Does cochlear implantation restore music appreciation?

Abstract

The LaryngoscopeVolume 124, Issue 3 p. 587-588 Triological Society Best PracticeFree Access Does cochlear implantation restore music appreciation? Gavriel Kohlberg MD, Gavriel Kohlberg MD Columbia University Cochlear Implant Center, Department of Otolaryngology–Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, New York, U.S.A.Search for more papers by this authorJaclyn B. Spitzer PhD, Jaclyn B. Spitzer PhD Columbia University Cochlear Implant Center, Department of Otolaryngology–Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, New York, U.S.A.Search for more papers by this authorDean Mancuso AuD, Dean Mancuso AuD Columbia University Cochlear Implant Center, Department of Otolaryngology–Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, New York, U.S.A.Search for more papers by this authorAnil K. Lalwani MD, Corresponding Author Anil K. Lalwani MD Columbia University Cochlear Implant Center, Department of Otolaryngology–Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, New York, U.S.A.Send correspondence to Anil K. Lalwani, MD, Division of Otology, Neurotology and Skull Base Surgery, Department of Otolaryngology, Columbia University College of Physicians and Surgeons, 180 Fort Washington Avenue, Harkness Pavilion, 8th Floor, New York, NY 10032. E-mail: anil.lalwani@columbia.eduSearch for more papers by this author Gavriel Kohlberg MD, Gavriel Kohlberg MD Columbia University Cochlear Implant Center, Department of Otolaryngology–Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, New York, U.S.A.Search for more papers by this authorJaclyn B. Spitzer PhD, Jaclyn B. Spitzer PhD Columbia University Cochlear Implant Center, Department of Otolaryngology–Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, New York, U.S.A.Search for more papers by this authorDean Mancuso AuD, Dean Mancuso AuD Columbia University Cochlear Implant Center, Department of Otolaryngology–Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, New York, U.S.A.Search for more papers by this authorAnil K. Lalwani MD, Corresponding Author Anil K. Lalwani MD Columbia University Cochlear Implant Center, Department of Otolaryngology–Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, New York, U.S.A.Send correspondence to Anil K. Lalwani, MD, Division of Otology, Neurotology and Skull Base Surgery, Department of Otolaryngology, Columbia University College of Physicians and Surgeons, 180 Fort Washington Avenue, Harkness Pavilion, 8th Floor, New York, NY 10032. E-mail: anil.lalwani@columbia.eduSearch for more papers by this author First published: 21 May 2013 https://doi.org/10.1002/lary.24171Citations: 21 Dr. Lalwani serves on the Medical Advisory Board of Advanced Bionics Corporation. The authors have no other funding, financial relationships, or conflicts of interest to disclose. AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat BACKGROUND The cochlear implant (CI) restores hearing to deafened individuals, allowing most CI users to reach an excellent level of speech discrimination, often to the point of being able to use a telephone. The increased ability to communicate afforded by cochlear implantation has been shown to have a significant positive effect on the quality of life of deafened individuals.1 Does CI lead to similar restoration of ability to appreciate and consume music? LITERATURE REVIEW Despite high levels of speech understanding, CI users have poor perception of basic music elements, which has been thought to decrease their enjoyment of music. During the validation of the University of Washington Clinical Assessment of Music Perception Test developed to quantify music perception, Kang et al.2 examined pitch direction discrimination, melody recognition, and timbre recognition in 42 postlingually deafened adult CI users and 10 normal hearing (NH) individuals. CI users had a mean pitch direction discrimination of three semitones compared to one semitone for NH individuals. Melodies were recognized 25.1% of the time by CI users compared to 87.5% of the time in NH listeners. In a test of timbre recognition, CI users correctly identified only 45.3% of musical instruments, whereas NH individuals did so at a 94.2% rate. There was a statistically significant difference in performance between CI and NH listeners in each of these tests, with the NH listeners performing superiorly. Low resolution, poor temporal resolution, and skewed mapping of transmitted frequencies are thought to decrease music perception and thereby music enjoyment. Lassaletta et al.3 surveyed 65 postlingually deafened CI users about their listening habits and their perception of the quality of musical sound. Survey recipients were asked to compare their music listening habits before hearing loss to that after implantation. Prior to hearing loss, 68% of those in this study listened to 3 or more hours of music per week. After implantation, 62% of the study participants listened to 2 hours or less of music per week, a statistically significant decrease in music listening time. Participants were also asked to describe themselves as someone who enjoyed music—from strongly disagree to strongly agree—before hearing loss and after implantation. Although there was a significant decrease in the level at which participants described themselves as enjoying music, 32% still enjoyed or strongly enjoyed music after implantation. Migirov et al.4 surveyed 53 CI users about their listening habits and enjoyment of music and demonstrated wide variation in music enjoyment in CI users. Overall, the survey respondents had a significantly decreased enjoyment of music from preimplantation to postimplantation. However, 73.6% of respondents still listened to music after implantation. Among those patients who still listened to music, there was only a small decrease in music enjoyment, from 7.92 to 7.56 on a 10-point enjoyment scale, whereas among those CI users who stopped listening to music, their enjoyment dropped from 8 to 1.93 out of 10. Among all survey respondents, music enjoyment ratings worsened in 50.9%, remained the same in 22.6%, and improved in 26.4%. Furthermore, 30.2% would have undergone implantation just for being able to listen to music. Of note, age at implantation, gender, duration of deafness, duration of CI use, type of CI device, speech coding strategy, or speech perception ability were not significantly related to listening versus not listening to music after implantation. In particular, speech discrimination was actually better in the nonlisteners than in those who listened to music after implantation—49.2 versus 43 on the Arthur Boothroyd monosyllabic word test. Mirza et al.5 assessed music appreciation in CI users through a questionnaire survey. Of 35 respondents, 46% listened to music after implantation. On a 10-point enjoyment scale, music enjoyment decreased significantly both in listeners (from 9.3 to 5.6) and in nonlisteners (from 8.2 to 0). Compared to nonlisteners, listeners were significantly younger, had a higher speech recognition score, and had a shorter duration of deafness. Even though 69% were disappointed with how music sounded after implantation, 37% would have undergone implantation just to listen to music. BEST PRACTICE There is wide variation in CI users' listening habits and enjoyment of music, with some implantees even greatly enjoying music. Implantees have decreased music perception, as measured by pitch, melody, and timbre recognition, contributing to a decrease in enjoyment of music. Although many CI listeners spend less time listening to music than they did prior to their deafness, 38% to 73.6% still listen to music, 49% find music equally or more enjoyable than before implantation, and 30.2% to 37% would undergo implantation just for being able to listen to music. Future research aimed at improving music perception through advances in CI hardware and software will likely lead to improved music enjoyment after implantation. Additionally, music engineering—designing music specifically for the cochlear implantee—may also enhance enjoyment of music. LEVEL OF EVIDENCE The references cited are level 4 (case series). BIBLIOGRAPHY 1Francis HW, Chee N, Yeagle J, Cheng A, Niparko JK. Impact of cochlear implants on the functional health status of older adults. Laryngoscope 2002; 112: 1482– 1488. Wiley Online LibraryPubMedWeb of Science®Google Scholar 2Kang R, Nimmons GL, Drennan W, et al. Development and validation of the University of Washington Clinical Assessment of Music Perception test. Ear Hear 2009; 30: 411– 418. CrossrefPubMedWeb of Science®Google Scholar 3Lassaletta L, Castro A, Bastarrica M, et al. Changes in listening habits and quality of musical sound after cochlear implantation. Otolaryngol Head Neck Surg 2008; 138: 363– 367. CrossrefPubMedWeb of Science®Google Scholar 4Migirov L, Kronenberg J, Henkin Y. Self-reported listening habits and enjoyment of music among adult cochlear implant recipients. Ann Otol Rhinol Laryngol 2009; 118: 350– 355. CrossrefPubMedWeb of Science®Google Scholar 5Mirza S, Douglas SA, Lindsey P, Hildreth T, Hawthorne M. Appreciation of music in adult patients with cochlear implants: a patient questionnaire. Cochlear Implants Int 2003; 4: 85– 95. Wiley Online LibraryCASPubMedGoogle Scholar Citing Literature Volume124, Issue3March 2014Pages 587-588 ReferencesRelatedInformation