Model for Understanding the Influence of Some Parameters in Cochlear Implantation

1992 ◽  
Vol 101 (1) ◽  
pp. 42-45 ◽  
Author(s):  
Christian Berger-Vachon ◽  
Bachir Djedou ◽  
Lionel Collet ◽  
Alain Morgon

Considering the recognition performance obtained by an implanted patient, the authors have developed models to explain the decrease in performance when the number of open channels on the prosthesis is increased. The French cochlear implant Chorimac was used in this experiment. Two models have been developed. The first is monodimensional and the second is multidimensional. They respectively represent an increase in information and its superposition. Results suggest that for the patient, the superposition factor prevails and is detrimental to recognition. Its elimination should be a major goal. A good selection of electrodes in a relatively small number seems to be the best policy. This is already done in some cochlear implants. Some other parameters in the signal that seem worth being analyzed are introduced.

2009 ◽  
Vol 19 (1) ◽  
pp. 4-13 ◽  
Author(s):  
Teresa A. Zwolan ◽  
Ellen Thomas

Abstract Candidacy criteria for determination of cochlear implantation for children have changed significantly since cochlear implants were first introduced. The contemporary evaluation process includes initial consultation, audiological assessment, speech and language assessment, preoperative counseling, selection of the ear to implant, medical evaluation, and additional assessments as needed. Ideally, an interdisciplinary team of professionals is involved in this evaluation process. The following article discusses procedures used in our clinic to determine a child's candidacy for a cochlear implant.


Author(s):  
Gillian Robyn Kerr ◽  
Seppo Tuomi ◽  
Alida Müller

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.


2013 ◽  
Vol 127 (9) ◽  
pp. 854-858 ◽  
Author(s):  
W-K Low ◽  
C A Tham ◽  
V-D D'Souza ◽  
S-W Teng

AbstractObjective:Except for a single case report, musical ear syndrome in cochlear implantees has not been studied. We aimed to study the prevalence and nature of musical ear syndrome among adult cochlear implant patients, as well as the effect on their emotional well-being.Study design, patients and intervention:A cross-sectional survey of patients aged 18 years and above who had received cochlear implants for profound hearing loss between 1997 and 2010.Results:Of the 82 patients studied, 18 (22 per cent) were found to have experienced musical ear syndrome. Seven and 11 patients had musical ear syndrome prior to and after cochlear implantation, respectively. The character of musical ear syndrome symptoms was described as instrumental music (n = 2), singing (6) or both (10). Fourteen patients reported an adverse emotional effect, with three expressing ‘intolerance’.Conclusions:In this study, 22 per cent of cochlear implantees experienced musical ear syndrome. These symptoms affected patients' emotional state, but most coped well. Musical ear syndrome can occur prior to and after cochlear implantation.


2015 ◽  
Vol 2015 ◽  
pp. 1-19 ◽  
Author(s):  
Micol Busi ◽  
Monica Rosignoli ◽  
Alessandro Castiglione ◽  
Federica Minazzi ◽  
Patrizia Trevisi ◽  
...  

Background. Specific clinical conditions could compromise cochlear implantation outcomes and drastically reduce the chance of an acceptable development of perceptual and linguistic capabilities. These conditions should certainly include the presence of inner ear malformations or brain abnormalities. The aims of this work were to study the diagnostic value of high resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in children with sensorineural hearing loss who were candidates for cochlear implants and to analyse the anatomic abnormalities of the ear and brain in patients who underwent cochlear implantation. We also analysed the effects of ear malformations and brain anomalies on the CI outcomes, speculating on their potential role in the management of language developmental disorders.Methods. The present study is a retrospective observational review of cochlear implant outcomes among hearing-impaired children who presented ear and/or brain anomalies at neuroimaging investigations with MRI and HRCT. Furthermore, genetic results from molecular genetic investigations (GJB2/GJB6and, additionally, in selected cases,SLC26A4or mitochondrial-DNA mutations) on this study group were herein described. Longitudinal and cross-sectional analysis was conducted using statistical tests.Results. Between January 1, 1996 and April 1, 2012, at the ENT-Audiology Department of the University Hospital of Ferrara, 620 cochlear implantations were performed. There were 426 implanted children at the time of the present study (who were <18 years). Among these, 143 patients (64 females and 79 males) presented ear and/or brain anomalies/lesions/malformations at neuroimaging investigations with MRI and HRCT. The age of the main study group (143 implanted children) ranged from 9 months and 16 years (average = 4.4; median = 3.0).Conclusions. Good outcomes with cochlear implants are possible in patients who present with inner ear or brain abnormalities, even if central nervous system anomalies represent a negative prognostic factor that is made worse by the concomitant presence of cochlear malformations. Common cavity and stenosis of the internal auditory canal (less than 2 mm) are negative prognostic factors even if brain lesions are absent.


1992 ◽  
Vol 107 (3) ◽  
pp. 410-417 ◽  
Author(s):  
Michael A. Seicshnaydre ◽  
Michele H. Johnson ◽  
M. Suzanne Hasenstab ◽  
George H. Williams

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.


2021 ◽  
Vol 42 (04) ◽  
pp. 373-380
Author(s):  
Lisa R. Park ◽  
Erika B. Gagnon ◽  
Kevin D. Brown

AbstractChildren require greater access to sound than adults as they are learning to communicate using hearing and spoken language. Yet when it comes to cochlear implant candidacy, currently approved Food and Drug Administration (FDA) criteria for adults are much less restrictive than those for children, allowing for greater levels of residual hearing and aided speech recognition in adults. Cochlear implant guidelines for children have changed very little in the 30 years since cochlear implants have been approved for pediatrics, and this lack of change has proven to be a barrier to implantation. Using evidence-based practice, centers have been providing off-label implantation for children who fall outside of current FDA criteria, including children with more residual hearing, children with single-side deafness younger than 5 years, and infants with bilateral profound loss younger than 9 months. The purpose of this article is to outline how these restrictions impede access to implants for children and describe the evidence supporting cochlear implantation in children who fall outside of current criteria.


2007 ◽  
Vol 86 (10) ◽  
pp. 612-613 ◽  
Author(s):  
Robert J. Stokroos ◽  
Pirn van Dijk

Cochlear implantation is considered to be a safe and effective treatment for severe to profound sensorineural hearing loss. Device failures are rare. We report the cases of 2 patients—a 44-year-old woman and a 3-year-old boy—with cochlear implants who were referred to our tertiary cochlear implant center for treatment of magnet migration secondary to mild head trauma. The migration had led to device failure in both cases. Surgical re-exploration was performed with nonmagnetic instruments, and both magnets were easily returned to their proper place. Postoperatively, implant function was restored to previous levels, and wound healing was uncomplicated. The incidence of magnet migration in cochlear implant patients is unknown. A few cases have been reported in children, but to the best of our knowledge, ours is the first report of magnet migration in an adult.


2004 ◽  
Vol 118 (12) ◽  
pp. 980-982 ◽  
Author(s):  
V.S. Sunkaraneni ◽  
A. Banerjee ◽  
R.F. Gray

Cochlear implants have transformed the treatment of sensorineural hearing loss. They have few major complications. The authors describe the case of a man fitted with a cochlear implant who suffered a postoperative subdural haematoma. The haematoma is thought to have been caused by bleeding from emissary veins opened by the drill passages used to anchor the sutures for the receiver/stimulator. The authors have abandoned tie down sutures in cochlear implants, preferring an appropriately deep well with squared-off rims, which would secure the implant in place. They have had no further complications of this nature.


2021 ◽  
pp. 019459982110213
Author(s):  
Kristen L. Seligman ◽  
A. Eliot Shearer ◽  
Kathy Frees ◽  
Carla Nishimura ◽  
Diana Kolbe ◽  
...  

Understanding genetic causes of hearing loss can determine the pattern and course of a patient’s hearing loss and may also predict outcomes after cochlear implantation. Our goal in this study was to evaluate genetic causes of hearing loss in a large cohort of adults and children with cochlear implants. We performed comprehensive genetic testing on all patients undergoing cochlear implantation. Of the 459 patients included in the study, 128 (28%) had positive genetic testing. In total, 44 genes were identified as causative. The top 5 genes implicated were GJB2 (20, 16%), TMPRSS3 (13, 10%), SLC26A4 (10, 8%), MYO7A (9, 7%), and MT-RNR1 (7, 5%). Pediatric patients had a higher diagnostic rate. This study lays the groundwork for future studies evaluating the relationship between genetic variation and cochlear implant performance.


Author(s):  
Owen M. Bradfield

AbstractIt has been forty years since the first multi-channel cochlear implant was used in Australia. While heralded in the hearing world as one of the greatest inventions in modern medicine, not everyone reflects on this achievement with enthusiasm. For many people in the Deaf community, they see the cochlear implant as a tool that reinforces a social construct that pathologizes deafness and removes Deaf identity. In this paper, I set out the main arguments for and against cochlear implantation. While I conclude that, on balance, cochlear implants improve the well-being and broaden the open futures of deaf children, this does not justify mandating implants in circumstances where parents refuse them because this may compound unintended harms when society interferes in the parent-child relationship. For this reason, I argue that parental refusal of cochlear implantation falls within Gillam’s concept of the zone of parental discretion.


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