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 Current criteria for selecting cochlear implant in deaf patients: a review

2021 ◽  
Vol 9 (1) ◽  
pp. 50
Author(s):  
Santosh Kumar Swain
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Neural Plasticity ◽  
Cochlear Implantation ◽  
Surgical Techniques ◽  
Low Frequency ◽  
Hearing Preservation ◽  
Electrode Arrays ◽  
Profound Hearing Loss ◽  
Unilateral Deafness

Cochlear implantation is indicated in patients with severe to profound hearing loss that cannot be adequately treated by other auditory rehabilitation measures. The definitive indication of cochlear implantation is made on the basis of an extensive interdisciplinary clinical, audiological, radiological, and psychological diagnostic work-up. There are numerous changes are happening in cochlear implant candidacy. These have been associated with concomitant changes in surgical techniques, which enhanced the utility and safety of cochlear implantation. Currently, cochlear implants are approved for individuals with severe to profound unilateral hearing loss rather than previously needed for bilateral profound hearing loss. Studies have begun using the short electrode arrays for shallow insertion in patients with low-frequency residual hearing loss. The advancement in designs of the cochlear implant along with improvements in surgical techniques reduce the complications and result in the safety and efficacy of the cochlear implant which further encourages the use of these devices. This review article aims to discuss the new concepts in the candidacy of the cochlear implant, cochlear implant in younger children and hearing preservation, a cochlear implant for unilateral deafness, bilateral cochlear implant, and cochlear implant with neural plasticity and selection of patients for the cochlear implant.

Qualification of unilateral cochlear implant recipients for a second device

2019 ◽  
Vol 73 (6) ◽  
pp. 8-17 ◽  
Author(s):  
Maria Drela ◽  
Karolina Haber ◽  
Iwona Wrukowska ◽  
Michael Puricelli ◽  
Anna Sinkiewicz ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Short Interval ◽  
Binaural Hearing ◽  
Speech Development ◽  
Vestibular Organ ◽  
Profound Hearing Loss ◽  
Potential Benefits ◽  
Effective Use

Introduction: Although it is recommended to perform cochlear implantation in both ears at the same time for management of profound hearing loss in children, many centers prefer to perform sequential implantation. There are many reasons as to why a simultaneous bilateral implantation is not commonly accepted and performed. The major risk is the possibility of bilateral vestibular organ impairment. However, it is beyond doubt that children who received the first implant should be given a chance for binaural hearing and associated benefits. In the literature, there are no homogenous criteria for bilateral implantation, and it is hard to find uniform and convincing algorithms for second cochlear implantation. The aim of this study is an attempt to identify a safe way of qualifying for second cochlear implantation in children. Material and methods: Forty children with one cochlear implant were qualified for the second implantation. During qualification, the following were taken into account: time of the first implantation, audiometry results, use of the hearing aid in the ear without an implant and benefit of the device, speech and hearing development, and vestibular organ function. R esults: Fifteen out of forty children (38%) were qualified for the second implantation. In 35% of children, the decision was delayed with possible second implantation in the future. Eleven children (27%) were disqualified from the second surgery. Discussion: During evaluation according to the protocol presented in our study, 38% of children with a single cochlear implant were qualified for the second implantation with a chance for an optimal development and effective use of the second cochlear implant. We are convinced that sequential implantation with a short interval between surgeries and with an examination of the vestibular organ, hearing and speech development as well as an assessment of potential benefits from the second implant (bimodal stimulation) before the second implantation is the safest and most beneficial solution for children with severe hearing loss.

Considerations for Pediatric Cochlear Implant Recipients With Unilateral or Asymmetric Hearing Loss: Assessment, Device Fitting, and Habilitation

2017 ◽  
Vol 26 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Laura Greaver ◽  
Hannah Eskridge ◽  
Holly F. B. Teagle
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Clinical Report ◽  
Loss Assessment ◽  
Profound Hearing Loss ◽  
Single Sided Deafness ◽  
Asymmetric Hearing Loss ◽  
Case Basis ◽  
Moderate Hearing Loss

Purpose The purpose of this clinical report is to present case studies of children who are nontraditional candidates for cochlear implantation because they have significant residual hearing in 1 ear and to describe outcomes and considerations for their audiological management and habilitation. Method Case information is presented for 5 children with profound hearing loss in 1 ear and normal or mild-to-moderate hearing loss in the opposite ear and who have undergone unilateral cochlear implantation. Pre- and postoperative assessments were performed per typical clinic routines with modifications described. Postimplant habilitation was customized for each recipient using a combination of traditional methods, newer technologies, and commercial materials. Results The 5 children included in this report are consistent users of their cochlear implants and demonstrate speech recognition in the implanted ear when isolated from the better hearing ear. Conclusions Candidacy criteria for cochlear implantation are evolving. Children with single-sided deafness or asymmetric hearing loss who have traditionally not been considered candidates for cochlear implantation should be evaluated on a case-by-case basis. Audiological management of these recipients is not vastly different compared with children who are traditional cochlear implant recipients. Assessment and habilitation techniques must be modified to isolate the implanted ear to obtain accurate results and to provide meaningful therapeutic intervention.

Contemporary Considerations for Cochlear Implantation for Children With Multiple Disabilities

2009 ◽  
Vol 19 (2) ◽  
pp. 69-74 ◽  
Author(s):  
Susan Waltzman
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Multiple Disabilities ◽  
Profound Hearing Loss ◽  
Contemporary Management

Abstract Due to advances in cochlear implant technology and the remarkable outcomes often achieved by persons with severe to profound hearing loss, cochlear implant candidacy criteria has expanded since the first children were implanted almost twenty years ago. Evidence of this can be seen in the increased willingness to provide cochlear implants for children with multiple disabilities. Over the last decade, several reports have appeared in the peer-reviewed literature describing cochlear implant outcomes of children with multiple disabilities. This paper will summarize those reports, discuss realistic expectations of implantation for children with multiple disabilities, and describe contemporary management protocols for the otologic, audiologic, and rehabilitative management of children with multiple disabilities.

scholarly journals Cochlear implantation in a patient with mucopolysaccharidosis IVA

2019 ◽  
Vol 7 ◽  
pp. 2050313X1987379 ◽  
Author(s):  
Kyoko Nagao ◽  
Cassidy Walter ◽  
William J Parkes ◽  
Michael Teixido ◽  
Mary C Theroux ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Cochlear Implant ◽  
Sensorineural Hearing Loss ◽  
Multidisciplinary Team ◽  
Cochlear Implantation ◽  
Sensorineural Hearing ◽  
Mucopolysaccharidosis Iva ◽  
Morquio A ◽  
Auditory Performance

Mucopolysaccharidosis IVA (OMIM 253000; also known as Morquio A syndrome) is associated with skeletal, airway, and hearing abnormalities. Cochlear implantation is an effective intervention for patients with severe-to-profound hearing loss. Patients can gain substantial improvement in auditory performance, speech perception, and their quality of life from cochlear implantation. Although severe progressive sensorineural hearing loss is a common feature of mucopolysaccharidosis IVA, no detailed description of cochlear implantation for mucopolysaccharidosis IVA has been reported. To review the effectiveness and special considerations associated with cochlear implantation in patients with mucopolysaccharidosis IVA, we here report the case of cochlear implantation in mucopolysaccharidosis IVA by a multidisciplinary team. A retrospective chart review was conducted on a 34-year-old female with mucopolysaccharidosis IVA, who received a cochlear implant. Audiometric thresholds, speech perception scores, and cochlear implant processor mapping information were reviewed during the first 12 months following cochlear implantation. The results of audiological tests indicate improved hearing thresholds as well as remarkable enhancement of speech perception skills over 12 months of cochlear implant use. Cochlear implantation improved auditory performance in a mucopolysaccharidosis IVA patient with postlingually severe-to-profound sensorineural hearing loss. The benefits of cochlear implantation could be meaningful for other Morquio patients with progressive hearing loss, although the risks of surgery and anesthesia should be carefully considered by a multidisciplinary team of experts during the cochlear implant candidacy process.

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 Cochlear implant application with postlingually deaf patients

2004 ◽  
Vol 132 (11-12) ◽  
pp. 427-430 ◽  
Author(s):  
Rade Kosanovic ◽  
Zoran Ivankovic ◽  
Sandra Stojanovic
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Technology Development ◽  
Modern Technology ◽  
Profound Hearing Loss ◽  
Male Adult ◽  
Coding Strategies ◽  
Prelingually Deaf

Through last several decades, cochlear implant has been fully recognized for treatment of profound hearing loss. Modern technology development enabled unimagined possibilities in technical qualities of the device, as well as development of usable coding strategies, which led to extraordinary results of patient rehabilitation. It is well known that postlingually deaf implanted patients show better results than prelingually deaf implanted patients. This is to be understood, concerning the fact of matured hearing paths and centers of CNS, presence of developed speech in patients postlingually deaf, contrary to prelingually deaf patients in whom the development of hearing paths and centers is yet to be established only after cochlear implantation. Accordingly, this is a case report of male adult patient B.D. who was implanted because of complete deafness following the application of gentamicin. The results of implantation were excellent and fully justified the choice of the patient for CI application.

scholarly journals Application of Wireless Contralateral Routing of Signal Technology in Unilateral Cochlear Implant Users with Bilateral Profound Hearing Loss

2019 ◽  
Vol 30 (07) ◽  
pp. 579-589 ◽  
Author(s):  
Hillary A. Snapp ◽  
Michael E. Hoffer ◽  
Anthony Spahr ◽  
Suhrud Rajguru
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Cochlear Implant ◽  
Repeated Measures ◽  
Statistical Significance ◽  
Profound Hearing Loss ◽  
Speech In Noise ◽  
Bonferroni Adjustment ◽  
Significant Difference ◽  
Hearing Outcomes

AbstractThe aim of the study was to determine if contralateral routing of signal (CROS) technology results in improved hearing outcomes in unilateral cochlear implant (CI) patients and provides similar gains in speech perception in noise to traditional monaural listeners (MLs).The study is a prospective, within-subject repeated-measures experiment.Adult, English-speaking patients with bilateral severe–profound sensorineural hearing loss using an Advanced Bionics CI (n = 12) in one ear were enrolled for the study.Hearing performance in the monaural listening condition (CI only) was compared with the CROS-aided (unilateral CI + CROS) condition. Participants were tested for speech-in-noise performance using the Bamford-Kowal-Bench Speech-in-Noise™ test materials in the speech front/noise front (0 degrees/0 degrees azimuth), speech front/noise back (0 degrees/180 degrees azimuth), speech deaf ear/noise monaural ear (90 degrees/270 degrees azimuth), and speech monaural ear/noise deaf ear (90 degrees/270 degrees azimuth) configurations. Localization error was assessed using three custom stimuli consisting of 1/3 octave narrowband noises centered at 500 and 4000 Hz and a broadband speech stimulus. Localization stimuli were presented at random in the front hemifield by 19 speakers spatially separated by 10 degrees. Outcomes were compared with a previously described group of traditional MLs in the CROS-aided condition (normal hearing ear + CROS).All participants were tested acutely with no adaptation to the CROS device. Statistical analyses were performed using Wilcoxon signed rank tests for nonparametric data and paired sample. Statistical significance was set to p < 0.00625 after Bonferroni adjustment for eight tests.Significant benefit was observed from unaided to the CI + CROS–aided condition for listening in noise across most listening conditions with the greatest benefit observed in the speech deaf ear/noise monaural ear (90 degrees/270 degrees azimuth) condition (p < 0.0005). When compared with traditional MLs, no significant difference in decibel gain from the unaided to CROS-aided conditions was observed between participant groups. There was no improvement in localization ability in the CROS-aided condition for either participant group and no significant difference in performance between traditional MLs and unilateral CI listeners.These findings support that unilateral CI users are capable of achieving similar gains in speech perception to that of traditional MLs with wireless CROS. These results indicate that the use of wireless CROS stimulation in unilateral CI recipients provides increased benefit and an additional rehabilitative option for this population when bilateral implantation is not possible. The results suggest that noninvasive CROS solutions can successfully rehabilitate certain monaural listening deficits, provide improved hearing outcomes, and expand the reach of treatment in this population.

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.

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