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Cochlear Implants (cochlear + implant)

Distribution by Scientific Domains

Medical Sciences	79%
Life Sciences	10%
Humanities and Social Sciences	6%

Terms modified by Cochlear Implants

cochlear implant surgery

cochlear implant user

Selected Abstracts

Defending Deaf Culture: The Case of Cochlear Implants*

THE JOURNAL OF POLITICAL PHILOSOPHY, Issue 2 2005
Robert Sparrow
First page of article [source]

Bilateral Cervical Plexus Block in Simultaneous Cochlear Implants: An Intervention We Won't Adopt

THE LARYNGOSCOPE, Issue S3 2010
Mazin A. Merdad MD
No abstract is available for this article. [source]

Incidence and Characteristics of Facial Nerve Stimulation in Children With Cochlear Implants,

THE LARYNGOSCOPE, Issue 10 2006
Sharon L. Cushing BScH
Abstract Objectives: Electrical stimulation from a cochlear implant can spread beyond the auditory nerve. The aims of this study were to accurately measure facial nerve stimulation in pediatric implant users and to determine the characteristics and incidence of this unwanted activity. Part A consisted of a prospective study of a randomized sample of 44 pediatric implant users. Part B consisted of a retrospective analysis of 121 children with previously recorded electrically evoked auditory brainstem responses (EABR). Study Design and Methods: Responses were evoked by 3 electrodes along the implant array in three groups of children: 1) postmeningitic, 2) abnormal cochlea, and 3) neither. Intraoperative measures were obtained under anesthesia; all other recordings were completed in awake children. Results: Intraoperative recordings revealed large nonauditory responses in a number of channels, including the midline EABR. Under paralysis, these responses disappeared, and clear EABRs were recorded. Similarly, prospective postoperative electromyographic (EMG) responses from the facial nerve were found in more than 59% (26 of 44) of experienced implant users (Nucleus 24): 31% of postmeningitic children (4 of 13), 80% of those with abnormal cochlea (8 of 10), and 66% of those with neither (14 of 21). Retrospective analysis of previously recorded postoperative EABRs demonstrated facial nerve stimulation in 35% (42 of 121). In most cases, facial nerve stimulation occurred when levels were perceptually loud but comfortable. Conclusions: 1) Facial nerve potentials can be recorded using EMG in a large proportion of cochlear implant users at high levels of stimulation. 2) The EABR can be obscured in the presence of facial nerve stimulation and care should be taken to distinguish it from the EMG response, particularly when auditory brainstem activity is in question. 3) Use of surface EMG provides an additional objective measure to ensure the safe and comfortable use of cochlear implants. [source]

Multichannel Cochlear Implants: Relation of Histopathology to Performance,

THE LARYNGOSCOPE, Issue 8 2006
Jose N. Fayad MD
Abstract Objectives: To determine the relationship of surviving neural elements to auditory function in multichannel cochlear implant temporal bones. Study Design: Case series of all 14 existing multichannel cochlear implants in our temporal bone collection. Methods: Devices included Nucleus 22 (n = 11), Nucleus 24 (n = 1), Ineraid (n = 1), and Clarion (n = 1). Morphologic evaluation of structural elements including spiral ligament, stria vascularis, hair cells, peripheral processes, and spiral ganglion cells was performed. Clinical performance data were obtained from patient charts. For eight patients, nonimplanted contralateral temporal bones were available and paired comparisons were made. Results: Despite frequent absence of hair cells and peripheral processes, all bones had at least some remaining spiral ganglion cells. Percent of normal remaining structures were unrelated to auditory performance with the implant for any of the structural elements. Ganglion cell count in segment III showed significant negative correlations to speech discrimination scores for words and sentences (Rhos = ,.687 and ,.661, P , .03 and .04) as did segment IV and total ganglion cell count with word score (Rhos = ,.632 and ,.638; P , .05). Spiral ganglion cell survival did not differ between implanted and nonimplanted ears, with the exception of segment I, which had fewer cells in the implanted ear (P , .028). Conclusions: Performance variability of cochlear implants cannot be explained on the basis of cochlear neuronal survival. Although hair cells and peripheral processes were frequently absent or greatly diminished from normal, all subjects had at least some spiral ganglion cells. And, in this series, there was an inverse relationship between survival of ganglion cells and performance. [source]

Cochlear Implants in Five Cases of Auditory Neuropathy: Postoperative Findings and Progress,

THE LARYNGOSCOPE, Issue 4 2001
Jon K. Shallop PhD
Abstract Objectives To review our experiences with some of the preoperative and postoperative findings in five children who were diagnosed with auditory neuropathy and were provided with cochlear implants. We describe changes in auditory function, which enabled these children to have significant improvement in their hearing and communication skills. Study Design Pre- and postoperatively, these children received complete medical examinations at Mayo Clinic, including related consultations in audiology, pediatrics, neurology, medical genetics, otolaryngology, psychology, speech pathology, and radiology. Methods These children typically had additional medical and audiological examinations at more than one medical center. The hearing assessments of these children included appropriate behavioral audiometric techniques, objective measures of middle ear function, acoustic reflex studies, transient (TOAE) or distortion product (DPOAE) otoacoustic emissions, auditory brainstem responses (ABR), and, in some cases, transtympanic electrocochleography (ECoG). After placement of the internal cochlear implant devices (Nucleus CI24), intraoperatively we measured electrode impedances, visually detected electrical stapedius reflexes (VESR) and neural response telemetry (NRT). These intraoperative objective measures were used to help program the speech processor for each child. Postoperatively, each child has had regular follow-up to assure complete healing of the surgical incision, to assess their general medical conditions, and for speech processor programming. Their hearing and communication skills have been assessed on a regular basis. Postoperatively, we have also repeated electrode impedance measurements, NRT measurements, otoacoustic emissions, and electrical auditory brainstem responses (EABR). We now have 1 year or more follow-up information on the five children. Results The five children implanted at Mayo Clinic Rochester have not had any postoperative medical or cochlear implant device complications. All of the children have shown significant improvements in their sound detection, speech perception abilities and communication skills. All of the children have shown evidence of good NRT results. All but case D (who was not tested) showed evidence of good postoperative EABR results. Otoacoustic emissions typically remained in the non-operated ear but, as expected, they are now absent in the operated ear. Conclusion Our experiences with cochlear implantation for children diagnosed with auditory neuropathy have been very positive. The five children we have implanted have not had any complications postoperatively, and each child has shown improved listening and communication skills that have enabled each child to take advantage of different communication and educational options. [source]

Clinical application of neurotrophic factors: the potential for primary auditory neuron protection

EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 9 2005
Lisa N. Gillespie
Abstract Sensorineural hearing loss, as a result of damage to or destruction of the sensory epithelia within the cochlea, is a common cause of deafness. The subsequent degeneration of the neural elements within the inner ear may impinge upon the efficacy of the cochlear implant. Experimental studies have demonstrated that neurotrophic factors can prevent this degeneration in animal models of deafness, and can even provide functional benefits. Neurotrophic factor therapy may therefore provide similar protective effects in humans, resulting in improved speech perception outcomes among cochlear implant patients. There are, however, numerous issues pertaining to delivery techniques and treatment regimes that need to be addressed prior to any clinical application. This review considers these issues in view of the potential therapeutic application of neurotrophic factors within the auditory system. [source]

Source localization of auditory evoked potentials after cochlear implantation

PSYCHOPHYSIOLOGY, Issue 1 2008
Stefan Debener
Abstract Little is known about how the auditory cortex adapts to artificial input as provided by a cochlear implant (CI). We report the case of a 71-year-old profoundly deaf man, who has successfully used a unilateral CI for 4 years. Independent component analysis (ICA) of 61-channel EEG recordings could separate CI-related artifacts from auditory-evoked potentials (AEPs), even though it was the perfectly time-locked CI stimulation that caused the AEPs. AEP dipole source localization revealed contralaterally larger amplitudes in the P1,N1 range, similar to normal hearing individuals. In contrast to normal hearing individuals, the man with the CI showed a 20-ms shorter N1 latency ipsilaterally. We conclude that ICA allows the detailed study of AEPs in CI users. [source]

Neurotrophic effects of GM1 ganglioside and electrical stimulation on cochlear spiral ganglion neurons in cats deafened as neonates

THE JOURNAL OF COMPARATIVE NEUROLOGY, Issue 6 2007
Patricia A. Leake
Abstract Previous studies have shown that electrical stimulation of the cochlea by a cochlear implant promotes increased survival of spiral ganglion (SG) neurons in animals deafened early in life (Leake et al. [1999] J Comp Neurol 412:543,562). However, electrical stimulation only partially prevents SG degeneration after deafening and other neurotrophic agents that may be used along with an implant are of great interest. GM1 ganglioside is a glycosphingolipid that has been reported to be beneficial in treating stroke, spinal cord injuries, and Alzheimer's disease. GM1 activates trkB signaling and potentiates neurotrophins, and exogenous administration of GM1 has been shown to reduce SG degeneration after hearing loss. In the present study, animals were deafened as neonates and received daily injections of GM1, beginning either at birth or after animals were deafened and continuing until the time of cochlear implantation. GM1-treated and deafened control groups were examined at 7,8 weeks of age; additional GM1 and no-GM1 deafened control groups received a cochlear implant at 7,8 weeks of age and at least 6 months of unilateral electrical stimulation. Electrical stimulation elicited a significant trophic effect in both the GM1 group and the no-GM1 group as compared to the contralateral, nonstimulated ears. The results also demonstrated a modest initial improvement in SG density with GM1 treatment, which was maintained by and additive with the trophic effect of subsequent electrical stimulation. However, in the deafened ears contralateral to the implant SG soma size was severely reduced several months after withdrawal of GM1 in the absence of electrical activation. J. Comp. Neurol. 501:837,853, 2007. © 2007 Wiley-Liss, Inc. [source]

Worldwide trends in bilateral cochlear implantation,

THE LARYNGOSCOPE, Issue S2 2010
B. Robert Peters MD
Abstract Objectives/Hypothesis: The goal of this study is to ascertain worldwide experience with bilateral cochlear implantation (BCI) with regard to patient demographics, trends in provision of BCI to adult and child patient populations, differences and similarities in BCI candidacy criteria, diagnostic requirements, and treatment approaches among clinicians in high-volume cochlear implant centers. Study Design: Retrospective/prospective. Methods: An electronic survey consisting of 59 mainly multiple-choice questions was developed for online completion. It examined the implant experience and clinical opinion of expert cochlear implant (CI) centers worldwide on the indications, motivations, and contraindications for adult and pediatric, simultaneous and sequential BCI candidacy. Centers were chosen to complete the survey based on their known reputation as a center of excellence. Patient demographics were queried for two time periods to elucidate trends: 2006 and prior, and for the year 2007. Results: Seventy-one percent (25/35) of the CI clinics approached completed the survey. Collectively, these 25 clinics represent experience with approximately 23,200 CI users globally, representing 15% of the total estimated CI population worldwide. The total number of BCI surgeries reflected in their experience (2,880) represents 36% of the estimated number worldwide as of December 2007. Cumulatively to the end of 2007, 70% of all BCI surgeries have occurred in children, with the 3- to 10-year-old age group having the highest representation (33% of all BCIs), followed in order by adults (30%), children under 3 years of age (26%), and children between 11 and 18 years of age (11%). Seventy-two percent of all BCI surgeries were performed sequentially (70% of children, 76% of adults). Children <3 years of age represent the only age group of all patients in which simultaneous surgeries predominate (58% simultaneous). For all other age groups, sequential surgeries far outnumber simultaneous (3,10 years, 84% sequential; 11,18 years, 94% sequential; adults, 76% sequential). Prior to January 2007, 68% of BCIs were performed in children. This increased to 79% for the year 2007 (P < .001). With regard to children only, a change is apparent over time in terms of the age group making up the majority of pediatric BCI surgeries performed. Prior to 2007, children 3 to 10 years of age made up 50% of the children undergoing BCI, whereas those <3 years made up only 33%. In 2007 this shifted more toward the younger age group (47% for those <3 years and 40% for 3,10-year-olds; P < .001). United States clinics had a higher proportion of adult BCI patients (59% children, 41% adults) than the non-United States clinics (78% children, 22% adults; P < .001). The majority of responders do not hold to a minimum or maximum age by which they limit BCI. Conclusions: Worldwide experience with BCI is now quite extensive and provides a useful base for evaluating clinical outcomes across patient categories and for providing further support during the patient/parent counseling process. Laryngoscope, 120:S17,S44, 2010 [source]

Long-Term Performance of Clarion 1.0 Cochlear Implant Users,

THE LARYNGOSCOPE, Issue 7 2007
Chad V. Ruffin BS
Abstract Objective/Hypothesis: To evaluate the long-term performance of adult Clarion 1.0 cochlear implant users. Study Design: This was a retrospective, longitudinal study evaluating word discrimination in quiet for 31 adult cochlear implant patients with preimplantation sentence scores of less than 10%. Methods: The length of the study was 135 months with a mean follow-up length of 93 (median, 96) months. For the duration of the study, all subjects used the Clarion 1.0 cochlear implant with speech processors programmed for the use of the continuous interleaved sampling strategy. Results: There was no significant growth or decline in speech perception after 24 months postimplantation unless adverse medical events were experienced. Age at implantation was significantly and substantially negatively correlated (,11% word score per decade, r = 0.68) with most recent score, maximum score, time to maximum score, range of performance, 24- to 130-month mean score, and for any longitudinal data point tested: 3 to 6 months, 6 months, 1 year, 2 years, 5 years, and 10 years. There were no age-related declines in performance. There were no observed correlations between duration of deafness and any of the variables listed above. Conclusions: The lack of correlation between duration of deafness and performance in a cohort without residual hearing suggests the presence of a strong correlation between age and speech performance with a cochlear implant. That the cochlear implant is a safe therapy for the treatment of profound deafness is supported by the stability of scores through the 10-year study period as well as a zero rate of device failures or explantation. [source]

Incidence and Characteristics of Facial Nerve Stimulation in Children With Cochlear Implants,

Divergence of Fine and Gross Motor Skills in Prelingually Deaf Children: Implications for Cochlear Implantation,

THE LARYNGOSCOPE, Issue 8 2006
David L. Horn MD
Abstract Objective: The objective of this study was to assess relations between fine and gross motor development and spoken language processing skills in pediatric cochlear implant users. Study Design: The authors conducted a retrospective analysis of longitudinal data. Methods: Prelingually deaf children who received a cochlear implant before age 5 and had no known developmental delay or cognitive impairment were included in the study. Fine and gross motor development were assessed before implantation using the Vineland Adaptive Behavioral Scales, a standardized parental report of adaptive behavior. Fine and gross motor scores reflected a given child's motor functioning with respect to a normative sample of typically developing, normal-hearing children. Relations between these preimplant scores and postimplant spoken language outcomes were assessed. Results: In general, gross motor scores were found to be positively related to chronologic age, whereas the opposite trend was observed for fine motor scores. Fine motor scores were more strongly correlated with postimplant expressive and receptive language scores than gross motor scores. Conclusions: Our findings suggest a disassociation between fine and gross motor development in prelingually deaf children: fine motor skills, in contrast to gross motor skills, tend to be delayed as the prelingually deaf children get older. These findings provide new knowledge about the links between motor and spoken language development and suggest that auditory deprivation may lead to atypical development of certain motor and language skills that share common cortical processing resources. [source]

The Potential Risk of Carotid Injury in Cochlear Implant Surgery

THE LARYNGOSCOPE, Issue 2 2002
B. R. Gastman MD
Abstract Background The advent of cochlear implantation has revolutionized the options afforded to the deaf population. With the increase in the prevalence of this procedure have come larger experiences in the associated technical challenges and complications. Results We present the evaluation and management of a patient with an unusual complication of improper placement of the implant electrode into the carotid canal and its management. We discuss the anatomy of the carotid artery and its proximity to the cochlea to emphasize the potential risk to this large vessel. Conclusions Damage to the carotid canal and the carotid artery is a potential risk of cochlear implant surgery. When available, we recommend intraoperative electrical testing of the cochlear implant be performed. If there is doubt as to the placement of the electrode, a radiograph should be obtained before the patient is taken out of the operating room to avoid this complication. [source]

Localized erosive pustular dermatosis of the scalp at the site of a cochlear implant: successful treatment with topical tacrolimus

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 5 2009
A. V. Marzano
Summary Erosive pustular dermatosis of the scalp (EPDS) is a rare form of nonmicrobial pustulosis mainly occurring in elderly patients with long-term sun damage to the skin. Clinically, it is characterized by pustular lesions that progressively merge into erosive and crusted areas over the scalp. The histology of EPDS is nonspecific, and its pathophysiology remains undetermined, with various types of local trauma possibly acting as the triggering factor. We describe a 24-year-old woman who developed EPDS after cochlear implant surgery for profound sensorineural hearing loss. We speculate that either the cutaneous surgery during cochlear implantation or the skin inflammation that commonly occurs near the magnet might have triggered the disorder. It is of note that the patient's skin lesions healed completely after treatment with topical tacrolimus, a relatively novel immunosuppressive molecule. Thus, topical tacrolimus may be indicated as a therapeutic alternative to the widely used steroids for this disease, mainly to avoid steroid-related cutaneous atrophy. [source]

Non-sutured fixation of cochlear implants using a minimally-invasive approach

CLINICAL OTOLARYNGOLOGY, Issue 3 2008
C. Loh
Keypoints ,,The minimal invasive techniques have become the main stay of the surgical approach for the cochlear implant. ,,Securing the implant with sutures can be challenging due to the limited access and awkward operating angle. ,,We have developed a non-sutured technique to secure the implant by placing and securing the proximal end of the electrode into a bony groove. ,,Our series supports the notion that the technique is suitable for implant cases in which the patient's age is older than 18 months. [source]

The predictive value of semilongitudinal and axial computerized tomography planes in assessing cochlear patency in cochlear implant candidates

CLINICAL OTOLARYNGOLOGY, Issue 4 2001
R.H.R. Bettman
Introduction. The objective was to establish the predictive value of semilongitudinal and axial computerized tomography (CT) planes in assessing cochlear patency in cochlear implant candidates. Methods. In a retrospective study, preoperative CT scans of 45 patients who received a cochlear implant were independently reviewed by a junior and senior observer. The predicted degree of cochlear patency was compared with the peroperative findings. Results. A decreased cochlear patency was found at surgery in nine patients (20%). The sensitivity of CT was 33% for the junior observer and 11% for the senior observer, whereas specificity was 86% and 89% respectively. Inter-observer reliability was reflected in a kappa of 0.38. In 14 patients deafened as a result of meningitis (31%), sensitivity for the junior observer amounted to 60% with a specificity of 89%. Statistical analysis revealed that this improvement did not solely depend on a higher prevalence of decreased cochlear patency. Conclusion. The sensitivity of CT scans in the semilongitudinal and axial plane in assessing cochlear patency, in our patient group, is small. In patients deafened as a result of meningitis, sensitivity was found to be increased. [source]

Delayed neurotrophin treatment following deafness rescues spiral ganglion cells from death and promotes regrowth of auditory nerve peripheral processes: Effects of brain-derived neurotrophic factor and fibroblast growth factor

JOURNAL OF NEUROSCIENCE RESEARCH, Issue 9 2007
Josef M. Miller
Abstract The extent to which neurotrophic factors are able to not only rescue the auditory nerve from deafferentation-induced degeneration but also promote process regrowth is of basic and clinical interest, as regrowth may enhance the therapeutic efficacy of cochlear prostheses. The use of neurotrophic factors is also relevant to interventions to promote regrowth and repair at other sites of nerve trauma. Therefore, auditory nerve survival and peripheral process regrowth were assessed in the guinea pig cochlea following chronic infusion of BDNF + FGF1 into scala tympani, with treatment initiated 4 days, 3 weeks, or 6 weeks after deafferentation from deafening. Survival of auditory nerve somata (spiral ganglion neurons) was assessed from midmodiolar sections. Peripheral process regrowth was assessed using pan-Trk immunostaining to selectively label afferent fibers. Significantly enhanced survival was seen in each of the treatment groups compared to controls receiving artificial perilymph. A large increase in peripheral processes was found with BDNF + FGF1 treatment after a 3-week delay compared to the artificial perilymph controls and a smaller enhancement after a 6-week delay. Neurotrophic factor treatment therefore has the potential to improve the benefits of cochlear implants by maintaining a larger excitable population of neurons and inducing neural regrowth. © 2007 Wiley-Liss, Inc. [source]

Laser stimulation of single auditory nerve fibers,,§¶,

THE LARYNGOSCOPE, Issue 10 2010
Philip D. Littlefield MD
Abstract Objectives/Hypothesis: One limitation with cochlear implants is the difficulty stimulating spatially discrete spiral ganglion cell groups because of electrode interactions. Multipolar electrodes have improved on this some, but also at the cost of much higher device power consumption. Recently, it has been shown that spatially selective stimulation of the auditory nerve is possible with a mid-infrared laser aimed at the spiral ganglion via the round window. However, these neurons must be driven at adequate rates for optical radiation to be useful in cochlear implants. We herein use single-fiber recordings to characterize the responses of auditory neurons to optical radiation. Study Design: In vivo study using normal-hearing adult gerbils. Methods: Two diode lasers were used for stimulation of the auditory nerve. They operated between 1.844 ,m and 1.873 ,m, with pulse durations of 35 ,s to 1,000 ,s, and at repetition rates up to 1,000 pulses per second (pps). The laser outputs were coupled to a 200-,m-diameter optical fiber placed against the round window membrane and oriented toward the spiral ganglion. The auditory nerve was exposed through a craniotomy, and recordings were taken from single fibers during acoustic and laser stimulation. Results: Action potentials occurred 2.5 ms to 4.0 ms after the laser pulse. The latency jitter was up to 3 ms. Maximum rates of discharge averaged 97 ± 52.5 action potentials per second. The neurons did not strictly respond to the laser at stimulation rates over 100 pps. Conclusions: Auditory neurons can be stimulated by a laser beam passing through the round window membrane and driven at rates sufficient for useful auditory information. Optical stimulation and electrical stimulation have different characteristics; which could be selectively exploited in future cochlear implants. Laryngoscope, 2010 [source]

Incidence and indications for revision cochlear implant surgery in adults and children,

THE LARYNGOSCOPE, Issue 1 2009
Kevin D. Brown MD
Abstract Objectives/Hypothesis: To identify the incidence of and common causes for cochlear implant revision. Study Design: Retrospective case series. Methods: Operative records were reviewed for all cases of revision cochlear implantation from 1992 to 2006. The causes for reimplantation were classified as hard device failure, soft device failure, exposure/infection, receiver/stimulator migration, and electrode migration. Manufacturers' failure analysis of explanted devices was likewise determined. Results: Eight hundred and six cochlear implants were performed during the study period including 44 (5.5%) revision procedures. The revision rate was 7.3% for children and 3.8% for adults and reached statistical significant difference. The most common reasons for revision were device failure (78%; 55% hard failure, 23% soft failure) followed by electrode migration (9%) and receiver/stimulator migration (7%). Manufacturers' analysis of failed devices revealed loss of hermetic seal and cracked cases to be the most common causes of failure. Bench analysis of 5/10 explanted devices that were soft failures demonstrated identifiable device defects. Conclusions: Revision cochlear implant surgery is an infrequent occurrence. Its incidence appears to be higher in children than in adults, although in this series does not appear to be due to increased wound complications, infections, or trauma. Explanted implants that have soft failure as the etiology may have demonstrable defects on bench testing. Laryngoscope, 119:152,157, 2009 [source]

Audiological Application Criteria for Implantable Hearing Aid Devices: A Clinical Experience at the Nijmegen ORL Clinic,

THE LARYNGOSCOPE, Issue 9 2008
Veronique J. O. Verhaegen MD
Abstract Objectives/Hypothesis: To define audiological application criteria for different implantable hearing aid devices. Study Design: Retrospective study. Methods: Comparisons were made between aided speech recognition scores obtained at conversational level (65 dB) in patients with the Vibrant Soundbridge (VSB) (n = 22), the Otologics middle ear transducer (MET) (n = 10), conventional hearing aids (behind-the-ears) (n = 47), and cochlear implants (CIs) (n = 123). Results: In relation to hearing loss, only for mild hearing loss, speech recognition scores with VSB were comparable to that with conventional hearing aids. In the Otologics MET users, speech recognition scores were comparable with those of the conventional hearing aid users until a mean hearing loss of about 75 dB HL. At a sensorineural hearing loss of about 65 dB HL or more, the Otologics MET users have better speech recognition scores than the VSB users. For comparison with CI users, we followed a more conservative approach. In 90% of the users of a CI, speech recognition scores were better than those in: 1) patients with a conventional hearing aid and a mean hearing loss of about 95 dB HL or worse; 2) patients with an Otologics MET and a mean hearing loss of 85 dB HL or worse. Conclusions: Patients fitted with a VSB or an Otologics MET middle ear implant do not demonstrate better speech recognition scores than patients fitted with today's conventional hearing aids. Results might even been worse. However, the VSB and Otologics MET are a good option in patients with moderate (VSB) to severe (Otologics MET) sensorineural hearing loss and external otitis. [source]

Incidence and Characteristics of Facial Nerve Stimulation in Children With Cochlear Implants,

Multichannel Cochlear Implants: Relation of Histopathology to Performance,

Implantation of the Ossified Cochlea: Management with the Split Electrode Array

THE LARYNGOSCOPE, Issue 12 2005
D A. Millar BS
Abstract Objectives/Hypothesis: To describe indications for, the surgical technique required, and the expected functional results of split electrode array cochlear implants. Study Design: Retrospective chart review. Methods: Data collected included etiology of deafness, radiographic findings, pre- and postoperative aided pure tone thresholds, and speech perception testing. Adult speech perception outcomes were measured using the Consonant Nucleus Consonant (CNC) monosyllable words and Hearing in Noise Test (HINT) in quiet/noise (+10dB). The children were assessed using the Infants and Toddlers Meaningful Auditory Integration Scale. Results: Five patients were implanted with a split electrode array. This included two adults and three children. Both adults had preoperative binaural aided pure tone averages worse than 50d B and scores of 0% on both HINT quiet and CNC words. The children had undetectable preoperative aided thresholds and scored an average 4/40 on the IT-MAIS. Postimplant, the average threshold gain was 38.5 dB in the adults and 81.5 dB in the children. One adult improved to score 51%/22% on HINT quiet/noise at 6 months and 72%/30% at 12 months. The other adult continued to score 0% on HINT at 12 months but claimed substantial subjective auditory improvement after the first year of device use. The children averaged 28/40 on the IT MAIS at 6 months after implantation. Forty-two of 48 implanted electrodes were functional. Conclusions: The split electrode array is a useful alternative to traditional cochlear implants in treating deafened patients with cochlear ossification. Patients implanted with the split array show marked improvement in sound and speech perception. [source]

Cochlear Implants in Five Cases of Auditory Neuropathy: Postoperative Findings and Progress,

Non-sutured fixation of cochlear implants using a minimally-invasive approach

Effects of stimulation rates on Cantonese lexical tone perception by cochlear implant users in Hong Kong

CLINICAL OTOLARYNGOLOGY, Issue 6 2003
D.K.K. Au
Effects of stimulation rates on Cantonese lexical tone perception by cochlear implant users in Hong Kong High, moderate and low stimulation rates of 1800, 800 and 400 pulse per second (pps)/channel, respectively, were used to test the effects of stimulation rates on the discrimination and identification of Cantonese lexical tones in 11 Chinese post-lingually deafened adults with cochlear implants (CIs). The subjects were implanted with the MED-EL Combi 40+ CI system. They were randomly assigned to each of the stimulation rate conditions according to an ABC design. In both the Cantonese lexical tone perception tests, the subjects reached the highest scores in the high-stimulation-rate condition, and the lowest scores in the low-stimulation-rate condition (P < 0.01). Post hoc comparisons between different stimulation rates did not yield consistent results. This study demonstrated that the maximum stimulation rate of 1800 pps/channel could be an ,optimal' stimulation rate and an informed choice of parameter for the benefit of Cantonese-speaking CI users in lexical tone perception. [source]

Perceived competence and school adjustment of hearing impaired children in mainstream primary school settings

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2008
N. Hatamizadeh
Abstract Background Although educational main streaming of children with special needs formally began in Iran since 1992 there is little information whether hearing impaired children feel competent in regular schools. Methods To determine the perceived competence and school adjustment of hearing impaired children in mainstream primary school settings, the self-perception profile was administered to 60 mainstreamed hard of hearing children and 60 classmates with normal hearing matched for gender by a single interviewer. The instrument comprised 28 items, 23 of which were similar to those of ,adapted test Image for children with cochlear implants' asking children about their feelings about their own cognitive, physical, socio-emotional and communication competence and school adjustment. The Cronbach alpha coefficient for the instrument was 0.93. Results Hard of hearing children rated their competence significantly poorer than their hearing classmates for all domains. Mean differences for the five domains ranged from 0.48 (for physical competence) to 0.90 (for school adjustment) on a scale of 1,4. There were no significant differences between girls' and boys' competence, in either the hearing or the hearing impaired groups. Classifying overall scores for perceived competence into four groups (,poor competence', ,low competence', ,moderate competence' and ,high competence'), 23.4% of hearing impaired children but none of the hearing classmates rated themselves as having low or poor competence. On the other hand 85% of hearing children and only 18.3% of hearing impaired children rated themselves as highly competent. Conclusion We suggest that periodical assessments of mainstreamed children might help to identify those children who are having difficulty adapting to their environment. [source]