Technical aids for speech understanding in cochlear implanted adults using cell-phones.

OBJECTIVES: The present study sought to assess (1) phone use habits and awareness of listening aids in adult cochlear implant bearers, and (2) objective and subjective benefit of listening aids for cell-phone communication. MATERIAL AND METHODS: A questionnaire was sent to 17 cochlear (Cochlear(®)) implanted adults to assess phone use and awareness of available listening aids. Speech perception without lip-reading was assessed in silence and in noise using Fournier dissyllabic word lists recorded on an iPhone 5C(®), with and without listening aids. Subjective benefit was assessed according to listening aid system. RESULTS: Sixty-five percent of adult cochlear implant bearers regularly used a phone with all kinds of correspondent. Eighty-eight percent phoned only in quiet conditions; 53% did not answer unknown callers; 71% never used listening aids. Speech discrimination scores for disyllabic words recorded on the phone were respectively 69%, 63%, 45% and 16% in quiet and 50, 60 and 70dB SPL noise. Speech perception in quiet and noise was improved by listening aids; the Roger system was the most beneficial, followed by the FM system, then the inductive system. CONCLUSION: Listening aids are effective, but little known by adult cochlear implant bearers.

[Cochlear implants in elderly: performance outcomes in the long term]. / L'implant cochléaire chez le sujet âgé: évolution des performances à long terme.

OBJECTIVES: To study and compare the evolving capacities of speech discrimination with cochlear implants in older patients compared to patients implanted at a younger age. METHODOLOGY: A retrospective study comparing a group of 52 patients aged over 65 with a control group of 58 patients aged between 30 and 50 years, followed for 5 years after implantation. We analyzed and compared the evolution of speech discrimination in silence (disyllabic words, sentences) and noise (sentences, S/N ratio: +10 dB) after implantation. RESULTS: In the group of elderly patients, the speech discrimination in silence remains stable over time (for disyllabic words, score at 6 months: 72.8 +/- 20.2%; score at 5 years: 73.7% +/- 19.7). Discrimination in noise tends to improve (mean score at 6 months: 70.5% +/- 21.5; score at 5 years: 76.9% +/- 16.9). The results obtained are in silence are comparable to the results of the group of patients aged between 30 and 50. In noise, their performance remains lower than the control group (mean differences between scores: -10.8; confidence interval at 95%: -17.9, -5.3). CONCLUSION: The cochlear implant is effective over the long term in elderly patients, for speech discrimination in quiet and in noise. In silence, their performance is comparable to younger patients with implants.

Benefits of cochlear implantation in elderly patients.

Cochlear implantation in elderly patients is a questionable subject. The purpose of this study was to evaluate the procedure and its outcome, the postoperative course, and the audiologic and social benefits of cochlear implantation in this population. Twenty-seven patients older than 60 years were compared with a control group of 15 adult patients. This retrospective study analyzed data concerning the outcome of the procedure, postoperative course, postoperative orthophonic test results, and answers of a questionnaire assessing the changes in communication, perception, and social outcomes. The procedure was uneventful in both groups. Minor complications were not more frequent in elderly patients. Orthophonic test results were comparable in both groups. At 12 months, 83% of the elderly patients had an open-set speech discrimination score above 60%. The benefits of cochlear implantation in terms of the quality of life are not statistically different with younger patients. Cost-utility analysis might support these findings.

[Conservation of residual hearing after cochlear implantation]. / Conservation de l'audition résiduelle après implantation cochléaire.

Indications for cochlear implantation have been expanded to include severely hearing impaired adults and may increase the number of patients presenting with preoperative residual hearing. Conservation of residual hearing may allow better performance with an implant. However, conventional thought is that implantation destroys auditory structures involved in residual hearing. This study was undertaken to assess if there are general or surgical factors intervening in the conservation of residual hearing in a sample of multichannel implant recipients. A retrospective study on 50 adult cochlear recipients with preoperative residual hearing has been undertaken. Sixteen of 50 implanted subjects (32%) were found to have conserved their residual hearing. Among them, seven patients have clinically non-significant changes of hearing. Age, side of implantation, gender and etiology did not influence the outcome of residual hearing. Round window ossification, ossification of the cochlea, length of insertion, approach and site of insertion (scala tympani vs.scala vestibuli) were not found to be statistically significant between the population having lost and the population having conserved residual hearing. This study emphasizes the need to undertake a larger multicenter longitudinal study to determine the existence of factors related to the conservation of residual hearing.

[Cochlear implants in the elderly]. / Implant cochléaire chez le sujet âgé.

The authors present a retrospective and multicenter study of 18 elderly patients aged above 60 years-old who underwent a cochlear implantation by comparing them with a population of adult patients. The purpose of this study is to evaluate the utility and benefits of cochlear implantation in the elderly by analyzing the clinical data and the results of a questionnaire assessing the use of the implant and the consequences of implantation on the quality of life. The results of this study indicate that the improvement of quality of life in the elderly is similar compared to a control group of adult patients.