scholarly journals Cochlear Implants in Patients with Fluctuant or Progressive Hearing Loss on the Better Ear

2020 ◽  
Author(s):  
Pedro Luiz Mangabeira-Albernaz ◽  
Andrea Felice dos Santos Malerbi
Keyword(s):  
Hearing Loss ◽  
Cochlear Implants ◽  
Sound Localization ◽  
Unilateral Hearing Loss ◽  
Speech Understanding ◽  
Noisy Environments ◽  
Progressive Hearing Loss ◽  
Profound Hearing Loss ◽  
Unilateral Deafness ◽  
Definite Improvement

Abstract Introduction Cochlear implants have been proposed for cases of unilateral hearing loss, especially in patients with tinnitus impairment. Several studies have shown that they result in definite improvement of sound localization and speech understanding, both in quiet and noisy environments. On the other hand, there are few references regarding cochlear implants in patients whose better ears present hearing loss. Objective To report the audiological outcomes of three patients with unilateral deafness, in whom the better ears presented hearing losses, submitted to cochlear implants. Methods Three patients with unilateral profound hearing loss underwent a cochlear implant performed by the same surgeon. Results The patients' data are presented in detail. Conclusion The indications for cochlear implants are becoming more diverse with the expansion of clinical experience and the observation that they definitely help patients with special hearing problems.

scholarly journals Using background noise to improve sound localization following simulated hearing loss

2019 ◽  
Author(s):  
Lindsey Ryan-Warden ◽  
Eva Ng ◽  
Peter Keating
Keyword(s):  
Hearing Loss ◽  
Sound Localization ◽  
Background Noise ◽  
Human Subjects ◽  
Normal Hearing ◽  
Unilateral Hearing Loss ◽  
Noisy Environments ◽  
Negative Effects ◽  
Neurophysiological Studies ◽  
Continuous Background

AbstractMany listening abilities become more difficult in noisy environments, particularly following hearing loss. Sound localization can be disrupted even if target sounds are clearly audible and distinct from background noise. Since subjects locate sounds by comparing the input to the two ears, sound localization is also considerably impaired by unilateral hearing loss. Currently, however, it is unclear whether the effects of unilateral hearing loss are worsened by background noise. To address this, we measured sound localization abilities in the presence or absence of broadband background noise. Adult human subjects of either sex were tested with normal hearing or with a simulated hearing loss in one ear (earplug). To isolate the role of binaural processing, we tested subjects with narrowband target sounds. Surprisingly, we found that continuous background noise improved narrowband sound localization following simulated unilateral hearing loss. By contrast, we found the opposite effect under normal hearing conditions, with background noise producing illusory shifts in sound localization. Previous attempts to model these shifts are inconsistent with behavioural and neurophysiological data. However, here we found that a simple hemispheric model of sound localization provides an explanation for our results, and provides key hypotheses for future neurophysiological studies. Overall, our results suggest that continuous background noise may be used to improve sound localization under the right circumstances. This has important implications for real-world hearing, both in normal-hearing subjects and the hearing-impaired.Significance StatementIn noisy environments, many listening abilities become more difficult, even if target sounds are clearly audible. For example, background noise can produce illusory shifts in the perceived direction of target sounds. Because sound localization relies on the two ears working together, it is also distorted by a hearing loss in one ear. We might therefore expect background noise to worsen the effects of unilateral hearing loss. Surprisingly, we found the opposite, with background noise improving sound localization when we simulated a hearing loss in one ear. A simple hemispheric model of sound localization also helped explain the negative effects of background noise under normal hearing conditions. Overall, our results highlight the potential for using background noise to improve sound localization.

Where Do We Go From Here? Some Messages to Take Forward Regarding Children With Mild Bilateral and Unilateral Hearing Loss

2020 ◽  
Vol 51 (1) ◽  
pp. 98-102
Author(s):  
Dawna E. Lewis
Keyword(s):  
Hearing Loss ◽  
Current Evidence ◽  
Unilateral Hearing Loss ◽  
Newborn Hearing Screening ◽  
Speech Understanding ◽  
Management Options ◽  
Progressive Hearing Loss ◽  
Ongoing Research ◽  
Newborn Hearing ◽  
New Criteria

Purpose This epilogue discusses messages that we can take forward from the articles in the forum. A common theme throughout the forum is the ongoing need for research. The forum begins with evidence of potential progressive hearing loss in infants with mild bilateral hearing loss, who may be missed by current newborn hearing screening protocols, and supports the need for consensus regarding early identification in this population. Consensus regarding management similarly is a continuing need. Three studies add to the growing body of evidence that children with mild bilateral or unilateral hearing loss are at risk for difficulties in speech understanding in adverse environments, as well as delays in language and cognition, and that difficulties may persist beyond early childhood. Ambivalence regarding if and when children with mild bilateral or unilateral hearing loss should be fitted with personal amplification also impacts management decisions. Two articles address current evidence and support the need for further research into factors influencing decisions regarding amplification in these populations. A third article examines new criteria to determine hearing aid candidacy in children with mild hearing loss. The final contribution in this forum discusses listening-related fatigue in children with unilateral hearing loss. The absence of research specific to this population is evidence for the need for further investigation. Ongoing research that addresses difficulties experienced by children with mild bilateral and unilateral hearing loss and potential management options can help guide us toward interventions that are specific for the needs of these children.

The Effect of Conventional and Transparent Surgical Masks on Speech Understanding in Individuals with and without Hearing Loss

2017 ◽  
Vol 28 (01) ◽  
pp. 058-067 ◽  
Author(s):  
Samuel R. Atcherson ◽  
Lisa Lucks Mendel ◽  
Wesley J. Baltimore ◽  
Chhayakanta Patro ◽  
Sungmin Lee ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Impairment ◽  
Visual Input ◽  
Acoustic Properties ◽  
Speech Understanding ◽  
Profound Hearing Loss ◽  
Cross Sectional ◽  
Surgical Masks ◽  
Significant Difference

AbstractIt is generally well known that speech perception is often improved with integrated audiovisual input whether in quiet or in noise. In many health-care environments, however, conventional surgical masks block visual access to the mouth and obscure other potential facial cues. In addition, these environments can be noisy. Although these masks may not alter the acoustic properties, the presence of noise in addition to the lack of visual input can have a deleterious effect on speech understanding. A transparent (“see-through”) surgical mask may help to overcome this issue.To compare the effect of noise and various visual input conditions on speech understanding for listeners with normal hearing (NH) and hearing impairment using different surgical masks.Participants were assigned to one of three groups based on hearing sensitivity in this quasi-experimental, cross-sectional study.A total of 31 adults participated in this study: one talker, ten listeners with NH, ten listeners with moderate sensorineural hearing loss, and ten listeners with severe-to-profound hearing loss.Selected lists from the Connected Speech Test were digitally recorded with and without surgical masks and then presented to the listeners at 65 dB HL in five conditions against a background of four-talker babble (+10 dB SNR): without a mask (auditory only), without a mask (auditory and visual), with a transparent mask (auditory only), with a transparent mask (auditory and visual), and with a paper mask (auditory only).A significant difference was found in the spectral analyses of the speech stimuli with and without the masks; however, no more than ∼2 dB root mean square. Listeners with NH performed consistently well across all conditions. Both groups of listeners with hearing impairment benefitted from visual input from the transparent mask. The magnitude of improvement in speech perception in noise was greatest for the severe-to-profound group.Findings confirm improved speech perception performance in noise for listeners with hearing impairment when visual input is provided using a transparent surgical mask. Most importantly, the use of the transparent mask did not negatively affect speech perception performance in noise.

scholarly journals The Physiologic and Psychophysical Consequences of Severe-to-Profound Hearing Loss

2018 ◽  
Vol 39 (04) ◽  
pp. 349-363 ◽  
Author(s):  
Eric Hoover ◽  
Pamela Souza
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Treatment Options ◽  
Sufficient Information ◽  
Noisy Environments ◽  
Cochlear Function ◽  
Profound Hearing Loss ◽  
Sound Perception ◽  
Severe Hearing Loss ◽  
Tuning Curves

AbstractSubstantial loss of cochlear function is required to elevate pure-tone thresholds to the severe hearing loss range; yet, individuals with severe or profound hearing loss continue to rely on hearing for communication. Despite the impairment, sufficient information is encoded at the periphery to make acoustic hearing a viable option. However, the probability of significant cochlear and/or neural damage associated with the loss has consequences for sound perception and speech recognition. These consequences include degraded frequency selectivity, which can be assessed with tests including psychoacoustic tuning curves and broadband rippled stimuli. Because speech recognition depends on the ability to resolve frequency detail, a listener with severe hearing loss is likely to have impaired communication in both quiet and noisy environments. However, the extent of the impairment varies widely among individuals. A better understanding of the fundamental abilities of listeners with severe and profound hearing loss and the consequences of those abilities for communication can support directed treatment options in this population.

Unilateral Hearing Loss in Youth: Development of Candidate Items for a Condition-Specific Validated Instrument

2018 ◽  
Vol 159 (6) ◽  
pp. 1043-1050 ◽  
Author(s):  
Patricia L. Purcell ◽  
Todd C. Edwards ◽  
Meghan Wisneski ◽  
Dylan K. Chan ◽  
Henry Ou ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sound Localization ◽  
Expert Panel ◽  
Assessment Instrument ◽  
Unilateral Hearing Loss ◽  
Specific Patient ◽  
Functional Impact ◽  
Noise Environment ◽  
Patient Reported ◽  
Functional Scores

Objective This study interviewed youth with unilateral hearing, utilizing their responses to generate candidate items for a condition-specific patient-reported instrument. Study Design Mixed methods, cross-sectional. Setting Tertiary care children’s hospital. Participants and Methods Youth with unilateral hearing loss and normal hearing in the contralateral ear were identified and recruited for participation through query of an audiometric database and through hearing loss clinics. Interviews with the youth were qualitatively analyzed to identify common themes and generate items related to functional impact. A multi-institutional expert panel reviewed items with prespecified item selection criteria. Participants rated items for impact on daily life. For preliminary criterion validity assessment, statistical analyses explored correlations between functional scores and type and severity of hearing loss. Results Thirty-nine youth aged 9 to 18 years with unilateral hearing loss participated; 31% used a hearing device. Fifteen youth participated in interviews; thematic analysis, item crafting, and expert panel item review resulted in 41 items. Twenty-six youth responded to the items, reporting low functional scores in the domains of sound localization, ear positioning, and noise environment. They reported better levels of function in carrying out group conversations, focusing on schoolwork, and feeling safe during activities. Multivariate linear regression found that youth scored 0.4 points (or approximately 8%) lower on the functional impact scale with every 20–dB HL increase in pure tone average in the abnormal ear. Conclusion Youth with unilateral hearing loss report functional impact, particularly related to sound localization, ear positioning, and noise environment; therefore, they may benefit from a condition-specific functional assessment instrument.

scholarly journals Speech Understanding and Sound Localization with a New Nonimplantable Wearing Option for Baha

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Tom Gawliczek ◽  
Wilhelm Wimmer ◽  
Fabio Munzinger ◽  
Marco Caversaccio ◽  
Martin Kompis
Keyword(s):  
Hearing Loss ◽  
Sound Localization ◽  
Bone Conduction ◽  
Speech Understanding ◽  
Bilateral Hearing Loss ◽  
Speech Understanding In Noise ◽  
Speech Reception ◽  
Significant Difference ◽  
Speech Reception Thresholds ◽  
Sound Processor

Objective. To measure the audiological benefit of the Baha SoundArc, a recently introduced nonimplantable wearing option for bone conduction sound processor, and to compare it with the known softband wearing option in subjects with normal cochlear function and a purely conductive bilateral hearing loss.Methods. Both ears of 15 normal hearing subjects were occluded for the time of the measurement, yielding an average unaided threshold of 49 dB HL (0.5 – 4 kHz). Soundfield thresholds, speech understanding in quiet and in noise, and sound localization were measured in unaided conditions and with 1 or 2 Baha 5 sound processors mounted on either a softband or a SoundArc device.Results. Soundfield thresholds and speech reception thresholds were improved by 19.5 to 24.8 dB (p<.001), when compared to the unaided condition. Speech reception thresholds in noise were improved by 3.7 to 4.7 dB (p<.001). Using 2 sound processors rather than one improved speech understanding in noise for speech from the direction of the2nddevice and sound localization error by 23° to 28°. No statistically significant difference was found between the SoundArc and the softband wearing options in any of the tests.Conclusions. Bone conduction sound processor mounted on a SoundArc or on a softband resulted in considerable improvements in hearing and speech understanding in subjects with a simulated, purely conductive, and bilateral hearing loss. No significant difference between the 2 wearing options was found. Using 2 sound processors improves sound localization and speech understanding in noise in certain spatial settings.

scholarly journals Impact of Unilateral Hearing Loss on Behavioral and Evoked Potential Measures of Auditory Function in Adults

2019 ◽  
Vol 30 (07) ◽  
pp. 564-578
Author(s):  
Oscar M. Cañete ◽  
Suzanne C. Purdy ◽  
Colin R. S. Brown ◽  
Michel Neeff ◽  
Peter R. Thorne
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Sound Localization ◽  
Auditory Evoked Potentials ◽  
Social Impact ◽  
Unilateral Hearing Loss ◽  
Control Group ◽  
Self Perception ◽  
Listening Effort ◽  
Speech Detection

AbstractA unilateral hearing loss (UHL) can have a significant functional and social impact on children and adults, affecting their quality of life. In adults, UHL is typically associated with difficulties understanding speech in noise and sound localization, and UHL increases the self-perception of auditory disability for a range of listening situations. Furthermore, despite evidence for the negative effects of reduced unilateral auditory input on the neural encoding of binaural cues, the perceptual consequences of these changes are still not well understood.Determine effects of UHL on auditory abilities and speech-evoked cortical auditory evoked potentials (CAEPs).CAEPs, sound localization, speech perception in noise and self-perception of auditory abilities (speech, spatial, and qualities hearing scale) were assessed.Thirteen adults with UHL with a range of etiologies, duration of hearing loss, and severity and a control group of eleven binaural listeners with normal hearing.Participants with UHL varied greatly in their ability to localize sound and reported speech recognition and listening effort were the greatest problem. There was a greater effect of right ear than left ear hearing loss on N1 amplitude hemispheric asymmetry and N1 latencies evoked by speech syllables in noise. As duration of hearing loss increased, contralateral dominance (N1 amplitude asymmetry) decreased. N1 amplitudes correlated with speech scores, larger N1 amplitudes were associated with better speech recognition in noise scores. N1 latencies are delayed (in the better ear) and amplitude hemisphere asymmetry differed across UHL participants as function of side of deafness, mainly for right-sided deafness.UHL affects a range of auditory abilities, including speech detection in noise, sound localization, and self-perceived hearing disability. CAEPs elicited by speech sounds are sensitive enough to evidence changes within the auditory cortex due to an UHL.

scholarly journals Cochlear Implantation after Bacterial Meningitis in Infants Younger Than 9 Months

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
B. Y. Roukema ◽  
M. C. Van Loon ◽  
C. Smits ◽  
C. F. Smit ◽  
S. T. Goverts ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Bacterial Meningitis ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Speech Intelligibility ◽  
Pneumococcal Meningitis ◽  
Profound Hearing Loss ◽  
Young Infants ◽  
Key Points ◽  
Auditory Performance

Objective. To describe the audiological, anesthesiological, and surgical key points of cochlear implantation after bacterial meningitis in very young infants.Material and Methods. Between 2005 and 2010, 4 patients received 7 cochlear implants before the age of 9 months (range 4–8 months) because of profound hearing loss after pneumococcal meningitis.Results. Full electrode insertions were achieved in all operated ears. The audiological and linguistic outcome varied considerably, with categories of auditory performance (CAP) scores between 3 and 6, and speech intelligibility rating (SIR) scores between 0 and 5. The audiological, anesthesiological, and surgical issues that apply in this patient group are discussed.Conclusion. Cochlear implantation in very young postmeningitic infants is challenging due to their young age, sequelae of meningitis, and the risk of cochlear obliteration. A swift diagnostic workup is essential, specific audiological, anesthesiological, and surgical considerations apply, and the outcome is variable even in successful implantations.

scholarly journals Cochlear Implants as a Treatment Option for Unilateral Hearing Loss, Severe Tinnitus and Hyperacusis

2015 ◽  
Vol 20 (Suppl. 1) ◽  
pp. 60-66 ◽  
Author(s):  
Angel Ramos Macías ◽  
Juan Carlos Falcón González ◽  
Manuel Manrique ◽  
Constantino Morera ◽  
Luis García-Ibáñez ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cochlear Implants ◽  
Sudden Hearing Loss ◽  
Unilateral Hearing Loss ◽  
Long Term Effects ◽  
Activation Data ◽  
Fitting In ◽  
Severe Tinnitus

Tinnitus is an incapacitating condition commonly affecting cochlear implant (CI) candidates. The aim of this clinical study is to assess the long-term effects of CI treatment in patients with severe-to-profound, sensorineural, unilateral hearing loss (UHL) and incapacitating tinnitus. We performed a prospective Cochlear™ company-sponsored multicentre study in five Spanish centres. Sixteen patients with UHL and incapacitating tinnitus, which was indicated by a Tinnitus Handicap Inventory (THI) score >58%, received a Nucleus® CI in their deaf ear. The study design includes repeated within-subject measures on hearing, tinnitus, hyperacusis and quality of life up to 12 months after initial CI fitting. In addition to hearing loss and tinnitus, all patients suffered from hyperacusis. Most patients had a sudden hearing loss and received a CI within 2 years after their hearing loss. Preliminary 6-month, post-CI activation data of 13 subjects showed that the majority of patients perceived a subjective benefit from CI treatment, which was assessed using the THI, a Visual Analogue Scale of tinnitus loudness/annoyance and the Speech, Spatial and Qualities of Hearing Scale. Preliminary 12-month data of 7 subjects showed that most patients also perceived a degree of relief from their hyperacusis. One patient showed no improvements in any of the applied scales, which could be explained by partial insertion of the electrode due to obstruction of the cochlea by otosclerosis. In conclusion, CI can successfully be used in the treatment of UHL patients with accompanying severe tinnitus and hyperacusis. Implantation resulted in hearing benefits and a durable relief from tinnitus and hyperacusis in the majority of patients. These findings support the hypothesis that pathophysiological mechanisms after peripheral sensorineural hearing loss are at least partly reversible when hearing is restored with a CI.

Current Practices in Pediatric Cochlear Implantation

2009 ◽  
Vol 19 (1) ◽  
pp. 32-42 ◽  
Author(s):  
Tamala S. Bradham ◽  
Geneine Snell ◽  
David Haynes
Keyword(s):  
Hearing Loss ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Healthcare Providers ◽  
Interdisciplinary Teams ◽  
Profound Hearing Loss ◽  
Comprehensive Management ◽  
Technological Advances ◽  
Management Protocol ◽  
Professional Guidelines

Abstract Technological advances, specifically cochlear implants, have significantly impacted the treatment of children with severe to profound hearing loss. There are, however, very few professional guidelines or resources providing direction for hearing healthcare providers who are serving children with cochlear implants. The following article discusses a comprehensive management protocol for interdisciplinary teams providing cochlear implant services for children.

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