Subject(s)
Cochlear Implants , Deafness/rehabilitation , Aged , Follow-Up Studies , Functional Laterality/physiology , Humans , Male , Middle Aged , Prosthesis Design , ReoperationABSTRACT
OBJECTIVE: This study aimed to review a single institution's experience with Clarion Multi-Strategy Cochlear Implant with respect to surgical technique, surgical complications, and rehabilitative outcome. STUDY DESIGN: This study was a review of patients implanted with the Clarion Multi-Strategy Cochlear Implant. SETTING: The setting was a tertiary referral center with care delivered in the inpatient and outpatient environment. PATIENTS: The first 37 patients were implanted under an Investigational Device Exemption as part of the Food and Drug Administration (FDA) clinical trial of the Clarion implant. Subsequent patients were implanted after the device received FDA approval. Patients met the following criteria for implantation: 18 years of age or older, psychological and emotional stability, profound postlingual deafness without evidence of middle ear disease, one cochlea at least partially patent, and marginal or no benefit from conventional hearing aids. INTERVENTION: Patients received implantation with the Clarion Multi-Strategy Cochlear Implant. MAIN OUTCOME MEASURES: Measured were presence or absence of surgical complications and auditory performance with open- and closed-set word and sentence recognition testing. RESULTS: A total of 47 patients have been implanted. Three patients have suffered complications: two cases of delayed-onset facial palsy both resolved with steroid therapy and one case of internal cochlear stimulator migration required refixation. Significant improvement in speech understanding has been seen in the majority of patients who were implanted within the first 6 months of device use. Specifically, at 6 months, scores on CID (Central Institute for the Deaf) sentences (implant alone) improved from a preoperative mean of 9% to a mean of 72%, and scores on the NU-6 (Northwestern University) monosyllabic word test increased from a preoperative mean of 3% (range, 0-20%) to a mean of 32% (range, 0-70%). More than two thirds (68%) of the adults were able to understand at least 50% of sentences over the telephone, and half were able to understand at least 75% of the sentence material. CONCLUSIONS: The authors' institutional experience with the Clarion Multi-Strategy Cochlear Implant shows minimal surgical morbidity and significant improvement on all open-set test measures of sentence and word recognition.
Subject(s)
Cochlear Implantation , Facial Paralysis/etiology , Hearing Loss, Sensorineural/rehabilitation , Postoperative Complications , Adult , Aged , Aged, 80 and over , Anti-Inflammatory Agents/therapeutic use , Facial Paralysis/drug therapy , Female , Humans , Longitudinal Studies , Male , Middle Aged , Postoperative Complications/drug therapy , Steroids , Treatment OutcomeABSTRACT
A model of auditory performance and a model of ganglion cell survival in postlinguistically deafened adult cochlear implant users are suggested to describe the effects of aetiology, duration of deafness, age at implantation, age at onset of deafness, and duration of implant use. The models were compared with published data and a composite data set including 808 implant users. Qualitative agreement with the model of auditory performance was found. Duration of deafness had a strong negative effect on performance. Age at implantation had a slight negative effect on performance, increasing after age 60 years. Age at onset of deafness had little effect on performance up to age 60. Duration of implant use had a positive effect on performance. Aetiology had a relatively weak effect on performance.
Subject(s)
Cochlear Implants , Deafness/rehabilitation , Neuronal Plasticity/physiology , Speech Perception/physiology , Adolescent , Adult , Age Factors , Aged , Cell Survival/physiology , Child , Child, Preschool , Deafness/etiology , Deafness/physiopathology , Female , Humans , Infant , Male , Middle Aged , Nerve Degeneration/physiopathology , Prognosis , Spiral Ganglion/physiopathology , Vestibulocochlear Nerve/physiopathologyABSTRACT
A study was carried out to compare the consonant perceptions of five Nucleus multichannel cochlear implant users, five Clarion-CIS users, and four Clarion-CA users. All subjects were administered the Iowa Medical Consonant Recognition Test in the auditory-only condition. The groups averaged approximately 1 year of implant use at the time of testing, and the average age at implantation was 47 years for the Nucleus users, 60 years for the Clarion-CIS users, and 56 years for the Clarion-CA users. The percent-corrected scores for all three devices were variable and ranged from 34% to 84%, with each group averaging about 50% correct consonant recognition. Consonant feature information transmission was calculated for five features: manner of articulation, nasality, place of articulation, duration, and voicing. The highest information transmission in the Nucleus group was for the features of duration (71%), nasality (60%), and voicing (57%), which agrees with previous studies. The Clarion-CIS group had the highest information transmission for duration, place of articulation, manner of articulation, and nasality (50%, 29%, 28%, and 27%). The Clarion-CA group had the highest information transmission for the features voicing, place of articulation, and duration (41%, 40%, and 37%). This study indicates that the Clarion device may carry some acoustic information related to place of articulation, a feature that has not been found to be encoded well by other multichannel cochlear implants.
