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Environmental sound perception of cochlear implant users

Cochlear Implants International — Fri, 30 Oct 2009 00:00:00 +0100

The purposes of this study were (1) to develop a new test of environmental sound perception, the Environmental Sounds Perception Test (EST), (2) to compare the performance of experienced cochlear implant (CI) recipients with that of age-equivalent normally hearing (NH) listeners using this new test, and (3) to pilot test its clinical use as a pre-to-post assessment tool. The closed-set EST consisted of 45 different sounds classified into nine categories, with each sound being represented by two different tokens. The results showed that the NH participants scored significantly higher than the experienced CI users (p < 0.001). For the pre-to-post CI group, higher scores were obtained post-surgery with the CI; this difference was approaching significance (p = 0.068). Overall these results sug...

Cochlear implantation in a profoundly deaf patient who also suffers from multiple sclerosis - a case study

Cochlear Implants International — Mon, 26 Oct 2009 00:00:00 +0100

We present a case study of cochlear implantation in a post-lingual adult having bilateral profound hearing loss for over 30 years in addition to multiple sclerosis unrelated to his deafness. Assessment of benefit in terms of speech-perception ability and quality of life reveal that long-term auditory deprivation and co-incidental multiple sclerosis are not a contraindication for cochlear implantation. Copyright © 2009 John Wiley & Sons, Ltd. (Source: Cochlear Implants International)

Acoustic analysis of voice in cochlear implant recipients with post-meningitic hearing loss

Cochlear Implants International — Mon, 05 Oct 2009 23:00:00 +0100

The objective of this study was to evaluate the critical time period between the onset of sensorineural hearing loss and cochlear implantation with respect to normal voice production in children with post-meningitic hearing loss. Acoustic measures of voice production were obtained from ten paediatric cochlear implant recipients with post-meningitic hearing loss. Acoustic measures were obtained utilising the Multi-Dimensional Voice Program and Computerized Speech Laboratory (Kay Elemetrics Corp.). Measures were based on sustained phonation of the vowel /a/. Acoustic parameters included fundamental frequency, short- and long-term frequency perturbation, and short- and long-term amplitude perturbation. Measures of fundamental frequency and short-term frequency and amplitude perturbation were ...

Associations between auditory capacity, speech and language, level of communication and parental assessment of children with cochlear implant

Cochlear Implants International — Wed, 19 Aug 2009 23:00:00 +0100

168 children with cochlear implants were assessed as regards to auditory capacity, level of speech and language and communicative skills. The assessments were made by speech and language pathologists and parents. The purpose of the study was to analyse the associations between the four areas and furthermore to analyse associations between professional and parental assessments. The children were assessed with the Tait Video Analysis, the receptive part of the Reynell Test, a phonological test and a vocabulary test. The four objective tests were analysed for potential associations between results. In addition, potential associations between the results of the four tests and parental assessment of their child's auditory capacity (CAP) and speech intelligibility (SIR) were investigated. The Ga...

Estimation of risks associated with paediatric cochlear implantation

Cochlear Implants International — Mon, 03 Aug 2009 23:00:00 +0100

The objectives of this study were to estimate the rates of complications associated with paediatric cochlear implantation use: a) at one Canadian cochlear implant (CI) centre, and b) in the published literature. It comprised a retrospective hospital-based chart review and a concurrent review of complications in the published literature. There were 224 children who had undergone surgery from 1994 to June 2007. Results indicate that the rates of complications at the local Canadian paediatric CI centre are not significantly different from the literature rates for all examined complication types. This hospital-based retrospective chart review and review of the literature provide readers with an estimation of the risks to aid in evidence-based decision-making surrounding paediatric cochlear imp...

The use of Lean Thinking techniques in implementing the Department of Health, UK, 18-week waiting time directive for cochlear implantation

Cochlear Implants International — Mon, 03 Aug 2009 23:00:00 +0100

In October 2007, Primary Care Trusts throughout the East of England agreed to fund assessment and implantation for all patients referred to Cambridge University Hospitals' Cochlear Implant Unit ('the Unit') providing they met locally agreed criteria.Subsequently, the Unit has employed Lean Thinking techniques to maximize departmental efficiency in order to comply with the Department of Health's 18-week guideline. Analysis of the patient's pathway, from referral to implantation surgery, highlighted areas of 'waste' that were causing delays in downstream processes. Through a number of streamlining measures a large waiting list of long-waiting patients (n = 141) has been cleared. Of those patients not receiving a preliminary hearing aid trial, 89% were implanted within 18 weeks (31/35 patient...

Conversion of scores between Bamford, Kowal and Bench (BKB) sentences and Arthur Boothroyd (AB) words in quiet for cochlear implant patients

Cochlear Implants International — Tue, 14 Jul 2009 23:00:00 +0100

This paper describes the relationship between the scores obtained in the Bamford, Kowal and Bench (BKB) sentence test and the Arthur Boothroyd (AB) word test in quiet for a group of 71 cochlear implant users. Each subject was tested at the same appointment and in the same environment during routine clinical appointments at the South of England Cochlear Implant Centre.Using rationalised arcsine transformation and a linear regression calculation, conversion tables were produced from BKB to AB and from AB to BKB scores. The relationship between scores obtained from the two tests was highly significant.These conversion tables may be of use in cochlear implant centres and by audiology clinics. Copyright © 2009 John Wiley & Sons, Ltd. (Source: Cochlear Implants International)

Bilateral sequential cochlear implantation in the congenitally deaf child: evidence to support the concept of a 'critical age' after which the second ear is less likely to provide an adequate level of speech perception on its own

Cochlear Implants International — Thu, 09 Jul 2009 23:00:00 +0100

This study attempts to answer the question of whether there is a 'critical age' after which a second contralateral cochlear implant is less likely to provide enough speech perception to be of practical use. The study was not designed to predict factors that determine successful binaural implant use, but to see if there was evidence to help determine the latest age at which the second ear can usefully be implanted, should the first side fail and become unusable.Outcome data, in the form of speech perception test results, were collected from 11 cochlear implant programmes in the UK and one centre in Australia. Forty-seven congenitally bilaterally deaf subjects who received bilateral sequential implants were recruited to the study. The study also included four subjects with congenital unilate...

The influence of the coupling of actuation drivers of implantable hearing systems on the mechanics of the middle ear

Cochlear Implants International — Fri, 24 Apr 2009 04:00:00 +0100

We used multifrequency tympanometry to provide middle ear mechanics after implantation of different implantable hearing aids. A total of 34 patients were included in the investigation; 19 of them were fitted with the Otologics system and 15 with the MED-EL Vibrant Soundbridge system. With the Otologics recipients, measurements were made preoperatively and both two months and at least 12 months postoperatively. Measurements involving the MED-EL patients were taken at least 12 months postoperatively. For all measurements, the non-implanted contralateral side was used as a control. Preoperatively, the resonance frequency of the Otologics patients was 904.3 ± 218.2 Hz for the implanted side and 907.1 ± 161.8 Hz for the non-implanted side. Postoperatively, a significant increase (p < 0.01) co...

The transmeatal approach: a new technique in cochlear and middle ear implants

Cochlear Implants International — Fri, 17 Apr 2009 04:00:00 +0100

We report on the use of this approach in 131 patients (115 consecutive paediatric and 16 adult) between May 2004 and December 2007. During 2 to 46 months of follow-up there was no electrode extrusion. Copyright © 2009, John Wiley & Sons, Ltd. (Source: Cochlear Implants International)

Cochlear implantation in inner ear malformations

Cochlear Implants International — Wed, 08 Apr 2009 04:00:00 +0100

Inner ear malformations constitute about 20% of congenital sensorineural hearing loss. In this review article an updated classification of cochlear malformations is provided. Incomplete partition and cochlear hypoplasia cases are each divided further into three groups. There are two main difficulties in the surgery of inner ear malformations; gusher and facial nerve abnormalities. Radiological features of malformations necessary to identify these problems preoperatively are discussed. Facial nerve abnormalities that may occur are described. Two different types of cerebrospinal fluid leakage are defined and necessary measures to prevent leakage are described. Standard and modified surgical approaches to overcome the described problems are described with literature findings. Finally meningit...

Cochlear implantation in inner ear malformations - a review article

Cochlear Implants International — Tue, 07 Apr 2009 23:00:00 +0100

Comparison of loudness adjustments by MCL and maplaw in users of the MED-EL COMBI 40/40+ cochlear implant system

Cochlear Implants International — Thu, 19 Mar 2009 04:00:00 +0100

The programming of a CI speech processor involves measurement of electrical threshold and 'most comfortable loudness' (MCL) levels on each electrode. However, when the derived 'map' is activated the resultant percept is often too loud or too soft. In this situation, adjustments of MCL settings are usually made in order to achieve a comfortable percept.The present study examined the range of volume control adjustments in 24 users of the MED-EL C40/40+ device. Volume control settings varied from 36% to 126% with a mean of 84.3% (SD = 20.4%). Additionally, the output compression function ('maplaw') was adjusted to test whether this alternative manipulation could result in a comfortable percept. It was found that this could be achieved satisfactorily, with maplaw values ranging from 10 to 2000...

Case report of a child with otoacoustic emissions and profound hearing loss in whom otoacoustic emissions were preserved after cochlear implantation

Cochlear Implants International — Sat, 14 Mar 2009 04:00:00 +0100

The management of patients characterised by the presence of otoacoustic emissions and/or cochlear microphonics suggesting normal outer hair cell function in conjunction with absent or grossly abnormal auditory brainstem responses is often associated with particularly poor response to amplification. Cochlear implantation has been shown to be an option in affected patients. Here, we report a case of successful cochlear implantation and preserved otoacoustic emissions in a child suffering from this hearing disorder. Copyright © 2009 John Wiley & Sons, Ltd. (Source: Cochlear Implants International)

A framework for good practice: managing failures in a cochlear implant service

Cochlear Implants International — Mon, 02 Mar 2009 05:00:00 +0100

Cochlear implants can provide the recipient and their family with wonderful outcomes in terms of their improved access to sound and to speech. However the experience of a cochlear implant failing is distressing for all concerned. Clinicians endeavour to ensure that the process of confirming the failure, re-implantation and subsequent rehabilitation is as smooth as possible. In order to benefit from each others experience, a working party of cochlear implant centre coordinators and representatives from the Ear Foundation met on a number of occasions to draw up a protocol which could be used widely throughout the British Cochlear Implant Group. The protocol indicates quality standards of clinical care to be used in the event of device failure. Copyright © 2009 John Wiley & Sons, Ltd. (Sourc...

Independent component analysis for robust assessment of auditory system maturation in children with cochlear implants

Cochlear Implants International — Sat, 28 Feb 2009 05:00:00 +0100

The long latency auditory evoked potential (LLAEP) has been used for tracking changes in latency and morphology of the P1 peak in order to evaluate the maturation of the auditory system in children with cochlear implants (CIs). Cochlear implants can induce an artefact in the recordings when sounds are presented, which makes the analysis of LLAEPs much harder. Independent component analysis (ICA) has been used to remove this artefact. In this paper we apply a procedure based on ICA to reduce the CI artefact, to detect the LLAEPs and to use the changes in the spatial projections of their independent components (ICs) for a robust evaluation of the maturation of the auditory system in children with CIs. Copyright © 2009 John Wiley & Sons, Ltd. (Source: Cochlear Implants International)

Simultaneous bilateral cochlear implantation: prospective study in adults

Cochlear Implants International — Thu, 26 Feb 2009 05:00:00 +0100

Normal-hearing listeners gain important everyday benefits from having two ears, particularly for determining where sounds come from and for understanding speech in noisy environments. Users of two cochlear implants may have the opportunity to experience some of these bilateral advantages. The primary aim of this study was to document bilateral versus unilateral listening benefit in 15 postlinguistically deafened adults implanted simultaneously with two Harmony® (HiRes 90K®) cochlear implants. Speech perception (in quiet and in noise) and localization accuracy were assessed for each ear alone and both ears together. Subjects showed improved sound localization and better speech perception in quiet and in noise when using two implants compared with using one implant alone. Copyright © 2009...

The importance of intra-operative imaging during cochlear implant surgery

Cochlear Implants International — Fri, 06 Feb 2009 05:00:00 +0100

In conclusion, intra-operative monitoring tests during CI surgery play different roles: measurement of impedances and NRI can evaluate the integrity of implant electrodes and the status of the electrode cochlea interface, but they cannot be the only way to confirm correct positioning of the array. In our opinion the intra-operative radiological check is helpful during CI surgery, especially when there is any doubt about correct electrode insertion. Copyright © 2009 John Wiley & Sons, Ltd. (Source: Cochlear Implants International)

Cochlear implant and delayed facial palsy

Cochlear Implants International — Thu, 05 Feb 2009 05:00:00 +0100

The objectives of this study were: to report a case of delayed facial palsy following cochlear implant surgery in a patient who had positive viral antibody markers pre operatively; and to review the literature on delayed onset facial paralysis following viral reactivation and its relation to cochlear implant surgery. An extensive literature review was done using internet and medical search engines and library facilities. Important articles on the topic were identified and summarised. Data on delayed facial palsy following cochlear implant surgery were collected, constructed in a coherent way and details discussed. Postulated mechanisms of delayed facial palsy include neural oedema, vasospasm and viral reactivation. Of these, reactivation of previous herpes simplex virus infection has speci...

Development of the computerized Mandarin Pediatric Lexical Tone and Disyllabic-word Picture Identification Test in Noise (MAPPID-N)