Contralateral hearing aid use in adult cochlear implant recipients: retrospective analysis of auditory outcomes.

OBJECTIVE: To investigate retrospectively the frequency of usage of bimodal stimulation among cochlear implant (CI) users, as well its clinical benefit relative to unilateral use. DESIGN: All subjects had been monitored with the clinical Minimal Outcome Measurements test battery. STUDY SAMPLES: 103 adults with bilateral postlingual profound sensorineural hearing loss and unilateral CI use were extracted from the local database. These were divided into two groups: those who only used a CI and those who used bimodal stimulation. RESULTS: The preoperative contralateral residual hearing in the bimodal group was significantly better than that of the CI-only group. In both groups, speech perception in quiet and in noise improved after CI, with no significant difference between postoperative unimodal conditions. For the bimodal group, an additional significant improvement was found for the bimodal condition compared to the unimodal. CONCLUSION: Given the observed auditory benefit of bimodal stimulation in comparison to unimodal stimulation and given the finding that degree of residual hearing is not correlated with bimodal benefits, it is recommended to encourage CI recipients to continue contralateral HA use after CI. As a result of expanding CI criteria worldwide, the population of bimodal users is expected to grow in the near future.

Improved speech reception and sound quality with the DUET2 audio processor for electric acoustic stimulation.

CONCLUSION: The results show that the DUET2 offers users speech perception that is equivalent to or better than the DUET. Moreover, the DUET2 offers subjective benefits above those provided by the DUET. BACKGROUND: The DUET is a combination of hearing aid and CI in one device for electric acoustic stimulation. Since its introduction: a second generation, the DUET2, has been developed. This study aimed to investigate the benefits of the DUET2 compared to the DUET. METHODS: Speech reception was determined in quiet and in noise. The sound quality of speech and music was rated using a visual analogue scale. Test intervals were at upgrade and at 3 and 6 months after upgrade. RESULTS: Speech reception in quiet and in noise was significantly better than with the DUET after 6 months. For sentence reception in quiet, the SRT with the DUET2 did not change significantly between test intervals. Sentence reception in noise with the DUET2 improved significantly between 3 and 6 months and upgrade and 6 months. After 6 months, speech reception in quiet and in noise with the DUET2 was significantly better than with the DUET. Subjects rated the sound quality of speech and of music with the DUET2 significantly better than with the DUET.

Long-term follow-up of hearing preservation in electric-acoustic stimulation patients.

BACKGROUND: Hearing preservation (HP) surgery was initiated more than 10 years ago for combined electric and acoustic stimulation (EAS). Preserved residual low-frequency hearing has been demonstrated to improve speech perception in noise as well as music appreciation in EAS users up to 2 years. Multiple study groups aimed to evaluate initial loss of residual hearing (RH) as a consequence of HP surgery. However, after 1 year and 2 years of follow-up, further decline was reported. This study aimed to determine RH, speech perception, and the subjective benefits of EAS 10 years after HP surgery. SUBJECTS AND METHODS: Nine postlingual EAS partially deaf patients who underwent HP surgery at Antwerp University Hospital were included in this study (11 implanted ears). Hearing preservation (0% = loss of hearing; >0%-25% = minimal HP; >25%-75% = partial HP; >75% = complete HP), speech perception and subjective benefits were evaluated preoperatively; at 3, 6, 12, 18, and 24 months postoperatively; and annually thereafter. RESULTS: Complete HP was obtained in three of 11 ears; partial HP in five of 11 ears; and minimal HP in two of 11 ears, measured during their most recent follow-up. One subject lost his RH completely across time. The mean rate of HP was 48% (ranging from 6 months up to 10 years postoperatively). Speech perception analysis up to 10 years showed a continuous statistically significant improvement. The maximum subjective benefit was reached 3 months after implantation and subsequently remained statistically significant unchanged for the next 10 years. CONCLUSION: Long-term HP in EAS users after HP surgery is feasible, although a small continuous decline of HP rate of 3% per year was observed (measured from first fitting up to 6 years postoperative). Nevertheless, a continuous improvement was found in the speech perception results of the EAS users across 10 years. Moreover, the positive subjective benefit, assessed 3 months postoperative, remained stable up to 10 years.

Quality-of-life benefit from cochlear implantation in the elderly.

OBJECTIVE: To compare the audiologic results of geriatric patients receiving cochlear implants with younger age groups and to evaluate the quality of life after cochlear implantation in the geriatric population by means of validated quality-of-life questionnaires. STUDY DESIGN: Cross-sectional study involving 89 postlingually deafened cochlear implant subjects. SETTING: Tertiary referral center. PATIENTS: A total of 89 postlingually deafened patients were included in the study, among which were 25 patients who were aged 70 years or older. INTERVENTIONS: All patients received a cochlear implant. Subjects were implanted with either the Laura, Nucleus 24, or Med-el Combi 40+ cochlear implant systems implementing the SPEAK, ACE, CIS, or CIS+ coding strategies. MEAN OUTCOME MEASURES: Speech recognition was determined by means of phonetically balanced monosyllabic word lists. The Hearing Handicap Inventory for Adults, the Glasgow Benefit Inventory, and the scale for the prediction of hearing disability in sensorineural hearing loss were used to quantify the quality of life. RESULTS: Mean audiologic performance for the three groups increased significantly after implantation (p < 0.001). Postoperative audiologic performance of the geriatric population led to useful hearing, but these scores were significantly lower than for the younger age groups (p = 0.002). However, the quality-of-life outcomes for the geriatric group were similar to those of the younger age groups (p = 0.411 for the Hearing Handicap Inventory for Adults; p = 0.886 for the Glasgow Benefit Inventory). CONCLUSION: The results of this study prove that cochlear implantation in the elderly provides improvements in quality of life and speech understanding, similar to those for younger adult cochlear implant recipients.

Bilateral cochlear implantation in children.

AIMS: to determine the benefit of bilateral cochlear implantation in a child on speech and language development. METHOD: This child got her first implant, a Nucleus 24-system, on the right side at the age of 2.5 years. The left side was implanted at the age of 4.4 years with a Nucleus 24Contour-system. On the right side she's now wearing an Esprit 24-speechprocessor (SPR). On the left side she has a Sprint-SPR. M. goes to a mainstream school and receives Speech and Language therapy in a Speech and Hearing Rehab Centre. The etiology of her deafness was hyperbilirubinemia. Auditory capacity and speech recognition tests were performed for both ears separately and together. RESULTS: Aided thresholds give a PTA of 28 dBA with the first implant, 22 dBA with the second implant and with both implants we get a PTA of 23 dBA. Results for speech identification and recognition demonstrated an increased performance when both implants are used together. Speech and language development was equivalent to the mean of age 4.5. At the time of testing M. was 4.8 years. At this time the speech and language development show no delays with normal hearing children. CONCLUSIONS: bilateral cochlear implantation in children may have additional value for their speech and language development. Also, implantation may be considered when auditory neuropathy is likely.