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PubMed1990

Performance of 3M/house cochlear implant users on tests of speech perception.

This report documents both closed- and open-set speech recognition performance for 18 adult experienced users of the 3M/House single-channel cochlear implant. The stimuli included tape-recorded, standard word and sentence recognition tests, an environmental-sound test, nonsense syllables, and sentences presented in auditory (implant-only), visual, and auditory-visual modes. All subjects were tested individually in a single session using their own cochlear implants, set to typical comfort use settings for running speech. Subjects' oral responses to the stimuli were transcribed by the experimenters and scored for percent correct. The results revealed considerable individual differences among the subjects and their performance on different tests. All subjects scored better than chance on the closed-set tests. Although they performed considerably poorer on the open-set tests, approximately half of these subjects demonstrated at least some open-set word recognition, a finding not previously reported in the literature for this device. All subjects performed better on the auditory-visual sentences than on either the auditory or visual conditions alone. These results contribute to the database on speech perception by cochlear implant users and show that open-set word recognition performance was somewhat better for these subjects using this implant than would have been predicted from the literature.

Acoustic Stimulation↗
PubMedDate not supplied

A psychological evaluation of cochlear implants in children.

Psychological evaluation is performed both pre- and postimplant as part of the children's cochlear implant program. The purposes are to select appropriate candidates and to study changes over time that may result from the implant. The children in this sample were of above average intelligence as a group, but demonstrated perceptual motor lags and academic underachievement consistent with previous findings for deaf children. Six-month postimplant results show significant improvements in perceptual motor skills, cognitive performance, and academic achievement. Some of these improvements may be the result of a reduction in distractibility and short attention span that was noted for a number of children after implantation. A hypothesis is presented that may explain how the cochlear implant affects this behavior.

Achievement↗
PubMed1994

[The French multi-electrode cochlear implant Digisonic: clinical results].

The Digisonic is a totally digitized and miniaturized multichannel cochlear implant. Owing to its flexible and articulated array, its 15 electrodes are usually introduced in the scala tympani. A special version of this device has been designed to be used in case of total obstructed cochlea. It consists of separated electrodes which may be inserted one by one in the inner ear in different holes gently drilled in the bony cochlea. The possibilities of the microprocessors allow the speech therapist to carefully select the best width and mean value of each frequency band respectively devoted to each functional electrode. These parameters may be adapted to progressively improve the patient's hearing performances as a function of his phonemic discrimination and or the number and the tonotopy of his functional electrodes. Moreover, owing to the versatility of this digitized emitter a lot of speech coding strategies may be easily programmed as a function of eventual desiderata. Owing to a special assessment protocol the scores presented by our 28 first patients including 5 young children are described. These scores inversely depend on the deafness duration. Thus the cochlear implant placement must be considered as an emergency. Special attention is devoted to the score of patients presenting a totally ossified cochlea.

Adult↗
PubMed2003

Facial nerve paralysis following cochlear implant surgery.

OBJECTIVES: Facial nerve paralysis is a rare but devastating complication of cochlear implant surgery. The aims of the study were to define the incidence of facial nerve paralysis in our series and understand possible mechanisms of injury. STUDY DESIGN: Retrospective chart review and case reports. METHODS: Charts were reviewed of all 705 patients implanted between 1980 and 2002 at the authors' institutions to identify those with postoperative facial nerve weakness and determine incidence. For patients with facial nerve weakness, onset, degree, and timing of paralysis were noted; clinical findings were correlated to operative report findings. The method of treatment was noted, and the final facial nerve function outcome was recorded. RESULTS: Five patients (one child and four adults) were found to have postoperative facial nerve weakness, for an incidence of 0.71%. This complication was delayed in all cases, ranging from 18 hours to 19 days postoperatively. All patients were treated with steroids or steroids combined with antiviral medication, and all ultimately recovered normal facial function. CONCLUSIONS: In the study series, the incidence of facial nerve paralysis following cochlear implant surgery was 0.71%. Possible mechanisms of injury included heating injury and viral reactivation. All patients presented with a delayed facial nerve paralysis and did recover normal facial nerve function.

Adult↗
PubMed2003

Cochlear implants in aplasia and hypoplasia of the cochleovestibular nerve.

OBJECTIVE: To report on the outcome of four patients with aplasia or hypoplasia of the cochleovestibular nerve who have received a cochlear implant. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Four patients with: 1) type I aplasia; 2) type IIa aplasia; 3) type IIa hypoplasia; and 4) type IIb aplasia received a cochlear implant. All patients had corner audiograms even with hearing aids. INTERVENTION: Three patients received a LAURA multichannel implant, and one patient received a Nucleus 24 implant. MAIN OUTCOME MEASURE: Auditory performance, educational setting. RESULTS: The patients with type I and type IIb aplasia did not have auditive perception with their implant and became non-users. Both are now in a total communication educational setting. The patients with type IIa aplasia and hypoplasia had moderate audiological results with the implant with audiometrical thresholds of approximately 40-60 dB HL (pure tone average), moderate phoneme discrimination, and poor word discrimination. One child is in a total communication educational setting and the other in an oral educational setting, but the preferred mode of communication remains total communication for both. Both appear to benefit from the implant nonetheless. CONCLUSION: Patients with aplasia/hypoplasia of the cochleovestibular nerve should be counseled with caution with respect to cochlear implantation, but particular circumstances may justify the intervention. At present these circumstances seem to be a type IIa aplasia or hypoplasia in which the end organ (cochlea or common cavity) still connects to a neural structure on MRI.

Auditory Perception↗
PubMed2003

Delayed loss of residual hearing in Clarion cochlear implant users.

Hearing threshold has been measured in a group of patients following cochlear implantation with a Clarion device for the last eight years. The patients had received either a pre-curved carrier or the Hi-Focus I plus Electrode Positioner System (EPS). The assessment was carried out within the first post-operative week as well as at a later stage, between six and 87 months, post-operatively. Residual hearing thresholds were still measurable early after surgery in 24.5 per cent of the patients, without differences between the two different Clarion models. However, the number of subjects with measurable hearing dropped to 16.3 per cent as observed when hearing was measured at a later stage, with an equal distribution between the two groups of patients. From this study it has been possible to observe that only a limited number of patients maintain residual hearing after Clarion cochlear implantation, and that this tends to decrease further over time. Nevertheless, the performance of these patients for speech tests did not appear to be affected by deterioration of the pure-tone auditory threshold.

Audiometry, Pure-Tone↗
PubMed1989

[Modification of speech encoding process of single channel cochlear implant utilizing digital delay circuit].

Speech perception by single channel cochlear implant can be improved to some extent by modifying the encoding process of the speech signals. The principle of our encoding strategy is to present speech signals with appropriate delay time for lower frequency components of the speech sound, while without delay for higher frequency components. This is based on a cochlear physiology that higher frequency sounds are perceived earlier than lower frequency sounds, since the former is perceived at the basal turn and the latter at the apical turn. The following tests were performed without the aid of lip reading in the two patients implanted with a single channel cochlear implant of 3M-House design. Lower frequency components of the speech signals were digitally delayed with a Sony SDP-777 ES surround processor. The results indicated that the optimal delay time for identification of /i/, /e/ and /u/ needed longer delay time, while that of /a/ and /o/ need shorter delay time, corresponding to the difference between the first and second formant of each vowel. Comparison of vowel perception with and without delay coding showed that vowel identification with delay coding was superior to that without it; 30% vs. 16% in case 1, and 48% vs. 30% in case 2.

Adult↗
PubMed2003

A novel retractor for use in cochlear implantation.

A new self-retaining scalp retractor is described, which elevates the scalp away from the skull to allow better access and vision in preparing the bony recess for a cochlear implant and protect the pericranium from surgical trauma. It is designed for use with the present generation of small vertical scalp incisions in cochlear implant surgery. In these incisions, the part of the skull drilled to create the implant bed is not directly under the wound; instead, it extends under a flap of scalp and pericranium for 5 cm or more. The retractor is simple to use, and the authors believe that it represents a new type of retractor, which may have other uses in the fields of orthopedic; ear, nose, and throat, cosmetic, and plastic surgery. Photographs demonstrate the instrument in use. A cochlear implant company has agreed to manufacture the instrument.

Cochlear Implantation↗
PubMed2004

A novel retractor for use in cochlear implantation.

A new self-retaining scalp retractor is described, which elevates the scalp away from the skull to allow better access and vision in preparing the bony recess for a cochlear implant and protect the pericranium from surgical trauma. It is designed for use with the present generation of small vertical scalp incisions in cochlear implant surgery. In these incisions, the part of the skull drilled to create the implant bed is not directly under the wound; instead, it extends under a flap of scalp and pericranium for 5 cm or more. The retractor is simple to use, and the authors believe that it represents a new type of retractor, which may have other uses in the fields of orthopedic; ear, nose, and throat, cosmetic, and plastic surgery. Photographs demonstrate the instrument in use. A cochlear implant company has agreed to manufacture the instrument.

Cochlear Implantation↗
PubMed1991

P300 response to tones and speech sounds after cochlear implant: a case report.

P300 potentials evoked by tones and spoken words were recorded from a 20-year-old man with a House-3M single-channel cochlear implant. Three months after cochlear implantation, there was a slight appearance of P300 response to both pure-tone stimuli and spoken-word stimuli; 6 months later, clearly identifiable P300 response to both pure-tone stimuli and spoken-word stimuli were obtained. These results are consistent with an encoding improvement for re-establishment of information processing after auditory rehabilitation.

Adult↗
PubMedDate not supplied

Results of cochlear implantation in patients with severe to profound hearing loss--implications for patient selection.

In patients with some residual hearing and minor benefit from conventional hearing aids, the benefits of cochlear implantation have to be weighed carefully against eventual adverse effects. In this study, pre- and post-operative thresholds as well as functional results after cochlear implantation are reported; 17 of 44 implanted adults had residual hearing pre-operatively (mean threshold(250 to 4000 Hz): 106 dB HL) in the implanted ear. Residual hearing in the implanted ear could not, in general, be preserved post-operatively. Seventeen of 44 implanted children had some amount of residual hearing in the implanted ear pre-operatively (implanted ear: 114 dB HL; contralateral ear: 109.9 dB HL; mean thresholds(250 to 4000 Hz))). Contrary to the results in adults, residual hearing in the implanted ear remained statistically unchanged. Hearing in the contralateral ear increased significantly from 109.9 to 101.9 dB HL post-operatively. This increase was mainly attributed to maturation of the central auditory pathway. In adults with residual hearing, the monosyllable word recognition scores increased significantly from 9 per cent pre-operatively to 42 per cent post-operatively. Children with residual hearing tended to perform better on speech-related test material compared to children without prior auditory experience. Cochlear implantation is indicated in adults and children with residual hearing and minor benefit from conventional amplification. The contralateral ear in children should be considered for additional acoustical stimulation.

Adult↗
PubMed2026

The Soundtrack of Everyday Life: Real-world Music Listening Habits of Adult Cochlear Implant Users.

OBJECTIVE: Characterize real-world patterns of music listening and reward sensitivity among adult cochlear implant (CI) users compared with normal-hearing (NH) listeners. STUDY DESIGN: Cross-sectional observational study. SETTING: Online. PATIENTS: Adults (&#x2265;18&#xa0;y) with a CI or NH who used a music-streaming platform as their primary listening method. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Objective measures included platform-derived audio features (acousticness, danceability, energy, tempo, and valence), listening volume, unique-song ratio, and decade preferences. Self-reported measures included listening habits and the Barcelona Music Reward Questionnaire (BMRQ). Group comparisons used ANCOVAs and mixed-effect models adjusting for age and gender; within-CI analyses compared prelingual versus postlingual deafness. RESULTS: Among 16 CI users (69% male, 39.0&#xb1;15.6&#xa0;y) and 29 NH listeners (38% male, 32.2&#xb1;11.3&#xa0;y), CI users demonstrated a higher unique-song ratio (&#x3b2;=-0.157, CI as reference; 95%CI [-0.281, -0.034]; P =0.014) and stronger preference for older music (Pillai trace=0.537; F8,35 =5.07; P <0.001), adjusting for age. No significant group differences were observed in weekly listening time, listening volume, audio features, or BMRQ scores (total and subscores). Equivalence was confirmed for Emotion Evocation and Sensory-Motor subscales. There were no statistically significant differences in listening environments after Holm correction. No statistically detectable differences were observed between pre- and postlingually deafened CI users. CONCLUSIONS: Musically active CI users showed no significant differences in listening volume or overall music-reward sensitivity compared with NH peers, but demonstrated higher unique-song ratios and a bias toward older music. Findings highlight the value of ecologically valid data in understanding real-world music experiences among CI users.

Adult↗
PubMed1994

Single-channel to multichannel conversions in pediatric cochlear implant recipients.

Speech perception skills were measured in five children who had received a 3M/House single-channel cochlear implant and were subsequently upgraded to a multichannel cochlear implant (Nucleus). A rationale was developed based upon performance with the single-channel device and anticipated performance with the multichannel device. All subjects demonstrated improved acoustic thresholds with the multichannel device. Three of the children demonstrated improvements on identification tasks and two on word recognition tasks.

Adolescent↗
PubMed2006

Elimination of facial nerve stimulation by reimplantation in cochlear implant subjects.

HYPOTHESIS: Perimodiolar intracochlear electrodes with contacts facing towards the modiolus have limited current flow towards the outer wall of the cochlea and therefore, may reduce the occurrence of facial nerve stimulation (FN) in cochlear implant subjects. BACKGROUND: Facial nerve stimulation is a well-known complication in cochlear implant treatment especially in the group of subjects with otosclerosis. The possible explanation of this side effect is a change of the electrical properties of the otosclerotic bone leading to leakage current and resulting in facial nerve stimulation. METHODS: Four CI subjects who had been implanted with a Nucleus Mini22 device with a Nucleus Straight electrode between 9 to 12 years ago suffered from severe FN stimulation. Electrode contacts had to be switched off so that they could only use 4, 11, 13, and 15 electrodes of their usual set of 22. The switch off resulted in deteriorating speech understanding over time. Therefore, all subjects were reimplanted with a Nucleus 24R device with a Contour electrode. Preoperatively, the threshold of FN stimulation was obtained on all electrodes subjectively. Intraoperatively, FN stimulation thresholds were measured objectively with both, the old and the new device and were compared. NRT and SRT thresholds were also obtained with the reimplanted device to assure effective electrical stimulation of the auditory nerve. RESULTS: In all four cases the postoperative fitting demonstrated no FN stimulation on all electrodes up to maximum comfortable level. The insertion of the Contour electrode array was complete in three cases, in one case the array could only be inserted partially similarly to the situation before the reimplantation. Speech perception tests showed a significant improvement in all subjects with the new device. CONCLUSION: Electrodes with modiolar facing contacts and perimodiolar position like the Nucleus Contour electrode reduce the possibility of facial nerve stimulation significantly due to more focused electrical stimulation.

Adult↗
PubMed2006

The influence of mastoidectomy on natural history of secretory otitis media in cochlear implant children.

Secretory otitis media (SOM) is a common childhood disease. The goal of the present study was to determine the influence of mastoidectomy on the incidence of postimplantation SOM in cochlear implant children. We conducted a retrospective study of all the children up to the age of 8 years, who underwent cochlear implantation from 1993 to 2001 in our department. The children were divided into two groups according to the surgical technique used for the implantation: 94 children underwent implantation with the posterior tympanotomy approach (including mastoidectomy) and 48 children were implanted with a suprameatal approach (without mastoidectomy). The incidence of SOM before and after the implantation was compared between the two groups. There were no significant differences between the two study groups in terms of age and the pre- and postimplantation incidence of SOM. Mastoidectomy failed to demonstrate any influence on the natural history of SOM.

Child↗
PubMed2003

[Postoperative radiography for cochlear implantation].

OBJECTIVE: To define a spatial position of the cochlea in the skull base and to design an appropriate method of skull radiography for demonstration of the multichannel intracochlear electrode array. METHOD: Measure the angle between the basal turn of the cochlear and the median sagittal line on the axial plane CT from 26 children candidates of cochlear implant and 32 adults. RESULT: The angle between the axis of the cochlear and the median sagittal line varied from 40 degrees to 68 degrees, the average is 52.66 degrees. The average angle in children is 52.52 degrees (s = 7.07) and 52.80 degrees (s = 5.78) in the adults. The difference between the two group has no significance (P > 0.05). CONCLUSION: The plain radiography cochlear view gives a clear image of the whole intracochlear electrode array and each individual electrode, it is useful for evaluating the depth and exact position of the electrodes, managing frequency mapping and optimizing speech processing strategies, it can be widely used in cochlear implant clinics and research.

Adolescent↗
PubMed1992

Cochlear implants in children: reliability of computed tomography.

Preoperative temporal bone computed tomography (CT) can demonstrate anatomic details relevant to surgical management and is therefore essential in the presurgical evaluation of patients receiving cochlear implants. The purpose of this study was to evaluate preoperative CT studies and compare them to surgical findings in 34 children who received the Nucleus multichannel cochlear implant. The focus of this report is to discuss the dependability of CT scans in predicting surgical findings at the time of cochlear implantation. Results indicate that agreement of CT interpretations with surgical findings is partially related to the etiology of hearing loss and the experience of the surgeon and neuroradiologist. Advantages and limitations of the CT scans in predicting surgical findings are discussed.

Adolescent↗