ORCID Profile
0000-0001-6249-7268
Current Organisations
Fiona Stanley Hospital
,
University of Western Australia
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Publisher: Wiley
Date: 02-04-2013
DOI: 10.1002/LARY.23764
Abstract: To investigate cochlear implantation (CI) in patients with unilateral deafness with and without tinnitus. Prospective case series of patients undergoing cochlear implantation for unilateral deafness and tinnitus in a tertiary academic unit. Nine postlingually deafened subjects with unilateral hearing loss, with and without tinnitus ipsilaterally, and functional hearing in the contralateral ear were implanted with a standard electrode. Speech perception in noise was tested using the Bamford‐Kowal‐Bench presented at 65 dB SPL. The Speech, Spatial, and Qualities (SSQ) of Hearing Scale was used to evaluate the subjective perception of hearing outcomes, and the Tinnitus Reaction Questionnaire assessed the effect on tinnitus. All patients were implanted with the Med‐El Flex soft electrode, Innsbruck, Austria. They are regularly wearing the speech processor and find it beneficial in improving their ability to hear, particularly in noise. Decrease of tinnitus perception and an improvement of sound localization sounds were also reported by these patients. In our case series, CI was successful for all nine patients, with improvement of speech recognition in noise, self‐perceived improvement of hearing, and for tinnitus control. Several factors such as deafness duration, age of deafness onset, the presence of residual hearing, patient motivation, and the rehabilitation intensity need to be further investigated in order to understand their impact on performance after implantation. 4.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 23-08-2023
DOI: 10.1097/MAO.0000000000003995
Abstract: To determine and compare the benefits a novel adhesive bone-conduction system and a conventional bone-conduction hearing aid (BCHA) on a softband for children with conductive hearing loss. Prospective, single-subject randomized, crossover trial. Tertiary referral center in Australia. Eight children aged from 4 to 17 years with conductive hearing loss. Rehabilitative with participants using the novel adhesive bone-conduction aid and a BCHA. Aided thresholds, as well as speech perception in quiet, unaided and aided with the novel adhesive bone-conduction aid and BCHA on a softband. For the six older children, speech in noise testing was also conducted. The mean unaided four frequency average hearing levels was 48 dB HL for air conduction, 10.5 dB HL for bone conduction, with a mean air-bone gap in the aided ear of 37.5 dB HL. Four-frequency average hearing level aided thresholds were 20.2 dB for the novel device and 19.8 dB for the BCHA, with no significant difference between the devices. Aided monosyllabic word scores improved from an average of 45% in the unaided condition to 81.6 and 85% for the novel adhesive and BCHA devices, respectively. Aided speech in noise performance improved, on average, by 1.6 dB SNR when wearing the BCHA and the novel adhesive device, with no significant difference in performance between the two devices. The novel device provided equivalent performance to the BCHA on all measures and can be considered as an alternative device for pediatric patients with conductive hearing loss.
Publisher: Frontiers Media SA
Date: 24-03-2022
DOI: 10.3389/FSURG.2022.823219
Abstract: The cochlear implant (CI) electrode insertion process is a key step in CI surgery. One of the aims of advances in robotic-assisted CI surgery (RACIS) is to realize better cochlear structure preservation and to precisely control insertion. The aim of this literature review is to gain insight into electrode selection for RACIS by acquiring a thorough knowledge of electrode insertion and related complications from classic CI surgery involving a manual electrode insertion process. A systematic electronic search of the literature was carried out using PubMed, Scopus, Cochrane, and Web of Science to find relevant literature on electrode tip fold over (ETFO), electrode scalar deviation (ESD), and electrode migration (EM) from both pre-shaped and straight electrode types. A total of 82 studies that include 8,603 ears implanted with a CI, i.e., pre-shaped (4,869) and straight electrodes (3,734), were evaluated. The rate of ETFO (25 studies, 2,335 ears), ESD (39 studies, 3,073 ears), and EM (18 studies, 3,195 ears) was determined. An incidence rate (±95% CI) of 5.38% (4.4–6.6%) of ETFO, 28.6% (26.6–30.6%) of ESD, and 0.53% (0.2–1.1%) of EM is associated with pre-shaped electrodes, whereas with straight electrodes it was 0.51% (0.1–1.3%), 11% (9.2–13.0%), and 3.2% (2.5–3.95%), respectively. The differences between the pre-shaped and straight electrode types are highly significant ( p & 0.001). Laboratory experiments show evidence that robotic insertions of electrodes are less traumatic than manual insertions. The influence of round window (RW) vs. cochleostomy (Coch) was not assessed. Considering the current electrode designs available and the reported incidence of insertion complications, the use of straight electrodes in RACIS and conventional CI surgery (and manual insertion) appears to be less traumatic to intracochlear structures compared with pre-shaped electrodes. However, EM of straight electrodes should be anticipated. RACIS has the potential to reduce these complications.
Publisher: Springer Science and Business Media LLC
Date: 27-03-2021
DOI: 10.1007/S00405-021-06766-W
Abstract: Audiology is an essential service for some patient groups and some interventions. This article sets forth experience-based recommendations for how audiological centers can continue to safely and effectively function during COVID-19. The recommendations are the result of panel discussion and are based on the clinical experience of the panelists/authors. The recommendations cover which patient groups and which interventions should be treated when and whether this can be performed in the clinic or remotely how to maintain the safety of workplace via optimizing patient flow within the clinic and the sanitation of rooms and equipment and overcoming communication challenges that COVID-19 intensifies. For essential audiological services to continue under COVID-19, safety measures must be implemented and maintained, and treatment and communication strategies must be adapted to offset communication difficulties due to personal protective equipment (PPE) and social distancing and to bolster patient confidence. In short, it is vital that staff feel safe, that patients either feel the clinic is safe enough to visit or that remote treatment may be an option, and that clinics and patients have a broad agreement on the urgency of any needed service. We hope that these recommendations help clinics effectively accomplish these goals.
Publisher: SAGE Publications
Date: 2021
DOI: 10.1177/23312165211020645
Abstract: Two-electrode stimuli presented on adjacent mid-array contacts in cochlear-implant users elicit pitch percepts that are not consistent with a summation of the two temporal patterns. This indicates that low-rate temporal rate codes can be applied with considerable independence on adjacent mid-array electrodes. At issue in this study was whether a similar independence of temporal pitch cues can also be observed for more apical sites of stimulation, where temporal cues have been shown to be more reliable than place cues, in contrast to middle and basal sites. In cochlear-implant recipients with single-sided deafness implanted with long lateral-wall electrode arrays, pitch percepts were assessed by matching the pitch of dual-electrode stimuli with pure tones presented to the contralateral normal-hearing ear. The results were supported with an additional pitch-ranking experiment, in a different subject population with bilateral deafness. Unmodulated pulse trains with 100, 200, and 400 pulses per second were presented on three pairs of adjacent electrodes. Pulses were separated by the minimal interchannel delay (1.7 µs) in a short-delay configuration and by half the pulse period in a long-delay configuration. The hypothesis was that subjects would perceive a pitch corresponding to the doubled temporal pattern for the long-delay stimuli due to the summation of excitation patterns from adjacent apical electrodes, if those electrodes were to activate largely overlapping neural populations. However, we found that the mean matched acoustic pitch of the long-delay pulses was not significantly different from that of the short-delay pulses. These findings suggest that also in the apical region in long-array cochlear-implant recipients, temporal cues can be transmitted largely independently on adjacent electrodes.
Publisher: MDPI AG
Date: 20-08-2023
DOI: 10.3390/JPM13081276
Abstract: Otoplan is a surgical planning software designed to assist with cochlear implant surgery. One of its outputs is a recommendation of electrode array type based on imaging parameters. In this retrospective study, we evaluated the differences in auditory outcomes between patients who were implanted with arrays corresponding to those recommended by the Otoplan software versus those in which the array selection differed from the Otoplan recommendation. Pre-operative CT images from 114 patients were imported into the software, and array recommendations were generated. These were compared to the arrays which had actually been implanted during surgery, both in terms of array type and length. As recommended, 47% of patients received the same array, 34% received a shorter array, and 18% received a longer array. For reasons relating to structure and hearing preservation, 83% received the more flexible arrays. Those who received stiffer arrays had cochlear malformations or ossification. A negative, although non-statistically significant correlation was observed between the CNC scores at 12 months and the absolute value of the difference between recommended array and implanted array. In conclusion, clinicians may be slightly biased toward shorter electrode arrays due to their perceived greater ability to achieve full insertion. Using 3D imaging during the pre-operative planning may improve clinicians’ confidence to implant longer electrode arrays, where appropriate, to achieve optimum hearing outcomes.
Publisher: Informa UK Limited
Date: 26-03-2021
DOI: 10.1080/14992027.2021.1900610
Abstract: To investigate the feasibility of using an extended scope (ES) audiology service to provide care to non-urgent adult patients waiting for an Ear Nose and Throat (ENT) appointment. Based on suitability criteria developed by the Audiology and ENT departments, an internal review of the ENT wait list identified patients who would be suitable for an ES audiology clinic. 220 non-urgent patients on the ENT wait list with hearing loss and/or tinnitus. A total of 220 patients were transferred from the ENT wait list to the ES audiology clinic: 200 (90.9%) were seen by the ES Audiologist and 20 (9.1%) patients self-discharged or did not attend the appointment. Out of the 200 patients seen, 175 (87.5%) were assessed, managed and discharged without the need for input from an Otologist. The remaining 25 (12.5%) patients needed an Otologist's input. This study has demonstrated the feasibility of an ES audiology clinic in a tertiary teaching hospital. Of those seen by ES audiologist, 87.5% were discharged from the ENT wait list without medical intervention. This model may represent an effective alternative pathway for lengthy outpatient waiting list management whilst providing patients with timely access to care.
Publisher: MDPI AG
Date: 22-02-2023
Abstract: The primary objectives of this study were to evaluate the effect of hearing implant (HI) use on quality of life (QoL) and to determine which QoL measure(s) quantify QoL with greater sensitivity in users of different types of HIs. Participants were adult cochlear implant (CI), active middle ear implant (VIBRANT SOUNDBRIDGE (VSB)), or active transcutaneous bone conduction implant (the BONEBRIDGE (BB)) recipients. Generic QoL and disease-specific QoL were assessed at three intervals: pre-activation, 6 months of device use, and 12 months of device use. 169 participants completed the study (110 CI, 18VSB, and 41BB). CI users’ QoL significantly increased from 0–6 m device use on both the generic- and the disease-specific measures. On some device-specific measures, their QoL also significantly increased between 6 and 12 m device use. VSB users’ QoL significantly increased between all tested intervals with the disease-specific measure but not the generic measure. BB users’ QoL significantly increased from 0–6 m device use on both the generic- and the disease-specific measures. In sum, HI users experienced significant postoperative increases in QoL within their first 12 m of device use, especially when disease-specific measures were used. Disease-specific QoL measures appeared to be more sensitive than their generic counterparts.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 23-06-2021
DOI: 10.1097/AUD.0000000000001075
Abstract: The primary goal of the study was to investigate electrical cortical auditory evoked potentials (eCAEPs) at maximum comfortable level (MCL) and 50% MCL on three cochlear implant (CI) electrodes and compare them with the acoustic CAEP (aCAEPs), in terms of the litude and latency of the P1–N1–P2 complex. This was achieved by comparing the eCAEP obtained with the method described and stimulating single electrodes, via the fitting software spanning the cochlear array and the aCAEP obtained using the HEARLab system at four speech tokens. Twenty MED-EL (MED-EL Medical Electronics, Innsbruck, Austria) CI adult users were tested. CAEP recording with HEARLab System was performed with speech tokens /m/, /g/, /t/, and /s/ in free field, presented at 55 dB SPL. eCAEPs were recorded with an Evoked Potential device triggered from the MAX Programming Interface (MED-EL Medical Devices) with 70 msec electrical burst at 0.9 Hz at the apical (1), middle (6), and basal (10 or 11) CI electrode at their MCL and 50% MCL. CAEP responses were recorded in 100% of the test subjects for the speech token /t/, 95% for the speech tokens /g/ and /s/, and 90% for the speech token /m/. For eCAEP recordings, in all subjects, it was possible to identify N1 and P2 peaks when stimulating the apical and middle electrodes. This incidence of detection decreased to an 85% chance of stimulation at 50% MCL on the same electrodes. A P1 peak was less evident for all electrodes. There was an overall increase in latency for stimulation at 50% MCL compared with MCL. There was a significant difference in the litude of adjacent peaks (P1–N1 and N1–P2) for 50% MCL compared with MCL. The mean of the maximum cross-correlation values were in the range of 0.63 to 0.68 for the four speech tokens. The distribution of the calculated time shift, where the maximum of the cross-correlation was found, was distributed between the speech tokens. The speech token /g/ had the highest number of valid cross-correlations, while the speech token /s/ had the lowest number. This study successfully compared aCAEP and eCAEP in CI users. Both acoustic and electrical P1–N1–P2 recordings obtained were clear and reliable, with good correlation. Latency increased with decreasing stimulation level, while litude decreased. eCAEP is potentially a better option to verify speech detection at the cortical level because it (1) uses direct stimulation and therefore creates less interference and delay of the sound processor and (2) creates more flexibility with the recording setup and stimulation setting. As such, eCAEP is an alternative method for CI optimization.
Publisher: Wiley
Date: 07-02-2023
DOI: 10.1111/PSYP.14267
Abstract: During preparation for action, the presentation of loud acoustic stimuli (LAS) can trigger movements at very short latencies in a phenomenon called the StartReact effect. It was initially proposed that a special, separate subcortical mechanism that bypasses slower cortical areas could be involved. We sought to examine the evidence for a separate mechanism against the alternative that responses to LAS can be explained by a combination of stimulus intensity effects and preparatory states. To investigate whether cortically mediated preparatory processes are involved in mediating reactions to LAS, we used an auditory reaction task where we manipulated the preparation level within each trial by altering the conditional probability of the imperative stimulus. We contrasted responses to non‐intense tones and LAS and examined whether cortical activation and subcortical excitability and motor responses were influenced by preparation levels. Increases in preparation levels were marked by gradual reductions in reaction time (RT) coupled with increases in cortical activation and subcortical excitability – at both condition and trial levels. Interestingly, changes in cortical activation influenced motor and auditory but not visual areas – highlighting the widespread yet selective nature of preparation. RTs were shorter to LAS than tones, but the overall pattern of preparation level effects was the same for both stimuli. Collectively, the results demonstrate that LAS responses are indeed shaped by cortically mediated preparatory processes. The concurrent changes observed in brain and behavior with increasing preparation reinforce the notion that preparation is marked by evolving brain states which shape the motor system for action.
Publisher: Informa UK Limited
Date: 21-09-2011
DOI: 10.3109/14992027.2011.606286
Abstract: In this study, we aimed to explore a variation of the NTT standard protocol that would be more beneficial for those patients with hearing loss >50 dB HL in the worst ear (average hearing thresholds at 0.5, 1, 2, and 4 KHz). This study involved 26 subjects who had previously undergone NTT at a single private practice. Patients with high level of hearing loss were ided into two groups: Standard protocol group (SP) concluded the treatment following the standard NTT protocol proposed by the treatment's developers and Neuromonics guidelines. Extended protocol group (EP) was treated using a variation of the standard protocol, in which patients continued in stage 1 of the treatment for a prolonged time. Consistent with previously reported studies of the NTT, the tinnitus reaction questionnaire was used to assess tinnitus distress. Clinical outcomes for the two groups were analysed. Both groups achieved statistically significant improvement of their tinnitus distress. EP group achieved quicker clinical benefits when compared to the SP group. Extension of high stimulation period from two to four months may be beneficial for patients with higher level of hearing loss undergoing NTT.
Publisher: AVES YAYINCILIK A.Ş.
Date: 07-04-2021
Publisher: Scientific Research Publishing, Inc.
Date: 2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-03-2022
DOI: 10.1097/MAO.0000000000003524
Abstract: The 59-item Work Rehabilitation Questionnaire (WORQ) was developed based on the International Classification of Functioning, Disability and Health (ICF) core set for vocational rehabilitation to assess work related functioning. It was revised to include 17 questions, assigned to 14 ICF categories relevant to cochlear implant (CI) users. This cross-sectional multicenter study aimed to evaluate CI users’ responses on the WORQ questions to describe and generate ICF qualifiers for the revised WORQ in CI users, forming part of a broader framework of CI outcome measures linked to the ICF. One hundred seventy-seven adults over the age of 18 years with a minimum of one year's device experience were included in the analysis. The WORQ was completed by the participants at a routine visit to the clinic, via email, or via post. Most of the CI users perceived no problem on the WORQ questions (53.7%-91%), finished secondary school (54.2%) or obtained a college or university degree (32.8%) and are either employed (41.2%) or retired (34.5%). CI users that are currently working mostly have a full-time position (34.5%). Subjects reported no problem (91%) with sensation of falling, while handling communication devices and techniques (10.9%) and tinnitus (9.6%) showed the highest number of subjects reporting a complete problem. Overall, most of the CI users experienced no impairment, restriction or limitation on the WORQ questions and their assigned ICF categories. Their education level resembles the education level of the general population and they seem to integrate or reintegrate well in professional life postoperatively.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-10-2022
DOI: 10.1097/MAO.0000000000003725
Abstract: To evaluate the functional and subjective outcomes in in iduals with single-sided deafness (SSD) treated with a cochlear implant (CI). Eighty-one adult CI users with SSD participated in this study. Functional assessments consisted of speech in noise testing and localization. Subjective assessments consisted of the Speech Spatial Quality of Hearing Scale, the Tinnitus Reaction Questionnaire, the Abbreviated Profile of Hearing Aid Benefit questionnaire, the Hearing Handicap Inventory for Adults questionnaire, and the Glasgow Health Status Inventory and the Glasgow Benefit Inventory questionnaires. SSD has remarkable consequences on quality of life (QoL) and imposes a substantial emotional and social handicap on the in iduals. Self-reported QoL improved after CI with tinnitus intrusion significantly reduced as early as 3 months post-CI. A significant improvement was seen in all speech understanding in noise configurations. Localization ability significantly improved with CI on. Our findings demonstrate that SSD reduces social and psychological QoL and imposes a remarkable level of handicap as per general and specific self-assessments tool. CI provided a significant improvement in function including speech understanding in noise and localization ability, as well as improved QoL and reduced tinnitus significantly in both the early and long terms.
Publisher: S. Karger AG
Date: 2023
DOI: 10.1159/000529797
Abstract: b i Introduction: /i /b This study was designed to investigate the use of electrically evoked cortical auditory evoked potentials (eCAEPs) as a tool for cochlear implant (CI) verification, the relationships between the site and intensity of stimulation and the detection rates and morphologies of eCAEPs as well as investigate whether correlations exist between the morphologies of eCAEPs and speech perception in quiet and in noise, duration of hearing loss, age at implantation, whether the hearing loss bilateral or single-sided and the electrode current level required to elicit MCL stimulation. b i Methods: /i /b 32 adult unilateral CI users with postlingual hearing loss were enrolled. The stimuli were 1 kHz biphasic alternating pulses and were presented at either the behaviorally measured MCL or 50% of this value (MCL sub .5 /sub ) via the CI fitting software. Pulses were directed to apical, medial, or basal electrodes. CAEPs were recorded from a scalp electrode placed at the vertex, low forehead, and contralateral mastoid and were evaluated by two electrophysiologists. b i Results: /i /b Overall, eCAEPs could be detected in 31/32 users when stimulating at MCL, and in 29/32 users when stimulating at MCL sub .5 /sub . The detection rates were 31, 31, and 28/32 for apical, medial, and basal stimulation at MCL, and 29, 29, and 26/32 at MCL sub .5 /sub . Significant differences in eCAEP litudes and latencies were observed across electrodes and stimulation levels. No significant correlations were found between eCAEP latencies and litudes and user age, duration of deafness prior to CI surgery, or with bilateral versus single-sided hearing loss, nor with the charge level required to elicit MCL, or with speech perception scores in quiet. Peak latencies correlated with speech perception scores in some configurations of speech-in-noise. b i Conclusion: /i /b eCAEPs can readily be elicited in the majority of adult CI users and show normal waveform characteristics at stimulation levels corresponding to MCL, as well as at basal, medial, and apical electrode stimulation sites. Neither the latencies nor litudes of eCAEPs are confounded by variables of age, duration of deafness prior to CI surgery, or the laterality of hearing loss. eCAEPs are a useful, objective method evaluate sound perception in CI users.
Publisher: S. Karger AG
Date: 2016
DOI: 10.1159/000455058
Abstract: b i Background: /i /b While hearing aids for a contralateral routing of signals (CROS-HA) and bone conduction devices have been the traditional treatment for single-sided deafness (SSD) and asymmetric hearing loss (AHL), in recent years, cochlear implants (CIs) have increasingly become a viable treatment choice, particularly in countries where regulatory approval and reimbursement schemes are in place. Part of the reason for this shift is that the CI is the only device capable of restoring bilateral input to the auditory system and hence of possibly reinstating binaural hearing. Although several studies have independently shown that the CI is a safe and effective treatment for SSD and AHL, clinical outcome measures in those studies and across CI centers vary greatly. Only with a consistent use of defined and agreed-upon outcome measures across centers can high-level evidence be generated to assess the safety and efficacy of CIs and alternative treatments in recipients with SSD and AHL. b i Methods: /i /b This paper presents a comparative study design and minimum outcome measures for the assessment of current treatment options in patients with SSD/AHL. The protocol was developed, discussed, and eventually agreed upon by expert panels that convened at the 2015 APSCI conference in Beijing, China, and at the CI 2016 conference in Toronto, Canada. b i Results: /i /b A longitudinal study design comparing CROS-HA, BCD, and CI treatments is proposed. The recommended outcome measures include (1) speech in noise testing, using the same set of 3 spatial configurations to compare binaural benefits such as summation, squelch, and head shadow across devices (2) localization testing, using stimuli that rove in both level and spectral content (3) questionnaires to collect quality of life measures and the frequency of device use and (4) questionnaires for assessing the impact of tinnitus before and after treatment, if applicable. b i Conclusion: /i /b A protocol for the assessment of treatment options and outcomes in recipients with SSD and AHL is presented. The proposed set of minimum outcome measures aims at harmonizing assessment methods across centers and thus at generating a growing body of high-level evidence for those treatment options.
Publisher: MDPI AG
Date: 10-10-2023
Publisher: Informa UK Limited
Date: 25-11-2013
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2015
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 30-08-2022
DOI: 10.1097/MAO.0000000000003659
Abstract: To investigate if acoustic cortical auditory evoked potential (aCAEP) measures can be used to verify the cochlear implant (CI) map and consequently improve auditory outcomes in adults with single-sided deafness (SSD). aCAEPs were measured in SSD-CI recipients using speech tokens /m/, /g/, /t/, and /s/. If aCAEP responses were present for all speech tokens at the outset, no map adjustments were implemented. If aCAEP responses were absent for one or more tokens, the map was adjusted until aCAEPs were observed for all four tokens. Speech in noise testing using BKB-SiN was performed before and after aCAEP recording. The results of the speech testing results at presurgery, 6, 12, and 24 months post-CI were also analyzed. Sixty-seven CI users with SSD participated in this study. All CIs had been mapped according to the conventional subjective loudness perception method. Twenty-three SSD-CI users exhibited an aCAEP response for all four speech tokens and were therefore considered optimized at outset. Forty-four participants lacked an aCAEP response from at least one speech token and had their most comfortable levels adjusted accordingly. Of these, map adjustments allowed aCAEPs to be elicited for all four speech tokens in 23 in iduals. Speech in noise testing significantly improved pre– to post–aCAEP-based adjustment. aCAEP recordings were successfully used to verify CI mapping and improve resultant speech outcomes in SSD-CI users.
Publisher: Informa UK Limited
Date: 02-03-2020
Publisher: Springer New York
Date: 2011
Publisher: Oxford University Press (OUP)
Date: 24-03-2021
DOI: 10.1093/BJS/ZNAB101
Abstract: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351 best case 196, worst case 816) or non-cancer surgery (733 best case 407, worst case 1664). Both exceeded the NNV in the general population (1840 best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-01-2023
DOI: 10.1097/AUD.0000000000001326
Abstract: Single-sided deafness (SSD) is characterized by a profoundly deaf ear and normal hearing in the contralateral ear. A cochlear implant (CI) is the only method to restore functional hearing in a profoundly deaf ear. In a previous study, we identified that the cortical processing of a CI signal differs from the normal-hearing ear (NHE) when directly compared using an auditory oddball paradigm consisting of pure tones. However, exactly how the brain integrates the electrical and acoustic signal is not well investigated. This study aims to understand how the provision of the CI in combination with the NHE may improve SSD CI users’ ability to discriminate and evaluate auditory stimuli. Electroencephalography from 10 SSD-CI participants (4 participated in the previous pure-tone study) were recorded during a semantic acoustic oddball task, where they were required to discriminate between odd and even numbers. Stimuli were presented in four hearing conditions: directly through the CI, directly to the NHE, or in free field with the CI switched on and off. We examined task-performance (response time and accuracy) and measured N1, P2, N2N4, and P3b event-related brain potentials (ERPs) linked to the detection, discrimination, and evaluation of task relevant stimuli. Sound localization and speech in noise comprehension was also examined. In direct presentation, task performance was superior during NHE compared with CI (shorter and less varied reaction times [~720 versus ~842 msec], higher target accuracy [~93 versus ~70%]) and early neural responses (N1 and P2) were enhanced for NHE suggesting greater signal saliency. However, the size of N2N4 and P3b target-standard effects did not differ significantly between NHE and CI. In free field, target accuracy was similarly high with the CI (FF-On) and without the CI (FF-Off) (~95%), with some evidence of CI interference during FF-On (more variable and slightly but significantly delayed reaction times [~737 versus ~709 msec]). Early neural responses and late effects were also greater during FF-On. Performance on sound localization and speech in noise comprehension (S CI N NHE configuration only) was significantly greater during FF-On. Both behavioral and neural responses in the semantic oddball task were sensitive to CI in both direct and free-field presentations. Direct conditions revealed that participants could perform the task with the CI alone, although performance was suboptimal and early neural responses were reduced when compared with the NHE. For free-field, the addition of the CI was associated with enhanced early and late neural responses, but this did not result in improved task performance. Enhanced neural responses show that the additional input from the CI is modulating relevant perceptual and cognitive processes, but the benefit of binaural hearing on behavior may not be realized in simple oddball tasks which can be adequately performed with the NHE. Future studies interested in binaural hearing should examine performance under noisy conditions and/or use spatial cues to allow headroom for the measurement of binaural benefit.
Publisher: Wiley
Date: 09-08-2021
DOI: 10.1111/ANAE.15560
Abstract: We aimed to determine the impact of pre‐operative isolation on postoperative pulmonary complications after elective surgery during the global SARS‐CoV‐2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre‐defined sub‐group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS‐CoV‐2 infection. Patients who isolated pre‐operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS‐CoV‐2 incidence and high‐income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre‐operative testing use of COVID‐19‐free pathways or community SARS‐CoV‐2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care.
Publisher: Elsevier BV
Date: 07-2016
Publisher: Springer Science and Business Media LLC
Date: 02-07-2012
Abstract: In the present case we report on the mismanagement of a patient misdiagnosed with otosclerosis, who was subsequently found to have enlarged vestibular aqueduct syndrome bilaterally. This highlights the need to not only be vigilant in pre-operative assessment of otosclerosis but also in post-operative investigations of stapedectomy failures. Our patient, a 56-year-old Caucasian Australian woman, lost the hearing in her right ear following a stapedectomy approximately 25 years ago. It is thought that preoperative imaging was not conducted, while an inadequate (unmasked) audiogram was used to formulate the initial diagnosis of otosclerosis. The hearing in her left ear deteriorated to the point that a cochlear implant was now being considered for her right ear. Imaging performed as part of our pre-cochlear implant battery revealed bilateral enlarged vestibular aqueducts and thus the decision to proceed with a right cochlear implant was made following discussion with our patient and her family in regard to not only general surgical risks but specifically the remote risk that the surgical drilling required during the procedure could risk a deterioration of the hearing in her left ear because of the enlarged vestibular aqueduct on that side. This report illustrates a case of misdiagnosis and mismanagement of bilateral enlarged vestibular aqueduct resulting in profound hearing loss. Fortunately our patient has been successfully implanted with a right cochlear implant with remarkable outcomes.
Publisher: S. Karger AG
Date: 2023
DOI: 10.1159/000529485
Abstract: b i Introduction: /i /b In in iduals with single-sided deafness (SSD), who are characterised by profound hearing loss in one ear and normal hearing in the contralateral ear, binaural input is no longer present. A cochlear implant (CI) can restore functional hearing in the profoundly deaf ear, with previous literature demonstrating improvements in speech-in-noise intelligibility with the CI. However, we currently have limited understanding of the neural processes involved (e.g., how the brain integrates the electrical signal produced by the CI with the acoustic signal produced by the normal hearing ear) and how modulation of these processes with a CI contributes to improved speech-in-noise intelligibility. Using a semantic oddball paradigm presented in the presence of background noise, this study aims to investigate how the provision of CI impacts speech-in-noise perception of SSD-CI users. b i Method: /i /b Task performance (reaction time, reaction time variability, target accuracy, subjective listening effort) and high density electroencephalography from twelve SSD-CI participants were recorded, while they completed a semantic acoustic oddball task. Reaction time was defined as the time taken for a participant to press the response button after stimulus onset. All participants completed the oddball task in three different free-field conditions with the speech and noise coming from different speakers. The three tasks were: (1) CI-On in background noise, (2) CI-Off in background noise, and (3) CI-On without background noise (Control). Task performance and electroencephalography data (N2N4 and P3b) were recorded for each condition. Speech in noise and sound localisation ability were also measured. b i Results: /i /b Reaction time was significantly different between all tasks with CI-On ( i M /i [ i SE /i ] = 809 [39.9] ms) having faster RTs than CI-Off ( i M /i [ i SE /i ] = 845 [39.9] ms) and Control ( i M /i [ i SE /i ] = 785 [39.9] ms) being the fastest condition. The Control condition exhibited significantly shorter N2N4 and P3b area latency compared to the other two conditions. However, despite these differences noticed in RTs and area latency, we observed similar results between all three conditions for N2N4 and P3b difference area. b i Conclusion: /i /b The inconsistency between the behavioural and neural results suggests that EEG may not be a reliable measure of cognitive effort. This rationale is further supported by different explanations used in past studies to explain N2N4 and P3b effects. Future studies should look to alternative measures of auditory processing (e.g., pupillometry) to gain a deeper understanding of the underlying auditory processes that facilitate speech-in-noise intelligibility.
Publisher: Informa UK Limited
Date: 26-10-2017
DOI: 10.1080/14670100.2017.1379933
Abstract: To provide multidisciplinary cochlear implant teams with a current consensus statement to support hearing preservation cochlear implantation (HPCI) in children, including those children with symptomatic partial deafness (PD) where the intention is to use electric-acoustic stimulation (EAS). The main objectives are to provide guidelines on who is a candidate, how to assess these children and when to implant if Med-El Flex electrode arrays are chosen for implantation. The HEARRING group reviewed the current evidence and practice regarding the management of children to be considered for HPCI surgery emphasizing the assessment needed prior to implantation in order to demonstrate the benefits in these children over time. The consensus statement addresses following three key questions: (1) Should these children be treated? (2) How to identify these children? (3) How to manage these children? The HEARRING group concludes that irrespective of the degree of residual hearing present, the concepts of hearing and structure preservation should be applied in every child undergoing cochlear implantation and that HPCI is a safe and reliable treatment option. Early detection and multidisciplinary assessment are key to the identification of children with symptomatic PD, these children should undergo HPCI as early as possible.
Publisher: Informa UK Limited
Date: 11-2013
Publisher: GN1 Genesis Network
Date: 2012
DOI: 10.5935/0946-5448.20120024
Abstract: To measure the Quality of Life outcomes and impact on tinnitus perception in a group of patients after Round Window Vibroplasty (RW-VSB) for mixed or conductive hearing loss. A single-subject, repeated measures design was employed. All VSB fittings were based on hearing thresholds results and were not set to mask tinnitus. Ten Round Window-Vibroplasty patients were assessed with the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Tinnitus Reaction Questionnaire (TRQ). Subjects reported less hearing difficulties in 3 of 4 APHAB subscales. Tinnitus perception was decreased in all subjects with tinnitus pre-operatively. Round window vibroplasty in our cohort of patients with mixed or conductive hearing improved quality of life outcomes. There was significant improvement on APHAB scores and a significant decrease in tinnitus perception in subjects experiencing tinnitus prior to implantation.
Publisher: Public Library of Science (PLoS)
Date: 14-01-2020
Publisher: Wiley
Date: 24-08-2021
DOI: 10.1111/ANAE.15563
Abstract: SARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery) recent (1–6 weeks before surgery) previous (≥7 weeks before surgery) or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS‐CoV‐2 2.2% (50/2317) in patients with peri‐operative SARS‐CoV‐2 1.6% (15/953) in patients with recent SARS‐CoV‐2 and 1.0% (11/1148) in patients with previous SARS‐CoV‐2. After adjustment for confounding factors, patients with peri‐operative (adjusted odds ratio 1.5 (95%CI 1.1–2.0)) and recent SARS‐CoV‐2 (1.9 (95%CI 1.2–3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS‐CoV‐2 (1.7 (95%CI 0.9–3.0)). Overall, venous thromboembolism was independently associated with 30‐day mortality (5.4 (95%CI 4.3–6.7)). In patients with SARS‐CoV‐2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri‐operative or recent SARS‐CoV‐2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS‐CoV‐2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.
Publisher: Informa UK Limited
Date: 29-07-2015
DOI: 10.3109/00016489.2015.1067904
Abstract: Bone conduction implants are useful in patients with conductive and mixed hearing loss for whom conventional surgery or hearing aids are no longer an option. They may also be used in patients affected by single-sided deafness. To establish a consensus on the quality standards required for centers willing to create a bone conduction implant program. To ensure a consistently high level of service and to provide patients with the best possible solution the members of the HEARRING network have established a set of quality standards for bone conduction implants. These standards constitute a realistic minimum attainable by all implant clinics and should be employed alongside current best practice guidelines. Fifteen items are thoroughly analyzed. They include team structure, accommodation and clinical facilities, selection criteria, evaluation process, complete preoperative and surgical information, postoperative fitting and assessment, follow-up, device failure, clinical management, transfer of care and patient complaints.
Publisher: Informa UK Limited
Date: 05-11-2012
DOI: 10.3109/14992027.2012.721934
Abstract: To assess the benefits of hearing aids on tinnitus according to the tinnitus reaction questionnaire (TRQ Wilson et al, 1991), to verify whether the degree of masking provided by the hearing aid influenced the TRQ score, to examine whether the matched tinnitus pitch predicted the effectiveness of hearing aids in masking tinnitus, and to determine whether prescription of high-frequency lification might be desirable in tinnitus management when tinnitus pitch is high. A retrospective evaluation of the clinical outcomes of 70 tinnitus patients fitted with hearing aids was undertaken. The primary outcome measure was the TRQ, with a secondary subjective measure of tinnitus masking. Participants who achieved masking with their hearing aids had greater reduction in TRQ scores. Masking was more likely to be achieved when participants had good low-frequency hearing and tinnitus pitch fell into the frequency range of the hearing aids. The results support the use of hearing aids for tinnitus management, and suggest that masking may be a significant contributor to hearing aid success, implying that high-frequency lification may be effective in high-pitch tinnitus.
Publisher: AVES YAYINCILIK A.Ş.
Date: 16-09-2021
Publisher: Public Library of Science (PLoS)
Date: 22-02-2018
Publisher: Informa UK Limited
Date: 03-05-2016
DOI: 10.1080/14670100.2016.1176303
Abstract: Cochlear implantation is becoming widely used outside the tertiary research centers for treatment of unilateral deafness (UD). No consensus exists, however, on the most suitable assessment/evaluation protocols for this group of adult patients. This paper aims to review the assessment and evaluation protocols used by various research groups and to propose a protocol for the use in the clinical setting. The PubMed, Embase, and Cochrane Library databases were searched with the keywords 'cochlear', 'implant', 'single-sided', 'deafness', 'adults', 'unilateral', and 'deafness'. The words were either used in idually, combined in pairs, or in groups of 5. All articles reporting on prospective studies, retrospective studies, or case studies were included. Sixteen published studies met the inclusion criteria. Measures of hearing performance, tinnitus, subjective quality of hearing, and quality of life varied greatly among studies. Adaptive speech in noise testing, localization, tinnitus measurement questionnaires, and self-rated hearing improvement are widely used among the research groups. These tools in conjunction assess and evaluate the main issues associated with UD. The test battery most commonly used to assess and evaluate adult cochlea implant users with UD consists of (a) a subjective self-rating of hearing performance, (b) localization testing, and
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-09-2013
Publisher: Elsevier BV
Date: 06-2016
DOI: 10.1016/J.ANORL.2016.04.016
Abstract: Although cochlear implantation is widely used to treat unilateral deafness in adults, very little literature exists on its use and effects on the paediatric population. This report adds to the literature showing the mid-term follow-up outcomes achieved by these children. Three children with congenital unilateral deafness were studied after implantation. Speech perception in noise, and sound localization ability were evaluated using age-appropriate materials. The preliminary data of our small group of 3 children with congenital unilateral profound hearing loss revealed that up to 3 years post-implantation, congenitally deaf children who received a cochlear implant after 4 years of age do not demonstrate binaural hearing benefits. Early intervention in the prelingual phase may be crucial for the development of binaural hearing.
Publisher: Frontiers Media SA
Date: 14-10-2022
DOI: 10.3389/FNINS.2022.983498
Abstract: Tonal and speech token auditory oddball tasks have been commonly used to assess auditory processing in various populations however, tasks using non-word sounds may fail to capture the higher-level ability to interpret and discriminate stimuli based on meaning, which are critical to language comprehension. As such, this study examines how neural signals associated with discrimination and evaluation-processes (P3b) from semantic stimuli compare with those elicited by tones and speech tokens. This study comprises of two experiments, both containing thirteen adults with normal hearing in both ears (PTA ≤ 20 dB HL). Scalp electroencephalography and auditory event related potentials were recorded in free field while they completed three different oddball tasks: (1) tones, (2) speech tokens and (3) odd/even numbers. Based on the findings of experiment one, experiment two was conducted to understand if the difference in responses from the three tasks was attributable to stimulus duration or other factors. Therefore, in experiment one, stimulus duration was not controlled and in experiment two, the duration of each stimulus was modified to be the same across all three tasks (∼400 ms). In both experiments, P3b peak latency was significantly different between all three tasks. P3b litude was sensitive to reaction time, with tasks that had a large reaction time variability resulting in the P3b litude to be smeared, thereby reducing the litude size. The findings from this study highlight the need to consider all factors of the task before attributing any effects to any additional process, such as semantic processing and mental effort. Furthermore, it highlights the need for more cautious interpretation of P3b results in auditory oddball tasks.
Publisher: MDPI AG
Date: 29-11-2022
DOI: 10.3390/JPM12121971
Abstract: The study aimed to develop a consensus classification system for the reporting of sound localization testing results, especially in the field of cochlear implantation. Against the background of an overview of the wide variations present in localization testing procedures and reporting metrics, a novel classification system was proposed to report localization errors according to the widely accepted International Classification of Functioning, Disability and Health (ICF) framework. The obtained HEARRING_LOC_ICF scale includes the ICF graded scale: 0 (no impairment), 1 (mild impairment), 2 (moderate impairment), 3 (severe impairment), and 4 (complete impairment). Improvement of comparability of localization results across institutes, localization testing setups, and listeners was demonstrated by applying the classification system retrospectively to data obtained from cohorts of normal-hearing and cochlear implant listeners at our institutes. The application of our classification system will help to facilitate multi-center studies, as well as allowing better meta-analyses of data, resulting in improved evidence-based practice in the field.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2022
DOI: 10.1097/MAO.0000000000003622
Abstract: To study the evolution of type D personality traits in older adults after cochlear implantation compared with a control group of severely hearing impaired older adults who did not receive a cochlear implant (CI). The influence of COVID-19 on this evolution was also explored. Type D personality combines a high degree of negative affectivity (NA) and social inhibition (SI). In this prospective, longitudinal, controlled multicenter exploratory study, 76 older CI users and 21 severely hearing impaired controls without CI were included. The CI group and the control group did not differ significantly regarding age, formal education, residual hearing, Type D Scale-14 (DS14) total score, NA, and SI at baseline. Type D personality traits were assessed with the DS14 at baseline (T0) and 14 months later (T14). Type D personality traits differed significantly over time between the CI group and the control group ( p 0.001). In the CI group, the DS14 total score (mean delta T = −6.63 p 0.001), NA (mean delta T = −3.26 p 0.001), and SI (mean delta T = −3.37 p 0.001) improved significantly over time (delta T = T14–T0), whereas no significant difference was found in the control group. Significantly fewer subjects were categorized as type D personalities in the CI group (delta T = −12 p = 0.023) at T14, whereas no significant change was found in the control group (delta T = 3 p = 0.250). COVID-19 did not influence the evolution of type D personality traits significantly in the CI group. Cochlear implantation has a positive effect on type D personality traits in older adults with a severe-to-profound hearing impairment.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2015
Publisher: Informa UK Limited
Date: 11-04-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-04-2020
DOI: 10.1097/MAO.0000000000002657
Abstract: Conventional bone conduction hearing aid solutions often require a cumbersome retention system such as a headband or cap. This study aims to determine if a novel, nonsurgical bone conduction aid utilizing an adhesive attachment over the mastoid is equivalent to the conventional bone conduction hearing aid (BCHA) for the management of conductive hearing loss. Prospective, single-subject randomized, crossover trial. Tertiary referral center. Eleven adults and 1 child between 11 and 70 years of age with unilateral conductive hearing loss were enrolled. Patients had their baseline hearing assessed and were randomized to receive either the novel device or BCHA headband system. Hearing loss etiologies were varied and included cholesteatoma, otosclerosis, chronic otitis media, and previous head and neck surgery. Patients had their baseline hearing assessed and trialled both the novel device or the BCHA headband system. Patients were randomly assigned one device which was worn for 2 weeks followed by a 2-week trial with the alternate device. Pure-tone thresholds and speech discrimination in quiet and noise were tested and patients also completed the short form of the Speech Spatial and Quality of Hearing (SSQ) questionnaire. The mean unaided 4 frequency pure-tone average (PTA) air conduction threshold was 53.9 dB, bone conduction was 11.9 dB, and the mean air bone gap was 42 dB in the target ear. One patient with an adhesive skin reaction could not complete the protocol. Aided PTA and threshold testing between 250 Hz to 8000 Hz showed statistically equivalent results between both devices. The aided CNC word score, signal-to-noise ratio, and SSQ scores were also equivalent between both devices. The novel bone conduction aid demonstrates equivalent performance to the conventional BCHA headband solution. The novel device should be considered an alternative option where the cosmetic and comfort issues of a headband worn device are a concern.
Publisher: Frontiers Media SA
Date: 07-2022
DOI: 10.3389/FSURG.2022.893839
Abstract: The last two decades have demonstrated that preoperative functional acoustic hearing (residual hearing) can be preserved during cochlear implant (CI) surgery. However, the relationship between the electrode array length and postoperative hearing preservation (HP) with lateral wall flexible electrode variants is still under debate. This is a systematic literature review that aims to analyze the HP rates of patients with residual hearing for medium-length and longer-length lateral wall electrodes. A systematic literature review methodology was applied following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) recommendations to evaluate the HP rates of medium-length and longer-length lateral wall electrodes from one CI manufacturer (medium length FLEX 24, longer length FLEX 28 and FLEX SOFT, MED-EL, Innsbruck, Austria). A search using search engine PubMed ( ubmed/ ) was performed using the search terms “hearing preservation” or “residual hearing” and “cochlear implant” in “All fields.” Articles published only in English between January 01, 2009 and December 31, 2020 were included in the search. The HP rate was similar between medium-length (93.4%–93.5%) and longer (92.1%–86.8%) electrodes at 4 months ( p = 0.689) and 12 months ( p = 0.219). In the medium-length electrode group, patients under the age of 45 years had better HP than patients above the age of 45 years. Both medium-length and longer electrode arrays showed high hearing preservation rates. Considering the hearing deterioration over time, implanting a longer electrode at primary surgery should be considered, thus preventing the need for future reimplantation.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-10-2020
DOI: 10.1097/AUD.0000000000000962
Abstract: To compare the cognitive evolution of older adults with severe or profound hearing impairment after cochlear implantation with that of a matched group of older adults with severe hearing impairment who do not receive a cochlear implant (CI). In this prospective, longitudinal, controlled, and multicenter study, 24 older CI users were included in the intervention group and 24 adults without a CI in the control group. The control group matched the intervention group in terms of gender, age, formal education, cognitive functioning, and residual hearing. Assessments were made at baseline and 14 months later. Primary outcome measurements included the change in the total score on the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing impaired in iduals score and on its subdomain score to assess cognitive evolution in both groups. Secondary outcome measurements included self-reported changes in sound quality (Hearing Implant Sound Quality Index), self-perceived hearing disability (Speech, Spatial, and Qualities of Hearing Scale), states of anxiety and depression (Hospital Anxiety and Depression Scale), and level of negative affectivity and social inhibition (Type D questionnaire). Improvements of the overall cognitive functioning ( p = 0.05) and the subdomain “Attention” ( p = 0.02) were observed after cochlear implantation in the intervention group their scores were compared to the corresponding scores in the control group. Significant positive effects of cochlear implantation on sound quality and self-perceived hearing outcomes were found in the intervention group. Notably, 20% fewer traits of Type D personalities were measured in the intervention group after cochlear implantation. In the control group, traits of Type D personalities increased by 13%. Intervention with a CI improved cognitive functioning (domain Attention in particular) in older adults with severe hearing impairment compared to that of the matched controls with hearing impairment without a CI. However, older CI users did not, in terms of cognition, bridge the performance gap with adults with normal hearing after 1 year of CI use. The fact that experienced, older CI users still present subnormal cognitive functioning may highlight the need for additional cognitive rehabilitation in the long term after implantation.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2015
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.IJPORL.2014.12.014
Abstract: A pilot study to investigate the utility of basic Fibroblast Growth Factor (bFGF) in tympanic membrane perforation (TMP) closure in a small cohort of pediatric patients. Prospective cohort study. Suitability for inclusion in the study was confirmed by the application of defined inclusion and exclusion criteria, and informed parental consent obtained. The technique used was a modification of the bFGF-technique by Kanemaru et al. Response to treatment was monitored with serial otoscopy and audiometric outcomes were determined. Statistical analysis of the outcomes was carried out. TMPs were successfully closed in 7/12 children at the first attempt (58%) and in 10/12 children overall (83%). Hearing improvement was observed in 8/10 successfully treated cases (80%). There were no complications or adverse outcomes. The topical bFGF regeneration technique offers a promising, minimally invasive alternative to conventional myringoplasty in pediatric patients with comparable success and reduced morbidity and cost, especially considering the option of performing repeat applications. Patients with an active infection or inflammation are not suitable for the bFGF-mediated technique.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2015
Publisher: Wiley
Date: 09-03-2021
DOI: 10.1111/ANAE.15458
Abstract: Peri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery within 0–2 weeks, 3–4 weeks and 5–6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3–4.8), 3.9 (2.6–5.1) and 3.6 (2.0–5.2), respectively). Surgery performed ≥ 7 weeks after SARS‐CoV‐2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9–2.1)). After a ≥ 7 week delay in undertaking surgery following SARS‐CoV‐2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2–8.7) vs. 2.4% (95%CI 1.4–3.4) vs. 1.3% (95%CI 0.6–2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS‐CoV‐2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.
Publisher: Hindawi Limited
Date: 2014
DOI: 10.1155/2014/501738
Abstract: The programming of CIs is essential for good performance. However, no Good Clinical Practice guidelines exist. This paper reports on the results of an inventory of the current practice worldwide. A questionnaire was distributed to 47 CI centers. They follow 47600 recipients in 17 countries and 5 continents. The results were discussed during a debate. Sixty-two percent of the results were verified through in idual interviews during the following months. Most centers (72%) participated in a cross-sectional study logging 5 consecutive fitting sessions in 5 different recipients. Data indicate that general practice starts with a single switch-on session, followed by three monthly sessions, three quarterly sessions, and then annual sessions, all containing one hour of programming and testing. The main focus lies on setting maximum and, to a lesser extent, minimum current levels per electrode. These levels are often determined on a few electrodes and then extrapolated. They are mainly based on subjective loudness perception by the CI user and, to a lesser extent, on pure tone and speech audiometry. Objective measures play a small role as indication of the global MAP profile. Other MAP parameters are rarely modified. Measurable targets are only defined for pure tone audiometry. Huge variation exists between centers on all aspects of the fitting practice.
Publisher: Informa UK Limited
Date: 17-10-2023
Publisher: SAGE Publications
Date: 2021
DOI: 10.1177/23312165211025938
Abstract: The aim of this study was to assess whether a computer-based speech-in-noise auditory training (AT) program would lead to short- and long-term changes in trained and untrained measures of listening, cognition, and quality of life. A secondary aim was to assess whether directly training the underlying cognitive abilities required for speech perception in noise, using a computer-based visual training (VT) program without the auditory component, would elicit comparable outcomes as the AT program. A randomized crossover study with repeated measures was conducted with 26 adult cochlear implant users. Participants completed either 6 weeks of speech perception in noise training followed by 6 weeks of masked text recognition training, or vice versa. Outcome measures were administered twice before each training program, as well as twice after the completion of each program. The test battery was designed to evaluate whether training led to improvements in listening abilities, cognitive abilities, or quality of life. Mixed-effects models were conducted to analyze whether changes occurred on the trained tasks and on untrained outcome measures after training. Statistically significant improvements were shown for verbal recognition performance during both training programs, in particular for consonants in words, and during the first 2 weeks of training. This on-task learning, however, did not lead to clear improvements in outcomes measured beyond the training programs. This suggests that experienced cochlear implant users may not show transfer of on-task learning to untrained tasks after computer-based auditory and visual training programs such as the ones used in this study.
Publisher: Elsevier BV
Date: 02-2021
Publisher: American Speech Language Hearing Association
Date: 03-03-2022
DOI: 10.1044/2021_AJA-21-00127
Abstract: This study used a collaborative approach to explore the needs, barriers, and facilitators to developing cochlear implant referral information material that would be valuable for hard of hearing adults and referring audiologists. During the development of a prototype referral aid to be used within the Australian context, a multistage qualitative study was conducted using a consultative process, informal and semistructured interviews, as well as online surveys. A deductive directed content analysis approach was applied to assess respondents' perspectives. A total of 106 participants (37 hard of hearing adults and 69 audiologists) were involved across the multiple phases of this study. Referral practices for the evaluation of cochlear implantation candidacy in Australia are highly inconsistent, supporting the need to streamline referral information. The following facilitators were identified to support the development of referral material: appropriate content, perceived patient benefit, and objectivity. Areas for improvement related to the broadness of the content, impact on professional identity, and accessibility. Practical insight from patients and referrers can inform the development of patient-facing material related to cochlear implant referrals. Streamlining information used in educational material could alleviate confusion inherent to varied health literacy levels and support patients in making informed decisions related to pursuing, or not, cochlear implantation candidacy evaluation services.
Publisher: Public Library of Science (PLoS)
Date: 07-10-2022
DOI: 10.1371/JOURNAL.PONE.0274643
Abstract: To investigate if cortical auditory evoked potential (CAEP) measures can be used to verify the cochlear implant (CI) map and consequently improve CI outcomes in adults with bilateral hearing loss. CAEPs were measured in CI recipients using the speech tokens /m/, /g/, /t/ and /s/. If CAEP responses were present for all speech tokens, the participant’s map was considered “satisfactory”. If CAEP responses were absent, the CI map was considered “unsatisfactory” and therefore adjusted and CAEP measures repeated. This was repeated until auditory potentials were seen in response to all four speech tokens. Speech testing was conducted pre-CI, as well as before and after CAEP-guided map adjustments. 108 adult unilateral CI users participated, whose sound processors were previously programmed using subjective methods. 42 CI users elicited a CAEP response to all four speech tokens and therefore no further mapping adjustments were made. 66 subjected lacked a CAEP response to at least one speech token and had their CI map adjusted accordingly. Of those, 31 showed a CAEP response to all four speech tokens, and the average speech score significantly improved after CI map adjustments based on CAEP responses. CAEP’s are an objective tool that can be used to guide and verify CI mapping in adults CI users. Significant improvement in speech scores was observed in participants who had their CI map adjusted based on CAEP responses.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 21-03-2018
Publisher: S. Karger AG
Date: 08-09-2023
DOI: 10.1159/000533273
No related grants have been discovered for Dayse Tavora-Vieira.