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1.
Adv Gerontol ; 35(1): 93-101, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35522114

RESUMO

Cognitive function is a complex brain function that is important in the cognition of the reality and connecting with it. It has a complicated reflex basis, arises from external factors exposure, improves by growing up and learning till its maximum and declines in the elderly age. For several years it was believed that cognitive function drop is connected with ageing processes of the whole organism. However, the results of the latest studies show that it can be affected by many factors. Two of the most influencing factors are hearing and vestibular efficiency. Moreover, hearing and vestibular normalization can even improve the cognitive function. Unfortunately, studies, that describe the role of hearing and vestibular function in the cognitive sphere, are extremely rare. That is why further research is very important, especially in the rehabilitation tactics. For elderly patients with severe-to-profound hearing loss cochlear implantation is the optimal rehabilitation method. However, ear surgery can lead to such complication as vestibular dysfunction. That is why preoperative diagnostics and postoperative care are very important for preventing cognitive impairments.


Assuntos
Implante Coclear , Disfunção Cognitiva , Perda Auditiva , Idoso , Implante Coclear/efeitos adversos , Cognição , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Audição , Perda Auditiva/diagnóstico , Perda Auditiva/etiologia , Humanos
2.
Trends Hear ; 26: 23312165221095364, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35505617

RESUMO

Speech recognition outcomes are highly variable among pediatric and adult cochlear implant (CI) listeners. Although there is some evidence that the quality of the electrode-neuron interface (ENI) contributes to this large variability in auditory perception, its relationship with speech outcomes is not well understood. Single-channel auditory detection thresholds measured in response to focused electrical fields (i.e., focused thresholds) are sensitive to properties of ENI quality, including electrode-neuron distance, intracochlear resistance, and neural health. In the present study, focused thresholds and speech perception abilities were assessed in 15 children and 21 adult CI listeners. Focused thresholds were measured for all active electrodes using a fast sweep procedure. Speech perception performance was evaluated by assessing listeners' ability to identify vowels presented in /h-vowel-d/ context. Consistent with prior literature, focused thresholds were lower for children than for adults, but vowel identification did not differ significantly across age groups. Higher across-array average focused thresholds, which may indicate a relatively poor ENI quality, were associated with poorer vowel identification scores in both children and adults. Adult CI listeners with longer durations of deafness had higher focused thresholds. Findings from this study demonstrate that poor-quality ENIs may contribute to reduced speech outcomes for pediatric and adult CI listeners. Estimates of ENI quality (e.g., focused thresholds) may assist in developing customized programming interventions that serve to improve the transmission of spectral cues that are important in vowel identification.


Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Adulto , Percepção Auditiva , Limiar Auditivo/fisiologia , Criança , Humanos
3.
Laryngorhinootologie ; 101(5): 428-441, 2022 05.
Artigo em Alemão | MEDLINE | ID: mdl-35500581

RESUMO

Personalized care in the context of cochlear implantation is becoming increasingly important. Choosing the right electrode could improve speech understanding. The measurement of the cochlear length plays an important role: preoperatively, in order to select a suitable electrode length; postoperatively, on the one hand to check the correct electrode position, on the other hand to enable anatomically based fitting of the electrode contacts. Of the various possible localizations of the CDL measurements within the cochlear turns, the one on the organ of Corti (CDLOC) is the most frequently used and clinically most important. In the CDL measurement, a direct and indirect evaluation can be distinguished. There is also the possibility of reconstructing and measuring the CDL in 3D and calculating it mathematically, e.g. using spiral equations. In this context, measurements based on radiological imaging are gaining increasing importance. Therefore, if there is the possibility of performing higher-resolution imaging, this should be strived preoperatively in order to enable the most precise possible procedure and thus a good outcome. Otological planning software can help to create an interface between new findings regarding CDL measurement and higher-resolution imaging for an individualized cochlear implantation.


Assuntos
Implante Coclear , Implantes Cocleares , Cóclea/diagnóstico por imagem , Cóclea/cirurgia , Ducto Coclear/cirurgia , Implante Coclear/métodos , Humanos , Tomografia Computadorizada por Raios X/métodos
4.
Trends Hear ; 26: 23312165221094202, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35473484

RESUMO

In asymmetric treatment of hearing loss, processing latencies of the modalities typically differ. This often alters the reference interaural time difference (ITD) (i.e., the ITD at 0° azimuth) by several milliseconds. Such changes in reference ITD have shown to influence sound source localization in bimodal listeners provided with a hearing aid (HA) in one and a cochlear implant (CI) in the contralateral ear. In this study, the effect of changes in reference ITD on speech understanding, especially spatial release from masking (SRM) in normal-hearing subjects was explored. Speech reception thresholds (SRT) were measured in ten normal-hearing subjects for reference ITDs of 0, 1.75, 3.5, 5.25 and 7 ms with spatially collocated (S0N0) and spatially separated (S0N90) sound sources. Further, the cues for separation of target and masker were manipulated to measure the effect of a reference ITD on unmasking by A) ITDs and interaural level differences (ILDs), B) ITDs only and C) ILDs only. A blind equalization-cancellation (EC) model was applied to simulate all measured conditions. SRM decreased significantly in conditions A) and B) when the reference ITD was increased: In condition A) from 8.8 dB SNR on average at 0 ms reference ITD to 4.6 dB at 7 ms, in condition B) from 5.5 dB to 1.1 dB. In condition C) no significant effect was found. These results were accurately predicted by the applied EC-model. The outcomes show that interaural processing latency differences should be considered in asymmetric treatment of hearing loss.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Percepção da Fala , Sinais (Psicologia) , Humanos
5.
J Int Adv Otol ; 18(2): 150-157, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35418364

RESUMO

BACKGROUND: Vestibular co-stimulation is a side effect of cochlear implant stimulation. The electrical currents delivered by the cochlear implant can spread toward the vestibular system and thus stimulate it. The aim of the study is to evaluate whether it is feasible to functionally restore the balance by modifying the vestibular co-stimulation. METHODS: Four adult patients, who had received a commercially available cochlear implant previously, were enrolled. Counterbalanced biphasic pulses were presented as bursts or as an amplitude-modulated biphasic pulse train (modulation frequencies ranging from 1 to 500 Hz) at the participant's upper comfortable level for electrical stimulation. Subjective sensations and vestibular-mediated eye movements were used for evaluating the possible effects of vestibular co-stimulation. RESULTS: One participant experienced a cyclic tilting of his head in response to an amplitude-modulated biphasic pulse train with a modulation frequency of 2 and 400 Hz. However, during a follow-up visit, the sensation could not be replicated. CONCLUSION: Subjective vestibular sensations or vestibular-mediated eye movements could not be electrically evoked with a commercially available cochlear implant in 4 adult patients with almost normal vestibular function. Therefore, customized design of the hard-, firm-, and/or software of the commercially available cochlear implant might be necessary in order to electrically restore vestibular performance.


Assuntos
Implante Coclear , Implantes Cocleares , Vestíbulo do Labirinto , Adulto , Estimulação Elétrica , Humanos , Sensação
6.
Trends Hear ; 26: 23312165221083091, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35435773

RESUMO

The purpose of this project was to evaluate differences between groups and device configurations for emotional responses to non-speech sounds. Three groups of adults participated: 1) listeners with normal hearing with no history of device use, 2) hearing aid candidates with or without hearing aid experience, and 3) bimodal cochlear-implant listeners with at least 6 months of implant use. Participants (n = 18 in each group) rated valence and arousal of pleasant, neutral, and unpleasant non-speech sounds. Listeners with normal hearing rated sounds without hearing devices. Hearing aid candidates rated sounds while using one or two hearing aids. Bimodal cochlear-implant listeners rated sounds while using a hearing aid alone, a cochlear implant alone, or the hearing aid and cochlear implant simultaneously. Analysis revealed significant differences between groups in ratings of pleasant and unpleasant stimuli; ratings from hearing aid candidates and bimodal cochlear-implant listeners were less extreme (less pleasant and less unpleasant) than were ratings from listeners with normal hearing. Hearing aid candidates' ratings were similar with one and two hearing aids. Bimodal cochlear-implant listeners' ratings of valence were higher (more pleasant) in the configuration without a hearing aid (implant only) than in the two configurations with a hearing aid (alone or with an implant). These data support the need for further investigation into hearing device optimization to improve emotional responses to non-speech sounds for adults with hearing loss.


Assuntos
Implante Coclear , Implantes Cocleares , Auxiliares de Audição , Percepção da Fala , Adulto , Emoções , Audição , Humanos
7.
Artigo em Chinês | MEDLINE | ID: mdl-35483684

RESUMO

Objective:By comparing the hearing and speech rehabilitation effects of cochlear implantation (CI) in children with Waardenburg syndrome (WS) and children with common deafness genes (SLC26A4, GJB2) in the Chinese population, and the hearing and speech rehabilitation effects of bilateral CI and unilateral CI in children with WS, to provide a reference for clinical CIin children with WS. Methods:Follow up and return visit 72 pedestrian cochlear implant children with severe and above sensorineural hearing loss and clear gene mutation type diagnosed by Kunming Children's Hospital from 2017 to 2019, including 24 cases in the WS group, 24 cases in the control group (SLC26A4 deafness group and GJB2 deafness group). All enrolled children were evaluated for auditory and speech ability 12 months after startup. Results:The hearing aid threshold, the correct recognition rate of speech recognition ability evaluation, IT-MAIS / MAIS score rate, CAP score, SIR score, there was no significant difference(P>0.05). The correct recognition rates of IT-MAIS / MAIS score, SIR score, natural environment sound recognition, vowel recognition, tone recognition, monosyllabic word recognition, disyllabic word recognition and short sentence recognition in children with WS bilateral CI were significantly higher than those in children with WS unilateral CI (P<0.05). There was no significant difference in CAP score, initial recognition and correct recognition rate of trisyllabic words between children with WS bilateral CI and children with WS unilateral CI (P>0.05). Conclusion:Common deafness genes in children with WS and Chinese population (SLC26A4, GJB2) the effect of cochlear implantation on hearing and speech rehabilitation of sick children is equivalent. For children with severe and above sensorineural hearing loss associated with this syndrome, CI can be used clinically to improve their hearing and speech ability. WS bilateral CI has advantages in some hearing and speech abilities compared with unilateral CI, so those whomeet the conditions should be encouraged bilateral implantation.


Assuntos
Implante Coclear , Surdez , Perda Auditiva Neurossensorial , Síndrome de Waardenburg , Criança , Surdez/genética , Audição , Perda Auditiva Neurossensorial/complicações , Humanos , Fala , Resultado do Tratamento
8.
Neural Plast ; 2022: 6894794, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35422857

RESUMO

Auditory deprivation affects normal age-related changes in the central auditory maturation. Cochlear implants (CIs) have already become the best treatment strategy for severe to profound hearing impairment. However, it is still hard to evaluate the speech-language outcomes of the pediatric CI recipients because of hearing-impaired children with limited speech-language abilities. The cortical auditory evoked potential (CAEP) provides a window into the development of the auditory cortical pathways. This preliminary study is aimed at assessing electrophysical characteristics of P1-N1 of electrically CAEP in children with CIs and at exploring whether these changes could be accounted for in auditory and speech outcomes of these patients. CAEP responses were recorded in 48 children with CIs in response to electrical stimulus to determine the presence of the P1-N1 response. Speech perception and speech intelligibility of the implanted children were further evaluated with the categories of auditory performance (CAP) test and speech intelligibility rating (SIR) test, respectively, to explore the relationship between the latency of P1-N1 and auditory and speech performance. This study found that P1 and N1 of the intracochlear CAEP were reliably evoked in children fitted with CIs and that the latency of the P1 as opposed to that of N1 was negative in relation to the wearing time of the cochlear implant. Moreover, the latency of the P1 produced significantly negative scores in both CAP and SIR tests, which indicates that P1 latency may be reflective of the auditory performance and speech intelligibility of pediatric CI recipients. These results suggest that the latency of P1 could be used for the objective assessment of auditory and speech function evaluation in cochlear-implanted children, which would be helpful in clinical decision-making regarding intervention for young hearing-impaired children.


Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Criança , Implante Coclear/métodos , Potenciais Evocados Auditivos/fisiologia , Humanos , Fala , Percepção da Fala/fisiologia
9.
BMJ Case Rep ; 15(4)2022 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-35428666

RESUMO

A woman in her late 40s who works as a veterinary technician represented to the emergency department with increasing headache, confusion, neck stiffness, subjective fevers and distorted hearing 2 days after diagnosis of viral infection at an outside emergency department.Diagnosis of Pasteurella multocida was made from blood cultures and lumbar puncture. Intravenous ceftriaxone was administered for 21 days. By the time of resolution of acute meningitis, she had become completely deaf bilaterally. MRI revealed faint early ossification/possible labyrinthitis ossificans of the basal cochlea, which was confirmed on surgical exploration during the placement of cochlear implants bilaterally 42 days later. We discuss how the atypical features of this infection lead to diagnostic delay and high morbidity, the unique imaging/surgical findings resulting from the infection, and the clinical utility of early and bilateral cochlear implantation in this and similar cases.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Meningites Bacterianas , Ossificação Heterotópica , Pasteurella multocida , Surdez/cirurgia , Diagnóstico Tardio , Feminino , Humanos , Meningites Bacterianas/complicações , Meningites Bacterianas/diagnóstico , Meningites Bacterianas/tratamento farmacológico , Ossificação Heterotópica/cirurgia
10.
J Neurosci Methods ; 375: 109592, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35367234

RESUMO

Cochlear implants (CI) are neural prostheses that can restore hearing in individuals with severe to profound hearing loss. Although CIs significantly improve quality of life, clinical outcomes are still highly variable. An important part of this variability is explained by the brain reorganization following cochlear implantation. Therefore, clinicians and researchers are seeking objective measurements to investigate post-implantation brain plasticity. Electroencephalography (EEG) is a promising technique because it is objective, non-invasive, and implant-compatible, but is nonetheless susceptible to massive artifacts generated by the prosthesis's electrical activity. CI artifacts can blur and distort brain responses; thus, it is crucial to develop reliable techniques to remove them from EEG recordings. Despite numerous artifact removal techniques used in previous studies, there is a paucity of documentation and consensus on the optimal EEG procedures to reduce these artifacts. Herein, and through a comprehensive review process, we provide a guideline for designing an EEG-CI experiment minimizing the effect of the artifact. We provide some technical guidance for recording an accurate neural response from CI users and discuss the current challenges in detecting and removing CI-induced artifacts from a recorded signal. The aim of this paper is also to provide recommendations to better appraise and report EEG-CI findings.


Assuntos
Implante Coclear , Implantes Cocleares , Artefatos , Implante Coclear/métodos , Análise de Dados , Eletroencefalografia/métodos , Potenciais Evocados Auditivos/fisiologia , Humanos , Qualidade de Vida , Projetos de Pesquisa
11.
Int J Pediatr Otorhinolaryngol ; 156: 111117, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35366421

RESUMO

OBJECTIVE: The aim of the study was to investigate if a directional microphone mode improves speech perception in noise and sound localization in experienced pediatric bilateral cochlear implant users. METHODS: 15 bilaterally implanted children were included in the analysis. Speech perception in 4 noise conditions (S0N0, S0N90, S0N-90, S0N180) and sound localization were measured when using the OPUS 2 audio processor (omnidirectional mode) and the SONNET audio processor (omnidirectional and natural mode). RESULTS: Speech perception in all 4 noise conditions was better with the SONNET natural mode than with the omnidirectional mode of either SONNET or OPUS 2. The root-mean-square error of the sound localization test was smaller with the natural mode of SONNET than with the omnidirectional mode of either SONNET or OPUS 2. The performance of the audio processors in the omnidirectional mode did not differ significantly except in the S0N0 condition of the speech perception test. CONCLUSION: The natural microphone mode of the SONNET audio processor improved speech perception in noise and sound localization in bilaterally implanted children.


Assuntos
Implante Coclear , Implantes Cocleares , Localização de Som , Percepção da Fala , Criança , Humanos , Ruído
12.
PLoS One ; 17(4): e0266077, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35452461

RESUMO

Access to low-frequency acoustic information in cochlear implant patients leads to better speech understanding in noise. Electrocochleography (ECochG) can provide real-time feedback about the health of the cochlea during the insertion process with the potential to reduce insertion trauma. We describe our experiences of using this technique. Data from 47 adult subjects with measurable residual hearing and an Advanced Bionics (Valencia, CA) SlimJ (46) or MidScala (1) electrode array were analyzed. ECochGs were recorded intraoperatively via the implant. The surgeon adjusted the course of the electrode insertion based on drops in the ECochG. The final array position was assessed using postoperative imaging and pure tone thresholds were measured before and after surgery. Three different patterns of ECochG response amplitude were observed: Growth, Fluctuating and Total Loss. Subjects in the growth group showed the smallest postoperative hearing loss. However, the group with fluctuating amplitudes showed no meaningful correlation between the ECochG responses and the postoperative hearing loss, indicating that amplitude alone is insufficient for detecting damage. Considering the phase of the signal additionally to the amplitude and reclassifying the data by both the phase and amplitude of the response into three groups Type I-Type III produced statistically significant correlations between postoperative hearing loss and the grouping based on amplitude and phase respectively. We showed significantly better hearing preservation for Type I (no drop in amplitude) and Type II (drop with a concurrent phase shift), while Type III (drop without concurrent phase shift) had more surgery induced hearing loss. ECochG potentials measured through the implant could provide valuable feedback during the electrode insertion. Both the amplitude and phase of the ECochG response are important to consider. More data needs to be evaluated to better understand the impact of the different signal components to design an automated system to alert the surgeon ahead of damaging the cochlea.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Perda Auditiva , Adulto , Audiometria de Resposta Evocada/métodos , Cóclea/cirurgia , Implante Coclear/métodos , Surdez/cirurgia , Audição , Perda Auditiva/cirurgia , Humanos
13.
Trends Hear ; 26: 23312165221087011, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35440245

RESUMO

Following the outbreak of the COVID-19 pandemic, public-health measures introduced to stem the spread of the disease caused profound changes to patterns of daily-life communication. This paper presents the results of an online survey conducted to document adult cochlear-implant (CI) users' perceived listening difficulties under four communication scenarios commonly experienced during the pandemic, specifically when talking: with someone wearing a facemask, under social/physical distancing guidelines, via telephone, and via video call. Results from ninety-four respondents indicated that people considered their in-person listening experiences in some common everyday scenarios to have been significantly worsened by the introduction of mask-wearing and physical distancing. Participants reported experiencing an array of listening difficulties, including reduced speech intelligibility and increased listening effort, which resulted in many people actively avoiding certain communication scenarios at least some of the time. Participants also found listening effortful during remote communication, which became rapidly more prevalent following the outbreak of the pandemic. Potential solutions identified by participants to ease the burden of everyday listening with a CI may have applicability beyond the context of the COVID-19 pandemic. Specifically, the results emphasized the importance of visual cues, including lipreading and live speech-to-text transcriptions, to improve in-person and remote communication for people with a CI.


Assuntos
COVID-19 , Implante Coclear , Implantes Cocleares , Percepção da Fala , Adulto , Humanos , Pandemias , Inteligibilidade da Fala
14.
Codas ; 34(5): e20210071, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35385028

RESUMO

PURPOSE: The aim of this study was to evaluate the contribution of the CROS system on the head shadow effect in unilateral implant users. METHODS: Prospective cross-sectional study, approved by the ethics committee under protocol 2.128.869. Eleven adults with post-lingual deafness users of unilateral Advanced Bionics CI were selected. Speech recognition was evaluated with recorded words presented at 65dBA at 0o azimuth and at 90o on the side contralateral to the CI, with noise at 55dBA, using CI alone and CI + CROS system. The results were analyzed using paired t-test with a 0.05 alpha. RESULTS: The mean speech recognition scores were significantly better with CI + CROS in relation to the condition of CI alone (p <0.05, p <0.005 and p <0.005 respectively). In the presentation at 0o azimuth, no significant differences were found. CONCLUSION: Users of unilateral CI without useful residual hearing for the use of hearing aids or unable to undergo bilateral surgery can benefit from the CROS device for speech recognition, especially when the speech is presented on the side contralateral to the CI.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Auxiliares de Audição , Percepção da Fala , Adulto , Estudos Transversais , Surdez/reabilitação , Humanos , Estudos Prospectivos
15.
J Acoust Soc Am ; 151(3): 2149, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35364963

RESUMO

Cochlear-implant (CI) users rely heavily on temporal envelope cues for speech understanding. This study examined whether their sensitivity to temporal cues in word segments is affected when the words are preceded by non-informative carrier sentences. Thirteen adult CI users performed phonemic categorization tasks that present primarily temporally based word contrasts: Buy-Pie contrast with word-initial stop of varying voice-onset time (VOT), and Dish-Ditch contrast with varying silent intervals preceding the word-final fricative. These words were presented in isolation or were preceded by carrier stimuli including a sentence, a sentence-envelope-modulated noise, or an unmodulated speech-shaped noise. While participants were able to categorize both word contrasts, stimulus context effects were observed primarily for the Buy-Pie contrast, such that participants reported more "Buy" responses for words with longer VOTs in conditions with carrier stimuli than in isolation. The two non-speech carrier stimuli yielded similar or even greater context effects than sentences. The context effects disappeared when target words were delayed from the carrier stimuli for ≥75 ms. These results suggest that stimulus contexts affect auditory temporal processing in CI users but the context effects appear to be cue-specific. The context effects may be governed by general auditory processes, not those specific to speech processing.


Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Adulto , Sinais (Psicologia) , Humanos , Fala , Percepção da Fala/fisiologia
16.
BMC Pediatr ; 22(1): 194, 2022 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-35410192

RESUMO

BACKGROUND: Although cochlear implantation (CI) has been performed in Kazakhstan since 2007 little is known about quality of life of patients after CI. The aim of this study was to assess the health-related quality of life (HRQoL) of Kazakhstani children after CI. METHODS: Altogether, 53 families with a child using a cochlear implant for at least 1 year participated in the study between July 20, 2019 and February 20, 2020 at the Audiological Сenter of Almaty, Kazakhstan. The parents/caregivers completed the "Children with Cochlear Implants: Parental Perspectives (CCIPP)" questionnaire. RESULTS: 'Well-being and happiness' subdomain of the HRQoL yielded the highest ratings. 'Communication', 'general functioning', 'self-reliance', and 'supporting the child' subdomains each achieved significant (p < 0.01) associations with all HRQoL subdomains. There were positive correlations between language used by the parent who completed the questionnaire (Kazakh or Russian) and three HRQoL subdomains, including 'well-being and happiness', 'supporting the child' and 'social relations'. CONCLUSION: Parents/caregivers reported high quality of life in all HRQoL subdomains. Further research in this area with more detailed socio-demographic and medical history data is required to identify quality of life predictors in children after cochlear implantation.


Assuntos
Implante Coclear , Implantes Cocleares , Criança , Humanos , Cazaquistão , Qualidade de Vida , Inquéritos e Questionários
17.
Biomolecules ; 12(4)2022 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-35454118

RESUMO

Cochlear implantation initiates an inflammatory cascade in which both acute insertion trauma and chronic foreign body reaction lead to intracochlear fibrosis and loss of residual hearing. Several strategies have been proposed to attenuate the local reactive process after implantation, including intracochlear drug delivery. The present study gives an overview of what is being investigated in the field of inner ear therapeutics and cochlear implant surgery. The aim is to evaluate its potential benefit in clinical practice. A systematic search was conducted in PubMed, Embase, and Cochrane Library databases identifying comparative prospective studies examining the effect of direct inner ear drug application on mechanical cochlear trauma. Both animal and human studies were considered and all studies were assessed for quality according to the validated risk of bias tools. Intracochlear administration of drugs is a feasible method to reduce the local inflammatory reaction following cochlear implantation. In animal studies, corticosteroid use had a significant effect on outcome measures including auditory brainstem response, impedance, and histological changes. This effect was, however, only durable with prolonged drug delivery. Significant differences in outcome were predominantly seen in studies where the cochlear damage was extensive. Six additional reports assessing non-steroidal agents were found. Overall, evidence of anti-inflammatory effects in humans is still scarce.


Assuntos
Implante Coclear , Implantes Cocleares , Orelha Interna , Animais , Orelha Interna/cirurgia , Audição , Estudos Prospectivos
18.
Codas ; 34(5): e20210125, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35352791

RESUMO

PURPOSE: The study was aimed to investigate the relationship between parental stress and attitude of parents towards the outcomes of cochlear implantation in an Indian scenario. METHODS: A total of 59 parents of children with cochlear implantation participated in the study. The outcomes of cochlear implant was measured using Parental attitudes of various aspects of cochlear implantation questionnaire and parental stress was measured using parental stress scale. The questionnaires were circulated to participants and data was collected in the form of e-survey. RESULTS: The present study showed that the parental stress level was similar among mothers and fathers. Further, the parental attitude towards communication abilities of children and education were positively correlated with the duration of cochlear implantation. Finally, a significant positive correlation was found between the parental stress and the parental attitude towards communication abilities of children and social skills. CONCLUSION: The present study showed a positive relationship between parental stress and parental attitude towards the outcomes of cochlear implantation for aspects of communication abilities and social skills.


Assuntos
Implante Coclear , Implantes Cocleares , Atitude , Criança , Feminino , Humanos , Pais , Inquéritos e Questionários
19.
Otol Neurotol ; 43(4): e408-e413, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35239618

RESUMO

INTRODUCTION: Intra-operative electrophysiological testing is being increasingly used to determine device functionality. Impedance abnormalities (open or short circuits) measured at time of surgery pose a dilemma: is it likely to resolve or is it a permanent fault? There is little in the literature on how to manage these intraoperative finding and if, at time of surgery, the back-up device should be used. METHODS: We routinely undertake impedance testing twice intraoperatively, as well as at switch on, 1 and 3 months postoperatively. Retrospective impedance thresholds were analysed for one surgeon's cases between January 2018 and December 2019. RESULTS: There were 235 cochlear implants performed for 217 patients (5,020 electrode contacts) analysed. Thirty-three electrodes had abnormal impedance thresholds on first intraoperative cycle of testing, 76% resolving with the second testing cycle electrode contacts that demonstrated abnormal impedance during both intraoperative test cycles were 16.54 times (95%CI 2.55-107.13, p = 0.003) more likely to be abnormal at three months. Fifty percent resolved by switch on. The intraoperative abnormalities made up 26% of electrode abnormalities seen at 3 months postoperatively. DISCUSSION: This study demonstrates the utility of 2 cycles of intraoperative impedance testing, with persistently abnormal electrodes having 16 times the likelihood of persistent abnormalities of impedance, and 50% resolution. These persistent intra-operative abnormal electrodes are responsibly for 26% of electrode abnormalities at 3 months. This information is useful for the surgeon when considering use of the backup cochlear implant device.


Assuntos
Implante Coclear , Implantes Cocleares , Cóclea/cirurgia , Impedância Elétrica , Humanos , Estudos Retrospectivos
20.
Int J Pediatr Otorhinolaryngol ; 156: 111041, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35272256

RESUMO

PURPOSE: This study aims to identify the auditory, speech, and surgical outcomes of cochlear implantation in patients with profound SNHL following bacterial meningitis. METHODS: Subjects with bilateral severe to profound SNHL who underwent unilateral cochlear implantation from 2003 to 2020 were included in this historical cohort study. The main outcomes were assessed using Categories of Auditory Performance (CAP) and Speech Intelligibility Ratings (SIR) scores. The CAP and SIR outcomes were collected as three-time points after surgery: 6, 12, and 24 months. In order to achieve the strength of the relationship and for computing the Risk Ratio (RR) by log-binominal regression method, we used two binary categorizations of CAP and SIR in our analyses. RESULTS: The mean of age at implantation of the study and control group were 144.30 (156.90) and 121.10 (133.70) months, respectively. In the study group, 19 of 35 (54.3%) patients were male, and 16 (45.7%) were female. In the control group, 34 of 81 (42.0%) patients were male and 47 (58.0%) were female. The mean scores of CAP and SIR in our study improved significantly during the time in both groups. All p-values (p) were significant in both groups (T2 vs T1, T3 vs T1, and T3 vs T2). Our analysis by log-binomial regression and computing the RR based on the first and second categorization of CAP and SIR showed moderate to strong relationships between the presence of a history of meningitis and inappropriate CAP and SIR outcomes in these patients. CONCLUSIONS: Although subjects who were deafened due to meningitis benefit significantly from cochlear implantation, we found moderate to strong relationships between the history of meningitis and inappropriate CAP and SIR outcomes in these patients.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Meningites Bacterianas , Percepção da Fala , Implante Coclear/métodos , Estudos de Coortes , Surdez/etiologia , Surdez/cirurgia , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Inteligibilidade da Fala , Resultado do Tratamento
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