ABSTRACT
Introduction: The COVID-19 pandemic has resulted in delayed provision of essential and nonessential medical care. The objective of this study was to identify trends and possible delays in the timing of pediatric cochlear implant (CI) preand postoperative care during COVID-19 compared with pre- COVID at a single center. Method(s): Patients under the age of 18 years old who underwent initial CI at a single tertiary care center between January 1, 2016, and February 29, 2020, were included in the pre- COVID-19 group, and patients implanted between March 1, 2020, and December 31, 2021, were included in the COVID- 19 group. Data from revision or sequential second-side CI surgeries were excluded. Time intervals between care milestones including confirmation of severe to profound hearing loss, CI surgery, and CI activation were compared for the pre- COVID-19 and COVID-19 groups, as were the number and type (virtual vs in person) of postoperative visits. Result(s): A total of 98 patients met inclusion criteria, of which 70 were implanted pre-COVID and 28 during COVID. At the time of first CI, patients in the COVID group were significantly older (mu=5.7 years, 95% CI, 4.0-7.5) compared with patients in the pre-COVID group (mu=3.7 years, 95% CI, 2.9-4.6;P=.02). The interval between severe to profound hearing loss confirmation and first CI surgery was significantly longer for the COVID group (mu=99.7 weeks, 95% CI, 48.8-150) compared with the pre-COVID group (mu=54.2 weeks, 95% CI, 39.6-68.8;P=.02). All patients underwent activation within 7 weeks after implantation, although the time between first CI surgery and activation was significantly shorter for the COVID group (mu=3.8 weeks, 95% CI, 3.6-4.0) compared with the pre-COVID group (mu=4.3 weeks, 95% CI, 4.1-4.5;P=.01). Conclusion(s): Pediatric patients undergoing cochlear implantation during the COVID-19 pandemic experienced significant delays in care. Future work will aim to reveal impact of delayed care on outcomes in this population.
ABSTRACT
Introduction: To evaluate and validate the use of a remote check application in real life to enable cochlear implant (CI) recipients or parent/caregivers to monitor at home their progress and to help their clinicians to determine and plan for clinical visits based on their needs. Method(s): A total of 110 implanted patients (age range: 6-77 years;12-month implant experience and familiarity with vocabulary for digits 0 to 9) were included in this study, in which each subject served as their own control. The test battery includes an implant-site photograph, impedance measurements, datalogs, questionnaires, speech perception, and aided threshold tests. Chi-square test was used for statistical analysis of the results obtained at home vs clinical setting. Result(s): In all but 2 cases (108/110, 98%) the test battery reached the same conclusion as the clinician in determining whether the recipient required any clinical action. Of recipients and parents/ caregivers, 90% (100/110) reported being "satisfied" or "very satisfied" if their clinic visits were based on results from the selfadministered remote test battery (P<.001). Reasons for satisfaction included the convenience of remote monitoring, the ability to request an appointment if needed, and the continued involvement of their clinician. Satisfaction ratings with the remote monitoring concept were moderately to strongly correlated with perceived improvement in convenience and time involved. Conclusion(s): Most respondents recognized that the remote check battery has the potential to save time, reduce costs, and increase the convenience of aftercare. The clinicians with remote check battery are adequately informed regarding patient management, appointment scheduling, and required clinical actions. This may also further support global case management during COVID-19 pandemic time of recommended social distancing.
ABSTRACT
Hearing impaired listeners heavily rely on facial expressions and unfiltered speech signals for a sufficient speech understanding. Due to the current Cov-id-19 pandemic face masks are worn by almost everyone every day. They therefore interfere especially with the communication of hearing impaired listeners. We used a modified audiovisual German matrix sentence test (AV-OLSA) 1 to further evaluate the effect of face masks on speech intelligibility in a cohort of cochlear implant users (CI, n = 15) and a control group of normal hearing listeners (NH, n = 5). Besides “audio-only”, “visual-only” and “audiovisual” conditions, we added modified conditions. These consisted of an audiovisual condition with a simulated mask and an audio signal, which was edited according to the acoustic filter properties of different face masks (surgical and FFP-2). Our preliminary data show a gain of 5.3 dB (CI) and 2.6 dB (NH) in speech reception thresholds at 80 % word recognition (SRT80%) respectively, if a speaker's video is added to an unfiltered audio signal. Different types of face masks (surgical and FFP-2) led to a deterioration in SRT80% in both groups of up to 7.6 dB (CI) and 4.2 dB (NH) when compared to an unfiltered audiovisual condition without a face mask. The acoustic filter properties of the face masks accounted for up to 2.2 dB (CI) and 1.5 dB (NH) of the deterioration in SRT80%. This effect was therefore less distinct compared to the effect of a missing video signal. Face masks complicate the daily communication. These effects are already detectable in a cohort of normal hearing listeners 2 and even more pronounced in hearing impaired listeners, e.g. cochlear implant users.