Long term results in late implanted adolescent and adult CI recipients

Bosco, Ersilia; Nicastri, Maria; Ballantyne, Deborah; Viccaro, Marika; Ruoppolo, Giovanni; Maddalena, Alessandra Ionescu; Mancini, Patrizia

doi:10.1007/s00405-012-2264-4

Cited by 23 publications

(24 citation statements)

References 36 publications

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“…High user satisfaction rates have consistently been reported in studies on early-deafened CI users, even in subjects with almost negligible gain in auditory performance [Bosco et al, 2013;Caposecco et al, 2012;Hinderink et al, 1995;Kaplan et al, 2003;Peasgood et al, 2003;Zwolan et al, 1996]. A number of studies have evaluated quality of life before and after implantation and found significant postoperative improvements, mainly in hearing-related quality of life questionnaires [Klop et al, 2007;Most et al, 2010;Schramm et al, 2002;Straatman et al, 2014;van Dijkhuizen et al, 2011], but also in hearingrelated domains of general health status questionnaires [Klop et al, 2007;Straatman et al, 2014].…”

Section: Introductionmentioning

confidence: 97%

“…As speechcoding strategies evolved towards SPEAK, CIS and ACE from the late 90s onwards, studies showed that more beneficial results were possible for prelingually deafened adults [Schramm et al, 2002;Waltzman and Cohen, 1999;Waltzman et al, 2002]. A number of recent studies have demonstrated significant postoperative improvement in the mean scores of this group of CI users in various speech-understanding tests [Bosco et al, 2013;Caposecco et al, 2012;Klop et al, 2007;Rousset et al, 2016;Santarelli et al, 2008;Shpak et al, 2009;van Dijkhuizen et al, 2011;Yang et al, 2011]. Nevertheless, there are still large interindividual differences, with part of the early-deafened population obtaining scores slightly above or at 0% when speech understanding is assessed using open-set words or sentences.…”

Section: Introductionmentioning

confidence: 99%

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Late Cochlear Implantation in Early-Deafened Adults: A Detailed Analysis of Auditory and Self-Perceived Benefits

2017

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Objectives: It is known that early-deafened cochlear implant (CI) users are a very heterogeneously performing group. To gain more insight into this population, this study investigated (1) postoperative changes in auditory performance over time based on various outcome measures, focusing on poor performers, (2) self-perceived outcomes, (3) relations between auditory and self-perceived outcomes, and (4) preimplantation factors predicting postoperative outcomes. Methods: Outcomes were assessed prospectively in a group of 27 early-deafened, late-implanted CI users, up to 3 years after implantation. Outcome measures included open-set word and sentence recognition, closed-set word recognition, speech tracking and a questionnaire on self-perceived outcomes. Additionally, the relative influence of 8 preimplantation factors on CI outcome was assessed with linear regression analyses. Results: Significant improvements were found for auditory performance measures and most of the questionnaire domains. Significant changes of the closed-set word test, speech tracking and questionnaire were also found for a subgroup of poor performers. Correlations between auditory and self-perceived outcomes were weak and nonsignificant. Preoperative word recognition and preoperative hearing thresholds, both for the implanted ear, were significant predictors of postoperative outcome in the multivariable regression model, explaining 63.5% of the variation. Conclusions: Outcome measurement in this population should be adjusted to the patients’ individual performance level and include self-perceived benefit. There is still a need for more knowledge regarding predictors of CI outcomes in this group, but the current study suggests the importance of the preoperative performance of the ear to be implanted.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Late Cochlear Implantation in Early-Deafened Adults: A Detailed Analysis of Auditory and Self-Perceived Benefits

2017

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“…For example, in one UK cochlear implant centre the partial or non-use rate was reported to be 15% (Emond et al, 2013). Under-use of the implant has also been reported in adolescents with monaural devices, even where hearing outcomes such as speech perception are good (Bosco et al, 2013 …”

Section: Discussionmentioning

confidence: 99%

“…In addition, teenagers with pre-lingual deafness can receive benefit from a second cochlear implant, even if there has been more than 16 years between devices (Galvin et al, 2010). A recent study of a small sample of ten pre-and perilingually deafened (during the development of speech and language) teenagers showed a significant improvement in speech perception with benefits such as improved self-esteem and greater self-sufficiency, and high satisfaction with the device (Bosco et al, 2013).…”

Section: Pre-and Post-lingual Cochlear Implantationmentioning

confidence: 99%

Exploring the experiences of teenagers with cochlear implants

Watson

Verschuur

Lathlean

2016

Cochlear Implants International

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Whilst much research has focused on the general health needs of adolescents, little is known about the specific needs of teenagers who wear cochlear implants. Thus it is important to widen the knowledge base regarding the experiences of this population, and to assist professionals to support this age group more effectively.This qualitative study investigated teenage cochlear implant users' perceptions of deafness, surgery, fitting of the device and life as a cochlear implant wearer in order to gain a more comprehensive understanding of teenagers' experiences of living with a cochlear implant by putting their perspectives at the heart of the research. This was achieved by working with the teenagers collaboratively throughout the research.Phase one of the study involved engaging with a small group of teenagers with cochlear implants to develop a website that would allow them to share their experiences. In phase two, ten semi-structured interviews were undertaken and nine were analysed using template analysis. Some teenagers experienced great preoperative anxiety and significant post-operative pain. Anxiety and pain are physiologically linked so strategies for reducing their anxiety are discussed. There was also a mismatch between their expectations and the disappointing reality of adjusting to the device. Disconfirmation-expectancy theory suggests that expectations counselling may narrow this gap. However, over time they experienced significant functional and psychosocial benefits as a result of their lives being easier. Almost all described complex, flexible identities where they felt connections with both the hearing and deaf world. Theoretical models of deaf identity support this 'bicultural' state. However, the hearing world sometimes posed difficulties for them when the listening environment was challenging. By giving prominence to the teenagers' voices this study has added new knowledge concerning their experience of surgery. The findings also more fully revealed the challenges of adjusting to the device and the impact of having a cochlear implant on the teenagers' identities.ii iii

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“…Cochlear implantation is considered an elective choice for the treatment of severe and profound deafness [3] . Cochlear implantation also represents a valid option in post-lingually deafened adults, who manage to achieve high levels of speech perception not only in quiet but also in the presence of noise and when using the telephone [4] .…”

Section: Discussionmentioning

confidence: 99%

Statistical Analysis of Various Factors Affecting the Results of Cochlear Implantation

Zohdi¹,

AbdelMessih²,

Maged³

et al. 2014

Int Adv Otol

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OBJECTIVE:Evaluation of several factors that affected the outcome in patients who underwent cochlear implant surgery. MATERIALS and METHODS:Retrospective study on 8 postlingual adults and 52 prelingual children with severe to profound hearing loss who underwent cochlear implantation at the Otolaryngology-Head and Neck surgery department, Kasr-Al Aini Hospital, Cairo University. A statistical analysis of several factors was performed to reveal any significant effect of the outcome of the procedure. RESULTS:The duration of deafness in adults showed a significant linear yet non-monotonic correlation with the postoperative average auditory thresholds as revealed by Pearson's correlation coefficient (r=0.839, p=0.009) and a linear regression model (f=14.211, p=0.009), which showed that the increase in the duration of deafness led to an increase in hearing thresholds and accounted for 70.3% of the variance in the outcome (β=0.839, t=3.770, and p=0.009). Age at implantation in children showed a positive linear, monotonic relation with the postoperative receptive (r=0.725, p<0.001, r S =0.354, p=0.010) and was a significant predictor of outcome (β=0.440, t=2.961; p=0.005) according to multiple linear regression. Mann-Whitney U-test was performed to evaluate the difference in medians of outcomes in relation to the regularity of attendance to speech rehabilitation. We found a significant effect over the auditory hearing thresholds (the mean ranks of regulars and irregulars were 21. 48 and 31.92, respectively; u=202.00, z=2.48, p<0.05) CONCLUSION: An increase in the duration of deafness leads to less favorable results of postoperative auditory thresholds in postlingual adults. Additionally, an increase in age at implantation may be associated with increased expressive language age in the first year postimplantation, and regular attendance to a speech rehabilitation program is associated with better postoperative auditory thresholds and a higher receptive language age.

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Long term results in late implanted adolescent and adult CI recipients

Cited by 23 publications

References 36 publications

Late Cochlear Implantation in Early-Deafened Adults: A Detailed Analysis of Auditory and Self-Perceived Benefits

Late Cochlear Implantation in Early-Deafened Adults: A Detailed Analysis of Auditory and Self-Perceived Benefits

Exploring the experiences of teenagers with cochlear implants

Statistical Analysis of Various Factors Affecting the Results of Cochlear Implantation

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