Cochlear Implants (CI)

Cochlear Implants (CI)

Bimodal Programming

Siburt and Holmes (2015) report that 93 responses to their survey, which queried who programs the hearing aid (adult patients) given a bimodal fitting (‘bimodal’ as used here indicates one ear has a cochlear implant [CI] and the other has a hearing aid). The respondents represented multiple clinical settings (private practice, ENT clinics, university clinics, and hospitals). Fifty-seven responses were from “small centers” (fewer than or up to 20 adult patients per year) and 36 were from “large centers” (more than 20 patients per year).

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The Importance of Pitch Discrimination in Cochlear Implant Users

Wang et al (2011) evaluated 19 adult cochlear implant (CI) users and 10 normal hearing listeners with regard to their perception of tone/pitch. CI users demonstrated a mean threshold for pitch discrimination of 5.5 semitones (with a range from 0.8 semitones to 19.6 semitones). People with normal hearing demonstrated average thresholds of 0.4 semitones.

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Cochlear Implant Satisfaction and Psychological Profiles

Kobosko et al (2015) report that when post-lingually deafened adults acquire a cochlear implant, the benefits extend beyond hearing. That is, quality of life improves, as does psychological well-being and social interactions. The authors studied the relationship between cochlear implant (CI) satisfaction and level of psychological distress, stress coping strategies, and global self-esteem.

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Cochlear Implants and Vestibular Anomalies

Cushing et al (2013) reported on 153 children with profound sensorinerual hearing loss (SNHL), 119 of whom had unilateral cochlear implants (CI) at the time of testing. Cushing and colleagues reported vestibular end-organ dysfunction was present in half of the subjects, and of note, none of the children reported signs or symptoms of vestibular injury after receiving their CI.

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Children with Congenital Deafness, Cochlear Implants (CIs), and Auditory Learning

Mishra, Boddupally, and Rayapati (2015) evaluated 27 children with congenital deafness who received cochlear implants to examine and characterize training-induced changes in speech-in-noise (SIN) perception. Thirteen children and 5 adults with normal hearing were also evaluated. Of note, 13 children with cochlear implants were trained (40 hours of training over 5 weeks) and 14 children with CIs were not trained.

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Characteristics of Children Less Likely to Achieve Open Set WRS Through Cochlear Implants

In general, cochlear implantation is phenomenally successful. That is, when children are identified and implanted early (preferably ages 6 to 12 months), the outcomes of cochlear implantation are typically good to excellent. Geers et al (2008) reported that “the best (CI) outcomes correlated with lower pure-tone averages obtained with their cochlear implant, younger age at implantation and higher nonverbal IQ.

 

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Cochlear Implants, Normal Hearing, and Single-Sided Deafness

Many reports in the literature have demonstrated that cochlear implants are a reasonable, successful, and viable option for people with severe-to-profound unilateral hearing loss (Arndt et al 2011; Baguley, 2010; Buechner et al 2010; Popelka et al 2010; Van Zon et al 2015; Van De Heyning et al 2008).


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When to Recommend Cochlear Implants vs Hearing Aids?

Lovett, Vickers, and Summerfield addressed the delineation point at which a child is four times more likely to excel with cochlear implants (CIs) as compared to hearing aids. Of note, CI outcomes for an individual cannot be predicted ahead of time as the variation in outcomes (among individuals) is huge (Davidson, 2011). Nonetheless, we can make statistical predictions for the population.

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Pediatric Cochlear Implant Failures and Vestibular Anomalies

Beck et al (2015) reported vestibular and balance disorders are highly associated with SNHL in children, however, most professionals don’t screen for vestibular dysfunction in (these same) children. The authors estimated the prevalence of vestibular and balance disorders in children may be as high as 15 percent of all children, and up to 70 percent children with SNHL.  

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CROS and BiCROS Hearing Aids

Contralateral routing of signal (CROS) amplification systems are intended to be used when (essentially) one ear is normal or has a mild/moderate hearing loss (i.e., is generally a candidate for amplification) and the other ear is (more-or-less) not “aidable.” CROS hearing aids might be recommended for single-sided deafness (SSD) or for people with very poor unilateral word recognition scores.

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