COCHLEAR IMPLANTS INTERNATIONAL最新文献

Objective: Neurophysiologic measures like the electrically evoked Stapedius Reflex Threshold (eSRT) offer valuable insights into personalized responses to Cochlear Implant (CI) stimuli. This study evaluates the effects of stimulation current amplitude and the number of stimulating electrodes on eSRT and its correlation with the Most Comfortable Loudness level (MCL or C-level) in all-polar, pseudo-monophasic, pulse-width loudness coded stimulations.

Approach: The study was conducted on seventeen adult patients with Oticon Medical implants. In these implants, current amplitude remains constant while loudness is coded through pulse-width. Stimulation amplitudes were set to low (default clinical) and high values, using single or multi electrode groups of 1, 3, and 5 (G1, G3, and G5) across five cochlear regions, spanning from apical to basal. For each amplitude and group, the eSRT detection rate and correlation with MCL were analyzed regionally and overall.

Results: Higher eSRT detection rates were observed in the contra-lateral ear, with G3 and G5 significantly enhancing detection over G1 for both low and high amplitudes. The current amplitude facilitated eSRT invocation, particularly for G1 and patients with higher MCLs. The correlation between eSRT and MCL was relatively high (r = 0.64-0.87) across all conditions, indicating accurate MCL estimation from eSRT at both low and high amplitudes.

Discussions: Among all condition interactions (amplitude, side, electrodes), low-amplitude contra-lateral G5 and high-amplitude contra-lateral G3 showed optimal modes for estimating MCL from eSRT, with linear slopes near 1.0, and detection rates of 54% and 63%, respectively. High-amplitude contra-lateral G5 further increased detection to 68%, though with a slope of 0.8, requiring a correction factor. These findings provide insights into eSRT mechanisms and its application in pseudo-monophasic all-polar CI programming.

Conclusion: The eSRT detection rate can be improved in pulse-width modulation cochlear implants by using multi-electrode stimulation and/or increasing the stimulation amplitude beyond the default clinical value, without significantly affecting the correlation coefficient between eSRT and MCL.

Objectives: The current study aims to describe subjects and audiological profiles of children with congenital inner ear anomalies (IEAs).

Materials and methods: A total of 193 children with sensorineural hearing loss (SNHL) and radiological evidence of one or more congenital IEAs were included.

Results and discussion: The most common IEAs in the current study was enlarged vestibular aqueduct (EVA) either isolated or associated with other IEAs. Incomplete partition (IP) with its three types (IP I, IP II, and IP III) was the second common anomaly, followed by cochlear hypoplasia (CH). At the time of radiological diagnosis, hearing loss degrees ranged from mild to profound in children with EVA, CH III, and CH IV with the majority having severe or profound degrees. The prevalence of severe and profound degree of hearing loss was higher in children with IP than children with isolated EVA or CH III and CH IV. In children with isolated EVA, hearing loss was asymmetric in 52.2% and progressive in 58%. In children with CH III and CH IV, hearing loss was asymmetric but stationary. Only children with EVA and IP III had air-bone gab (ABG) at low frequencies, while children with other IEAs did not have ABG except if there was an association with EVA. Children with severe anomalies such as CH I, CH II, common cavity, and cochlear nerve hypoplasia had profound degrees of hearing loss or just sound detection.

Conclusions: Knowing the audiological profile of children with IEAs has important clinical implications in the management of those children.

Objectives: The aim of this study wasto systemically examine the relationship between AutoNRT thresholds and subjective programming levels by controlling for individual subject variation, and further, to propose an alternative way to calculate the AutoNRT threshold profile for programming purposes.

Methods: The study was a prospective observational study. AutoNRT thresholds, T- and C-levels were recorded at six and twelve months after activation. All subjects had received a CI24RE implant.

Results: Forty-one adults participated in the study. A linear mixed-effects model analysis of the relationship between the AutoNRT thresholds and the T-and C-levels resulted in a large unexplainable variation between subjects, the standard deviation was between 15.42 and 18.89 CL. However, the study showed that the profiles for the T- and C-levels could be predicted with an acceptable accuracy from AutoNRT. A model for calculating profiles from AutoNRT thresholds based on linear regression resulted in the lowest deviation from the subjective programming thresholds, with somewhat better results for C-levels than T-levels.

Conclusion: The results from this study showed that the predictability was reasonable when calculating the profiles for the T- and C-levels based on AutoNRT. And, further, that AutoNRT thresholds can be used when programming cochlear implants, to make global adjustments without predicting actual T- or C-levels.

Objective: Early diagnosis, intervention and consistent follow-up of hearing loss is of great importance in children, given the broad impact of untreated childhood hearing loss. Currently, no hearing-specific QOL proxy questionnaire exists for preschool children with hearing loss in the Dutch language. Therefore, the aim of this study was to translate and validate the Preschool HEAR-QL questionnaire into Dutch.

Methods: Translation was conducted according the forward-backward procedure. Parents or caregivers of 60 normal-hearing children and 50 children with bilateral hearing loss aged 2-6 years old were invited to digitally complete the questionnaire.

Results: The Preschool HEAR-QL questionnaire showed good discriminant validity between the normal-hearing and the hearing loss group, for its total score and some subscales. We concluded satisfying internal consistency given Cronbach's alpha values being above 0.70, nearly all alpha if item deleted values approaching the overall values, and item-subscale correlations above 0.30. Test-retest reliability was satisfying with all intraclass correlation coefficients being greater than 0.70.

Conclusion: This Dutch hearing-specific QOL proxy questionnaire can play an important role in the management and follow-up of early childhood hearing loss in Dutch health care and hearing centers. Future research on clinical data will further verify its utility in clinical practice.

Objective: The current study aimed to evaluate cochlear reimplantation rate, causes, and audiological outcomes in a large group of patients in a multicenter study.

Methods: This retrospective study was conducted on patients with cochlear reimplantation surgeries between 2000 and 2022 in five academic referral centers. The rate and reasons for cochlear reimplantation surgeries were evaluated. The auditory performance and speech production outcomes were compared before and after cochlear reimplantation surgeries.

Results: Of 9,287 primary cochlear implantation surgeries, 186 reimplantations were performed (a cochlear reimplantation rate of 2%). The highest risk of reimplantation was found 2 to 4 years after primary implantation. Device failure was the main reason for cochlear reimplantation (81.2%). The categories of auditory performance and speech intelligibility rating scores were unchanged or improved in 57 out of 59 patients (96.6%), and 55 out of 59 patients (93.2%), respectively.

Conclusion: The cochlear reimplantation rate seems to be relatively low, with the cause of device failure in most cases. While the highest risk of reimplantation happened during the first four years after primary surgery, regular follow-ups are necessary, particularly during this time. The audiological outcomes do not worsen after reimplantation in most patients, and some children may experience some improvements.

Objective: The cochlear implant is a commonly used implantable device for the auditory rehabilitation of severe bilateral sensorineural hearing loss. The effectiveness of the implant, depends on many factors, including intensive auditory training, which is crucial. Intelligibility in a noisy environment is a current issue and poses a major difficulty for implanted patients. The aim of this study is to evaluate the improvement in auditory performance in noise among cochlear implant patients who underwent personalized auditory-cognitive training for speech understanding tasks in noise.

Design: This was a prospective study involving cochlear implanted patients divided into two groups. One group underwent auditory training in a noisy environment at home for 2 months (G1) while the other group served as a control (G0). A test of intelligibility performance in noise was conducted at inclusion and two months later.

Results: 52 patients were included in the study. The trained group, G1, showed a significant improvement with an increase of 4.8 dB in signal-to-noise ratio (SNR) between the two tests (P < 0.01). There was no significant improvement in the control group (G0) (P = 0.756).

Conclusions: This study demonstrated a significantly positive impact of personalized auditory training in a noisy environment for cochlear implant patients.

Introduction: Wolfram syndrome, a rare autosomal recessive disorder, is characterised by diabetes insipidus, juvenile diabetes mellitus, optic nerve atrophy and deafness (DIDMOAD).

Case report: We present a case of a 21-year-old male diagnosed with Wolfram syndrome who underwent cochlear implantation due to progressive hearing loss. The patient first complained of bilateral hearing loss at the age of 8 years. As the hearing loss progressed hearing aids provided minimal benefit. A multidisciplinary team evaluated his extensive medical history, which included juvenile-onset diabetes mellitus, seizures, vision abnormalities and hypergonadotrophic hypogonadism. Pure tone audiometry was done which showed sloping bilateral severe to profound hearing loss, more at higher frequencies. Hrct and Mri temporal bone showed normal cochlear architecture and cochlear nerve. The patient received a Nucleus Profile™ CI 632 cochlear implant. Postoperative evaluation revealed significant improvement, with a speech discrimination score of 90% at the most comfortable level three months post-implantation.

Conclusion: Wolfram syndrome is a rare genetic disorder with multisystem involvement and debilitating symptoms. High-frequency sensorineural hearing loss is a common association and hearing rehabilitation using hearing aids and cochlear implants must be considered to improve the quality of life.

Objective: This study aims to identify the acquisition features of functional near-infrared spectroscopy (fNIRS) in cochlear implant users.

Methods: A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, EMBASE, LILACS, Web of Science, Scopus, PsycINFO, IEEE Xplore, Google Scholar, and ProQuest Dissertations & Theses Global were searched using the PECOS acronym. Inclusion criteria encompassed studies involving fNIRS with speech stimuli in cochlear implant users of any age, with information on acquisition parameters and features. Risk of bias assessment was performed using the Joanna Briggs Institute tool.

Results: Nineteen studies were included, with thirteen exhibiting a low risk of bias. Noteworthy uniformity was observed in certain fNIRS acquisition features among cochlear implant users, including the waking state (awake), auditory stimuli of words or phrases presented in a free field, visual stimuli displayed during data collection as a secondary task, recording of responses in the bilateral temporal lobe, and a three-centimeter distance between optodes. Variations in acquisition were attributed to differing study purposes.

Conclusion: This review identifies common acquisition characteristics for fNIRS in cochlear implant users. Multicenter research efforts are advocated to further advance the utility of fNIRS in this population.

Introduction: We report an unusual case of cochlear implant complication and eventual explantation secondary to an allergic reaction to silicone.

Case report: A 62-year-old man who underwent cochlear implantation for asymmetric hearing loss developed an allergic response to the implant within a few weeks of the surgery. This led to subsequent explantation. Patch testing using the various parts of the implant revealed a hypersensitive response to the silicone component of the receiver stimulator. There have only been 6 reported cases of cochlear implant explantation secondary to allergic reactions to cochlear implants. The inflammatory reaction has been to the silicone component of the cochlear implant found in the silicone used in Cochlear America's implants.

Conclusion: Although rare, it's important to be aware of delayed hypersensitivity reactions to the silicone component of a cochlear implant. Attention should be made to associate symptoms such as pruritis, urticaria and loss of hair as symptoms and signs of possible allergic reaction to the implanted component. Steroids may help to alleviate symptoms; however, symptoms have been shown to recur after cessation of steroids. Treatment requires the removal of the device.

Objectives: To investigate the effects of automatic scene classification (SCAN) on speech perception in noise and real-world functional performance in children using cochlear implants (CIs).

Methods: We used a within-subjects repeated measures design in two studies. The first study assessed speech perception in noise with or without SCAN enabled in 25 school-aged children. The second study evaluated functional auditory performance in real life. Parents of 18 children provided ratings using the Parents' Evaluation of Aural/oral Performance of Children (PEACH) questionnaire; and children provided ratings using the Self Evaluation of Listening Function (SELF) questionnaire. Analyses of variance with repeated measures were used to examine the effect of SCAN.

Results: On average, speech perception in noise was significantly better with SCAN enabled (mean SRT: -4.1 dB; SD: 4.0), compared to SCAN disabled (mean SRT: 0.5 dB; SD: 3.5). Children's functional performance in real life was similar between the two device settings.

Conclusion: Automatic auditory scene classification provides significant benefits for speech perception in noise (4.6 dB improvement). On average, there were no perceived detrimental or beneficial effects in real life. These findings support the use of SCAN in CIs for young children.