Benefits of Bimodal Stimulation to Speech Perception in Noise and Silence

Abstract Introduction Understanding all the benefits of bimodality with self-assessment questionnaires on the effect of hearing on quality of life is still necessary. Objective To present whether bimodality still offers hearing benefits to the population who uses acoustic stimulation associated with electrical stimulation. Methods The present study included 13 participants aged between 16 and 80 years old who were users of cochlear implants from Cochlear Corporation and hearing aids. All patients underwent the Hearing in Noise Test, and their visual analog scale score was obtained. Four-tone means were collected, and the participants answered the Speech, Spatial and Hearing Qualities questionnaire. Results Bimodal users had an average sentence recognition rate of 76.0% in silence and 67.6% in fixed noise, and the signal-to-noise ratio in adaptive noise was +2.89dB. In addition, a lower level of difficulty was observed in the test using the visual analog scale. The domain with the highest average was auditory qualities (6.50), followed by spatial hearing (6.26) and hearing for speech (5.81). Individuals with an average between 50 and 70 dB of hearing level showed better sentence recognition in silence and noise. Conclusion Bimodal stimulation showed benefits for users with different degrees of hearing loss; however, individuals who presented greater hearing residue had better performance in speech recognition with noise and in silence in addition to a good perception of hearing quality.

Hearing Rehabilitation through Bone-Conducted Sound Stimulation: Preliminary Results

Abstract Introduction The bone-anchored hearing aid (BAHA) is a bone conduction system that transmits the sound directly to the inner ear by surpassing the skin impedance and the subcutaneous tissue. It is indicated for patients with mixed, conductive and unilateral sensorineural hearing loss who did not benefit from conventional hearing aids (HAs). Although the benefits from BAHA are well demonstrated internationally, this field still lacks studies in Brazil. Objective To assess the auditory rehabilitation process in BAHA users through audiological, speech perception and tinnitus aspects. Methods Individuals with hearing loss were assessed before and after the implantation. The participants were subjected to pure tone audiometry in free field, functional gain audiometry, speech perception tests, tinnitus handicap inventory (THI) in open format, and to the visual analog scale (VAS). Results It was found that the participants benefited from the use of BAHA. The difference in the performance of the participants before and after the BAHA surgery was significant in terms of hearing acuity. There was no statistically significant difference in the speech perception tests. The tinnitus assessment showed that 80% of the participants scored slight tinnitus severity in THI after using a BAHA. Eighty percent of the participants classified their tinnitus as absent tomild in the VAS after the surgery. Conclusion Based on the results of the current study, we can conclude that the participants improved both the auditory perception and the tinnitus handicap. (AU)

Analysis of electrically evoked compound action potential of the auditory nerve in children with bilateral cochlear implants / Análise do potencial de ação composto do nervo auditivo evocado eletricamente em crianças usuárias de implante coclear bilateral

ABSTRACT INTRODUCTION: The cochlear implant device has the capacity to measure the electrically evoked compound action potential of the auditory nerve. The neural response telemetry is used in order to measure the electrically evoked compound action potential of the auditory nerve. OBJECTIVE: To analyze the electrically evoked compound action potential, through the neural response telemetry, in children with bilateral cochlear implants. METHODS: This is an analytical, prospective, longitudinal, historical cohort study. Six children, aged 1-4 years, with bilateral cochlear implant were assessed at five different intervals during their first year of cochlear implant use. RESULTS: There were significant differences in follow-up time (p = 0.0082) and electrode position (p = 0.0019) in the T-NRT measure. There was a significant difference in the interaction between time of follow-up and electrode position (p = 0.0143) when measuring the N1-P1 wave amplitude between the three electrodes at each time of follow-up. CONCLUSION: The electrically evoked compound action potential measurement using neural response telemetry in children with bilateral cochlear implants during the first year of follow-up was effective in demonstrating the synchronized bilateral development of the peripheral auditory pathways in the studied population.

RESUMO INTRODUÇÃO: O implante coclear tem a capacidade de medir o potencial de ação composto eletricamente evocado do nervo auditivo (ECAP). Para esta verificação utiliza-se uma medida chamada telemetria de respostas neurais. OBJETIVO: Analisar o potencial de ação composto evocado eletricamente, por meio da neurotelemetria de respostas neurais, em crianças usuárias de implante coclear bilateral. MÉTODO: Trata-se de um estudo analítico, prospectivo, de coorte histórica longitudinal. Foram recrutadas seis crianças, com idades entre de 1-4 anos, usuárias de implante coclear bilateral. Estas crianças foram avaliadas em cinco momentos durante o primeiro ano de uso do implante coclear. RESULTADOS: Houve diferença significativa no tempo de acompanhamento (p = 0,0082) e posição do eletrodo (p = 0,0019) na medida de T-NRT. Houve diferença significativa na interação entre tempo de acompanhamento e posição do eletrodo (p = 0,0143) na medida da amplitude das ondas N1-P1 entre os três eletrodos a cada tempo de acompanhamento. CONCLUSÃO: A mensuração do ECAP por meio da NRT nas crianças com implante coclear bilateral durante o primeiro ano de acompanhamento foi uma medida importante para apresentar o desenvolvimento bilateral da via auditiva periférica de forma sincronizada nesta população estudada.

Hearing rehabilitation in cerebral palsy: development of language and hearing after cochlear implantation / Reabilitação auditiva na paralisia cerebral: desenvolvimento da audição e linguagem após implante coclear

INTRODUCTION: Auditory rehabilitation in children with bilateral severe-to-profound sensorineural hearing loss with cochlear implant has been developed in recent decades; however, the rehabilitation of children with cerebral palsy still remains a challenge to otolaryngology and speech therapy professionals. OBJECTIVE: To verify the effectiveness of cochlear implants in the development of auditory and language skills in children with cerebral palsy. METHODS: A prospective analytical study. The evaluation of auditory responses to speech test was applied to the children in this study at regular intervals following implantation. Standardized tests that assess and quantify the development of auditory and language skills were administered and speech therapy video records and speech therapy files were analyzed. All children went through individually tailored intensive audiological rehabilitation programs following cochlear implantation. RESULTS: Two participants had gradual auditory and language development when compared to other participants who reached advanced levels in hearing and oral language classifications. CONCLUSION: The use of the Cochlear implant enabled participants to reach advanced stages of hearing and language skills in three of the five participants with cerebral palsy in this study. This electronic device is a viable therapeutic option for children with cerebral palsy to help them achieve complex levels of auditory and language skills. .

INTRODUÇÃO: A reabilitação auditiva em crianças com deficiência auditiva neurossensorial severa a profunda bilateral com o Implante Coclear foi consagrado nas últimas décadas, contudo, ainda permanece um desafio para a otorrinolaringologia e a fonoaudiologia a reabilitação do portador de paralisia cerebral. OBJETIVO: Verificar a efetividade do Implante Coclear no desenvolvimento das habilidades auditivas e de linguagem em crianças com paralisia cerebral. MÉTODO: Estudo analítico prospectivo. Foram aplicados testes padronizados que avaliam e quantificam o desenvolvimento das habilidades auditivas e de linguagem. Foram analisadas as filmagens das terapias fonoaudiológicas e os registros descritos ao término de cada sessão de terapia. RESULTADOS: As crianças analisadas apresentaram desenvolvimento auditivo e de linguagem satisfatório quando comparado às demais crianças que alcançaram níveis mais complexos nas categorias de audição e evolução significativa no desenvolvimento da linguagem oral. CONCLUSÃO: O uso do Implante Coclear favoreceu o alcance de etapas avançadas das habilidades de audição e linguagem em três das cinco crianças com paralisia cerebral desse estudo. Esse dispositivo eletrônico tem sido uma opção terapêutica viável para que crianças com paralisia cerebral alcancem etapas complexas no que se refere às habilidades auditivas e de linguagem. .

Fatores que interferem no desempenho de usuários de implante coclear em testes de percepção de fala / Factors affecting the performance of users of cochlear implant in speech perception testing

Objetivo : analisar os fatores que interferem no desempenho de usuários de implante coclear em testes de percepção de fala.Métodos : foram aplicados questionários e testes de percepção de fala em 25 indivíduos, de ambos os sexos, portadores de perda auditiva neurossensorial e usuários de IC unilateral.Resultados : - 48% dos participantes atingiram bom desempenho nos resultados dos testes de percepção de fala, apresentando porcentagens maiores ou iguais a 50 % de acertos. - Os participantes que obtiveram melhores resultados não são necessariamente os que possuem maior idade auditiva. - Dos 12 participantes que atingiram desempenho acima de 50%, 10 (83,3%) foram implantados mais precocemente (até 5 anos). - O uso do AASI na orelha contralateral influenciou significantemente nos índices de reconhecimento das palavras ou sentenças. - Os participantes que iniciaram o uso de AASI mais cedo não foram necessariamente os que apresentaram melhores resultados nos testes.Conclusão : a ativação mais precoce dos IC mostrou-se uma variável importante no desempenho dos testes. - O uso do AASI na orelha contralateral influenciou significantemente nos índices de reconhecimento das palavras ou sentenças.

Purpose : to analyze the relation between speech perception tests in cochlear implant users.Methods : questionnaires and speech perception tests were applied in 25 individuals from both genders with sensorioneural hearing loss and users of unilateral cochlear implant.Results : 48% of the participants had a good performance (50%) on speech perception tests. The participants who had the best results are not the ones with higher auditory age. 12 participants had a score higher than 50% and 10 (83%) of those, did the cochlear implant surgery before 5 years old. The use of hearing aid contralateral to the cochlear implant had a significant influence on the participants performances on tests. The participants who started using hearing aids earlier did not have the best results on the tests.Conclusion : the early activation of the cochlear implant is an important variable on the tests performance. The use of hearing aid contralateral to the cochlear implant had a significant influence on the speech recognition tests.

Cochlear Implants in Children Diagnosed with CHARGE Syndrome

The CHARGE association (coloboma of the eyes; heart disease; atresia of the choanae; retarded growth and development; genital hypoplasia/genitourinary anomalies; ear anomalies and/or hearing loss) was first described in 1979 by Hall, and among its main features is hearing loss. This study presents a case aiming to establish relationships between performance on Infant Toddler Meaningful Auditory Integration Scale (IT-MAIS) and Meaningful Use of Speech Scales (MUSS) tests and the analysis of hearing and language categories of a patient diagnosed with CHARGE syndrome, before and after cochlear implant (CI) surgery. Case Report: A 7-year-old girl was diagnosed with CHARGE. She had severe sensorineural hearing loss and was a prelingual unilateral CI user. We analyzed data from the patient's medical records regarding therapies and video recordings. Results: The patient showed positive results in all evaluations after CI. IT-MAIS rose from 5 to 90% following the use of CI. MUSS also rose, from 75 to 72.5%, after use of CI. Classification of Auditory Skills changed from category 1 before use of CI to category 6 after use of CI. Classification of Language Skills changed from category 1 before use of CI to category 3 after use of CI. The CI is an aid but there are many factors in the therapeutic process, and great heterogeneity in individuals diagnosed with CHARGE should be investigated. Conclusion: The development of listening and language skills after CI use was demonstrated by IT-MAIS and MUSS tests, and categorization of speech and hearing in this child with a diagnosis of CHARGE syndrome shows that CI can be an effective technological resource to provide information on hearing as one source for language construction...