Bilateral cochlear implantation: Current concepts, indications, and results

Basura, Gregory J.; Eapen, Rose J.; Buchman, Craig A.

doi:10.1002/lary.20751

Cited by 72 publications

(58 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…implanting two dif-ferent CIs, provides speech perception improvement in quiet (+10 to 15 dB compared to the better ear alone) and in noise [Freyman et al, 1999[Freyman et al, , 2001Gantz et al, 2002;Müller et al, 2002;Tyler et al, 2002;Laszig et al, 2004;Litovsky et al, 2004Litovsky et al, , 2006Ramsden et al, 2005;Buss et al, 2008;Mosnier et al, 2009] and offers sound localization abilities Schoen et al, 2005;Van Deun et al, 2010]. Benefits in speech perception are mainly provided by the head-shadow effect that is potentiated by the use of two CIs, especially in mid and high frequencies (natural noise attenuation of the head, +4 to 7 dB [Basura et al, 2009]). Making profit of binaural cues relying on central processing, evaluated by the squelch effect (based on the interaural level differences and the interaural time differences; = 3 dB expected advantage in case of bilateral implantation [Basura et al, 2009]) and the summation effect (central summation of the level of presentation of the signal; =1.5 to 2.9 dB expected advantage in case of bilateral implantation [Basura et al, 2009]), is less efficient than in normal-hearing listeners [Bronkhorst and Plomp, 1988;van Hoesel and Tyler, 2003;Litovsky et al, 2006].…”

Section: Introductionmentioning

confidence: 99%

“…Benefits in speech perception are mainly provided by the head-shadow effect that is potentiated by the use of two CIs, especially in mid and high frequencies (natural noise attenuation of the head, +4 to 7 dB [Basura et al, 2009]). Making profit of binaural cues relying on central processing, evaluated by the squelch effect (based on the interaural level differences and the interaural time differences; = 3 dB expected advantage in case of bilateral implantation [Basura et al, 2009]) and the summation effect (central summation of the level of presentation of the signal; =1.5 to 2.9 dB expected advantage in case of bilateral implantation [Basura et al, 2009]), is less efficient than in normal-hearing listeners [Bronkhorst and Plomp, 1988;van Hoesel and Tyler, 2003;Litovsky et al, 2006]. Despite these obvious functional benefits, implanting two devices cannot be performed in all patients due to the additional cost [Summerfield et al, 2002[Summerfield et al, , 2003].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Speech Performance and Sound Localization Abilities in Neurelec Digisonic® SP Binaural Cochlear Implant Users

Verhaert

Lazard

Gnansia³

et al. 2012

Audiol Neurotol

View full text Add to dashboard Cite

In this prospective study the outcome of the Digisonic® SP Binaural cochlear implant (CI), a device enabling electric stimulation of both cochleae by a single receiver, was evaluated in 14 postlingually deafened adults after 12 months of use. Speech perception was tested using French disyllabic words in quiet and in speech-shaped noise at +10 dB signal-to-noise ratio. Horizontal sound localization in quiet was tested using pink noise coming from 5 loudspeakers, from –90 to +90° along the azimuth. Speech scores in quiet were 76% (±19.5 SD) in the bilateral condition, 62% (±24 SD) for the better ear alone and 43.5% (±27 SD) for the poorer ear alone. Speech scores in noise were 60% (±27.5 SD), 46% (±28 SD) and 28% (±25 SD), respectively, in the same conditions. Statistical analysis showed a significant advantage of the bilateral use in quiet and in noise (p < 0.05 compared to the better ear). Significant spatial perception benefits such as summation effect (p < 0.05), head shadow effect (p < 0.0001) and squelch effect (p < 0.0005) were noted. Sound localization accuracy improved significantly when using the device in the bilateral condition with an average root mean square of 35°. Compared with published outcomes of usual bilateral cochlear implantation, this device could be a valuable alternative to two CIs. Prospective controlled trials, comparing the Digisonic SP Binaural CI with a standard bilateral cochlear implantation are mandatory to evaluate their respective advantages and cost-effectiveness.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Speech Performance and Sound Localization Abilities in Neurelec Digisonic® SP Binaural Cochlear Implant Users

Verhaert

Lazard

Gnansia³

et al. 2012

Audiol Neurotol

View full text Add to dashboard Cite

show abstract

“…Bilateral implantation have added benefits (over unilateral) to recipients with bilateral profound hearing loss including improved sound localization and speech perception in noise [28,29]. This follows on to provide improved quality of life in a way that can be measured as a positive over the economic cost [10][11][12][13].…”

Section: The Second Side In Bilateral Cochlear Implantationmentioning

confidence: 99%

Variables that Effect Psychophysical Parameters and Duration to Stability in Cochlear Implant Mapping

Cs¹,

Pls²

2016

Otolaryngol

View full text Add to dashboard Cite

The process of rehabilitation after cochlear implant surgery involves programming the psychophysical parameters of the implant in a process called mapping. The audiology appointments involved in the mapping process are large contributors to cost of implant rehabilitation. The map is defined as stable when there is little variation over time.Once an implant map is stable there is reduced need for intensive rehabilitation and an increase in implant patient satisfaction. A literature search was conducted using the terms "map cochlear implant", "mapping cochlear implant", "psychophysical cochlear implant" with a date range from August 1957 to February 2016. A total of 560 articles were identified and 29 articles were retrieved for detailed evaluation. The most important factor identified, that determines map stability, is the patient's subjective implant experience. Patient demographics and implant variables have not been identified as significant. The second side implant in bilateral implantation has been shown to have significantly less time to map stability. There is a need for further studies to examine relationships between preoperative variables and the mapping process, rather than applying a "one size fits all approach", which is the current standard of care. This is of particular need in the setting of the second side in bilateral implantation.

show abstract

“…Although there is little doubt that two implants are acoustically superior to one, 8 the cost-efficacy of bilateral implantation is still controversial, 1 and some people considering a second implant can still use a hearing aid effectively in the unimplanted ear. Such "bimodal hearing" is potentially beneficial for the detection of the pitch of a target speaker's voice, a critical cue for speech perception in fluctuating background noise, 9 and for semantic and musical pitch perception.…”

mentioning

confidence: 99%

Cochlear implants: the hazards of unexpected success

Rubinstein

2012

CMAJ

View full text Add to dashboard Cite

T hirty years ago, cochlear implants were in their infancy as research projects conducted at a handful of institutions around the world. The devices were crude, typically manufactured in a university or other noncommercial engineering laboratory, unapproved by any government regulatory agency, and implanted in experimental animals or humans for short periods. There was substantial skepticism, not only about the efficacy of the existing devices but also about the entire concept. It simply was not believable to many that such a device could ever functionally replace the complex and elegant biophysics of the cochlea. Pioneering implant surgeons were accused of performing unethical human studies. I was strongly encouraged, as were other interested students, to seek alternative, and putatively more rewarding, dissertation projects.Today, cochlear implants are a global commercial enterprise, with three major manufacturers and a few smaller entities developing or marketing these devices. Various implants are approved by government regulatory agencies across the developed world and are reimbursed to various degrees by commercial and government payors. Financial analysts now pay as much attention to the results of clinical trials of these devices as do clinicians. It is a new world for these remarkable devices because they represent a highly effective and cost-effective treatment 1 of severe-profound sensorineural hearing loss in both children and adults.It is now well established that prelingually deafened children (loss of hearing before speech begins) can develop near-normal levels of speech and language and achieve normal educational milestones when given an implant at an early age. Postlingually deaf adults, even octogenarians, 3 can usually speak on the telephone and, in some cases, achieve normal levels of speech understanding in quiet environments within a year of implantation. This level of success is beyond the wildest dreams of the pioneering engineers and clinicians. So what are the hazards? Implants previously underpromised and overdelivered. In an era in which patients were unable to understand speech with a hearing aid, any chance of improvement was welcome. Patients were warned that they might not benefit from an implant but would often proceed anyway because there was little risk associated with implanting a device in an ear that already had essentially no hearing. Even minimal postoperative speech perception would represent a substantial auditory benefit. As the devices improved over time, so did the risk-benefit ratio, at least for people with severe or total hearing loss.Today there are several quite promising nontraditional applications of implants that challenge this highly favourable risk-benefit analysis because they either involve implanting a device in a partly hearing ear or demand extremely high levels of performance from an ear with an implanted device (implanted ear) to provide benefit.Because speech discrimination with implants has improved dramatically, the criteria for implantation has ap...

show abstract

Bilateral cochlear implantation: Current concepts, indications, and results

Cited by 72 publications

References 65 publications

Speech Performance and Sound Localization Abilities in Neurelec Digisonic® SP Binaural Cochlear Implant Users

Speech Performance and Sound Localization Abilities in Neurelec Digisonic® SP Binaural Cochlear Implant Users

Variables that Effect Psychophysical Parameters and Duration to Stability in Cochlear Implant Mapping

Cochlear implants: the hazards of unexpected success

Contact Info

Product

Resources

About