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Cochlear Implantation and Hearing Rehabilitation

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Otolaryngology".

Deadline for manuscript submissions: closed (20 January 2022) | Viewed by 27394

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Prof. Dr. Per Caye-Thomasen

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Copenhagen Hearing and Balance Center, Ear, Nose and Throat (ENT) and Audiology Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Interests: hearing rehabilitation; cochlear implantation; outcome studies
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Dear Colleagues,

The cochlear implant constitutes the first and only restitution of a human sense—hearing. The number of patients implanted worldwide is approaching one million, including newborns with congenital profound hearing loss or deafness, and children and adults with progressive hearing loss too severe to be treated with conventional hearing aids. The average benefit for patients is remarkable, and as an example, a vast majority of deafborn children will develop normal language before school age, provided that the implantation is performed at an early stage and that rehabilitation is designed appropriately. Recent developments have refined the technology behind and within the implant itself, including, for example, the wireless streaming of telephone calls and music directly to the implant, which has improved versatility and user satisfaction considerably. Indications for implantation are broadening, as for example, patients with residual hearing or single-sided deafness experience significant improvement of their hearing and social abilities. This Special Issue is relaying contemporary pediatric and adult outcomes and other contemporary aspects of cochlear implantation.

Prof. Dr. Per Caye-Thomasen
Guest Editor

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Keywords

hearing rehabilitation
cochlear implantation
hearing loss
pediatric
adult
inner ear surgery
vestibular function

Published Papers (11 papers)

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Research

15 pages, 717 KiB

Open AccessArticle

Cochlear Implantation Improves Both Speech Perception and Patient-Reported Outcomes: A Prospective Follow-Up Study of Treatment Benefits among Adult Cochlear Implant Recipients

by Kasper Møller Boje Rasmussen, Niels Cramer West, Michael Bille, Matilde Grønborg Sandvej and Per Cayé-Thomasen

J. Clin. Med. 2022, 11(8), 2257; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11082257 - 18 Apr 2022

Cited by 6 | Viewed by 2338

Abstract

Cochlear implantation is considered the best treatment option for patients with severe-to-profound sensorineural hearing loss for whom conventional hearing aids are insufficient. We used a repeated measures longitudinal approach to evaluate speech recognition and patient-reported outcomes after cochlear implantation in an unbiased cohort of Danish adult patients in a prospective cohort study. We assessed 39 recipients before and two times after implantation using a battery of tests that included Dantale I, the Danish Hearing in Noise Test, the Nijmegen Cochlear Implant Questionnaire, and the Speech, Spatial, and Qualities of Hearing Scale. The study group improved significantly on all outcome measures following implantation. On average, Dantale I scores improved by 29 percentage points and Hearing in Noise Test scores improved by 22 percentage points. Most notably, the average Dantale score improved from 26 to 70% in the CI in quiet condition and from 12 to 42% in the cochlear implantation in noise condition when tested monaurally. Dantale demonstrated a significant positive correlation with Nijmegen Cochlear Implant Questionnaire and Speech, Spatial, and Qualities of Hearing Scale scores, while Hearing in Noise Test had no significant correlation with the patient-reported outcome measures. Patients improved significantly at 4 months and marginally improved further at 14 months, indicating that they were approaching a plateau. Our study’s use of audiometric and patient-reported outcome measures provides evidence of the treatment benefits of cochlear implantation in adults, which may help physicians advise patients on treatment decisions and align treatment benefit expectations, as well as serve as a foundation for the development of new cochlear implantation selection criteria. Full article

(This article belongs to the Special Issue Cochlear Implantation and Hearing Rehabilitation)

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14 pages, 817 KiB

Open AccessArticle

Attention to Speech and Music in Young Children with Bilateral Cochlear Implants: A Pupillometry Study

by Amanda Saksida, Sara Ghiselli, Lorenzo Picinali, Sara Pintonello, Saba Battelino and Eva Orzan

J. Clin. Med. 2022, 11(6), 1745; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11061745 - 21 Mar 2022

Cited by 3 | Viewed by 2162

Abstract

Early bilateral cochlear implants (CIs) may enhance attention to speech, and reduce cognitive load in noisy environments. However, it is sometimes difficult to measure speech perception and listening effort, especially in very young children. Behavioral measures cannot always be obtained in young/uncooperative children, whereas objective measures are either difficult to assess or do not reliably correlate with behavioral measures. Recent studies have thus explored pupillometry as a possible objective measure. Here, pupillometry is introduced to assess attention to speech and music in noise in very young children with bilateral CIs (N = 14, age: 17–47 months), and in the age-matched group of normally-hearing (NH) children (N = 14, age: 22–48 months). The results show that the response to speech was affected by the presence of background noise only in children with CIs, but not NH children. Conversely, the presence of background noise altered pupil response to music only in in NH children. We conclude that whereas speech and music may receive comparable attention in comparable listening conditions, in young children with CIs, controlling for background noise affects attention to speech and speech processing more than in NH children. Potential implementations of the results for rehabilitation procedures are discussed. Full article

(This article belongs to the Special Issue Cochlear Implantation and Hearing Rehabilitation)

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12 pages, 2053 KiB

Open AccessArticle

Intra-Cochlear Current Spread Correlates with Speech Perception in Experienced Adult Cochlear Implant Users

by Charles-Alexandre Joly, Pierre Reynard, Ruben Hermann, Fabien Seldran, Stéphane Gallego, Samar Idriss and Hung Thai-Van

J. Clin. Med. 2021, 10(24), 5819; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10245819 - 13 Dec 2021

Cited by 4 | Viewed by 2681

Abstract

Broader intra-cochlear current spread (ICCS) implies higher cochlear implant (CI) channel interactions. This study aimed to investigate the relationship between ICCS and speech intelligibility in experienced CI users. Using voltage matrices collected for impedance measurements, an individual exponential spread coefficient (ESC) was computed. Speech audiometry was performed to determine the intelligibility at 40 dB Sound Pressure Level (SPL) and the 50% speech reception threshold: I40 and SRT50 respectively. Correlations between ESC and either I40 or SRT50 were assessed. A total of 36 adults (mean age: 50 years) with more than 11 months (mean: 34 months) of CI experience were included. In the 21 subjects for whom all electrodes were active, ESC was moderately correlated with both I40 (r = −0.557, p = 0.009) and SRT50 (r = 0.569, p = 0.007). The results indicate that speech perception performance is negatively affected by the ICCS. Estimates of current spread at the closest vicinity of CI electrodes and prior to any activation of auditory neurons are indispensable to better characterize the relationship between CI stimulation and auditory perception in cochlear implantees. Full article

(This article belongs to the Special Issue Cochlear Implantation and Hearing Rehabilitation)

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13 pages, 979 KiB

Open AccessArticle

Cochlear Implantation in Elderly Patients with Residual Hearing

by Farnaz Matin, Eralp-Niyazi Artukarslan, Angelika Illg, Anke Lesinski-Schiedat, Thomas Lenarz and Marie Charlot Suhling

J. Clin. Med. 2021, 10(19), 4305; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10194305 - 22 Sep 2021

Cited by 2 | Viewed by 1436

Abstract

This retrospective study aimed to investigate the range of hearing levels in a cochlear implant (CI) elderly population receiving electric-acoustic-stimulation (EAS) or electric-stimulation (ES) alone. The investigation evaluates the degree of hearing preservation (HP) and the speech comprehension resulting from EAS or ES-only to identify audiometric factors that predict adequate EAS and ES use. We analyzed the pure tone audiometry and speech perception in quiet and noise preoperatively and 12-months after activation of 89 elderly adults (age of 65 years old or older), yielding in total 97 CIs. Thirty-two (33.1%) patients were potential EAS candidates preoperatively, of which 18 patients used EAS at the time of first fitting and the other 14 patients continued to use their residual hearing for EAS at 12-months. Post-treatment, patients with EAS system and ES-only users’ with longer electrodes showed better results in monosyllable word scores in quiet than ES-only users with shorter electrodes. A similar trend was revealed for the speech recognition in noise. Patients with an EAS system benefit from maintaining their natural residual hearing. Nevertheless, strict preoperative patient selection is warranted particularly in elderly patients, in whom the hearing thresholds for EAS indication differ slightly from that in younger adults. Full article

(This article belongs to the Special Issue Cochlear Implantation and Hearing Rehabilitation)

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16 pages, 2448 KiB

Open AccessArticle

Challenges of Cochlear Implantation in Intralabyrinthine Schwannoma Patients: Surgical Procedures and Auditory Outcome

by Sophia Marie Häussler, Agnieszka J. Szczepek, Stefan Gräbel and Heidi Olze

J. Clin. Med. 2021, 10(17), 3899; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10173899 - 30 Aug 2021

Cited by 7 | Viewed by 2308

Abstract

Intralabyrinthine schwannoma (ILS) is a rare benign tumor of the inner ear potentially causing unilateral sensorineural hearing loss and vertigo. This study evaluated the outcome of one surgical session comprising microsurgical ILS resection and cochlear implantation in terms of surgical feasibility, complications, and auditory outcome. Ten clinically and histologically confirmed ILS patients included in this study (three women and seven men; mean age 56.4 ± 8.6) underwent surgery between July 2015 and February 2020. Eight patients had intracochlear tumor location; the remaining two had vestibulocochlear and intravestibular ILS. One of the three following methods was used for tumor removal: an extended cochleostomy, subtotal cochleoectomy, or a translabyrinthine approach. Although negligible improvement was observed in two of the patients, two patients were lost to follow-up, and one opted out from using CI, the speech perception of the five remaining ILS patients improved as per the Freiburg Monosyllable Test (FMT) from 0% before surgery to 45– 50% after the implantation. Our study supports the presented surgical approach’s feasibility and safety, enabling tumor removal and hearing restoration shortly after surgery. Full article

(This article belongs to the Special Issue Cochlear Implantation and Hearing Rehabilitation)

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12 pages, 1651 KiB

Open AccessArticle

Comparing the Speech Perception of Cochlear Implant Users with Three Different Finnish Speech Intelligibility Tests in Noise

by Tytti Willberg, Ville Sivonen, Pia Linder and Aarno Dietz

J. Clin. Med. 2021, 10(16), 3666; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10163666 - 19 Aug 2021

Cited by 4 | Viewed by 2304

Abstract

Background: A large number of different speech-in-noise (SIN) tests are available for testing cochlear implant (CI) recipients, but few studies have compared the different tests in the same patient population to assess how well their results correlate. Methods: A clinically representative group of 80 CI users conducted the Finnish versions of the matrix sentence test, the simplified matrix sentence test, and the digit triplet test. The results were analyzed for correlations between the different tests and for differences among the participants, including age and device modality. Results: Strong and statistically significant correlations were observed between all of the tests. No floor or ceiling effects were observed with any of the tests when using the adaptive test procedure. Age or the length of device use showed no correlation to SIN perception, but bilateral CI users showed slightly better results in comparison to unilateral or bimodal users. Conclusions: Three SIN tests that differ in length and complexity of the test material provided comparable results in a diverse CI user group. Full article

(This article belongs to the Special Issue Cochlear Implantation and Hearing Rehabilitation)

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13 pages, 550 KiB

Open AccessArticle

Improvement of Working Memory and Processing Speed in Patients over 70 with Bilateral Hearing Impairment Following Unilateral Cochlear Implantation

by Steffen Knopke, Arvid Schubert, Sophia Marie Häussler, Stefan Gräbel, Agnieszka J. Szczepek and Heidi Olze

J. Clin. Med. 2021, 10(15), 3421; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10153421 - 31 Jul 2021

Cited by 16 | Viewed by 3038

Abstract

Several studies demonstrated the association of hearing disorders with neurocognitive deficits and dementia disorders, but little is known about the effects of auditory rehabilitation on the cognitive performance of the elderly. Therefore, the research question of the present study was whether cochlear implantation, performed in 21 patients over 70 with bilateral severe hearing impairment, could influence their cognitive skills. The measuring points were before implantation and 12 months after the first cochlear implant (CI) fitting. Evaluation of the working memory (WMI) and processing speed (PSI) was performed using the Wechsler Adult Intelligence Scale 4th edition (WAIS-IV). The audiological assessment included speech perception (SP) in quiet (Freiburg monosyllabic test; FMT), noise (Oldenburg sentence test; OLSA), and self-assessment inventory (Oldenburg Inventory; OI). Twelve months after the first CI fitting, not only the auditory parameters (SP and OI), but also the WMI and PSI, improved significantly (p < 0.05) in the cohort. The presented results imply that cochlear implantation of bilaterally hearing-impaired patients over 70 positively influences their cognitive skills. Full article

(This article belongs to the Special Issue Cochlear Implantation and Hearing Rehabilitation)

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Graphical abstract

10 pages, 766 KiB

Open AccessArticle

Hearing Outcomes and Complications of Cochlear Implantation in Elderly Patients over 75 Years of Age

by Rie Kanai, Shin-ichi Kanemaru, Kaoru Tamura, Yoshiko Noda, Naomi Umezawa, Misaki Yoshida, Toru Miwa, Tomoya Yamaguchi, Shinichiro Kita, Akiko Kumazawa, Hiroyuki Harada and Toshiki Maetani

J. Clin. Med. 2021, 10(14), 3123; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10143123 - 15 Jul 2021

Cited by 5 | Viewed by 1448

Abstract

Objective: Populations are aging in many countries, and the proportion of elderly people with severe to profound hearing loss is increasing in parallel with the increasing average life span. The objective of this study was to investigate the outcomes of cochlear implant (CI) surgery in elderly patients compared to those in younger patients. Methods: The outcomes of CI surgery were retrospectively investigated for 81 adults (32 men and 49 women) who underwent CI surgery at our hospital. They were divided according to age at the time of implantation into the younger group (<75 years of age; n = 49) or elderly group (≥75 years of age; n = 32). Results: The mean sentence recognition score on the CI-2004 Japanese open-set test battery (±standard deviation) was 82.9% ± 24.1 in the younger group and 81.9% ± 23.2 in the elderly group, with no significant difference between the groups (Mann–Whitney U test). The incidence of major complications that required surgical treatment was not significantly different between the groups (4.1% vs. 6.2%, respectively). Thus, there were no severe complications that could affect general health status in either group. Three patients in each group died for reasons unrelated to CI surgery during follow-up. The proportion of patients who were alive and continued to use the CI five years after surgery was 92.8% and 91.5%, respectively. Conclusion: Our results show good speech recognition and a low incidence of major complications in elderly patients. This comprehensive report on the outcomes of CI surgery in elderly patients will be helpful to the elderly with severe to profound hearing loss when deciding whether to undergo CI surgery. Full article

(This article belongs to the Special Issue Cochlear Implantation and Hearing Rehabilitation)

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13 pages, 2188 KiB

Open AccessArticle

Improvements in Hearing and in Quality of Life after Sequential Bilateral Cochlear Implantation in a Consecutive Sample of Adult Patients with Severe-to-Profound Hearing Loss

by Ville Sivonen, Saku T. Sinkkonen, Tytti Willberg, Satu Lamminmäki, Hilkka Jääskelä-Saari, Antti A. Aarnisalo and Aarno Dietz

J. Clin. Med. 2021, 10(11), 2394; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10112394 - 28 May 2021

Cited by 7 | Viewed by 4051

Abstract

Bilateral cochlear implantation is increasing worldwide. In adults, bilateral cochlear implants (BICI) are often performed sequentially with a time delay between the first (CI1) and the second (CI2) implant. The benefits of BICI have been reported for well over a decade. This study aimed at investigating these benefits for a consecutive sample of adult patients. Improvements in speech-in-noise recognition after CI2 were followed up longitudinally for 12 months with the internationally comparable Finnish matrix sentence test. The test scores were statistically significantly better for BICI than for either CI alone in all assessments during the 12-month period. At the end of the follow-up period, the bilateral benefit for co-located speech and noise was 1.4 dB over CI1 and 1.7 dB over CI2, and when the noise was moved from the front to 90 degrees on the side, spatial release from masking amounted to an improvement of 2.5 dB in signal-to-noise ratio. To assess subjective improvements in hearing and in quality of life, two questionnaires were used. Both questionnaires revealed statistically significant improvements due to CI2 and BICI. The association between speech recognition in noise and background factors (duration of hearing loss/deafness, time between implants) or subjective improvements was markedly smaller than what has been previously reported on sequential BICI in adults. Despite the relatively heterogeneous sample, BICI improved hearing and quality of life. Full article

(This article belongs to the Special Issue Cochlear Implantation and Hearing Rehabilitation)

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13 pages, 1283 KiB

Open AccessArticle

Language Development for the New Generation of Children with Hearing Impairment

by Lone Percy-Smith, Signe Wischmann, Jane Lignel Josvassen, Christina Schiøth and Per Cayé-Thomasen

J. Clin. Med. 2021, 10(11), 2350; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10112350 - 27 May 2021

Cited by 3 | Viewed by 2296

Abstract

A new generation of children with hearing impairment (HI) has emerged due to the introduction of universal neonatal hearing screening, medical–surgical/technical and educational advances. Aim: Investigation of long-term development of vocabulary and social well-being of children with HI, including children with HI and additional disability. Method and Material: The project design was prospective, longitudinal, and comparative. Level of receptive vocabulary was compared to children with normal hearing, type of hearing technology, gender, additional disability, diagnosis of HI, level of social well-being, and start age for use of hearing technology. A total of 231 children participated. Intervention included early start of hearing technology and three years of auditory–verbal therapy (AVT) at the preschool level, followed by 3 years of AV guidance at the school level. Results: Children with HI scored within the norm for receptive vocabulary but were outperformed by the control group. Children with HI and a diagnosed additional disability scored lower than children without additional disability, in terms of parental assessments of social well-being. Children with additional disabilities showed positive progression in terms of receptive vocabulary development. Conclusions: New generations with HI possess the potential to succeed academically in accordance with individual abilities and become active participants in the working market. Full article

(This article belongs to the Special Issue Cochlear Implantation and Hearing Rehabilitation)

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10 pages, 861 KiB

Open AccessArticle

Correlation between Speech Perception Outcomes after Cochlear Implantation and Postoperative Acoustic and Electric Hearing Thresholds

by Ursina Rüegg, Adrian Dalbert, Dorothe Veraguth, Christof Röösli, Alexander Huber and Flurin Pfiffner

J. Clin. Med. 2021, 10(2), 324; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10020324 - 17 Jan 2021

Cited by 4 | Viewed by 1577

Abstract

The reliable prediction of cochlear implant (CI) speech perception outcomes is highly relevant and can facilitate the monitoring of postoperative hearing performance. To date, multiple audiometric, demographic, and surgical variables have shown some degree of correlation with CI speech perception outcomes. In the present study, postsurgical acoustic and electric hearing thresholds that are routinely assessed in clinical practice were compared to CI speech perception outcomes in order to reveal possible markers of postoperative cochlear health. A total of 237 CI recipients were included in this retrospective monocentric study. An analysis of the correlation of postoperative pure-tone averages (PTAs) and electric CI fitting thresholds (T-/C-levels) with speech perception scores for monosyllabic words in quiet was performed. Additionally, a correlation analysis was performed for postoperative acoustic thresholds in intracochlear electrocochleography (EcochG) and speech recognition scores in a smaller group (n = 14). The results show that neither postoperative acoustic hearing thresholds nor electric thresholds correlate with postoperative speech perception outcomes, and they do not serve as independent predictors of speech perception outcomes. By contrast, the postoperative intracochlear total EcochG response was significantly correlated with speech perception. Since the EcochG recordings were only performed in a small population, a large study is required to clarify the usefulness of this promising predictive parameter. Full article

(This article belongs to the Special Issue Cochlear Implantation and Hearing Rehabilitation)

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