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1.
HNO ; 69(1): 42-51, 2021 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-32856120

RESUMO

INTRODUCTION: After cochlear implantation, auditory and speech training is usually necessary. Up until now, this has been performed on an out- or inpatient basis in direct contact with a therapist. Due to technical advances but also particularly because of an increasing use of digital media and a desire for mobility and independence, the demand for digital training programs is increasing in the field of hearing rehabilitation. MATERIALS AND METHODS: In a first step, the most important elements of auditory training were determined on the basis of commonly used auditory and speech processing models, and the core features of a computer-based teletherapeutic hearing platform were defined. This process considered motivational elements and adaptive mechanisms as regularly used in educational and speech and language therapy. In a second step, an initial prototype of the "train2hear" teletherapeutic hearing platform was developed by an interdisciplinary research team. RESULTS: The core of the train2hear platform is an initial analysis according to the International Classification of Functioning, Disability, and Health (ICF), on the basis of which an individual training plan is designed. Various adaptive mechanisms enable the level of difficulty to be continually adapted to the individual user's learning progress. A videoconference tool enables contact between the patient and the therapist. CONCLUSION: The train2hear platform represents a first prototype of a computer-based auditory rehabilitation program in German. Further evaluation and development in a clinical study are needed to determine the feasibility and efficacy of the platform.


Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Audição , Humanos , Internet
2.
Ear Nose Throat J ; 100(1): 31-37, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32804575

RESUMO

The indications for cochlear implantation have gradually expanded as advancements in technology have evolved, resulting in improved audiologic outcomes for both adult and children. There remains a significant underutilization of cochlear implant technology in the United States, and recognition of the potential benefits of cochlear implantation for non-traditional indications is critical for encouraging the evolution of candidacy criteria. Adult cochlear implantation candidacy has progressed from patients with bilateral profound sensorineural hearing loss (SNHL) to include patients with greater degrees of residual hearing, single-sided deafness and asymmetric hearing, and atypical etiologies of hearing loss (eg, vestibular schwannoma, Ménière's disease, and otosclerosis). Indications for pediatric cochlear implantation have similarly evolved from children with bilateral severe to profound SNHL to implanting children at a younger age, including those with residual hearing, asymmetric hearing loss, inner ear malformations, as well as cochlear nerve deficiency. In this editorial, the literature investigating cochlear implantation for nontraditional indications is reviewed with an aim to use the best available evidence to encourage the evolution of candidacy criteria.


Assuntos
Implante Coclear , Perda Auditiva/cirurgia , Seleção de Pacientes , Adulto , Criança , Feminino , Humanos , Masculino , Estados Unidos
3.
Ear Nose Throat J ; 100(1): 38-43, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32330070

RESUMO

OBJECTIVE: The objective of this study was to determine the shape of cochlear basal turn through basic cochlear parameters measurement. The secondary aim was to overlay an image of the precurved electrode array on top of the three-dimensional (3D) image of the cochlea to determine which shape of the cochlear basal turn gives optimal electrode-to-modiolus proximity. MATERIALS AND METHODS: Computed tomography (CT) preoperative image-data sets of 117 ears were made available for the measurements of cochlear parameters retrospectively. Three-dimensional slicer was used in the visualization and measurement of cochlear parameters from both 3D and 2D (2-dimensional) images of the inner ear. Cochlear parameters including basal turn diameter (A), width of the basal turn (B), and cochlear height (H) were measured from the appropriate planes. B/A ratio was made to investigate which ratios correspond to round and elliptical shape of the cochlear basal turn. RESULTS: The cochlear size as measured by A value ranged between 7.4 mm and 10 mm. The B value and the cochlear height (H) showed a weak positive linear relation with A value. The ratio between the B and A values anything above or below 0.75 could be an indicator for a more round- or elliptical shaped cochlear basal turn, respectively. One sized/shaped commercially available precurved electrode array would not offer a tight electrode-to-modiolus in the cochlea that has an elliptical shaped basal turn as identified by the B/A ratio of <0.75. CONCLUSION: Accurate measurement of cochlear parameters adds value to the overall understanding of the cochlear geometry before a cochlear implantation procedure. The shape of cochlear basal turn could have clinical implications when comes to electrode-to-modiolus proximity.


Assuntos
Antropometria/métodos , Cóclea/anatomia & histologia , Implante Coclear , Imageamento Tridimensional , Tomografia Computadorizada por Raios X , Cóclea/diagnóstico por imagem , Implantes Cocleares , Feminino , Humanos , Masculino , Estudos Retrospectivos
4.
Ann Otol Rhinol Laryngol ; 130(1): 112-115, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32613850

RESUMO

OBJECTIVE: To report presentation, diagnostic process, management and outcome of a case of autoimmune inner ear disease (AIED) related with Churg-Strauss syndrome, also known as eosinophilic granulomatosis with polyangiitis (EGPA), treated with cochlear implantation, and review of relevant literature. CASE PRESENTATION AND MANAGEMENT: A retrospective case report of AIED associated with EGPA treated with cochlear implantation was described. A multi-step approach for diagnosis and confirmation of AIED and hearing rehabilitation was conducted, eventually leading to left cochlear implantation. RESULTS: The surgery was without complications and postoperative course was uneventful. Two years after surgery, pure-tone and speech soundfield audiometry with left cochlear implant switched on showed a good improvement in pure-tone threshold and a word recognition score of 50% at 60 dB nHL. Literature review does not report any previous case of AIED EGPA-related. CONCLUSIONS: Cochlear implantation in AIED EGPA-related have been shown to be a viable treatment option in a stabilized phase of disease.


Assuntos
Síndrome de Churg-Strauss/complicações , Implante Coclear , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Súbita/etiologia , Adulto , Feminino , Perda Auditiva Neurossensorial/cirurgia , Perda Auditiva Súbita/cirurgia , Humanos
5.
Braz. j. otorhinolaryngol. (Impr.) ; 86(6): 720-726, Nov.-Dec. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1142596

RESUMO

Abstract Introduction: The increase in the spectral information offered by the sound processing strategy HiRes 120 has led to great expectations for the pediatric population. Due to a shorter duration of auditory deprivation and higher neural plasticity, children could benefit more substantially from the spectral information of this sound processing strategy. Objective: To compare auditory and language skills in Brazilian children with cochlear implants using the HiRes and HiRes 120 sound processing strategies. Methods: Thirty children, aged 1-3 years, with congenital hearing loss, were divided into two groups, according to the signal processing strategy adjusted at the time of the cochlear implant activation. The assessed children were matched according to chronological age and the time of the cochlear implant use. The auditory and language skills were evaluated longitudinally through the Infant-Toddler Meaningful Auditory Integration Scale and Production Infant Scale Evaluation, carried out before surgery, and 3, 6 and 12 months after device implantation. The Mann-Whitney test was applied for the comparison between the two groups with a 5% significance level. Results: The findings indicated development of hearing and language skills in the first year of cochlear implant use; however, there was no statistically significant difference in the evolution of such skills due to the adjusted processing strategy in the activation of the cochlear implant electrodes. Conclusion: The development of auditory and language skills in the assessed children was similar during the entire study period, regardless of which signal processing strategy was used.


Resumo Introdução: O aumento das informações espectrais proporcionado pela estratégia de processamento de sinal HiRes 120 gera expectativas em relação à população pediátrica, uma vez que, devido ao curto período de privação sensorial e da maior plasticidade neural, as crianças poderiam se beneficiar de forma mais substancial das informações espectrais dessa estratégia de processamento de sinal. Objetivo: Comparar as habilidades auditivas e de linguagem em crianças usuárias de implante coclear, com a estratégia de processamento de sinal HiRes e HiRes 120. Método: Trinta crianças de um a três anos e com perda auditiva congênita foram divididas em dois grupos, de acordo com a estratégia de processamento de sinal ajustada no momento da ativação do implante coclear. As crianças avaliadas foram pareadas de acordo com a idade cronológica e o tempo de uso do implante coclear. As habilidades auditivas e de linguagem foram avaliadas, longitudinalmente, por meio do Infant-Toddler Meaningful Auditory Integration Scale e Production Infant Scale Evaluation, antes do implante coclear e com 3, 6 e 12 meses de uso do dispositivo. O teste estatístico de Mann-Whitney foi aplicado para comparar os resultados dos grupos, com nível de significância de 5%. Resultados: Os achados indicaram desenvolvimento das habilidades auditivas e de linguagem no primeiro ano de uso do implante coclear, porém sem diferença estatisticamente significante na evolução de tais habilidades, em função da estratégia de processamento ajustada na ativação dos eletrodos do implante coclear. Conclusão: O desenvolvimento das habilidades auditivas e de linguagem das crianças avaliadas foi semelhante durante o período do presente estudo, independentemente da estratégia de processamento de sinal usada.


Assuntos
Humanos , Lactente , Pré-Escolar , Percepção da Fala , Implantes Cocleares , Implante Coclear , Surdez/cirurgia , Brasil , Idioma , Desenvolvimento da Linguagem
6.
Codas ; 32(6): e20180295, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33331539

RESUMO

Waardenburg syndrome (WS) is a rare autosomal-dominant syndrome that can be presented with sensorineural hearing loss. In this report, we describe the outcomes of three children with WS at zero, three, nine, twelve and sixty months after cochlear implant (CI) fitting. The outcomes were assessed using IT-MAIS (Infant-Toddler Meaningful Auditory Integration Scale - younger than 5 year), MAIS (Meaningful Auditory Integration Scale - older than 5 year), MUSS (Meaningful Use of Speech Scale), and categories of auditory performance and speech intelligibility. The results showed an improvement in auditory and language performance over time, two patients who used CI for 5 years achieved 100% in IT-MAIS and MUSS tests. In addition, both were able to understand sentences in open set and achieve fluent speech. Moreover, both reached fluency on auditory and language performance scale. The third patient with 50 months of follow-up and in the 48 months evaluation, is in category 5 of auditory performance and 3 of speech intelligibility. We concluded that all children who had low levels of hearing and language before cochlear implant have improved hearing and language skills after implantation and rehabilitation.


Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Síndrome de Waardenburg , Pré-Escolar , Audição , Humanos , Lactente , Resultado do Tratamento
7.
Artigo em Chinês | MEDLINE | ID: mdl-33254298

RESUMO

Objective:The purpose of this study is to review the difficulties that can occur during cochlear implant surgery in patients with inner ear abnormalities and the management. Method:A retrospective analysis was made on 186 cases of cochlear implant with inner ear malformation, the types of inner ear malformations included 6 cases(3.23%) of isolated semicircular dysplasia, 137 cases(73.66%) of isolated large vestibular aqueducts, 26 cases(13.98%) of Mondini malformations, 6 cases(3.23%) of incomplete septal type Ⅲ, 3 cases(1.61%) of internal auditory stenosis, 7 cases(3.76%) of cochlear dysplasia and 1 case(0.54%) of incomplete septal typeⅠ. Two hundred patients with normal inner ear structures were randomly selected as the control group. The data collected included the types of inner ear abnormalities, intraoperative manifestations, clinical management strategies, and postoperative speech rehabilitation, and the literature was reviewed. Result:148 patients(77.49%) with inner ear malformation underwent successful surgery, electrode insertion was incomplete in 6 patients(3.14%), and cerebrospinal fluid blowout occurred in 29 patients(15.18%), it was difficult to locate the window because of the abnormal structure of the window in 8 cases(4.19%). In 191 patients, the facial recess approach was adopted intraoperatively, and 17.8% of the patients had significant structural abnormalities of the facial nerve, significantly more than the group with normal inner ear structure. Only 1 patient showed delayed facial nerve paralysis 1 week after surgery, and recovered well after treatment. 6.81% of the patients adopted the expanded round window approach, which was significantly lower than that of the group with normal inner ear structure(28%). There was no significant difference between patients with inner ear malformation and patients with extremely severe deafness with normal inner ear structure who received cochlear implant in speech rehabilitation. Conclusion:Cochlear implant is safe, feasible and effective for patients with inner ear malformation. For patients with inner ear malformation, special attention should be paid to the preoperative imaging reading to predict the possible risks during the operation. The safest surgical plan, including the type of electrode and the manner in which the window is opened, must be prepared before the operation, and the operation must be performed or directed by an experienced surgeon who can adjust the optimal surgical plan according to what is seen during the operation.


Assuntos
Implante Coclear , Implantes Cocleares , Orelha Interna , Cóclea/cirurgia , Orelha Interna/cirurgia , Humanos , Estudos Retrospectivos
8.
Artigo em Chinês | MEDLINE | ID: mdl-33254311

RESUMO

Objective:To describe the effects of the possible related factors in unilateral cochlear implantation(CI) on tinnitus,and analysis the hearing and speech ability in different tinnitus prognosis mode. Method:The 70 post-lingual deafness CI patients(27.73±14.032 years old) in the clinical trial for LCI-20PI cochlear implant and LSP-20A sound processor project by a fast questionnaire about the tinnitus positive or negative respectively before the CI, 3rd, 6th, 9th and 12th months after the first mapping. 6 modes about tinnitus development were record: Type A(-to-), no tinnitus before the CI and continued negative until the last follow-up; Type B(+ to-), have tinnitus before CI and disappeared after the mapping; Type C(-to +), no tinnitus before but appeared after the surgery; Type D(+ to-to +), have tinnitus before the CI and disappeared during the continue follow-up, but finally the tinnitus show up again at last; Type E(-to + to-), no tinnitus before and suffered from tinnitus after the CI surgery, but the noise disappeared at last; Type F(+ to +), have the tinnitus in all the duration. Then we briefly analyzed the factors like age, gender, the duration of hearing loss, and the duration of hearing aids usage. Compare the characteristics in all the modes of tinnitus prognosis. Result:In this research CI treatment effect rate on tinnitus is 80%. The mean age of Type A (tinnitus from -to- ) group is (20.79 ±11.364) years old; Type B (tinnitus from + to-) group is (32.69±10.606) years old; Type C(tinnitus from-to +) group is (40.25±2.217) years old; Type D(tinnitus from + to-to +) group is (28.00±0) years old; Type E (tinnitus from-to + to-) group is (52.50±6.364) years old; Type F (tinnitus from + to +) group is (30.33±11.015) years old. And P<0.05 between the groups, while the severe-deaf-duration intergroup differences (P>0.05). The mean speech discrimination rates are all elevate after 12 months and no statistical significance between the groups. But the E group has a lowst elevation in mean pure tone threshold (22.50±3.535 ) dB HL, when the F group has the best promotion (56.04±10.649 ) dB HL, and the difference between the groups is statistically significant. Conclusion:The cochlear implantation could eliminate tinnitus in 80% patients in this research. The better elevation of hearing and speech ability in the patients with persist tinnitus pre-and post-CI usage may related to amount and functions of the residual auditory nerves. Age may be an important factor in tinnitus generation, which may need more explanation and attention during the rehabilitation period.


Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Zumbido , Adolescente , Adulto , Criança , Humanos , Pessoa de Meia-Idade , Prognóstico , Fala , Resultado do Tratamento , Adulto Jovem
9.
Artigo em Chinês | MEDLINE | ID: mdl-33254319

RESUMO

Objective:The study is aimed to evaluate impacts of cochlear implantation on speech perception and quality of life in postlingual deaf adults, and to explore the correlation between speech perception and quality of life using Nijimegen Cochlear Implantation Questionnaire and Mandarin version of Minimum Speech Test Battery. Method:Thirty-six postlingual deafpatients were recruited, including 20 males and 16 females. Patient age was 20 to 72 years old(52±16) when CI was implanted, and the hearing loss duration was 2 to 25 years(14±6) before cochlear implantation. The single syllable recognition rate score were tested by using Mandarin version of Minimum Speech Test Battery, and the quantify quality of life was tested by using Nijimegen Cochlear Implantation Questionnaire. Result:Speech recognition and quality of life have significantly improved in patients with CI after cochlear implantiont. The scores of basic sound perception, advanced sound perception, speech ability, self-confidence, social activity ability, and social ability have improved, but the differences were not statistically significant. The Mandrin single-syllable recognition rate scores were related to basic sound perception(r=-0.36; P=0.004), advanced sound perception(r=-0.41; P=0.002), and speech ability(r=-0.67; P=0.001), and the differences are statistically significant. Conclusion:The postlingual deafnesses ability of auditory, speech perception and the quality of life have improved significantly in patients with CI after cochlear implantiont.


Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Fala , Adulto Jovem
10.
Artigo em Chinês | MEDLINE | ID: mdl-33254356

RESUMO

Sensorineural hearing loss(SNHL) is a difficult and hot issue in the field of otology. The effect of medications targeting the mechanism of SNHL are often unsatisfactory for hearing improvement. Hearing aids and cochlear implants are the mainstream treatment methods at present, but neither of them can reverse the pathological changes of affected inner ear. In recent years, mesenchymal stem cells transplantation has been confirmed by several animal studies and clinical trials to have great potential for clinical applications in restoring the structure of the inner ear and hearing improvement to some extent. In this review, we review the characteristics of umbilical cord blood derived mesenchymal stem cells(UCBMSCs), the approaches of transplantation, the efficacy and mechanism of UCBMSCs in the treatment of SNHL, and the safety of clinical application, covering the existing problems and future prospects of this rising treatment.


Assuntos
Implante Coclear , Perda Auditiva Neurossensorial , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais , Animais , Sangue Fetal , Perda Auditiva Neurossensorial/terapia
11.
Vestn Otorinolaringol ; 85(5): 29-32, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33140930

RESUMO

To determine the electrode impedance dynamics changes in the postoperative period after cochlear implantation as well as the time of their stabilization. MATERIAL AND METHODS: 75 patients with a bilateral sensorineural deafness aged from 1 to 4 years (average age - 1.5 years) were included in the study. 50 patients were implanted with Nucleus cochlear implants (Cochlear - Australia) and other 25 patients - with Advanced Bionics implants (Switzerland). RESULTS: The impedance dynamics analysis in two groups of patients implanted with «Cochlear¼ and «Advanced Bionics¼ cochlear implants demonstrated that statistically significant decrease in impedance (p<0.05) was observed after the beginning of electrical stimulation and the reduction of postoperative inflammatory process in the inner ear. The stabilization of the impedance levels in both groups of patients was obtained in 3-6 months after the switch-on of speech processor.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Perda Auditiva Neurossensorial , Criança , Pré-Escolar , Cóclea , Impedância Elétrica , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/cirurgia , Humanos , Lactente
12.
Codas ; 32(5): e20190139, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33053089

RESUMO

PURPOSE: To develop and to apply a musical stimulation program for children using Cochlear Implant. METHOD: The research was conducted at the Educational Audiology Outpatient Clinic, UNIFESP, and was carried out in two stages - conception of the musical stimulation activities and its application in five children using Cochlear Implant, aged between 2 and 5 years, who had been under speech therapy for at least 12 months. The study group was submitted to six sessions of musical stimulation. We used three instruments to quantify the evolution of the child: Children's Musical Identification, Musical Skills Development and Musical Aptitude Test - all of them were designed by one of the authors. RESULTS: Musical stimulation had a positive effect, thereby improving the rhythm and the melody skills of the participants. The children showed a performance over 50% in the tasks undertaken. Musical stimulation had a positive effect, thereby improving the rhythm (p=0.0267) and the melody (p=0.0445) skills of the participants. CONCLUSION: We conclude that it is possible to develop a musical stimulation program that can be applied to children using Cochlear Implant inserted in aurioral rehabilitation, who benefit from the activities.


Assuntos
Implante Coclear , Implantes Cocleares , Drama , Música , Criança , Humanos , Lactente
13.
Trends Hear ; 24: 2331216520960601, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33054620

RESUMO

Speech recognition in complex environments involves focusing on the most relevant speech signal while ignoring distractions. Difficulties can arise due to the incoming signal's characteristics (e.g., accented pronunciation, background noise, distortion) or the listener's characteristics (e.g., hearing loss, advancing age, cognitive abilities). Listeners who use cochlear implants (CIs) must overcome these difficulties while listening to an impoverished version of the signals available to listeners with normal hearing (NH). In the real world, listeners often attempt tasks concurrent with, but unrelated to, speech recognition. This study sought to reveal the effects of visual distraction and performing a simultaneous visual task on audiovisual speech recognition. Two groups, those with CIs and those with NH listening to vocoded speech, were presented videos of unaccented and accented talkers with and without visual distractions, and with a secondary task. It was hypothesized that, compared with those with NH, listeners with CIs would be less influenced by visual distraction or a secondary visual task because their prolonged reliance on visual cues to aid auditory perception improves the ability to suppress irrelevant information. Results showed that visual distractions alone did not significantly decrease speech recognition performance for either group, but adding a secondary task did. Speech recognition was significantly poorer for accented compared with unaccented speech, and this difference was greater for CI listeners. These results suggest that speech recognition performance is likely more dependent on incoming signal characteristics than a difference in adaptive strategies for managing distractions between those who listen with and without a CI.


Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Cognição , Humanos , Fala
14.
Expert Rev Med Devices ; 17(11): 1193-1206, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33090055

RESUMO

INTRODUCTION: Cochlear implants (CIs) are biomedical devices that restore sound perception for people with severe-to-profound sensorineural hearing loss. Most postlingually deafened CI users are able to achieve excellent speech recognition in quiet environments. However, current CI sound processors remain limited in their ability to deliver fine spectrotemporal information, making it difficult for CI users to perceive complex sounds. Limited access to complex acoustic cues such as music, environmental sounds, lexical tones, and voice emotion may have significant ramifications on quality of life, social development, and community interactions. AREAS COVERED: The purpose of this review article is to summarize the literature on CIs and music perception, with an emphasis on music training in pediatric CI recipients. The findings have implications on our understanding of noninvasive, accessible methods for improving auditory processing and may help advance our ability to improve sound quality and performance for implantees. EXPERT OPINION: Music training, particularly in the pediatric population, may be able to continue to enhance auditory processing even after performance plateaus. The effects of these training programs appear generalizable to non-trained musical tasks, speech prosody and, emotion perception. Future studies should employ rigorous control groups involving a non-musical acoustic intervention, standardized auditory stimuli, and the provision of feedback.


Assuntos
Percepção Auditiva/fisiologia , Implantes Cocleares , Música , Criança , Implante Coclear , Humanos , Idioma , Nível de Percepção Sonora/fisiologia
15.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 55(10): 952-956, 2020 Oct 07.
Artigo em Chinês | MEDLINE | ID: mdl-33036510

RESUMO

Objective: To evaluate the safety and outcomes of robot-assisted electrode insertion in cochlear implantation. Methods: We first reported the case of robot-assisted electrode insertion of cochlear implantation in October 2019. A new slim electrode array of Nurotron cochlear implant (CS-10A TM) and RobOtol(®) robot system were used in this case. The robotic assistance procedures, surgical outcomes were analyzed. Results: Robot-assisted electrode insertion was successfully performed in this adult patient. The preparation of robot system cost six minutes, the electrode array was slowly and fully inserted into tympanic scala with robot assistance. No damage in the surgical field occurred by the robotic instrument. Intraoperative electrode impedances and neural response measurements were normal. No postoperative complications occurred. Up to three months of follow up after implantation, the cochlear implant functioned well and rehabilitated hearing was satisfactory. Conclusion: Otological robot system shows its advantage in the elimination of human involuntary tremors and the augmentation of accuracy during micromanipulation, it could safely assist cochlear implantation to realize minimally invasive and full tympanic scala insertion of the electrode array, and to ensure the good preservation of the intracochlear fine structure.


Assuntos
Implante Coclear , Implantes Cocleares , Robótica , Adulto , Cóclea/cirurgia , Eletrodos Implantados , Audição , Humanos
16.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3260-3263, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018700

RESUMO

Auditory stream segregation is an important function of the auditory system, and the extent to which this function works has a major impact on listener's ability to recognize auditory objects in complex listening environments. However, cochlear implant (CI) listeners are poorly equipped for this challenge, mainly owing to the impoverished sensory information available via their implants. The purpose of this study was to examine two factors, i.e., frequency separation and time interval, affecting the auditory stream segregation in vocoder simulations simulating CI speech processing based on an event-related potential (ERP) experiment. The pure-tone stimuli were processed by a vocoding process, and presented to normal-hearing listeners in an ERP experiment. Experimental results showed that a large frequency separation or a short time interval led to a larger mismatch negativity (MMN) response. The MMN results in this work suggested that the degree of auditory stream segregation was affected by frequency separation and time interval, and MMN could serve as a potential index for future ERP studies on auditory stream segregation in CI users.


Assuntos
Implante Coclear , Implantes Cocleares , Estimulação Acústica , Percepção Auditiva , Potenciais Evocados , Humanos
18.
HNO ; 68(10): 734-748, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-32886128

RESUMO

INTRODUCTION: Hearing rehabilitation with cochlear implants has attracted increasing interest also for patients with cochleovestibular schwannoma. The authors report their experience with the surgical management of tumors with rare transmodiolar or transmacular extension and outcomes after cochlear implantation (CI). METHODS: This retrospective case series included nine patients with either primary intralabyrinthine tumors or secondary invasion of the inner ear from the internal auditory canal. The primary endpoint with CI, performed in six patients, was word recognition score at 65 dB SPL (sound pressure level). Secondary endpoints were intra- and postoperative electrophysiological parameters, impedance measures, the presence of a wave V in the electrically evoked (via the CI) auditory brainstem responses, the specifics of postoperative CI programming, and adverse events. RESULTS: Hearing rehabilitation with CI in cases of transmodiolar tumor growth could be achieved only with incomplete tumor removal, whereas tumors with transmacular growth could be completely removed. All six patients with CI had good word recognition scores for numbers in quiet conditions (80-100% at 65 dB SPL, not later than 6 to 12 months post CI activation). Four of these six patients achieved good to very good results for monosyllabic words within 1-36 months (65-85% at 65 dB SPL). The two other patients, however, had low scores for monosyllables at 6 months (25 and 15% at 65 dB SPL, respectively) with worsening of results thereafter. CONCLUSIONS: Cochleovestibular schwannomas with transmodiolar and transmacular extension represent a rare entity with specific management requirements. Hearing rehabilitation with CI is a principal option in these patients.


Assuntos
Implante Coclear , Implantes Cocleares , Neurilemoma , Neuroma Acústico , Humanos , Neurilemoma/terapia , Neuroma Acústico/terapia , Estudos Retrospectivos
19.
Trends Hear ; 24: 2331216520948974, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32865486

RESUMO

Automatic gain control (AGC) compresses the wide dynamic range of sounds to the narrow dynamic range of hearing-impaired listeners. Setting AGC parameters (time constants and knee points) is an important part of the fitting of hearing devices. These parameters do not only influence overall loudness elicited by the hearing devices but can also affect the recognition of speech in noise. We investigated whether matching knee points and time constants of the AGC between the cochlear implant and the hearing aid of bimodal listeners would improve speech recognition in noise. We recruited 18 bimodal listeners and provided them all with the same cochlear-implant processor and hearing aid. We compared the matched AGCs with the default device settings with mismatched AGCs. As a baseline, we also included a condition with the mismatched AGCs of the participants' own devices. We tested speech recognition in quiet and in noise presented from different directions. The time constants affected outcomes in the monaural testing condition with the cochlear implant alone. There were no specific binaural performance differences between the two AGC settings. Therefore, the performance was mostly dependent on the monaural cochlear implant alone condition.


Assuntos
Implante Coclear , Implantes Cocleares , Auxiliares de Audição , Percepção da Fala , Humanos , Fala
20.
Trends Hear ; 24: 2331216520948385, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32895024

RESUMO

This study examined the contribution of temporal and spectral modulation sensitivity to discrimination of stimuli modulated in both the time and frequency domains. The spectrotemporally modulated stimuli contained spectral ripples that shifted systematically across frequency over time at a repetition rate of 5 Hz. As the ripple density increased in the stimulus, modulation depth of the 5 Hz amplitude modulation (AM) reduced. Spectrotemporal modulation discrimination was compared with subjects' ability to discriminate static spectral ripples and the ability to detect slow AM. The general pattern from both the cochlear implant (CI) and normal hearing groups showed that spectrotemporal modulation thresholds were correlated more strongly with AM detection than with static ripple discrimination. CI subjects' spectrotemporal modulation thresholds were also highly correlated with speech recognition in noise, when partialing out static ripple discrimination, but the correlation was not significant when partialing out AM detection. The results indicated that temporal information was more heavily weighted in spectrotemporal modulation discrimination, and for CI subjects, it was AM sensitivity that drove the correlation between spectrotemporal modulation thresholds and speech recognition. The results suggest that for the rates tested here, temporal information processing may limit performance more than spectral information processing in both CI users and normal hearing listeners.


Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Humanos , Ruído , Fala
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