COCHLEAR IMPLANTS INTERNATIONAL最新文献

Objective: This study aimed to determine if the major public awareness campaign for cochlear implants 'International Cochlear Implant Day' influenced national and international public interest as measured by internet search activity.

Methods: Weekly search volume data in the United States, Canada, Australia, Germany, United Kingdom, Brazil, India, Japan, and a 'Worldwide' group for the search topic 'cochlear implant' was collected from Google Trends over a 5-year period (2017-2021). The 'Campaign' window was defined as 1 week before, the week of, and 2 weeks after International Cochlear Implant Day (February 25th). 'Non-Campaign' weeks were considered any data outside the 'Campaign' window.

Results: Of the studied regions, the United States, United Kingdom, Australia, India, and 'Global' demonstrated a significant increase in internet search activity between 2017 and 2021. Although some individual years showed significant increases during the 'Campaign' period for Canada, Germany, Brazil, and Japan, none showed statistically significant increases over the 5-year period studied.

Conclusion: Public awareness campaigns are recognized crucial elements to delivering effective healthcare, but their success varies worldwide. While data from Google Trends suggests that cochlear implant awareness campaigns can translate into increased internet searches, greater efforts can be made in select countries to improve public interest.

Objectives: To investigate the prevalence of cochlear-facial dehiscence (CFD) and other radiographical pathologies in ears with facial nerve stimulation (FNS) from a cochlear implant (CI). Methods: Retrospective case-control study of 27 patients with CI and FNS on either ear (study group) and 27 patients without FNS, matched for age, sex and type of electrode array (control group). Preoperative CT scans of all 108 ears were re-evaluated. Subanalyses included comparisons between the study and control groups and associations between FNS and radiographic pathologies. Results: CFDs were detected in 20 of 54 ears (37%) in the study group and in 3 of 54 ears (6%) in the control group (P < 0.001). The corresponding numbers of otosclerosis were 10 (18%) and 0 (P = 0.011) and of developmental anomalies 16 (30%) and 8 (15%) (not significant). FNS was present in 33 ears in the study group, of which 14 (42%) had a CFD. FNS was absent in six ears with CFD and CI, four of which contralateral to an ear with FNS. Eight of 14 ears with FNS and CFD had a lateral electrode array and six had a perimodiolar electrode array. We found no association between the presence of CFD and stimulation thresholds for FNS. The adjusted odds ratio for developing FNS in the presence of a CFD was 9.9 (95% CI 2.7-36.0). Conclusions: CFD was the most common radiographic pathology in ears with FNS, with a 10-fold increased risk of FNS. To avoid CI-related FNS, preoperative CT scan and awareness of typical dehiscence symptoms are strongly recommended.

Objective and method: Skin breakdown over receiver/stimulator (RS) after cochlear implantation poses a serious challenge. We report our experience using a one-stage reconstruction and implant salvage approach.

Results: Between the years 2005 and 2017 five children, all females, with congenital- bilateral sensorineural hearing loss were identified. In all cases, a temporoparietal fascia flap (TPFF) and a large scalp flap were used to provide a two-layer coverage to the exposed RS. In the first three cases, a split-thickness skin graft was used to cover the donor site defect. In the latter two cases, a larger rotation flap was used, and a skin graft was not required. One case required revision due to the dehiscence of the wound and exposure of the RS. In another case, an accidental electrode array explantation occurred and the patient underwent a revision cochlear implantation. All patients had achieved complete healing and no change in hearing thresholds with the implants.

Conclusions: We demonstrate our one-stage salvage technique with TPFF that saves the implant and prevents a two-stage procedure. The success rate can be improved with special care at reconstruction and with better protection of the implant during the procedure.

Purpose: This study evaluates the effect of cochlear implantation (CI) on work ability. The influences of quality of life (QOL), age, mental health, and hearing were analyzed.

Methods: Seventy-nine patients undergoing CI surgery were evaluated preoperatively and 12 months postoperatively. Work ability was evaluated using the Work Ability Index (WAI). QOL was assessed with the Nijmegen Cochlear Implant Questionnaire (NCIQ) and the WHOQOL-BREF. Mental health was assessed with the Patient Health Questionnaire.

Results: The WAI was unaffected by CI (Δ 0.8 ± 6.8, p = 0.42). No significant changes in WAI were observed for employees (Δ - 1.1 ± 5.7, p = 0.25) and pensioners (Δ -0.4 ± 7.8, p = 0.73). Patients without elevated depressiveness, stress, or somatoform symptoms had significantly better WAI.The multiple regression analyses show that WHOQOL-BREF (ß = 0.49, p ≤ 0.001), age (ß = -0.34, p ≤ 0.001), and depressiveness (ß = 0.33, p = 0.04) were significantly associated with WAI. In the employee group, the NCIQ (ß = 0.58, p = 0.008) had the strongest association with the WAI.

Conclusion: Age, mental health, and QOL are predictive factors for work ability. This should be considered in the consultation and the rehabilitation process.

Objective: To evaluate and compare children undergoing cochlear implantation (CI) with myringotomy tubes (MT) placed preoperatively or intraoperatively to those without MT .

Methods: This was a retrospective review of pediatric patients undergoing CI between 2015 to 2020 at a tertiary care pediatric hospital. CI patients with and without MT were reviewed for the following outcomes: intraoperative findings, intraoperative and postoperative complications, and surgical time. Descriptive and bivariable statistical analysis was performed.

Results: 192 cochlear implant surgeries were included: 116 without MT tubes and 76 with a history of MT. Twenty-six patients had MT present at the time of CI surgery. No statistical difference existed between patients with MT (CI + MT group) and those without MT (CI - MT group) with regard to intraoperative complications (P = 0.760) and intraoperative findings (P = 0.545). MT association with total post-operative complications (GEE) showed no statistical significance (OR 2.45, 95% CI 0.83-7.22, P-value 0.105). CI + MT patients were significantly more likely to have inflamed middle ear mucosa at time of surgery (P = 0.003). CI + MT patients did not have a longer length of surgery compared to the CI - MT group (3.47 h vs 3.3 h, respectively, P = 0.342).

Conclusion: Our data confirms it is safe to perform CI in ears with myringotomy tubes, although the surgeon should be aware of possibly encountering increased middle ear inflammation during the surgery.

Objectives: Evaluate potential effects of calcium channel blockers (CCB) and bisphosphonates (BP) on residual hearing following cochlear implantation.

Methods: Medications of 303 adult hearing preservation (HP) candidates (low frequency pure tone average [LFPTA] of 125, 250, and 500 Hz ≤80 dB HL) were reviewed. Postimplantation LFPTA of patients taking CCBs and BPs were compared to controls matched by age and preimplantation LFPTA.

Results: Twenty-six HP candidates were taking a CCB (N = 14) or bisphosphonate (N = 12) at implantation. Median follow-up was 1.37 years (range 0.22-4.64y). Among subjects with initial HP, 29% (N = 2 of 7) CCB users compared to 50% (N = 2 of 4) controls subsequently lost residual hearing 3-6 months later (OR = 0.40, 95% CI = 0.04-4.32, p = 0.58). None of the four BP patients with initial HP experienced delayed loss compared to 50% (N = 2 of 4) controls with initial HP (OR = 0.00, 95% CI = 0.00-1.95, P = 0.43). Two CCB and one BP patients improved to a LFPTA <80 dB HL following initial unaided thresholds that suggested loss of residual hearing.

Discussion: There were no significant differences in the odds of delayed loss of residual hearing with CCBs or BPs.

Conclusion: Further investigation into potential otoprotective adjuvants for maintaining residual hearing following initial successful hearing preservation is warranted, with larger cohorts and additional CCB/BP agents.

Objectives: Communication breakdowns and their repair by deaf and hard-of-hearing (DHH) and hearing adolescents were examined in conversation with an unfamiliar communication partner.

Method: This study compared the number and type of clarification requests and responses to those requests of 16 DHH and 16 normal-hearing adolescents aged 11-16 years, in a 10-minute conversation with an unfamiliar adult. It also analyzed the relationship between speech intelligibility, communication breakdowns, and clarification requests by an unfamiliar adult. the Children's Communication Checklist (CCC) was completed by parents.

Results: DHH adolescents demonstrated significantly higher usage of nonverbal clarification requests and verbal and nonverbal responses to clarification requests compared to normal-hearing adolescents in conversations with an unfamiliar adult. Furthermore, the subscale scores of the CCC and the speech intelligibility of DHH adolescents were significantly lower than those of normal-hearing adolescents. There were correlations between speech intelligibility and the speech subscale score of the CCC, as well as correlations between the pragmatic composite score of the CCC, the number of communication breakdowns, and the number of clarification requests by an unfamiliar adult.

Discussion: The adolescents with DHH experienced more communication breakdowns in conversation with an unfamiliar adult and the number of clarification requests made by adults was higher.

Background: Hearing loss is known to be an independent risk factor for inadequate health literacy. The objective of this study was to assess the level of health literacy among patients undergoing cochlear implantation to determine areas for improvement in delivery of patient information.

Methods: A cross-sectional survey was conducted at the otology-neurotology clinic at Sunnybrook Health Sciences Centre. Patients eligible for cochlear implantation completed two health literacy screening tools: The Short Test of Functional Health Literacy in Adults (S-TOFHLA) and Brief Health Literacy Screen (BHLS).

Results: Thirty seven patients were included (41% female, 59% male, mean age: 55 years). Most patients had adequate health literacy through BHLS (76%) and S-TOFHLA (98%) scoring. Over 80% of patients were not able to correctly recount all the operative risks associated with cochlear implant surgery and one third of patients did not correctly recount any risks associated with a cochlear implant surgery. Female sex was associated with higher scores (p=0.03) and low income (<$35,000) was associated with lower scores (p=0.05).

Conclusion: Patients eligible for cochlear implants have adequate health literacy, but most are not able to recount operative risks. Educational tools are required to improve patient retention, understand, and perioperative health information delivery.

An increasing number of young infants, as early as six months of age with congenital hearing loss receive cochlear implantation, and it is probable that many of these patients will require revision surgery later in life. The possibility of explantation of the cochlear electrode and reimplantation may cause damage to the cochlea, compromising the speech perception outcome in revision implant is of concern. There is only one prior temporal bone histopathology study to look at the outcome of revision surgery and no prior study evaluating revision cochlear implantation that used the round window approach. We conducted a histopathological study of four temporal bone specimens from four patients who underwent revision cochlear implantation and when available post-operative speech perception tests were evaluated. In all cases, the reimplanted electrode followed into the same fibrous sheath without evidence of additional intracochlear damage due to revision surgery. The intracochlear damage from the initial cochlear implantation appears to be a more important factor in outcomes rather than changes associated with explantation and reimplantation.

Background: Device activation typically occurs four weeks post cochlear implant surgery. Emerging evidence suggests earlier activation is feasible and beneficial, giving patients quicker access to sound and rehabilitation.

Objectives: Assess current literature for effects of early cochlear implant activation.

Methods: Electronic searches of Medline/PubMed, AMED, EMBASE, CINAHL and the Cochrane Library following PRISMA guidelines. Studies investigating any aspect of early activation were included for review.

Results: From 15 studies, 625 patients received early activation, compared with 243 patients in the control groups. Early activation was considered as within 7 days post-operatively with 12 studies reporting within 1 day post-operatively, compared with standard activation of 9-46 days post-operatively in the control group. Some studies indicated earlier low levels of impedance in the early activation group. Magnet strength adjustment or off-ear processor wear was often recommended within the early activation cohort. Complication rates were low in both groups. Early activation improved patient satisfaction and anxiety levels without detriment to speech recognition or rehabilitation.

Conclusion: Early cochlear implant activation is feasible and allows patients with no contraindications, earlier access to auditory perception and rehabilitation and reduces anxiety linked to delay in activation. Further evidence is required to monitor long-term effects of early activation.