Current Profile of Adults Presenting for Preoperative Cochlear Implant Evaluation

Holder, Jourdan T.; Reynolds, Susan M.; Sunderhaus, Linsey W.; Gifford, René H.

doi:10.1177/2331216518755288

Cited by 113 publications

(148 citation statements)

References 72 publications

(102 reference statements)

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“…poorer) audiometric thresholds, on average. This is consistent with a recent prospective study of 287 preoperative CI candidates of whom those self-selecting for sequential bilateral implantation had significantly poorer preoperative audiometric thresholds in the second implanted ear as compared to the group of individuals who had chosen to retain bimodal hearing (Holder et al, 2018). Despite significant differences at the group level, there was still considerable overlap in audiometric thresholds between the two groups-both in the current study as well as in Holder et al (2018).…”

Section: Limitationssupporting

confidence: 91%

Bimodal Hearing or Bilateral Cochlear Implants? Ask the Patient

Gifford

Dorman

2019

Ear &Amp; Hearing

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Objective: The objectives of this study were to assess the effectiveness of various measures of speech understanding in distinguishing performance differences between adult bimodal and bilateral cochlear implant (CI) recipients and to provide a preliminary evidence-based tool guiding clinical decisions regarding bilateral CI candidacy. Design: This study used a multiple-baseline, cross-sectional design investigating speech recognition performance for 85 experienced adult CI recipients (49 bimodal, 36 bilateral). Speech recognition was assessed in a standard clinical test environment with a single loudspeaker using the minimum speech test battery for adult CI recipients as well as with an R-SPACE™ 8loudspeaker, sound-simulation system. All participants were tested in three listening conditions for each measure including each ear alone as well as in the bilateral/bimodal condition. In addition, we asked each bimodal listener to provide a yes/no answer to the question, "Do you think you need a second CI?" Results: This study yielded three primary findings: 1) there were no significant differences between bimodal and bilateral CI performance or binaural summation on clinical measures of speech recognition, 2) an adaptive speech recognition task in the R-SPACE™ system revealed significant differences in performance and binaural summation between bimodal and bilateral CI users, with bilateral CI users achieving significantly better performance and greater summation, and 3) the patient's answer to the question, "Do you think you need a second CI?" held high sensitivity (100% hit rate) for identifying likely bilateral CI candidates and moderately high specificity (77% correct rejection rate) for correctly identifying listeners best suited with a bimodal hearing configuration. Conclusions: Clinics cannot rely on current clinical measures of speech understanding, with a single loudspeaker, to determine bilateral CI candidacy for adult bimodal listeners nor to accurately document bilateral benefit relative to a previous bimodal hearing configuration. Speech recognition in a complex listening environment, such as R-SPACE™, is a sensitive and appropriate measure for determining bilateral CI candidacy and also likely for documenting bilateral benefit relative to a previous bimodal configuration. In the absence of an available R-SPACE™ system, asking the patient whether or not s/he thinks s/he needs a second CI is a highly sensitive measure which may prove clinically useful.

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Section: Limitationssupporting

confidence: 91%

Bimodal Hearing or Bilateral Cochlear Implants? Ask the Patient

Gifford

Dorman

2019

Ear &Amp; Hearing

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“…The results described above endorse the idea that in countries that hold on to more conservative criteria for CI candidacy, expansion of CI indication is beneficial for long-term benefit [ 2 – 4 , 28 , 29 ]. CI performance has improved and more evidence was found for the positive effect of residual hearing on CI outcome, strengthening the growing need for a shift of CI indication.…”

Section: Discussionsupporting

confidence: 67%

Expanding unilateral cochlear implantation criteria for adults with bilateral acquired severe sensorineural hearing loss

Huinck

Mylanus

Snik

2019

Eur Arch Otorhinolaryngol

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Objectives To report on a retrospective cohort study on the effects of expanding inclusion criteria for application of cochlear implants (CIs) on the performance 1-year post-implantation. Methods Based on pre-implantation audiometric thresholds and aided speech recognition scores, the data of 164 CI recipients were divided into a group of patients that fulfilled conservative criteria (mean hearing loss at 0.5, 1 and 2 kHz > 85 dB HL and phoneme scores with hearing aids < 30%), and the remaining group of patients that felt outside this conservative criterion. Speech recognition scores (in quiet) and quality of life (using the NCIQ) of both groups, measured at 1-year post-implantation, were compared. Results The group that felt outside the conservative criterion showed a higher phoneme score at 1-year post-implantation compared to the conservative group, suggesting that relaxed criteria have a positive influence on the speech recognition results with CI. With respect to quality of life, both groups significantly improved 1-year post-implantation. The conservative group showed a higher benefit on the advanced perception domain of the NCIQ. Based on their worse pre-implantation hearing, this was expected. Conclusions The data suggest that relaxation of CI indication positively affects the speech recognition performance of patients with severe hearing loss. Both groups of patients showed a positive effect of CI on the quality of life. This benefit relates to communication skills and the subjective day-to-day functioning in society.

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“…Age-related hearing loss (ARHL), or presbycusis, affects more than 30% of adults over age 50 years and its prevalence roughly doubles with each decade of life, making it the third leading chronic health condition among aging adults (Agrawal et al, 2008). Hearing aids and cochlear implants may restore audibility in ARHL, yet less than 15% of adults who could benefit from hearing aids in the United States use them (Chien and Lin, 2012) and this statistic is even lower (8%) among those adults who could benefit from cochlear implants (Holder et al, 2018). For the small percentage of adults who do seek treatment, treatment is sought out late, typically 7-10 years after initial hearing loss onset (Davis et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Cortical Neuroplasticity and Cognitive Function in Early-Stage, Mild-Moderate Hearing Loss: Evidence of Neurocognitive Benefit From Hearing Aid Use

Glick

Sharma

2020

Front. Neurosci.

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Age-related hearing loss (ARHL) is associated with cognitive decline as well as structural and functional brain changes. However, the mechanisms underlying neurocognitive deficits in ARHL are poorly understood and it is unclear whether clinical treatment with hearing aids may modify neurocognitive outcomes. To address these topics, cortical visual evoked potentials (CVEPs), cognitive function, and speech perception abilities were measured in 28 adults with untreated, mild-moderate ARHL and 13 agematched normal hearing (NH) controls. The group of adults with ARHL were then fit with bilateral hearing aids and re-evaluated after 6 months of amplification use. At baseline, the ARHL group exhibited more extensive recruitment of auditory, frontal, and pre-frontal cortices during a visual motion processing task, providing evidence of cross-modal re-organization and compensatory cortical neuroplasticity. Further, more extensive cross-modal recruitment of the right auditory cortex was associated with greater degree of hearing loss, poorer speech perception in noise, and worse cognitive function. Following clinical treatment with hearing aids, a reversal in cross-modal reorganization of auditory cortex by vision was observed in the ARHL group, coinciding with gains in speech perception and cognitive performance. Thus, beyond the known benefits of hearing aid use on communication, outcomes from this study provide evidence that clinical intervention with well-fit amplification may promote more typical cortical organization and functioning and provide cognitive benefit.

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Current Profile of Adults Presenting for Preoperative Cochlear Implant Evaluation

Cited by 113 publications

References 72 publications

Bimodal Hearing or Bilateral Cochlear Implants? Ask the Patient

Bimodal Hearing or Bilateral Cochlear Implants? Ask the Patient

Expanding unilateral cochlear implantation criteria for adults with bilateral acquired severe sensorineural hearing loss

Cortical Neuroplasticity and Cognitive Function in Early-Stage, Mild-Moderate Hearing Loss: Evidence of Neurocognitive Benefit From Hearing Aid Use

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