Cochlear Implantation in Adults

Carlson, Matthew L.

doi:10.1056/nejmra1904407

Cited by 119 publications

(126 citation statements)

References 84 publications

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“…There are reports now on remote mapping [ 14 ], but this is seldom used in the German-speaking region. In the Anglo-American area, in which rehabilitation as we know it does not exist [ 3 ], positive effects of online auditory training are described [ 4 , 5 , 16 ]. However, the question arises of whether these forms of training alone (mapping plus auditory training) meet the term “rehabilitation” according to the WHO [ 12 ], and financing such models has not been clarified for the German-speaking region thus far.…”

Section: Discussionmentioning

confidence: 99%

Quality of cochlear implant rehabilitation under COVID-19 conditions

Aschendorff

Arndt

Kröger

et al. 2020

HNO

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Background The rehabilitation process following cochlear implant (CI) surgery is carried out in a multimodal therapy according to German national guidelines and includes technical and medical aftercare. In times of the corona pandemic surgery and rehabilitation appointments were cancelled or delayed leading to a more difficult access to auditory rehabilitation. Newly implemented hygiene modalities due to the SARS-CoV‑2 pandemic have changed medical aftercare and the rehabilitation process. The aim of this study was to evaluate the quality of rehabilitation under corona conditions. Material and methods An anonymous survey of adult cochlear implant patients was carried out by a non-standardized questionnaire. Demographics were analyzed and the quality of medical aftercare, speech therapy, technical aftercare, psychological support and the hygiene modalities were compared to previous rehabilitation stays. Results In total 109 patients completed the questionnaire. The quality of rehabilitation and individual therapy were rated as qualitatively similar or improved. The threat of the pandemic and fear of corona were rated unexpectedly high with 68% and 50%, respectively. The hygiene measures during the rehabilitation stay eased subjective fears at the same time. The majority of patients were annoyed by wearing face masks but visors, protection shields and social distancing were more tolerated. Conclusion The implementation of the new hygiene modalities within the therapeutic rehabilitation setting was well-accepted by patients allowing access to auditory rehabilitation. A successful rehabilitation should ensure a fear-free environment by adhering to the necessary hygiene modalities.

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Section: Discussionmentioning

confidence: 99%

Quality of cochlear implant rehabilitation under COVID-19 conditions

Aschendorff

Arndt

Kröger

et al. 2020

HNO

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“…Cochlear implants consist of five parts – an external microphone, an external speech processor, an external transmitter, an internal receiver, and an internal electrode array ( Figure 1 ; Lenarz et al, 2012 ; Roche and Hansen, 2015 ). These work in concert to receive sounds from the external environment, convert them to radio waves that cross the skin from the transmitter to the receiver, further convert the radio waves to electrical impulses, and then send these electric impulses along the electrode array to stimulate the auditory nerve ( Figure 1 ; Niparko and Marlowe, 2010 ; Roche and Hansen, 2015 ; Carlson, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Genotype-Phenotype Correlation for Predicting Cochlear Implant Outcome: Current Challenges and Opportunities

et al. 2020

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The use and utility of cochlear implantation has rapidly increased in recent years as technological advances in the field have expanded both the efficacy and eligible patient population for implantation. This review aims to serve as a general overview of the most common hearing disorders that have favorable auditory outcomes with cochlear implants (CI). Hearing loss in children caused by congenital cytomegalovirus infection, syndromic conditions including Pendred Syndrome, and non-syndromic genetic conditions such as hearing impairment associated with GJB2 mutations have shown to be successfully managed by CI. Furthermore, cochlear implantation provides the auditory rehabilitation for the most common etiology of hearing loss in adults and age-related hearing loss (ARHL) or presbycusis. However, in some cases, cochlear implantation have been associated with some challenges. Regarding implantation in children, studies have shown that sometimes parents seem to have unrealistic expectations regarding the ability of CI to provide auditory rehabilitation and speech improvement. Given the evidence revealing the beneficial effects of early intervention via CI in individuals with hearing disorders especially hearing loss due to genetic etiology, early auditory and genetic screening efforts may yield better clinical outcomes. There is a need to better understand genotype-phenotype correlations and CI outcome, so that effective genetic counseling and successful treatment strategies can be developed at the appropriate time for hearing impaired individuals.

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“…Cochlea surgery has proven to be an effective and straightforward surgical procedure with low complication rates. 11 However, electrode insertion may be impaired or even impossible based on changes of the cochlea in patients after head trauma, acute labyrinthitis, or otosclerosis. [12][13][14] In patients with cholesteatoma or chronic suppurative otitis media, CI can be challenging and, in many cases, requires special operative strategies.…”

Section: Discussionmentioning

confidence: 99%

Cochlear Implantation Following Explorative Tympanotomy in Patients With Sudden Sensorineural Hearing Loss: Surgical Features and Audiological Outcomes

et al. 2021

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Objective: To investigate the anatomical status of the round window niche and hearing outcome of cochlear implantation (CI) after explorative tympanotomy (ExT) with sealing of the round window membrane in patients with sudden sensorineural hearing loss at a tertiary referral medical center. Methods: Between January 1, 2007, and July 30, 2020, 1602 patients underwent CI at our department. Out of these, all patients previously treated by ExT with sealing of the round window membrane because of unilateral sudden hearing loss were included in the study. A retrospective chart review was conducted concerning method of round window membrane sealing, intraoperative findings during CI, postoperative imaging, and hearing results. Results: Twenty one patients (9 females; 8 right ears; 54.3 years [± 12.9 years]) underwent ExT with sealing of the round window membrane with subsequent CI after 26.6 months (± 32.9 mo) on average. During CI, in 76% of cases (n = 16), the round window niche was blocked by connective tissue due to the previous intervention but could be removed completely in all cases. The connective tissue itself and its removal had no detrimental effects on the round window membrane. Postoperative computed tomography scan showed no electrode dislocation. Mean postoperative word recognition score after 3 months was 57.4% (± 17.2%) and improved significantly to 73.1% (± 16.4%, P = .005) after 2 years. Conclusion: Performing CI after preceding ExT, connective tissue has to be expected blocking the round window niche. Remaining tissue can be removed safely and does not alter the round window membrane allowing for a proper electrode insertion. Short- and long-term hearing results are satisfactory. Consequently, ExT with sealing of the round window membrane in patients with sudden sensorineural hearing loss does not impede subsequent CI that can still be performed safely.

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Cochlear Implantation in Adults

Cited by 119 publications

References 84 publications

Quality of cochlear implant rehabilitation under COVID-19 conditions

Quality of cochlear implant rehabilitation under COVID-19 conditions

Genotype-Phenotype Correlation for Predicting Cochlear Implant Outcome: Current Challenges and Opportunities

Cochlear Implantation Following Explorative Tympanotomy in Patients With Sudden Sensorineural Hearing Loss: Surgical Features and Audiological Outcomes

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