Impact of Cochlear Implantation on Neurocognitive Subdomains in Adult Cochlear Implant Recipients

2021 ◽  
pp. 1-10
Author(s):  
Christiane Völter ◽  
Lisa Götze ◽  
Imme Haubitz ◽  
Janine Müther ◽  
Stefan Dazert ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Verbal Fluency ◽  
Homogeneous Population ◽  
Delayed Recall ◽  
Hearing Status ◽  
Age Related ◽  
Significant Difference ◽  
The Impact

<b><i>Introduction:</i></b> Age-related hearing loss affects about one-third of the population worldwide. Studies suggest that hearing loss may be linked to cognitive decline and auditory rehabilitation may improve cognitive functions. So far, the data are limited, and the underlying mechanisms are not fully understood. The study aimed to analyze the impact of cochlear implantation on cognition in a large homogeneous population of hearing-impaired adults using a comprehensive non-auditory cognitive assessment with regard to normal-hearing (NH) subjects. <b><i>Material and Methods:</i></b> Seventy-one cochlear implant (CI) candidates with a postlingual, bilateral severe or profound hearing loss aged 66.3 years (standard deviation [SD] 9.2) and 105 NH subjects aged 65.96 years (SD 9.4) were enrolled. The computer-based neurocognitive tool applied included 11 subtests covering attention (M3), short- and long-term memory (recall and delayed recall), working memory (0- and 2-back, Operation Span [OSPAN] task), processing speed (Trail Making Test [TMT] A), mental flexibility (TMT B), inhibition (cFlanker and iFlanker), and verbal fluency. CI patients underwent a neurocognitive testing preoperatively as well as 12 months postoperatively. Impact of hearing status, age, gender, and education on cognitive subdomains was studied. Additionally, after controlling for education and age, cognitive performance of CI subjects (<i>n</i> = 41) was compared to that of NH (<i>n</i> = 34). <b><i>Results:</i></b> CI users achieved significantly better neurocognitive scores 12 months after cochlear implantation than before in most subtests (M3, [delayed] recall, 2-back, OSPAN, iFlanker, and verbal fluency; all <i>p</i> &#x3c; 0.05) except for the TMT A and B. A significant correlation could be found between the postoperative improvement in speech perception and in the attentional task M3 (<i>p</i> = 0.01). Hearing status (<i>p</i> = 0.0006) had the strongest effect on attention, whereas education had a high impact on recall (<i>p</i> = 0.002), OSPAN (<i>p</i> = 0.0004), and TMT A (<i>p</i> = 0.005) and B (<i>p</i> = 0.003). Inhibition was mainly age-dependent with better results in younger subjects (<i>p</i> = 0.016). Verbal fluency was predicted by gender as females outperformed men (<i>p</i> = 0.009). Even after controlling for age and education NH subjects showed a significantly better performance than CI candidates in the recall (<i>p</i> = 0.03) and delayed recall (<i>p</i> = 0.01) tasks. Postoperatively, there was no significant difference between the 2 groups anymore. <b><i>Conclusion:</i></b> Impact of cochlear implantation on neurocognitive functions differs according to the cognitive subdomains. Postoperatively, CI recipients performed as good as age- and education-matched NH subjects.

Delaying Cochlear Implantation Impacts Postoperative Speech Perception of Nontraditional Pediatric Candidates

2020 ◽  
pp. 1-6
Author(s):  
Lisa R. Park ◽  
Elizabeth L. Perkins ◽  
Jennifer S. Woodard ◽  
Kevin D. Brown
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Word Recognition ◽  
Cochlear Implantation ◽  
Delay Time ◽  
Residual Hearing ◽  
Progressive Hearing Loss ◽  
Significant Difference ◽  
Significant Regression ◽  
The Impact

<b><i>Introduction:</i></b> As pediatric cochlear implant (CI) candidacy expands, children with greater degrees of residual hearing are receiving CIs. These nontraditional candidates have audiometric thresholds that meet adult manufacturer labeling but are better than current pediatric guidelines allow. The purpose of this study was to determine the impact of delayed cochlear implantation on speech perception in nontraditional pediatric CI recipients. <b><i>Methods:</i></b> Pediatric CI recipients with a history of progressive hearing loss and a preoperative 4-frequency pure-tone average of ≤75 dB HL at the time of implantation were considered for this retrospective study. Preoperative serial audiograms and word recognition scores were reviewed, and a method was created to establish a date when each individual ear 1st met nontraditional candidacy. The length of time between the date of candidacy and implantation was calculated and defined as the “delay time.” A multiple linear regression investigated delay time, age at surgery, surgery type (1st vs. 2nd side), and array type as predictive factors of maximum postoperative Consonant-Nucleus-Consonant (CNC) word scores. A one-way ANCOVA was performed comparing the postoperative CNC scores between subjects grouped by delay time. <b><i>Results:</i></b> A significant regression was found (<i>F</i>(4, 38) = 5.167, <i>p</i> = 0.002, <i>R</i><sup>2</sup> = 0.353). Both age at implantation (<i>p</i> = 0.023) and delay time (<i>p</i> = 0.002) predicted CNC word scores. Longer delay time was associated with poorer word recognition scores, while older age at implantation correlated with higher CNC word scores in this progressive hearing loss group. A significant difference was noted between subjects implanted with &#x3c;1 year of delay and those with 3 or more years of delay (<i>p</i> = 0.003). All ears implanted within a year of candidacy achieved word recognition abilities that are generally accepted as above average (<i>M</i> = 84.91). <b><i>Conclusion:</i></b> CI candidacy for adults has evolved to allow for greater degrees of residual hearing, while audiometric guidelines for children have not changed since 2000. Our findings suggest that delay of cochlear implantation, even for children with significant levels of residual hearing, leads to poorer outcomes. Modified candidacy guidelines for children should be established to expedite referral to multidisciplinary CI teams and minimize delays in this population.

scholarly journals The Effects of Round Window Membrane Injury and the Use of a Model Electrode Application on Hearing in Rats

2021 ◽  
pp. 014556132199018
Author(s):  
Murat Koc ◽  
Abdullah Dalgic ◽  
Mehmet Ziya Ozuer
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Round Window ◽  
Mechanical Trauma ◽  
Round Window Membrane ◽  
Albino Rats ◽  
Topical Steroids ◽  
Distortion Product ◽  
Significant Difference ◽  
Group 3

Objective: To investigate the effects of the mechanical trauma to the round window, a model electrode inserted into the scala tympani on the cochlear reserve, and the efficacy of topical steroids in preventing hearing loss. Materials and Methods: 21 male Wistar Albino rats were equally categorized into three groups. In all groups an initial mechanical injury to round window was created. Only subsequent dexamethasone injection was administrated into the cochlea in the subjects of group 2 while a multichannel cochlear implant guide inserted into the cochlea prior to dexamethasone administration for group 3. Distortion product otoacoustic emissions (DPOAEs) were obtained prior to and immediately after the surgical injury, eventually on postoperative seventh day (d 7). Mean signal/noise ratios (S/Ns) obtained at 2000, 3000, and 4000 Hz were calculated. Data sets were compared with non-parametric statistical tests. Results: The early intraoperative mean S/Ns were significantly less than preoperative measurements for group 1 and 2; however, preoperative and postoperative d 7 average S/Ns did not differ. There was statistically significant difference between preoperative, intraoperative and postoperative d 7 average S/Ns for group 3. Conclusion: We observed that hearing was restored approximately to the preoperative levels following early postoperative repair. However, an electrode insertion into the cochlea via round window subsequent to mechanical trauma seems to cause a progressive hearing loss. Therefore, a special care must be taken to avoid the injury to the round window membrane in the course of the placement of a cochlear implant electrode and surgery for the chronic otitis media.

scholarly journals Dual Effects of Hearing Loss and Dementia on Functional Limitations in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 214-214
Author(s):  
Michael McKee ◽  
Yunshu Zhou ◽  
Joshua Ehrlich ◽  
Elham Mahmoudi ◽  
Jennifer Deal ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Self Care ◽  
Household Activity ◽  
Cross Sectional ◽  
Age Related ◽  
Increased Risk ◽  
Lower Mobility ◽  
Independent Effects ◽  
The Impact

Abstract Age-related hearing loss (HL) is both common and associated with elevated risk for cognitive decline and poorer health. To care for an aging population, it is critical to understand the effect of coexisting HL and dementia on functional activities. The effect of co-existing dementia and self-reported HL on daily functioning were assessed. A cross-sectional analysis was performed using nationally-representative data from the 2015 National Health and Aging Trends Study consisting of U.S. adults 65+. The sample included 1,829 adults with HL (22.8%) and 5,338 adults without HL. Multivariable Poisson regression was used to model the independent effects and interaction of self-reported HL and dementia status on three validated functional activity scales (self-care, mobility, and household). All analyses adjusted for sociodemographic and medical factors. HL participants were more likely to be white, older, male, less educated (p &lt;0.01). 8.4% had possible dementia and 6.5% had probable dementia. Respondents with HL or possible or probable dementia had significantly lower mobility, self-care, and household activity scores (p&lt;.001 for all comparisons) compared to their peers. A small yet significant interaction was present in all models, suggesting that HL respondents with co-occurring dementia had lower mobility, self-care, and household activity scores than predicted by the independent effects of dementia and self-reported HL (p&lt;.001 for all comparisons). Older adults with co-occurring dementia and HL are at increased risk for poor functioning and should be screened by healthcare providers. Future work should consider the impact of intervention in this vulnerable/at-risk population.

AGE-RELATED ISSUES OF THE QUALITY OF LIFE IN HEARING IMPAIRED PATIENTS

2021 ◽  
pp. 885-892
Author(s):  
Л. Е. Голованова ◽  
Е. А. Огородникова ◽  
Е. С. Лаптева ◽  
М. Ю. Бобошко
Keyword(s):  
Quality Of Life ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Pure Tone Audiometry ◽  
Hearing Impaired ◽  
Hearing Disorders ◽  
Age Related ◽  
Sf 36 ◽  
Significant Difference

Целью исследования было изучение качества жизни лиц с нарушениями слуха в разных возрастных группах. Обследованы 100 пациентов, обратившихся в городской сурдологический центр для взрослых в связи с нарушением слуха: 50 человек - 34-59 лет, 50 - 60 лет и старше, из которых 32 человека были пожилого возраста (60-74 года)и 18 - старческого (75-86 лет). Степень тугоухости оценивали на основании результатов тональной пороговой аудиометрии. Для исследования качества жизни все пациенты заполняли общий опросник MOS SF-36, отражающий физический и психологический компоненты здоровья, а также специальный опросник HHIА(E)-S для лиц с нарушениями слуха. Установлено, что шкала HHIА(E)-S демонстрирует высокую корреляцию со степенью тугоухости у пациентов моложе 60 лет ( R =0,98; достоверность различий на уровне p <0,05), которая снижается у пациентов 60 лет и старше ( R =0,94; различия в оценках при разной степени тугоухости недостоверны). Значительные трудности в старшей возрастной группе могут быть связаны с тем, что людям пожилого и, особенно, старческого возраста сложно пользоваться слуховыми аппаратами (или они для них неэффективны) и оценивать свои затруднения по шкалам опросника. Целесообразно использовать шкалу HHIА(Е)-S в качестве скринингового инструмента для раннего выявления тугоухости, направления пациентов к сурдологу и своевременного слухопротезирования. The aim of the research was to study the quality of life in hearing impaired patients of different age. 100 patients referred to the city audiology centre because of their hearing disorders were examined: 50 patients from 34 to 59 years old and 50 patients from 60 years and older, from which 32 patients were of older age (60 to 74 years old) and 18 of oldest age (75 to 86 years old). A degree of hearing loss was assessed according to results of pure tone audiometry. To study the quality of life all patients filled in the questionnaire MOS SF-36, which evaluates physical and psychological components of health, and the questionnaire HHIA(E)-S, designed specifically for patients with hearing disorders. The HHIA(E)-S scale was found to show high correlation with hearing loss degree in patients younger than 60 years old ( R =0,98 with statistically significant difference, p <0,05), with decreasing correlation in patients from 60 years and older ( R =0,98; no significant difference while assessing various hearing loss degrees). Considerable difficulties in this age group may be explained by the fact, that older and especially oldest patients have a challenge with hearing aids usage (or they are of low efficiency for them) and with assessing theirs difficulties on the questionnaire scales. The HHIA(E)-S scale is useful as a screening tool for early detection of hearing loss, referral of patients to an audiologist and prompt hearing aid fitting.

Cochlear Implant Patients with Superficial Siderosis

2009 ◽  
Vol 20 (06) ◽  
pp. 348-352 ◽  
Author(s):  
Sarah A. Sydlowski ◽  
Michael J. Cevette ◽  
Jon Shallop ◽  
David M. Barrs
Keyword(s):  
Central Nervous System ◽  
Hearing Loss ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Case Reports ◽  
Superficial Siderosis ◽  
Viable Option ◽  
Retrospective Case ◽  
Fatal Disease ◽  
The Central Nervous System

Background: Considered a rare disorder, superficial siderosis of the central nervous system (SSCN) has become more frequently diagnosed in recent years. As it is characterized by progressive sensorineural hearing loss, patients' needs may surpass the capability of hearing aid technology. Despite the retrocochlear nature of the disorder, patients have undergone cochlear implantation (CI) with varying success. Purpose: To summarize the issues surrounding cochlear implant candidates with SSCN as well as highlight trends in performance postimplantation. Research Design: Retrospective case reports of seven cochlear implant candidates detail the symptoms, typical audiologic presentation, and array of clinical issues for patients with this progressive and potentially fatal disease. Results: Despite the retrocochlear component of a hearing loss caused by SSCN, cochlear implantation may be a viable option. Conclusions: It is essential that the CI audiologist not only be aware of the disorder but also be well versed in the resulting implications for the cochlear implant process. A more thorough case history, an expanded candidacy test battery, and knowledge of the typical presentation of SSCN are critical. The diagnosis of SSCN will impact expectations for success with the cochlear implant, and counseling should be adjusted accordingly.

scholarly journals Complications of cochlear implant surgery

2004 ◽  
Vol 132 (9-10) ◽  
pp. 302-305 ◽  
Author(s):  
Rade Kosanovic ◽  
Zoran Ivankovic ◽  
Sandra Stojanovic
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Fatal Outcome ◽  
Modern Technology ◽  
Hearing Impairments ◽  
Severe Hearing Loss ◽  
Cochlear Implant Surgery ◽  
Coding Strategies ◽  
The World

During the last several decades, cochlear implant has been fully recognized in treatment of severe hearing loss. Development of modern technology enabled inconceivable possibilities of technical qualities of the device as well as development of usable coding strategies, which led to extraordinary results in patient rehabilitation. Although cochlear implantation has become one of the routine operative procedures throughout the world nowadays, it gives rise to certain complications. These complications, though rare, can sometimes be very serious, even with fatal outcome. If cochlear implantation is performed by experienced and well-educated team of experts, the possibility of complications is minimal and is certainly not the argument against cochlear implantation as a method of treatment of severe hearing impairments.

Hearing Status in Brucellosis

2002 ◽  
Vol 127 (1) ◽  
pp. 97-100 ◽  
Author(s):  
Yildirim A. Bayazit ◽  
Mustafa Namiduru ◽  
Nurhayat Bayazit ◽  
Enver Özer ◽  
Muzaffer Kanlikama
Keyword(s):  
Hearing Loss ◽  
Study Design ◽  
Pure Tone ◽  
Speech Audiometry ◽  
Normal Limits ◽  
Hearing Status ◽  
Significant Difference ◽  
The Mean

BACKGROUND: Although brucellosis can lead to multisystem complications, involvement of the ear in brucellosis is rarely reported in the literature. The purpose of this study was to assess the hearing status of patients with brucellosis. STUDY DESIGN: Thirty-two patients with brucellosis were included in the study. Pure tone and speech audiometry and tympanometry were performed in the patients. RESULTS: The mean pure tone averages of the patients were within normal limits and were similar in both ears ( P > 0.05). The pure tone averages of the patients with or without anti- Brucella treatment were not significantly different ( P > 0.05) and were within the normal limits. When the hearing levels of these patients were compared at the frequencies of 250, 500, 1000, 2000, 4000, and 8000 Hz, there was no significant difference as well ( P > 0.05). CONCLUSIONS: Peripheral brucellosis does not appear to be associated with hearing loss.

Audiological outcome of stapes surgery for far advanced cochlear otosclerosis

2017 ◽  
Vol 131 (11) ◽  
pp. 961-964 ◽  
Author(s):  
C Heining ◽  
R Banga ◽  
R Irving ◽  
C Coulson ◽  
P Monksfield
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Revision Surgery ◽  
Cochlear Implantation ◽  
Stapes Surgery ◽  
Hearing Thresholds ◽  
Suitable Treatment ◽  
Conductive Component ◽  
Clinically Significant ◽  
Hearing Outcomes

AbstractBackground:Patients with advanced otosclerosis can present with hearing thresholds eligible for cochlear implantation. This study sought to address whether stapes surgery in this patient group provides a clinically significant audiological benefit.Objectives:To assess pre- and post-operative hearing outcomes of patients with advanced otosclerosis, and to determine what proportion of these patients required further surgery including cochlear implantation.Methods:Between 2002 and 2015, 252 patients underwent primary stapes surgery at our institution. Twenty-eight ears in 25 patients were deemed to have advanced otosclerosis, as defined by pure audiometry thresholds over 80 dB. The patients’ records were analysed to determine audiological improvement following stapes surgery, and assess whether any further surgery was required.Results:The audiological outcome for most patients who underwent primary stapes surgery was good. A minority of patients (7 per cent) required revision surgery. Patients who underwent cochlear implantation after stapes surgery (10 per cent) also demonstrated a good audiological outcome.Conclusion:Stapes surgery is a suitable treatment option for patients with advanced otosclerosis, and should be considered mandatory, before offering cochlear implantation, for those with a demonstrable conductive component to their hearing loss. A small group of patients get little benefit from surgery and subsequently a cochlear implant should be considered.

scholarly journals Investigation of Tinnitus Patients in Italy: Clinical and Audiological Characteristics

2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Francesco Martines ◽  
Daniela Bentivegna ◽  
Fabiola Di Piazza ◽  
Enrico Martines ◽  
Vincenzo Sciacca ◽  
...  
Keyword(s):  
Hearing Loss ◽  
High Frequency ◽  
Pure Tone ◽  
Hearing Threshold ◽  
Related Factors ◽  
High Frequencies ◽  
Tinnitus Severity ◽  
Hearing Status ◽  
Neural Connection ◽  
The Impact

Objective. 312 tinnitus sufferers were studied in order to analyze: the clinical characteristics of tinnitus; the presence of tinnitus-age correlation and tinnitus-hearing loss correlation; the impact of tinnitus on subjects' life and where possible the etiological/predisposing factors of tinnitus.Results. There is a slight predominance of males. The highest percentage of tinnitus results in the decades 61–70. Of the tinnitus sufferers, 197 (63.14%) have a hearing deficit (light hearing loss in 37.18% of cases). The hearing impairment results of sensorineural type in 74.62% and limited to the high frequencies in 58.50%. The tinnitus is referred as unilateral in 59.93%, a pure tone in 66.99% and 10 dB above the hearing threshold in 37.7%. It is limited to high frequencies in 72.10% of the patients with sensorineural hearing loss (SNHL) while the 88.37% of the patients with high-frequency SNHL have a high-pitched tinnitus ( ).Conclusion. Hearing status and age represent the principal tinnitus related factors; there is a statistically significant association between high-pitched tinnitus and high-frequency SNHL. There is no significant correlation between tinnitus severity and tinnitus loudness confirming the possibility that neural connection involved in evoking tinnitus-related negative reactions are governed by conditioned reflexes.

Cochlear Implants in Children: Reliability of Computed Tomography

1992 ◽  
Vol 107 (3) ◽  
pp. 410-417 ◽  
Author(s):  
Michael A. Seicshnaydre ◽  
Michele H. Johnson ◽  
M. Suzanne Hasenstab ◽  
George H. Williams
Keyword(s):  
Computed Tomography ◽  
Hearing Loss ◽  
Cochlear Implant ◽  
Temporal Bone ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Ct Scans ◽  
Presurgical Evaluation ◽  
Preoperative Ct ◽  
Ct Studies

Preoperative temporal bone computed tomography (CT) can demonstrate anatomic details relevant to surgical management and is therefore essential in the presurgical evaluation of patients receiving cochlear implants. The purpose of this study was to evaluate preoperative CT studies and compare them to surgical findings in 34 children who received the Nucleus multichannel cochlear implant. The focus of this report is to discuss the dependability of CT scans in predicting surgical findings at the time of cochlear implantation. Results indicate that agreement of CT interpretations with surgical findings is partially related to the etiology of hearing loss and the experience of the surgeon and neuroradiologist. Advantages and limitations of the CT scans in predicting surgical findings are discussed.

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