Amplitude Modulation Detection and Speech Recognition in Late-Implanted Prelingually and Postlingually Deafened Cochlear Implant Users

Purpose The purpose of this study was to investigate the relationship between speech recognition benefit derived from the addition of a hearing aid (HA) to the nonimplanted ear (i.e., bimodal benefit) and spectral modulation detection (SMD) performance in the nonimplanted ear in a large clinical sample. An additional purpose was to investigate the influence of low-frequency pure-tone average (PTA) of the nonimplanted ear and age at implantation on the variance in bimodal benefit. Method Participants included 311 unilateral cochlear implant (CI) users who wore an HA in the nonimplanted ear. Participants completed speech recognition testing in quiet and in noise with the CI-alone and in the bimodal condition (i.e., CI and contralateral HA) and SMD in the nonimplanted ear. Results SMD performance in the nonimplanted ear was significantly correlated with bimodal benefit in quiet and in noise. However, this relationship was much weaker than previous reports with smaller samples. SMD, low-frequency PTA of the nonimplanted ear from 125 to 750 Hz, and age at implantation together accounted for, at most, 19.1% of the variance in bimodal benefit. Conclusions Taken together, SMD, low-frequency PTA, and age at implantation account for the greatest amount of variance in bimodal benefit than each variable alone. A large portion of variance (~80%) in bimodal benefit is not explained by these variables. Supplemental Material https://doi.org/10.23641/asha.12185493

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Long-Term Follow-Up of Early Cochlear Implant Device Activation

Audiology and Neurotology ◽

10.1159/000512760 ◽

2021 ◽

pp. 1-11

Author(s):

Stefanie Bruschke ◽

Uwe Baumann ◽

Timo Stöver

Keyword(s):

Speech Recognition ◽

Side Effects ◽

Cochlear Implant ◽

Surgical Techniques ◽

Control Group ◽

First Year ◽

Safe Procedure ◽

Sound Processor

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.

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