Usefulness of cochlear implantation in children with single sided deafness

Ehrmann-Mueller, Desiree; Kurz, Anja; Kuehn, Heike; Rak, Kristen; Mlynski, Robert; Hagen, Rudolf; Shehata‐Dieler, Wafaa

doi:10.1016/j.ijporl.2019.109808

Cited by 30 publications

(32 citation statements)

References 34 publications

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“…Intervention can include (re)activating the deaf ear using appropriate hearingassistive devices such as a bone-anchored hearing aid or CI for profound hearing loss (Dorman et al, 2016;Laszig et al, 2017;Mertens et al, 2018). It has also been claimed that restoration of binaural hearing with a CI actually improves the speech-in-noise and sound localization capabilities of unilateral deaf individuals regardless of the deafened side (Ehrmann-mueller et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Ear-Specific Hemispheric Asymmetry in Unilateral Deafness Revealed by Auditory Cortical Activity

Han

Lee

2021

Front. Neurosci.

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Profound unilateral deafness reduces the ability to localize sounds achieved via binaural hearing. Furthermore, unilateral deafness promotes a substantial change in cortical processing to binaural stimulation, thereby leading to reorganization over the whole brain. Although distinct patterns in the hemispheric laterality depending on the side and duration of deafness have been suggested, the neurological mechanisms underlying the difference in relation to behavioral performance when detecting spatially varied cues remain unknown. To elucidate the mechanism, we compared N1/P2 auditory cortical activities and the pattern of hemispheric asymmetry of normal hearing, unilaterally deaf (UD), and simulated acute unilateral hearing loss groups while passively listening to speech sounds delivered from different locations under open free field condition. The behavioral performances of the participants concerning sound localization were measured by detecting sound sources in the azimuth plane. The results reveal a delayed reaction time in the right-sided UD (RUD) group for the sound localization task and prolonged P2 latency compared to the left-sided UD (LUD) group. Moreover, the RUD group showed adaptive cortical reorganization evidenced by increased responses in the hemisphere ipsilateral to the intact ear for individuals with better sound localization whereas left-sided unilateral deafness caused contralateral dominance in activity from the hearing ear. The brain dynamics of right-sided unilateral deafness indicate greater capability of adaptive change to compensate for impairment in spatial hearing. In addition, cortical N1 responses to spatially varied speech sounds in unilateral deaf people were inversely related to the duration of deafness in the area encompassing the right auditory cortex, indicating that early intervention would be needed to protect from maladaptation of the central auditory system following unilateral deafness.

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Section: Discussionmentioning

confidence: 99%

Ear-Specific Hemispheric Asymmetry in Unilateral Deafness Revealed by Auditory Cortical Activity

Han

Lee

2021

Front. Neurosci.

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“…The 2019 FDA labeling approval for implantation in cases of SSD in children aged 5 and older (MED-EL) was welcomed. Early studies and case reports have indicated benefits in chil-dren, 42 particularly when it comes to hearing in noise [43][44][45][46][47] and localization. 43,48,49 The age limit of 5 years was likely set due to safety, as the clinical trial used for approval did not include young children.…”

Section: Single-side Deafnessmentioning

confidence: 99%

“…Early studies and case reports have indicated benefits in chil-dren, 42 particularly when it comes to hearing in noise [43][44][45][46][47] and localization. 43,48,49 The age limit of 5 years was likely set due to safety, as the clinical trial used for approval did not include young children. The FDA labeling carries a limitation of 10 years of deafness, reflective of the importance of limiting auditory deprivation.…”

Section: Single-side Deafnessmentioning

confidence: 99%

The Limitations of FDA Criteria: Inconsistencies with Clinical Practice, Findings, and Adult Criteria as a Barrier to Pediatric Implantation

2021

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Children require greater access to sound than adults as they are learning to communicate using hearing and spoken language. Yet when it comes to cochlear implant candidacy, currently approved Food and Drug Administration (FDA) criteria for adults are much less restrictive than those for children, allowing for greater levels of residual hearing and aided speech recognition in adults. Cochlear implant guidelines for children have changed very little in the 30 years since cochlear implants have been approved for pediatrics, and this lack of change has proven to be a barrier to implantation. Using evidence-based practice, centers have been providing off-label implantation for children who fall outside of current FDA criteria, including children with more residual hearing, children with single-side deafness younger than 5 years, and infants with bilateral profound loss younger than 9 months. The purpose of this article is to outline how these restrictions impede access to implants for children and describe the evidence supporting cochlear implantation in children who fall outside of current criteria.

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“…Benefits in these rare cohorts include better speech perception in noise, improved sound localization, and alleviation of tinnitus [31][32][33][34][35] . Recent findings in small cohorts of children with SSD who have received CIs suggest improved speech perception in quiet and noise 29,[36][37][38][39] . Moreover, many children in these cohorts wear their devices consistently 37,[39][40][41] .…”

mentioning

confidence: 99%

“…Recent findings in small cohorts of children with SSD who have received CIs suggest improved speech perception in quiet and noise 29,[36][37][38][39] . Moreover, many children in these cohorts wear their devices consistently 37,[39][40][41] . Such benefits rely on establishing neural representation from the deaf ear and decreasing preference for the intact ear to promote bilateral auditory development through CI use.…”

mentioning

confidence: 99%

Consistent and chronic cochlear implant use partially reverses cortical effects of single sided deafness in children

Lee

Smieja

Polonenko

et al. 2020

Sci Rep

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Potentially neuroprotective effects of CI use were studied in 22 children with single sided deafness (SSD). Auditory-evoked EEG confirmed strengthened representation of the intact ear in the ipsilateral auditory cortex at initial CI activation in children with early-onset SSD (n = 15) and late-onset SSD occurring suddenly in later childhood/adolescence (n = 7). In early-onset SSD, representation of the hearing ear decreased with chronic CI experience and expected lateralization to the contralateral auditory cortex from the CI increased with longer daily CI use. In late-onset SSD, abnormally high activity from the intact ear in the ipsilateral cortex reduced, but responses from the deaf ear weakened despite CI use. Results suggest that: (1) cortical reorganization driven by unilateral hearing can occur throughout childhood; (2) chronic and consistent CI use can partially reverse these effects; and (3) CI use may not protect children with late-onset SSD from ongoing deterioration of pathways from the deaf ear.

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Usefulness of cochlear implantation in children with single sided deafness

Cited by 30 publications

References 34 publications

Ear-Specific Hemispheric Asymmetry in Unilateral Deafness Revealed by Auditory Cortical Activity

Ear-Specific Hemispheric Asymmetry in Unilateral Deafness Revealed by Auditory Cortical Activity

The Limitations of FDA Criteria: Inconsistencies with Clinical Practice, Findings, and Adult Criteria as a Barrier to Pediatric Implantation

Consistent and chronic cochlear implant use partially reverses cortical effects of single sided deafness in children

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