Success Of Cochlear Implantation Research Articles

Musical Training for Auditory Rehabilitation in Hearing Loss.

Despite the overall success of cochlear implantation, language outcomes remain suboptimal and subject to large inter-individual variability. Early auditory rehabilitation techniques have mostly focused on low-level sensory abilities. However, a new body of literature suggests that cognitive operations are critical for auditory perception remediation. We argue in this paper that musical training is a particularly appealing candidate for such therapies, as it involves highly relevant cognitive abilities, such as temporal predictions, hierarchical processing, and auditory-motor interactions. We review recent studies demonstrating that music can enhance both language perception and production at multiple levels, from syllable processing to turn-taking in natural conversation.

First experiences with Cochlear Implant Function Index (CIFI) in Hungary

Introduction: The success of cochlear implantation can be evaluated with audiological measurements and quality of life questionnaires. Aim: Our aim was to translate and introduce the Cochlear Implant Function Index (CIFI) test to analyze the physical, psychological and social state of our cochlear implant patients. Method: Between 01. 11. 2016 and 31. 05. 2018, 30 patients filled the questionnaire before and 6 and 12 months after the implantation. Results and conclusion: Results showed a remarkable improvement in the quality of life in several patients even after 6 months. Further improvements could be measured after 12 months. Orv Hetil. 2019; 160(33): 1296-1303.

How can the Success Post Cochlear Implant be Measured or Defined in Older Adults? Implications of the International Classification of Functioning Brief Core Set for Hearing Loss

Objectives: Hearing loss (HL) represents a broad category of normal age-related changes that lead to several diminished domains of functions including sensory, cognition, emotional, social, and overall quality of life which may increase loss of independence. Despite the enormous success of cochlear implantation (CI) to treat profound HL in older adults, the individual differences in outcome measures due to several functional deteriorations raise an important question: “How can the success post-CI be measured or defined in older adults?” In 2012, the International classification of functioning (ICF) brief core set of hearing loss was designed to provide clinicians an international standard of what to assess and report on persons with HL. The main objective of this pilot study is to demonstrate success post-CI in older adults using the ICF concepts and brief core set of HL and to discuss what is needed in order to meet the functional decline in older adult CI users. Design: Case studies of nine older adult CI users were analyzed using single-subject analysis. Results: Twenty of 27 ICF brief core set items were linked to from the study materials. The ICF analysis clearly demonstrated the individual differences in outcome measures. One case of nine met the criteria of the ICF. Conclusions: The ICF is a valuable instrumental tool that can be used in CI clinics to optimize audiologic rehabilitation services provided to the aging population. Undoubtedly, there is a need to re-define success post CI in the elderly according to the ICF concept.

Short-term results of Neurelec Digisonic SP cochlear implantation in prelingually deafened children

This paper examines the reports on the selection criteria and the post-operative performance of 25 children implanted with the Neurelec Digisonic SP. This study reported benefits from Neurelec Digisonic SP cochlear implant in auditory and speech perception outcomes. There has been a lack of studies into the additional factors such as level of the mothers' education and bilingualism, which is a factor that may have a significant effect on the success of cochlear implantation. This paper examines the reports on the reasons for the differences in performance and the post-operative performance of 25 children implanted with the Neurelec Digisonic SP. Meaningful Auditory Integration Scale and Meaningful Use of Speech Scale questionnaires were used just before 3, 6, 12, and 18months following implantation. Electrode array was inserted without difficulty in all cases, with no complications to date. This is a retrospective and cross-sectional study and all the data were collected between March 2010 and December 2012. Auditory performance improved over time for up to 12months after implantation. Our experience indicates that the Neurelec Digisonic SP cochlear implant system in children under the age of two is relatively safe and reliable. The Neurelec Digisonic SP device surgery can be performed without complications. Auditory performance results support the effectiveness of early implantation. These important findings further support the importance of professionals working very closely with parents or especially mothers and enhancing their involvement in achieving therapy goals to develop auditory skills and speech in young children following cochlear implantation.

Parental reported benefits and shortcomings of cochlear implantation: Pilot study findings from Southeast Asia

ObjectiveThe aim of the study was to understand the reported benefits and shortcomings by parents of children with cochlear implants and who contribute towards the cost of the implant.MethodThirty parents of children with cochlear implants from a hearing impaired school in Southeast Asia completed open-ended questionnaires and the data were analysed using content analysis.ResultsA wide range of benefits and shortcomings were reported. However, it is notable that the single most reported shortcoming was related to cost.DiscussionThe results suggest that, even though, in general, the reports about benefits and shortcomings were similar to previous results from western countries, the emphasis given to various aspects of shortcomings was different. In particular, it appears that parentally reported outcomes could be related to many factors including the hearing healthcare system with the costs involved for the implanted individuals and their families. These findings help us understand the parental perspectives of the success of cochlear implantation and will be useful during parental counselling sessions.

The role of active middle-ear implants in the rehabilitation of hearing loss

The surgical implantation of auditory devices to improve or restore the sensation of hearing in affected individuals is a rapidly growing area of modern ear, nose and throat, and audiological practice. Following the enormous success of cochlear implantation and set to take an increasing role in the rehabilitation of deafness is the active middle-ear implant. They should be viewed as an alternative to conventional hearing aids for individuals who are either unable to wear hearing aids or reject them for a variety of reasons. This article discusses the different types of middle-ear implant that are currently in use and examines the significant challenges that remain to be overcome to further advance this field.

Gentamicin uptake in the chinchilla inner ear

Studies of transtympanic gentamicin have focused on clinical use and outcomes. This study presents evidence of bilateral uptake and retention of gentamicin in certain inner ear cells and structures following transtympanic gentamicin application. Middle ear application of gentamicin was performed by either minipump (Alza model, 2002) or transtympanic injection in a chinchilla model. Histological sections of decalcified temporal bones were stained to identify the distribution of gentamicin. Using both anti-gentamicin immunohistochemistry and autoradiography of tracer amounts of tritiated gentamicin, Scarpa’s and spiral ganglion cells, stria vascularis, and vestibular dark cells of the injected ear were found to have higher levels of gentamicin and retain it within cell bodies while staining levels fell to background levels in the rest of the injected ear over the course of 14 days. There was no evidence of an apical to basal gradient of anti-gentamicin staining within the spiral ganglion. Contralateral inner ear cells showed light anti-gentamicin staining. Cell bodies in the ipsilateral dorsal cochlear nucleus bordering the cochlear aqueduct (CA) showed a lateral to medial gradient of gentamicin staining, suggesting the CA as a potential site of transfer of gentamicin to the contralateral ear. Direct effects of aminoglycosides on ganglion cells may have implications on both the success of cochlear implantation in patients deafened following systemic aminoglycoside therapy and on the advisability of clinical practices of transtympanic gentamicin therapy and ototopic aminoglycoside treatment.

Clinical and audiological features in auditory neuropathy.

To medically and audiologically characterize a population of children diagnosed as having auditory neuropathy (AN). Retrospective medical chart review. We identified 22 patients from a pediatric otology clinic in a tertiary care pediatric hospital setting. A genetic factor in AN is suggested by our identification of 3 families with 2 affected children and 2 other children with family histories that were positive for hearing loss. Clinical features common among our population included a history of hyperbilirubinemia (n = 11 [50%]), prematurity (n = 10 [45%]), ototoxic drug exposure (n = 9 [41%]), family history of hearing loss (n = 8 [36%]), neonatal ventilator dependence (n = 8 [36%]), and cerebral palsy (n = 2 [9%]). Full clinical and audiological data were available for 18 of the 22 children, including otoacoustic emissions, auditory brainstem responses with cochlear microphonics, and age-appropriate audiometric findings. Significantly, 9 of these 18 patients showed improvement in behavioral thresholds over time, indicating that a subset of children with AN may recover useful hearing levels. Also significant was the success of cochlear implantation in 4 children. Management of AN in children requires serial clinical and audiometric evaluations, with a prominent role for behavioral testing. Prematurity, genetics, and hyperbilirubinemia appear to be significant factors in the development of AN; hyperbilirubinemia can be associated with spontaneous improvement of hearing thresholds. For those children not benefiting from amplification or FM systems, cochlear implantation remains a potentially successful method of habilitation.

Pediatric cochlear implantation in auditory neuropathy.

Auditory neuropathy (AN) is characterized by varying degrees of sensorineural hearing loss, an absent or severely abnormal auditory brainstem response, and normal otoacoustic emissions. The nomenclature for this condition reflects the concept that the site of lesion is proximal to the cochlea (e.g., cochlear nerve). Given this hypothesis, it is reasonable to expect limited benefit from cochlear implantation in patients with AN. However, a growing body of evidence shows the striking benefits of cochlear implantation in AN. To explore this topic, we reviewed our population of children with AN and, specifically, the performance results in those children having undergone cochlear implantation. A retrospective case review of those patients diagnosed with AN from 1993 to 2001. A tertiary pediatric referral center. A diagnosis of AN reported from the Center for Hearing and Deafness Research, Cincinnati, OH, database. Eighteen patients were diagnosed with AN (11 girls, 7 boys), with 3 sets of siblings, including 1 set of identical twins. Four patients with AN underwent implantation in the previous 5 years. Twelve out of the 18 patients had classic risk factors for AN (e.g., prematurity and hyperbilirubinemia). The degree of hearing loss varied in our patients, with a majority showing severe to profound deficits. All children with implants showed improvement in auditory and verbal development, but this improvement was variable. The success of cochlear implantation in these patients suggests that some children with AN have an auditory system lesion that can be compensated for by cochlear implantation. This implies either an inner hair cell or inner hair cell-cochlear nerve junctional pathology that can be overcome by direct electrical stimulation.

Value of high-resolution MR in patients scheduled for cochlear implantation

Objective: To determine sensitivity and specificity of high-resolution MR imaging and of high-resolution axial CT (HRCT) and to compare the two modalities in predicting the surgical and functional success of cochlear implantation. Material and Methods: The presurgical MR images (2D T2W TSE, 3D T2*W CISS, plain and contrast-enhanced 3D T1W MP-RAGE) and axial HRCT findings of 26 patients were evaluated with regard to the predictive value concerning the success of cochlear implantation. Results: We found a high correlation between MR and HRCT and the success of cochlear implantation. In all 26 patients, the MR-based predictions concerning the success of cochlear implantation were correct. In 10 patients, MR gave additional information to HRCT. In all patients, MR gave sufficient information about the status of the inner ear, inner auditory canal and cochlear nerve to aid the surgeon during the operation. Conclusion: A high-resolution MR protocol consisting of coronal 2D T2W TSE, 3D T2*W axial CISS, plain and contrast-enhanced sagittal T1W 3D MP-RAGE is recommended for the evaluation of candidates scheduled for cochlear implantation. It provides information which cannot be obtained by HRCT.

Value of high-resolution MR in patients scheduled for cochlear implantation

To determine sensitivity and specificity of high-resolution MR imaging and of high-resolution axial CT (HRCT) and to compare the two modalities in predicting the surgical and functional success of cochlear implantation. The presurgical MR images (2D T2W TSE, 3D T2*W CISS, plain and contrast-enhanced 3D T1W MP-RAGE) and axial HRCT findings of 26 patients were evaluated with regard to the predictive value concerning the success of cochlear implantation. We found a high correlation between MR and HRCT and the success of cochlear implantation. In all 26 patients, the MR-based predictions concerning the success of cochlear implantation were correct. In 10 patients, MR gave additional information to HRCT. In all patients, MR gave sufficient information about the status of the inner ear, inner auditory canal and cochlear nerve to aid the surgeon during the operation. A high-resolution MR protocol consisting of coronal 2D T2W TSE, 3D T2*W axial CISS, plain and contrast-enhanced sagittal T1W 3D MP-RAGE is recommended for the evaluation of candidates scheduled for cochlear implantation. It provides information which cannot be obtained by HRCT.

Cochlear implantation: a review of the literature and the Nijmegen results.

The field of cochlear implantation is developing rapidly. In subjects with bilateral profound deafness who gain no benefit from conventional hearing aids the aim of cochlear implantation is to provide a means for them to receive auditory sensations. Throughout the world, most cochlear implant centres are still continuing their research efforts to improve the results with this technique. Although it is still difficult to predict how an individual will perform with a cochlear implant, the success of cochlear implantation can no longer be denied. In this paper, we review some recent papers and reports, and the results of the various Nijmegen cochlear implant studies. Data about subject selection, examinations, surgery and the outcome are discussed. Our results were in good agreement with those of other authors. It can be concluded once again that cochlear implantation is an effective treatment for postlingually deaf adults and children, and for prelingually (congenital or acquired) deaf children with profound bilateral sensorineural deafness.

Cochlear Implantation in Deaf Children

A cochlear implant (CI) is a hearing device introduced in the 1980s for profoundly deaf subjects who gained little or no benefit from powerful hearing aids. This device comprises an electrode array inserted in the cochlea, connected to an internal receiver, and an externally worn speech processor. The CI transforms acoustic signals into electrical currents which directly stimulate the auditory nerve. Since the early 1990s, cochlear implantation in children has been developing rapidly. Although it is still difficult to predict how a child will perform with a cochlear implant, the success of cochlear implantation can no longer be denied. In this paper, some recent papers and reports, and the results of the various Nijmegen cochlear implant studies, are reviewed. Issues about selection, examinations, surgery and the outcome are discussed. Overall, our results were comparable with those of other authors. It can be concluded that cochlear implantation is an effective treatment for postlingually deaf as well as prelingually (congenital or acquired) deaf children with profound bilateral sensorineural deafness.