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1.
Artigo em Chinês | MEDLINE | ID: mdl-34521164

RESUMO

Objective: To investigate the development of auditory speech perception and spatial hearing abilities within one year after cochlear implantation in preschool prelingual deaf children and the relationship between the two abilities. Methods: This retrospective study analyzed 31 preschool children with an average age of (2.3±1.2) years. All cases were assessed at pre-implant, 6 months and 12 months post-implant using the Infant-toddler Meaningful Auditory Integration Scale (IT-MAIS), the Meaningful Auditory Integration Scale (MAIS) and the Mandarin Early Speech Perception test (MESP) to evaluate their listening and speech perception abilities, and using the Speech,Spatial,and Other Qualities of Hearing Scale for Parents (SSQ-P) questionnaires to evaluate their speech perception and spatial hearing abilities. SPSS 23.0 was used for the statistical analysis. Results: All children performed better at 6 months and 12 months post-implant with IT-MAIS/MAIS, MESP than pre-implant, and the scoring rate continued to improve, with a significant difference (P<0.01). For the SSQ-P (Speech) and SSQ-P (Spatial) scores, the mean scores of pre-implant were (0.9±0.2) points and (0.8±0.3) points, those of 6 months post-implant were (4.6±0.2) and (2.6±0.3), and 12 months post-implant were (6.2±0.2) and (6.3±0.3), the scores of the two groups were significantly different at pre-implant, 6 months and 12 months post-implant (P<0.01). The growth rate of SSQ-P (Spatial) from pre-implant to 12 months post-implant was 675.3%, and the growth rate from 6 months post-implant to 12 months post-implant was 140.6%, the growth rate showed an significant increase compared with IT-MAIS/MAIS, MESP and SSQ-P (Speech).SSQ-P (Speech) and SSQ-P (Spatial) scores were moderate correlation at 12 months post-implant(r=0.465, P=0.008). Conclusions: Within one year after cochlear implantation, listening, speech perception and spatial hearing abilities of preschool prelingual deaf children could show a comprehensive, continuous and significant progress as the implantation time increasing. The growth rate of spatial hearing is greater than that of speech perception at 12 months post-implant, and the spatial hearing could still show rapid development characteristics after 6 months post-implant.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Percepção da Fala , Percepção Auditiva , Pré-Escolar , Surdez/cirurgia , Audição , Humanos , Lactente , Estudos Retrospectivos , Fala
2.
Int J Pediatr Otorhinolaryngol ; 149: 110876, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34385039

RESUMO

BACKGROUND: Little is known regarding fitting parameters and receptive and expressive language development in cochlear-implanted children (CCI) with profound sensorineural hearing loss (SHL) who are diagnosed with Autism Spectrum Disorder (ASD). The aim of the study was to evaluate a group of ASD CCI users in order to describe their ASD clinical features and CCI outcomes; report on the average electrical charge requirements; and evaluate the possible correlations between electrical and psychophysical outcomes with ASD characteristics. MATERIALS AND METHODS: A multicentre observational study of 22 ASD children implanted in four cochlear implant (CI) centers. Data concerning profound SHL diagnosis, ASD diagnosis, CI timing and CI compliance were collected. Sound Field (SF) was assessed through repeated behavioural measurements. Categories of Auditory Perception (CAP) and Categories of Language (CL) were used to evaluate speech perception and language skills at short (≤2 yrs), medium (5 yrs) and long term (>10 yrs) follow-up. Fitting parameters such as comfortable thresholds, pulse-width (pw, µsec) and clinical units converted into units of charge/phase were collected. The diagnosis of ASD was acquired by the referral neuropsychiatric department and severity was assessed through the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and the Childhood Autism Rating Scale (CARS). RESULTS: At the final follow-up session the median SF threshold for CI outcomes was 30 dB HL (min 15 - max 60). CAP score was extremely variable: 45.5% showed no improvement over time and only 22% of children reached CAP scores of 5-7. CL 45.5% showed no improvement over time and score was 1-2 in the majority of ASD children (72.7%), while only 18.2% reached the highest level of language skills. There were no statistically significant differences at each follow-up between subjects with or without comorbidities. CAP and CL were inversely correlated with DSM-V A and B domains, corresponding to lower speech and language scores in children with more severe ASD symptoms, and maintained their correlation at mid and long follow-ups whilst controlling for age at CI. Electrical charge requirements did not correlate with SF or age at implant but did inversely correlate with ASD severity. With regards to CI compliance: only 13.6% children (3) with severe DSM-V A/B levels and CARS score were partial/intermittent users. CONCLUSION: The present study is a targeted contribution to the current literature to support clinical procedures for CI fitting and audiological follow-up in children with ASD. The findings indicate that the outcomes of CI use and the fitting procedures are both influenced by the severity of the ASD symptoms rather than the demographic variables or associated disorders.


Assuntos
Transtorno do Espectro Autista , Implante Coclear , Implantes Cocleares , Surdez , Percepção da Fala , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/diagnóstico , Criança , Surdez/cirurgia , Humanos
3.
Med Clin North Am ; 105(5): 799-811, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34391534

RESUMO

A focused history, otoscopic and tuning fork examination and formal hearing testing are the diagnostic pillars for the workup of hearing loss and tinnitus. The causes of hearing loss and tinnitus are varied and range from relatively common age-related hearing loss to rare tumors of the brain and skull base. In this chapter, the authors explain the diagnostic workup of hearing loss and tinnitus, review the pathophysiology of the most common causes, and describe the treatments available.


Assuntos
Perda Auditiva/fisiopatologia , Zumbido/fisiopatologia , Audiometria , Implantes Cocleares , Auxiliares de Audição , Perda Auditiva/diagnóstico , Perda Auditiva/etiologia , Perda Auditiva/terapia , Perda Auditiva Condutiva/diagnóstico , Perda Auditiva Condutiva/fisiopatologia , Perda Auditiva Condutiva/terapia , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva Neurossensorial/terapia , Testes Auditivos , Humanos , Atenção Primária à Saúde , Índice de Gravidade de Doença , Zumbido/diagnóstico , Zumbido/etiologia , Zumbido/terapia
4.
J Acoust Soc Am ; 150(1): 339, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34340485

RESUMO

Children with normal hearing (CNH) have greater difficulty segregating competing speech than do adults with normal hearing (ANH). Children with cochlear implants (CCI) have greater difficulty segregating competing speech than do CNH. In the present study, speech reception thresholds (SRTs) in competing speech were measured in Chinese Mandarin-speaking ANH, CNH, and CCIs. Target sentences were produced by a male Mandarin-speaking talker. Maskers were time-forward or -reversed sentences produced by a native Mandarin-speaking male (different from the target) or female or a non-native English-speaking male. The SRTs were lowest (best) for the ANH group, followed by the CNH and CCI groups. The masking release (MR) was comparable between the ANH and CNH group, but much poorer in the CCI group. The temporal properties differed between the native and non-native maskers and between forward and reversed speech. The temporal properties of the maskers were significantly associated with the SRTs for the CCI and CNH groups but not for the ANH group. Whereas the temporal properties of the maskers were significantly associated with the MR for all three groups, the association was stronger for the CCI and CNH groups than for the ANH group.


Assuntos
Implantes Cocleares , Percepção da Fala , Adulto , Criança , Feminino , Audição , Humanos , Masculino , Mascaramento Perceptivo , Fala
5.
J Acoust Soc Am ; 150(1): 506, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34340491

RESUMO

We simulated the effect of several automatic gain control (AGC) and AGC-like systems and head movement on the output levels, and resulting interaural level differences (ILDs) produced by bilateral cochlear-implant (CI) processors. The simulated AGC systems included unlinked AGCs with a range of parameter settings, linked AGCs, and two proprietary multi-channel systems used in contemporary CIs. The results show that over the range of values used clinically, the parameters that most strongly affect dynamic ILDs are the release time and compression ratio. Linking AGCs preserves ILDs at the expense of monaural level changes and, possibly, comfortable listening level. Multichannel AGCs can whiten output spectra, and/or distort the dynamic changes in ILD that occur during and after head movement. We propose that an unlinked compressor with a ratio of approximately 3:1 and a release time of 300-500 ms can preserve the shape of dynamic ILDs, without causing large spectral distortions or sacrificing listening comfort.


Assuntos
Implante Coclear , Implantes Cocleares , Localização de Som , Percepção da Fala , Percepção Auditiva , Movimentos da Cabeça
6.
Artigo em Chinês | MEDLINE | ID: mdl-34344094

RESUMO

Objective: To investigate the effect of insertion technique and electrode array type on the insertion force of electrode array, and to provide a basis for further optimizing electrode design and facilitating mini-invasive electrode insertion. Methods: Three types of electrode array from Nurotron (Standard Electrode, Slim-medium Electrode, Slim-long Electrode) were studied. from July 2019 to December 2019. These electrode arrays were inserted into the phantom models of the cochlea, manually or robot-assisted(medium speed and low speed). The real-time force during electrode array insertion was recorded by ATI Nano 17 Ti sensors and was analyzed by accessory software. Origin 2020b software was used for statistical processing. Results: The insertion force of all electrode arrays progressively increased with the insertion depth. With the manual technique, the peak force of slim-medium electrode insertion was significantly smaller than that of the standard electrode insertion((71.0±16.6) mN vs (140.9±52.7) mN, Z=3.683, P<0.01), and the peak force of the slim-long electrode insertion was between the peak force of standard electrode and slim-medium electrode(P>0.05). No difference was found in the force variation of insertion among the three electrodes(P>0.05). With medium-speed and low-speed robotic assistance, the peak force characteristics of three electrodes were similar to those with the manual technique, but the force variation of standard electrode insertion ((83.9±9.7) mN/s) at medium speed was significantly larger than that of the slim-long electrode insertion ((69.2±4.0)mN/s), and the force variation of the standard electrode insertion at low speed was significantly greater than the other two electrodes. For the same electrode, robot-assisted insertion presented significantly lower peak force and force variation than manual insertion for each type of electrode array. But there was no difference in the peak force and force variation between two-speed levels of robot assistance (P>0.05). Conclusions: The insertion force of the electrode array will be lower when a slim electrode array or robot technique is applied. Long electrode array might make manual insertion difficult or less precise. Robot assistance has advantage on force control during electrode array insertion.


Assuntos
Implante Coclear , Implantes Cocleares , Robótica , Cóclea/cirurgia , Eletrodos Implantados , Humanos
7.
Molecules ; 26(16)2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34443480

RESUMO

Within this study, new materials were synthesized and characterized based on polysiloxane modified with different ratios of N-acetyl-l-cysteine (NAC) and crosslinked via UV-assisted thiol-ene addition, in order to obtain efficient membranes able to resist bacterial adherence and biofilm formation. These membranes were subjected to in vitro testing for microbial adherence against S. pneumoniae using standardized tests. WISTAR rats were implanted for 4 weeks with crosslinked siloxane samples without and with NAC. A set of physical characterization methods was employed to assess the chemical structure and morphological aspects of the new synthetized materials before and after contact with the microbiological medium.


Assuntos
Antibacterianos/química , Materiais Revestidos Biocompatíveis/química , Implantes Cocleares/microbiologia , Otite/tratamento farmacológico , Polímeros/química , Siloxanas/química , Acetilcisteína/química , Acetilcisteína/farmacologia , Acetilcisteína/uso terapêutico , Animais , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Aderência Bacteriana/efeitos dos fármacos , Biofilmes/efeitos dos fármacos , Materiais Revestidos Biocompatíveis/farmacologia , Materiais Revestidos Biocompatíveis/uso terapêutico , Implantes Cocleares/efeitos adversos , Polímeros/farmacologia , Polímeros/uso terapêutico , Ratos Wistar , Siloxanas/farmacologia , Siloxanas/uso terapêutico , Streptococcus pneumoniae/efeitos dos fármacos , Compostos de Sulfidrila/química , Propriedades de Superfície
8.
Artigo em Inglês | MEDLINE | ID: mdl-34398757

RESUMO

Cochlear implants are very well established in the rehabilitation of hearing loss and are regarded as the most successful neuroprostheses to date. While a lot of progress has also been made in the neighboring field of specific vestibular implants, some diseases affect the entire inner ear, leading to both hearing and vestibular hypo- or dysfunction. The proximity of the cochlear and vestibular organs suggests a single combined implant as a means to alleviate the associated impairments. While both organs can be stimulated in a similar way with electric pulses applied through implanted electrodes, the typical phase durations needed in the vestibular system seem to be substantially larger than those typically needed in the cochlear system. Therefore, when using sequential stimulation in a combined implant, the pulse stream to the cochlea is interrupted by comparatively large gaps in which vestibular stimulation can occur. We investigate the impact of these gaps in the auditory stream on speech perception. Specifically, we compare a number of stimulation strategies with different gap lengths and distributions and evaluate whether it is feasible to use them without having a noticeable decline in perception and quality of speech. This is a prerequisite for any practicable stimulation strategy of a combined system and can be investigated even in recipients of a normal cochlear implant. Our results show that there is no significant deterioration in speech perception for the different strategies examined in this paper, leaving the strategies as viable candidates for prospective combined cochleo-vestibular implants.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Percepção da Fala , Estimulação Acústica , Estimulação Elétrica , Humanos , Estudos Prospectivos
9.
Saudi Med J ; 42(8): 813-824, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34344804

RESUMO

OBJECTIVES: To systematically review the occurrence of magnet or receiver/stimulator displacement following cochlear implant (CI) placement complication and evaluate the existing literature on this topic. METHODS: A systematic literature search was conducted using PubMed, Scopus, Web of Science, Virtual Health Library (VHL), and Cochrane Library. Original studies reporting cases of magnet or receiver-stimulator migration occurring as a complication after CI placement were included. The quality of the included studies was evaluated using the National Institutes of Health Quality Assessment Tool for observational studies and CARE checklist for case studies. RESULTS: A total of 36 studies, including 6469 patients, were included. Magnet migration was reported in 82 (1.3%) patients, while receiver/stimulator was reported in 4 (0.1%) cases. The cause of magnet migration was identified in 78 cases; MRI-induced movement was the most frequently reported cause (n=43, 55.1%), followed by head trauma (n=25, 32.1%). A total of 20 studies involving 35 patients with magnet migration performed skull radiography to diagnose magnet migration. Revision/exploratory surgery with surgical repositioning or replacement was the most frequent management procedure (n=46). CONCLUSIONS: Further research on magnet pocket design and standard protocols for MRI in CI users is needed. Early diagnosis of magnet migration and instant referral to specialized CI centers is necessary for proper management and prevention of major complications. PROSPERO REG. NO. CRD: 42020204514.


Assuntos
Implante Coclear , Implantes Cocleares , Humanos , Imageamento por Ressonância Magnética , Imãs/efeitos adversos , Reoperação
10.
J Acoust Soc Am ; 149(5): 3052, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34241104

RESUMO

Bilateral cochlear-implant (CI) users struggle to understand speech in noisy environments despite receiving some spatial-hearing benefits. One potential solution is to provide acoustic beamforming. A headphone-based experiment was conducted to compare speech understanding under natural CI listening conditions and for two non-adaptive beamformers, one single beam and one binaural, called "triple beam," which provides an improved signal-to-noise ratio (beamforming benefit) and usable spatial cues by reintroducing interaural level differences. Speech reception thresholds (SRTs) for speech-on-speech masking were measured with target speech presented in front and two maskers in co-located or narrow/wide separations. Numerosity judgments and sound-localization performance also were measured. Natural spatial cues, single-beam, and triple-beam conditions were compared. For CI listeners, there was a negligible change in SRTs when comparing co-located to separated maskers for natural listening conditions. In contrast, there were 4.9- and 16.9-dB improvements in SRTs for the beamformer and 3.5- and 12.3-dB improvements for triple beam (narrow and wide separations). Similar results were found for normal-hearing listeners presented with vocoded stimuli. Single beam improved speech-on-speech masking performance but yielded poor sound localization. Triple beam improved speech-on-speech masking performance, albeit less than the single beam, and sound localization. Thus, triple beam was the most versatile across multiple spatial-hearing domains.


Assuntos
Implante Coclear , Implantes Cocleares , Localização de Som , Percepção da Fala , Acústica , Fala
11.
Turk J Pediatr ; 63(3): 450-460, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34254490

RESUMO

BACKGROUND: To date, studies have mostly focused on the language outcome of early-auditory interventions including amplification for congenital hearing loss within the first 6 months. We aimed to examine the effect of early-auditory intervention in patients with congenital hearing loss on cognitive, motor and language outcomes, and determine the clinical variables that affect developmental outcomes. METHODS: The medical records of 104 patients were retrospectively reviewed. Children were evaluated by the Bayley Scales of Infant and Toddler Development, Third Edition. RESULTS: The median ages of confirmation of hearing loss, amplification, starting auditory-verbal intervention and cochlear implantation were 9, 10, 13 and 19 months, respectively. Of the patients, 26% received a hearingaid fitting ≤6 months of age. Fifty-one children (49%) had additional disabilities. The median cognitive, language and motor scores of children with no additional disabilities were 95 (65-115), 68 (47-103) and 97 (58- 130), respectively and children with early-auditory intervention (≤6 months) demonstrated higher cognitive, receptive and expressive language subscale scores than late-auditory intervention group (p < 0.05) whereas there was no significant difference in motor scores (p > 0.05). A significant negative correlation was found between additional disability and cognitive, language and motor outcomes (r=-0.78, r=-0.54 and r=-0.75, respectively p < 0.01). There was a significant negative correlation between language outcomes and the degree of hearing loss (r=-0.20, p < 0.05). Multiple regression analyses revealed that additional disability and early-auditory intervention showed a significant amount of variance in cognitive and language scores. The early intervention did not make a significant, independent contribution on motor outcomes whereas additional disability did. CONCLUSIONS: Presence of additional disability was the strongest significant variable on developmental outcomes in hearing-impaired children. In children with no additional disability, significantly better cognitive and language scores were associated with the early-auditory intervention. Motor skills were not affected by the early-auditory intervention.


Assuntos
Implantes Cocleares , Perda Auditiva , Cognição , Humanos , Lactente , Desenvolvimento da Linguagem , Estudos Retrospectivos
12.
Int J Pediatr Otorhinolaryngol ; 148: 110816, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34198228

RESUMO

OBJECTIVES: This study aimed to document the observation of the Crista Fenestra's morphological types (CF) of the round window and to detect its impact during cochlear implant operation. STUDY DESIGN: A prospective descriptive cohort study. SETTINGS: We conducted this study at tertiary referral institutions in Egypt. PATIENTS: This study included 140 children who underwent cochlear implantation. INTERVENTION: We observed the CF's morphological type during the operation according to (Baki-Elzayat) novel classification of CF anatomy, and the need for drilling in each CI operation. MAIN OUTCOME MEASURES: CF has two main types. Type A, in which CF was present at the same level of round window membrane and attached to it. Type B, in which CF was medial to the Round window membrane. RESULTS: Type (A) CF was detected in 125 cases (89.28%), while 25 cases (10.71%) showed type (B) CF. Drilling was needed in 10 cases (7.14%), including CF types A.3 and B2. Drilling was not needed in 130 cases (92.85%), including CF type A.1, A.2, and B.1. There was a statistically significant difference in the need for drilling (P-value <0.001). CONCLUSIONS: According to this prospective study, CF had complicated anatomy. Baki-Elzayat classified the CF into two main types. In type A, CF was at the same level of RWM and attached to it. In type B, CF was medial to RWM. We recommended drilling for partial removal of massive CF types (A.3 and B.2) for atraumatic safe insertion of the electrode without deflection. This classification can offer an easy language system for CI surgeons to describe and register CF during their operations and in the surgical files.


Assuntos
Implante Coclear , Implantes Cocleares , Criança , Estudos de Coortes , Humanos , Estudos Prospectivos , Janela da Cóclea/cirurgia
13.
Int J Pediatr Otorhinolaryngol ; 148: 110814, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34214825

RESUMO

OBJECTIVES: Monitoring children's development of auditory perception, speech and language after implant programming is critical to post-implantation success. Most of the time, it is not possible to perform an evaluation in clinical conditions, and the tests administered may not provide adequate data on children's everyday functional hearing skills. Therefore, administration of functional hearing measures alongside clinical tests will present supplementary data as to both language development and functional hearing performance of children. In addition, determining demographic and environmental variables affecting functional hearing skills and language development will facilitate the implementation of countermeasures. The main objective of this study was to investigate the relationship of functional hearing behaviors in cochlear-implanted children with semantics, morphology and syntax, and to determine how various variables affect functional hearing and language development. METHOD: The study was conducted with 48 cochlear implant users (24 female and 24 male) aged between 3 years and 5 years 11 months with no additional disability. The Test of Early Language Development -Third Edition (TELD-3) was administered to the children participating in the study, and the Functioning after Pediatric Cochlear Implantation (FAPCI) and the demographic information form was completed pursuant to the information provided by the parents. RESULTS: Data analysis in accordance with our hypotheses revealed a significant relationship between semantics, morphology, syntax and functional hearing skill (p < 0.05). The results indicated that language development and functional hearing skill were positively affected by duration of implant use, duration of auditory rehabilitation and kindergarten attendance, and a negative relationship between screen time and functional hearing skill. CONCLUSIONS: In conclusion, the FAPCI is a suitable measure for early listening development and language assessment after cochlear implantation surgery, providing supplementary data on functional hearing and language development when administered in conjunction with other tests. Many factors are affecting functional hearing and language development that determine cochlear implant success. It is important to identify these factors.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Percepção da Fala , Criança , Pré-Escolar , Feminino , Audição , Humanos , Lactente , Desenvolvimento da Linguagem , Masculino , Semântica
14.
Int J Pediatr Otorhinolaryngol ; 148: 110821, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34225082

RESUMO

OBJECTIVES: To investigate the usefulness of measuring the electrically evoked auditory brainstem responses (eABRs) to electrical stimulation at the round window niche (RWN) and round window membrane (RWM) and the effect of deafness duration on functions of the auditory pathway to the level of the brainstem. METHODS: According to the age at cochlear implantation (CI), 99 children with profound sensorineural hearing loss were divided into four groups: ≤12 months (group A), 13-36 months (group B), 37-60 months (group C) and >60 months (group D). The eABRs were evoked by electrical stimulation at RWN and RWM during the operation of CI. RESULTS: The higher eABR extraction rate and lower threshold for RWM stimulation was found than those for RWN stimulation. The eⅢ latencies and eⅢ-eⅤ latency intervals for RWM stimulation were similar among four groups. However, children with earlier CI (group A) showed a significantly shorter eⅤ latency than others. CONCLUSION: The eABR evoked by the electrical stimulation at RWM is more stable and sensitive compared with that at RWN for evaluating functions of the auditory conduction pathway. Development in the upper brainstem pathway may be more vulnerable to long-term deafness as revealed by the eⅤ latency.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Perda Auditiva Neurossensorial , Limiar Auditivo , Criança , Estimulação Elétrica , Potenciais Evocados Auditivos do Tronco Encefálico , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/terapia , Humanos
15.
J Speech Lang Hear Res ; 64(8): 3330-3342, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34251908

RESUMO

Purpose In individuals with cochlear implants, speech recognition is not associated with tests of working memory that primarily reflect storage, such as forward digit span. In contrast, our previous work found that vocoded speech recognition in individuals with normal hearing was correlated with performance on a forward digit span task. A possible explanation for this difference across groups is that variability in auditory resolution across individuals with cochlear implants could conceal the true relationship between speech and memory tasks. Here, our goal was to determine if performance on forward digit span and speech recognition tasks are correlated in individuals with cochlear implants after controlling for individual differences in auditory resolution. Method We measured sentence recognition ability in 20 individuals with cochlear implants with Perceptually Robust English Sentence Test Open-set sentences. Spectral and temporal modulation detection tasks were used to assess individual differences in auditory resolution, auditory forward digit span was used to assess working memory storage, and self-reported word familiarity was used to assess vocabulary. Results Individual differences in speech recognition were predicted by spectral and temporal resolution. A correlation was found between forward digit span and speech recognition, but this correlation was not significant after controlling for spectral and temporal resolution. No relationship was found between word familiarity and speech recognition. Forward digit span performance was not associated with individual differences in auditory resolution. Conclusions Our findings support the idea that sentence recognition in individuals with cochlear implants is primarily limited by individual differences in working memory processing, not storage. Studies examining the relationship between speech and memory should control for individual differences in auditory resolution.


Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Humanos , Reconhecimento Psicológico , Fala
16.
J Speech Lang Hear Res ; 64(8): 3212-3229, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34284611

RESUMO

Purpose Aims of this research were (a) to investigate higher order linguistic and cognitive skills of Italian children with cochlear implants (CIs); (b) to correlate them with the comprehension of irony, which has never been systematically studied in this population; and (c) to identify the factors that facilitate the development of this competence. Method We tested 28 Italian children with CI (mean chronological age = 101 [SD = 25.60] months, age range: 60-144 months), and two control groups of normal-hearing (NH) peers matched for chronological age and for hearing age, on a series of tests assessing their cognitive abilities (nonverbal intelligence and theory of mind), linguistic skills (morphosyntax and prosody recognition), and irony comprehension. Results Despite having grammatical abilities in line with the group of NH children matched for hearing age, children with CI lag behind both groups of NH peers on the recognition of emotions through prosody and on the comprehension of ironic stories, even if these two abilities were not related. Conclusions This is the first study that targeted irony comprehension in children with CI, and we found that this competence, which is crucial for maintaining good social relationships with peers, is impaired in this population. In line with other studies, we found a correlation between this ability and advanced theory of mind skills, but at the same time, a deeper investigation is needed, to account for the high variability of performance in children with CI.


Assuntos
Implante Coclear , Implantes Cocleares , Teoria da Mente , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Compreensão , Humanos , Idioma
17.
J Speech Lang Hear Res ; 64(8): 3343-3356, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34310192

RESUMO

Purpose The aim of the study was to assess the susceptibility to energetic and informational masking in patients with single-sided deafness (SSD) with one normal-hearing (NH) ear and a cochlear implant (CI) in the contralateral ear, understand the effect on speech recognition when spatially separating noise and speech maskers, and investigate the influence of the CI in situations with energetic and informational masking. Method Speech recognition was measured in the presence of either a modulated speech-shaped noise or one of two competing speech maskers in 11 SSD-CI listeners. The speech maskers were manipulated with respect to fundamental frequency to consider the effect of different voices. Measurements were conducted in the unaided (NH) and aided (NHCI) conditions. Spatial release from masking (SRM) was calculated for each masker type and both listening conditions (NH and NHCI) by subtracting scores of the colocated target and masker condition (S0N0) from the spatially separated target and masker conditions (S0N≠0). Results Speech recognition was highly variable depending on the type of masker. SRM occurred in the unaided (NH) and aided (NHCI) conditions when the speech masker had the same gender as the target talker. Adding the CI improved speech recognition when this speech masker was ipsilateral to the NH ear. Conclusions The amount of informational masking is substantial in SSD-CI listeners with both colocated and spatially separated target and masker signals. The contribution of SRM to better speech recognition largely depends on the masker and is considerable when no differences in voices between the target and the competing talker occur. There is only a slight improvement in speech recognition by adding the CI.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Percepção da Fala , Humanos , Mascaramento Perceptivo , Fala
18.
J Acoust Soc Am ; 149(5): 3449, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34241110

RESUMO

Active mechanisms that regulate cochlear gain are hypothesized to influence speech-in-noise perception. However, evidence of a relationship between the amount of cochlear gain reduction and speech-in-noise recognition is mixed. Findings may conflict across studies because different signal-to-noise ratios (SNRs) were used to evaluate speech-in-noise recognition. Also, there is evidence that ipsilateral elicitation of cochlear gain reduction may be stronger than contralateral elicitation, yet, most studies have investigated the contralateral descending pathway. The hypothesis that the relationship between ipsilateral cochlear gain reduction and speech-in-noise recognition depends on the SNR was tested. A forward masking technique was used to quantify the ipsilateral cochlear gain reduction in 24 young adult listeners with normal hearing. Speech-in-noise recognition was measured with the PRESTO-R sentence test using speech-shaped noise presented at -3, 0, and +3 dB SNR. Interestingly, greater cochlear gain reduction was associated with lower speech-in-noise recognition, and the strength of this correlation increased as the SNR became more adverse. These findings support the hypothesis that the SNR influences the relationship between ipsilateral cochlear gain reduction and speech-in-noise recognition. Future studies investigating the relationship between cochlear gain reduction and speech-in-noise recognition should consider the SNR and both descending pathways.


Assuntos
Implantes Cocleares , Percepção da Fala , Audição , Humanos , Ruído/efeitos adversos , Razão Sinal-Ruído , Fala , Adulto Jovem
19.
Trends Hear ; 25: 23312165211031751, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34281434

RESUMO

In children with congenital deafness, cochlear implantation (CI) prior to 12 months of age offers the opportunity to foster more typical auditory development during late infancy and early childhood. Recent studies have found a positive association between early implantation and expressive and receptive language outcomes, with some children able to achieve normal language skills by the time of school entry. Universal newborn hearing screening improved early detection and diagnosis of congenital hearing loss, allowing for earlier intervention, including decision-making regarding cochlear implant (CI) candidacy. It can be more challenging to confirm CI candidacy in infants; therefore, a multidisciplinary approach, including objective audiometric testing, is recommended to not only confirm the diagnosis but also to counsel families regarding expectations and long-term management. Surgeons performing CI surgery in young children should consider both the anesthetic risks of surgery in infancy and the ways in which mastoid anatomy may differ between infants and older children or adults. Multiple studies have found CI surgery in infants can be performed safely and effectively. This article reviews current evidence regarding indications for implantation in children younger than 12 months of age and discusses perioperative considerations and surgical technique.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Perda Auditiva Neurossensorial , Adolescente , Adulto , Criança , Pré-Escolar , Surdez/diagnóstico , Surdez/cirurgia , Humanos , Lactente , Recém-Nascido
20.
Trends Hear ; 25: 23312165211030411, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34293981

RESUMO

Acoustic hearing listeners use binaural cues-interaural time differences (ITDs) and interaural level differences (ILDs)-for localization and segregation of sound sources in the horizontal plane. Cochlear implant users now often receive two implants (bilateral cochlear implants [BiCIs]) rather than one, with the goal to provide access to these cues. However, BiCI listeners often experience difficulty with binaural tasks. Most BiCIs use independent sound processors at each ear; it has often been suggested that such independence may degrade the transmission of binaural cues, particularly ITDs. Here, we report empirical measurements of binaural cue transmission via BiCIs implementing a common "n-of-m" spectral peak-picking stimulation strategy. Measurements were completed for speech and nonspeech stimuli presented to an acoustic manikin "fitted" with BiCI sound processors. Electric outputs from the BiCIs and acoustic outputs from the manikin's in-ear microphones were recorded simultaneously, enabling comparison of electric and acoustic binaural cues. For source locations away from the midline, BiCI binaural cues, particularly envelope ITD cues, were found to be degraded by asymmetric spectral peak-picking. In addition, pulse amplitude saturation due to nonlinear level mapping yielded smaller ILDs at higher presentation levels. Finally, while individual pulses conveyed a spurious "drifting" ITD, consistent with independent left and right processor clocks, such variation was not evident in transmitted envelope ITDs. Results point to avenues for improvement of BiCI technology and may prove useful in the interpretation of BiCI spatial hearing outcomes reported in prior and future studies.


Assuntos
Implante Coclear , Implantes Cocleares , Localização de Som , Estimulação Acústica , Sinais (Psicologia) , Humanos
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