 ◽  
Vol 36 (4) ◽  
pp. 527-537 ◽  
Author(s):  
Norman P. Erber
Keyword(s):  
Hearing Aids ◽  
High Frequency ◽  
Hearing Aid ◽  
Low Frequency ◽  
Acoustic Stimulation ◽  
Deaf Children ◽  
Frequency Range ◽  
Frequency Limit ◽  
Unpublished Studies ◽  
Published Research

Two types of special hearing aid have been developed recently to improve the reception of speech by profoundly deaf children. In a different way, each special system provides greater low-frequency acoustic stimulation to deaf ears than does a conventional hearing aid. One of the devices extends the low-frequency limit of amplification; the other shifts high-frequency energy to a lower frequency range. In general, previous evaluations of these special hearing aids have obtained inconsistent or inconclusive results. This paper reviews most of the published research on the use of special hearing aids by deaf children, summarizes several unpublished studies, and suggests a set of guidelines for future evaluations of special and conventional amplification systems.

A Role for Acoustic Stimulation in Advanced Otosclerosis: Direct Acoustic Cochlear Implant versus Cochlear Implant

2018 ◽  
Vol 23 (2) ◽  
pp. 89-97
Author(s):  
Nicolas Verhaert ◽  
Charlotte Borgers ◽  
Katleen De Voecht ◽  
Ellen Boon ◽  
Christian Desloovere
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Hearing Aids ◽  
Standard Treatment ◽  
Acoustic Stimulation ◽  
Grading System ◽  
Effective Treatment Option ◽  
Computed Tomographic ◽  
Direct Acoustic Cochlear Implant ◽  
Acoustic Component

Recent findings support the efficacy of the direct acoustic cochlear implant (DACI) in patients with advanced otosclerosis whose rehabilitation is very challenging. Standard treatment consists of stapes surgery combined with hearing aids or a cochlear implant (CI). CI surgery, however, is often challenging depending on the grade of otosclerosis. This study aims to compare speech perception scores in quiet and noise of 6 DACI and 12 CI patients with advanced otosclerosis at 3 and 12 months after fitting. Preoperative computed tomographic scans of all patients were scored by experts using an existing otosclerosis grading system (stages 1–3). Speech perception in quiet was significantly better for DACI compared to CI users at 3 months after fitting. At 12 months, no difference was found between DACI and CI patients. Speech perception scores in noise were significantly better in the DACI group. In summary, a DACI system seems to provide an effective treatment option as the acoustic component can be preserved in patients with advanced otosclerosis.

scholarly journals Listener Performance with a Novel Hearing Aid Frequency Lowering Technique

2017 ◽  
Vol 28 (09) ◽  
pp. 810-822 ◽  
Author(s):  
Benjamin J. Kirby ◽  
Judy G. Kopun ◽  
Meredith Spratford ◽  
Clairissa M. Mollak ◽  
Marc A. Brennan ◽  
...  
Keyword(s):  
Signal Processing ◽  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Aids ◽  
High Frequency ◽  
Hearing Aid ◽  
Sound Quality ◽  
Processing Strategy ◽  
Listening Effort ◽  
At Home

AbstractSloping hearing loss imposes limits on audibility for high-frequency sounds in many hearing aid users. Signal processing algorithms that shift high-frequency sounds to lower frequencies have been introduced in hearing aids to address this challenge by improving audibility of high-frequency sounds.This study examined speech perception performance, listening effort, and subjective sound quality ratings with conventional hearing aid processing and a new frequency-lowering signal processing strategy called frequency composition (FC) in adults and children.Participants wore the study hearing aids in two signal processing conditions (conventional processing versus FC) at an initial laboratory visit and subsequently at home during two approximately six-week long trials, with the order of conditions counterbalanced across individuals in a double-blind paradigm.Children (N = 12, 7 females, mean age in years = 12.0, SD = 3.0) and adults (N = 12, 6 females, mean age in years = 56.2, SD = 17.6) with bilateral sensorineural hearing loss who were full-time hearing aid users.Individual performance with each type of processing was assessed using speech perception tasks, a measure of listening effort, and subjective sound quality surveys at an initial visit. At the conclusion of each subsequent at-home trial, participants were retested in the laboratory. Linear mixed effects analyses were completed for each outcome measure with signal processing condition, age group, visit (prehome versus posthome trial), and measures of aided audibility as predictors.Overall, there were few significant differences in speech perception, listening effort, or subjective sound quality between FC and conventional processing, effects of listener age, or longitudinal changes in performance. Listeners preferred FC to conventional processing on one of six subjective sound quality metrics. Better speech perception performance was consistently related to higher aided audibility.These results indicate that when high-frequency speech sounds are made audible with conventional processing, speech recognition ability and listening effort are similar between conventional processing and FC. Despite the lack of benefit to speech perception, some listeners still preferred FC, suggesting that qualitative measures should be considered when evaluating candidacy for this signal processing strategy.

Impact of Electric Stimulation on Residual Hearing

2015 ◽  
Vol 26 (08) ◽  
pp. 732-740 ◽  
Author(s):  
Margaret T. Dillon ◽  
Andrea L. Bucker ◽  
Marcia C. Adunka ◽  
English R. King ◽  
Oliver F. Adunka ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Electric Stimulation ◽  
Bone Conduction ◽  
Low Frequency ◽  
Electrode Array ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
First Year ◽  
Residual Hearing ◽  
Listening Experience

Background: Candidacy criteria for cochlear implantation are expanding to include patients with substantial low-to-mid frequency hearing sensitivity. Postoperative hearing preservation has been achieved in cochlear implant recipients, though with variable outcomes. Previous investigations on postoperative hearing preservation outcomes have evaluated intraoperative procedures. There has been limited review as to whether electric stimulation influences hearing preservation. Purpose: The purpose of this analysis was to evaluate whether charge levels associated with electric stimulation influence postoperative hearing preservation within the first year of listening experience. Research Design: Retrospective analysis of unaided residual hearing and charge levels. Study Sample: Twenty-eight cochlear implant recipients with postoperative residual hearing in the operative ear and at least 12 mo of listening experience with electric-acoustic stimulation (EAS). Data Collection and Analysis: Assessment intervals included initial cochlear implant activation, initial EAS activation, and 3-, 6-, and 12-mo postinitial EAS activation. A masked low-frequency bone-conduction (BC) pure-tone average (PTA) was calculated for all participants at each assessment interval. Charge levels for each electrode were determined using the most comfortable loudness level and pulse width values. Charge levels associated with different regions of the electrode array were compared to the change in the low-frequency BC PTA between two consecutive intervals. Results: Charge levels had little to no association with the postoperative change in low-frequency BC PTA within the first year of listening experience. Conclusions: Electric charge levels do not appear to be reliably related to the subsequent loss of residual low-frequency hearing in the implanted ear within the first year of EAS listening experience.

scholarly journals Current criteria for selecting cochlear implant in deaf patients: a review

2021 ◽  
Vol 9 (1) ◽  
pp. 50
Author(s):  
Santosh Kumar Swain
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Neural Plasticity ◽  
Cochlear Implantation ◽  
Surgical Techniques ◽  
Low Frequency ◽  
Hearing Preservation ◽  
Electrode Arrays ◽  
Profound Hearing Loss ◽  
Unilateral Deafness

Cochlear implantation is indicated in patients with severe to profound hearing loss that cannot be adequately treated by other auditory rehabilitation measures. The definitive indication of cochlear implantation is made on the basis of an extensive interdisciplinary clinical, audiological, radiological, and psychological diagnostic work-up. There are numerous changes are happening in cochlear implant candidacy. These have been associated with concomitant changes in surgical techniques, which enhanced the utility and safety of cochlear implantation. Currently, cochlear implants are approved for individuals with severe to profound unilateral hearing loss rather than previously needed for bilateral profound hearing loss. Studies have begun using the short electrode arrays for shallow insertion in patients with low-frequency residual hearing loss. The advancement in designs of the cochlear implant along with improvements in surgical techniques reduce the complications and result in the safety and efficacy of the cochlear implant which further encourages the use of these devices. This review article aims to discuss the new concepts in the candidacy of the cochlear implant, cochlear implant in younger children and hearing preservation, a cochlear implant for unilateral deafness, bilateral cochlear implant, and cochlear implant with neural plasticity and selection of patients for the cochlear implant.

scholarly journals Hearing Preservation in Cochlear Implant Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Priscila Carvalho Miranda ◽  
André Luiz Lopes Sampaio ◽  
Rafaela Aquino Fernandes Lopes ◽  
Alessandra Ramos Venosa ◽  
Carlos Augusto Costa Pires de Oliveira
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Surgical Techniques ◽  
Low Frequency ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
Electrode Design ◽  
High Frequency Region ◽  
Electric Acoustic Stimulation ◽  
New Treatment

In the past, it was thought that hearing loss patients with residual low-frequency hearing would not be good candidates for cochlear implantation since insertion was expected to induce inner ear trauma. Recent advances in electrode design and surgical techniques have made the preservation of residual low-frequency hearing achievable and desirable. The importance of preserving residual low-frequency hearing cannot be underestimated in light of the added benefit of hearing in noisy atmospheres and in music quality. The concept of electrical and acoustic stimulation involves electrically stimulating the nonfunctional, high-frequency region of the cochlea with a cochlear implant and applying a hearing aid in the low-frequency range. The principle of preserving low-frequency hearing by a “soft surgery” cochlear implantation could also be useful to the population of children who might profit from regenerative hair cell therapy in the future. Main aspects of low-frequency hearing preservation surgery are discussed in this review: its brief history, electrode design, principles and advantages of electric-acoustic stimulation, surgical technique, and further implications of this new treatment possibility for hearing impaired patients.

scholarly journals Current Research with Cochlear Implants at Arizona State University

2012 ◽  
Vol 23 (06) ◽  
pp. 385-395 ◽  
Author(s):  
Michael F. Dorman ◽  
Anthony Spahr ◽  
Rene H. Gifford ◽  
Sarah Cook ◽  
Ting Zhang ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Low Frequency ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
National Institutes Of Health ◽  
State University ◽  
Arizona State University ◽  
Listening Environments

In this article we review, and discuss the clinical implications of, five projects currently underway in the Cochlear Implant Laboratory at Arizona State University. The projects are (1) norming the AzBio sentence test, (2) comparing the performance of bilateral and bimodal cochlear implant (CI) patients in realistic listening environments, (3) accounting for the benefit provided to bimodal patients by low-frequency acoustic stimulation, (4) assessing localization by bilateral hearing aid patients and the implications of that work for hearing preservation patients, and (5) studying heart rate variability as a possible measure for quantifying the stress of listening via an implant.The long-term goals of the laboratory are to improve the performance of patients fit with cochlear implants and to understand the mechanisms, physiological or electronic, that underlie changes in performance. We began our work with cochlear implant patients in the mid-1980s and received our first grant from the National Institutes of Health (NIH) for work with implanted patients in 1989. Since that date our work with cochlear implant patients has been funded continuously by the NIH. In this report we describe some of the research currently being conducted in our laboratory.

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