Quality of life in adult cochlear implant users. / Qualidade de vida em adultos usuários de implante coclear.

Objective To evaluate the quality of life (QOL) of adult cochlear implant users (CI) and compare it with the QOL of adults with normal hearing; and study the influence of the variables socioeconomic status, education, age at assessment, auditory sensory deprivation time, device usage time and performance in auditory speech perception tests in the QOL of adult cochlear implant users. Design The QOL was assessed using the World Health Organization Quality of Life (WHOQOL-BREF) generic assessment questionnaire. Study sample Seventy adult CI users formed the experimental group (EG) and 50 adults with normal hearing formed the control group (CG). Results The EG scores were close to the maximum score in satisfactory quality of life for all domains of the WHOQOL-BREF and there were similar results between the EG and CG. The variables age at assessment, duration of auditory sensory deprivation, duration of CI use and performance in auditory speech perception did not influence the results of the QOL of adult cochlear implant users. Conclusion Evaluating the QOL should be a concern of interdisciplinary teams in CI for an intervention with humanized care.

Qualidade de vida em adultos usuários de implante coclear / Quality of life in adult cochlear implant users

RESUMO Objetivo Avaliar a qualidade de vida (QV) de adultos usuários de implante coclear (IC), comparando-a com a QV de adultos com audição normal, além de estudar a influência, na QV dos adultos usuários de IC, destas variáveis: nível socioeconômico, escolaridade, idade na avaliação, tempo de privação sensorial auditiva, tempo de uso do dispositivo e desempenho nos testes de percepção auditiva da fala. Desenho A QV foi avaliada segundo o questionário genérico de avaliação World Health Organization Quality of Life (WHOQOL-bref). Amostra do estudo Setenta adultos usuários de IC formaram o grupo experimental (GE) e 50 adultos com audição normal fizeram parte do grupo controle (GC). Resultados O GE apresentou escores muito próximos à pontuação máxima que representa QV satisfatória para todos os domínios do questionário WHOQOL-bref e houve resultados semelhantes entre os GE e GC. Na avaliação, as variáveis idade, tempo de privação sensorial auditiva, tempo de uso do IC e desempenho em percepção auditiva da fala não influenciaram os resultados de QV de adultos usuários de IC. Conclusão Avaliar a QV deve ser uma preocupação das equipes interdisciplinares em IC para uma intervenção com um cuidado humanizado.

ABSTRACT Objective To evaluate the quality of life (QOL) of adult cochlear implant users (CI) and compare it with the QOL of adults with normal hearing; and study the influence of the variables socioeconomic status, education, age at assessment, auditory sensory deprivation time, device usage time and performance in auditory speech perception tests in the QOL of adult cochlear implant users. Design The QOL was assessed using the World Health Organization Quality of Life (WHOQOL-BREF) generic assessment questionnaire. Study sample Seventy adult CI users formed the experimental group (EG) and 50 adults with normal hearing formed the control group (CG). Results The EG scores were close to the maximum score in satisfactory quality of life for all domains of the WHOQOL-BREF and there were similar results between the EG and CG. The variables age at assessment, duration of auditory sensory deprivation, duration of CI use and performance in auditory speech perception did not influence the results of the QOL of adult cochlear implant users. Conclusion Evaluating the QOL should be a concern of interdisciplinary teams in CI for an intervention with humanized care.

Assessment of telephone speech perception in individuals who received cochlear implant in the period 1993-2003 / Avaliacao da percepcao de fala ao telefone em individuos que receberam o implante coclear no periodo de 1993 a 2003

OBJECTIVE: To evaluate telephone speech perception in individuals who received cochlear implant in the period 1993-2003. METHODS: Twenty seven CI users were divided into pre and post-lingual groups, being the speech perception assessed in two stages: first by a list of sentences imposed on speakerphone with the same mapping used to evaluate the phone and, in a second stage, using the landline, landline phone adapter with CI and cell phone. RESULTS: In the group of pre-lingual hearing loss, 75% of subjects were able to maintain a dialogue with the interlocutor and 19% did so with difficulty. In the post-lingual group, 89% were able to maintain the dialogue with the interlocutor and 11% did so with difficulty. Both groups of subjects pre and post-lingual use the phone as a media, and most have satisfactory performance without the need for aid or CI accessories. CONCLUSION: One of the benefits of the CI is to introduce the life of the hearing impaired phone use regardless of their technology and accessories, as well as with the phone adapter and cell phone. In this study, most individuals CI users showed satisfactory performance in the comprehension of sentence and questions by the telephone, with better performance, although discrete, for the group post-lingual. Thus, there is the importance of careful indication of the IC and auditory rehabilitation program that minimize the impact of deafness in the communication, especially via telephone, regardless of the time when the hearing was acquired. So, this fact improves the conditions for CI users to maintain their daily activities, following the dynamism of contemporary life. .

OBJETIVO: Avaliar a percepção de fala ao telefone em indivíduos que receberam o implante coclear multicanal no período de 1993 a 2003. MÉTODOS: Vinte e sete usuários de IC foram divididos em grupos pré e pós-lingual, sendo que a percepção de fala foi avaliada em dois momentos: primeiramente por uma lista de sentenças aplicada a viva-voz com o mesmo mapeamento utilizado na avaliação ao telefone e, em um segundo, utilizando-se o telefone fixo, telefone fixo com adaptador para IC e telefone celular. RESULTADOS: No grupo de deficiência auditiva pré-lingual, 75% dos indivíduos foram capazes de manter o diálogo com o interlocutor e 19% o fizeram com dificuldade. Já no pós-lingual, 89% foram capazes de manter o diálogo com o interlocutor e 11% o fizeram com dificuldade. Tanto os indivíduos dos grupos pré quanto os do pós-lingual utilizam o telefone como meio de comunicação, e a maioria apresenta desempenho satisfatório sem a necessidade de auxílio ou acessórios do IC. CONCLUSÃO: Um dos benefícios do IC é introduzir na vida do deficiente auditivo o uso do telefone independente de sua tecnologia e acessórios, bem como o telefone com adaptador e o celular. Neste estudo, a maioria dos indivíduos usuários de IC apresentou desempenho satisfatório de compreensão de sentenças e perguntas ao telefone, com melhor desempenho, apesar de discreto, do grupo pós-lingual. Desta forma, verifica-se a importância da indicação criteriosa do IC e do programa de reabilitação auditiva, que minimizam os prejuízos da surdez na comunicação, principalmente via telefone, independente do momento no qual a deficiência auditiva foi adquirida. Assim, melhoram-se as condições para os usuários de IC manterem suas atividades ...

Assessment of telephone speech perception in individuals who received cochlear implant in the period 1993-2003.

OBJECTIVE: To evaluate telephone speech perception in individuals who received cochlear implant in the period 1993-2003. METHODS: Twenty seven CI users were divided into pre and post-lingual groups, being the speech perception assessed in two stages: first by a list of sentences imposed on speakerphone with the same mapping used to evaluate the phone and, in a second stage, using the landline, landline phone adapter with CI and cell phone. RESULTS: In the group of pre-lingual hearing loss, 75% of subjects were able to maintain a dialogue with the interlocutor and 19% did so with difficulty. In the post-lingual group, 89% were able to maintain the dialogue with the interlocutor and 11% did so with difficulty. Both groups of subjects pre and post-lingual use the phone as a media, and most have satisfactory performance without the need for aid or CI accessories. CONCLUSION: One of the benefits of the CI is to introduce the life of the hearing impaired phone use regardless of their technology and accessories, as well as with the phone adapter and cell phone. In this study, most individuals CI users showed satisfactory performance in the comprehension of sentence and questions by the telephone, with better performance, although discrete, for the group post-lingual. Thus, there is the importance of careful indication of the IC and auditory rehabilitation program that minimize the impact of deafness in the communication, especially via telephone, regardless of the time when the hearing was acquired. So, this fact improves the conditions for CI users to maintain their daily activities, following the dynamism of contemporary life.

Speech perception and cortical auditory evoked potentials in cochlear implant users with auditory neuropathy spectrum disorders.

OBJECTIVE: To characterize the P(1) component of long latency auditory evoked potentials (LLAEPs) in cochlear implant users with auditory neuropathy spectrum disorder (ANSD) and determine firstly whether they correlate with speech perception performance and secondly whether they correlate with other variables related to cochlear implant use. METHODS: This study was conducted at the Center for Audiological Research at the University of São Paulo. The sample included 14 pediatric (4-11 years of age) cochlear implant users with ANSD, of both sexes, with profound prelingual hearing loss. Patients with hypoplasia or agenesis of the auditory nerve were excluded from the study. LLAEPs produced in response to speech stimuli were recorded using a Smart EP USB Jr. system. The subjects' speech perception was evaluated using tests 5 and 6 of the Glendonald Auditory Screening Procedure (GASP). RESULTS: The P(1) component was detected in 12/14 (85.7%) children with ANSD. Latency of the P(1) component correlated with duration of sensorial hearing deprivation (*p=0.007, r=0.7278), but not with duration of cochlear implant use. An analysis of groups assigned according to GASP performance (k-means clustering) revealed that aspects of prior central auditory system development reflected in the P(1) component are related to behavioral auditory skills. CONCLUSIONS: In children with ANSD using cochlear implants, the P(1) component can serve as a marker of central auditory cortical development and a predictor of the implanted child's speech perception performance.

Habilidades de ordenação temporal em usuários de implante coclear multicanal / Temporal organization skills in cochlear implants recipients

O processamento das pistas acústicas dos sons da fala depende da adequada percepção da freqüência e da duração dos estímulos enquanto seqüência de eventos. OBJETIVO: Avaliar as habilidades de ordenação temporal em usuários de IC multicanal. MÉTODO: 14 indivíduos com audição normal, formadores do grupo controle equiparados em idade e gênero com 14 usuários de IC, que formaram o grupo experimental, foram avaliados e comparados quanto ao Teste de Padrões de Freqüência (TPF) e Teste de Padrões de Duração (TPD). RESULTADOS: Os usuários de IC apresentaram bom desempenho nas tarefas de ordenação temporal, com resultados médios de 48,7 por cento no TPF e 59,6 por cento no TPD. Para o grupo controle, o desempenho médio no TPF foi de 63,4 por cento e no TPD de 64,6 por cento. Não foi obtida diferença significativa estatisticamente entre os resultados dos grupos controle e experimental. CONCLUSÃO: O IC proporcionou desempenho favorável nas tarefas que exigem habilidades de ordenação temporal para os indivíduos avaliados neste estudo.

Processing acoustic clues from the sounds of speech depends on the proper perception of the frequency and duration of stimuli as a sequence of events. AIM: To assess the capacity for temporal organization in users of multichannel CI. METHOD: 14 normal hearing individuals formed the control group, matching in age and gender other 14 users of multichannel CI, who made up the study group, and they were assessed and compared as to the Frequency Patterns Test (FPT) and Duration Patterns Test (DPT). RESULTS: CI users had good performance in temporal organization tasks, with mean results of 48.7 percent in the FPT and 59.6 percent in the DPT. For the control group, mean performance at the FPT was of 63.4 percent and in the DPT of 64.6 percent. We did not see statistically significant difference between the results from the control and study groups. CONCLUSION: the CI provided favorable performance in the tasks that required temporal organization skill for individuals evaluated in this study.

Temporal organization skills in cochlear implants recipients.

UNLABELLED: Processing acoustic clues from the sounds of speech depends on the proper perception of the frequency and duration of stimuli as a sequence of events. AIM: To assess the capacity for temporal organization in users of multichannel CI. METHOD: 14 normal hearing individuals formed the control group, matching in age and gender other 14 users of multichannel CI, who made up the study group, and they were assessed and compared as to the Frequency Patterns Test (FPT) and Duration Patterns Test (DPT). RESULTS: CI users had good performance in temporal organization tasks, with mean results of 48.7% in the FPT and 59.6% in the DPT. For the control group, mean performance at the FPT was of 63.4% and in the DPT of 64.6%. We did not see statistically significant difference between the results from the control and study groups. CONCLUSION: The CI provided favorable performance in the tasks that required temporal organization skill for individuals evaluated in this study.

[Oral language of children with five years of experience using [corrected] cochlear implant]. / Linguagem oral de crianças com cinco anos de uso do implante coclear.

BACKGROUND: Cochlear implant (CI) in children. AIM: 1) to delineate a profile of receptive and expressive verbal language of children who have been using cochlear implant for five years and five years and eleven months; 2) to verify the influence of time of auditory sensorial privation in the receptive and expressive verbal language of these children. METHOD: 19 children users of CI with auditory deficiency acquired before language development, who have been using CI for 5y - 5y11m and who have an average time of sensorial privation of 3y (standard deviation of 1 year). These children were assessed using the Reynell Developmental Scales (RDLS) (Reynell e Gruber, 1990) which is composed of: Comprehension Scale (C), Expression Scale (E) and its Structure Sub-Scales (Es), Vocabulary (Ev) and Content (Ec). RESULTS: The median values and the values found for quartile 75 and quartile 25 were: .44, 57 and 54 for C; 48, 60 and 55 for E; 20, 21 and 20 for Es; 15, 19 and 17 for Ev; 15, 22 and 18 for Ec; 96, 116 and 108 for the total score. A statistical correlation between the time of sensorial privation and the score obtained for C (p=- 0.62; R=0.0044) and Ec (p=-0.48; R=0.0348) was observed. Therefore the time of sensorial privation had an influence on the overall score (p=- 0.53; R=0.0174). CONCLUSION: The language profile of children who use CI for five years is devious and similar to that of five year old hearing children regarding Expression and to that of four year old hearing regarding Comprehension; time of sensorial privation was statistically significant for the score obtained in C--receptive language--and for the score obtained in the E section (Ec)--expressive language, as well as in the overall score of RDLS.

Linguagem oral de crianças com cinco anos de uso do implante coclear / Oral language of children with five years of experience using cochlear implant

TEMA: implante coclear (IC) em crianças. Objetivo: traçar um perfil de linguagem oral receptiva e expressiva de crianças usuárias de implante coclear há cinco anos a cinco anos e onze meses; verificar a influência do tempo de privação sensorial na linguagem oral receptiva e expressiva dessas crianças. MÉTODO: 19 crianças deficientes auditivas usuárias de IC com deficiência auditiva pré-lingual, com tempo de uso do IC variando de 5a a 5a11m e média do tempo de privação sensorial de 3a (desvio padrão um ano) foram avaliadas por meio da Reynell Developmental Language Scales (RDLS) (Reynell e Gruber, 1990) que é composta pela Escala de Compreensão (C), Escala de Expressão (E) e suas Sub-Escalas Estrutura (Ee), Vocabulário (Ev) e Conteúdo (Ec). RESULTADOS: a mediana e os valores do quartil 75 e quartil 25 encontrados foram: 44, 57 e 54 para C; 48, 60 e 55 para E; 20, 21 e 20 para Ee; 15, 19 e 17 para Ev; 15, 22 e 18 para Ec; 96, 116 e 108 para a pontuação total. Houve correlação estatística entre o tempo de privação sensorial e a pontuação de C (p = - 0,62; R = 0,0044) e Ec (p = - 0,48; R = 0,0348) tornando o tempo de privação influente na pontuação total (p = - 0,53; R = 0,0174). CONCLUSÃO: o perfil de linguagem das crianças usuárias de implante coclear há cinco anos é desviante e semelhante ao perfil das crianças ouvintes de cinco anos para a Expressão e ao das crianças ouvintes de quatro anos para a Compreensão; a influência do tempo de privação sensorial foi estatisticamente significante na pontuação da C - linguagem receptiva - e na pontuação de uma seção (Ec) da E - linguagem expressiva, sendo significante na pontuação total da RDLS.

BACKGROND: cochlear implant (CI) in children. AIM: 1) to delineate a profile of receptive and expressive verbal language of children who have been using cochlear implant for five years and five years and eleven months; 2) to verify the influence of time of auditory sensorial privation in the receptive and expressive verbal language of these children. METHOD: 19 children users of CI with auditory deficiency acquired before language development, who have been using CI for 5y - 5y11m and who have an average time of sensorial privation of 3y (standard deviation of 1 year). These children were assessed using the Reynell Developmental Scales (RDLS) (Reynell e Gruber, 1990) which is composed of: Comprehension Scale (C), Expression Scale (E) and its Structure Sub-Scales (Es), Vocabulary (Ev) and Content (Ec). RESULTS: the median values and the values found for quartile 75 and quartile 25 were:.44, 57 and 54 for C; 48, 60 and 55 for E; 20, 21 and 20 for Es; 15, 19 and 17 for Ev; 15, 22 and 18 for Ec; 96, 116 and 108 for the total score. A statistical correlation between the time of sensorial privation and the score obtained for C (p= - 0.62; R= 0.0044) and Ec (p= - 0.48; R = 0.0348) was observed. Therefore the time of sensorial privation had an influence on the overall score (p= - 0.53; R = 0.0174). CONCLUSION: the language profile of children who use CI for five years is devious and similar to that of five year old hearing children regarding Expression and to that of four year old hearing regarding Comprehension; time of sensorial privation was statistically significant for the score obtained in C - receptive language - and for the score obtained in the E section (Ec) - expressive language, as well as in the overall score of RDLS.

Avaliação da percepção da fala com ruído competitivo em adultos com implante coclear / Evaluation of speech perception in noise in cochlear implanted adults

OBJETIVOS: Avaliar os efeitos das diferentes relações sinal/ruído no reconhecimento da fala com o implante coclear (IC); comparar o reconhecimento da fala no ruído com diferentes tipos de implantes cocleares (ICs) multicanais e avaliar o grau de dificuldade dos usuários de IC em situações com ruído competitivo no dia-a-dia. FORAMA DE ESTUDO: coorte transversal. MATERIAL E MÉTODO: Quarenta adultos com deficiência auditiva pós-lingual, com os IC Nucleus 22, Nucleus 24, Combi 40, Combi 40+ e Clarion. Foi avaliado o reconhecimento das sentenças CPA no silêncio e nas relações S/R de +15 dB, +10 dB, +5 dB e aplicado o questionário Social Hearing Handicap Index (SHHI) para a auto-avaliação do desempenho com o IC. RESULTADOS E CONCLUSÕES: Os usuários de todos os tipos de IC apresentaram redução significativa dos índices de reconhecimento de sentenças CPA em função da diminuição da relação S/R, a curva das medianas de reconhecimento das sentenças CPA alcançou 50 por cento na relação S/R de +10 dB. Não houve diferença estatisticamente significante nos índices de reconhecimento das sentenças CPA e escores de dificuldade do SHHI, obtidos com os diferentes tipos de ICs. As dificuldades dos usuários de IC foram raras nas situações de silêncio e ocasionais nas situações com ruído competitivo no questionário SHHI.

[Speech perception in cochlear implant users: two programming situations]. / Percepção de fala em usuários de implante coclear: duas situações de programação.

BACKGROUND: In order to shorten the programming process of cochlear implanted (CI) children it is possible to establish the T level (threshold level) as being 10% of the C level (most comfortable level). AIM: To compare the results of speech perception tests using the map of the real thresholds levels and the map corresponding to 10% of the C level. MRTHODS: A list of monosyllables and sentences were used with 30 CI individuals in two programming situations. RESULTS: no difference was found between the results in the speech tests in the two programming situations. CONCLUSION: The use of the map with the T level corresponding to 10% of the C level can be an option to program young children, especially for those who do not respond to the investigation of the real T levels.

Evaluation of speech perception in noise in cochlear implanted adults.

AIM: To evaluate the effects of different signal-to-noise ratios on speech recognition obtained by the use of cochlear implant (CI); to compare the speech recognition in noise with different types of multichannel cochlear implants (CIs) and to evaluate the degree of difficulty for speech understanding in noise in daily life situations. STUDY DESIGN: Cohort transversal. MATERIAL AND METHOD: Forty adults with post-lingual hearing loss implanted with Nucleus 22, Nucleus 24, Combi 40, Combi 40+ and Clarion. We evaluated the recognition for CPA sentences in quiet and in S/N +15, +10 and +5 dB. We also applied the Social Hearing Handicap Index (SHHI) questionnaire for self-assessment in daily life. RESULTS AND CONCLUSION: All the implanted adults presented a significant reduction in the scores for sentences recognition as the S/N decreased. The medians' curve for sentence recognition reached 50% in the signal-to-noise ratio of +10 dB. There was no statistically significant difference in sentences' recognition scores and difficulty scores obtained with the SHHI, for all types of implants. The difficulties of implanted adults were rare in quiet and occasional in noisy situations according to SHHI questionnaire.

Uso combinado do implante coclear e aparelho de amplificação sonora individual em adultos / Evaluation of the combined use of hearing aid and cochlear implants in adults

Analisa os benefícios do uso de IC e AASI em seis adultos com deficiência auditiva neurossenrorial bilateral severa a profunda pós--lingual submetidos a audiometria tonal em campo livre, avaliação do crescimento da loudness, teste de percepção de fala e questionário de auto-avaliação