Awareness of Hearing Loss in Older Adults: Results of a Survey Conducted in 500 Subjects Across 5 European Countries as a Basis for an Online Awareness Campaign.

The objectives of this study were to assess the factors which contribute to individuals' health motivation to address hearing loss and to gather baseline data that could then be used to measure the impact of an awareness campaign. An online questionnaire with 13 closed set questions was completed by 100 subjects in each country including Austria, Germany, France, Sweden, and the United Kingdom. The questionnaire was based around the Health Belief Model, which describes how, in order to take action to address a medical problem, the individual must perceive that the condition presents a threat to their well-being that exceeds any barriers to treatment. Good hearing was regarded as being important in all countries. There was agreement that the main sign of hearing loss was turning up the TV or radio. In most countries, hearing aids were thought to be not particularly visible, not require much maintenance, a hindrance while doing sport, and must be removed before bed. Perceptions of hearing implants were that they were permanently fitted, not externally visible, and do not need to be removed before bed. Medical issues were mostly researched through a doctor and then via the Internet. In this sample, there was a good understanding of the consequences and signs of hearing loss, but although hearing implants were viewed as being different to hearing aids, there was little understanding that the external speech processor was similar to a hearing aid in its physical characteristics. When actions were taken, the key professionals consulted about hearing problems were the general practitioner and ear, nose, and throat specialist.

Can a Digital Awareness Campaign Change Knowledge and Beliefs Regarding Cochlear Implants? A Study in Older Adults in 5 European Countries.

There are 466 million people living with a disabling hearing loss and the challenges of managing this public health crisis cannot be underestimated. Yet, adult utilization of cochlear implants is poor with less than 10% of suitable candidates receiving one. The aim of this study was to investigate the awareness levels regarding cochlear implants in older adults after a digital campaign to raise awareness of cochlear implantation in this population. To address the lack of awareness of the cochlear implants in the general population, adverts were placed in online medical magazines and mainstream newspapers. Data were collected in 400 subjects via an online market research questionnaire, in Germany, Austria, Sweden, and the United Kingdom, and compared with baseline data collected in a previous study. Median click rates were in line with expectations for the medical industry and approximately 22 000 individuals clicked through to the cochlear implant Web site. However, there were few significant differences between the 2 sets of data. The Internet was consulted as much as the doctor for medical information in Germany, Austria, and Sweden. The study reinforces the importance of the Internet in accessing information about health, including hearing loss. The click through rates shows that there is interest in learning about cochlear implants. Further work is needed to assess the impact of this type of campaign on individuals who have already been identified as hearing impaired.

The knowledge and beliefs regarding practical aspects of cochlear implants: A study of otorhinolaryngologists in a secondary setting in a multi-country study.

OBJECTIVE: The main goal of this study was to determine the knowledge and beliefs of otorhinolaryngologists in a secondary setting in selected economically advanced European countries concerning severe hearing loss, hearing aids, and cochlear implants (CIs). Secondary goals of the study looked into the information sources of the otorhinolaryngologists and into key topics of importance for these professionals. In Europe, many adults, who could benefit from a CI, do not have one despite their availability via national health care systems. This lack of coverage might be due, in part, to the knowledge and beliefs of otorhinolaryngologists. METHODS: Otorhinolaryngologists in a secondary setting in Germany, England, France, Austria, and Sweden were emailed a custom-made questionnaire on their knowledge and beliefs regarding hearing loss and its treatments. Results were presented in relative frequencies (%) according to each nation. RESULTS: Two-hundred and forty otorhinolaryngologists responded (50 from each nation except Sweden). Each nation regarded rehabilitation and hearing preservation as particularly important in CIs. National and international conferences and conversations with colleagues were much more popular methods of keeping abreast of medical issues than other information sources such as online media or company information. CONCLUSION: The otorhinolaryngologists of the surveyed nations share many common beliefs about hearing loss, hearing aids, and CIs, although some national variation in opinion is present. The otorhinolaryngologists of each nation are knowledgeable, but could still benefit from an increased knowledge and awareness of hearing loss treatment modalities.

Long-term data on children implanted with a short electrode array.

Ossification and cochlear malformations are no longer seen as a contra-indication to cochlear implantation. The MED-EL COMBI 40+ short electrode was designed specifically for cases where major ossification has occurred, or where full insertion of an electrode may not be possible due to abnormal structure of the cochlea. This study investigates outcomes of 18 children implanted with the short electrode array. These children were assessed using the EARS test battery pre-operatively and at a number of intervals thereafter. Results show a consistent improvement in time on most tests; these results appear to be independent of aetiology. Data from these children were compared to 18 matched pairs implanted with the standard COMBI 40+ electrode array. The short electrode children do not perform as well as the standard children initially, but do tend to catch-up at later test intervals. Results indicate the benefit of using a short electrode when complete insertion of the standard electrode is not viable.

Cochlear implantation in children under the age of two--what do the outcomes show us?

OBJECTIVES: Literature that discusses the benefits of cochlear implantation (CI) in children under the age of two is limited. Previous concerns about surgical risk have been raised and addressed; however, actual benefit in terms of outcomes needs to be clearly defined. This study evaluates outcomes of children implanted under the age of two and compares them to children implanted at a later age. METHODS: Data were reviewed from the MED-EL International Children's study database. Thirty-seven children enrolled in the study have received cochlear implants before the age of two. Outcomes were assessed using the LiP and MTP tests and the MAIS and MUSS questionnaires pre-operatively and then at initial fitting, 1, 3, 6 and 12 months after first fitting and then annually thereafter. RESULTS: Statistical analysis demonstrated that these children's scores improved significantly over time. Improvement was shown to occur at a quicker rate than for children implanted at an older age with the MTP and MUSS, but not with the LiP and the MAIS. Scores may be limited by sample size and the fact that children reached ceiling on some tests. CONCLUSIONS: Results suggest a distinct advantage early implantation may have for severe to profoundly hearing impaired children. This may be particularly the case for skills necessary for development of receptive and expressive language skills.

Multicenter U.S. bilateral MED-EL cochlear implantation study: speech perception over the first year of use.

OBJECTIVE: Binaural hearing has been shown to support better speech perception in normal-hearing listeners than can be achieved with monaural stimulus presentation, particularly under noisy listening conditions. The purpose of this study was to evaluate whether bilateral electrical stimulation could confer similar benefits for cochlear implant listeners. DESIGN: A total of 26 postlingually deafened adult patients with short duration of deafness were implanted at five centers and followed up for 1 yr. Subjects received MED-EL COMBI 40+ devices bilaterally; in all but one case, implantation was performed in a single-stage surgery. Speech perception testing included CNC words in quiet and CUNY sentences in noise. Target speech was presented at the midline (0 degrees), and masking noise, when present, was presented at one of three simulated source locations along the azimuth (-90, 0, and +90 degrees). RESULTS: Benefits of bilateral electrical stimulation were observed under conditions in which the speech and masker were spatially coincident and conditions in which they were spatially separated. Both the "head shadow" and "summation" effects were evident from the outset. Benefits consistent with "binaural squelch" were not reliably observed until 1 yr after implantation. CONCLUSIONS: These results support a growing consensus that bilateral implantation provides functional benefits beyond those of unilateral implantation. Longitudinal data suggest that some aspects of binaural processing continue to develop up to 1 yr after implantation. The squelch effect, often reported as absent or rare in previous studies of bilateral cochlear implantation, was present for most subjects at the 1 yr measurement interval.

Opinions on cochlear implant use in senior MED-EL patients.

This study assessed the subjective benefits of cochlear implants in senior patients wearing a MED-EL device. Data was compared with previous studies to assess the influence of recent speech-coding strategies and behind-the-ear speech processors; users of the behind-the-ear device and the body-worn device were also compared. An adaptation of the Nucleus 22-channel survey was sent to 141 cochlear implant users. The survey assesses perception of the device, communication benefits, handling the device and quality of life. Ninety-five surveys were returned. Results demonstrate that advanced technology provides greater benefit now than 9-13 years ago, notably: improved listening across noise, better understanding on the telephone and better speech perception. Users of the behind-the-ear device did not report more difficulties than body-worn device users but demonstrated better performance. Results show a positive outcome for cochlear implantation in a MED-EL seniors group.