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1.
Otolaryngol Head Neck Surg ; 162(6): 926-932, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32178574

RESUMO

OBJECTIVE: Default frequency filters of cochlear implant (CI) devices assign frequency information irrespective of intracochlear position, resulting in varying degrees of frequency-to-place mismatch. Substantial mismatch negatively influences speech recognition in postlingually deafened CI recipients, and acclimatization may be particularly challenging for older adults due to effects of aging on the auditory pathway. The present report investigated the influence of mismatch and age at implantation on speech recognition within the initial 6 months of CI use. STUDY DESIGN: Retrospective review. SETTING: Tertiary referral center. SUBJECTS AND METHODS: Forty-eight postlingually deafened adult CI recipients of lateral wall electrode arrays underwent postoperative computed tomography to determine angular insertion depth of each electrode contact. Frequency-to-place mismatch was determined by comparing spiral ganglion place frequencies to default frequency filters. Consonant-nucleus-consonant (CNC) scores in the CI-alone condition at 1, 3, and 6 months postactivation were compared to the degree of mismatch at 1500 Hz and age at implantation. RESULTS: Younger adult CI recipients experienced more rapid growth in speech recognition during the initial 6 months postactivation. Greater degrees of frequency-to-place mismatch were associated with poorer performance, yet older listeners were not particularly susceptible to this effect. CONCLUSIONS: While older adults are not necessarily more sensitive to detrimental effects of frequency-to-place mismatch, other factors appear to limit early benefit with a CI in this population. These results suggest that minimizing mismatch could optimize outcomes in adult CI recipients across the life span, which may be particularly beneficial in the elderly considering auditory processing deficits associated with advanced age.


Assuntos
Implante Coclear/métodos , Surdez/reabilitação , Percepção da Fala/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Surdez/diagnóstico , Surdez/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
4.
Audiol Neurootol ; 24(5): 264-269, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31661682

RESUMO

OBJECTIVE: Our aim was to determine the effect of acute changes in cochlear place of stimulation on cochlear implant (CI) sound quality. DESIGN: In Experiment 1, 5 single-sided deaf (SSD) listeners fitted with a long (28-mm) electrode array were tested. Basal shifts in place of stimulation were implemented by turning off the most apical electrodes and reassigning the filters to more basal electrodes. In Experiment 2, 2 SSD patients fitted with a shorter (16.5-mm) electrode array were tested. Both basal and apical shifts in place of stimulation were implemented. The apical shifts were accomplished by current steering and creating a virtual place of stimulation more apical that that of the most apical electrode. RESULTS: Listeners matched basal shifts by shifting, in the normal-hearing ear, the overall spectrum up in frequency and/or increasing voice pitch (F0). Listeners matched apical shifts by shifting down the overall frequency spectrum in the normal-hearing ear. CONCLUSION: One factor determining CI voice quality is the location of stimulation along the cochlear partition.


Assuntos
Percepção Auditiva/fisiologia , Cóclea/cirurgia , Implante Coclear , Implantes Cocleares , Surdez/reabilitação , Estimulação Acústica , Feminino , Testes Auditivos , Humanos , Masculino , Pessoa de Meia-Idade
5.
Trends Hear ; 23: 2331216519866029, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31533581

RESUMO

Cochlear implantation in subjects with single-sided deafness (SSD) offers a unique opportunity to directly compare the percepts evoked by a cochlear implant (CI) with those evoked acoustically. Here, nine SSD-CI users performed a forced-choice task evaluating the similarity of speech processed by their CI with speech processed by several vocoders presented to their healthy ear. In each trial, subjects heard two intervals: their CI followed by a certain vocoder in Interval 1 and their CI followed by a different vocoder in Interval 2. The vocoders differed either (i) in carrier type-(sinusoidal [SINE], bandfiltered noise [NOISE], and pulse-spreading harmonic complex) or (ii) in frequency mismatch between the analysis and synthesis frequency ranges-(no mismatch, and two frequency-mismatched conditions of 2 and 4 equivalent rectangular bandwidths [ERBs]). Subjects had to state in which of the two intervals the CI and vocoder sounds were more similar. Despite a large intersubject variability, the PSHC vocoder was judged significantly more similar to the CI than SINE or NOISE vocoders. Furthermore, the No-mismatch and 2-ERB mismatch vocoders were judged significantly more similar to the CI than the 4-ERB mismatch vocoder. The mismatch data were also interpreted by comparing spiral ganglion characteristic frequencies with electrode contact positions determined from postoperative computed tomography scans. Only one subject demonstrated a pattern of preference consistent with adaptation to the CI sound processor frequency-to-electrode allocation table and two subjects showed possible partial adaptation. Those subjects with adaptation patterns presented overall small and consistent frequency mismatches across their electrode arrays.


Assuntos
Implante Coclear/métodos , Implantes Cocleares/normas , Perda Auditiva Unilateral/reabilitação , Adulto , Surdez/reabilitação , Feminino , Humanos , Masculino , Som , Fala , Percepção da Fala/fisiologia , Gânglio Espiral da Cóclea
6.
Rev. logop. foniatr. audiol. (Ed. impr.) ; 39(3): 115-128, jul.-sept. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-185830

RESUMO

Introduction: children with severe to profound sensorineural hearing loss and prelingual onset of deafness exhibit less linguistic skills and poorer academic achievements when compared with their hearing peers. Recent studies show that cochlear implants may promote language development in this paediatric population, although phonological development does not always follow the patterns attested for typically developing children. Aim and method: the present study aims at describing the phonetic properties of segments and the phonological processes produced by 18 deaf Portuguese children with more than 2.0 years of implant use, divided into two groups according of their hearing age (A=2.10-4.04 and B=5.04-7.03) For this purpose, we used a formal articulation test validated for the Portuguese population. Results: results show that Group B, with a higher hearing age, exhibit a consonant repertoire more complete than Group A, whose hearing age was lower. Syllable and segmental difficulties tend to persist over a long period of time, even after 4 years of implant experience (i.e. hearing age). Discussion: the children's consonant repertoire of plosives and fricatives seems to take longer to establish in deaf children with cochlear implants than in their Portuguese hearing peer; other phonological patterns found in the data show an immature phonological development (e.g. syllable omission and onset deletion); these results match the ones reported for other languages in other studies on cochlear implanted children


Introducción: los niños con un nivel de hipoacusia neurosensitiva entre intensa y profunda, y en fases iniciales de sordera prelocutiva presentan conocimientos lingüísticos y resultados académicos inferiores en relación con otros niños de su misma edad con un cuadro auditivo normal. Estudios recientes muestran que los implantes cocleares pueden promover el desarrollo lingüístico de este segmento pediátrico, aun cuando el desarrollo fonológico no siempre siga la progresión estándar que se observa en niños con una evolución prototípica. Objetivo y metodología: este estudio tiene como objetivo describir las propiedades de los segmentos fonéticos y de las pautas fonológicas producidos por 18 niños sordos portugueses con más de 2 años de experiencia con el implante coclear, divididos en dos cohortes en función del tiempo que han utilizado este tipo de implantes (A = 2.10-4.04 y B = 5.04-7.03). Con este propósito nos hemos servido de una prueba de articulación formal validada para hablantes portugueses. Resultados: los resultados muestran que el grupo B, con mayor edad auditiva, presenta un repertorio de consonantes más completo que el grupo A. Las dificultades en la producción de sílabas y segmentos suelen persistir durante un largo período de tiempo, incluso después de los 4 años de experiencia con el implante, es decir, con 4 años de edad auditiva. Discusión: al parecer, el repertorio de consonantes obstruyentes (oclusivas y fricativas) tarda más tiempo en establecerse en niños sordos con implantes cocleares que en niños con audición normal. Los datos obtenidos revelan, además, pautas propias de un desarrollo fonológico inmaduro (p. ej., omisión total de sílabas y omisión de ataques silábicos); los resultados coinciden así con los que arrojan varios estudios sobre niños de otras lenguas que llevan también implante coclear


Assuntos
Humanos , Surdez/complicações , Transtorno Fonológico/fisiopatologia , Implantes Cocleares/estatística & dados numéricos , Transtornos do Desenvolvimento da Linguagem/reabilitação , Portugal , Transtorno Fonológico/reabilitação , Surdez/reabilitação , Crianças com Deficiência
7.
Am J Audiol ; 28(3): 686-696, 2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31430174

RESUMO

Purpose There is a growing body of literature that suggests a linkage between impaired auditory function, increased listening effort, and fatigue in children and adults with hearing loss. Research suggests this linkage may be associated with hearing loss-related variations in diurnal cortisol levels. Here, we examine variations in cortisol profiles between young adults with and without severe sensorineural hearing loss and examine associations between cortisol and subjective measures of listening effort and fatigue. Method This study used a repeated-measures, matched-pair design. Two groups (n = 8 per group) of adults enrolled in audiology programs participated, 1 group of adults with hearing loss (AHL) and 1 matched control group without hearing loss. Salivary cortisol samples were collected at 7 time points over a 2-week period and used to quantify physiological stress. Subjective measures of listening effort, stress, and fatigue were also collected to investigate relationships between cortisol levels, perceived stress, and fatigue. Results Subjective ratings revealed that AHL required significantly more effort and concentration on typical auditory tasks than the control group. Likewise, complaints of listening-related fatigue were more frequent and more of a problem in everyday life for AHL compared to the control group. There was a significant association between subjective ratings of listening effort and listening-related fatigue for our AHL, but not for the control group. In contrast, there was no significant difference in cortisol measures between groups, nor were there significant associations between cortisol and any subjective measure. Conclusions Young AHL experience more effortful listening than their normal hearing peers. This increased effort is associated with increased reports of listening-related fatigue. However, diurnal cortisol profiles were not significantly different between groups nor were they associated with these perceived differences.


Assuntos
Ritmo Circadiano , Surdez/reabilitação , Fadiga/metabolismo , Hidrocortisona/metabolismo , Estresse Psicológico/metabolismo , Adulto , Estudos de Casos e Controles , Implantes Cocleares , Fadiga/psicologia , Feminino , Humanos , Masculino , Projetos Piloto , Estresse Psicológico/psicologia , Adulto Jovem
8.
Res Dev Disabil ; 93: 103453, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31421305

RESUMO

BACKGROUND AND AIM: It remains unclear how recognition of segmental and suprasegmental phonemes contributes to sentence-level language processing skills in Mandarin-speaking children with cochlear implants (CIs). Our study examined the influence of implantation age on the recognition of consonants, lexical tones and sentences respectively, and more importantly, the contribution of phonological skills to sentence repetition accuracy in Mandarin-speaking children with CIs. METHODS: The participants were three groups of prelingually deaf children who received cochlear implants at various ages and their age-matched controls with normal hearing. Three tasks were administered to assess their consonant perception, lexical tone recognition and language skills in open-set sentence repetition. RESULTS: Children with CIs lagged behind NH peers in all the three tests, and performances on segmental, suprasegmental and sentence-level processing were differentially modulated by implantation age. Furthermore, performances on recognition of consonants and lexical tones were significant predictors of sentence repetition accuracy in the children with CIs. CONCLUSION: Overall, segmental and suprasegmental perception as well as sentence-level processing is impaired in Mandarin-speaking children with CIs compared with age-matched children with NH. In children with CIs recognition of segmental and suprasegmental phonemes at the lower level predicts sentence repetition accuracy at the higher level. More importantly, implantation age plays an important role in the development of phonological skills and higher-order language skills, suggesting that age-appropriate aural rehabilitation and speech intervention programs need to be developed in order to better help CI users who receive CIs at different ages.


Assuntos
Grupo com Ancestrais do Continente Asiático , Percepção Auditiva , Linguagem Infantil , Implantes Cocleares , Correção de Deficiência Auditiva , Surdez , Fatores Etários , Criança , Pré-Escolar , Implante Coclear/instrumentação , Implante Coclear/métodos , Correção de Deficiência Auditiva/métodos , Correção de Deficiência Auditiva/psicologia , Surdez/psicologia , Surdez/reabilitação , Surdez/cirurgia , Crianças com Deficiência/psicologia , Crianças com Deficiência/reabilitação , Feminino , Humanos , Masculino , Medida da Produção da Fala/métodos
9.
Int J Pediatr Otorhinolaryngol ; 126: 109631, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31445481

RESUMO

OBJECTIVE: Although various studies have depicted the importance of language intervention programs in facilitating language acquisition in cochlear implanted children, to this date rarely has a specific language intervention approach been recommended as better than the other and no best practice has been introduced in terms of language acquisition outcomes. Thus, the therapists remain uncertain as to which approach to follow and how to apply evidence to practice. Hence, the main goal of this study was to take a step in this regard by comparing the communication development of pediatric cochlear implant users who enrolled in two different language intervention approaches: the routine auditory-verbal approach, and the routine auditory-verbal approach plus a new intervention protocol specifically designed to enhance receptive vocabulary development in cochlear implanted children. METHOD AND MATERIALS: This prospective experimental study compared the receptive and expressive communication developmental scores of 26 cochlear implanted 20-24 months old children who received both a routine auditory-verbal intervention and a new cognitive based intervention protocol specifically designed to enhance receptive vocabulary development, with that of a group of 25 participants whose intervention program was only auditory-verbal. The children were recruited from Fars cochlear implant center situated in the city of Shiraz in Iran, and were assigned randomly to the two groups. The communication development of both groups was evaluated by the Bayley scales of Infant and Toddler Development- Third Edition, and statistical analysis was performed using the Statistical Package for Social Sciences-version 21(SPSS-21). RESULTS: The two groups were not significantly different in terms of age, sex and parents' educational level. Both the receptive and expressive communication outcomes of the children who received auditory-verbal as well as the new specifically-designed cognitive-based intervention protocol focusing on receptive vocabulary enhancement, were significantly higher than the control group (p < 0.001). CONCLUSION: The new specifically-designed cognitive-based language intervention protocol focusing on receptive vocabulary enhancement was significantly more effective in promoting and enhancing the communication development of cochlear implanted children than the routine auditory-verbal intervention.


Assuntos
Implantes Cocleares , Surdez/reabilitação , Terapia da Linguagem , Fonoterapia , Vocabulário , Pré-Escolar , Correção de Deficiência Auditiva/métodos , Surdez/cirurgia , Feminino , Humanos , Lactente , Desenvolvimento da Linguagem , Masculino , Estudos Prospectivos
10.
HNO ; 67(10): 778-785, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31468082

RESUMO

BACKGROUND: Hearing rehabilitation of patients with severe hearing loss by cochlear implant (CI) enhances their opportunities for communication immensely with regard to their normal-hearing social environment. The degree of participation depends decisively on speech discrimination. This study examines whether speech discrimination can be improved by equipping patients with next-generation speech processors (SP). METHODS: The changes in speech discrimination of 420 CI patients upon receiving a newer SP from 2003-2012 were retrospectively analyzed. Audiometry comprised the Freiburg number and monosyllable tests and the Oldenburg sentence test in quiet and noise, with a presentation volume of 70 dB. RESULTS: In all audiometric tests, the newer SP showed a significant improvement compared to the preceding SP. This improvement was attainable for the majority of patients and was independent of age. CONCLUSION: Upgrade of the SP results in improved speech discrimination. This holds true for several test settings. We therefore recommend earlier upgrades and that the costs for new SP be met.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Percepção da Fala , Compreensão , Surdez/reabilitação , Humanos , Estudos Retrospectivos , Fala
11.
Am J Otolaryngol ; 40(5): 724-728, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31277886

RESUMO

Linguistic information and cognitive rehabilitation has more related with auditory perception and verbal intelligibility. The aim of the present study was to assessment of the effectiveness of cognitive rehabilitation program on the auditory perception and verbal intelligibility of deaf children. This study was a quasi-experimental study with pre-test, post-test and control group design. Participants were 24 deaf children from Ava rehabilitation center of mother child in Isfahan city, Iran. Participants were selected by convenient sampling method. They were randomly divided into experimental and control groups, each group consisted of 12 children. The experimental group participated in the cognitive rehabilitation training program in 10 sessions for 45 min, while control group did not participate this program. The instruments of present research were Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR). The data were analyzed using multivariate analysis of covariance (MANCOVA) in 24th version of SPSS. The results of MANCOVA showed that cognitive rehabilitation program had significant effect on the auditory perception and verbal intelligibility in the experimental group at post intervention stage (P < 0/0001). There was a positive and significant increase in auditory perception and verbal intelligibility of experimental group. Our findings showed that Cognitive rehabilitation program training led to promote of auditory perception and verbal intelligibility of deaf children.


Assuntos
Percepção Auditiva/fisiologia , Terapia Cognitivo-Comportamental/organização & administração , Surdez/diagnóstico , Surdez/reabilitação , Inteligibilidade da Fala/fisiologia , Estudos de Casos e Controles , Pré-Escolar , Feminino , Humanos , Irã (Geográfico) , Masculino , Análise Multivariada , Estudos Prospectivos , Melhoria de Qualidade , Valores de Referência , Medição de Risco , Resultado do Tratamento
12.
Res Dev Disabil ; 92: 103444, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31336346

RESUMO

BACKGROUND: It is unclear whether phonological awareness and vocabulary knowledge are independent predictors of reading fluency for deaf children in different grades. AIMS: This study examined the relative contributions of phonological awareness and vocabulary knowledge to Chinese deaf children's reading fluency in grades 3-4 (lower grades; mean age 14.08 years) and 5-6 (higher grades; mean age 15.05 years). METHODS AND PROCEDURES: One hundred and forty-one deaf children and 163 hearing children were enrolled. All children completed assessments of general cognitive ability, onset and tone awareness, vocabulary knowledge and reading fluency. OUTCOMES AND RESULTS: The results showed that for lower-grade deaf children, the unique effect of onset awareness on reading fluency was not statistically significant, but it was an independent predictor in higher grades; for lower-grade hearing children, onset awareness accounted for variance in reading fluency, but its effect was not significant in higher grades. No significant effect of tone awareness was found in deaf or hearing children. However, vocabulary knowledge significantly explained the variance in reading fluency for all subgroups. CONCLUSIONS AND IMPLICATIONS: The predictive patterns of phonological awareness on reading fluency are complex and depend on many factors, while vocabulary knowledge is an important and consistent predictor for both deaf and hearing children.


Assuntos
Conscientização , Cognição , Surdez , Fonética , Leitura , Vocabulário , Pré-Escolar , China , Surdez/psicologia , Surdez/reabilitação , Feminino , Testes Auditivos/métodos , Humanos , Testes de Linguagem , Masculino , Pessoas com Deficiência Auditiva/psicologia , Pessoas com Deficiência Auditiva/reabilitação
13.
Int J Pediatr Otorhinolaryngol ; 125: 23-31, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31238158

RESUMO

BACKGROUND: Despite early identification and intervention, many children who are deaf/hard of hearing (D/HH) demonstrate significant gaps in language development which can directly impact social interactions. AIMS: The objective of this pilot study was to determine whether integrating augmentative and alternative communication (AAC) core word language strategies into a speech-language therapy program for young children who are D/HH improves spoken language outcomes. METHODS: Eleven young children, median age 5 years 7 months (range 3y;11 m to 10y;8 m) with bilateral hearing loss were enrolled in a single-case experimental design and completed a 24-week intervention that incorporated high-tech AAC strategies into a traditional speech-language therapy model (technology-assisted language intervention or TALI). The goal of the TALI was to improve spoken language development in children who were D/HH. Language samples were collected throughout the study and pragmatic language was assessed pre and post intervention. RESULTS: At the end of 24 weeks, children demonstrated a significant increase in their mean length of utterance, number of words spoken, and mean turn length according to language samples. Children also made gains in their pragmatic skills pre to post intervention. CONCLUSIONS: Results of this study suggest that using AAC core word language strategies delivered via iPad technology may support continued and rapid spoken language skill growth among young school-age children who are D/HH. By leveraging AAC technology, we are pioneering a structured and dynamic approach to language learning, building an effective foundation for concepts and grammar for children who are D/HH.


Assuntos
Comunicação , Surdez/reabilitação , Pessoas com Deficiência Auditiva/reabilitação , Terapia Assistida por Computador , Criança , Pré-Escolar , Computadores de Mão , Feminino , Humanos , Desenvolvimento da Linguagem , Terapia da Linguagem , Masculino , Projetos Piloto , Software , Fonoterapia
14.
Rev. logop. foniatr. audiol. (Ed. impr.) ; 39(2): 75-85, abr.-jun. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-185744

RESUMO

Introducción: el objetivo del trabajo fue determinar el papel de los códigos ortográficos y fonológicos en el aprendizaje de la lectura en estudiantes sordos con y sin implante coclear (IC). Se analizaron varias cuestiones: 1) si la calidad de las representaciones fonológicas que poseen y su capacidad para manipularlas depende o no del uso de IC; 2) si los niveles lectores que alcanzan dependen de la calidad de las representaciones fonológicas, y 3) si las representaciones ortográficas que almacenan provienen de las representaciones fonológicas correspondientes. Metodología: participaron 172 estudiantes sordos con edades entre los 6 y los 18 años, divididos en 4 grupos: alumnos con IC precoz, alumnos con IC tardío, alumnos sin IC con sordera moderada y alumnos sin IC con sordera profunda. Como grupo control, participó un grupo de 797 oyentes de igual edad. Todos fueron evaluados con una prueba de lectura, una de ortografía y 3 de metafonología. Resultados: los resultados muestran que los IC, sobre todo los colocados precozmente (antes de 30 meses), conducen a mejores resultados en todas las tareas experimentales. En el extremo opuesto encontramos el grupo con sordera profunda sin IC. Las representaciones ortográficas parecen almacenarse utilizando las representaciones fonológicas correspondientes, que a su vez mejoran gracias a la información ortográfica proporcionada por la actividad de lectura en sí. Discusión y conclusiones: se discute la necesidad de establecer una enseñanza explícita y sistemática en habilidades metafonológicas antes y durante la enseñanza de lectura de los estudiantes sordos


Introduction: the objective of this study was to determine the role of orthographic and phonological codes in deaf students learning to read with and without cochlear implant (CI). Several questions were analyzed: 1) whether the quality of the phonological representations they possess and their ability to manipulate them depends or not on the use of CI; 2) whether the reading levels they reach depend on the quality of the phonological representations; and 3) whether the orthographic representations they store come from the corresponding phonological representations. Methodology: participating in the study were 172 deaf students aged between 6 and 18 years, divided into 4 groups: students with early CI, students with late CI, students without CI and moderate hearing loss and students without CI and profound hearing loss. As a control group, a group of 797 listeners of the same age participated. All were evaluated with a reading test, a spelling test and 3 metaphonology tests. Results: the results show that the CIs, especially those fitted early (before 30 months), lead to better results in all experimental tasks. The group with profound deafness without CI were at the opposite extreme. The orthographic representations seem to be stored using the corresponding phonological representations, which in turn improve thanks to the orthographic information provided by the reading activity itself. Discussion and conclusions: the need to establish an explicit and systematic training in metaphonological skills before and during the reading instruction of deaf students is discussed


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Implantes Cocleares/estatística & dados numéricos , Surdez/reabilitação , Educação de Pessoas com Deficiência Auditiva/métodos , Deficiências da Aprendizagem , Estudos de Casos e Controles , Leitura , Escrita Manual , Transtorno Fonológico , Aprendizagem
15.
HNO ; 67(8): 612-619, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31065763

RESUMO

BACKGROUND: Auditory training is an established intervention in adult cochlear implant (CI) aural rehabilitation. In most cases, training is implemented in an individual therapy setting. Increasing patient numbers and the associated time-economic and cost-related demands as well as psychosocial and communicative aspects support the use of aural group interventions. OBJECTIVES: This study aimed 1) to describe concepts and contents of group interventions for adult CI users and 2) to present results of a questionnaire-based evaluation. METHODS: Group interventions have been offered at the CI Centre Erlangen CICERO for several years. In Auditory Training Groups, exercises have priority, while Thematic Group Workshops focus on psychosocial aspects and provide information for the participants. The Auditory Training Groups were evaluated based on a patient questionnaire. Additionally, the reliability of the questionnaire was analyzed. RESULTS: The median overall satisfaction of CI users participating in Auditory Training Groups was rated as good. Training of speech perception in noise as well as communicative exchange are of great importance for CI users. They rated the therapeutic design as very good to good. Reliability analysis showed significant positive intercorrelations of the questionnaire items. CONCLUSION: Group interventions are well accepted by CI users and represent a useful complement to individual therapy during the rehabilitation process. As group interventions place special demands on patients and therapists, structured and well-proven concepts should be used in practice.


Assuntos
Implante Coclear , Implantes Cocleares , Correção de Deficiência Auditiva , Surdez , Psicoterapia de Grupo , Percepção da Fala , Adulto , Percepção Auditiva , Correção de Deficiência Auditiva/métodos , Surdez/reabilitação , Surdez/cirurgia , Humanos , Reprodutibilidade dos Testes
16.
Eur Arch Otorhinolaryngol ; 276(8): 2205-2213, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31102018

RESUMO

PURPOSE: Many bilaterally deaf adults are only able to receive one cochlear implant (CI), resulting in suboptimal listening performance, especially in challenging listening environments. Adding a contralateral routing of signal (CROS) device to a unilateral CI is one possibility to alleviate these challenges. This study examined the benefit of such a CROS device. METHODS: Thirteen adult subjects with at least 6 months of CI use, and no or limited benefit of a hearing instrument in the contralateral ear were included in the study. The perceived benefit of a CROS device in everyday listening environments was evaluated up to 1 year after initial fitting using several questionnaires. Speech intelligibility performance was determined using the French matrix sentence test in quiet and in two speech-in-noise setups and was followed for 3 months after CROS fitting. RESULTS: Subjects indicated high satisfaction with the practical usability of the CROS device and long-term device retention was high. Perceived benefits in everyday listening environments were reported. Formal speech intelligibility tests revealed statistically significant median improvements of 6.93 dB SPL (Wilcoxon Z = 2.380, p = 0.017) in quiet and up to 8.00 dB SNR (Wilcoxon Z = 2.366, p = 0.018) in noise. These benefits were accessible immediately without a need for prolonged acclimatization. CONCLUSIONS: Subjective satisfaction and device retention as well as speech intelligibility benefits in quiet and in noise prove the CROS device to be a valuable addition to a unilateral CI in cases of bilateral deafness where bilateral implantation is not an option.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Retenção da Prótese , Inteligibilidade da Fala , Idoso , Implante Coclear/efeitos adversos , Implante Coclear/métodos , Implante Coclear/psicologia , Surdez/psicologia , Surdez/reabilitação , Feminino , França , Testes Auditivos/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Localização de Som
17.
Am J Audiol ; 28(1): 62-68, 2019 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-30938557

RESUMO

Purpose The aim of the current study was to review all pediatric cases with congenital deafness who underwent bilateral implantation in our center. Specifically, auditory performance and speech intelligibility ratings were compared across children based on their mode of bilateral stimulation (simultaneous or sequential implantation). Method A retrospective chart review design was used in this study. A total of 46 congenitally deaf children were included. Children ranged in age between 2 and 8 years, with a mean of 3 years 7 months. Participants were divided into 2 groups: those who received their bilateral implant simultaneously and those who received them sequentially. Categories of Auditory Performance (CAP; Archbold, Lutman, & Marshall, 1995 ) scores and Speech Intelligibility Rating (SIR; M. C. Allen, Nikolopoulos, & O'Donoghue, 1998 ) scores were used to measure their performance. Results Children scored an average of 4.1 (±1.6) on the CAP Scale and 1.6 (±1) on the SIR Scale. Results showed that children who received their implants simultaneously scored relatively higher on the CAP Scale than those with sequential implants. However, there were no differences between the 2 groups in SIR scores. These 2 outcome measures were not correlated with age at implantation. Conclusion The current study demonstrated that simultaneous implantation could potentially improve audiologic outcome.


Assuntos
Implante Coclear/métodos , Surdez/reabilitação , Inteligibilidade da Fala , Percepção Auditiva , Criança , Pré-Escolar , Surdez/congênito , Surdez/fisiopatologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Percepção da Fala , Inquéritos e Questionários , Resultado do Tratamento
18.
Ear Hear ; 40(6): 1368-1375, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30946137

RESUMO

OBJECTIVES: Cochlear implant (CI) users frequently report poor sound quality while listening to music, although the specific parameters responsible for this loss of sound quality remain poorly understood. Audio compression, which reduces the dynamic range (DR) for a given sound, is a ubiquitous component of signal processing used by both CI and hearing aid technology. However, the relative impact of compression for acoustic and electric hearing on music perception has not been well studied, an important consideration especially given that most compression algorithms in CIs were developed to optimize speech perception. The authors hypothesized that normal-hearing (NH) listeners would detect increased levels of compression more easily than CI users, but that both groups would perceive a loss of sound quality with increasing compression levels. DESIGN: The present study utilizes the Cochlear Implant-MUltiple Stimulus with Hidden Reference and Anchor to evaluate the listener sensitivity to increasing levels of compression applied to music stimuli. The Cochlear Implant-MUltiple Stimulus with Hidden Reference and Anchor is a tool used to assess relative changes in the perceived sound quality of music across increasingly degraded listening conditions, in both CI and NH subjects. In this study, the authors applied multiple iterations of an aggressive compression algorithm to the music clips using Adobe Audition. The test conditions included 1, 3, 5, and 20 iterations sound tokens, with the 20-iteration samples serving as the Anchor stimuli. The compressed excerpts were 5 sec in length, with five clips for each of the five common musical genres (i.e., Classical, Jazz, Country, Rock, and Hip-Hop). Subjects were also presented with a Reference excerpt, which was the original music clip without any additional compression applied. CI recipients (n = 7, 11 ears) and NH listeners (n = 10) were asked to rate the sound quality of additionally compressed music as compared to the Reference. RESULTS: Although both NH and CI groups could detect sound quality differences as a function of compression level, the discriminatory ability of the CI group was blunted compared to the NH group. The CI group had less variability in their responses and overall demonstrated reduced sensitivity to deterioration caused by excessive levels of compression. On average, the CI group rated the Anchor condition as only "Slightly worse" than the Reference. The music clips that were most affected by the compression were from Jazz and Hip-Hop genres and less so for Rock and Country clips. Corollary to this was a small but statistically significant impact of DR of the music clips on sound quality ratings, with narrower DR showing an association with poorer ratings. CONCLUSIONS: These results indicate that CI users exhibit less sensitivity to sound quality changes in music attributable to high levels of compression. These findings may account for another contributing factor to the generally poor music perception observed in CI users, particularly when listening to commercially recorded music.


Assuntos
Implantes Cocleares , Compressão de Dados , Surdez/reabilitação , Música , Processamento de Sinais Assistido por Computador , Acústica , Adulto , Idoso , Estudos de Casos e Controles , Implante Coclear , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
19.
Audiol Neurootol ; 24(1): 32-37, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30955013

RESUMO

In this study, we tested whether the speech recognition, through radio communications, of cochlear implant (CI) users inside a noisy helicopter cockpit is adequate for safe flight. METHOD: Speech recognition tests (sentences, numbers and disyllables) through a very-high-frequency radio were administered to 12 CI users in a soundproof booth, inside a helicopter with the engine turned off and turned on. RESULTS: In quiet environments, radio communications were impacted only for disyllable intelligibility, but in noisy situations, all tests were affected. CONCLUSIONS: CI subjects did not achieve the auditory levels recommended by the International Civil Aviation Organization.


Assuntos
Aeronaves , Implante Coclear , Implantes Cocleares , Surdez/reabilitação , Ruído , Percepção da Fala , Adolescente , Adulto , Medicina Aeroespacial , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
20.
Audiol Neurootol ; 24(1): 38-48, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30995658

RESUMO

BACKGROUND: In electric-acoustic pitch matching experiments in patients with single-sided deafness and a cochlear implant, the observed "mismatch" between perceived pitch and predicted pitch, based on the amended Greenwood frequency map, ranges from -1 to -2 octaves. It is unknown if and how this mismatch differs for perimodiolar versus lateral wall electrode arrays. OBJECTIVES: We aimed to investigate if the type of electrode array design is of influence on the electric-acoustic pitch match. METHOD: Fourteen patients (n = 8 with CI422 + lateral wall electrode array, n = 6 with CI512 + perimodiolar electrode array; Cochlear Ltd.) compared the pitch of acoustic stimuli to the pitch of electric stimuli at two test sessions (average interval 4.3 months). We plotted these "pitch matches" per electrode contact against insertion angle, calculated from high-resolution computed tomography scans. The difference between these pitch matches and two references (the spiral ganglion map and the default frequency allocation by Cochlear Ltd.) was defined as "mismatch." RESULTS: We found average mismatches of -2.2 octaves for the CI422 group and -1.3 octaves for the CI512 group. For any given electrode contact, the mismatch was smaller for the CI512 electrode array than for the CI422 electrode array. For all electrode contacts together, there was a significant difference between the mismatches of the two groups (p < 0.05). Results remained stable over time, with no significant difference between the two test sessions considering all electrode contacts. Neither group showed a significant correlation between the mismatch and phoneme recognition scores. CONCLUSION: The pitch mismatch was smaller for the perimodiolar electrode array than for the lateral wall electrode array.


Assuntos
Implante Coclear/métodos , Implantes Cocleares , Perda Auditiva Unilateral/reabilitação , Nível de Percepção Sonora , Estimulação Acústica , Adulto , Idoso , Surdez/reabilitação , Eletrodos Implantados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gânglio Espiral da Cóclea , Resultado do Tratamento , Adulto Jovem
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