Stationäre Rehabilitationsmaßnahmen bei erwachsenen CI-Trägern

Objective This study investigated the speech perception of cochlear implant (CI) recipients with measurable preoperative ipsilateral speech perception. These data should support improved individual counselling of CI candidates. Materials and methods Pre- and postoperative speech audiometric parameters were analyzed, including maximum score for phonemically balanced words (PB max ) and monosyllabic score at a normal conversational level of 65 dB SPL , with hearing aids one hand and CI on the other. Data of 284 experienced adult CI wearers were grouped and evaluated in terms of preoperative PB max . Results The preoperative PB max was exceeded by the postoperative monosyllabic score in 96% of cases. The overall median postoperative score was 72.5%. The groups with preoperative PB max > 0% showed significantly better speech perception scores with CI than the group with PB max = 0%. Median improvement compared to the preoperative monosyllabic score with hearing aids was 65 percentage points, independent of preoperative PB max . Conclusion The preoperatively measured PB max may be used as a predictor for the minimum speech perception obtained with CI. This is of high clinical relevance for CI candidates with a PB max above zero.

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“…3 b). This finding is in line with the results of other groups [ 2 , 8 , 17 , 29 ]. A detailed comparison of the results of Holden et al.…”

Section: Discussionsupporting

confidence: 93%

Maximum preimplantation monosyllabic score as predictor of cochlear implant outcome

Hoppe

Hocke²,

Hast

et al. 2019

HNO

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“…Another important aspect in this context appears to be extended contact with professionals as well as CI-patients. Therefore intensive inpatient rehabilitation programs may address non-auditory problems more effectively and thereby lead to improved self-perceived benefits and potentially also to accelerated improvements in speech comprehension tests as suggested by a previous study ( 40 ). Further elucidation of benefit associated with different types of CI-rehabilitation is warranted.…”

Section: Discussionmentioning

confidence: 86%

“…Beyond that, interaction with fellow CI-patients is encouraged and the patients do not have to worry about everyday life duties but can concentrate on their hearing. A detailed description of the spectrum typically offered by a CI-rehabilitation clinic can be found in ( 40 ).…”

Section: Resultsmentioning

confidence: 99%

Patient Benefit Following Bimodal CI-provision: Self-reported Abilities vs. Hearing Status

et al. 2018

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Objectives: Patient-reported outcomes gain importance for the assessment of auditory abilities in cochlear implant users and for the evaluation of auditory rehabilitation. Aims of the study were to explore the interrelation of self-reported improvements in auditory ability with improvements in speech comprehension and to identify factors other than audiological improvement that affect self-reported auditory ability.Study Design: Explorative prospective analysis using a within-subjects repeated measures design.Setting: Academic tertiary care center.Participants: Twenty-seven adult participants with bilateral sensorineural hearing loss who received a HiRes 90K CI and continued use of a HA at the non-implanted ear (bimodal hearing).Intervention: Cochlear implantation.Main Outcome Measures: Self-reported auditory ability/disability assessed by the comparative version of the Speech, Spatial and Qualities of Hearing Scale (SSQ-B), and monosyllable as well as sentence comprehension in quiet and within speech modulated noise from different directions assessed pre- as well as 3 and 6 months post-implantation.Results: Data of 17 individuals were analyzed. At the endpoint of the study, improvement of self-reported auditory ability was significant. Regarding audiometric measures, significant improvement was seen for CI-aided pure tone thresholds, for monaural CI-assisted and bimodal sentence comprehension in quiet and in speech-modulated noise that was presented from the same source or at the side of the HA-ear. Correlations between self-reported and audiometric improvements remained weak, with the exception of the improvement seen for monaural CI-aided sentence comprehension in quiet and self-perceived improvement of sound quality. Considerable correlations existed between self-reported improvements and current level of depression and anxiety, and with general self-efficaciousness. Regression analyses substantiated a positive influence of self-efficaciousness on self-reported improvement in speech comprehension and between the improvement of monaural CI-aided sentence comprehension in quiet and perceived sound quality as well as a negative influence of anxiety on self-reported improvement in spatial hearing. Self-reported improvements were significantly better in the subgroup with intensive as compared to regular rehabilitation.Conclusions: Self-reported auditory ability/disability represents an important measure for the success of bimodal CI-provision. It is influenced by personal and mental health factors that may improve CI-rehabilitation results if addressed during rehabilitation.

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“…Die Cochlea-Implantation ist auch beim älteren Patienten aufgrund anästhesiologischer Fortschritte ein sicherer und komplikationsarmer Eingriff [6][7][8]. Zudem konnte gezeigt werden, dass eine nutzbare Sprachverständlichkeit in nützlicher Frist auch beim älteren Patienten ( ≥ 70 Jahre) erreicht wird [6,[8][9][10]. Trotz gutem Nutzen von Rehabilitationsmassnahmen schneidet diese Altersgruppe im Langzeitverlauf betreffend Sprachentwicklung und -verständlichkeit schlechter ab als jüngere CI-Träger [6,9,10].…”

Section: Conclusion Most Elderly Patients Benefit From Bimodal Stimulunclassified

“…Zudem konnte gezeigt werden, dass eine nutzbare Sprachverständlichkeit in nützlicher Frist auch beim älteren Patienten ( ≥ 70 Jahre) erreicht wird [6,[8][9][10]. Trotz gutem Nutzen von Rehabilitationsmassnahmen schneidet diese Altersgruppe im Langzeitverlauf betreffend Sprachentwicklung und -verständlichkeit schlechter ab als jüngere CI-Träger [6,9,10]. Da die Ergebnisse dennoch in einem vergleichbaren Bereich liegen, kann durch eine Cochlea-Implantation mit anschließender Rehabilitation die Teilnahme am gesellschaftlichen Leben wieder ermöglicht und die Gefahr einer sozialen Isolierung durch die Hörminderung reduziert werden.…”

Section: Conclusion Most Elderly Patients Benefit From Bimodal Stimulunclassified

Cochlea-Implantation ab dem 70. Lebensjahr – Nutzen der bimodalen Versorgung mit Hörgerät und CI

et al. 2017

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Cochlear implant (CI) surgery is the standard of care for postlingual deafness in adults. A hearing aid (HA) for the non-implanted ear is normally used if residual hearing is available. There is limited data on bimodal stimulation in elderly patients. We compare the outcome of bimodal stimulation and analyzed the correlation of bimodal benefit and residual hearing in elderly patients. 22 patients≥70 years were implanted with a single-sided CI from 2002 till 2014. 17 patients use a HA on the non-implanted ear (bimodal). In a retrospective chart review we analyzed the audiological benefit (pure tone average, speech recognition). Time to follow-up was 6 month to 12 years. The subjective benefit was assessed using a structured questionnaire. The speech recognition (monosyllabic word testing in quiet @ 65 dB SPL) showed a score of 61% in bimodal condition vs. 53% with CI alone (p=0.35). There was no statistically significant correlation between residual hearing in the lower frequencies (250 Hz, 500 Hz and 1 kHz) and bimodal benefit. Most elderly patients benefit from bimodal stimulation. In quiet and in comparison with CI alone, most patients showed some improvement in word recognition scores using bimodal fitting, and all of them were using the contralateral hearing aid all day long. Postlingual deafened elderly patients fitted with a unilateral CI require a short rehabilitation period. In case of contralateral hearing aid fitting, regular control of the hearing aid should not be overlooked.

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Stationäre Rehabilitationsmaßnahmen bei erwachsenen CI-Trägern

Cited by 41 publications

References 17 publications

Maximum preimplantation monosyllabic score as predictor of cochlear implant outcome

Maximum preimplantation monosyllabic score as predictor of cochlear implant outcome

Patient Benefit Following Bimodal CI-provision: Self-reported Abilities vs. Hearing Status

Cochlea-Implantation ab dem 70. Lebensjahr – Nutzen der bimodalen Versorgung mit Hörgerät und CI

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