scholarly journals Prediction of Behavioral T/C Levels in Cochlear Implant Patients Based Upon Analysis of Electrode Impedances

2021 ◽  
Author(s):  
A. Molisz ◽  
A. Zarowski ◽  
E. Cardinael ◽  
A. Vermeiren ◽  
T. Theunen ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Objective Measure ◽  
Analysis Data ◽  
Case Review ◽  
Data Collection And Analysis ◽  
Compound Action Potentials ◽  
Subjective Threshold ◽  
Electrode Contact ◽  
Maximum Comfort

Abstract Background Fitting cochlear implants in babies and noncooperative patients is cumbersome and time consuming. Therefore, objective parameters have been sought in order to predict the subjective threshold (T) and maximum comfort (C) levels. Measurements of the electrically evoked compound action potentials (ECAPs) have been widely used for this purpose, yet the correlation between these objective measures and the subjective T/C levels is weak to moderate. Purpose This article aims (1) to evaluate correlations between the subjective parameters of the fitting maps such as thresholds (T level) and maximum comfort levels (C level), the impedance of the electrode contacts, and the ECAP thresholds, and (2) to compare the value of the electrode impedances and the ECAP measures for prediction of the T/C levels. Research Design Case review study in a quaternary otologic referral center. Study Sample Ninety-eight consecutive CI patients were enrolled. The average age of the patients was 49 years. All patients were users of the Nucleus 24RECA (Freedom, Contour Advance-of-Stylet electrode) cochlear implant. Data Collection and Analysis Data on impedance of the electrode contacts and the behavioral T/C levels at the first fitting session (2–5 weeks after surgery) and at the 5th fitting session (4–6 months after surgery) have been retrospectively collected in 98 consecutive CI patients. Additionally, the intraoperative impedance values and the ECAP thresholds (tNRT) have been recorded. Results Impedances of electrode contacts show significant strong negative correlations with the stabilized T/C levels at 4 to 6 months after implantation and are an important predictor for the behavioral T/C levels. They can explain R 2 = 28 to 41% of the variability of the behavioral T/C levels. In multiple regression analysis electrode contact impedances can explain twice as much of the variability of the stabilized T/C levels than the tNRT values. The electrode impedances together with the tNRT values are able to explain R 2 = 37 to 40% of the global variability of the T/C levels while the tNRT thresholds solely are able to explain only R 2 = 5 to 14% of the T/C levels variability. Conclusion Impedances of electrode contacts correlate strongly with the stabilized behavioral T/C levels and may be used as an objective measure for fitting of cochlear implants.

scholarly journals Neural envelope tracking as a measure of speech understanding in cochlear implant users

2018 ◽  
Author(s):  
Eline Verschueren ◽  
Ben Somers ◽  
Tom Francart
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Closed Loop ◽  
Objective Measure ◽  
Speech Understanding ◽  
Envelope Tracking ◽  
Actual Speech ◽  
Speech Envelope ◽  
Electroencephalogram Eeg ◽  
Automatic Fitting

ABSTRACTThe speech envelope is essential for speech understanding and can be reconstructed from the electroencephalogram (EEG) recorded while listening to running speech. This so-called neural envelope tracking has been shown to relate to speech understanding in normal hearing listeners, but has barely been investigated in persons wearing cochlear implants (CI). We investigated the relation between speech understanding and neural envelope tracking in CI users.EEG was recorded in 8 CI users while they listened to a story. Speech understanding was varied by changing the intensity of the presented speech. The speech envelope was reconstructed from the EEG using a linear decoder and then correlated with the envelope of the speech stimulus as a measure of neural envelope tracking which was compared to actual speech understanding.This study showed that neural envelope tracking increased with increasing speech understanding in every participant. Furthermore behaviorally measured speech understanding was correlated with participant specific neural envelope tracking results indicating the potential of neural envelope tracking as an objective measure of speech understanding in CI users. This could enable objective and automatic fitting of CIs and pave the way towards closed-loop CIs that adjust continuously and automatically to individual CI users.

scholarly journals Qualitative assessment of YouTube videos as a source of patient information for cochlear implant surgery

2021 ◽  
pp. 1-4
Author(s):  
C Thomas ◽  
J Westwood ◽  
G F Butt
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Qualitative Assessment ◽  
Supplementary Information ◽  
Implant Surgery ◽  
Critical Elements ◽  
Positive Elements ◽  
Cochlear Implant Surgery ◽  
Youtube Videos

Abstract Background YouTube is increasingly used as a source of healthcare information. This study evaluated the quality of videos on YouTube about cochlear implants. Methods YouTube was searched using the phrase ‘cochlear implant’. The first 60 results were screened by two independent reviewers. A modified Discern tool was used to evaluate the quality of each video. Results Forty-seven videos were analysed. The mean overall Discern score was 2.0 out of 5.0. Videos scored higher for describing positive elements such as the benefits of a cochlear implant (mean score of 3.4) and scored lower for negative elements such as the risks of cochlear implant surgery (mean score of 1.3). Conclusion The quality of information regarding cochlear implant surgery on YouTube is highly variable. These results demonstrated a bias towards the positive attributes of cochlear implants, with little mention of the risks or uncertainty involved. Although videos may be useful as supplementary information, critical elements required to make an informed decision are lacking. This is of particular importance when patients are considering surgery.

Using Evoked Compound Action Potentials to Assess Activation of Electrodes and Predict C-Levels in the Tempo+ Cochlear Implant Speech Processor

2010 ◽  
Vol 31 (1) ◽  
pp. 134-145 ◽  
Author(s):  
Isaac Alvarez ◽  
Angel de la Torre ◽  
Manuel Sainz ◽  
Cristina Roldán ◽  
Hansjoerg Schoesser ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Action Potentials ◽  
Speech Processor ◽  
Compound Action Potentials ◽  
Compound Action

scholarly journals Auditory Speech Perception Development in Relation to Patient's Age with Cochlear Implant

2016 ◽  
Vol 21 (03) ◽  
pp. 206-212 ◽  
Author(s):  
Grace Ciscare ◽  
Erika Mantello ◽  
Carla Fortunato-Queiroz ◽  
Miguel Hyppolito ◽  
Ana Reis
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Cochlear Implants ◽  
Statistical Difference ◽  
Hearing Aid ◽  
Age Groups ◽  
Auditory Thresholds ◽  
Caregiver Education ◽  
Auditory Speech ◽  
Hearing Aid Use

Introduction A cochlear implant in adolescent patients with pre-lingual deafness is still a debatable issue. Objective The objective of this study is to analyze and compare the development of auditory speech perception in children with pre-lingual auditory impairment submitted to cochlear implant, in different age groups in the first year after implantation. Method This is a retrospective study, documentary research, in which we analyzed 78 reports of children with severe bilateral sensorineural hearing loss, unilateral cochlear implant users of both sexes. They were divided into three groups: G1, 22 infants aged less than 42 months; G2, 28 infants aged between 43 to 83 months; and G3, 28 older than 84 months. We collected medical record data to characterize the patients, auditory thresholds with cochlear implants, assessment of speech perception, and auditory skills. Results There was no statistical difference in the association of the results among groups G1, G2, and G3 with sex, caregiver education level, city of residence, and speech perception level. There was a moderate correlation between age and hearing aid use time, age and cochlear implants use time. There was a strong correlation between age and the age cochlear implants was performed, hearing aid use time and age CI was performed. Conclusion There was no statistical difference in the speech perception in relation to the patient's age when cochlear implant was performed. There were statistically significant differences for the variables of auditory deprivation time between G3 - G1 and G2 - G1 and hearing aid use time between G3 - G2 and G3 - G1.

Differences in Children’s Sound Production When Speaking With a Cochlear Implant Turned On and Turned Off

1996 ◽  
Vol 39 (3) ◽  
pp. 604-610 ◽  
Author(s):  
Nancy Tye-Murray ◽  
Linda Spencer ◽  
Elizabeth Gilbert Bedia ◽  
George Woodworth
Keyword(s):  
Cochlear Implant ◽  
Speech Production ◽  
Cochlear Implants ◽  
Sound Production ◽  
Proprioceptive Feedback ◽  
Speech Sample ◽  
Speech Language Pathologists ◽  
Monosyllabic Words ◽  
Consonant Voicing ◽  
Vowel Height

Twenty children who have worn a Cochlear Corporation cochlear implant for an average of 33.6 months participated in a device-on/off experiment. They spoke 14 monosyllabic words three times each after having not worn their cochlear implant speech processors for several hours. They then spoke the same speech sample again with their cochlear implants turned on. The utterances were phonetically transcribed by speech-language pathologists. On average, no difference between speaking conditions on indices of vowel height, vowel place, initial consonant place, initial consonant voicing, or final consonant voicing was found. Comparisons based on a narrow transcription of the speech samples revealed no difference between the two speaking conditions. Children who were more intelligible were no more likely to show a degradation in their speech production in the device-off condition than children who were less intelligible. In the device-on condition, children sometimes nasalized their vowels and inappropriately aspirated their consonants. Their tendency to nasalize vowels and aspirate initial consonants might reflect an attempt to increase proprioceptive feedback, which would provide them with a greater awareness of their speaking behavior.

scholarly journals P127: Paramedics perception of working in Nova Scotia’s collaborative emergency centres

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S121
Author(s):  
S. Whalen ◽  
J. Goldstein ◽  
R. Urquhart ◽  
A. Carter
Keyword(s):  
Health Care ◽  
Nova Scotia ◽  
Care Delivery ◽  
Analysis Data ◽  
Team Work ◽  
Healthcare Team ◽  
Telephone Interviews ◽  
Leadership Support ◽  
Data Collection And Analysis ◽  
Constant Comparative Analysis

Introduction: The Collaborative Emergency Centre (CEC) model of health care delivery was implemented in rural Nova Scotia in July 2011 without an identifiable, directly comparable precedent. It features interprofessional teams working under one roof with the goal of providing improved access to timely primary health care, and appropriate access to 24/7 emergency care. One important component of the CEC model is overnight staffing by a paramedic/registered nurse team consulting with an offsite physician via telephone. Our objective was to ascertain the attitudes, feelings and experiences of paramedics working within the CEC construct. Methods: We conducted a qualitative study, guided by the principles of grounded theory. Semi-structured telephone interviews were carried out by the principal investigator with paramedics with experience working in a CEC in the province of Nova Scotia. Interviews were recorded, transcribed and analyzed. Analysis involved an inductive and deductive grounded approach using constant comparative analysis. Data collection and analysis continued until thematic saturation was reached. Results: Fourteen paramedics participated in the study. The majority were male (n=10, 71%), with a mean age of 44 years (STD=8.8) and mean experience as a paramedic of 14 years (STD=9.7). Four major themes were identified from the data: 1) leadership support, encompassing support from Emergency Health Services and Government prior to and after implementation of the model, 2) team work and collaboration, including interprofessional relationships among members of the healthcare team, 3) value to patients and the communities, and 4) professional and personal benefits of working in CECs. Conclusion: Paramedics have found working in CECs to be both professionally and personally rewarding. They perceive the CEC model to be of great value to the patients and communities it serves. Key lessons that might help future expansion of the model in Nova Scotia and other jurisdictions across the country include the importance of building and strengthening relationships between paramedics and nurses, and the need for greater feedback and support from leadership.

scholarly journals Comparison of Electrically Evoked Compound Action Potential Thresholds and Loudness Estimates for the Stimuli Used to Program the Advanced Bionics Cochlear Implant

2010 ◽  
Vol 21 (01) ◽  
pp. 016-027 ◽  
Author(s):  
Eun Kyung Jeon ◽  
Carolyn J. Brown ◽  
Christine P. Etler ◽  
Sara O'Brien ◽  
Li-Kuei Chiou ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Dynamic Range ◽  
Compound Action Potential ◽  
Behavioral Measures ◽  
Speech Processor ◽  
Compound Action Potentials ◽  
Evoked Compound Action Potential ◽  
The Individual ◽  
The Relationship ◽  
Compound Action

Background: In the mid-1990s, Cochlear Corporation introduced a cochlear implant (CI) to the market that was equipped with hardware that made it possible to record electrically evoked compound action potentials (ECAPs) from CI users of all ages. Over the course of the next decade, many studies were published that compared ECAP thresholds with levels used to program the speech processor of the Nucleus CI. In 2001 Advanced Bionics Corporation introduced the Clarion CII cochlear implant (the Clarion CII internal device is also known as the CII Bionic Ear). This cochlear implant was also equipped with a system that allowed measurement of the ECAP. While a great deal is known about how ECAP thresholds compare with the levels used to program the speech processor of the Nucleus CI, relatively few studies have reported comparisons between ECAP thresholds and the levels used to program the speech processor of the Advanced Bionics CI. Purpose: To explore the relationship between ECAP thresholds and behavioral measures of perceptual dynamic range for the range of stimuli commonly used to program the speech processor of the Advanced Bionics CI. Research Design: This prospective and experimental study uses correlational and descriptive statistics to define the relationship between ECAP thresholds and perceptual dynamic range measures. Study Sample: Twelve postlingually deafened adults participated in this study. All were experienced users of the Advanced Bionics CI system. Data Collection and Analysis: ECAP thresholds were recorded using the commercially available SoundWave software. Perceptual measures of threshold (T-level), most comfortable level (M-level), and maximum comfortable level (C-level) were obtained using both “tone bursts” and “speech bursts.” The relationship between these perceptual and electrophysiological variables was defined using paired t-tests as well as correlation and linear regression. Results: ECAP thresholds were significantly correlated with the perceptual dynamic range measures studied; however, correlations were not strong. Analysis of the individual data revealed considerable discrepancy between the contour of ECAP threshold versus electrode function and the behavioral loudness estimates used for programming. Conclusion: ECAP thresholds recorded from Advanced Bionics cochlear implant users always indicated levels where the programming stimulus was audible for the listener. However, the correlation between ECAP thresholds and M-levels (the primary metric used to program the speech processor of the Advanced Bionics CI), while statistically significant, was quite modest. If programming levels are to be determined on the basis of ECAP thresholds, care should be taken to ensure that stimulation is not uncomfortably loud, particularly on the basal electrodes in the array.

Auditory Temporal Gap Detection in Children with and without Auditory Processing Disorder

2010 ◽  
Vol 21 (06) ◽  
pp. 404-408 ◽  
Author(s):  
Dennis P. Phillips ◽  
Michel Comeau ◽  
Jessica N. Andrus
Keyword(s):  
Auditory Processing ◽  
Silent Period ◽  
Analysis Data ◽  
Auditory Processing Disorder ◽  
Gap Detection ◽  
Temporal Acuity ◽  
Normal Children ◽  
Modified Method ◽  
Simple Event ◽  
Data Collection And Analysis

Background: Auditory gap detection is a measure of temporal acuity. The paradigm comes in two forms, distinguished by whether the sounds bounding the silent period are the same (within channel [WC]) or different (between channel [BC]). Purpose: The purpose of this study was to test normal children and children referred for auditory processing disorder (APD) assessment, with both gap detection paradigms. Research Design: Best gap durations (i.e., shortest reliably detected gaps) were measured in a two-interval, two-alternative forced-choice design embedded within a modified method of limits, for both WC and BC paradigms, with stimuli presented at 55 dB HL. Study Sample: Sixteen control children and 20 children referred for APD assessment participated in the study. Of the 20 referred children, 9 were diagnostically positive for APD (APD+), and 11 were negative (APD−). The mean age of children in all three groups was 10–11 yr. Data Collection and Analysis: Data collected were best gap durations for each paradigm, for each child. Group differences were assessed using Kruskal-Wallis analyses of variance. Results: WC best gap durations were very similar across the three participant groups. BC best gap durations varied significantly between listener groups, with the greatest difference being between controls and APD+ samples. Conclusions: BC best gap durations differed among the listener groups while WC ones did not. This suggests that the relative timing perceptual operations required by the BC task are more susceptible to the perceptual disturbances in APD than is the simple event detection required by the WC task.

Sign in / Sign up

Export Citation Format

Share Document