Cochlear Implantation Improves Spatial Release From Masking and Restores Localization Abilities in Single-sided Deaf Patients

Großmann, Wilma; Brill, Stefan; Moeltner, Alexander; Mlynski, Robert; Hagen, Rudolf; Radeloff, Andreas

doi:10.1097/mao.0000000000001043

Cited by 53 publications

(61 citation statements)

References 42 publications

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“…Initial studies have shown improvement with localization (Arndt et al 2011; Firszt et al 2012; Hansen et al 2013; Zeitler et al 2015) and speech recognition in noise, depending on the type and location (Bernstein et al 2016; Grossman et al 2016; Zeitler et al 2015); however, considerable work remains to fully understand communication deficits and expected benefits from cochlear implantation. The range of performance for unaided/nonimplanted UHL participants in the current study (and others), provides a framework to gauge potential benefits gained from cochlear implantation.…”

Section: Discussionmentioning

confidence: 99%

Unilateral Hearing Loss: Understanding Speech Recognition and Localization Variability—Implications for Cochlear Implant Candidacy

2017

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Objectives At a minimum, unilateral hearing loss (UHL) impairs sound localization ability and understanding speech in noisy environments, particularly if the loss is severe to profound. Accompanying the numerous negative consequences of UHL is considerable unexplained individual variability in the magnitude of its effects. Identification of co-variables that affect outcome and contribute to variability in UHLs could augment counseling, treatment options, and rehabilitation. Cochlear implantation as a treatment for UHL is on the rise yet little is known about factors that could impact performance or whether there is a group at risk for poor cochlear implant outcomes when hearing is near-normal in one ear. The overall goal of our research is to investigate the range and source of variability in speech recognition in noise and localization among individuals with severe to profound UHL and thereby help determine factors relevant to decisions regarding cochlear implantation in this population. Design The present study evaluated adults with severe to profound UHL and adults with bilateral normal hearing. Measures included adaptive sentence understanding in diffuse restaurant noise, localization, roving-source speech recognition (words from 1 of 15 speakers in a 140° arc) and an adaptive speech-reception threshold psychoacoustic task with varied noise types and noise-source locations. There were three age-gender-matched groups: UHL (severe to profound hearing loss in one ear and normal hearing in the contralateral ear), normal hearing listening bilaterally, and normal hearing listening unilaterally. Results Although the normal-hearing-bilateral group scored significantly better and had less performance variability than UHLs on all measures, some UHL participants scored within the range of the normal-hearing-bilateral group on all measures. The normal-hearing participants listening unilaterally had better monosyllabic word understanding than UHLs for words presented on the blocked/deaf side but not the open/hearing side. In contrast, UHLs localized better than the normal hearing unilateral listeners for stimuli on the open/hearing side but not the blocked/deaf side. This suggests that UHLs had learned strategies for improved localization on the side of the intact ear. The UHL and unilateral normal hearing participant groups were not significantly different for speech-in-noise measures. UHL participants with childhood rather than recent hearing loss onset localized significantly better; however, these two groups did not differ for speech recognition in noise. Age at onset in UHL adults appears to affect localization ability differently than understanding speech in noise. Hearing thresholds were significantly correlated with speech recognition for UHL participants but not the other two groups. Conclusions Auditory abilities of UHLs varied widely and could be explained only in part by hearing threshold levels. Age at onset and length of hearing loss influenced performance on some, but not all measures. Results suppo...

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Section: Discussionmentioning

confidence: 99%

Unilateral Hearing Loss: Understanding Speech Recognition and Localization Variability—Implications for Cochlear Implant Candidacy

2017

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“…The loss of binaural function has been associated with reduced localization, speech understanding in noise, and quality of life (QoL) in SSD patients [Cabral et al, 2016;Finke et al, 2017;Grossmann et al, 2016;Kuppler et al, 2013;Nawaz et al, 2014;Tokita et al, 2014;Wie et al, 2010]. For SSD patients, restoration of binaural function is possible with a cochlear implant (CI).…”

Section: Introductionmentioning

confidence: 99%

Binaural Perception in Single-Sided Deaf Cochlear Implant Users with Unrestricted or Restricted Acoustic Hearing in the Non-Implanted Ear

Dorbeau

Galvin

et al. 2018

Audiol Neurotol

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Cochlear implantation (CI) can benefit patients with single-sided deafness (SSD) in terms of sound localization, speech understanding in noise, tinnitus severity, and quality of life (QoL). In previous studies, CI outcomes have been largely reported for SSD patients with normal “unrestricted” hearing in the contralateral ear. However, SSD patients may often have some degree of hearing loss in the contralateral ear (“restricted” acoustic hearing). In this study, we report results from a French clinical trial for CI in in SSD patients (NCT02204618). Localization, speech reception thresholds (SRTs) in noise, tinnitus severity, and QoL were evaluated in 18 SSD patients 1 year after CI. Data were analyzed for 2 subject groups according to the pure-tone average thresholds in the non-implanted ear: unrestricted acoustic hearing (UNRES; ≤25 dB HL; n = 10) and restricted acoustic hearing (RES; > 25 dB HL; n = 8). Across all subjects, localization was significantly better with the CI on than off (p = 0.005); there was no significant difference between subject groups (p = 0.301). When speech and noise were co-located (S0N0), there was no significant difference in SRTs with the CI on or off (p = 0.480); SRTs were significantly better for the UNRES than for the RES group (p = 0.005). When speech and noise were spatially separated (S_CIN_NH), SRTs were significantly better with the CI on than off (p < 0.001). While SRTs were better for the UNRES than for the RES group (p = 0.024), the CI benefit was more than 50% greater for the RES group due to the restoration of high-frequency speech cues. Questionnaire data showed that tinnitus severity was significantly reduced (p = 0.045) and QoL was significantly improved after one year of experience with the CI (p < 0.001). Age at testing was significantly correlated with SRTs for the S0N0 condition; duration of deafness was correlated with SRTs for the S_CIN_NH condition. There were relatively few correlations between behavioral and subjective measures, suggesting that both were valuable when assessing CI benefits for SSD patients. The present data suggest that indications for CI should be expanded to include unilaterally deaf patients who have normal hearing or mild-to-moderate hearing loss in the non-implanted ear.

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“…A study of CI for adult-acquired SSD was reviewed. Two systematic reviews [13,14] and several subsequent reports [15][16][17][18] yielded similar results. These are summarized as follows.…”

Section: Cochlear Implantmentioning

confidence: 56%

Associated Health Issues of Patients with Acquired Unilateral Hearing Loss

Sano¹

2020

Advances in Rehabilitation of Hearing Loss

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Patients with unilateral hearing loss have impaired hearing of sounds coming from the affected side, decreased comprehension of speech in noisy environments, and lack of sound localization. There are many conditions that can induce unilateral hearing loss, but idiopathic sudden sensorineural hearing loss (ISSHL) is thought to be most notable because of its high incidence. Patients with ISSHL suddenly acquire unilateral hearing loss; therefore, there are additional significant health problems that complicate the abovementioned symptoms due to the characteristic clinical course of ISSHL including hearing-related discomfort, tinnitus, and anxiety. It has been reported that hearing-related discomfort is closely associated with patients' quality of life. In this chapter, the associated health issues of patients with ISSHL are described, and the interventions employed for patients with unilateral hearing loss are evaluated for their potential in improving the lives of ISSHL patients.

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Cochlear Implantation Improves Spatial Release From Masking and Restores Localization Abilities in Single-sided Deaf Patients

Abstract: The present data demonstrates that spatial release from masking can be restored in patients with SSD using a cochlear implant.

Cited by 53 publications

References 42 publications

Unilateral Hearing Loss: Understanding Speech Recognition and Localization Variability—Implications for Cochlear Implant Candidacy

Unilateral Hearing Loss: Understanding Speech Recognition and Localization Variability—Implications for Cochlear Implant Candidacy

Binaural Perception in Single-Sided Deaf Cochlear Implant Users with Unrestricted or Restricted Acoustic Hearing in the Non-Implanted Ear

Associated Health Issues of Patients with Acquired Unilateral Hearing Loss

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