ABSTRACT
Cochlear and brainstem implants have been included on the list of reimbursable products (LPPR) in France since March of 2009. The implants were initially inscribed for 5 years, after which an application for renewal with the French National Commission for the Evaluation of Medical Devices and Health Technologies (Commission Nationale d'évaluation des dispositifs médicaux et des technologies de santé - CNEDiMTS) was required [Haute Autorité de santé, 2009]. Upon registration to the list of reimbursable products, the companies and the reference centers for cochlear and brainstem implants were asked to set up a post-registration registry called EPIIC. This article reports the evolution in the EPIIC registry of the general indicators for 5051 patients over the five years from 2012-2016.
Subject(s)
Auditory Brain Stem Implants/statistics & numerical data , Cochlear Implants/statistics & numerical data , Registries/statistics & numerical data , Advisory Committees/organization & administration , Age Factors , Aged , Aged, 80 and over , Auditory Brain Stem Implants/economics , Cochlear Implantation/statistics & numerical data , Cochlear Implants/economics , Computer Security , Databases as Topic , Device Approval/legislation & jurisprudence , Device Removal/statistics & numerical data , France , Guidelines as Topic/standards , Health Care Sector/economics , Health Care Sector/legislation & jurisprudence , Humans , Infant , Infant, Newborn , Insurance, Health, Reimbursement , Quality Control , Reference Standards , Time FactorsABSTRACT
AIM: To evaluate azimuthal sound-source localization performance under different conditions, with a view to optimizing a routine sound localization protocol. MATERIAL AND METHOD: Two groups of healthy, normal-hearing subjects were tested identically, except that one had to keep their head still while the other was allowed to turn it. Sound localization was tested without and then with a right ear plug (acute auditory asymmetry) for each of the following sound stimuli: pulsed narrow-band centered on 250Hz, continuous narrowband centered on 2000Hz, 4000Hz and 8000Hz, continuous 4000Hz warble, pulsed white noise, and word ("lac" (lake)). Root mean square error was used to calculate sound-source localization accuracy. RESULTS: With fixed head, localization was significantly disturbed by the earplug for all stimuli (P<0.05). The most discriminating stimulus was continuous 4000Hz narrow-band: area under the ROC curve (AUC), 0.99 [95% CI, 0.95-1.01] for screening and 0.85 [0.82-0.89] for diagnosis. With mobile head, localization was significantly better than with fixed head for 4000 and 8000Hz stimuli (P<0.05). The most discriminating stimulus was continuous 2000Hz narrow-band: AUC, 0.90 [0.83-0.97] for screening and 0.75 [0.71-0.79] for diagnosis. In both conditions, pulsed noise (250Hz narrow-band, white noise or word) was less difficult to localize than continuous noise. CONCLUSION: The test was more sensitive with the head immobile. Continuous narrow-band stimulation centered on 4000Hz most effectively explored interaural level difference. Pulsed narrow-band stimulation centered on 250Hz most effectively explored interaural time difference. Testing with mobile head, closer to real-life conditions, was most effective with continuous narrow-band stimulation centered on 2000Hz.
Subject(s)
Acoustic Stimulation , Sound Localization/physiology , Adult , Female , Hearing Tests , Humans , Male , Reference Values , Young AdultABSTRACT
Sound source localization is paramount for comfort of life, determining the position of a sound source in 3 dimensions: azimuth, height and distance. It is based on 3 types of cue: 2 binaural (interaural time difference and interaural level difference) and 1 monaural spectral cue (head-related transfer function). These are complementary and vary according to the acoustic characteristics of the incident sound. The objective of this report is to update the current state of knowledge on the physical basis of spatial sound localization.
