The effects of cognitive effort on academic performance of learners with cochlear implants in a private mainstream school in Gauteng

This research investigated the phenomenon of learners with cochlear implants and their challenges with cognitive effort in private mainstream schools in Gauteng. Many learners with cochlear implants encounter academic and social challenges at school, despite the advanced technology. Objectives: This study aimed to explore how learners with cochlear implants experience cognitive effort and whether it impacts their academic potential. Methods: Research was conducted using a phenomenological design. Phenomenography was used as theoretical framework to perceive, interpret and understand experiences of the cochlear implant recipients. The six former learners who were recipients of cochlear implants were selected using purposive sampling. Semi structured interviews were utilised to gather information, which was analysed using thematic content analysis. Results: Five themes emerged from the analysis, namely auditory challenges, cognitive functioning, peer interactions, emotional health and concealed disability. This article only presents the first theme of cognitive functioning and highlights three subthemes related to cognitive effort. Findings show that many learners struggled with their concentration span and fatigue, as a result of their cognitive effort difficulties. Conclusion: This study demonstrated how learners with cochlear implants face challenges with cognitive effort at their mainstream schools. It indicates the need for awareness of and training on educating learners with cochlear implants to help them reach their academic potential. Contribution: This study contributes a unique focus on learners with cochlear implants in mainstream schools in South Africa. The study highlights that cognitive effort of learners with cochlear implants influenced their capabilities to multitask and retain information, despite the effort they have to put into listening. Further research should be conducted to develop interventions that could lesson cognitive effort while increasing learner productivity. The article responds to disability studies and inclusive education

Postoperative rehabilitation effect and influence factors of adult prelingual deafness with cochlear implant / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate whether pre-lingual deafness adult caused by inadequate auditory compensation in childhood can benefit from cochlear implants and the related influencing factors. Methods: A total of 26 prelingual deafness as experimental group [11 males and 15 females, the age of operation was (24.5±5.7) years] and 13 postlingual deafness as control group [5 males and 8 females, the age at the time of operation was (42.2±11.4) years] were recruited. Objective assessment included hearing threshold and speech recognition rate tests while wearing cochlear implants. Subjective assessment used Nijmegen Cochlear Implant Questionnaire to assess hearing-related quality of life of subjects. The changes of hearing ability in the prelingual deafness group before and after operation and the differences with the postlingual deafness group were compared, and the correlation between speech recognition ability and the age diagnosed as severe or profound deafness, the age of hearing aid invalid, and duration of wearing cochlear implant were analyzed as factor indicators. All statistical results were analyzed by SAS 9.4 software. Results: In terms of objective indicators, the speech recognition rate of pre-lingual deafness was significantly lower than that of post-lingual deafness [(35.4±28.0)% vs (80.9±8.0)%,t=7.67, P<0.001], while there was no statistical difference in hearing threshold between the two groups [(34.8±4.0) dB HL vs (33.1±3.7) dB HL, t=1.30, P>0.05]. The indicators in the subjective questionnaire showed that the prelingual deafness group was only weaker in advanced sound perception, confidence and total mean score than the post-lingual deafness group (P<0.05), and there was no significant difference in other aspects(P>0.05), meanwhile, all indicators of the prelingual deafness group were significantly improved compared with the preoperative level (P<0.001). There was a moderate positive correlation between the hearing quality and the speech recognition rate in the prelingual deafness group(r=0.51, P=0.008). The regression analysis showed that the invalid age of hearing aid was the exact influencing factor of speech recognition rate. Conclusions: Certain prelingual deaf adults can adapt to cochlear implants and obtain different degrees of auditory assistance. Compared with the improvement of objective auditory ability assessment, the patient who received cochlear implantation gain more improvement in auditory related quality of life subjectively. The ineffective age of preoperative hearing aid is an important factor, which needs to be aroused sufficient preoperative attention.

Percepção e atuação de professores sobre o aluno com perda auditiva na escola / Teachers' perception and action toward the student with hearing loss at school / Percepción y desempeño de los maestros sobre los estudiantes con pérdida auditiva en la escuela

Introdução: O aluno com perda auditiva que utiliza a comunicação oral pode necessitar de diferentes adequações na escola e condutas adequadas são fundamentais para o seu desenvolvimento. Visto que o professor é importante nesse processo e sua formação não o capacita para atuar com esses alunos, torna-se relevante a parceria entre as áreas da Saúde e Educação. Objetivo: Verificar a percepção e a atuação dos professores sobre o seu aluno com perda auditiva, usuário de aparelho de amplificação sonora individual (AASI) e/ou implante coclear (IC), que utiliza comunicação oral. Método: Participaram 42 professores que atuavam com alunos com perda auditiva em escolas públicas do município de Marília. Os dados foram obtidos por meio do questionário de acompanhamento mensal e de reuniões com a equipe escolar. As respostas foram categorizadas e analisada a frequência de ocorrência. Foi aplicado o Teste de Igualdade de Duas Proporções, admitindo-se como significância (p<0,05). Resultados: Observou-se que o questionário de acompanhamento mensal permitiu o registro das informações de forma detalhada, em relação às reuniões, com frequência de ocorrência estatisticamente significante para as categorias "Acadêmica" (p=0,024), "Comunicação" (p<0,001) e "Participação em sala" (p=0,034). Os professores apresentaram relatos com frequência de ocorrência variável, para cada categoria. Conclusão: Os achados deste estudo em relação à percepção e à atuação dos professores demonstraram respostas aos aspectos com frequência de ocorrência substancialmente diferentes, as quais não conotam uma atuação focada nas necessidades do aluno com perda auditiva que utiliza comunicação oral, no ambiente escolar.

Introduction: The student with hearing loss who uses oral communication might need different adaptations at school and appropriate conducts are essential for their development. Since the teachers are important in this process and their training does not enable them to work with these students, the partnership between the areas of Health and Education is relevant. Objective: To verify the perception and actions of the teachers towards their students with hearing loss, users of hearing aids (HA) and/or cochlear implant (CI), who use oral communication. Methods: Forty-two (42) teachers who taught students with hearing loss in public schools in Marília participated in this study. The data was obtained through the monthly monitoring questionnaire and meetings with school staff. The answers were categorized, and the frequency of occurrence was analyzed. The Two-Proportion Equality Test was applied and assuming a level of significance (p<0.05). Results: It was observed that the monthly follow-up questionnaire allowed the recording of information in detail, in relation to meetings, with frequency of statistically significant occurrence for the "Academic" (p=0.024), "Communication" (p<0.001) and "Participation in the classroom" (p=0.034) categories. The teachers presented reports with variable frequency of occurrence for each category. Conclusion: The findings of this study in relation to the perception and action of teachers showed responses to the aspects evaluated with substantially different frequency of occurrence, indicating a lack of action focused on the needs of students with hearing loss who use oral communication at school.

Introduccion: El estudiante con pérdida auditiva que usa la comunicación oral puede necesitar diferentes adaptaciones en la escuela y los comportamientos adecuados son fundamentales para su desarrollo. Dado que el maestro es importante en este proceso y su formación no le permite trabajar con estos estudiantes, la alianza entre las áreas de Salud y Educación cobra relevancia. Objetivo: Verificar la percepción y desempeño de los maestros sobre su estudiante con pérdida auditiva, usuario de audífono y/o implante coclear (IC), que utiliza la comunicación oral. Metodos: En este estudio participaron cuarenta y dos maestros que enseñaron a estudiantes con pérdida auditiva en escuelas públicas en Marília. Los datos se obtuvieron a través del cuestionario de seguimiento mensual y reuniones con el equipo escolar. Las respuestas se categorizaron y se analizó la frecuencia de ocurrencia. Se aplicó el Test de Igualdad de Dos Proporciones, asumiendo significancia (p <0.05). Resultados: Se observó que el cuestionario de seguimiento mensual permitió registrar información detalladamente, en relación a las reuniones, con una frecuencia de ocurrencia estadísticamente significativa para las categorías "Académico" (p = 0.024), "Comunicación" (p <0.001) y "Participación en el aula" (p = 0,034). Los maestros presentaron informes con frecuencia variable de ocurrencia, para cada categoría. Conclusión: Los hallazgos de este estudio en relación a la percepción y desempeño de los maestros evidenciaron respuestas a aspectos con frecuencia de ocurrencia sustancialmente diferente, que no connotan una acción enfocada en las necesidades de los estudiantes con pérdida auditiva que utilizan la comunicación oral en el ámbito escolar.

Cochlear implant and tinnitus-a meta-analysis / Implante coclear e zumbido - Uma metanálise

Abstract Introduction Tinnitus is a frequent symptom in cochlear implant patients, often reported as persistent and disabling in implant candidates. Tinnitus is rarely considered in the preoperative evaluation of patients who are eligible for cochlear implantation. Many studies have shown that a cochlear implant leads to a significant change in the perception of tinnitus. Objective To identify evidence in the scientific literature indicating that cochlear implant in eligible patients with tinnitus can improve tinnitus perception. Methods One hundred forty articles were found from nine databases, and 20 articles from the gray literature mentioned the relationship between cochlear implant and tinnitus perception in patients eligible for cochlear implant. The PICOS (population, intervention, comparison, and outcome) strategy, was used to define the eligibility criteria. The studies that met the inclusion criteria for this second step were included in a qualitative synthesis, and each type of study was analyzed using the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies and the Joanna Briggs Institute critical appraisal checklist for randomized clinical trials. Results The full texts of 11 articles were read, and 6 studies were selected for the meta-analysis. The total sample size in the evaluated articles was 136 patients with tinnitus who were eligible for cochlear implantation. Conclusions Taken together, these findings support the feasibility of cochlear implantation to reduce the perception of tinnitus, thus providing a new perspective in the treatment of tinnitus in patients with hearing loss who are candidates for cochlear implantation.

Resumo Introdução Zumbido é um sintoma frequente em pacientes com implante coclear, comumente relatado como persistente e incapacitante em candidatos ao procedimento. Entretanto, o zumbido raramente é considerado na avaliação pré-operatória de pacientes elegíveis para o implante coclear. Muitos estudos têm demonstrado que o implante coclear leva a uma mudança significativa na percepção do zumbido. Objetivo Identificar evidências na literatura científica que indiquem que o implante coclear em pacientes com zumbido pode melhorar a percepção. Método Foram encontrados 140 artigos em nove bases de dados e 20 artigos da literatura cinzenta mencionaram a relação entre o implante coclear e a percepção do zumbido em pacientes elegíveis para o procedimento. A estratégia PICOS (população, intervenção, comparação e desfecho) foi usada para definir os critérios de elegibilidade. Os estudos que atenderam aos critérios de inclusão para esta segunda etapa foram incluídos em uma síntese qualitativa e cada tipo de estudo foi analisado com a critical appraisal checklist for quasi-experimental studies e a critical appraisal checklist for randomized clinical trials do Joanna Briggs Institute. Resultados Foram lidos os textos completos de 11 artigos e selecionados 6 estudos para a metanálise. O tamanho total da amostra dos artigos avaliados foi de 136 pacientes com zumbido, elegíveis para o implante coclear. Conclusões Em conjunto, esses achados apoiam a viabilidade do implante coclear para reduzir a percepção do zumbido, proporcionam uma nova perspectiva no tratamento do zumbido em pacientes com deficiência auditiva candidatos a esse procedimento.

Phrases in noise test (PINT) Brasil: efetividade do teste em crianças com deficiência auditiva

Resumo Introdução: Uma das principais implicações da deficiência auditiva é a dificuldade na percepção dos sons da fala, sobretudo em ambientes ruidosos. Dessa forma, o sistema de frequência modulada é considerado uma importante ferramenta educacional para crianças com deficiência auditiva, pois promove a melhoria da percepção da fala em ambientes acusticamente desfavoráveis, como em sala de aula. Entre o protocolo de verificação desse dispositivo é indicada a avaliação da percepção da fala no ruído. Objetivo: Verificar a efetividade do teste de percepção da fala no ruído Phrases in Noise Test Brasil em crianças com deficiência auditiva adaptadas com o sistema frequência modulada. Método: Estudo de corte transversal. A amostra incluiu 40 indivíduos, dos 4 anos até os 11 anos e 11 meses, distribuídos em 4 grupos: (1) 10 crianças normo-ouvintes; (2) 13 crianças adaptadas com aparelho de amplificação sonora individual e com sistema frequência modulada; (3) 12 crianças usuárias de implante coclear e adaptadas com sistema de frequência modulada; e (4) 5 crianças com diagnóstico de desordem do espectro da neuropatia auditiva, adaptadas com aparelho de amplificação sonora individual e/ou implante coclear e com sistema de frequência modulada. Foi usado o Phrases in Noise Test Brasil para avaliar a percepção da fala no ruído nas condições sem e com o sistema frequência modulada. Para a análise estatística dos dados foi adotado nível de significância de 5% (p < 0,05). Resultados: Obteve-se uma diferença significativa entre os grupos quando avaliados com o sistema frequência modulada. O teste também foi validado por meio das medidas de validação concorrente e convergente. O Phrases in Noise Test Brasil é uma opção viável para o acompanhamento do desempenho auditivo no ruído em diferentes grupos de crianças com deficiência auditiva. Conclusão: O Phrases in Noise Test Brasil foi efetivo para avaliar a percepção de fala no ruído e pode contribuir para o aprimoramento dos protocolos de indicação, adaptação e acompanhamento do uso do sistema frequência modulada.

Variáveis influenciadoras na qualidade de vida de crianças com implante coclear: revisão sistemática / Influencing variables in the quality of life of children with cochlear implants: a systematic review

RESUMO Objetivo Verificar como a qualidade de vida de crianças com implante coclear foi avaliada em estudos publicados e analisar criticamente quais foram as variáveis influenciadoras. Estratégia de pesquisa Pesquisa norteada pelas recomendações do PRISMA. A pergunta norteadora foi elaborada com base na estratégia PICO, sendo: "Quais variáveis são consideradas como influenciadoras sobre a qualidade de vida de crianças com implante coclear?". Os descritores selecionados foram: implante coclear, implantes cocleares, qualidade de vida, criança e seus sinônimos, nos idiomas português, inglês e espanhol. Foram identificados estudos indexados nas bases de dados: Pubmed/MEDLINE, LILACS, Scopus, SciELO, Embase, EBSCO/CINAHL e Web of Science. Critérios de seleção Foram selecionados estudos direcionados ao tema, com níveis de evidência científica de 1 a 4, publicados nos idiomas português, inglês e espanhol, no período de 2009 a 2018. Análise dos dados: inicialmente analisou-se os títulos de todos os estudos encontrados, seguido dos resumos e da leitura na íntegra dos textos mais relevantes. Resultados Após a análise rigorosa dos 1062 artigos, oito foram classificados como contendo as respostas necessárias à pergunta norteadora de pesquisa. Os estudos selecionados foram publicados entre os anos de 2009 a 2016, classificados em nível de evidência 2a e 4, com casuística entre dez a 259 crianças e com idades entre 18 meses a 18 anos incompletos. Conclusão Os fatores influenciadores que se correlacionaram com a qualidade de vida das crianças com implante coclear foram: a implantação precoce, o uso do dispositivo eletrônico, as habilidades auditivas e as habilidades de linguagem.

ABSTRACT Purpose To verify how the quality of life of children with cochlear implant was evaluated in published studies and to critically analyze which were the influencing variables. Research Strategy Research guided by PRISMA recommendations. The guiding question was elaborated based on the PICO strategy, being: "Which variables are considered as influencers on the quality of life of children with cochlear implants?" The selected descriptors were cochlear implants, cochlear implants, quality of life, child and their synonyms, in the Portuguese, English and Spanish languages. We have identified indexed studies in the databases: Pubmed / MEDLINE, LILACS, Scopus, SciELO, Embase, EBSCO / CINAHL and Web of Science. Selection Criteria Selected studies were selected, with levels of scientific evidence from 1 to 4, published in the Portuguese, English and Spanish languages, from 2009 to 2018. Data analysis: initially the titles of all the studies, followed by summaries and full reading of the most relevant texts. Results After the rigorous analysis of the 1062 articles, eight were classified as containing the necessary answers to the guiding question of research. The selected studies were published between 2009 and 2016, classified as evidence level 2a and 4, with a sample of between 10 and 259 children and between the ages of 18 months and 18 years. Conclusion The influencing factors that correlated with the quality of life of children with cochlear implants were early implantation, use of the electronic device, hearing skills and language skills.

Design of Scalable Model of Cochlear Scala Tympani / 中国医疗器械杂志

For cochlear implant training and robotic cochlear implant experiments, the design method of scalable scala tympani model was proposed. The mathematical model of the cochlea was used as the central curve of scala tympani channel. Referring to the clinical anatomy data, the contour of the scala tympani cross-section was approximated as an ellipse. The profile was placed along the central curve, and the angle was adjusted to determine the position and orientation of the profile in three dimensions such that the central curve passes through its center. The data was imported into Matlab to generate a three-dimensional mathematical model of scala tympani, which can be expanded by setting different scale factors. The virtual scala tympani model was generated in SolidWorks, and the 2:1 fully transparent scala tympani model were fabricated by 3D printing to replace the specimen for experiment.

The imaging characteristics and prognosis of patients with cochlear implants whose cochlear nerves are not shown on MRI / 中华耳鼻咽喉头颈外科杂志

Objective: To analyze the temporal bone CT and inner ear magnetic resonance imaging characteristics of cochlear implant patients with no cochlear nerve display in the inner auditory canal under MRI. To retrospectively analyze the long-term hearing and speech rehabilitation effects of such patients after cochlear implant. And to analyze the correlation between the results of imaging examinations and the postoperative effects of cochlear implant patients with this type of cochlear nerve deficiency. Methods: A total of 88 children with cochlear nerve deficiency, who underwent cochlear implantation in Shandong Provincial ENT Hospital from May 2014 to October 2018, were enrolled. Patients with cochlear malformations were excluded,only the patients with cochlear nerve deficiency whose cochlear structure was normal and no cochlear nerve displayed in inner auditory canal under MRI were enrolled. There were 64 patients, including 4 bilaterally implanted, 68 ears in total, with an average age of (2.8±1.7) years (range 1-6 years) at the time of implantation. The implanted product was Cochlear, including 24RECA and 512 models. All patients underwent inner ear magnetic resonance imaging and temporal bone CT scan before operation. Auditory speech function assessments were performed at 12 months, 24 months, and 36 months after surgery, including categories of auditory performance (CAP), speech intelligibility rating (SIR) and hearing aid threshold test. The imaging evaluation content included the width of the cochlear nerve canal of temporal bone CT, the width of the internal auditory canal, the width of the auditory nerve at the cerebellopontine angle of the inner ear MRI, and the ratio of the facial nerve to the width of the auditory nerve at the cerebellopontine angle. The correlations between the results of postoperative hearing aid hearing threshold, CAP, SIR and imaging results were analyzed. Results: Among the 64 cases of cochlear nerve not shown under MRI, 56 ears with CT data showed that the width of the cochlear nerve canal in temporal bone CT was (0.72±0.30) mm (mean±standard deviation, the same below), and the width of the internal auditory canal was (4.07±1.10) mm; 66 ears with MRI data showed that the diameter of the auditory nerve at the cerebellopontine angle of the inner ear MRI was (1.58±0.27) mm, the diameter of the facial nerve was (1.57±0.27) mm, and the ratio of the diameter of the facial nerve to the auditory nerve was (1.02±0.23). The average hearing thresholds at 12, 24, and 36 months after surgery were (46.8±2.5) dB HL, (40.7±0.8) dB HL, and (36.8±1.5) dB HL, respectively. The preoperative and postoperative CAP scores at 12, 24 and 36 months were (1.0±1.0), (3.8±1.4), (4.5±1.4) and (5.1±0.7) points, respectively. The preoperative and postoperative SIR scores at 12, 24, and 36 months were (1.1±0.3), (1.9±0.9), (2.5±0.9), and (2.9±0.6) points, respectively. The hearing threshold at 24 months after surgery was negatively correlated with the width of the internal auditory canal of temporal bone CT (r=-0.349, P=0.037), and the hearing threshold at 36 months after surgery was positively correlated with the ratio of the diameter of the facial nerve to the auditory nerve at the cerebellopontine angle of the inner ear MRI (r=0.740, P=0.001). Conclusions: Children with cochlear implants whose cochlear nerves are not shown on MRI can benefit from cochlear implantation, and their speech and auditory functions can improve significantly after surgery. The width of the internal auditory canal in the temporal bone CT and the ratio of the diameter of the facial nerve to the auditory nerve at the cerebellopontine angle of the inner ear MRI may be related to the long-term hearing threshold after surgery.

Study on the feature of cortical auditory evoked potential under different auditory tasks in cochlear implant children / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the variation regularity and influencing factors of cortical auditory evoked potential (CAEP) evoked by pure tone, syllable and tone stimuli in cochlear implant (CI) children. Methods: Cortical auditory evoked potential (CAEP) responses were collected from 46 CI children in the sound field. Pure tones with frequencies of 1 kHz and 2 kHz were used as the standard and the deviant respectively in the pure tone stimulation condition. The Chinese Mandarin tokens/ba/-/pa/and/ba1/-/ba4/pairs were used as the stimuli respectively in the syllable and tone stimulation condition. The latency, amplitude and presence rate of P1 and mismatch negative(MMN) were obtained and the correlation between the difficulty of auditory task, the age of hearing month, the duration of severe-profound hearing loss, the wearing history of hearing aid before CI, the hearing threshold of the better ear before CI and the latency and amplitude of P1 and MMN were analyzed. All statistical analyses and figures were conducted using SPSS 25.0. Results: The P1 presence rate of pure tone, syllable and tone group was 100% (17/17), 100% (13/13) and 75.0% (12/16), respectively, with significant difference (χ²=8.214, P=0.016). There was significant difference between pure tone group and tone group (χ²=4.836, P=0.028), but no significant difference between pure tone group and syllable group, syllable group and tone group. The MMN presence rate of pure tone, syllable and tone group was 94.1% (16/17), 84.6% (11/13) and 62.5% (10/16), respectively, but no significant difference among the three groups with different auditory tasks(χ²=0.066, P=0.066). No significant difference was observed among the three groups of different auditory tasks in the latency and amplitude of P1 and MMN. Multiple linear regression analysis showed that the latency of P1 was positively correlated with the difficulty of auditory task and the hearing threshold of the better ear before CI, and negatively correlated with hearing age and the history of hearing aid before CI. The latency of MMN was positively correlated with the difficulty of auditory task, and negatively correlated with hearing age. Conclusions: The P1 presence rate of pure tone auditory task is significantly higher than that of tone auditory task. The difficulty of auditory task, hearing age, the history of hearing aid before CI, and the hearing threshold of the better ear before CI has significant effects on the P1 latency. The difficulty of auditory task and hearing age has significant effects on the MMN latency.

The development of auditory speech perception and spatial hearing abilities within one year after cochlear implantation in preschool prelingual deaf children / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the development of auditory speech perception and spatial hearing abilities within one year after cochlear implantation in preschool prelingual deaf children and the relationship between the two abilities. Methods: This retrospective study analyzed 31 preschool children with an average age of (2.3±1.2) years. All cases were assessed at pre-implant, 6 months and 12 months post-implant using the Infant-toddler Meaningful Auditory Integration Scale (IT-MAIS), the Meaningful Auditory Integration Scale (MAIS) and the Mandarin Early Speech Perception test (MESP) to evaluate their listening and speech perception abilities, and using the Speech,Spatial,and Other Qualities of Hearing Scale for Parents (SSQ-P) questionnaires to evaluate their speech perception and spatial hearing abilities. SPSS 23.0 was used for the statistical analysis. Results: All children performed better at 6 months and 12 months post-implant with IT-MAIS/MAIS, MESP than pre-implant, and the scoring rate continued to improve, with a significant difference (P<0.01). For the SSQ-P (Speech) and SSQ-P (Spatial) scores, the mean scores of pre-implant were (0.9±0.2) points and (0.8±0.3) points, those of 6 months post-implant were (4.6±0.2) and (2.6±0.3), and 12 months post-implant were (6.2±0.2) and (6.3±0.3), the scores of the two groups were significantly different at pre-implant, 6 months and 12 months post-implant (P<0.01). The growth rate of SSQ-P (Spatial) from pre-implant to 12 months post-implant was 675.3%, and the growth rate from 6 months post-implant to 12 months post-implant was 140.6%, the growth rate showed an significant increase compared with IT-MAIS/MAIS, MESP and SSQ-P (Speech).SSQ-P (Speech) and SSQ-P (Spatial) scores were moderate correlation at 12 months post-implant(r=0.465, P=0.008). Conclusions: Within one year after cochlear implantation, listening, speech perception and spatial hearing abilities of preschool prelingual deaf children could show a comprehensive, continuous and significant progress as the implantation time increasing. The growth rate of spatial hearing is greater than that of speech perception at 12 months post-implant, and the spatial hearing could still show rapid development characteristics after 6 months post-implant.

Effect of electrode array type and insertion technique on the insertion force: in vitro cochlear model study / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the effect of insertion technique and electrode array type on the insertion force of electrode array, and to provide a basis for further optimizing electrode design and facilitating mini-invasive electrode insertion. Methods: Three types of electrode array from Nurotron (Standard Electrode, Slim-medium Electrode, Slim-long Electrode) were studied. from July 2019 to December 2019. These electrode arrays were inserted into the phantom models of the cochlea, manually or robot-assisted(medium speed and low speed). The real-time force during electrode array insertion was recorded by ATI Nano 17 Ti sensors and was analyzed by accessory software. Origin 2020b software was used for statistical processing. Results: The insertion force of all electrode arrays progressively increased with the insertion depth. With the manual technique, the peak force of slim-medium electrode insertion was significantly smaller than that of the standard electrode insertion((71.0±16.6) mN vs (140.9±52.7) mN, Z=3.683, P<0.01), and the peak force of the slim-long electrode insertion was between the peak force of standard electrode and slim-medium electrode(P>0.05). No difference was found in the force variation of insertion among the three electrodes(P>0.05). With medium-speed and low-speed robotic assistance, the peak force characteristics of three electrodes were similar to those with the manual technique, but the force variation of standard electrode insertion ((83.9±9.7) mN/s) at medium speed was significantly larger than that of the slim-long electrode insertion ((69.2±4.0)mN/s), and the force variation of the standard electrode insertion at low speed was significantly greater than the other two electrodes. For the same electrode, robot-assisted insertion presented significantly lower peak force and force variation than manual insertion for each type of electrode array. But there was no difference in the peak force and force variation between two-speed levels of robot assistance (P>0.05). Conclusions: The insertion force of the electrode array will be lower when a slim electrode array or robot technique is applied. Long electrode array might make manual insertion difficult or less precise. Robot assistance has advantage on force control during electrode array insertion.

Development of auditory and language skills in children using cochlear implants with two signal processing strategies / Desenvolvimento das habilidades auditivas e de linguagem em crianças usuárias de implante coclear com duas estratégias de processamento de sinal

Abstract Introduction: The increase in the spectral information offered by the sound processing strategy HiRes 120 has led to great expectations for the pediatric population. Due to a shorter duration of auditory deprivation and higher neural plasticity, children could benefit more substantially from the spectral information of this sound processing strategy. Objective: To compare auditory and language skills in Brazilian children with cochlear implants using the HiRes and HiRes 120 sound processing strategies. Methods: Thirty children, aged 1-3 years, with congenital hearing loss, were divided into two groups, according to the signal processing strategy adjusted at the time of the cochlear implant activation. The assessed children were matched according to chronological age and the time of the cochlear implant use. The auditory and language skills were evaluated longitudinally through the Infant-Toddler Meaningful Auditory Integration Scale and Production Infant Scale Evaluation, carried out before surgery, and 3, 6 and 12 months after device implantation. The Mann-Whitney test was applied for the comparison between the two groups with a 5% significance level. Results: The findings indicated development of hearing and language skills in the first year of cochlear implant use; however, there was no statistically significant difference in the evolution of such skills due to the adjusted processing strategy in the activation of the cochlear implant electrodes. Conclusion: The development of auditory and language skills in the assessed children was similar during the entire study period, regardless of which signal processing strategy was used.

Resumo Introdução: O aumento das informações espectrais proporcionado pela estratégia de processamento de sinal HiRes 120 gera expectativas em relação à população pediátrica, uma vez que, devido ao curto período de privação sensorial e da maior plasticidade neural, as crianças poderiam se beneficiar de forma mais substancial das informações espectrais dessa estratégia de processamento de sinal. Objetivo: Comparar as habilidades auditivas e de linguagem em crianças usuárias de implante coclear, com a estratégia de processamento de sinal HiRes e HiRes 120. Método: Trinta crianças de um a três anos e com perda auditiva congênita foram divididas em dois grupos, de acordo com a estratégia de processamento de sinal ajustada no momento da ativação do implante coclear. As crianças avaliadas foram pareadas de acordo com a idade cronológica e o tempo de uso do implante coclear. As habilidades auditivas e de linguagem foram avaliadas, longitudinalmente, por meio do Infant-Toddler Meaningful Auditory Integration Scale e Production Infant Scale Evaluation, antes do implante coclear e com 3, 6 e 12 meses de uso do dispositivo. O teste estatístico de Mann-Whitney foi aplicado para comparar os resultados dos grupos, com nível de significância de 5%. Resultados: Os achados indicaram desenvolvimento das habilidades auditivas e de linguagem no primeiro ano de uso do implante coclear, porém sem diferença estatisticamente significante na evolução de tais habilidades, em função da estratégia de processamento ajustada na ativação dos eletrodos do implante coclear. Conclusão: O desenvolvimento das habilidades auditivas e de linguagem das crianças avaliadas foi semelhante durante o período do presente estudo, independentemente da estratégia de processamento de sinal usada.

Correlação entre reconhecimento de fala, tempo de privação auditiva e tempo de uso de Implante Coclear em usuários com surdez pós-lingual / Correlation between speech recognition, time of auditory deprivation, and duration of cochlear implant use in people with postlingual deafness / Correlación entre el reconocimiento del habla, el tiempo de privación auditiva y el tiempo de uso del implante coclear em usuários com sorder apos lingual

Introdução: A mensuração do benefício proporcionado pelo Implante Coclear é fundamental e há vários métodos de avaliação descritos, mas, os testes de percepção de fala ainda são os mais utilizados, dentre eles a "Lista de Sentenças em Português" - LSP. Determinar os fatores que influenciam o reconhecimento de fala nos usuários de IC auxilia nas orientações da etapa pré-operatória, melhora a adaptação, reabilitação e evidencia mudanças necessárias no dispositivo. Objetivo: Verificar a correlação das variáveis: tempo de privação auditiva e tempo de uso de Implante Coclear (IC) com os resultados dos testes de percepção de fala no silêncio e no ruído em usuários de IC com deficiência auditiva pós-lingual e idade entre 14 e 60 anos. Método: Os 27 participantes foram submetidos às seguintes avaliações: levantamento de dados- para coleta de informações que caracterizem a perda auditiva prévia, como tempo de privação auditiva e início do uso do IC -, audiometria em campo livre com IC nas frequências sonoras de 250 a 4000 Hz e o reconhecimento de fala que foi avaliado por meio do teste "Listas de Sentenças em Português" - LSP aplicado na condição favorável (silêncio) e na condição desfavorável (ruído) de escuta. Na análise estatística foram utilizados o coeficiente de correlação linear de Pearson e gráficos de dispersão bidimensional, além disso, a análise descritiva dos dados. Resultados: Não houve relação estatisticamente significante entre a privação auditiva e a percepção de fala no silêncio e no ruído. Por outro lado, houve correlação positiva estatisticamente significante entre o Tempo de Uso do IC com o desempenho no teste de reconhecimento de sentenças no silêncio. Conclusão: Verificou-se correlação significante apenas entre tempo de uso de implante e reconhecimento de sentenças no silêncio em usuários de implante com surdez pós-lingual.

Introduction: It is essential to measure the benefits provided by the cochlear implant, to which end various assessment methods have been described. Of these, the speech perception tests are still the most used, including the List of Sentences in Portuguese ­ LSP. Determining the factors that influence the speech recognition of CI users helps in preoperative instructions, improves adaptation and rehabilitation, and reveals necessary changes to be made in the device. Purpose: To verify the correlation between time of auditory deprivation and duration of use of the cochlear implant (CI) with the results of the speech perception in silence and noise tests in CI users with post lingual hearing loss aged 14 to 60 years old. Method: The 27 participants were submitted to the following assessments: data collection to characterize the previous hearing loss, such as the time of auditory deprivation and beginning of CI use; free-field audiometry with CI at the frequencies of 250 to 4000 Hz; speech recognition assessed through the Lists of Phrases in Portuguese (LPP), presented in favorable (silence) and unfavorable (noise) hearing conditions. In the statistical analysis, Pearson's linear correlation coefficient was used, as well as bidimensional dispersion graphs and descriptive data analysis. Results: There was no statistically significant relationship between auditory deprivation and speech perception in silence and noise. On the other hand, there was a statistically significant positive correlation between the duration of CI use and the performance in sentence recognition in silence. Conclusion: A significant correlation was verified only between duration of implant use and sentence recognition in silence in implant users with post lingual deafness.

Introduccion: La medición del beneficio proporcionado por el implante coclear es esencial y existen varios métodos para evaluar lãs pruebas, pero lãs pruebas de percepción Del habla son aún más utilizadas, entre ellas la "Lista de oraciones em portugués" - LSP. Determinar los factores que influyen o El reconocimiento de lãs conversaciones em los usuários del IC auxiliar em lãs instrucciones pre-operatorias, mejora La adaptación, la rehabilitación y la evidencia de cambios alterados em el dispositivo.Objetivo: Verifique la correlación de las variables: tiempo de privación auditiva y tiempo de uso del implante coclear (CI) com los resultados de las pruebas de percepción del habla en silencio y el ruído em usuarios de CI com audición poslingual y edad entre 14 y 60 años. Método: los 27 participantes se sometieron a los siguientes pasos: recopilación de datos - para la recopilación de datos que caracteriza la pérdida auditiva previa, como el tiempo de privación auditiva y el comienzo del uso de CI -, audiometria e nel campo libre con CI a 250 a 4000 Hz frecuencias de sonido y El reconocimiento de voz se evaluó mediante la prueba "Lista de oraciones em portugués" - LSP aplicado em la condición favorable (silencio) y em la condición desfavorable (ruido) de la escucha. Em el análisis estadístico, se utilizaron coeficientes de correlación lineal de Pearson y gráficos de dispersión bidimensionales, además, um análisis descriptivo de los datos. Resultados: No hubo una relación estadísticamente significativa entre la privación auditiva y la percepción del habla en silencio y ruido. Por otro lado, hubo una correlación positiva estadísticamente significativa entre el tiempo de uso del implante coclear y el rendimento em la prueba de reconocimiento de oraciones en silencio. Conclusión: Hubo una correlación significativa solo entre el tiempo de uso del implante y el reconocimiento de oraciones en silencio em usuarios de implantes com sordera poslingual.

Resultados del programa nacional de implantes cocleares y garantías explícitas en salud en beneficiarios pertenecientes al servicio de salud Aconcagua / Results of the national program of cochlear implants and explicit health guarantees in beneficiaries belonging to the Aconcagua health service

Resumen Introducción: En Chile, desde la ejecución de políticas públicas vinculadas a la implementación de implantes cocleares, sólo existen estudios elaborados y publicados en la Región Metropolitana que han buscado describir los resultados que estas han alcanzado en la población. Objetivo: Describir los resultados del Programa Nacional de Implantes Cocleares y Garantías Explícitas en Salud en pacientes beneficiados pertenecientes al Servicio de Salud Aconcagua. Material y Método: Estudio de corte transversal. Se reportan los resultados de la totalidad de pacientes beneficiados implantados en el período 2003-2016 del Servicio de Salud Aconcagua. Resultados: Del total de personas postuladas a nivel nacional, el 3% (n = 17) fueron postuladas desde el Servicio de Salud Aconcagua, de las cuales, el 58,8% (n = 10), fueron beneficiadas con implante coclear. La totalidad de los beneficiados fueron pesquisados a través de consulta en policlínico de Otorrinolaringología. La mediana de diagnóstico auditivo fue 22 meses (Q1-Q3:16-24), implementación de audífonos 24 meses (Q1-Q3:17-25), implementación de implante coclear 50 meses (Q1-Q3:29-56) y encendido de 52 (Q1-Q3:33-57). La mediana de ganancia funcional con implante fue 58,4 dB (Q1-Q3:46-65); estadísticamente significativa (p < 0,05). Conclusión: Los resultados en pacientes usuarios de implante coclear son satisfactorios. Es necesario ampliar la cobertura de estas políticas en el valle del Aconcagua, en coherencia con la mejora de procesos vinculados al diagnóstico oportuno de hipoacusia y posterior implementación de ayudas auditivas en tiempos que la evidencia sugiere pertinentes.

Abstract Introduction: In Chile, since the implementation of public policies linked to the program of cochlear implants, the only published studies were prepared in the Metropolitan Region, that have sought to describe the results that these responses have obtained in the population. Aim: Describe the results of the National Cochlear Implants Program and explicit health guarantees in beneficiary patients belonging to Aconcagua health service. Material and Method: Cross-sectional study. The results of all the patients benefited implanted in the period 2003-2016 are reported. Results: Of the total number of people nominated nationwide, 3% (n = 17) were chosen from the Aconcagua health service, of which 58.8% (n = 10) were benefited with cochlear implants. All the benefited patients were investigated through consultation in the Otolaryngology polyclinic. The median auditory diagnosis was 22 months (Q1-Q3: 16-24), hearing aid implementation 24 months (Q1-Q3: 17-25), cochlear implant implementation 50-month (Q1-Q3: 29-56) and on of cochlear implant 52 months (Q1-Q3: 33-57). The median functional gain with implant was 58.4 dB (Q1-Q3: 46-65); statistically significant (p < 0.05). Conclusion: The results in patients using cochlear implants are satisfactory. It is necessary to expand the coverage of these public policies in the Aconcagua valley, consistent with the improvement of the processes related to the timely diagnosis of hearing loss and subsequent implementation of hearing aids in the times that the relevant evidence.

Factors influencing the quality of life of children with cochlear implants / Fatores influenciadores na qualidade de vida de crianças com implante coclear

Abstract Introduction The multidimensional impact of hearing loss on the various demands of life in children using cochlear implants is represented by variables that can influence the hearing, language and quality of life outcomes of this population. Objective To evaluate the factors influencing the quality of life of children with cochlear implantation, considering age, hearing age, age at evaluation, hearing skills, spoken language, family degree of receptiveness, schooling and socioeconomic status of the parents. Methods Participated 30 children using cochlear implants, aged 6 to 12 years and their respective parents. The children were evaluated by the categories auditory performance, by language category, and by the children with cochlear implants: perspectives parents questionnaire. Parents were assessed by the family involvement scale. Results The cochlear implant impacted the quality of life of the children, with more significant results on the increase of the social relations domain and the decrease of the family support domain. Overall, the increase of the age in the evaluation, better hearing and language skills, the mother's level of schooling and the family receptiveness correlated with the quality of life of children with cochlear implants. Conclusion The influencing factors that correlated with the quality of life of the implanted children were the child's older age at the evaluation, the better hearing and language skills, the mother's level of schooling and the family receptiveness.

Resumo Introdução O impacto multidimensional da deficiência auditiva nas várias demandas da vida das crianças usuárias de implante coclear é representado por variáveis que podem influenciar os resultados de audição, de linguagem e de qualidade de vida desta população. Objetivo Avaliar os fatores influenciadores na qualidade de vida de crianças com implante coclear, considerando a idade na cirurgia, a idade auditiva, a idade na avaliação, as habilidades auditivas, a linguagem falada, o grau de permeabilidade familiar, a escolaridade e o nível socioeconômico dos pais. Método Participaram 30 crianças usuárias de implante coclear com idades entre 6 a 12 anos e seus respectivos pais. As crianças foram avaliadas pelos instrumentos categories auditory performance, pela categoria de linguagem e pelo questionário crianças com implante coclear: perspectivas dos pais. Os pais foram avaliados pela escala de envolvimento familiar. Resultados O implante coclear impactou a qualidade de vida das crianças, com resultados mais significativos sobre o aumento do domínio relações sociais e a diminuição do domínio suporte da família. De maneira geral, maior idade na avaliação, as melhores habilidades auditivas e de linguagem, a escolaridade da mãe e a permeabilidade da família se correlacionaram com a qualidade de vida de crianças com implante coclear. Conclusão Os fatores influenciadores que se correlacionaram com a qualidade de vida das crianças implantadas foram a maior idade na avaliação, as melhores habilidades auditivas e de linguagem, a escolaridade da mãe e a permeabilidade da família.

Language evaluation in children with pre-lingual hearing loss and cochlear implant / Avaliação de linguagem em crianças com deficiência auditiva pré-lingual e implante coclear

Abstract Introduction The cochlear implant is an effective device for children with severe and/or profound prelingual hearing loss, since it provides considerable improvement in oral language acquisition through the auditory pathway. The use of a cochlear implant contributes to the development of auditory perception, favoring the acquisition of the linguistic processes related to communication skills, which might have a positive effect on other areas of development. Objective The aim of this study was to verify the performance of children using cochlear implants for expressive and receptive oral language. Methods This was a prospective cross-sectional study that used the following tests: Child language test in the phonology, vocabulary, fluency and pragmatics areas, and the Peabody picture vocabulary test. Thirty children participated in this study, of both genders, aged between 36 and 72 months, with severe and/or profound bilateral sensorineural hearing loss, without other impairments and users of unilateral cochlear implant with full electrode insertion for a minimum of 12 months. Results The longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language. Even though when compared to the normative language acquisition process, the results showed that these children had patterns of linguistic skills that are below their chronological age; the results indicate that these children are developing expressive and receptive oral language skills, and this is the outcome that should be taken into account in this study. Conclusion The longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language skills, but not in all the studied semantic categories.

Resumo Introdução O implante coclear é um tratamento eficaz para crianças com deficiência auditiva pré-lingual de grau severo e/ou profundo, uma vez que proporciona melhoria considerável na aquisição da linguagem oral por meio da via auditiva. O uso do implante coclear contribui para o desenvolvimento da percepção auditiva e favorece a aquisição dos processos linguísticos voltados à aquisição de habilidades comunicativas que poderá repercutir positivamente em outras áreas do desenvolvimento. Objetivo Verificar o desempenho de crianças usuárias de implante coclear quanto à linguagem oral expressiva e receptiva. Método Estudo prospectivo transversal onde os seguintes testes foram usados: teste de linguagem infantil nas áreas de fonologia, vocabulário, fluência e pragmática e teste de vocabulário de imagens Peabody. Participaram deste estudo 30 crianças de ambos os sexos de 36 a 72 meses, com deficiência auditiva sensorioneural de grau severo e/ou profundo bilateral, sem outros comprometimentos e usuárias de implante coclear unilateral com inserção total dos eletrodos havia, no mínimo, 12 meses. Resultados O maior tempo de uso do implante coclear, a menor idade na cirurgia e o melhor desempenho na percepção auditiva da fala influenciaram o desempenho na linguagem oral expressiva e receptiva. Embora comparativamente ao processo de aquisição normativo da linguagem os resultados encontrados tenham revelado que essas crianças demonstraram habilidades linguísticas em padrões abaixo de sua idade cronológica, os resultados apontaram que essas crianças estão em evolução da linguagem oral expressiva e receptiva, esse é o resultado que deve ser valorizado neste estudo. Conclusão O maior tempo de uso do implante coclear, a menor idade na cirurgia e o melhor desempenho na percepção auditiva da fala influenciaram o desempenho na linguagem oral expressiva e receptiva, porém não em todas as categorias semânticas estudadas.

Reconhecimento de fala e índice de inteligibilidade de fala em usuários de próteses auditivas intra-aurais: um estudo comparativo / Speech recognition and speech intelligibility index in intra-aural hearing aids users: a comparative study

RESUMO Objetivo Comparar o Índice de Inteligibilidade de Fala e o Índice Percentual de Reconhecimento de Fala (IPRF) obtidos pré e pós-ajustes de acordo com valores prescritos, investigar correlações entre o Índice de Inteligibilidade de Fala pré e pós-ajustes e investigar correlações entre o IPRF pré e pós-ajustes em usuários de próteses auditivas intra-aurais. Métodos Participaram 20 adultos de 18 a 59 anos, com perda auditiva neurossensorial bilateral de graus moderado e severo. Foram comparados o Índice de Inteligibilidade de Fala e o IPRF obtidos com próteses auditivas, em dois momentos: com os ajustes até então utilizados (momento pré) e após a regulagem de acordo com os valores prescritos em verificação, com emprego do método NAL-NL1 (momento pós). Os dados foram analisados por meio de estatística descritiva e de testes não paramétricos, com nível de significância de 0,05. Resultados Verificou-se correlação negativa entre o IPRF pré-ajuste e seu Delta pós-pré-ajuste, assim como entre o Índice de Inteligibilidade de Fala pré-ajuste e seu Delta pós-pré-ajuste. Houve correlação positiva entre o IPRF e o Índice de Inteligibilidade de Fala pós-ajuste. Conclusão Quanto menores o IPRF e o Índice de Inteligibilidade de Fala pré-ajuste, maiores suas diferenças, comparando os momentos pré e pós-regulagem. Quanto maior o acesso aos sons de fala, promovido pela regulagem ideal das próteses auditivas, maior o IPRF.

ABSTRACT Purpose To compare the Speech Intelligibility Index (SII) and the Word Recognition Score (WRS) in quiet obtained pre and post adjustments according to prescribed values, to investigate correlations between the Speech Intelligibility Index before and after adjustments, and to investigate correlations between pre- and post-adjustment SII in intra-aural hearing aids users. Methods 20 adults participated, aged 18 to 59 years, with moderate or severe bilateral sensorineural hearing loss. We compared the Speech Intelligibility Index and the WRS obtained with hearing aids in two moments: with the adjustments previously used (pre-adjustment moment) and after modification according to the values prescribed in verification using the NAL-NL1 method (post-adjustment moment). The data were analyzed through descriptive statistics and nonparametric tests, with a significance level of 0.05. Results There was a negative correlation between the pre-adjustment WRS and its post-pre adjustment difference, as well as between the pre-adjustment Speech Intelligibility Index and its post-pre adjustment Delta. There was a positive correlation between post-adjustment PISR and the SII. Conclusion The lower the pre-adjustment WRS and Speech Intelligibility Index, the greater their differences comparing the pre- and post-adjustment moments. The greater the access to speech sounds, promoted by the ideal regulation of the hearing aids, the higher the WRS.