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Cochlear Implant Users (cochlear + implant_user)
Selected AbstractsLong-Term Performance of Clarion 1.0 Cochlear Implant Users,THE LARYNGOSCOPE, Issue 7 2007Chad 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] Preoperative Functional Assessment of Auditory Cortex in Adult Cochlear Implant Users,,THE LARYNGOSCOPE, Issue 1 2001Peter S. Roland MD Abstract Objectives To e-plore functional neuroanatomical responses to auditory stimulation before and after implantation. Study Design A prospective study of three cochlear implant candidates (pure-tone averages of 90 dB HL or greater bilaterally and hearing in noise test [HINT] performances of <40%) in which regional cerebral blood flow (rCBF) was assessed using single photon emission computed tomography (SPECT). Methods Candidates watched a 15-minute videotaped story under four conditions: audio presented monaurally in the right and left ears (aided), audio presented binaurally (aided), and visual-only presentation of the story. Five minutes into each story, 20 to 25 mCi of technetium 99m (99mTc) hexamethyl-propyleneamine-oxime (HMPAO) (Ceratec; Nycomed Amersham, Princeton, NJ, U.S.A.) was injected over a 30-second period to ensure that subjects were unaware of tracer administration. Subjects were scanned for 20 minutes using a PRISM 3000 gamma camera (Picker International, Cleveland, OH, U.S.A.). Data were normalized and co-registered, and subtraction images were compiled. Subtraction images contrasted activation patterns generated under the visual-only control condition to the auditory activation states acquired monaurally and binaurally. Results Right and left ear monaural stimulation in normal hearing subjects resulted in significant bilateral activation of Brodmann areas 41, 42, 21, 22, and 38. Although substantial intersubject response variability was noted, subjects generally failed to bilaterally activate these areas under monaural hearing aid presentations; however, bilateral activation of areas 41 and 22 was noted under binaural presentations. Conclusions Despite relatively similar hearing losses in each ear, significant differences in preoperative auditory corte- activation were observed between ears. These data suggest that functional brain imaging provides a useful tool for e-ploring the responsiveness of the auditory corte- in cochlear implant candidates. [source] Long-Term Performance of Clarion 1.0 Cochlear Implant Users,THE LARYNGOSCOPE, Issue 7 2007Chad 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,THE LARYNGOSCOPE, Issue 10 2006Sharon 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] Divergence of Fine and Gross Motor Skills in Prelingually Deaf Children: Implications for Cochlear Implantation,THE LARYNGOSCOPE, Issue 8 2006David 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] Effects of stimulation rates on Cantonese lexical tone perception by cochlear implant users in Hong KongCLINICAL OTOLARYNGOLOGY, Issue 6 2003D.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] | ||||||||||