Cochlear Implantation Outcome in Prelingually Deafened Young Adults

Abstract

The outcome of cochlear implantation in patients with deafness of prelingual onset is largely unpredictable due to high individual variability. This study evaluated speech perception performances in a group of 18 prelingually deafened subjects (aged 13–30 years) which was homogeneous with respect to duration of deafness, hearing aid use before cochlear implantation, mode of communication and administration of auditory-oral speech therapy. Word discrimination length, word and sentence identification, phoneme identification and word and sentence recognition were tested before cochlear implantation and at 6 months, 1, 2 and 3 years of cochlear implant use. Scores on all tests significantly improved after cochlear implantation, although mean values were lower compared to those achieved by postlingually deafened patients. Speech performances on both word and sentence recognition continued to increase over time also beyond 1 year after cochlear implantation. Moreover, scores on sentence recognition tests were significantly higher compared to disyllabic words at 3 years of cochlear implant use. The presence of an auditory input delivered by hearing aids before cochlear implantation associated with auditory-oral therapy and a good level of education may positively influence the cochlear implant outcome in prelingually deafened adults.

Assessment and Outcome in Non-Traditional Cochlear Implant Candidates

“…Early studies of speech perception in NT CI candidates showed little or no improvement in open set speech discrimination, though the devices and coding strategies available then were less sophisticated than those in use today [Clark et al, 1987;Waltzman et al, 1992;Zwolan et al, 1996]. Later studies demonstrate that speech perception scores do improve, though to a lesser degree than in traditional candidates [Bond et al, 2009;Santarelli et al, 2008;Teoh et al, 2004a;Waltzman et al, 2002;Yang et al, 2011]. In our group, the mean BKB score increased from 3% before implantation to 39% at 2 years, compared to average outcome scores of 80% for traditional CI candidates in our Department.…”

“…Recipients who used oral communication as a child, had a progressive hearing loss, and wore a hearing aid in the implanted ear up to the time of surgery have been identified as more likely to achieve better speech perception scores [Caposecco et al, 2012]. Prior auditory-verbal therapy, hearing aid use, aural/oral communication, residual hearing or a slowly progressive hearing loss, and development of speech perception all reflect at least some development of the auditory and association pathways prior to loss of neural plasticity and maintenance of these pathways prior to CI [Chee et al, 2004;Clark et al, 1987;Eisenberg, 1982;Kaplan et al, 2003;Klop et al, 2007;Santarelli et al, 2008;Teoh et al, 2004b;Yang et al, 2011;Yoshida et al, 2008]. Good speech intelligibility presumably occurs secondary to reasonable auditory input during the plastic period.…”

“…It was recognised though that despite poor speech recognition, most of these patients were satisfied with their cochlear implant, used it regularly, and reported improved communication abilities [Zwolan et al, 1996]. More recent studies report greater improvements in speech perception outcomes, although not to the same extent as conventional cochlear implant recipients [Teoh et al, 2004a;Santarelli et al, 2008]. Nevertheless, NT cochlear implant recipients have been shown to have significant improvement in quality of life [Peasgood et al, 2003;Straatman et al, 2014).…”

Amplitude Modulation Detection and Speech Recognition in Late-Implanted Prelingually and Postlingually Deafened Cochlear Implant Users

“…While many cochlear implant (CI) users have excellent speech recognition in quiet (Dorman & Spahr 2006), part of this population still struggles (Teoh et al 2004a;Santarelli et al 2008;Lazard, Giraud et al 2012). Most of them are lateimplanted prelingually deafened patients, that is, with an onset of deafness before the end of the language acquisition period.…”

Cochlear implantation in late childhood and adolescence: is there such a thing as ‘too late’?

“…In a review by Santarelli et al of 18 prelingually deaf-implanted adolescents and young adults (age 13-30 years), cochlear implant performance at 6 months, and 1, 2 and 3 years was reported [19]. Although cochlear implant performance was found to be lower than previously published data within the literature obtained from early implanted congenitally deaf patients, phoneme identification, word and sentence identification scores improved significantly following cochlear implantation in these late implanted patients.…”