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Cochlear Implants (CI)

Cochlear Implants (CI)

Cochlear Implants, Aging, and Speech-in-Noise

Fullgrabe and Moore (2015) recently reported that (even) for older people with normal hearing, speech-in-noise ability does indeed, decline with age. Therefore, Fullgrabe and Moore recommended tests beyond the audiogram to assess older people and their hearing/listening ability, and they reported it is necessary to take age into account, when addressing the audiological needs of older patients.

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Combining Cochlear Implants and Normal Hearing

Since 2008 (see Van De Hetning, Vermeire and Diebl), multiple reports and studies have addressed the benefit of cochlear implants (CIs) in the worse (unilateral deafness or “unaidable”) ear, given a normal (or nearly normal, or aidable) contralateral ear (see Arndt, Aschendorff, Laszig et al 2011, Baguley 2010, Buechner, Brendel, Lesinki-schiedat et al 2010, VanZon, Peters, Stegeman et al, 2015).

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Single-Sided Deafness and Cochlear Implants

Van Zon et al (2015) report a systematic review of the professional literature to determine the likely outcome for people with single-sided deafness (SSD, or asymmetric hearing loss, AHL) who undergo cochlear implantation in the worse ear. The authors note that the most common clinical solutions for people with SSD or AHL includes contralateral routing of signal (CROS) or bone-conduction (BC) devices.

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Cochlear Implants and Pediatric Post-Op Pain and Dizziness

Birman, Gibson, and Elliott (2015) evaluated post-operative surgical pain in children (ages 16 years and younger), following cochlear implant surgery via assessment of analgesia use. Between August 2010 and November 2012, 98 children were implanted, 61 were reported. Of the 61 children who were reported, 19 children required no pain relief and 42 children used paracetamol (aka acetaminophen in the United States) Additionally, 1 child required oxycodeine for 1 day (following bilateral implant surgery), and codeine phosphate was used by 1 child for 3 days.

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Cochlear Implant Candidacy Revisited

Lovett, Vickers, and Summerfield (2015) report their observational study of children with bilateral cochlear implants (CIs) compared to children with bilateral hearing aids (HAs) to better determine a criterion for CI candidacy for young children. Determining CI candidacy criteria is difficult, as candidacy is assessed based on (often estimated) pure-tones, while outcomes are measured through listening and language skills. The authors note that CI outcomes cannot be predicted for a specific individual, as the variation in outcomes-based performance is huge (see Davidson, 2011). 

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Spoken Language and Bilateral Cochlear Implants

Sarant et al (2014) compared the spoken language outcomes of children with unilateral and bilateral cochlear implants (CIs). The authors report that “bilateral cochlear implantation is becoming the standard of care….” They note that bilateral CIs offer binaural redundancy through the involvement of two ears. The brain has two opportunities to process sound: (1) binaural summation (the increased loudness availed via 2 ears) and (2) the head-shadow effect (the head acting as a barrier and therefore reducing the loudness at the ear farther from the sound source).

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Bilateral Cochlear Implants and Enhanced Spatial Cues

Brown (2014) reports that bilateral cochlear implant (BCI) users typically receive only limited binaural cues and “show little improvement to speech intelligibility from spatial cues….”  Therefore, Brown artificially extended interaural loudness differences (ILDs, which normally occur above 1,500 Hz) into the low frequencies, where they would be better perceived by BCI users. He compared results from naturally occurring ILDs and artificially extended ILDs.

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Re-Implanting Cochlear Implants

Mahtani et al (2014) report that the experience of some 30 adults (32 ears) who had re-implantation of their cochlear implants (CI) due to device failure for 17 patients, infection for 4 patients, pain for 2 patients, change to multi-channel device for 2 patients, head trauma for 2 patients, displaced device for 2 patients, partial insertion for 1 patient, and unknown for 2 patients.

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Aging and Speech Perception

Jin, Liu, and Sladen reported on the 1988 Working Group on Speech Understanding and Aging Committee on Hearing, Bioacoustics and Biomechanics (CHABA), which stated three likely factors for age-related listening problems: (1) changes in the peripheral auditory system, (2) changes in central auditory processing, and (3) changes in cognitive performance.

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Expanding Cochlear Implant Criteria?

Hughes et al (2014) retrospectively evaluated post-cochlear implant (CI) performance for CI recipients who had better hearing than the established FDA criteria. Charts from 37 patients (26 adults, 11 children) from 1991 to 2013 were included and three groups were established as follows.

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