scholarly journals Influence of Postponed Follow-Up after Cochlear Implant Activation during the COVID-19 Pandemic on Aided Sound Field Detection and Speech Recognition

2021 ◽  
pp. 1-8
Author(s):  
Teresa G. Vos ◽  
Kevin D. Brown ◽  
Emily Buss ◽  
Andrea L. Bucker ◽  
Matthew M. Dedmon ◽  
...  
Keyword(s):  
Speech Recognition ◽  
Word Recognition ◽  
Cochlear Implant ◽  
Sound Field ◽  
Control Group ◽  
Field Detection ◽  
Tertiary Referral Center ◽  
Behavioral Thresholds ◽  
Comfort Levels

<b><i>Introduction:</i></b> The objective of this study was to assess the influence of postponing the first post-activation follow-up due to the COVID-19 pandemic on the aided sound field detection thresholds and speech recognition of cochlear implant (CI) users. <b><i>Methods:</i></b> A retrospective review was performed at a tertiary referral center. Two groups of adult CI recipients were evaluated: (1) patients whose first post-activation follow-up was postponed due to COVID-19 closures (postponed group; <i>n</i> = 10) and (2) a control group that attended recommended post-activation follow-ups prior to the COVID-19 pandemic (control group; <i>n</i> = 18). For both groups, electric thresholds were estimated at initial activation based on comfort levels and were measured behaviorally at subsequent post-activation follow-ups. For the control group, behavioral thresholds were measured at the 1-month follow-up. For the postponed group, behavioral thresholds were not measured until 3 months post-activation since the 1-month follow-up was postponed. The aided pure-tone average (PTA) and word recognition results were compared between groups at the 3-month follow-up and at an interim visit 2–9 weeks later. <b><i>Results:</i></b> At the 3-month follow-up, the postponed group had significantly poorer word recognition (23 vs. 42%, <i>p</i> = 0.027) and aided PTA (42 vs. 37 dB HL, <i>p</i> = 0.041) than the control group. No significant differences were observed between 3-month data from the control group and interim data from the postponed group. <b><i>Conclusions:</i></b> The postponed follow-up after CI activation was associated with poorer outcomes, both in terms of speech recognition and aided audibility. However, these detrimental effects were reversed following provision of an individualized map, with behaviorally measured electric threshold and comfort levels. While adult CI recipients demonstrate an improvement in speech recognition with estimated electric thresholds, the present results suggest that behavioral mapping within the initial weeks of device use may support optimal outcomes.

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

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.

Maximizing Cochlear Implant Outcomes with Short-Term Aural Rehabilitation

2021 ◽  
Author(s):  
Claire Marcus Bernstein ◽  
Diane Majerus Brewer ◽  
Matthew H. Bakke ◽  
Anne D. Olson ◽  
Elizabeth Jackson Machmer ◽  
...  
Keyword(s):  
Clinical Study ◽  
Speech Recognition ◽  
Cochlear Implant ◽  
Active Control ◽  
Analysis Of Variance ◽  
Control Group ◽  
Active Control Group ◽  
Short Term ◽  
Aural Rehabilitation ◽  
Profound Deafness

Abstract Background Increasing numbers of adults are receiving cochlear implants (CIs) and many achieve high levels of speech perception and improved quality of life. However, a proportion of implant recipients still struggle due to limited speech recognition and/or greater communication demands in their daily lives. For these individuals a program of aural rehabilitation (AR) has the potential to improve outcomes. Purpose The study investigated the effects of a short-term AR intervention on speech recognition, functional communication, and psychosocial outcomes in post lingually deafened adult CI users. Research Design The experimental design was a multisite clinical study with participants randomized to either an AR treatment or active control group. Each group completed 6 weekly 90-minute individual treatment sessions. Assessments were completed pretreatment, 1 week and 2 months post-treatment. Study Sample Twenty-five post lingually deafened adult CI recipients participated. AR group: mean age 66.2 (48–80); nine females, four males; months postactivation 7.7 (3–16); mean years severe to profound deafness 18.4 (2–40). Active control group: mean age 62.8 (47–85); eight females, four males; months postactivation 7.0 (3–13); mean years severe to profound deafness 18.8 (1–55). Intervention The AR protocol consisted of auditory training (words, sentences, speech tracking), and psychosocial counseling (informational and communication strategies). Active control group participants engaged in cognitive stimulation activities (e.g., crosswords, sudoku, etc.). Data Collection and Analysis Repeated measures ANOVA or analysis of variance, MANOVA or multivariate analysis of variance, and planned contrasts were used to compare group performance on the following measures: CasperSent; Hearing Handicap Inventory; Nijmegen Cochlear Implant Questionnaire; Client Oriented Scale of Improvement; Glasgow Benefit Inventory. Results The AR group showed statistically significant improvements on speech recognition performance, psychosocial function, and communication goals with no significant improvement seen in the control group. The two groups were statistically equivalent on all outcome measures at preassessment. The robust improvements for the AR group were maintained at 2 months post-treatment. Conclusion Results of this clinical study provide evidence that a short-term AR intervention protocol can maximize outcomes for adult post lingually deafened CI users. The impact of this brief multidimensional AR intervention to extend CI benefit is compelling, and may serve as a template for best practices with adult CI users.

scholarly journals P3 Cognitive Potential in Cochlear Implant Users

2018 ◽  
Vol 22 (04) ◽  
pp. 408-414 ◽  
Author(s):  
Signe Grasel ◽  
Mario Greters ◽  
Maria Goffi-Gomez ◽  
Roseli Bittar ◽  
Raimar Weber ◽  
...  
Keyword(s):  
Speech Recognition ◽  
Cochlear Implant ◽  
Auditory Processing ◽  
Evoked Potential ◽  
Control Group ◽  
Central Auditory Processing ◽  
Speech Discrimination ◽  
Significant Difference ◽  
Cortical Responses ◽  
Peripheral Auditory System

Introduction The P3 cognitive evoked potential is recorded when a subject correctly identifies, evaluates and processes two different auditory stimuli. Objective to evaluate the latency and amplitude of the P3 evoked potential in 26 cochlear implant users with post-lingual deafness with good or poor speech recognition scores as compared with normal hearing subjects matched for age and educational level. Methods In this prospective cohort study, auditory cortical responses were recorded from 26 post-lingual deaf adult cochlear implant users (19 with good and 7 with poor speech recognition scores) and 26 control subjects. Results There was a significant difference in the P3 latency between cochlear implant users with poor speech recognition scores (G-) and their control group (CG) (p = 0.04), and between G- and cochlear implant users with good speech discrimination (G+) (p = 0.01). We found no significant difference in the P3 latency between the CG and G+. In this study, all G- patients had deafness due to meningitis, which suggests that higher auditory function was impaired too. Conclusion Post-lingual deaf adult cochlear implant users in the G- group had prolonged P3 latencies as compared with the CG and the cochlear implant users in the G+ group. The amplitudes were similar between patients and controls. All G- subjects were deaf due to meningitis. These findings suggest that meningitis may have deleterious effects not only on the peripheral auditory system but on the central auditory processing as well.

scholarly journals Subjective Benefits of Bimodal Listening in Cochlear Implant Recipients with Asymmetric Hearing Loss

2020 ◽  
Vol 162 (6) ◽  
pp. 933-941 ◽  
Author(s):  
Nicholas J. Thompson ◽  
Margaret T. Dillon ◽  
Emily Buss ◽  
Meredith A. Rooth ◽  
English R. King ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hearing Loss ◽  
Word Recognition ◽  
Cochlear Implant ◽  
Sound Field ◽  
Profound Hearing Loss ◽  
Sentence Recognition ◽  
Academic Center ◽  
Asymmetric Hearing Loss

Objective To investigate the influence of cochlear implant (CI) use on subjective benefits in quality of life in cases of asymmetric hearing loss (AHL). Study Design Prospective clinical trial. Setting Tertiary academic center. Subjects and Methods Subjects included CI recipients with AHL (n = 20), defined as moderate-to-profound hearing loss in the affected ear and mild-to-moderate hearing loss in the contralateral ear. Quality of life was assessed with the Speech, Spatial, and Qualities of Hearing Scale (SSQ) pragmatic subscales, which assess binaural benefits. Subjective benefit on the pragmatic subscales was compared to word recognition in quiet and spatial hearing abilities (ie, masked sentence recognition and localization). Results Subjects demonstrated an early, significant improvement ( P < .01) in abilities with the CI as compared to preoperative abilities on the SSQ pragmatic subscales by the 1-month interval. Perceived abilities were either maintained or continued to improve over the study period. There were no significant correlations between results on the Speech in Quiet subscale and word recognition in quiet, the Speech in Speech Contexts subscale and masked sentence recognition, or the Localization subscale and sound field localization. Conclusions CI recipients with AHL report a significant improvement in quality of life as measured by the SSQ pragmatic subscales over preoperative abilities. Reported improvements are observed as early as 1 month postactivation, which likely reflect the binaural benefits of listening with bimodal stimulation (CI and contralateral hearing aid). The SSQ pragmatic subscales may provide a more in-depth insight into CI recipient experience as compared to behavioral sound field measures alone.

scholarly journals Method of selection and assessment of hearing aids efficiency based on comparative speech audiometry

2021 ◽  
Vol 6 (3) ◽  
pp. 21-24
Author(s):  
Evgeniya R. Tsygankova ◽  
Vladimir E. Gaufman ◽  
Irina E. Grebenyuk ◽  
Elena E. Saveleva ◽  
Evgenii S. Savelev
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Sound Field ◽  
Sensorineural Hearing ◽  
Speech Audiometry ◽  
Average Score ◽  
Control Group ◽  
Modified Method

Objectives to improve the quality of hearing aids (HA) selection for patients with sensorineural hearing loss using a comparative free sound field speech audiometry according to our modified method "Delta Test". Material and methods. The study involved 56 patients aged from 18 to 62 years with bilateral chronic sensorineural hearing loss of 2-4 degrees. The study group included 32 patients, a test for speech recognition in a free sound field (speech audiometry) was conducted using the method proposed by us. The control group consisted of 24 patients who were aided without the use of comparative speech audiometry. The "Delta Test" included the use of audio files sets containing a speech material in pure form and mixed with speech noise with different signal-to-noise ratios, supplied through a speaker system connected to a personal computer. The percentage of correctly repeated words was measured without HA and with several HA having different settings. The effectiveness of using HA was defined as the difference in the percentage of speech recognition when using HA in relation to the "ear without HA". Results. According to "The International Outcome Inventory for Hearing Aids" the average score was 4.13 0.10 in the group where the HA were selected using the "Delta Test", which is statistically significantly higher than in the control group, where the average score was 3.720.15(p 0.05). "Delta Test" allows optimally select the HA parameters. This method is easy to perform and does not require expensive equipment.

Speech Recognition Outcomes in Adults With Slim Straight and Slim Modiolar Cochlear Implant Electrode Arrays

2021 ◽  
pp. 019459982110363
Author(s):  
Margaret E. MacPhail ◽  
Nathan T. Connell ◽  
Douglas J. Totten ◽  
Mitchell T. Gray ◽  
David Pisoni ◽  
...  
Keyword(s):  
Speech Recognition ◽  
Cochlear Implant ◽  
Pure Tone ◽  
Lateral Wall ◽  
Electrode Arrays ◽  
Academic Hospital ◽  
Pure Tone Average ◽  
Data Log ◽  
Percentage Correct

Objective To compare differences in audiologic outcomes between slim modiolar electrode (SME) CI532 and slim lateral wall electrode (SLW) CI522 cochlear implant recipients. Study Design Retrospective cohort study. Setting Tertiary academic hospital. Methods Comparison of postoperative AzBio sentence scores in quiet (percentage correct) in adult cochlear implant recipients with SME or SLW matched for preoperative AzBio sentence scores in quiet and aided and unaided pure tone average. Results Patients with SLW (n = 52) and patients with SME (n = 37) had a similar mean (SD) age (62.0 [18.2] vs 62.6 [14.6] years, respectively), mean preoperative aided pure tone average (55.9 [20.4] vs 58.1 [16.4] dB; P = .59), and mean AzBio score (percentage correct, 11.1% [13.3%] vs 8.0% [11.5%]; P = .25). At last follow-up (SLW vs SME, 9.0 [2.9] vs 9.9 [2.6] months), postoperative mean AzBio scores in quiet were not significantly different (percentage correct, 70.8% [21.3%] vs 65.6% [24.5%]; P = .29), and data log usage was similar (12.9 [4.0] vs 11.3 [4.1] hours; P = .07). In patients with preoperative AzBio <10% correct, the 6-month mean AzBio scores were significantly better with SLW than SME (percentage correct, 70.6% [22.9%] vs 53.9% [30.3%]; P = .02). The intraoperative tip rollover rate was 8% for SME and 0% for SLW. Conclusions Cochlear implantation with SLW and SME provides comparable improvement in audiologic functioning. SME does not exhibit superior speech recognition outcomes when compared with SLW.

Cortical and subcortical processing of speech in cochlear implant recipients with Auditory Neuropathy Spectrum Disorder

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Adel Abdel Maksoud Nassar ◽  
Dalia Mohammed Hassan ◽  
Tayseer Taha Abdel Rahman ◽  
Amal Younis
Keyword(s):  
Cochlear Implant ◽  
Speech Processing ◽  
Cochlear Implantation ◽  
Sound Field ◽  
Auditory Brainstem ◽  
Auditory Neuropathy ◽  
Control Group ◽  
Auditory Information ◽  
Speech Communication ◽  
Brainstem Response

Abstract Background Cochlear implantation (CI) is now recognized as one of the possible lines of interventions in ANSD patients to improve their hearing and speech communication. Desynchronized of the auditory information is the most widely accepted mechanism in ANSD. Objectives To study speech processing in the brainstem level as measured by speech-auditory brainstem response (S-ABR) in ANSD and CAEP P1 in ANSD subjects fitted with CIs and the results will be compared to SNHL subjects fitted with unilateral CIs. Subjects and method A total number of 45 subjects were included classified into three groups (one control and two study groups). The control group 16 subjects, age ranged from 5 to 29.5 years with mean of (11.1 years) with normal peripheral hearing sensitivity. The study group comprised 29 children who underwent cochlear implantation. It was subdivided into two subgroups: Group (SNHL) ;their age ranged from2.9 to 15.5 years with mean of (7.7 years) and group (ANSD); Their age ranged from 3.2 to 29 years with mean of (9.3 years) They were subjected to detailed history taking, aided warble-tone sound field audiometry, Questionnaire and Speech-evoked potentials (P1 &c-ABR) recording evoked by the 150-ms synthesized /da/ syllable stimulus. Results C-ABR waves were detected in 100% of control group, 75% of SNHL group and 53.8% of ANSD group. A statistically significant differences existed between the control group and the two study subgroups regarding the P1 latencies. While; there were no statistically significant differences between {SNHL group &ANSD}. Sound-field S-ABR in the CI recipients showed delayed latencies in both SNHL group &ANSD group comparable to the control group with more delay in ANSD group than SNHL group. Finally, the neural phase locking was significantly higher in CI recipients due to electrical artifact. Conclusions • There were no statistically significant differences between {SNHL group & ANSD group} regarding P1 latency. • C-ABR waves were detected in 75% of SNHL group and 53.8% of ANSD group with delayed latencies and higher amplitude than control group with more delay in ANSD group than SNHL group. The findings of sound-field S-ABR demonstrated that CI recipients have neural encoding deficits in temporal and spectral domains at the brainstem level; therefore, the sound-field S-ABR can be considered an efficient clinical procedure to assess the speech processing in ANSD subjects fitted with cochlear implant.

Masking Level Differences for Tones and Speech in Elderly Listeners With Relatively Normal Audiograms

1994 ◽  
Vol 37 (2) ◽  
pp. 422-428 ◽  
Author(s):  
John H. Grose ◽  
Elizabeth A. Poth ◽  
Robert W. Peters
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Word Recognition ◽  
The Elderly ◽  
Normal Hearing ◽  
The Other ◽  
Control Group ◽  
Central Effects ◽  
Masking Level Difference ◽  
Tone Detection

This study measured the masking level difference (MLD) for both 500-Hz tone detection and spondee word recognition in two groups of listeners. One group consisted of 9 elderly listeners with normal audiometric sensitivity bilaterally, up to at least 2000 Hz. The other group was a control group of 10 young listeners with normal hearing. The intent was to determine whether the elderly listeners exhibited a reduction in binaural performance that might contribute to the difficulties many such listeners have in understanding speech in noisy situations. By measuring MLDs in elderly listeners in the absence of marked peripheral hearing loss, it was hoped that any observed changes in MLD could be more strongly attributed to central effects. For both tone detection and speech recognition, it was found that the elderly performed more poorly than the young listeners, primarily on the NoSπ condition.

scholarly journals Rates, Indications, and Speech Perception Outcomes of Revision Cochlear Implantations

2021 ◽  
Vol 10 (15) ◽  
pp. 3215
Author(s):  
Doron Sagiv ◽  
Yifat Yaar-Soffer ◽  
Ziva Yakir ◽  
Yael Henkin ◽  
Yisgav Shapira
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Outcome Analysis ◽  
Tertiary Referral Center ◽  
Patient Demographics ◽  
Included Patient ◽  
Decision Making Processes ◽  
Surgical Failure ◽  
Improved Performance

Revision cochlear implant (RCI) is a growing burden on cochlear implant programs. While reports on RCI rate are frequent, outcome measures are limited. The objectives of the current study were to: (1) evaluate RCI rate, (2) classify indications, (3) delineate the pre-RCI clinical course, and (4) measure surgical and speech perception outcomes, in a large cohort of patients implanted in a tertiary referral center between 1989–2018. Retrospective data review was performed and included patient demographics, medical records, and audiologic outcomes. Results indicated that RCI rate was 11.7% (172/1465), with a trend of increased RCI load over the years. The main indications for RCI were device-related failures (soft-45.4%, hard-23.8%), medical failure (14%), trauma (8.1%), and surgical failure (6.4%). Success rate was 98.8%. Children comprised 78% (134) of the cohort and were more likely than adults to undergo RCI. Most (70%) of the RCIs were performed within 10 years from primary implantation. Speech perception outcome analysis revealed unchanged or improved performance in 85% of the cases and declined performance in 15%. Current findings confirm that RCI is a safe with high clinical efficacy; however, the non-negligible percentage of patients that exhibited declined performance post-RCI should be considered in decision-making processes regarding RCI. Routine follow-up during their first years post-implantation is warranted.

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