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.

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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.

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A Longitudinal Study in Children With Sequential Bilateral Cochlear Implants

Reeder, R.M. et al. (2017) Journal of Speech, Language, and Hearing Research, January Vol. 60. pp. 276-287.

Purpose: Whether, and if so when, a second-ear cochlear implant should be provided to older, unilaterally implanted children is an ongoing clinical question. This study evaluated rate of speech recognition progress for the second implanted ear and with bilateral cochlear implants in older sequentially implanted children and evaluated localization abilities.

Conclusions: Older sequentially implanted children with several years between surgeries may obtain speech understanding in the second implanted ear; however, performance may be limited and rate of progress gradual. Continued contralateral ear hearing aid use and reduced time between surgeries may enhance outcomes.

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Clinical outcomes with the Kanso™ off-the-ear cochlear implant sound processor

Stefan J. Mauger et. al. Clinical outcomes with the Kanso™ off-the-ear cochlear implant sound processor International Journal Of Audiology. Published online: 09 Jan 2017

Objective: To investigate clinical outcomes and subjective ratings of the Kanso™ off-the-ear (OTE) cochlear implant sound processor.

Design: Prospective, within-subject design investigating outcomes with a range of single and dual-microphone programmes for Kanso compared to conventional behind-the-ear (BTE) sound processors. Study sample: Twenty post-lingually hearing-impaired cochlear implant recipients who were experienced Nucleus® 5 or Nucleus® 6 BTE users.

Results: No significant difference in performance was found for words in quiet or sentences in co-located noise between the Kanso and Nucleus 6 devices. For the moderately directional Standard programme, no significant difference was found for sentences in spatially separated noise between the Kanso and Nucleus 6 devices, but a performance decrement between 1.4 and 2.0 dB was found in highly directional and adaptive directional programmes. The default Kanso programme, SCAN, provided improvements of 6.9 dB over a single-microphone programme and 2.3 dB over the Standard programme in spatially separated noise. Participants rated Kanso significantly better than their own BTE processor on measures of comfort, look and feel, ease of use, music and overall hearing performance.

Conclusion: Dual-microphone directional processing provides significant benefit over a single microphone for OTE processors. This study demonstrates clinical outcomes and acceptance of the Kanso OTE sound processor.

Avoiding disconnection: An evaluation of telephone options for cochlear implant users

Marcrum, S. C. et al. International Journal of Audiology. Published online: 4 November 2016

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Objective: The primary aim of this study was to evaluate the effect of coupling method on telephone-based speech recognition and perceived listening difficulty in noise for cochlear implant (CI) users. A secondary aim was to evaluate potential impacts of additional processing modifications within coupling conditions, such as activating noise reducing algorithms or muting environmental microphones.

Design: Hochmair–Schulz–Moser sentences were bandpass-filtered (300–3400 Hz) and presented unilaterally either via telephone handset or advanced wireless streaming device in a background of cafeteria babble (signal-to-noise ratio =15 dB). Sentence recognition was scored at the word level and perceived listening difficulty was assessed via visual-analogue scale for each of five test conditions.

Study sample: Twenty native German-speaking CI users participated.

Results: Repeated measures analysis of variance revealed coupling via advanced streaming significantly improved sentence recognition and reduced listening difficulty, when compared to either telecoil or acoustic coupling configurations. In addition, program modifications further increased benefit within a coupling condition. CI users who exhibited the most difficulty during basic acoustic coupling were most likely to benefit from advanced wireless streaming.

Conclusion: CI users have several options for improving speech recognition and decreasing listening difficulty over the telephone when listening in noisy environments.

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