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1.
Otol Neurotol ; 43(8): e865-e871, 2022 Sep 01.
Article in English | MEDLINE | ID: covidwho-1992397

ABSTRACT

PURPOSE: To study the evolution of type D personality traits in older adults after cochlear implantation compared with a control group of severely hearing impaired older adults who did not receive a cochlear implant (CI). The influence of COVID-19 on this evolution was also explored. Type D personality combines a high degree of negative affectivity (NA) and social inhibition (SI). METHODS: In this prospective, longitudinal, controlled multicenter exploratory study, 76 older CI users and 21 severely hearing impaired controls without CI were included. The CI group and the control group did not differ significantly regarding age, formal education, residual hearing, Type D Scale-14 (DS14) total score, NA, and SI at baseline. Type D personality traits were assessed with the DS14 at baseline (T0) and 14 months later (T14). RESULTS: Type D personality traits differed significantly over time between the CI group and the control group (p < 0.001). In the CI group, the DS14 total score (mean delta T = -6.63; p < 0.001), NA (mean delta T = -3.26; p < 0.001), and SI (mean delta T = -3.37; p < 0.001) improved significantly over time (delta T = T14-T0), whereas no significant difference was found in the control group. Significantly fewer subjects were categorized as type D personalities in the CI group (delta T = -12; p = 0.023) at T14, whereas no significant change was found in the control group (delta T = 3; p = 0.250). COVID-19 did not influence the evolution of type D personality traits significantly in the CI group. CONCLUSION: Cochlear implantation has a positive effect on type D personality traits in older adults with a severe-to-profound hearing impairment.


Subject(s)
COVID-19 , Cochlear Implantation , Cochlear Implants , Hearing Loss , Type D Personality , Aged , Hearing , Hearing Loss/surgery , Humans , Prospective Studies
2.
Otol Neurotol ; 43(8): e820-e823, 2022 Sep 01.
Article in English | MEDLINE | ID: covidwho-1931942

ABSTRACT

OBJECTIVE: This study aimed to assess the efficacy of same-day cochlear implant (SDCI) evaluation and surgery in improving patient experience. PATIENTS: Adult CI candidates participated in this study. INTERVENTIONS: Education materials and communication with providers were offered via telephone, e-mail, and/or telemedicine. Patients then arrived for in-person consultation, imaging studies, and outpatient CI surgery in one visit and received a 3-month postoperative survey. MAIN OUTCOME MEASURES: Preoperative hearing, referral-to-surgery time, travel burden, and patient satisfaction were included as outcome measures. RESULTS: Of 35 patients who qualified, 14 were successfully contacted regarding the same-day program: 9 underwent CI, 1 enrolled but did not ultimately meet candidacy criteria, and 4 declined because of coronavirus and/or active medical conditions and did not pursue a CI. For the nine patients who underwent SDCI, mean age was 78 years, and mean preoperative consonant-nucleus-consonant score was 16% in the implanted ear. Mean referral-to-surgery time was 103 days and, after accounting for cancellations because of coronavirus, was 52 days. Mean travel distance to institution was 234 miles. Of the seven patients who completed the follow-up survey, none felt rushed for surgery, and mean program experience was rated 8.6 out of 10. Net promoter score was positive (+72), supporting high experience favorability among patients. Barriers to program expansion included patient recruitment and education, surgery scheduling, and the coronavirus pandemic. CONCLUSIONS: No patients declined the SDCI program to pursue traditional CI evaluation, and all patients were satisfied with their experience. The SDCI program is a feasible and successful model that overcomes barriers to implantation, including travel burden, and improves access to care.


Subject(s)
Cochlear Implantation , Cochlear Implants , Hearing Loss, Sensorineural , Adult , Aged , Cochlear Implantation/methods , Hearing Loss, Sensorineural/surgery , Humans , Patient Outcome Assessment , Referral and Consultation
3.
Otol Neurotol ; 43(6): 638-642, 2022 07 01.
Article in English | MEDLINE | ID: covidwho-1909021

ABSTRACT

OBJECTIVE: Present results with remote intraoperative neural response telemetry (NRT) during cochlear implantation (CI) and its usefulness in overcoming the inefficiency of in person NRT. STUDY DESIGN: Case series. SETTING: Tertiary academic otology practice. PATIENTS: All patients undergoing primary or revision CI, both adult and pediatric, were enrolled. INTERVENTIONS: Remote intraoperative NRT performed by audiologists using a desktop computer to control a laptop in the operating room. Testing was performed over the hospital network using commercially available software. A single system was used to test all three FDA-approved manufacturers' devices. MAIN OUTCOME MEASURES: Success rate and time savings of remote NRT. RESULTS: Out of 254 procedures, 252 (99.2%) underwent successful remote NRT. In two procedures (0.7%), remote testing was unsuccessful, and required in-person testing to address technical issues.Both failed attempts were due to hardware failure (OR laptop or headpiece problems). There was no relation between success of the procedure and patient/surgical factors such as difficult anatomy, or the approach used for inner ear access. The audiologist time saved using this approach was considerable when compared with in-person testing. CONCLUSIONS: Remote intraoperative NRT testing during cochlear implantation can be performed effectively using standard hardware and remote-control software. Especially important during the Covid-19 pandemic, such a procedure can reduce in-person contacts, and limit the number of individuals in the operating room. Remote testing can provide additional flexibility and efficiency in audiologist schedules.


Subject(s)
COVID-19 , Cochlear Implantation , Cochlear Implants , Adult , Child , Cochlear Implantation/methods , Humans , Pandemics , Telemetry/methods
4.
Trends Hear ; 26: 23312165221087011, 2022.
Article in English | MEDLINE | ID: covidwho-1799133

ABSTRACT

Following the outbreak of the COVID-19 pandemic, public-health measures introduced to stem the spread of the disease caused profound changes to patterns of daily-life communication. This paper presents the results of an online survey conducted to document adult cochlear-implant (CI) users' perceived listening difficulties under four communication scenarios commonly experienced during the pandemic, specifically when talking: with someone wearing a facemask, under social/physical distancing guidelines, via telephone, and via video call. Results from ninety-four respondents indicated that people considered their in-person listening experiences in some common everyday scenarios to have been significantly worsened by the introduction of mask-wearing and physical distancing. Participants reported experiencing an array of listening difficulties, including reduced speech intelligibility and increased listening effort, which resulted in many people actively avoiding certain communication scenarios at least some of the time. Participants also found listening effortful during remote communication, which became rapidly more prevalent following the outbreak of the pandemic. Potential solutions identified by participants to ease the burden of everyday listening with a CI may have applicability beyond the context of the COVID-19 pandemic. Specifically, the results emphasized the importance of visual cues, including lipreading and live speech-to-text transcriptions, to improve in-person and remote communication for people with a CI.


Subject(s)
COVID-19 , Cochlear Implantation , Cochlear Implants , Speech Perception , Adult , Humans , Pandemics , Speech Intelligibility
5.
Lang Speech Hear Serv Sch ; 53(2): 391-403, 2022 04 11.
Article in English | MEDLINE | ID: covidwho-1684139

ABSTRACT

PURPOSE: The purpose of this study is to evaluate the effects of switching from in-person assessment to virtual assessment during the COVID-19 pandemic on the growth trajectories of children with hearing loss who are learning spoken language. METHOD: Sixty-eight children with typical hearing, 44 children with cochlear implants, and 47 children with hearing aids were assessed with a norm-referenced measure of receptive vocabulary, a criterion-referenced measure of phonological awareness, and a criterion-referenced measure of conceptual print knowledge at least 4 times, at 6-month intervals, between the ages of 4 and 6 years. Of those participants, 26 children with typical hearing, 13 children with cochlear implants, and 13 children with hearing aids entered virtual testing as a result of the COVID-19 pandemic. The slopes of growth for children who entered virtual testing were compared to their own slopes prepandemic and to the growth slopes of children who completed all testing in-person, prepandemic. RESULTS: Within-subject comparisons across all measures did not show a change in growth slopes prepandemic to postpandemic. For the measure of conceptual print knowledge, children who were tested during the pandemic showed slower overall growth than children who were tested prepandemic. No effects of hearing status were found across growth on any measure. CONCLUSION: These preliminary data support the use of virtual assessment to measure growth in receptive vocabulary, phonological awareness, and conceptual print knowledge in children with hearing loss learning spoken language.


Subject(s)
COVID-19 , Cochlear Implantation , Cochlear Implants , Deafness , Hearing Aids , Hearing Loss , Child , Child, Preschool , Deafness/surgery , Humans , Language Development , Pandemics , Vocabulary
6.
HNO ; 70(3): 214-223, 2022 Mar.
Article in German | MEDLINE | ID: covidwho-1536289

ABSTRACT

BACKGROUND: Due to the COVID-19 pandemic, digitalization in healthcare grew rapidly. Auditory training after cochlear implantation usually takes place face-to-face but social distancing interferes with this therapeutic approach. MATERIALS AND METHODS: In follow-up treatment, 42 adult cochlear implant (CI) users aged 53.8 (±15.6) years received video therapy 1 x/week for 5 weeks on a certified platform. After each therapy session, the technical process and therapeutic content were assessed. At the end of the study, usability and the relationship between therapist and patient were evaluated by patients and therapists using the System Usability Scale (SUS), a final questionnaire and by the Skala Therapeutische Allianz - Revised (STA-R). Furthermore, a cost-benefit analysis was done. RESULTS: Usability for both users was high (87.97 versus 93.0). Despite the lack of personal contact, therapeutic alliance was highly appreciated by patients and therapists (87.8% versus 84.8%). The main advantages for the patients were reductions in time and costs. In contrast, the rehabilitation center faced higher costs initially due to the longer time therapists needed to prepare the lessons. Technical problems had to be solved in > 75% of the first sessions but did not bother training thereafter. In total, 47.6% of the patients believe that teletherapy can completely fulfill their therapeutic needs. CONCLUSION: Video therapy has been judged as a useful tool by all users and the majority wants to continue. However, it remains questionable whether the therapist-patient relationship can be sufficiently maintained over a longer period and whether online therapy is as effective as face-to-face therapy.


Subject(s)
COVID-19 , Cochlear Implantation , Cochlear Implants , Adult , Humans , Middle Aged , Pandemics , SARS-CoV-2
7.
Audiol Neurootol ; 27(3): 227-234, 2022.
Article in English | MEDLINE | ID: covidwho-1528607

ABSTRACT

INTRODUCTION: The objective of this study was to assess the influence of postponing the first post-activation follow-up due to the COVID-19 pandemic on the aided sound field detection thresholds and speech recognition of cochlear implant (CI) users. METHODS: A retrospective review was performed at a tertiary referral center. Two groups of adult CI recipients were evaluated: (1) patients whose first post-activation follow-up was postponed due to COVID-19 closures (postponed group; n = 10) and (2) a control group that attended recommended post-activation follow-ups prior to the COVID-19 pandemic (control group; n = 18). For both groups, electric thresholds were estimated at initial activation based on comfort levels and were measured behaviorally at subsequent post-activation follow-ups. For the control group, behavioral thresholds were measured at the 1-month follow-up. For the postponed group, behavioral thresholds were not measured until 3 months post-activation since the 1-month follow-up was postponed. The aided pure-tone average (PTA) and word recognition results were compared between groups at the 3-month follow-up and at an interim visit 2-9 weeks later. RESULTS: At the 3-month follow-up, the postponed group had significantly poorer word recognition (23 vs. 42%, p = 0.027) and aided PTA (42 vs. 37 dB HL, p = 0.041) than the control group. No significant differences were observed between 3-month data from the control group and interim data from the postponed group. CONCLUSIONS: The postponed follow-up after CI activation was associated with poorer outcomes, both in terms of speech recognition and aided audibility. However, these detrimental effects were reversed following provision of an individualized map, with behaviorally measured electric threshold and comfort levels. While adult CI recipients demonstrate an improvement in speech recognition with estimated electric thresholds, the present results suggest that behavioral mapping within the initial weeks of device use may support optimal outcomes.


Subject(s)
COVID-19 , Cochlear Implantation , Cochlear Implants , Speech Perception , Adult , Auditory Threshold , Cochlear Implantation/methods , Follow-Up Studies , Humans , Pandemics , Speech Perception/physiology
9.
J Laryngol Otol ; 135(10): 918-925, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1376163

ABSTRACT

OBJECTIVE: This study aimed to explore the impact of the coronavirus disease 2019 pandemic and postponement of elective surgical procedures for profoundly deaf patients awaiting cochlear implantation. METHOD: Open-ended questionnaires were sent to all adult patients awaiting cochlear implantation surgery. Qualitative analysis was performed using a grounded theory approach. RESULTS: Participants described a primarily negative impact on wellbeing from the surgery delay, expressing feelings of isolation or loneliness. Low mood, depression or hopelessness were commonly expressed by elderly participants; frustration and anxiety were described by young adults. Participants described a negative impact on their general daily life, describing difficulties communicating with facemasks and struggles with reliance on telephone communication because of social distancing. Despite these significant psychosocial challenges, only a minority described adaptive coping strategies. DISCUSSION: Profoundly deaf patients may be at greater psychosocial risk because of unique challenges from their hearing disability. Our findings can be used to develop evidence-driven strategies to improve communication, wellbeing and quality of life.


Subject(s)
COVID-19/psychology , Cochlear Implantation/methods , Cochlear Implants/statistics & numerical data , Deafness/surgery , Time-to-Treatment/statistics & numerical data , Adult , Aged , Anxiety/epidemiology , Anxiety/psychology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Cochlear Implants/supply & distribution , Communication , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Elective Surgical Procedures/standards , Female , Frustration , Humans , Loneliness/psychology , Male , Middle Aged , Physical Distancing , Qualitative Research , Quality of Life/psychology , SARS-CoV-2/genetics , Surveys and Questionnaires/statistics & numerical data , Young Adult
10.
BMJ Case Rep ; 14(8)2021 Aug 25.
Article in English | MEDLINE | ID: covidwho-1373952

ABSTRACT

We present a case of a 7-year-old Afro-Caribbean girl presenting with rapidly progressive bilateral sensorineural hearing loss. She was found to have an elevated Angiotensin converting enzyme (ACE) and mediastinal lymphadenopathy containing non-caseating granulomas with multinucleate giant cells, in keeping with sarcoidosis. Cranial imaging demonstrated labyrinthitis. She underwent urgent bilateral cochlear implantation with rehabilitation of hearing sufficient to restart education within 1 month.


Subject(s)
Cochlear Implantation , Hearing Loss, Sensorineural , Labyrinthitis , Sarcoidosis , Child , Female , Hearing Loss, Bilateral/etiology , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/etiology , Hearing Loss, Sensorineural/surgery , Humans , Sarcoidosis/complications , Sarcoidosis/diagnosis
11.
Otol Neurotol ; 42(9): e1256-e1262, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1315714

ABSTRACT

OBJECTIVE: To evaluate the potential significance of social distancing and quarantine precautions for COVID-19 on speech outcomes, missed appointments, wear time, and exposure to various sound environments in the first 6 months following activation for elderly cochlear implant (CI) recipients. STUDY DESIGN: Retrospective cohort. SETTING: Tertiary private practice. PATIENTS: Fifty cochlear implant recipients ≥65 years were evaluated. A Control Group consisted of 26 patients implanted between November 2, 2018 and February 18, 2019 while the Pandemic Group included 24 patients implanted between November 1, 2019 and February 17, 2020. INTERVENTION: Rehabilitative. MAIN OUTCOME MEASURES: Preoperative and 6-month postoperative AzBio sentence scores in quiet were compared between groups along with the number of missed appointments as well as datalogged information regarding average CI wear time and average hours in various sound environments such as quiet, speech, and speech-in-noise. RESULTS: The Control Group averaged 36.5% improvement for AzBio in quiet scores while the Pandemic Group averaged only 17.2% improvement, a difference that was both statistically and clinically significant (p = 0.04; g = 0.64). Patients in the Pandemic Group were nearly twice as likely to miss CI programming appointments than the Control Group. The Pandemic Group wore their CI 1.2 less hours per day on average, and while the Pandemic Group spent similar times in quiet and speech environments to the Control Group, the Pandemic Group spent less time in speech with presence of background noise. CONCLUSIONS: While social distancing and quarantine measures are crucial to limiting spread of COVID-19, these precautions may have negatively impacted early speech performance for elderly cochlear implant recipients. Missed CI programming appointments, decreased sound processor wear time, and reduced exposure to complex listening environments such as speech in the presence of background noise were more common in the Pandemic Group than in the Control Group operated the year prior.


Subject(s)
COVID-19 , Cochlear Implantation , Cochlear Implants , Speech Perception , Aged , Humans , Pandemics , Retrospective Studies , SARS-CoV-2
12.
Cochlear Implants Int ; 23(1): 43-51, 2022 01.
Article in English | MEDLINE | ID: covidwho-1301303

ABSTRACT

BACKGROUND: Effective information giving and goal setting before cochlear implantation and individualised rehabilitation following implantation are both crucial for shaping patients' expectations and optimising outcomes. The Covid-19 pandemic led to temporary cessation of face to face clinic appointments. This created a need for telehealth rehabilitation for adults whose hearing loss presents unique communication challenges. AIMS: We describe the piloting and implementation of telehealth rehabilitation within an adult cochlear implant service. METHOD: Video conferencing and telehealth tools were assessed in terms of security, accessibility and functionality. Written support materials were developed. Telehealth sessions were piloted with lay volunteers. During service implementation, feedback was collected from patients and staff. OUTCOMES & RESULTS: A video call platform was identified that was supported by the host Trust and also met the rehabilitation service's needs. A telehealth service was successfully implemented, ensuring continuity of care during lockdown. We share the platform selection framework used, practical lessons learned and patient support materials. CONCLUSION: .Telehealth rehabilitation facilitated a well-received, effective service for adult cochlear implant patients. It is predicted that the benefits of telehealth rehabilitation will last beyond the lockdown restrictions posed by Covid-19.


Subject(s)
COVID-19 , Cochlear Implantation , Cochlear Implants , Telemedicine , Adult , Communicable Disease Control , Humans , Pandemics , SARS-CoV-2
13.
Cochlear Implants Int ; 22(6): 353-357, 2021 11.
Article in English | MEDLINE | ID: covidwho-1272924

ABSTRACT

INTRODUCTION: Understanding the clinical manifestations of the coronavirus disease (COVID-19) has become an urgent objective in the research community. Amongst the emerging neurologic complications is sensorineural hearing loss. While several cases of hearing loss amongst COVID-19 patients have been reported, the management of these patients has yet to be discussed and determined. Herein we present cochlear implant outcomes for a patient who suffered from unilateral sensorineural hearing loss after a prolonged hospital course for COVID-19. METHODS: A patient who was hospitalized for COVID-19 for one month and subsequently developed unilateral profound sensorineural hearing loss underwent cochlear implantation for single-sided deafness. His COVID-19 hospital course was reviewed in detail. Speech perception and audiometric assessments were used to evaluate cochlear implant outcomes. RESULTS: After cochlear implantation, the patient demonstrated improved speech perception on the implanted side and decreased tinnitus within 1 month of activation. CONCLUSIONS: Cochlear implantation may be an appropriate intervention for patients who suffer from severe sensorineural hearing loss following infection with COVID-19.


Subject(s)
COVID-19 , Cochlear Implantation , Deafness , Hearing Loss, Unilateral , Deafness/etiology , Deafness/surgery , Hearing Loss, Unilateral/etiology , Hearing Loss, Unilateral/surgery , Hospitalization , Humans , SARS-CoV-2
14.
HNO ; 69(Suppl 2): 92-95, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1237474

ABSTRACT

This article presents a case of sudden bilateral deafness in the context of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection and resultant coronavirus disease 2019 (COVID-19). After treatment in the intensive care unit for acute respiratory distress syndrome and acute kidney failure, hearing ability had drastically changed. While hearing had been subjectively normal before the infection, deafness was now measured on the left and profound hearing loss on the right ear. The patient was treated with cochlea implants on the left and a hearing aid in the right ear. The hearing loss is most likely a complication of COVID-19.


Subject(s)
COVID-19 , Cochlear Implantation , Cochlear Implants , Deafness , Hearing Loss, Sudden , Speech Perception , Deafness/diagnosis , Deafness/surgery , Hearing Loss, Sudden/diagnosis , Hearing Loss, Sudden/etiology , Humans , RNA, Viral , SARS-CoV-2
15.
HNO ; 69(8): 666-670, 2021 Aug.
Article in German | MEDLINE | ID: covidwho-1173882

ABSTRACT

This article presents a case of sudden bilateral deafness in the context of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection and resultant coronavirus disease 2019 (COVID-19). After treatment in the intensive care unit for acute respiratory distress syndrome and acute kidney failure, hearing ability had drastically changed. While hearing had been subjectively normal before the infection, deafness was now measured on the left and profound hearing loss on the right ear. The patient was treated with cochlea implants on the left and a hearing aid in the right ear. The hearing loss is most likely a complication of COVID-19.


Subject(s)
COVID-19 , Cochlear Implantation , Cochlear Implants , Deafness , Hearing Loss, Sudden , Speech Perception , Deafness/surgery , Humans , RNA, Viral , SARS-CoV-2
17.
HNO ; 69(Suppl 1): 1-6, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1130734

ABSTRACT

BACKGROUND: The rehabilitation process following cochlear implant (CI) surgery is carried out in a multimodal therapy according to German national guidelines and includes technical and medical aftercare. In times of the corona pandemic surgery and rehabilitation appointments were cancelled or delayed leading to a more difficult access to auditory rehabilitation. Newly implemented hygiene modalities due to the SARS-CoV­2 pandemic have changed medical aftercare and the rehabilitation process. The aim of this study was to evaluate the quality of rehabilitation under corona conditions. MATERIAL AND METHODS: An anonymous survey of adult cochlear implant patients was carried out by a non-standardized questionnaire. Demographics were analyzed and the quality of medical aftercare, speech therapy, technical aftercare, psychological support and the hygiene modalities were compared to previous rehabilitation stays. RESULTS: In total 109 patients completed the questionnaire. The quality of rehabilitation and individual therapy were rated as qualitatively similar or improved. The threat of the pandemic and fear of corona were rated unexpectedly high with 68% and 50%, respectively. The hygiene measures during the rehabilitation stay eased subjective fears at the same time. The majority of patients were annoyed by wearing face masks but visors, protection shields and social distancing were more tolerated. CONCLUSION: The implementation of the new hygiene modalities within the therapeutic rehabilitation setting was well-accepted by patients allowing access to auditory rehabilitation. A successful rehabilitation should ensure a fear-free environment by adhering to the necessary hygiene modalities.


Subject(s)
COVID-19 , Cochlear Implantation , Cochlear Implants , Adult , Humans , Pandemics , SARS-CoV-2
18.
J Laryngol Otol ; 135(1): 21-27, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1065743

ABSTRACT

OBJECTIVES: To demonstrate the feasibility of continuing cochlear implantation during the coronavirus disease 2019 crisis and to report on trends of referrals via the neonatal hearing screening programme. METHODS: A prospective case series was conducted on children who underwent cochlear implantation during the coronavirus disease 2019 crisis in the UK and a sample of referrals via the neonatal hearing screening programme. A step-by-step description of peri-operative management is included. RESULTS: Regionally, between February and May 2020, 106 babies were referred via the neonatal hearing screening programme to paediatric audiology. Eleven children were operated on during the coronavirus disease 2019 study period. None of the 11 children developed coronavirus symptoms. DISCUSSION: It is widely recognised that the demands of managing the current pandemic may compromise screening, clinical assessment and elective surgery. Time-sensitive issues such as cancer management have gained prominence, but a similar need exists for timely paediatric cochlear implantation. CONCLUSION: Implantation in the paediatric population during the coronavirus disease 2019 pandemic is feasible with careful planning.


Subject(s)
COVID-19 , Cochlear Implantation , Deafness/surgery , Neonatal Screening , Child, Preschool , Cochlear Implantation/statistics & numerical data , Feasibility Studies , Female , Hearing Tests , Humans , Infant , Infant, Newborn , Male , Prospective Studies , Referral and Consultation/trends , United Kingdom
19.
Ear Hear ; 42(1): 20-28, 2021.
Article in English | MEDLINE | ID: covidwho-998492

ABSTRACT

OBJECTIVES: The impact of social distancing on communication and psychosocial variables among individuals with hearing impairment during COVID-19 pandemic. It was our concern that patients who already found themselves socially isolated (Wie et al. 2010) as a result of their hearing loss would be perhaps more susceptible to changes in their communication habits resulting in further social isolation, anxiety, and depression. We wanted to better understand how forced social isolation (as part of COVID-19 mitigation) effected a group of individuals with hearing impairment from an auditory ecology and psychosocial perspective. We hypothesized that the listening environments would be different as a result of social isolation when comparing subject's responses regarding activities and participation before COVID-19 and during the COVID-19 pandemic. This change would lead to an increase in experienced and perceived social isolation, anxiety, and depression. DESIGN: A total of 48 adults with at least 12 months of cochlear implant (CI) experience reported their listening contexts and experiences pre-COVID and during-COVID using Ecological Momentary Assessment (EMA; methodology collecting a respondent's self-reports in their natural environments) through a smartphone-based app, and six paper and pencil questionnaires. The Smartphone app and paper-pencil questionnaires address topics related to their listening environment, social isolation, depression, anxiety, lifestyle and demand, loneliness, and satisfaction with amplification. Data from these two-time points were compared to better understand the effects of social distancing on the CI recipients' communication abilities. RESULTS: EMA demonstrated that during-COVID CI recipients were more likely to stay home or be outdoors. CI recipients reported that they were less likely to stay indoors outside of their home relative to the pre-COVID condition. Social distancing also had a significant effect on the overall signal-to-noise ratio of the environments indicating that the listening environments had better signal-to-noise ratios. CI recipients also reported better speech understanding, less listening effort, less activity limitation due to hearing loss, less social isolation due to hearing loss, and less anxiety due to hearing loss. Retrospective questionnaires indicated that social distancing had a significant effect on the social network size, participant's personal image of themselves, and overall loneliness. CONCLUSIONS: Overall, EMA provided us with a glimpse of the effect that forced social isolation has had on the listening environments and psychosocial perspectives of a select number of CI listeners. CI participants in this study reported that they were spending more time at home in a quieter environments during-COVID. Contrary to our hypothesis, CI recipients overall felt less socially isolated and reported less anxiety resulting from their hearing difficulties during-COVID in comparison to pre-COVID. This, perhaps, implies that having a more controlled environment with fewer speakers provided a more relaxing listening experience.


Subject(s)
COVID-19/prevention & control , Cochlear Implantation , Hearing Loss/psychology , Physical Distancing , Psychosocial Functioning , Signal-To-Noise Ratio , Speech Perception , Adult , Aged , Anxiety/psychology , Cochlear Implants , Deafness/physiopathology , Deafness/psychology , Deafness/rehabilitation , Depression/psychology , Ecological Momentary Assessment , Environment , Female , Hearing Aids , Hearing Loss/physiopathology , Hearing Loss/rehabilitation , Hearing Loss, Bilateral/physiopathology , Hearing Loss, Bilateral/psychology , Hearing Loss, Bilateral/rehabilitation , Hearing Loss, Unilateral/physiopathology , Hearing Loss, Unilateral/psychology , Hearing Loss, Unilateral/rehabilitation , Humans , Male , Middle Aged , Noise , SARS-CoV-2 , Social Isolation/psychology
20.
Cochlear Implants Int ; 22(3): 170-175, 2021 05.
Article in English | MEDLINE | ID: covidwho-960440

ABSTRACT

OBJECTIVE: To assess if a vacuum-assisted closure device initially utilised as a temporising measure to dress a wound defect over a cochlear implant prior to definitive surgical intervention could instead be used to close the soft tissue and avoid surgery. METHOD: This is a case report describing the novel use of VAC (Vacuum-Assisted Closure Device) in the successful closure of a wound defect with cochlear implant hardware exposure post soft tissue infection during the Covid-19 pandemic. RESULTS: While the VAC system was initiated for temporary wound coverage, it was observed at each dressing change to be successfully decreasing the soft tissue defect for our patient. This resulted in complete epithelisation of the soft tissue defect at Day 35 and avoidance of a surgical procedure. The patient was able to restart wearing her device on Day 50 and Cochlear MAPping performed on Day 58 showed minimal changes in patient's current requirements compared to her settings pre-infection. CONCLUSION: The use of V.A.C dressing for a small soft tissue defect over an extruded cochlear implant seems promising as exemplified by our case study. However, due to the lack of literature, more studies should be done to prove its usefulness in such an application.


Subject(s)
Cochlear Implantation/adverse effects , Cochlear Implants/adverse effects , Negative-Pressure Wound Therapy/instrumentation , Prosthesis Failure/adverse effects , Surgical Wound/surgery , Aged , Female , Humans
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