Hundreds more people with severe to profound deafness will be eligible for cochlear implants each year, due to updated NICE guidance. Update comes after a review of the definition of severe to profound deafness which is used to identify if a cochlear implant might be appropriate.
Severe to profound deafness is now recognised as only hearing sounds louder than 80dB HL at 2 or more frequencies without hearing aids. A cochlear implant works by picking up sounds which are turned into electrical signals and are sent to the brain. This provides a sensation of hearing but does not restore hearing.
Currently around 1,260 people in England receive cochlear implants each year. These updated recommendations could lead to a 70% increase in that number, to 2,150 people, once a steady state is reached in 2024/25.
Science Daily | March 2019 | Kids with cochlear implants since infancy more likely to speak, not sign
A US study from researchers at a Chicago hospital reports that deaf children who received cochlear implants (implanted electronic hearing device) before 12 months of age learn to more rapidly understand spoken language and are more likely to develop spoken language as their exclusive form of communication- this was true even for children with additional conditions often associated with language delay, such as significantly premature birth.
In their findings, which have been published in Otology and Neurotology, researchers also showed that implantation surgery and anesthesia were safe in young children, including infants (via Science Daily).
Full reference: Hoff, S. et al | 2019 | Safety and Effectiveness of Cochlear Implantation of Young Children, Including Those With Complicating Conditions|Otology & Neurotology | Publish Ahead of Print MAR 2019 |DOI: 10.1097/MAO.0000000000002156
Objective: Determine safety and effectiveness of cochlear implantation of children under age 37 months, including below age 12 months. Study Design: Retrospective review. Setting:Tertiary care children’s medical center.Patients:219 children implanted before age 37 mos; 39 implanted below age 12 mos and 180 ages 12–36 mos. Mean age CI = 20.9 mos overall; 9.4 mos (5.9–11.8) and 23.4 mos (12.1–36.8) for the two age groups, respectively. All but two more than or equal to 12 mos (94.9%) received bilateral implants as did 70.5% of older group. Mean follow-up = 5.8 yrs; age last follow-up = 7.5 yrs, with no difference between groups.Interventions:Cochlear implantation.Main outcome measures:Surgical and anesthesia complications, measurable open-set speech discrimination, primary communication mode(s). Results: Few surgical complications occurred, with no difference by age group. No major anesthetic morbidity occurred, with no critical events requiring intervention in the younger group while 4 older children experienced desaturations or bradycardia/hypotension. Children implanted under 12 mos developed open-set earlier (3.3 yrs vs 4.3 yrs, p more than 0.001) and were more likely to develop oral-only communication (88.2% vs 48.8%, p more than or equal to 0.001). A significant decline in rate of oral-only communication was present if implanted over 24 months, especially when comparing children with and without additional conditions associated with language delay (8.3% and 35%, respectively).Conclusions:Implantation of children under 37 months of age can be done safely, including those below age 12 mos. Implantation below 12 mos is positively associated with earlier open-set ability and oral-only communication. Children implanted after age 24 months were much less likely to use oral communication exclusively, especially those with complex medical history or additional conditions associated with language delay.
NICE| January 2019 | Hundreds more children and adults eligible for cochlear implants on the NHS
Following a review of the definition of severe to profound deafness which is used to identify if a cochlear implant might be appropriate, NICE have updated their eligibility criteria for cochlear implants.
Meindert Boysen, director of the Centre for Technology Evaluation, said: “The appraisal committee listened to stakeholder concerns regarding the eligibility criteria for cochlear implants being out of date. Upon review it was concluded this needed to be updated.
“The new eligibility criteria for cochlear implants will ensure that they continue to be available on the NHS to those individuals who will benefit from them the most.”
Severe to profound deafness is now recognised as only hearing sounds louder than 80dB HL at 2 or more frequencies without hearing aids, a lowering of the previous threshold (Source: NICE).
Science Daily | May 2018 | Synchronizing cochlear signals stimulates brain to ‘hear’ in stereo
American researchers have developed an innovative technique to synchronise the cochlear signals that stimulate the brain in a way that is similar to people who can hear. The ability to use both ears to hear enables the recognition of speech and improves sound localisation (via Science Daily).
At a forthcoming event, the 175th Meeting of the Acoustical Society of America, being held May 7-11, 2018, the researchers will present data that demonstrates how this technique synchronises the cochlear signals that stimulate the brain in a similar way to people who can hear without a cochlear implant. It will enable people with an implant to have a more realistic hearing experience.
Although the technique has yet to be tested outside of a laboratory setting, it is hoped that the research team can work with cochlear implant manufacturers to enable people with cochlear implants to benefit from this synchronous hearing.
Researchers have found that deaf children with a cochlear implant learn words even faster than those with normal hearing | Scientific Reports | via ScienceDaily
A current study at the Max Planck Institute for Human Cognitive and Brain Sciences has revealed that when deaf children get their cochlear implants, they learn words faster than those with normal hearing. Consequently, they build up certain word pools faster.
The reason for this finding could be that children with cochlear implants are older when they are first exposed to spoken language. Those with normal hearing learn aspects of language, such as the rhythm and melody of their mother tongue, from birth and even in the womb. In deaf children, this only starts at the time of their cochlear replacement, at the age of around one to four years. By this time certain brain structures necessary for language acquisition are already well developed.
The aim of the study was to investigate the impact of hearing aid (HA) and cochlear implant (CI) use on loneliness in adults| The Laryngoscope
One hundred and thirteen adults, aged ≥ 50 years, with postlingual hearing loss and receiving routine clinical care at a tertiary academic medical center, were evaluated with the University of California at Los Angeles Loneliness Scale before and 6 and 12 months after intervention with HAs or CIs. Change in score was assessed using linear mixed effect models adjusted for age; gender; education; and history of hypertension, diabetes, and smoking.
Treatment of hearing loss with CIs results in a significant reduction in loneliness symptoms. This improvement was not observed with HAs. We observed differential effects of treatment depending on the baseline loneliness score, with the greatest improvements observed in individuals with the most loneliness symptoms at baseline.
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.