The Impact of Daily Processor Use on Adult Cochlear Implant Outcomes: Reexamining the Roles of Duration of Deafness and Age at Implantation

DeFreese, Andrea; Lindquist, Nathan R.; Shi, Lin; Holder, Jourdan T.; Berg, Katelyn A; Haynes, David S.; Gifford, René H.

doi:10.1097/mao.0000000000003920

Cited by 7 publications

(3 citation statements)

References 39 publications

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“…Therefore, the findings support the benefit of auditory training in adult CI listeners, which is consistent with several other reports ( Fu and Galvin, 2008 ; Dornhoffer et al , 2024 ). Other forms of training, such as through daily practice and CI use, also seem to improve outcomes with CIs across the lifespan ( DeFreese et al , 2023 ). It is unclear if adaptive training that targets temporal-processing abilities differs from other more traditional training approaches, including speech recognition in noise ( Fu and Galvin, 2008 ).…”

Section: Discussionmentioning

confidence: 99%

Cochlear-implant listeners benefit from training with time-compressed speech, even at advanced ages

Ezenwa,

Goupell,

Gordon-Salant

2024

JASA Express Letters

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This study evaluated whether adaptive training with time-compressed speech produces an age-dependent improvement in speech recognition in 14 adult cochlear-implant users. The protocol consisted of a pretest, 5 h of training, and a posttest using time-compressed speech and an adaptive procedure. There were significant improvements in time-compressed speech recognition at the posttest session following training (>5% in the average time-compressed speech recognition threshold) but no effects of age. These results are promising for the use of adaptive training in aural rehabilitation strategies for cochlear-implant users across the adult lifespan and possibly using speech signals, such as time-compressed speech, to train temporal processing.

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Section: Discussionmentioning

confidence: 99%

Cochlear-implant listeners benefit from training with time-compressed speech, even at advanced ages

Ezenwa,

Goupell,

Gordon-Salant

2024

JASA Express Letters

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“…1). A direct relationship between average daily CI usage and speech outcomes has been well established (8–10). This study further highlights that early processor use influences long-term speech recognition outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Cochlear implants (CIs) have become the standard treatment option for patients with moderate-to-profound hearing loss who derive limited benefit from their hearing aids. Several factors can influence outcomes after CI surgery: age at implantation, duration of deafness, preoperative hearing, cognitive status, and device utilization (1–10). With innovative healthcare delivery models such as same-day CI consultation and surgery, where sound processor activation is performed within a few days after implantation, understanding how the timing of activation impacts postoperative outcomes is imperative (11,12).…”

Section: Introductionmentioning

confidence: 99%

Improved Postoperative Speech Recognition and Processor Use With Early Cochlear Implant Activation

Patro,

Lindquist,

Holder

et al. 2024

Otol Neurotol

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Objective To report speech recognition outcomes and processor use based on timing of cochlear implant (CI) activation. Study Design Retrospective cohort. Setting Tertiary referral center. Patients A total of 604 adult CI recipients from October 2011 to March 2022, stratified by timing of CI activation (group 1: ≤10 d, n = 47; group 2: >10 d, n = 557). Main Outcome Measures Average daily processor use; Consonant-Nucleus-Consonant (CNC) and Arizona Biomedical (AzBio) in quiet at 1-, 3-, 6-, and 12-month visits; time to peak performance. Results The groups did not differ in sex (p = 0.887), age at CI (p = 0.109), preoperative CNC (p = 0.070), or preoperative AzBio in quiet (p = 0.113). Group 1 had higher median daily processor use than group 2 at the 1-month visit (12.3 versus 10.7 h/d, p = 0.017), with no significant differences at 3, 6, and 12 months. The early activation group had superior median CNC performance at 3 months (56% versus 46%, p = 0.007) and 12 months (60% versus 52%, p = 0.044). Similarly, the early activation group had superior median AzBio in quiet performance at 3 months (72% versus 59%, p = 0.008) and 12 months (75% versus 68%, p = 0.049). Both groups were equivalent in time to peak performance for CNC and AzBio. Earlier CI activation was significantly correlated with higher average daily processor use at all follow-up intervals. Conclusion CI activation within 10 days of surgery is associated with increased early device usage and superior speech recognition at both early and late follow-up visits. Timing of activation and device usage are modifiable factors that can help optimize postoperative outcomes in the CI population.

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Frequency-to-Place Mismatch and Cochlear Implant Outcomes by Electrode Type

DeFreese,

Berg,

Noble

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportanceSpeech recognition outcomes with a cochlear implant (CI) are highly variable. One factor suggested to correlate with CI-aided speech recognition is frequency-to-place mismatch, or the discrepancy between the natural tonotopic organization of the cochlea and the electric frequency allocation of the CI electrodes within the patient’s cochlea.ObjectiveTo evaluate the association between frequency-to-place mismatch and speech recognition outcomes in a large cohort of postlingually deafened adult CI users, while controlling for various clinical factors known to be associated with those outcomes.Design, Setting, and ParticipantsThis retrospective cohort study used data from a CI program at a tertiary medical center and included CIs from postlingually deafened adult CI users. After excluding patients whose data were not logged, patients with implantations occurring between 2016 and 2023 were included in the analysis. The data were extracted in November 2023.Main Outcomes and MeasuresResults of the Consonant-Nucleus-Consonant (CNC) monosyllabic word recognition test measured in the CI-aided alone condition 1 month, 3 months, 6 months, and 12 months after activation served as the main outcome. The independent variables included frequency-to-place mismatch, electrode array type, mean modiolar distance, electrode position, age at implantation, biological sex, contralateral hearing abilities, time since CI activation (test interval), and daily device use.ResultsIn 498 CIs from 447 postlingually deafened adults (mean [SD] age, 63.1 [17.1] years; 271 [54.4%] CIs with male users), frequency-to-place mismatch was negatively correlated with CI-aided speech recognition outcomes, but the association was only significant for precurved electrode arrays and not straight electrode arrays. In the linear mixed effects model for straight electrode arrays, only test interval (β = 1.14 [95% CI, 0.90-1.38]) and daily device use (β = 0.90 [95% CI, 0.42-1.38]) were correlated with the improvement of word recognition over the first year of device use. In the model for precurved electrode arrays, mismatch at 1500 Hz (β = −0.011 [95% CI, −0.011 to −0.006]), scalar location (β = 16.37 [95% CI, 9.01 to 23.74]), test interval (β = 1.18 [95% CI, 1.18-1.41]) and daily device use (β = 1.65 [95% CI, 1.15-2.14]) all were significantly associated with the improvement of word recognition over the first year of device use.Conclusions and RelevanceIn this cohort study of postlingually deafened adult CI users, including both straight and precurved electrode arrays, daily device use and time since CI activation were found to be significantly associated with improved CI-aided speech recognition outcomes. Frequency-to-place mismatch at 1500 Hz and scalar location were associated with word recognition only for precurved arrays. These findings suggest that, for patients with straight arrays, any interference produced by frequency-to-place mismatch may be overcome by adaptation, which could be supported by daily device use. However, for patients with precurved arrays, daily device use may not be sufficient to completely overcome electrode placement factors, including scalar location and mismatch.

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The Impact of Daily Processor Use on Adult Cochlear Implant Outcomes: Reexamining the Roles of Duration of Deafness and Age at Implantation

Cited by 7 publications

References 39 publications

Cochlear-implant listeners benefit from training with time-compressed speech, even at advanced ages

Cochlear-implant listeners benefit from training with time-compressed speech, even at advanced ages

Improved Postoperative Speech Recognition and Processor Use With Early Cochlear Implant Activation

Frequency-to-Place Mismatch and Cochlear Implant Outcomes by Electrode Type

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