Pediatric Performance with the Med-EL Combi 40+ Cochlear Implant System

2002 ◽  
Vol 111 (5_suppl) ◽  
pp. 66-68 ◽  
Author(s):  
Darla C. Franz
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Functional Improvement ◽  
Auditory Information ◽  
Profound Hearing Loss ◽  
Group Data ◽  
Communication Method ◽  
Age Appropriate ◽  
Device Use ◽  
Implant System

Presented here are the results of speech perception measures and subjective scales from 68 children with 6 months of device experience and from 49 children with 12 months of experience in using the Med-El Combi 40+ cochlear implant system. All children demonstrated bilateral profound hearing loss before operation, and 90% experienced onset before 3 years of age, but their hearing losses had a broad range of causes. A battery of age-appropriate objective speech perception measures was administered, in addition to a battery of subjective auditory skill assessments. The group data indicate that the children showed a statistically significant improvement in a wide array of speech perception skills and auditory behaviors with this device. In addition, subjective therapist survey data indicated changes in primary receptive and expressive communication method with Combi 40+ device use. Individually, all children showed significant improvement on at least 1 of the speech perception measures used in the test battery. This evidence suggests that the Med-El Combi 40+ system can provide meaningful auditory information for profoundly deaf children, which in turn supports meaningful functional improvement in speech perception and communicative skill development.

scholarly journals Costs involved in using a cochlear implant in South Africa

2012 ◽  
Vol 59 (1) ◽  
Author(s):  
Gillian Robyn Kerr ◽  
Seppo Tuomi ◽  
Alida Müller
Keyword(s):  
South Africa ◽  
Cochlear Implant ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Consumer Price Index ◽  
Information Costs ◽  
Profound Hearing Loss ◽  
Short And Long Term ◽  
Implant System

Cochlear implantation is an expensive but effective lifelong intervention for individuals with a severe-to-profound hearing loss. The primary aim of this study was to survey the short- and long-term costs of cochlear implantation. Individuals (N=154) using cochlear implants obtained from the University of Stellenbosch-Tygerberg Hospital Cochlear Implant Unit in Cape Town, South Africa were surveyed using a questionnaire and patient record review. The questionnaire used a combination of closed and open-ended questions to gather both quantitative and qualitative information. Costs were categorised as short- and long-term costs. All costs were converted to constant rands (June 2010) using the Consumer Price Index to allow for comparison in real terms over time. In the first 10 years of implantation the average estimated costs incurred by adults totalled R379 626, and by children R455 225. The initial purchase of the implant system was the most substantial cost, followed by upgrading of the processor. Travel and accommodation costs peaked in the first 2 years. On average the participants spent R2 550 per year on batteries and spares. Rehabilitation for children cost an average of R7 200. Insurance costs averaged R4 040 per year, and processor repairs R3 000 each. In addition to the upfront expense of obtaining the cochlear implant system, individuals using a cochlear implant in South Africa should be prepared for the long-term costs of maintenance, accessing the unit, support services and additional costs associated with use. Knowledge of these costs is important to ensure that individuals are successful users of their cochlear implants in the long term.

scholarly journals Cochlear Implant Characteristics and Speech Perception Skills of Adolescents With Long-Term Device Use

2010 ◽  
Vol 31 (8) ◽  
pp. 1310-1314 ◽  
Author(s):  
Lisa S. Davidson ◽  
Ann E. Geers ◽  
Christine Brenner
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Device Use

scholarly journals Using a cochlear implant processor as contralateral routing of signals device in unilateral cochlear implant recipients

2021 ◽  
Author(s):  
Tom Gawliczek ◽  
Jérémie Guignard ◽  
Christoph Schmid ◽  
Wilhelm Wimmer ◽  
Marco Caversaccio ◽  
...  
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Auditory Information ◽  
Significant Gain ◽  
Subjective Ratings ◽  
Summation Effect ◽  
Processing Strategies ◽  
Acoustic Chamber ◽  
The Difference ◽  
To Receive

Abstract Purpose In unilateral cochlear implant (CI) recipients, a contralateral routing of signals (CROS) device enables to receive auditory information from the unaided side. This study investigates the feasibility as well as subjective and objective benefits of using a CI processor as a CROS device in unilateral CI recipients. Methods This is a single-center, prospective cohort study. First, we tested the directionality of the CROS processor in an acoustic chamber. Second, we examined the difference of speech perception in quiet and in noise in ten unilateral CI recipients with and without the CROS processor. Third, subjective ratings with the CROS processor were evaluated according to the Client Oriented Scale of Improvement Questionnaire. Results There was a time delay between the two devices of 3 ms. Connection of the CROS processor led to a summation effect of 3 dB as well as a more constant amplification along all azimuths. Speech perception in quiet showed an increased word recognition score at 50 dB (mean improvement 7%). In noise, the head shadow effect could be mitigated with significant gain in speech perception (mean improvement 8.4 dB). This advantage was reversed in unfavorable listening situations, where the CROS device considerably amplified the noise (mean:  – 4.8 dB). Subjectively, patients who did not normally wear a hearing aid on the non-CI side were satisfied with the CROS device. Conclusions The connection and synchronization of a CI processor as a CROS device is technically feasible and the signal processing strategies of the device can be exploited. In contra-laterally unaided patients, a subjective benefit can be achieved when wearing the CROS processor.

scholarly journals Recent Results with the MED-EL COMBI 40+ Cochlear Implant and TEMPO+ behind-the-ear Processor

2002 ◽  
Vol 81 (4) ◽  
pp. 229-233 ◽  
Author(s):  
Ilona Anderson ◽  
Viktor Weichbold ◽  
Patrick D'Haese
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Distinct Advantage ◽  
Profound Hearing Loss ◽  
Speech Processor ◽  
German Study ◽  
Viable Treatment

Cochlear implantation is a viable treatment for patients with severe to profound hearing loss. We report the results of speech perception tests (numbers, monosyllables, and sentence tests) achieved with MED-EL's COMBI 40+ (C40+) cochlear implant after 12 months of use. These findings, which were taken from a larger German study, were similar to those of other studies of the C40+ implant. We also compared the differences in speech perception observed with the CIS PRO+ body-worn speech processor and the newer TEMPO+ behind-the-ear speech processor. Although these results were similar with respect to most of the measured parameters, the TEMPO+ processor had a distinct advantage during tests in noise.

scholarly journals Impact of Consistency in Daily Device Use on Speech Perception Abilities in Children with Cochlear Implants: Datalogging Evidence

2018 ◽  
Vol 29 (09) ◽  
pp. 835-846 ◽  
Author(s):  
Vijayalakshmi Easwar ◽  
Joseph Sanfilippo ◽  
Blake Papsin ◽  
Karen Gordon
Keyword(s):  
Speech Perception ◽  
Cochlear Implants ◽  
Positive Influence ◽  
Mean Difference ◽  
Dose Effect ◽  
Profound Hearing Loss ◽  
Speech Test ◽  
The Asymmetry ◽  
Device Use ◽  
The Impact

AbstractCochlear implants (CIs) give children with severe to profound hearing loss access to sound. There appears to be a dose effect of sound exposure on speech perception abilities as shown by the positive influence of early implantation and CI experience. The consistency in device use per day could also affect sound dose, potentially affecting perceptual abilities in children with CIs.The objectives of the present study were to identify the impact of consistency in device use on: (1) speech perception abilities and (2) asymmetry in speech perception abilities between bilateral CIs.Retrospective analysis.To achieve the first objective, data from 65 children (age range at speech test: 1.91–18.05 yrs) with one (unilaterally implanted or bimodal) or two CIs (sequentially or simultaneously implanted) were included. A subset of data from 40 children with bilateral CIs was included to achieve the second objective. Of the 40 children with two CIs, 15 received their CIs sequentially.Device use information was extracted from datalogs stored in personal speech processors using custom software. Speech perception scores per CI collected in quiet were also evaluated. Multiple regression was used to assess the impact of daily CI use, while controlling for factors previously identified to affect speech perception: age at speech test, length of pre-CI (acoustic) hearing experience, length of CI hearing experience, and order of CI for the first objective, and CI category (simultaneous/sequential implantation), interimplant delay, and length of CI experience for the second objective.On average, children wore their CIs for 11.59 ± 2.86 hours/day and, with one CI, exhibited 65.07 ± 22.64% accuracy on speech perception tests. Higher monaural speech perception scores were associated with longer everyday CI use and CI experience (p < 0.05). Among children with bilateral CIs, those with simultaneously implanted CIs and similar bilateral hearing experience demonstrated a small but significant right ear advantage with higher speech perception scores when using the right rather than left CI (mean difference = 4.55 ± 9.83%). The asymmetry in speech perception between CIs was larger and more variable in children who received their CIs sequentially (mean difference CI1-CI2 = 27.48 ± 24.87%). These asymmetries decreased with longer/consistent everyday use of the newer CI (p < 0.05). Yet, despite consistent everyday device use of the second CI (>12 hours/day), only a small proportion of children implanted sequentially (one out of seven children) achieved symmetrical function similar to children with simultaneously received bilateral CIs.Consistent everyday CI use contributes to higher speech perception scores. Although consistent CI use can help reduce the asymmetry in speech perception abilities of children with sequentially implanted CIs subsequent to interimplant delay, residual asymmetry often persists.

scholarly journals Speech Perception Outcomes in Older Children Who Use Multichannel Cochlear Implants: Older is Not Always Poorer

2002 ◽  
Vol 111 (5_suppl) ◽  
pp. 97-101 ◽  
Author(s):  
Richard C. Dowell ◽  
Elizabeth Winton ◽  
Shani J. Dettman ◽  
Elizabeth J. Barker ◽  
Katie Hill ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Cochlear Implant ◽  
Linear Regression Analysis ◽  
Informed Choice ◽  
Multiple Linear Regression Analysis ◽  
Older Children ◽  
Profound Hearing Loss ◽  
Open Set ◽  
The Mean

Speech perception outcomes for early-deafened children who undergo implantation as teenagers or young adults are generally reported to be poorer than results for young children. It is important to provide appropriate expectations when counseling adolescents and their families to help them make an informed choice regarding cochlear implant surgery. The considerable variation of results in this group makes this process more difficult. This study considered a number of factors in a group of 25 children who underwent implantation in Melbourne between the ages of 8 and 18 years. Each subject completed open-set speech perception testing with Bamford-Kowal-Bench sentences before and after implantation and preoperative language testing with the Peabody Picture Vocabulary Test. Data were collected regarding the type of hearing loss, age at implantation, age at hearing aid fitting, audiometric details, and preoperative and postoperative communication mode. Results were submitted to a stepwise multiple linear regression analysis with postoperative open-set sentence scores as the dependent variables. The analysis suggested that 3 factors have a significant predictive value for speech perception after implantation: preoperative open-set sentence score, duration of profound hearing loss, and equivalent language age. These 3 factors accounted for 66% of the variance in this group. The results of this study suggest that children who have useful speech perception before implantation, and higher age-equivalent scores on language measures, would be expected to do well with a cochlear implant. Consistent with other studies, a shorter duration of profound hearing loss is also advantageous. The mean sentence score for this group, 47%, was not significantly different from the mean result across all children in the Melbourne program.

scholarly journals Speech Perception as a Function of Electrical Stimulation Rate: Using the Nucleus 24 Cochlear Implant System

2000 ◽  
Vol 21 (6) ◽  
pp. 608-624 ◽  
Author(s):  
Andrew E. Vandali ◽  
Lesley A. Whitford ◽  
Kerrie L. Plant ◽  
and Graeme M. Clark
Keyword(s):  
Electrical Stimulation ◽  
Speech Perception ◽  
Cochlear Implant ◽  
Stimulation Rate ◽  
Implant System ◽  
Nucleus 24

Conversion from the SPEAK to the ACE Strategy in Children Using the Nucleus 24 Cochlear Implant System: Speech Perception and Speech Production Outcomes

2002 ◽  
Vol 23 (Supplement) ◽  
pp. 18S-27S ◽  
Author(s):  
C. E. Psarros ◽  
K. L. Plant ◽  
K. Lee ◽  
J. A. Decker ◽  
L. A. Whitford ◽  
...  
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Speech Production ◽  
Implant System ◽  
Nucleus 24

scholarly journals Comparing the Speech Perception of Cochlear Implant Users with Three Different Finnish Speech Intelligibility Tests in Noise

2021 ◽  
Vol 10 (16) ◽  
pp. 3666
Author(s):  
Tytti Willberg ◽  
Ville Sivonen ◽  
Pia Linder ◽  
Aarno Dietz
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Speech Intelligibility ◽  
Test Procedure ◽  
Test Material ◽  
User Group ◽  
Speech In Noise ◽  
Adaptive Test ◽  
The Matrix ◽  
Device Use

Background: A large number of different speech-in-noise (SIN) tests are available for testing cochlear implant (CI) recipients, but few studies have compared the different tests in the same patient population to assess how well their results correlate. Methods: A clinically representative group of 80 CI users conducted the Finnish versions of the matrix sentence test, the simplified matrix sentence test, and the digit triplet test. The results were analyzed for correlations between the different tests and for differences among the participants, including age and device modality. Results: Strong and statistically significant correlations were observed between all of the tests. No floor or ceiling effects were observed with any of the tests when using the adaptive test procedure. Age or the length of device use showed no correlation to SIN perception, but bilateral CI users showed slightly better results in comparison to unilateral or bimodal users. Conclusions: Three SIN tests that differ in length and complexity of the test material provided comparable results in a diverse CI user group.

Effect of Increased IIDR in the Nucleus Freedom Cochlear Implant System

2007 ◽  
Vol 18 (09) ◽  
pp. 777-793 ◽  
Author(s):  
Laura K. Holden ◽  
Margaret W. Skinner ◽  
Marios S. Fourakis ◽  
Timothy A. Holden
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Dynamic Range ◽  
Sound Field ◽  
The Other ◽  
Threshold Levels ◽  
Speech In Noise ◽  
El Sistema ◽  
Initial Activation ◽  
Implant System

The objective of this study was to evaluate the effect of the increased instantaneous input dynamic range (IIDR) in the Nucleus Freedom cochlear implant (CI) system on recipients' ability to perceive soft speech and speech in noise. Ten adult Freedom CI recipients participated. Two maps differing in IIDR were placed on each subject's processor at initial activation. The IIDR was set to 30 dB for one map and 40 dB for the other. Subjects used both maps for at least one month prior to speech perception testing. Results revealed significantly higher scores for words (50 dB SPL), for sentences in background babble (65 dB SPL), and significantly lower sound field threshold levels with the 40 compared to the 30 dB IIDR map. Ceiling effects may have contributed to non-significant findings for sentences in quiet (50 dB SPL). The Freedom's increased IIDR allows better perception of soft speech and speech in noise. El objetivo de este estudio fue evaluar el efecto del rango dinámico aumentado instantáneo de ingreso (IIDR) en el sistema de implante coclear (IC) Nucleus Freedom, sobre la capacidad de sujetos implantados para percibir lenguaje a bajo volumen y lenguaje en ruido. Diez sujetos implantados con el IC Freedom participaron. En la activación inicial, dos mapas con una diferencia en cuanto al IIDR se colocaron en el procesador de cada sujeto. El IIDR fue ajustado a 30 dB para un mapa y a 40 dB para el otro. Los sujetos utilizaron ambos mapas por al menos un mes, antes de una evaluación de percepción del lenguaje. Los resultados revelaron puntajes significativamente más altos para palabras (50 dB SPL), para frases en balbuceo de fondo (65 dB SPL), y niveles umbrales en campo libre significativamente más bajos con el mapa de IIDR de 40 comparado con el de 30. Efectos tope pueden haber contribuido a los hallazgos no significativos para frases en silencio (50 dB SPL). El IIDR aumentado para Freedom permite mejor percepción para el lenguaje a bajo volumen y el lenguaje en medio de ruido.

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