scholarly journals The Clinical Effects of Steroids Therapy in the Preserving Residual Hearing after Cochlear Implantation with the OTICON Neuro Zti EVO

2021 ◽  
Vol 10 (13) ◽  
pp. 2868
Author(s):  
Magdalena B. Skarzynska ◽  
Aleksandra Kolodziejak ◽  
Elżbieta Gos ◽  
Piotr H. Skarzynski
Keyword(s):  
Cochlear Implant ◽  
Body Mass ◽  
Steroid Therapy ◽  
Cochlear Implantation ◽  
Control Group ◽  
Clinical Effects ◽  
Residual Hearing ◽  
Intravenous Steroid ◽  
Hearing Thresholds ◽  
Implant System

Background: A prospective clinical study was conducted to investigate whether two different pharmacotherapy strategies of steroid administration impact hearing preservation in adult patients who underwent cochlear implantation with the Oticon Medical Neuro cochlear implant system. Methods: Twenty nine adult participants were included. Pure tone audiometry was performed before implantation, during processor activation and 12 months after activation. There were three treatment groups: (1) intravenous steroid therapy (standard steroid therapy with dexamethasone administrated intravenously at the dose 0.1 mg/kg body mass twice a day); (2) combined oral and intravenous steroid therapy (extended steroid therapy with dexamethasone administrated intravenously at the dose 0.1 mg/kg b.m. twice a day and prednisone (orally) at the dose 1 mg/kg body mass/24 h), and (3) no steroid therapy (a control group). Patients’ hearing thresholds before implantation were on average 103 dB HL, 89 dB HL, and 93 dB HL, respectively. Results: Deterioration of hearing thresholds was observed in all three patients’ groups. Twelve months after surgery the patients with and without steroid therapy had similar hearing thresholds. Conclusions: The steroid regimen used in this study did not play a significant role in patients with non-functional residual hearing, who underwent cochlear implantation with the Oticon Medical Neuro cochlear implant system.

Delayed loss of residual hearing in Clarion® cochlear implant users

2003 ◽  
Vol 117 (11) ◽  
pp. 850-853 ◽  
Author(s):  
M. Barbara ◽  
A. Mattioni ◽  
S. Monini ◽  
I. Chiappini ◽  
F. Ronchetti ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Pure Tone ◽  
Hearing Threshold ◽  
Auditory Threshold ◽  
Residual Hearing ◽  
Equal Distribution ◽  
Hearing Thresholds ◽  
Number Of Patients ◽  
Over Time

Hearing threshold has been measured in a group of patients following cochlear implantation with a Clarion® device for the last eight years. The patients had received either a pre-curved carrier or the Hi-Focus I plus Electrode Positioner System (EPS). The assessment was carried out within the first post-operative week as well as at a later stage, between six and 87 months, post-operatively. Residual hearing thresholds were still measurable early after surgery in 24.5 per cent of the patients, without differences between the two different Clarion® models. However, the number of subjects with measurable hearing dropped to 16.3 per cent as observed when hearing was measured at a later stage, with an equal distribution between the two groups of patients. From this study it has been possible to observe that only a limited number of patients maintain residual hearing after Clarion® cochlear implantation, and that this tends to decrease further over time. Nevertheless, the performance of these patients for speech tests did not appear to be affected by deterioration of the pure-tone auditory threshold.

scholarly journals Costs involved in using a cochlear implant in South Africa

2012 ◽  
Vol 59 (1) ◽  
Author(s):  
Gillian Robyn Kerr ◽  
Seppo Tuomi ◽  
Alida Müller
Keyword(s):  
South Africa ◽  
Cochlear Implant ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Consumer Price Index ◽  
Information Costs ◽  
Profound Hearing Loss ◽  
Short And Long Term ◽  
Implant System

Cochlear implantation is an expensive but effective lifelong intervention for individuals with a severe-to-profound hearing loss. The primary aim of this study was to survey the short- and long-term costs of cochlear implantation. Individuals (N=154) using cochlear implants obtained from the University of Stellenbosch-Tygerberg Hospital Cochlear Implant Unit in Cape Town, South Africa were surveyed using a questionnaire and patient record review. The questionnaire used a combination of closed and open-ended questions to gather both quantitative and qualitative information. Costs were categorised as short- and long-term costs. All costs were converted to constant rands (June 2010) using the Consumer Price Index to allow for comparison in real terms over time. In the first 10 years of implantation the average estimated costs incurred by adults totalled R379 626, and by children R455 225. The initial purchase of the implant system was the most substantial cost, followed by upgrading of the processor. Travel and accommodation costs peaked in the first 2 years. On average the participants spent R2 550 per year on batteries and spares. Rehabilitation for children cost an average of R7 200. Insurance costs averaged R4 040 per year, and processor repairs R3 000 each. In addition to the upfront expense of obtaining the cochlear implant system, individuals using a cochlear implant in South Africa should be prepared for the long-term costs of maintenance, accessing the unit, support services and additional costs associated with use. Knowledge of these costs is important to ensure that individuals are successful users of their cochlear implants in the long term.

Audiological outcome of stapes surgery for far advanced cochlear otosclerosis

2017 ◽  
Vol 131 (11) ◽  
pp. 961-964 ◽  
Author(s):  
C Heining ◽  
R Banga ◽  
R Irving ◽  
C Coulson ◽  
P Monksfield
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Revision Surgery ◽  
Cochlear Implantation ◽  
Stapes Surgery ◽  
Hearing Thresholds ◽  
Suitable Treatment ◽  
Conductive Component ◽  
Clinically Significant ◽  
Hearing Outcomes

AbstractBackground:Patients with advanced otosclerosis can present with hearing thresholds eligible for cochlear implantation. This study sought to address whether stapes surgery in this patient group provides a clinically significant audiological benefit.Objectives:To assess pre- and post-operative hearing outcomes of patients with advanced otosclerosis, and to determine what proportion of these patients required further surgery including cochlear implantation.Methods:Between 2002 and 2015, 252 patients underwent primary stapes surgery at our institution. Twenty-eight ears in 25 patients were deemed to have advanced otosclerosis, as defined by pure audiometry thresholds over 80 dB. The patients’ records were analysed to determine audiological improvement following stapes surgery, and assess whether any further surgery was required.Results:The audiological outcome for most patients who underwent primary stapes surgery was good. A minority of patients (7 per cent) required revision surgery. Patients who underwent cochlear implantation after stapes surgery (10 per cent) also demonstrated a good audiological outcome.Conclusion:Stapes surgery is a suitable treatment option for patients with advanced otosclerosis, and should be considered mandatory, before offering cochlear implantation, for those with a demonstrable conductive component to their hearing loss. A small group of patients get little benefit from surgery and subsequently a cochlear implant should be considered.

Residual Hearing Thresholds in Cochlear Implantation and Reimplantation

2007 ◽  
Vol 12 (3) ◽  
pp. 165-169 ◽  
Author(s):  
Walter Di Nardo ◽  
Italo Cantore ◽  
Francesca Cianfrone ◽  
Pietro Melillo ◽  
Mario Rigante ◽  
...  
Keyword(s):  
Cochlear Implantation ◽  
Residual Hearing ◽  
Hearing Thresholds

scholarly journals Extra- and Intracochlear Electrocochleography in Cochlear Implant Recipients

2015 ◽  
Vol 20 (5) ◽  
pp. 339-348 ◽  
Author(s):  
Adrian Dalbert ◽  
Flurin Pfiffner ◽  
Christof Röösli ◽  
Konrad Thoele ◽  
Jae Hoon Sim ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Middle Ear ◽  
Cochlear Implantation ◽  
Low Frequency ◽  
Electrode Array ◽  
Postoperative Phase ◽  
Residual Hearing ◽  
Middle Ear Effusion ◽  
Cochlear Function ◽  
Ear Effusion

Objective: To monitor cochlear function by extra- and intracochlear electrocochleography (ECoG) during and after cochlear implantation and thereby to enhance the understanding of changes in cochlear function following cochlear implantation surgery. Methods: ECoG responses to acoustic stimuli of 250, 500 and 1,000 Hz were recorded in 9 cochlear implant recipients with presurgical residual hearing. During surgery extracochlear ECoG recordings were performed before and after insertion of the cochlear implant electrode array. After insertion of the electrode array, intracochlear ECoG recordings were conducted using intracochlear electrode contacts as recording electrodes. Intracochlear ECoG recordings were performed up to 6 months after implantation. ECoG findings were correlated with findings from audiometric tests. Results: Extra- and intracochlear ECoG responses could be recorded in all subjects. Extracochlear ECoG recordings during surgery showed moderate changes. Loss or reduction of the ECoG signal at all three frequencies did not occur during cochlear implantation. During the first week following surgery, conductive hearing loss, due to middle ear effusion, led to a decrease in intracochlear ECoG signal amplitudes. This was not attributable to changes of cochlear function. All persistent reductions in ECoG response magnitude after normalization of the tympanogram occurred during the first week following implantation. Thresholds of ECoG signals were at or below hearing thresholds in all cases. Conclusion: Gross intracochlear trauma during surgery appears to be rare. In the early postoperative phase the ability to assess cochlear status by ECoG recordings was limited due to the regular occurrence of middle ear effusion. Still, intracochlear ECoG along with tympanogram recordings suggests that any changes of low-frequency cochlear function occur mainly during the first week after cochlear implantation. ECoG seems to be a promising tool to objectively assess changes in cochlear function in cochlear implant recipients and may allow further insight into the mechanisms underlying the loss of residual hearing.

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

2021 ◽  
Vol 42 (04) ◽  
pp. 373-380
Author(s):  
Lisa R. Park ◽  
Erika B. Gagnon ◽  
Kevin D. Brown
Keyword(s):  
Clinical Practice ◽  
Cochlear Implant ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Spoken Language ◽  
Evidence Based ◽  
Residual Hearing ◽  
Off Label ◽  
Single Side ◽  
Hearing Children

AbstractChildren 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.

A Postoperative Audiometric Evaluation of Cochlear Implant Patients

1988 ◽  
Vol 98 (3) ◽  
pp. 203-206 ◽  
Author(s):  
Franklin M. Rizer ◽  
Peter N. Arkis ◽  
William H. Lippy ◽  
Arnold G. Schuring
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Residual Hearing

As the benefits of the cochlear implantation become more defined, many investigators hope that these devices can be offered to patients with a lesser degree of hearing loss. Accordingly, it is necessary to investigate the audiometric thresholds in the implanted ear after surgery. Preservation of the residual hearing after implantation would support the claims that surgery and the presence of a cochlear implant do not adversely affect the implanted ear.

Cochlear implant placement: round window approach

2014 ◽  
Vol 36 (v1supplement) ◽  
pp. 1 ◽  
Author(s):  
Douglas D. Backous
Keyword(s):  
Clinical Trials ◽  
Surgical Technique ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Round Window ◽  
Hearing Preservation ◽  
Residual Hearing ◽  
Implant Placement ◽  
Single Sided Deafness ◽  
Window Approach

The indications for cochlear implantation continue to extend to patients with increased levels of residual hearing. Single-sided deafness and tinnitus are currently under various clinical trials as even further expansion of the application of cochlear implant device and programming technology is underway. This video details a round window and hearing preservation approach for cochlear implant placement, and incorporates the most recent advances in surgical technique.The video can be found here: http://youtu.be/bDqkbboXrU4.

Cortical and subcortical processing of speech in cochlear implant recipients with Auditory Neuropathy Spectrum Disorder

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Adel Abdel Maksoud Nassar ◽  
Dalia Mohammed Hassan ◽  
Tayseer Taha Abdel Rahman ◽  
Amal Younis
Keyword(s):  
Cochlear Implant ◽  
Speech Processing ◽  
Cochlear Implantation ◽  
Sound Field ◽  
Auditory Brainstem ◽  
Auditory Neuropathy ◽  
Control Group ◽  
Auditory Information ◽  
Speech Communication ◽  
Brainstem Response

Abstract Background Cochlear implantation (CI) is now recognized as one of the possible lines of interventions in ANSD patients to improve their hearing and speech communication. Desynchronized of the auditory information is the most widely accepted mechanism in ANSD. Objectives To study speech processing in the brainstem level as measured by speech-auditory brainstem response (S-ABR) in ANSD and CAEP P1 in ANSD subjects fitted with CIs and the results will be compared to SNHL subjects fitted with unilateral CIs. Subjects and method A total number of 45 subjects were included classified into three groups (one control and two study groups). The control group 16 subjects, age ranged from 5 to 29.5 years with mean of (11.1 years) with normal peripheral hearing sensitivity. The study group comprised 29 children who underwent cochlear implantation. It was subdivided into two subgroups: Group (SNHL) ;their age ranged from2.9 to 15.5 years with mean of (7.7 years) and group (ANSD); Their age ranged from 3.2 to 29 years with mean of (9.3 years) They were subjected to detailed history taking, aided warble-tone sound field audiometry, Questionnaire and Speech-evoked potentials (P1 &c-ABR) recording evoked by the 150-ms synthesized /da/ syllable stimulus. Results C-ABR waves were detected in 100% of control group, 75% of SNHL group and 53.8% of ANSD group. A statistically significant differences existed between the control group and the two study subgroups regarding the P1 latencies. While; there were no statistically significant differences between {SNHL group &ANSD}. Sound-field S-ABR in the CI recipients showed delayed latencies in both SNHL group &ANSD group comparable to the control group with more delay in ANSD group than SNHL group. Finally, the neural phase locking was significantly higher in CI recipients due to electrical artifact. Conclusions • There were no statistically significant differences between {SNHL group & ANSD group} regarding P1 latency. • C-ABR waves were detected in 75% of SNHL group and 53.8% of ANSD group with delayed latencies and higher amplitude than control group with more delay in ANSD group than SNHL group. The findings of sound-field S-ABR demonstrated that CI recipients have neural encoding deficits in temporal and spectral domains at the brainstem level; therefore, the sound-field S-ABR can be considered an efficient clinical procedure to assess the speech processing in ANSD subjects fitted with cochlear implant.

scholarly journals Amplitude Growth Functions of Auditory Nerve Responses to Electric Pulse Stimulation With Varied Interphase Gaps in Cochlear Implant Users With Ipsilateral Residual Hearing

2021 ◽  
Vol 25 ◽  
pp. 233121652110141
Author(s):  
Marina Imsiecke ◽  
Andreas Büchner ◽  
Thomas Lenarz ◽  
Waldo Nogueira
Keyword(s):  
Cochlear Implant ◽  
Dynamic Range ◽  
Electric Pulse ◽  
Objective Measure ◽  
Stimulus Level ◽  
Control Group ◽  
Electrode Impedance ◽  
Residual Hearing ◽  
Growth Functions ◽  
Amplitude Growth

Amplitude growth functions (AGFs) of electrically evoked compound action potentials (eCAPs) with varying interphase gaps (IPGs) were measured in cochlear implant users with ipsilateral residual hearing (electric-acoustic stimulation [EAS]). It was hypothesized that IPG effects on AGFs provide an objective measure to estimate neural health. This hypothesis was tested in EAS users, as residual low-frequency hearing might imply survival of hair cells and hence better neural health in apical compared to basal cochlear regions. A total of 16 MED-EL EAS subjects participated, as well as a control group of 16 deaf cochlear implant users. The IPG effect on the AGF characteristics of slope, threshold, dynamic range, and stimulus level at 50% maximum eCAP amplitude (level50%) was investigated. AGF threshold and level50% were significantly affected by the IPG in both EAS and control group. The magnitude of AGF characteristics correlated with electrode impedance and electrode-modiolus distance (EMD) in both groups. In contrast, the change of the AGF characteristics with increasing IPG was independent of these electrode-specific measures. The IPG effect on the AGF level50% in both groups, as well as on the threshold in EAS users, correlated with the duration of hearing loss, which is a predictor of neural health. In EAS users, a significantly different IPG effect on level50% was found between apical and medial electrodes. This outcome is consistent with our hypothesis that the influence of IPG effects on AGF characteristics provides a sensitive measurement and may indicate better neural health in the apex compared to the medial cochlear region in EAS users.

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