Interaction of tinnitus suppression and hearing ability after cochlear implantation

To study the postoperative impact of cochlear implants (CIs) on tinnitus, as well as the impact of tinnitus on speech recognition with CI switched on | Acta Oto-Laryngologica 

Methods: Fifty-two postlingual deafened CI recipients (21 males and 31 females) were assessed using an established Tinnitus Characteristics Questionnaire and Tinnitus Handicap Inventory (THI) before and after cochlear implantation. The tinnitus loudness was investigated when CI was switched on and off in CI recipients with persistent tinnitus. The relation between tinnitus loudness and recipients’ satisfaction of cochlear implantation was analyzed by the visual analogue scale (VAS) score.

Results: With CI ‘OFF’, 42 CI recipients experienced tinnitus postimplant ipsilaterally and 44 contralaterally. Tinnitus was totally suppressed ipsilateral to the CI with CI ‘ON’ in 42.9%, partially suppressed in 42.9%, unchanged in 11.9% and aggravated in 2.4%. Tinnitus was totally suppressed contralaterally with CI ‘ON’ in 31.8% of CI recipients, partially suppressed in 47.7%, unchanged in 20.5%. Pearson correlation analysis showed that tinnitus loudness and the results of cochlear implant patients satisfaction was negatively correlated (r = .674, p < .001).

Conclusion: The study suggests six-month CI activation can be effective for suppressing tinnitus. The tinnitus loudness may affect patients’ satisfaction with the use of CI.

Full reference: Wang, Q. Interaction of tinnitus suppression and hearing ability after cochlear implantation. Acta Oto-Laryngologica Vol. 137 (Issue 10) pp. 1077-1082

Cochlear implantation – which child when?

In the last 30 years, the field of cochlear implantation has rapidly evolved | Paediatrics and Child Health

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Technological advances in hardware and corresponding developments in surgical techniques, along with new sound processing strategies and innovative rehabilitation, have combined to maximise functional outcomes. Informed by the evidence base of such outcomes, the inclusion criteria for children who might benefit from a cochlear implant (CI) has been refined and expanded. CIs are now the standard of care for children with severe to profound hearing loss where the desired outcome is spoken language. There are several emerging trends within the field of paediatric CIs that have already translated into clinical practice in some countries, but have not yet been universally adopted.

These include, but are not limited to, the expansion of audiometric CI candidacy criteria for cohorts with:

  • (1) more residual hearing;
  • (2) partial hearing which may benefit from electric-acoustic stimulation (EAS)
  • (3) asymmetric hearing levels. This review will describe the historical context and provide an overview of the candidacy trends as they relate to children.

Full reference: Maggs, J. et al. (2017) Cochlear implantation – which child when? Paediatrics and Child Health. Published online: July 12, 2017

Outcomes of cochlear implantation for the patients with specific genetic etiologies

Cochlear implantation (CI) is the most important and effective treatment for patients with profound sensorineural hearing loss. However, the outcomes of CI vary among patients | Acta Oto-Laryngologica 

One of the reasons of this heterogeneous outcome for cochlear implantation is thought to be the heterogeneous nature of hearing loss. Indeed, genetic factors, the most common etiology in severe-to-profound hearing loss, might be one of the key determinants of outcomes for CI and electric acoustic stimulation (EAS). Patients with genetic causes involving an ‘intra-cochlear’ etiology show good CI/EAS outcomes.

This review article aimed to summarize the reports on CI/EAS outcomes in patients with special genetic causes as well as to assist in future clinical decision-making. Most of the cases were suspected of an intra-cochlear etiology, such as those with GJB2SLC26A4, and OTOF mutations, which showed relatively good CI outcomes. However, there have only been a limited number of reports on patients with other gene mutations.

Most of the cases with gene mutations of intra-cochlear etiology showed relatively good CI outcomes. To progress toward more solid evidence-based CI intervention, a greater number of reports including CI outcomes for specific gene mutations are desired.

Full reference: Nishio, S-Y. & Usami, S-I. (2017)Outcomes of cochlear implantation for the patients with specific genetic etiologies: a systematic literature review. Acta Oto-Laryngologica. Vol. 137 (no. 7) pp. 730-742 

Speech Intelligibility and Psychosocial Functioning in Deaf Children and Teens with Cochlear Implants

Deaf children with cochlear implants (CIs) are at risk for psychosocial adjustment problems, possibly due to delayed speech–language skills | The Journal of Deaf Studies and Deaf Education

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This study investigated associations between a core component of spoken-language ability—speech intelligibility—and the psychosocial development of prelingually deaf CI users. Audio-transcription measures of speech intelligibility and parent reports of psychosocial behaviors were obtained for two age groups (preschool, school-age/teen). CI users in both age groups scored more poorly than typically hearing peers on speech intelligibility and several psychosocial scales.

Among preschool CI users, five scales were correlated with speech intelligibility: functional communication, attention problems, atypicality, withdrawal, and adaptability. These scales and four additional scales were correlated with speech intelligibility among school-age/teen CI users: leadership, activities of daily living, anxiety, and depression.

Results suggest that speech intelligibility may be an important contributing factor underlying several domains of psychosocial functioning in children and teens with CIs, particularly involving socialization, communication, and emotional adjustment.

Full reference: Freeman, V. et al. (2017) Speech Intelligibility and Psychosocial Functioning in Deaf Children and Teens with Cochlear Implants. The Journal of Deaf Studies and Deaf Education. 22(3) pp.278-289.

Music Rehabilitation for Adult Cochlear Implant Users

A music-related quality of life (MuRQoL) questionnaire was developed for the evaluation of music rehabilitation for adult cochlear implant (CI) users. The present studies were aimed at refinement and validation | American Journal of Audiology

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Method: Twenty-four experts reviewed the MuRQoL items for face validity. A refined version was completed by 147 adult CI users, and psychometric techniques were used for item selection, assessment of reliability, and definition of the factor structure. The same participants completed the Short Form Health Survey for construct validation. MuRQoL responses from 68 CI users were compared with those of a matched group of adults with normal hearing.

Results: Eighteen items measuring music perception and engagement and 18 items measuring their importance were selected; they grouped together into 2 domains. The final questionnaire has high internal consistency and repeatability. Significant differences between CI users and adults with normal hearing and a correlation between music engagement and quality of life support construct validity. Scores of music perception and engagement and importance for the 18 items can be combined to assess the impact of music on the quality of life.

Conclusion: The MuRQoL questionnaire is a reliable and valid measure of self-reported music perception, engagement, and their importance for adult CI users with potential to guide music aural rehabilitation.

Full reference: Dritsakis, G. et al. (2017) A Music-Related Quality of Life Measure to Guide Music Rehabilitation for Adult Cochlear Implant Users. American Journal of Audiology. Published online: 15 June 2017

Pre- and post-operative dizziness, tinnitus, and taste disturbances among cochlear implant recipients.

Mikkelsen, K.S. et al. (2017) The Journal of Laryngology & Otology. 131(4) pp. 309-315.

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To determine the pre- and post-operative prevalence of dizziness, tinnitus and taste disturbances in adult cochlear implant recipients.

The high prevalence of dizziness, tinnitus and taste disturbances reported by cochlear implant recipients necessitates that assessment of symptoms related to inner ear and chorda tympani damage are included when evaluating operative results.

Read the full abstract here

Cochlear implantation in deaf patients with eosinophilic otitis media

Sugimoto, H.et al. European Archives of Otorhinolaryngology. 274(2) pp. 1173–1177

We investigated the usefulness and safety of our cochlear implantation method for two deaf patients with eosinophilic otitis media. The surgical approach was a subtotal petrosectomy to remove the theater of eosinophilic infiltration and to prevent leaching of foreign substances and entry of stimuli that are the cause of eosinophilic inflammations. The operative cavity was obliterated with abdominal fat.

There were no complications or recurrent inflammation following surgery in the cases of both patients. It was confirmed by CT scan that the eustachian tube was closed and the operative cavity remained obliterated with abdominal fat. Following the procedure, the hearing threshold results of the two patients were 30 and 34 dB. Cochlear implantation procedures in this report for deaf patients resulting from eosinophilic otitis media may be effective and safe. Using steroids before surgery may be the better option. To further confirm the efficacy and safety of our surgical concept, we need to administer this treatment concept for a large number of cases in a future study.

Read the abstract here