Cochlear Implantation in Postlingual Adult Patients With Long-Term Auditory Deprivation

Medina, María del Mar Venegas; Polo, Rubén; Gutiérrez, Auxiliadora; Muriel, Alfonso; Vaca, Miguel; Pérez, Cecilia Taborda; Cordero, Adela; Cobeta, Ignacio

doi:10.1097/mao.0000000000001257

Cited by 31 publications

(38 citation statements)

References 17 publications

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“…Twenty‐two studies with 1167 patients presented data on vowel/consonant and monosyllabic word perception scores, namely the best monosyllabic discrimination (BMD) score, 41 the Consonant‐Nucleus‐Consonant (CNC) words, 4,35,38,45‐47 Consonant‐Vowel tests, 31,32,37,48 the Northwestern University Auditory Test No.6 (NU‐6), 29,35,49 Freiburg monosyllabic word test, 34,40 vowel identification score 30,39,50 , a word perception test 15,51,52 and different tests 24 …”

Section: Resultsmentioning

confidence: 99%

“…Data on speech perception measured by sentence‐tests was available from 22 studies with 1024 patients. The following tests were used: the AzBio Sentence Test, 19,26 the Hearing in Noise Test (HINT), 19,46,53 Bamford‐Kowal‐Bench sentences (BKB), 25,42 Central Institute of the Deaf sentences (CID), 29,49,54,55 its Korean version K‐CID, 8,43 City University of New York sentences (CUNY), 23,28,47,56,57 Iowa Sentence Test, 58 Hochmair‐Schulz‐Moser test, 40 a Japanese phrase intelligibility test, 37 a Spanish sentence test 39 and unspecified tests 24 . Monosyllabic and sentence tests were separately analyzed.…”

Section: Resultsmentioning

confidence: 99%

“…For the meta‐analysis, we included studies presenting Pearson or Spearman correlation coefficients on DoD and postoperative speech perception tests at the latest follow‐up visit. For better comparability, we converted Spearman rho into Pearson's correlation coefficient using Rupinski's equation 36 from eligible studies 8,15,26,29,35,37‐43 …”

Section: Methodsmentioning

confidence: 99%

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Duration of deafness impacts auditory performance after cochlear implantation: A meta‐analysis

Bernhard

Gauger

Ventura

et al. 2021

Laryngoscope Investig Oto

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Objective Hearing loss is a highly disabling condition. Cochlear implantation is an established remedy if conventional hearing aids have failed to alleviate the level of disability. Unfortunately, cochlear implant (CI) performance varies dramatically. This study aims to examine the effects of duration of deafness (DoD) prior to cochlear implantation and the postoperative duration of implant experience with resulting hearing performance in postlingually deaf patients. Methods A systematic literature review and two meta‐analyses were conducted using the search terms cochlear implant AND duration deafness. Included studies evaluate the correlation between the DoD and auditory performance after cochlear implantation using monosyllabic and sentence tests. Correlation coefficients were determined using Pearson's correlation and Spearman rho. Results A total of 36 studies were identified and included data on cochlear implantations following postlingual deafness and postoperative speech testing of hearing outcomes for 1802 patients. The mean age ranged from 44 to 68 years with a DoD of 0.1 to 77 years. Cochlear implant use varied from 3 months to 14 years of age. Speech perception, which was assessed by sentence and monosyllabic word perception, was negatively correlated with DoD. Subgroup analyses revealed worse outcomes for longer DoD and shorter postoperative follow‐up. Conclusion DoD is one of the most important factors to predict speech perception after cochlear implantation in postlingually deaf patients. The meta‐analyses revealed a negative correlation between length of auditory deprivation and postoperative sentence and monosyllabic speech perception. Longer DoD seems to lead to worse CI performance, whereas more experience with CI mitigates the effect.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Duration of deafness impacts auditory performance after cochlear implantation: A meta‐analysis

Bernhard

Gauger

Ventura

et al. 2021

Laryngoscope Investig Oto

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“…Further the auditory cortex might not effectively process acoustical speech input (Teoh et al, 2004; Lazard et al, 2010). Due to this different development of the auditory pathways, some studies suggest that implantation might not be beneficial in this group, at least not for speech perception (Connell and Balkany, 2006; Medina et al, 2017). In fact, in clinical practice, up until recently, early-deafened individuals were not frequently implanted because of the expected low benefit of implantation for speech outcomes (Heywood et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Early Deafened, Late Implanted Cochlear Implant Users Appreciate Music More Than and Identify Music as Well as Postlingual Users

2019

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Introduction: Typical cochlear implant (CI) users, namely postlingually deafened and implanted, report to not enjoy listening to music, and find it difficult to perceive music. Another group of CI users, the early-deafened (during language acquisition) and late-implanted (after a long period of auditory deprivation; EDLI), report a higher music appreciation, but is this related to a better music perception?Materials and Methods: Sixteen EDLI and fifteen postlingually deafened (control group) CI users participated in the study. The inclusion criteria for EDLI were: severe or profound hearing loss onset before the age of 6 years, implantation after the age of 16 years, and CI experience more than 1 year. Subjectively, music perception and appreciation was evaluated using the Dutch Musical Background Questionnaire. Behaviorally, music perception was measured with melodic contour identification (MCI), using two instruments (piano and organ), each tested with and without a masking contour. Semitone distance between successive tones of the target varied from 1 to 3 semitones.Results: Subjectively, the EDLI group reported to appreciate music more than postlingually deafened CI users. Behaviorally, while clinical phoneme recognition test score on average was lower in the EDLI group, melodic contour identification did not significantly differ between the two groups. There was, however, an effect of instrument and masker for both groups; the piano was the best-recognized instrument, and for both instruments, the masker with non-overlapping pitch was best recognized.Discussion: EDLI group reported higher appreciation of music than postlingual control group, even though behaviorally measured music perception did not differ significantly between the two groups. Both surprising findings since EDLI CI users would be expected to have lower outcomes based on the early deafness onset, long duration of auditory deprivation, and on average lower clinical speech scores. Perhaps, the music perception difficulty comes from similar electric hearing limitations in both groups. The higher subjective appreciation in EDLI might be due to the lack of a musical memory, with no ability to compare music heard via the CI to acoustic music perception. Overall, our findings support a benefit from implantation for a positive music experience in EDLI CI users.

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“…One widely held view is that the success with a CI declines with increasing duration of profound deafness prior to implantation (Gantz et al 1993 ; Blamey et al 1996 ; UK Cochlear Implant Study Group 2004 ; Holden et al 2013 ). Nevertheless, several recent studies have failed to show an appreciable effect of duration of deafness (Medina et al 2017 ), particularly after eliminating a confound of age at testing (Beyea et al 2016 ). Others have shown a marked influence of duration of deafness on CI performance only for durations of deafness > 30 years (UK Cochlear Implant Study Group 2004 ; Moon et al 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Chronic Deafness Degrades Temporal Acuity in the Electrically Stimulated Auditory Pathway

Middlebrooks

2018

JARO

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Electrical stimulation of the auditory nerve with a penetrating intraneural (IN) electrode in acutely deafened cats produces much more restricted spread of excitation than is obtained in that preparation with a conventional cochlear implant (CI) as reported by Middlebrooks and Snyder (J Assoc Res Otolaryngol 8:258–279, 2007). That suggests that a future auditory prosthesis employing IN stimulation might offer human patients greater frequency selectivity than is available with a present-day CI. Nevertheless, it is a concern that the electrical field produced by an IN electrode might be too restricted to produce adequate stimulation of the partially depopulated auditory nerve of a deaf patient. We evaluated this by testing responses to IN and CI stimulation in adult-deafened cats. Activation of the auditory pathway was monitored by recording from the central nucleus of the inferior colliculus (ICC). Cats deaf for 153–277 days exhibited a ~ 30 % loss of auditory nerve fibers compared to cats deaf for < 18 h. Contrary to our concern, measures of thresholds and dynamic ranges showed no significant deafness-related impairment of excitation by IN or CN stimulation. Surprisingly, however, temporal acuity decreased dramatically in these adult-deafened cats, as demonstrated by a marked decrease in the maximum rate of electrical cochlear stimulation to which ICC neurons synchronized to IN or CI stimulation. For instance, half of ICC neurons synchronized to IN stimulation up to 203 pulses per second (pps) in acute deafness, whereas that number dropped to 79 pps for chronic deafness. Such a loss of temporal acuity might contribute to the poor sensitivity to temporal fine structure that has been reported in human CI users. Seemingly, the degraded temporal acuity that we observed in cats was even worse than the fine-structure sensitivity of human CI users, suggesting that most patients experience some improvement of temporal acuity resulting from restoration of patterned auditory nerve stimulation by a CI.

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Cochlear Implantation in Postlingual Adult Patients With Long-Term Auditory Deprivation

Abstract: Long-term auditory deprivation in the ear to be implanted does not negatively influence cochlear implantation results and should not be considered criterion to reject cochlear implantation.

Cited by 31 publications

References 17 publications

Duration of deafness impacts auditory performance after cochlear implantation: A meta‐analysis

Duration of deafness impacts auditory performance after cochlear implantation: A meta‐analysis

Early Deafened, Late Implanted Cochlear Implant Users Appreciate Music More Than and Identify Music as Well as Postlingual Users

Chronic Deafness Degrades Temporal Acuity in the Electrically Stimulated Auditory Pathway

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