Dataset Information

Measures of Comparative Behavior in Hearing Loss Patients with Cochlear Implant: Caretaker Assessment.

ABSTRACT: The aim of this study was to assess comparative behavior domain in patients with cochlear implants, using caretaker assessment. A prospective cross-sectional study was conducted. Of 106 patients with hearing loss and receiving cochlear implants were included along with their caretakers. The caretaker' perspective questionnaire-22 was implemented covering emotions, education, and social relationships domain. A repeated measure ANOVA was used to statistical analysis. The implantation elicited a slight reduction in emotions scores domain as well as slight increase in social relationships scores from pre-cochlear implants to 12 months in all aged (6-10 years: -?10.7, 95%CI -?8.4 to 12.9; 4.2, 95%CI 3.0-5.5, 11-20 years: -?8.6, 95%CI -?6.7 to 10.5; 2.5, 95%CI 1.6-3.3, 21-59 years: -?6.8, 95%CI -?4.9 to 8.6; 2.0, 95%CI 1.3-2.7, and older 60 years: -?12.1, 95%CI -?9.5 to 14.6; 3.6, 95%CI 2.7-4.5, respectively). However, the education scores domain has slight increase only in aged 21-59 years group (1.8, 95%CI 0.7-2.8). A long-term after cochlear implants (12 months), but not after only 6 months elicits a statistically significant increase the social relationships scores and the reduction in negative emotions scores in all aged at implantation. However, the education scores have slight increase only in aged 21-59.

SUBMITTER: Sirirattawan J

PROVIDER: S-EPMC6841886 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Measures of Comparative Behavior in Hearing Loss Patients with Cochlear Implant: Caretaker Assessment.

Sirirattawan Jarinratn J Khuancharee Kitsarawut K

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India 20190104 Suppl 2

The aim of this study was to assess comparative behavior domain in patients with cochlear implants, using caretaker assessment. A prospective cross-sectional study was conducted. Of 106 patients with hearing loss and receiving cochlear implants were included along with their caretakers. The caretaker' perspective questionnaire-22 was implemented covering emotions, education, and social relationships domain. A repeated measure ANOVA was used to statistical analysis. The implantation elicited a sl ...[more]

PMID: 31750140

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Project description:Neuroprostheses designed to interface with the nervous system to replace injured or missing senses can significantly improve a patient's quality of life. The challenge remains to provide implants that operate optimally over several decades. Changes in the implant-tissue interface may precede performance problems. Tools to identify and characterize such changes using existing clinical measures would be highly valuable. Modern cochlear implant (CI) systems allow easy and regular measurements of electrode impedance (EI). This measure is routinely performed as a hardware integrity test, but it also allows a level of insight into the immune-mediated response to the implant, which is associated with performance outcomes. This study is a 5-year retrospective investigation of MED-EL CI users at the University of Southampton Auditory Implant Service including 176 adult ears (18-91) and 74 pediatric ears (1-17). The trend in EI in adults showed a decrease at apical electrodes. An increase was seen at the basal electrodes which are closest to the surgery site. The trend in the pediatric cohort was increasing EI over time for nearly all electrode positions, although this group showed greater variability and had a smaller sample size. We applied an outlier-labeling rule to statistically identify individuals that exhibit raised impedance. This highlighted 14 adult ears (8%) and 3 pediatric ears (5%) with impedance levels that deviated from the group distribution. The slow development of EI suggests intra-cochlear fibrosis and/or osteogenesis as the underlying mechanism. The usual clinical intervention for extreme impedance readings is to deactivate the relevant electrode. Our findings highlight some interesting clinical contradictions: some cases with raised (but not extreme) impedance had not prompted an electrode deactivation; and many cases of electrode deactivation had been informed by subjective patient reports. This emphasizes the need for improved objective evidence to inform electrode deactivations in borderline cases, for which our outlier-labeling approach is a promising candidate. A data extraction and analysis protocol that allows ongoing and automated statistical analysis of routinely collected data could benefit both the CI and wider neuroprosthetics communities. Our approach provides new tools to inform practice and to improve the function and longevity of neuroprosthetic devices.

Project description:IntroductionCandidacy criteria for cochlear implantation in the United States has expanded to include children with single-sided deafness (SSD) who are at least 5 years of age. Pediatric cochlear implant (CI) users with SSD experience improved speech recognition with increased daily device use. There are few studies that report the hearing hour percentage (HHP) or the incidence of non-use for pediatric CI recipients with SSD. The aim of this study was to investigate factors that impact outcomes in children with SSD who use CIs. A secondary aim was to identify factors that impact daily device use in this population.MethodsA clinical database query revealed 97 pediatric CI recipients with SSD who underwent implantation between 2014 and 2022 and had records of datalogs. The clinical test battery included speech recognition assessment for CNC words with the CI-alone and BKB-SIN with the CI plus the normal-hearing ear (combined condition). The target and masker for the BKB-SIN were presented in collocated and spatially separated conditions to evaluate spatial release from masking (SRM). Linear mixed-effects models evaluated the influence of time since activation, duration of deafness, HHP, and age at activation on performance (CNC and SRM). A separate linear mixed-effects model evaluated the main effects of age at testing, time since activation, duration of deafness, and onset of deafness (stable, progressive, or sudden) on HHP.ResultsLonger time since activation, shorter duration of deafness, and higher HHP were significantly correlated with better CNC word scores. Younger age at device activation was not found to be a significant predictor of CNC outcomes. There was a significant relationship between HHP and SRM, with children who had higher HHP experiencing greater SRM. There was a significant negative correlation between time since activation and age at test with HHP. Children with sudden hearing loss had a higher HHP than children with progressive and congenital hearing losses.ConclusionThe present data presented here do not support a cut-off age or duration of deafness for pediatric cochlear implantation in cases of SSD. Instead, they expand on our understanding of the benefits of CI use in this population by reviewing the factors that influence outcomes in this growing patient population. Higher HHP, or greater percentage of time spent each day using bilateral input, was associated with better outcomes in the CI-alone and in the combined condition. Younger children and those within the first months of use had higher HHP. Clinicians should discuss these factors and how they may influence CI outcomes with potential candidates with SSD and their families. Ongoing work is investigating the long-term outcomes in this patient population, including whether increasing HHP after a period of limited CI use results in improved outcomes.

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Project description:ObjectiveFitting cochlear implants, especially the precise determination of electrical hearing thresholds, is a time-consuming and complex task for patients as well as audiologists. Aim of the study was to develop a method that enables cochlear implant (CI) patients to determine their electrical hearing thresholds precisely and independently. Applicability and impact of this method on speech perception in noise at soft speech levels were evaluated.MethodAn adaptive psychoacoustic procedure for precise hearing threshold determination (precT) was implemented using MatLab (MathWorks) and a graphical user interface was created. Sound signals were calibrated with a CIC4-Implant-Decoder. Study design: A prospective study including 15 experienced adult cochlear implant users was conducted. Electrical hearing thresholds were determined using the automated precT procedure (auto-precT). Speech perception in noise at 50 dB SPL presentation levels was measured for three conditions: (P1) T-levels kept at the previously established T-levels; (P2) T-levels set to the hearing thresholds determined using auto-precT application; (P3) T-levels set 10 cu below the values determined with auto-precT.ResultsAll subjects were able to perform the auto-precT application independently. T-levels were altered on average by an absolute value of 10.5 cu using auto-precT. Median speech reception thresholds were significantly improved from 2.5 dB SNR (P1) to 1.6 dB SNR (P2, p = 0.02). Speech perception was lowest using the globally lowered T-levels, median 2.9 dB SNR (P3, not significant compared to P1 and P2).ConclusionThe applicability of the developed auto-precT application was confirmed in the present clinical study. Patients benefited from adjusting previously established T-levels to the threshold levels determined by the auto-precT application. The integration of the application in the clinical fitting routine as well as a remote fitting software approach is recommended. Furthermore, future possibilities of auto-precT include the implementation of the application on tablets or smart phones.

Dataset Information

Measures of Comparative Behavior in Hearing Loss Patients with Cochlear Implant: Caretaker Assessment.

Publications

Measures of Comparative Behavior in Hearing Loss Patients with Cochlear Implant: Caretaker Assessment.

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