Characteristics and pathogenesis of facial nerve stimulation after cochlear implant surgeries: A single-center retrospective analysis from 1,151 patients.

PubMed

Kim, Y R; Yoo, M H; Lee, J Y; Yang, C J; Park, J W; Kang, B C; Kang, W S; Ahn, J H; Chung, J W; Park, H J

2018-05-29

Incidence of facial nerve stimulation (FNS) was 2.8% (32 out of 1151) and higher in ears with cochlear anomaly (6.4%, 25 out of 391) than without cochlear anomaly (0.9%, 7 out of 760). FNS occurred at various current levels and locations of electrodes by different mechanisms related to incomplete insertion of electrodes, cochleo-facial dehiscence, and types of cochlear anomalies. FNS at apical electrodes related to cochleo-facial dehiscence with low current levels, and FNS at basal electrodes with high current levels and partial insertion of electrodes. FNS at most electrodes with high current levels was the most common type in patients with a common cavity or narrowing of the bony cochlear nerve canal. Understanding the mechanisms of FNS might provide insight for preventing FNS when performing CI surgeries. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The contribution of short-term memory capacity to reading ability in adolescents with cochlear implants.

PubMed

Edwards, Lindsey; Aitkenhead, Lynne; Langdon, Dawn

2016-11-01

This study aimed to establish the relationship between short-term memory capacity and reading skills in adolescents with cochlear implants. A between-groups design compared a group of young people with cochlear implants with a group of hearing peers on measures of reading, and auditory and visual short-term memory capacity. The groups were matched for non-verbal IQ and age. The adolescents with cochlear implants were recruited from the Cochlear Implant Programme at a specialist children's hospital. The hearing participants were recruited from the same schools as those attended by the implanted adolescents. Participants were 18 cochlear implant users and 14 hearing controls, aged between 12 and 18 years. All used English as their main language and had no significant learning disability or neuro-developmental disorder. Short-term memory capacity was assessed in the auditory modality using Forward and Reverse Digit Span from the WISC IV UK, and visually using Forward and Reverse Memory from the Leiter-R. Individual word reading, reading comprehension and pseudoword decoding were assessed using the WIAT II UK. A series of ANOVAs revealed that the adolescents with cochlear implants had significantly poorer auditory short-term memory capacity and reading skills (on all measures) compared with their hearing peers. However, when Forward Digit Span was entered into the analyses as a covariate, none of the differences remained statistically significant. Deficits in immediate auditory memory persist into adolescence in deaf children with cochlear implants. Short-term auditory memory capacity is an important neurocognitive process in the development of reading skills after cochlear implantation in childhood that remains evident in later adolescence. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Response Properties of Cochlear Nucleus Neurons in Monkeys

PubMed Central

Roth, G. Linn; Recio, A.

2009-01-01

Much of what is known about how the cochlear nuclei participate in mammalian hearing comes from studies of non-primate mammalian species. To determine to what extent the cochlear nuclei of primates resemble those of other mammalian orders, we have recorded responses to sound in three primate species: marmosets, Cynomolgus macaques, and squirrel monkeys. These recordings show that the same types of temporal firing patterns are found in primates that have been described in other mammals. Responses to tones of neurons in the ventral cochlear nucleus have similar tuning, latencies, post-stimulus time and interspike interval histograms as those recorded in non-primate cochlear nucleus neurons. In the dorsal cochlear nucleus, too, responses were similar. From these results it is evident that insights gained from non-primate studies can be applied to the peripheral auditory system of primates. PMID:19531377

Intraoperative cochlear nerve mapping with the mobile cochlear nerve compound action potential tracer in vestibular schwannoma surgery.

PubMed

Watanabe, Nobuyuki; Ishii, Takuya; Fujitsu, Kazuhiko; Kaku, Shogo; Ichikawa, Teruo; Miyahara, Kosuke; Okada, Tomu; Tanino, Shin; Uriu, Yasuhiro; Murayama, Yuichi

2018-05-18

OBJECTIVE The authors describe the usefulness and limitations of the cochlear nerve compound action potential (CNAP) mobile tracer (MCT) that they developed to aid in cochlear nerve mapping during vestibular schwannoma surgery (VSS) for hearing preservation. METHODS This MCT device requires no more than 2 seconds for stable placement on the nerve to obtain the CNAP and thus is able to trace the cochlear nerve instantaneously. Simultaneous bipolar and monopolar recording is possible. The authors present the outcomes of 18 consecutive patients who underwent preoperative useful hearing (defined as class I or II of the Gardner-Robertson classification system) and underwent hearing-preservation VSS with the use of the MCT. Mapping was considered successful when it was possible to detect and trace the cochlear nerve. RESULTS Mapping of the cochlear nerve was successful in 13 of 18 patients (72.2%), and useful hearing was preserved in 11 patients (61.1%). Among 8 patients with large tumors (Koos grade 3 or 4), the rate of successful mapping was 62.5% (5 patients). The rate of hearing preservation in patients with large tumors was 50% (4 patients). CONCLUSIONS In addition to microsurgical presumption of the arrangement of each nerve, frequent probing on and around an unidentified nerve and comparison of each waveform are advisable with the use of both more sensitive monopolar and more location-specific bipolar MCT. MCT proved to be useful in cochlear nerve mapping and may consequently be helpful in hearing preservation. The authors discuss some limitations and problems with this device.

Speech recognition and communication outcomes with cochlear implantation in Usher syndrome type 3.

PubMed

Pietola, Laura; Aarnisalo, Antti A; Abdel-Rahman, Akram; Västinsalo, Hanna; Isosomppi, Juha; Löppönen, Heikki; Kentala, Erna; Johansson, Reijo; Valtonen, Hannu; Vasama, Juha-Pekka; Sankila, Eeva-Marja; Jero, Jussi

2012-01-01

Usher syndrome Type 3 (USH3) is an autosomal recessive disorder characterized by variable type and degree of progressive sensorineural hearing loss and retinitis pigmentosa. Cochlear implants are widely used among these patients. To evaluate the results and benefits of cochlear implantation in patients with USH3. A nationwide multicenter retrospective review. During the years 1995-2005, in 5 Finnish university hospitals, 19 patients with USH3 received a cochlear implant. Saliva samples were collected to verify the USH3 genotype. Patients answered to 3 questionnaires: Glasgow Benefit Inventory, Glasgow Health Status Inventory, and a self-made questionnaire. Audiological data were collected from patient records. All the patients with USH3 in the study were homozygous for the Finnish major mutation (p.Y176X). Either they had severe sensorineural hearing loss or they were profoundly deaf. The mean preoperative hearing level (pure-tone average, 0.5-4 kHz) was 110 ± 8 dB hearing loss (HL) and the mean aided hearing level was 58 ± 11 dB HL. The postoperative hearing level (34 ± 9 dB HL) and word recognition scores were significantly better than before surgery. According to the Glasgow Benefit Inventory scores and Glasgow Health Status Inventory data related to hearing, the cochlear implantation was beneficial to patients with USH3. Cochlear implantation is beneficial to patients with USH3, and patients learn to use the implant without assistance.

Effect of cochlear nerve electrocautery on the adult cochlear nucleus.

PubMed

Iseli, Claire E; Merwin, William H; Klatt-Cromwell, Cristine; Hutson, Kendall A; Ewend, Matthew G; Adunka, Oliver F; Fitzpatrick, Douglas C; Buchman, Craig A

2015-04-01

Electrocauterization and subsequent transection of the cochlear nerve induce greater injury to the cochlear nucleus than sharp transection alone. Some studies show that neurofibromatosis Type 2 (NF2) patients fit with auditory brainstem implants (ABIs) fail to achieve speech perception abilities similar to ABI recipients without NF2. Reasons for these differences remain speculative. One hypothesis posits poorer performance to surgically induced trauma to the cochlear nucleus from electrocautery. Sustained electrosurgical depolarization of the cochlear nerve may cause excitotoxic-induced postsynaptic nuclear injury. Equally plausible is that cautery in the vicinity of the cochlear nucleus induces necrosis. The cochlear nerve was transected in anesthetized adult gerbils sharply with or without bipolar electrocautery at varying intensities. Gerbils were perfused at 1, 3, 5, and 7 days postoperatively; their brainstem and cochleas were embedded in paraffin and sectioned at 10 μm. Alternate sections were stained with flourescent markers for neuronal injury or Nissl substance. In additional experiments, anterograde tracers were applied directly to a sectioned eighth nerve to verify that fluorescent-labeled profiles seen were terminating auditory nerve fibers. Cochlear nerve injury was observed from 72 hours postoperatively and was identical across cases regardless of surgical technique. Postsynaptic cochlear nucleus injury was not seen after distal transection of the nerve. By contrast, proximal transection was associated with trauma to the cochlear nucleus. Distal application of bipolar electrocautery seems safe for the cochlear nucleus. Application near the root entry zone must be used cautiously because this may compromise nuclear viability needed to support ABI stimulation.

Ischemia-reperfusion injury of the cochlea: pharmacological strategies for cochlear protection and implications of glutamate and reactive oxygen species.

PubMed

Tabuchi, Keiji; Nishimura, Bungo; Tanaka, Shuho; Hayashi, Kentaro; Hirose, Yuki; Hara, Akira

2010-06-01

A large amount of energy produced by active aerobic metabolism is necessary for the cochlea to maintain its function. This makes the cochlea vulnerable to blockade of cochlear blood flow and interruption of the oxygen supply. Although certain forms of human idiopathic sudden sensorineural hearing loss reportedly arise from ischemic injury, the pathological mechanism of cochlear ischemia-reperfusion injury has not been fully elucidated. Recent animal studies have shed light on the mechanisms of cochlear ischemia-reperfusion injury. It will help in the understanding of the pathology of cochlear ischemia-reperfusion injury to classify this injury into ischemic injury and reperfusion injury. Excitotoxicity, mainly observed during the ischemic period, aggravates the injury of primary auditory neurons. On the other hand, oxidative damage induced by hydroxyl radicals and nitric oxide enhances cochlear reperfusion injury. This article briefly summarizes the generation mechanisms of cochlear ischemia-reperfusion injury and potential therapeutic targets that could be developed for the effective management of this injury type.

The secondary spiral lamina and its relevance in cochlear implant surgery.

PubMed

Agrawal, Sumit; Schart-Morén, Nadine; Liu, Wei; Ladak, Hanif M; Rask-Andersen, Helge; Li, Hao

2018-03-01

We used synchrotron radiation phase contrast imaging (SR-PCI) to study the 3D microanatomy of the basilar membrane (BM) and its attachment to the spiral ligament (SL) (with a conceivable secondary spiral lamina [SSL] or secondary spiral plate) at the round window membrane (RWM) in the human cochlea. The conception of this complex anatomy may be essential for accomplishing structural preservation at cochlear implant surgery. Sixteen freshly fixed human temporal bones were used to reproduce the BM, SL, primary and secondary osseous spiral laminae (OSL), and RWM using volume-rendering software. Confocal microscopy immunohistochemistry (IHC) was performed to analyze the molecular constituents. SR-PCI reproduced the soft tissues including the RWM, Reissner's membrane (RM), and the BM attachment to the lateral wall (LW) in three dimensions. A variable SR-PCI contrast enhancement was recognized in the caudal part of the SL facing the scala tympani (ST). It seemed to represent a SSL allied to the basilar crest (BC). The SSL extended along the postero-superior margin of the round window (RW) and immunohistochemically expressed type II collagen. Unlike in several mammalian species, the human SSL is restricted to the most basal portion of the cochlea around the RW. It anchors the BM and may influence its hydro-mechanical properties. It could also help to shield the BM from the RW. The microanatomy should be considered at cochlear implant surgery.

The Hearing Outcomes of Cochlear Implantation in Waardenburg Syndrome.

PubMed

Koyama, Hajime; Kashio, Akinori; Sakata, Aki; Tsutsumiuchi, Katsuhiro; Matsumoto, Yu; Karino, Shotaro; Kakigi, Akinobu; Iwasaki, Shinichi; Yamasoba, Tatsuya

2016-01-01

Objectives. This study aimed to determine the feasibility of cochlear implantation for sensorineural hearing loss in patients with Waardenburg syndrome. Method. A retrospective chart review was performed on patients who underwent cochlear implantation at the University of Tokyo Hospital. Clinical classification, genetic mutation, clinical course, preoperative hearing threshold, high-resolution computed tomography of the temporal bone, and postoperative hearing outcome were assessed. Result. Five children with Waardenburg syndrome underwent cochlear implantation. The average age at implantation was 2 years 11 months (ranging from 1 year 9 months to 6 years 3 months). Four patients had congenital profound hearing loss and one patient had progressive hearing loss. Two patients had an inner ear malformation of cochlear incomplete partition type 2. No surgical complication or difficulty was seen in any patient. All patients showed good hearing outcome postoperatively. Conclusion. Cochlear implantation could be a good treatment option for Waardenburg syndrome.

The Hearing Outcomes of Cochlear Implantation in Waardenburg Syndrome

PubMed Central

Koyama, Hajime; Kashio, Akinori; Sakata, Aki; Tsutsumiuchi, Katsuhiro; Matsumoto, Yu; Karino, Shotaro; Kakigi, Akinobu; Iwasaki, Shinichi; Yamasoba, Tatsuya

2016-01-01

Objectives. This study aimed to determine the feasibility of cochlear implantation for sensorineural hearing loss in patients with Waardenburg syndrome. Method. A retrospective chart review was performed on patients who underwent cochlear implantation at the University of Tokyo Hospital. Clinical classification, genetic mutation, clinical course, preoperative hearing threshold, high-resolution computed tomography of the temporal bone, and postoperative hearing outcome were assessed. Result. Five children with Waardenburg syndrome underwent cochlear implantation. The average age at implantation was 2 years 11 months (ranging from 1 year 9 months to 6 years 3 months). Four patients had congenital profound hearing loss and one patient had progressive hearing loss. Two patients had an inner ear malformation of cochlear incomplete partition type 2. No surgical complication or difficulty was seen in any patient. All patients showed good hearing outcome postoperatively. Conclusion. Cochlear implantation could be a good treatment option for Waardenburg syndrome. PMID:27376080

Consonant Cluster Production in Children with Cochlear Implants: A Comparison with Normally Hearing Peers

ERIC Educational Resources Information Center

Faes, Jolien; Gillis, Steven

2017-01-01

In early word productions, the same types of errors are manifest in children with cochlear implants (CI) as in their normally hearing (NH) peers with respect to consonant clusters. However, the incidence of those types and their longitudinal development have not been examined or quantified in the literature thus far. Furthermore, studies on the…

Cochlear implant revision surgeries in children.

PubMed

Amaral, Maria Stella Arantes do; Reis, Ana Cláudia Mirândola B; Massuda, Eduardo T; Hyppolito, Miguel Angelo

2018-02-16

The surgery during which the cochlear implant internal device is implanted is not entirely free of risks and may produce problems that will require revision surgeries. To verify the indications for cochlear implantation revision surgery for the cochlear implant internal device, its effectiveness and its correlation with certain variables related to language and hearing. A retrospective study of patients under 18 years submitted to cochlear implant Surgery from 2004 to 2015 in a public hospital in Brazil. Data collected were: age at the time of implantation, gender, etiology of the hearing loss, audiological and oral language characteristics of each patient before and after Cochlear Implant surgery and any need for surgical revision and the reason for it. Two hundred and sixty-five surgeries were performed in 236 patients. Eight patients received a bilateral cochlear implant and 10 patients required revision surgery. Thirty-two surgeries were necessary for these 10 children (1 bilateral cochlear implant), of which 21 were revision surgeries. In 2 children, cochlear implant removal was necessary, without reimplantation, one with cochlear malformation due to incomplete partition type I and another due to trauma. With respect to the cause for revision surgery, of the 8 children who were successfully reimplanted, four had cochlear calcification following meningitis, one followed trauma, one exhibited a facial nerve malformation, one experienced a failure of the cochlear implant internal device and one revision surgery was necessary because the electrode was twisted. The incidence of the cochlear implant revision surgery was 4.23%. The period following the revision surgeries revealed an improvement in the subject's hearing and language performance, indicating that these surgeries are valid in most cases. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Comparison of learning preferences of Turkish children who had been applied cochlear implantation in Turkey and Germany according to theory of multiple intelligence.

PubMed

Sahli, Sanem; Laszig, Roland; Aschendorff, Antje; Kroeger, Stefanie; Wesarg, Thomas; Belgin, Erol

2011-12-01

The aim of the study is to determinate the using dominant multiple intelligence types and compare the learning preferences of Turkish cochlear implanted children aged four to ten in Turkey and Germany according to Theory of multiple intelligence. The study has been conducted on a total of 80 children and four groups in Freiburg/Germany and Ankara/Turkey. The applications have been done in University of Freiburg, Cochlear Implant Center in Germany, and University of Hacettepe, ENT Department, Audiology and Speech Pathology Section in Turkey. In this study, the data have been collected by means of General Information Form and Cochlear Implant Information Form applied to parents. To determine the dominant multiple intelligence types of children, the TIMI (Teele Inventory of Multiple Intelligences) which was developed by Sue Teele have been used. The study results exposed that there was not a statistically significant difference on dominant intelligence areas and averages of scores of multiple intelligence types in control groups (p>0.05). Although, the dominant intelligence areas were different (except for first dominant intelligence) in cochlear implanted children in Turkey and Germany, there was not a statistically significant difference on averages of scores of dominant multiple intelligence types. Every hearing impaired child who started training, should be evaluated in terms of multiple intelligence areas and identified strengths and weaknesses. Multiple intelligence activities should be used in their educational programs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Dynamics of cochlear nonlinearity: Automatic gain control or instantaneous damping?

PubMed

Altoè, Alessandro; Charaziak, Karolina K; Shera, Christopher A

2017-12-01

Measurements of basilar-membrane (BM) motion show that the compressive nonlinearity of cochlear mechanical responses is not an instantaneous phenomenon. For this reason, the cochlear amplifier has been thought to incorporate an automatic gain control (AGC) mechanism characterized by a finite reaction time. This paper studies the effect of instantaneous nonlinear damping on the responses of oscillatory systems. The principal results are that (i) instantaneous nonlinear damping produces a noninstantaneous gain control that differs markedly from typical AGC strategies; (ii) the kinetics of compressive nonlinearity implied by the finite reaction time of an AGC system appear inconsistent with the nonlinear dynamics measured on the gerbil basilar membrane; and (iii) conversely, those nonlinear dynamics can be reproduced using an harmonic oscillator with instantaneous nonlinear damping. Furthermore, existing cochlear models that include instantaneous gain-control mechanisms capture the principal kinetics of BM nonlinearity. Thus, an AGC system with finite reaction time appears neither necessary nor sufficient to explain nonlinear gain control in the cochlea.

Music training improves pitch perception in prelingually deafened children with cochlear implants.

PubMed

Chen, Joshua Kuang-Chao; Chuang, Ann Yi Chiun; McMahon, Catherine; Hsieh, Jen-Chuen; Tung, Tao-Hsin; Li, Lieber Po-Hung

2010-04-01

The comparatively poor music appreciation in patients with cochlear implants might be ascribed to an inadequate exposure to music; however, the effect of training on music perception in prelingually deafened children with cochlear implants remains unknown. This study aimed to investigate whether previous musical education improves pitch perception ability in these children. Twenty-seven children with congenital/prelingual deafness of profound degree were studied. Test stimuli consisted of 2 sequential piano tones, ranging from C (256 Hz) to B (495 Hz). Children were asked to identify the pitch relationship between the 2 tones (same, higher, or lower). Effects of musical training duration, pitch-interval size, current age, age of implantation, gender, and type of cochlear implant on accuracy of pitch perception were evaluated. The duration of musical training positively correlated with the correct rate of pitch perception. Pitch perception performance was better in children who had a cochlear implant and were older than 6 years than in those who were aged < or =6 years (ie, preschool). Effect of pitch-interval size was insignificant on pitch perception, and there was no correlation between pitch perception and the age of implantation, gender, or type of cochlear implant. Musical training seems to improve pitch perception ability in prelingually deafened children with a cochlear implant. Auditory plasticity might play an important role in such enhancement. This suggests that incorporation of a structured training program on music perception early in life and as part of the postoperative rehabilitation program for prelingually deafened children with cochlear implants would be beneficial. A longitudinal study is needed to show whether improvement of music performance in these children is measurable by use of auditory evoked potentials.

Factors constraining the benefit to speech understanding of combining information from low-frequency hearing and a cochlear implant.

PubMed

Dorman, Michael F; Cook, Sarah; Spahr, Anthony; Zhang, Ting; Loiselle, Louise; Schramm, David; Whittingham, JoAnne; Gifford, Rene

2015-04-01

Many studies have documented the benefits to speech understanding when cochlear implant (CI) patients can access low-frequency acoustic information from the ear opposite the implant. In this study we assessed the role of three factors in determining the magnitude of bimodal benefit - (i) the level of CI-only performance, (ii) the magnitude of the hearing loss in the ear with low-frequency acoustic hearing and (iii) the type of test material. The patients had low-frequency PTAs (average of 125, 250 and 500 Hz) varying over a large range (<30 dB HL to >70 dB HL) in the ear contralateral to the implant. The patients were tested with (i) CNC words presented in quiet (n = 105) (ii) AzBio sentences presented in quiet (n = 102), (iii) AzBio sentences in noise at +10 dB signal-to-noise ratio (SNR) (n = 69), and (iv) AzBio sentences at +5 dB SNR (n = 64). We find maximum bimodal benefit when (i) CI scores are less than 60 percent correct, (ii) hearing loss is less than 60 dB HL in low-frequencies and (iii) the test material is sentences presented against a noise background. When these criteria are met, some bimodal patients can gain 40-60 percentage points in performance relative to performance with a CI. This article is part of a Special Issue entitled . Copyright © 2014 Elsevier B.V. All rights reserved.

Cochlear implanted pupils in Scottish schools: 4-year school attainment data (2000-2004).

PubMed

Thoutenhoofd, Ernst

2006-01-01

The Achievements of Deaf Pupils in Scotland (ADPS) project has been tracking the educational attainment of deaf pupils in Scotland's schools since 2000. At the time of writing, the database contains records for 1,752 deaf pupils (2000-2005). Here 4-year aggregate educational attainment data are reported for a subset of 152 school-aged deaf pupils with cochlear implants notified to the ADPS database between June 2000 and June 2004. The data describe primary and secondary school results in reading, writing, and math for this subgroup, as well as placement and communication characteristics. The educational attainment of the group of deaf pupils with cochlear implants is clearly marked when the deaf pupil population is disaggregated for hearing loss, achieving comparatively higher average attainment in both 5-14 Curriculum National Tests (Mathematics in particular) and Standard Grades. Therefore the gap in performance relative to the national population data is reduced for those deaf pupils, although it still widens at higher levels of achievement for the National Tests. Although most pupils with cochlear implants are placed in the mainstream, there is no pattern of migration toward mainstream schools. Some deaf pupils with cochlear implants moved out of mainstream to other types of placement, and this has implications for health-economic cost-utility assessments of cochlear implantation that favor mainstream education by drawing upon the relative cost of different placement types. These findings suggest that the ADPS program of research can contribute school outcome data as valuable real-life outcome measures in wider assessments of the benefit of cochlear implants to deaf children and deaf young people.

Use of Vaccines to Prevent Meningitis in Persons with Cochlear Implants

MedlinePlus

... candidates for cochlear implants. CDC also recommends pneumococcal polysaccharide vaccine (PPSV23) for people 2 years and older ... pneumococcal conjugate (PCV13) (Prevnar 13®) 23-valent pneumococcal polysaccharide (PPSV23) (Pneumovax®) Haemophilus influenzae type b conjugate (Hib) ( ...

Some considerations concerning cochlear implantation in IFACF-ORL

PubMed Central

Hainarosie, M; Zainea, V; Serban, S; Georgescu, MG; Hainarosie, R; Marinescu, A; Georgescu, G

2014-01-01

The article analyzes the patients who have received a cochlear implant at “Prof. Dr. Dorin Hociota” Institute of Phonoaudiology and Functional ENT Surgery, Bucharest, over a period of 13 years, from the beginning of this program in the year 2000. It presents the types of devices used, the particularities of the patients, the surgical techniques and the outcome, critically analyzing the complications encountered. The authors’ comments on the selection of patient protocol, surgical intraoperative challenges and cochlear implant technologies and capabilities are presented. PMID:25870683

Use of a gentamicin-impregnated collagen sheet (Collatamp(®)) in the management of major soft tissue complications in pediatric cochlear implants.

PubMed

Benito-González, Fernando; Benito, Jose; Sánchez, Luis Alberto Guardado; Estevez Alonso, Santiago; Muñoz Herrera, Angel; Batuecas-Caletrio, Angel

2014-09-01

The objective was to report the effectiveness of salvage treatment in soft tissue infection around cochlear implants with an absorbable gentamicin collagen sheet and a periosteum and skin rotation flaps. Three patients with cochlear implant and persistent surrounding soft tissue infection are included. All of them underwent antibiotic treatment prior to surgery without any response. In this study preoperative and postoperative audiograms were practiced. Surgical excision of infectious skin and a periosteum and skin rotation flaps were performed. The cochlear implant was refixed in the temporal bone and a gentamicin-impregnated collagen sheet was located covering the cochlear implant. headings In all patients with soft tissue infection around the cochlear implant, infection was completely resolved. It was not necessary to remove the device in any case. The use of an absorbable gentamicin-impregnated collagen sheet is not described for the management of soft tissue complications in pediatric cochlear implant patients. The local application of high concentrations of antibiotic administered by this sheet may be effective against resistant bacteria and, in conjunction with surgery, may resolve this type of complications.

The Effect of Cochlear Implantation on the Improvement of the Auditory Performance in 2-7 Years old Children, Shiraz 2004-2008.

PubMed

Hashemi, Sayed Basir; Rajaeefard, Abdolreza; Norouzpour, Hasan; Tabatabaee, Hamid Reza; Monshizadeh, Leila

2013-03-01

Hearing loss is the most common sensorineural deficiency in human beings. Cochlear implantation is introduced worldwide to treat the severe to profound sensorineural hearing loss, and can result in both speech comprehension and production. The present study aims to determine the effect of cochlear implantation on the improvement of the auditory performance in 2-7 years old children. The present follow-up study is a kind of cohort study which was conducted on 98 children between 2-7 years old who had referred to Fars Cochlear Implantation Center. The patients' information was gathered from their profiles both before and after the operation. The auditory performance score was obtained in 3 stages; 6 months, 1 year, and 2 years after the cochlear implantation through the Cap test. The data was analyzed using the nonparametric Friedman test as well as Mann-Withney, Kruskal-Wallis, and Spearman's Ranks Correlation coefficients. The mean and the median of the auditory performance score of the children who had undergone the cochlear implantation revealed a significant improvement from 6 months to 1 year, and 2 years after the implantation. It showed a significant statistical association between implantation age, type of hearing loss, regular reference, and the length of being present in the rehabilitation program with the auditory performance. It showed no significant association between sex, mother's level of education, being monolingual or bilingual, and family size with the auditory performance. This study revealed that the type of hearing loss, Presence in the rehabilitation program, and the age of cochlear implantation can be major prognostic factors of the response to the treatment, then the country's health policy makers and health planners must executively take into account the infants' hearing screening program during the first 6 month of age.

Effects of residual hearing on cochlear implant outcomes in children: A systematic-review.

PubMed

Chiossi, Julia Santos Costa; Hyppolito, Miguel Angelo

2017-09-01

to investigate if preoperative residual hearing in prelingually deafened children can interfere on cochlear implant indication and outcomes. a systematic-review was conducted in five international databases up to November-2016, to locate articles that evaluated cochlear implantation in children with some degree of preoperative residual hearing. Outcomes were auditory, language and cognition performances after cochlear implant. The quality of the studies was assessed and classified according to the Oxford Levels of Evidence table - 2011. Risk of biases were also described. From the 30 articles reviewed, two types of questions were identified: (a) what are the benefits of cochlear implantation in children with residual hearing? (b) is the preoperative residual hearing a predictor of cochlear implant outcome? Studies ranged from 04 to 188 subjects, evaluating populations between 1.8 and 10.3 years old. The definition of residual hearing varied between studies. The majority of articles (n = 22) evaluated speech perception as the outcome and 14 also assessed language and speech production. There is evidence that cochlear implant is beneficial to children with residual hearing. Preoperative residual hearing seems to be valuable to predict speech perception outcomes after cochlear implantation, even though the mechanism of how it happens is not clear. More extensive researches must be conducted in order to make recommendations and to set prognosis for cochlear implants based on children preoperative residual hearing. Copyright © 2017 Elsevier B.V. All rights reserved.

Beneficial auditory and cognitive effects of auditory brainstem implantation in children.

PubMed

Colletti, Liliana

2007-09-01

This preliminary study demonstrates the development of hearing ability and shows that there is a significant improvement in some cognitive parameters related to selective visual/spatial attention and to fluid or multisensory reasoning, in children fitted with auditory brainstem implantation (ABI). The improvement in cognitive paramenters is due to several factors, among which there is certainly, as demonstrated in the literature on a cochlear implants (CIs), the activation of the auditory sensory canal, which was previously absent. The findings of the present study indicate that children with cochlear or cochlear nerve abnormalities with associated cognitive deficits should not be excluded from ABI implantation. The indications for ABI have been extended over the last 10 years to adults with non-tumoral (NT) cochlear or cochlear nerve abnormalities that cannot benefit from CI. We demonstrated that the ABI with surface electrodes may provide sufficient stimulation of the central auditory system in adults for open set speech recognition. These favourable results motivated us to extend ABI indications to children with profound hearing loss who were not candidates for a CI. This study investigated the performances of young deaf children undergoing ABI, in terms of their auditory perceptual development and their non-verbal cognitive abilities. In our department from 2000 to 2006, 24 children aged 14 months to 16 years received an ABI for different tumour and non-tumour diseases. Two children had NF2 tumours. Eighteen children had bilateral cochlear nerve aplasia. In this group, nine children had associated cochlear malformations, two had unilateral facial nerve agenesia and two had combined microtia, aural atresia and middle ear malformations. Four of these children had previously been fitted elsewhere with a CI with no auditory results. One child had bilateral incomplete cochlear partition (type II); one child, who had previously been fitted unsuccessfully elsewhere with a CI, had auditory neuropathy; one child showed total cochlear ossification bilaterally due to meningitis; and one child had profound hearing loss with cochlear fractures after a head injury. Twelve of these children had multiple associated psychomotor handicaps. The retrosigmoid approach was used in all children. Intraoperative electrical auditory brainstem responses (EABRs) and postoperative EABRs and electrical middle latency responses (EMLRs) were performed. Perceptual auditory abilities were evaluated with the Evaluation of Auditory Responses to Speech (EARS) battery - the Listening Progress Profile (LIP), the Meaningful Auditory Integration Scale (MAIS), the Meaningful Use of Speech Scale (MUSS) - and the Category of Auditory Performance (CAP). Cognitive evaluation was performed on seven children using the Leiter International Performance Scale - Revised (LIPS-R) test with the following subtests: Figure ground, Form completion, Sequential order and Repeated pattern. No postoperative complications were observed. All children consistently used their devices for >75% of waking hours and had environmental sound awareness and utterance of words and simple sentences. Their CAP scores ranged from 1 to 7 (average =4); with MAIS they scored 2-97.5% (average =38%); MUSS scores ranged from 5 to 100% (average =49%) and LIP scores from 5 to 100% (average =45%). Owing to associated disabilities, 12 children were given other therapies (e.g. physical therapy and counselling) in addition to speech and aural rehabilitation therapy. Scores for two of the four subtests of LIPS-R in this study increased significantly during the first year of auditory brainstem implant use in all seven children selected for cognitive evaluation.

Interrelated striated elements in vestibular hair cells of the rat

NASA Technical Reports Server (NTRS)

Ross, M. D.; Bourne, C.

1983-01-01

A series of interrelated striated organelles in types I and II vestibular hair cells of the rat which appear to be less developed in cochlear hair cells have been revealed by unusual fixation procedures, suggesting that contractile elements may play a role in sensory transduction in the inner ear, especially in the vestibular system. Included in the series of interrelated striated elements are the cuticular plate and its basal attachments to the hair cell margins, the connections of the strut array of the kinociliary basal body to the cuticular plate, and striated organelles associated with the plasma membrane and extending below the apical junctional complexes.

A tool for hearing aid and cochlear implant users to judge the usability of cellular telephones in field conditions

NASA Astrophysics Data System (ADS)

Deer, Maria Soledad

The auditory experience of using a hearing aid or a cochlear implant simultaneously with a cell phone is driven by a number of factors. These factors are: radiofrequency and baseband interference, speech intelligibility, sound quality, handset design, volume control and signal strength. The purpose of this study was to develop a tool to be used by hearing aid and cochlear implant users in retail stores as they try cell phones before buying them. This tool is meant to be an efficient, practical and systematic consumer selection tool that will capture and document information on all the domains that play a role in the auditory experience of using a cell phone with a hearing aid or cochlear implant. The development of this consumer tool involved three steps as follows: preparation, verification and measurement of success according to a predefined criterion. First, the consumer tool, consisting of a comparison chart and speech material, was prepared. Second, the consumer tool was evaluated by groups of subjects in a two-step verification process. Phase I was conducted in a controlled setting and it was followed by Phase II which took place in real world (field) conditions. In order to perform a systematic evaluation of the consumer tool two questionnaires were developed: one questionnaire for each phase. Both questionnaires involved five quantitative variables scored with the use of ratings scales. These ratings were averaged yielding an Overall Consumer Performance Score. A qualitative performance category corresponding to the Mean Opinion Score (MOS) was allocated to each final score within a scale ranging from 1 to 5 (where 5 = excellent and 1 = bad). Finally, the consumer tool development was determined to be successful if at least 80% of the participants in verification Phase II rated the comparison chart as excellent or good according to the qualitative MOS score. The results for verification Phase II (field conditions) indicated that the Overall Consumer Performance score for 92% of the subjects (11/12) was 3.7 and above corresponding to Good and Excellent MOS qualitative categories. It was concluded that this is a practical and efficient tool for hearing aid/cochlear implant users as they approach a cell phone selection process.

Comparison of intelligence quotients of first- and second-generation deaf children with cochlear implants.

PubMed

Amraei, K; Amirsalari, S; Ajalloueyan, M

2017-01-01

Hearing impairment is a common type of sensory loss in children. Studies indicate that children with hearing impairment are deficient in social, cognitive and communication skills. This study compared the intelligence quotients of first- and second-generation deaf children with cochlear implants. This research is causal-comparative. All 15 deaf children investigated had deaf parents and were selected from Baqiyatallah Cochlear Implant Center. The 15 children with cochlear implants were paired with similar children with hearing parents using purposive sampling. The findings show that the Hotelling trace of multivariate analysis of variance (F = 6.78, p < 0.01, η P 2  = 0.73) was significant. The tests of between-subjects effects for second-generation children was significantly higher than for first-generation children for all intelligence scales except knowledge. It can be assumed that second-generation children joined their family in the use of sign language as the primary experience before a cochlear implant. The use of sign language before cochlear implants is recommended. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The relationship between loudness intensity functions and the click-ABR wave V latency.

PubMed

Serpanos, Y C; O'Malley, H; Gravel, J S

1997-10-01

To assess the relationship of loudness growth and the click-evoked auditory brain stem response (ABR) wave V latency-intensity function (LIF) in listeners with normal hearing or cochlear hearing loss. The effect of hearing loss configuration on the intensity functions was also examined. Behavioral and electrophysiological intensity functions were obtained using click stimuli of comparable intensities in listeners with normal hearing (Group I; n = 10), and cochlear hearing loss of flat (Group II; n = 10) or sloping (Group III; n = 10) configurations. Individual intensity functions were obtained from measures of loudness growth using the psychophysical methods of absolute magnitude estimation and production of loudness (geometrically averaged to provide the measured loudness function), and from the wave V latency measures of the ABR. Slope analyses for the behavioral and electrophysiological intensity functions were separately performed by group. The loudness growth functions for the groups with cochlear hearing loss approximated the normal function at high intensities, with overall slope values consistent with those reported from previous psychophysical research. The ABR wave V LIF for the group with a flat configuration of cochlear hearing loss approximated the normal function at high intensities, and was displaced parallel to the normal function for the group with sloping configuration. The relationship between the behavioral and electrophysiological intensity functions was examined at individual intensities across the range of the functions for each subject. A significant relationship was obtained between loudness and the ABR wave V LIFs for the groups with normal hearing and flat configuration of cochlear hearing loss; the association was not significant (p = 0.10) for the group with a sloping configuration of cochlear hearing loss. The results of this study established a relationship between loudness and the ABR wave V latency for listeners with normal hearing, and flat cochlear hearing loss. In listeners with a sloping configuration of cochlear hearing loss, the relationship was not significant. This suggests that the click-evoked ABR may be used to estimate loudness growth at least for individuals with normal hearing and those with a flat configuration of cochlear hearing loss. Predictive equations were derived to estimate loudness growth for these groups. The use of frequency-specific stimuli may provide more precise information on the nature of the relationship between loudness growth and the ABR wave V latency, particularly for listeners with sloping configurations of cochlear hearing loss.

Effects of input processing and type of personal frequency modulation system on speech-recognition performance of adults with cochlear implants.

PubMed

Wolfe, Jace; Schafer, Erin; Parkinson, Aaron; John, Andrew; Hudson, Mary; Wheeler, Julie; Mucci, Angie

2013-01-01

The objective of this study was to compare speech recognition in quiet and in noise for cochlear implant recipients using two different types of personal frequency modulation (FM) systems (directly coupled [direct auditory input] versus induction neckloop) with each of two sound processors (Cochlear Nucleus Freedom versus Cochlear Nucleus 5). Two different experiments were conducted within this study. In both these experiments, mixing of the FM signal within the Freedom processor was implemented via the same scheme used clinically for the Freedom sound processor. In Experiment 1, the aforementioned comparisons were conducted with the Nucleus 5 programmed so that the microphone and FM signals were mixed and then the mixed signals were subjected to autosensitivity control (ASC). In Experiment 2, comparisons between the two FM systems and processors were conducted again with the Nucleus 5 programmed to provide a more complex multistage implementation of ASC during the preprocessing stage. This study was a within-subject, repeated-measures design. Subjects were recruited from the patient population at the Hearts for Hearing Foundation in Oklahoma City, OK. Fifteen subjects participated in Experiment 1, and 16 subjects participated in Experiment 2. Subjects were adults who had used either unilateral or bilateral cochlear implants for at least 1 year. In this experiment, no differences were found in speech recognition in quiet obtained with the two different FM systems or the various sound-processor conditions. With each sound processor, speech recognition in noise was better with the directly coupled direct auditory input system relative to the neckloop system. The multistage ASC processing of the Nucleus 5 sound processor provided better performance than the single-stage approach for the Nucleus 5 and the Nucleus Freedom sound processor. Speech recognition in noise is substantially affected by the type of sound processor, FM system, and implementation of ASC used by a Cochlear implant recipient.

Cochlear implantation in children with auditory neuropathy spectrum disorder: A multicenter study on auditory performance and speech production outcomes.

PubMed

Daneshi, Ahmad; Mirsalehi, Marjan; Hashemi, Seyed Basir; Ajalloueyan, Mohammad; Rajati, Mohsen; Ghasemi, Mohammad Mahdi; Emamdjomeh, Hesamaldin; Asghari, Alimohamad; Mohammadi, Shabahang; Mohseni, Mohammad; Mohebbi, Saleh; Farhadi, Mohammad

2018-05-01

To evaluate the auditory performance and speech production outcome in children with auditory neuropathy spectrum disorder (ANSD). The effect of age on the outcomes of the surgery at the time of implantation was also evaluated. Cochlear implantation was performed in 136 children with bilateral severe-to- profound hearing loss due to ANSD, at four tertiary academic centers. The patients were divided into two groups based on the age at the time of implantation; Group I: Children ≤24 months, and Group II: subjects >24 months. The categories of auditory performance (CAP) and speech intelligibility rating (SIR) scores were evaluated after the first and second years of implantation. The differences between the CAP and SIR scores in the two groups were assessed. The median CAP scores improved significantly after the cochlear implantation in all the patients (p value < 0.001). The improvement in the CAP scores during the first year in Group II was greater than Group I (p value: 0.007), but the improvement in CAP scores tended to be significantly higher in patients who were implanted at ≤24 months (p value < 0.001). There was no significant difference between two groups in SIR scores at first-year and second-year follow-ups. The evaluation of the SIR improvement revealed significantly higher values for Group I during the second-year follow-up (p value: 0.003). The auditory performance and speech production skills of the children with ANSD improved significantly after cochlear implantation, and this improvement was affected by age at the time of implantation. Copyright © 2018 Elsevier B.V. All rights reserved.

Cochlear implantation using a custom guide catheter in fourteen patients with incomplete partition type III.

PubMed

Tian, Hao; Wang, Line; Gao, Fenqi; Liang, Wenqi; Peng, Kevin A

2018-05-22

Incomplete partition type III (IP-III), also termed X-linked deafness with stapes gusher, is a heterogeneous condition that predominantly affects males; however, females demonstrating the phenotype also exist. The absence of a bony partition between the fundus of the internal auditory canal (IAC) and cochlea predisposes these patients to cerebrospinal fluid leak or electrode passage into the IAC when performing cochlear implantation. We describe a surgeon-fabricated guide catheter, made intraoperatively from a 16-gauge intravenous catheter, that helps avoid electrode passage into the IAC during CI for patients with IP-III. Acceptable cochlear implant outcomes were attainable in IP-III patients, but these patients scored worse than matched CI patients with normal inner ear structures. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Cochlear implants and ex vivo BDNF gene therapy protect spiral ganglion neurons.

PubMed

Rejali, Darius; Lee, Valerie A; Abrashkin, Karen A; Humayun, Nousheen; Swiderski, Donald L; Raphael, Yehoash

2007-06-01

Spiral ganglion neurons often degenerate in the deaf ear, compromising the function of cochlear implants. Cochlear implant function can be improved by good preservation of the spiral ganglion neurons, which are the target of electrical stimulation by the implant. Brain derived neurotrophic factor (BDNF) has previously been shown to enhance spiral ganglion survival in experimentally deafened ears. Providing enhanced levels of BDNF in human ears may be accomplished by one of several different methods. The goal of these experiments was to test a modified design of the cochlear implant electrode that includes a coating of fibroblast cells transduced by a viral vector with a BDNF gene insert. To accomplish this type of ex vivo gene transfer, we transduced guinea pig fibroblasts with an adenovirus with a BDNF gene cassette insert, and determined that these cells secreted BDNF. We then attached BDNF-secreting cells to the cochlear implant electrode via an agarose gel, and implanted the electrode in the scala tympani. We determined that the BDNF expressing electrodes were able to preserve significantly more spiral ganglion neurons in the basal turns of the cochlea after 48 days of implantation when compared to control electrodes. This protective effect decreased in the higher cochlear turns. The data demonstrate the feasibility of combining cochlear implant therapy with ex vivo gene transfer for enhancing spiral ganglion neuron survival.

The Use of Voice Cues for Speaker Gender Recognition in Cochlear Implant Recipients

ERIC Educational Resources Information Center

Meister, Hartmut; Fürsen, Katrin; Streicher, Barbara; Lang-Roth, Ruth; Walger, Martin

2016-01-01

Purpose: The focus of this study was to examine the influence of fundamental frequency (F0) and vocal tract length (VTL) modifications on speaker gender recognition in cochlear implant (CI) recipients for different stimulus types. Method: Single words and sentences were manipulated using isolated or combined F0 and VTL cues. Using an 11-point…

Lexical and Grammatical Development in a Child with Cochlear Implant and Attention Deficit: A Case Study

ERIC Educational Resources Information Center

Moreno-Torres, Ignacio; Torres, Santiago; Santana, Rafael

2010-01-01

This is the first study to explore lexical and grammatical development in a deaf child diagnosed with Attention Deficit Hyperactivity Disorder, Inattentive sub-type (ADHDI). The child, whose family language was Spanish, was fitted with a cochlear implant (CI) when she was 18 months old. ADHDI, for which she was prescribed medication, was diagnosed…

Type 2 iodothyronine deiodinase expression in the cochlea before the onset of hearing

PubMed Central

Campos-Barros, Angel; Amma, Lori L.; Faris, Jonathan S.; Shailam, Ranu; Kelley, Matthew W.; Forrest, Douglas

2000-01-01

Thyroid hormone signaling during a postnatal period in the mouse is essential for cochlear development and the subsequent onset of hearing. To study the control of this temporal dependency, we investigated the role of iodothyronine deiodinases, which in target tissues convert the prohormone thyroxine into triiodothyronine (T3), the active ligand for the thyroid hormone receptor (TR). Type 2 5′-deiodinase (D2) activity rose dramatically in the mouse cochlea to peak around postnatal day 7 (P7), after which activity declined by P10. This activity peak a few days before the onset of hearing suggests a role for D2 in amplifying local T3 levels at a critical stage of cochlear development. A mouse cochlear D2 cDNA was isolated and demonstrated near identity to rat D2. In situ hybridization localized D2 mRNA in periosteal connective tissue in the modiolus, the cochlear outer capsule and the septal divisions between the turns of the cochlea. Surprisingly, D2 expression in these regions that give rise to the bony labyrinth was complementary to TR expression in the sensory epithelium. Thus, the connective tissue may control deiodination of thyroxine and release of T3 to confer a paracrine-like control of TR activation. These results suggest that temporal and spatial control of ligand availability conferred by D2 provides an unexpectedly important level of regulation of the TR pathways required for cochlear maturation. PMID:10655523

Developmental and cell-specific expression of thyroid hormone transporters in the mouse cochlea.

PubMed

Sharlin, David S; Visser, Theo J; Forrest, Douglas

2011-12-01

Thyroid hormone is essential for the development of the cochlea and auditory function. Cochlear response tissues, which express thyroid hormone receptor β (encoded by Thrb), include the greater epithelial ridge and sensory epithelium residing inside the bony labyrinth. However, these response tissues lack direct blood flow, implying that mechanisms exist to shuttle hormone from the circulation to target tissues. Therefore, we investigated expression of candidate thyroid hormone transporters L-type amino acid transporter 1 (Lat1), monocarboxylate transporter (Mct)8, Mct10, and organic anion transporting polypeptide 1c1 (Oatp1c1) in mouse cochlear development by in situ hybridization and immunofluorescence analysis. L-type amino acid transporter 1 localized to cochlear blood vessels and transiently to sensory hair cells. Mct8 localized to the greater epithelial ridge, tympanic border cells underlying the sensory epithelium, spiral ligament fibrocytes, and spiral ganglion neurons, partly overlapping with the Thrb expression pattern. Mct10 was detected in a highly restricted pattern in the outer sulcus epithelium and weakly in tympanic border cells and hair cells. Organic anion transporting polypeptide 1c1 localized primarily to fibrocytes in vascularized tissues of the spiral limbus and spiral ligament and to tympanic border cells. Investigation of hypothyroid Tshr(-/-) mice showed that transporter expression was delayed consistent with retardation of cochlear tissue maturation but not with compensatory responses to hypothyroidism. The results demonstrate specific expression of thyroid hormone transporters in the cochlea and suggest that a network of thyroid hormone transport underlies cochlear development.

Single and Multiple Microphone Noise Reduction Strategies in Cochlear Implants

PubMed Central

Azimi, Behnam; Hu, Yi; Friedland, David R.

2012-01-01

To restore hearing sensation, cochlear implants deliver electrical pulses to the auditory nerve by relying on sophisticated signal processing algorithms that convert acoustic inputs to electrical stimuli. Although individuals fitted with cochlear implants perform well in quiet, in the presence of background noise, the speech intelligibility of cochlear implant listeners is more susceptible to background noise than that of normal hearing listeners. Traditionally, to increase performance in noise, single-microphone noise reduction strategies have been used. More recently, a number of approaches have suggested that speech intelligibility in noise can be improved further by making use of two or more microphones, instead. Processing strategies based on multiple microphones can better exploit the spatial diversity of speech and noise because such strategies rely mostly on spatial information about the relative position of competing sound sources. In this article, we identify and elucidate the most significant theoretical aspects that underpin single- and multi-microphone noise reduction strategies for cochlear implants. More analytically, we focus on strategies of both types that have been shown to be promising for use in current-generation implant devices. We present data from past and more recent studies, and furthermore we outline the direction that future research in the area of noise reduction for cochlear implants could follow. PMID:22923425

Patients reported outcome post-cochlear implantation: how severe is their dizziness?

PubMed

Zawawi, Faisal; Alobaid, Faisal; Leroux, Tony; Zeitouni, Anthony G

2014-01-01

The reported prevalence of vestibular dysfunction after cochlear implantation (CI) is varies between different scientific papers. The aim of this study is to determine the reported post-implantation outcome in terms of dizziness, and to measure its impact on quality of life using the Dizziness handicap inventory (DHI). This was a prospective questionnaire based study of postoperative cochlear implant patients. The questionnaire assessed the type and onset of dizziness in addition to the DHI. 122 patients were recruited in this study, which is the largest sample size in the literature reported so far. Dizziness was evident in 45.9% of the population post-CI and in 27% pre-CI. The commonest subtype of the dizziness was unsteadiness followed by lightheadedness. The dizziness was mild in most of the patients. Although mild, dizziness is a common complaint post-cochlear implantation. An understanding of symptoms helps counsel patients preoperatively.

Vestibulo-ocular and vestibulospinal function before and after cochlear implant surgery

NASA Technical Reports Server (NTRS)

Black, F. O.; Lilly, D. J.; Peterka, R. J.; Fowler, L. P.; Simmons, F. B.

1987-01-01

Vestibular function in cochlear implant candidates varies from normal to total absence of function. In patients with intact vestibular function preoperatively, invasion of the otic capsule places residual vestibular function at risk. Speech-processing strategies that result in large amplitude electrical transients or strategies that employ high amplitude broad frequency carrier signals have the potential for disrupting vestibular function. Five patients were tested with and without electrical stimulation via cochlear electrodes. Two patients experienced subjective vestibular effects that were quickly resolved. No long-term vestibular effects were noted for the two types of second generation cochlear implants evaluated. Histopathological findings from another patient, who had electrically generated vestibular reflex responses to intramodiolar electrodes, indicated that responses elicited were a function of several variables including electrode location, stimulus intensity, stimulus amplitude, and stimulus frequency. Differential auditory, vestibulocolic, and vestibulospinal reflexes were demonstrated from the same electrode as a function of stimulus amplitude, frequency, and duration.

Electric charge requirements of pediatric cochlear implant recipients enrolled in the Childhood Development After Cochlear Implantation study.

PubMed

Zwolan, Teresa A; O'Sullivan, Mary Beth; Fink, Nancy E; Niparko, John K

2008-02-01

To evaluate mapping characteristics of children with cochlear implants who are enrolled in the Childhood Development After Cochlear Implantation (CDACI) multicenter study. Longitudinal evaluation during 24 months of speech processor maps of children with cochlear implants prospectively enrolled in the study. Six tertiary referral centers. One hundred eighty-eight children enrolled in the CDACI study who were 5 years old or younger at the time of enrollment. Of these children, 184 received unilateral implants, and 4 received simultaneous bilateral implants. Children attended regular mapping sessions at their implant clinic as part of the study protocol. Maps were examined for each subject at 4 different time intervals: at device activation and 6, 12, and 24 months postactivation. Mean C/M levels (in charge per phase) were compared for 4 different time intervals, for 3 different devices, for 6 different implant centers, and for children with normal and abnormal cochleae. All 3 types of implant devices demonstrate significant increases in C/M levels between device activation and the 24-month appointment. Significant differences in mean C/M levels were noted between devices. Children with cochlear anomalies demonstrate significantly greater C/M levels than children with normal cochleae. The CDACI study has enabled us to evaluate the mapping characteristics of pediatric patients who use 3 different devices and were implanted at a variety of implant centers. Analysis of such data enables us to better understand the mapping characteristics of children with cochlear implants.

Exploring the Identities of Hearing Parents Who Chose Cochlear Implantation for Their Children with Hearing Loss

ERIC Educational Resources Information Center

Scharp, Kristina M.; Barker, Brittan A.; Rucker, Sidney N.; Jones, Hannah D.

2018-01-01

We aimed to determine the types of identities hearing parents construct when telling online stories about their children with hearing loss (HL) who use cochlear implants (CIs). To do so, we employed a qualitative design and sampled 20 different blogs United States origins and written by parents of children who use CIs. We then used thematic…

Reflective type objective based spectral-domain phase-sensitive optical coherence tomography for high-sensitive structural and functional imaging of cochlear microstructures through intact bone of an excised guinea pig cochlea

NASA Astrophysics Data System (ADS)

Subhash, Hrebesh M.; Wang, Ruikang K.; Chen, Fangyi; Nuttall, Alfred L.

2013-03-01

Most of the optical coherence tomographic (OCT) systems for high resolution imaging of biological specimens are based on refractive type microscope objectives, which are optimized for specific wave length of the optical source. In this study, we present the feasibility of using commercially available reflective type objective for high sensitive and high resolution structural and functional imaging of cochlear microstructures of an excised guinea pig through intact temporal bone. Unlike conventional refractive type microscopic objective, reflective objective are free from chromatic aberrations due to their all-reflecting nature and can support a broadband of spectrum with very high light collection efficiency.

Local cochlear damage reduces local nonlinearity and decreases generator-type cochlear emissions while increasing reflector-type emissions.

PubMed

Dong, Wei; Olson, Elizabeth S

2010-03-01

Distortion product otoacoustic emissions (DPOAEs) originate in cochlear nonlinearity and emerge into the ear canal as an apparent sum of emission types, one of which (generator) travels directly out and the other (reflector) travels out following linear reflection. The present study explores intracochlear sources of DPOAEs via simultaneous ear canal and intracochlear pressure measurements in gerbils. A locally damaged cochlea was produced with reduced local intracochlear nonlinearity and significant elevation of the compound action potential thresholds at frequencies represented within the damaged region. In the DPOAE the comparison of healthy to locally damaged cochleae showed the following: (1) In the broad frequency region corresponding to the locally damaged best frequency, DPOAEs evoked by wider f(2)/f(1) stimuli decreased, consistent with the reduction in local nonlinearity. (2) DPOAEs evoked by narrow f(2)/f(1) stimuli often had a bimodal change, decreasing in a lower frequency band and increasing in a band just adjacent and higher, and the DPOAE phase-vs-frequency slope steepened. These changes confirm the complex nature of the DPOAE.

Sinus MRI scan

MedlinePlus

... your body: Brain aneurysm clips Certain types of artificial heart valves Heart defibrillator or pacemaker Inner ear (cochlear) implants Recently placed artificial joints Certain types of vascular stents Pain pumps ...

Case report: acquisition of three spoken languages by a child with a cochlear implant.

PubMed

Francis, Alexander L; Ho, Diana Wai Lam

2003-03-01

There have been only two reports of multilingual cochlear implant users to date, and both of these were postlingually deafened adults. Here we report the case of a 6-year-old early-deafened child who is acquiring Cantonese, English and Mandarin in Hong Kong. He and two age-matched peers with similar educational backgrounds were tested using common, standardized tests of vocabulary and expressive and receptive language skills (Peabody Picture Vocabulary Test (Revised) and Reynell Developmental Language Scales version II). Results show that this child is acquiring Cantonese, English and Mandarin to a degree comparable to two classmates with normal hearing and similar educational and social backgrounds.

Modeling the Electrode-Neuron Interface of Cochlear Implants: Effects of Neural Survival, Electrode Placement, and the Partial Tripolar Configuration

PubMed Central

Goldwyn, Joshua H.; Bierer, Steven M.; Bierer, Julie A.

2010-01-01

The partial tripolar electrode configuration is a relatively novel stimulation strategies that can generate more spatially focused electric fields than the commonly used monopolar configuration. Focused stimulation strategies should improve spectral resolution in cochlear implant users, but may also be more sensitive to local irregularities in the electrode-neuron interface. In this study, we develop a practical computer model of cochlear implant stimulation that can simulate neural activation in a simplified cochlear geometry and we relate the resulting patterns of neural activity to basic psychophysical measures. We examine how two types of local irregularities in the electrode-neuron interface, variations in spiral ganglion nerve density and electrode position within the scala tympani, affect the simulated neural activation patterns and how these patterns change with electrode configuration. The model shows that higher partial tripolar fractions activate more spatially restricted populations of neurons at all current levels and require higher current levels to excite a given number of neurons. We find that threshold levels are more sensitive at high partial tripolar fractions to both types of irregularities, but these effects are not independent. In particular, at close electrode-neuron distances, activation is typically more spatially localized which leads to a greater influence of neural dead regions. PMID:20580801

Developmental and Cell-Specific Expression of Thyroid Hormone Transporters in the Mouse Cochlea

PubMed Central

Sharlin, David S.; Visser, Theo J.

2011-01-01

Thyroid hormone is essential for the development of the cochlea and auditory function. Cochlear response tissues, which express thyroid hormone receptor β (encoded by Thrb), include the greater epithelial ridge and sensory epithelium residing inside the bony labyrinth. However, these response tissues lack direct blood flow, implying that mechanisms exist to shuttle hormone from the circulation to target tissues. Therefore, we investigated expression of candidate thyroid hormone transporters L-type amino acid transporter 1 (Lat1), monocarboxylate transporter (Mct)8, Mct10, and organic anion transporting polypeptide 1c1 (Oatp1c1) in mouse cochlear development by in situ hybridization and immunofluorescence analysis. L-type amino acid transporter 1 localized to cochlear blood vessels and transiently to sensory hair cells. Mct8 localized to the greater epithelial ridge, tympanic border cells underlying the sensory epithelium, spiral ligament fibrocytes, and spiral ganglion neurons, partly overlapping with the Thrb expression pattern. Mct10 was detected in a highly restricted pattern in the outer sulcus epithelium and weakly in tympanic border cells and hair cells. Organic anion transporting polypeptide 1c1 localized primarily to fibrocytes in vascularized tissues of the spiral limbus and spiral ligament and to tympanic border cells. Investigation of hypothyroid Tshr−/− mice showed that transporter expression was delayed consistent with retardation of cochlear tissue maturation but not with compensatory responses to hypothyroidism. The results demonstrate specific expression of thyroid hormone transporters in the cochlea and suggest that a network of thyroid hormone transport underlies cochlear development. PMID:21878515

CO-LOCALIZATION OF THE VANILLOID CAPSAICIN RECEPTOR AND SUBSTANCE P IN SENSORY NERVE FIBERS INNERVATING COCHLEAR AND VERTEBRO-BASILAR ARTERIES

PubMed Central

VASS, Z.; DAI, C. F.; STEYGER, P. S.; JANCSÓ, G.; TRUNE, D. R.; NUTTALL, A. L.

2014-01-01

Evidence suggests that capsaicin-sensitive substance P (SP)-containing trigeminal ganglion neurons innervate the spiral modiolar artery (SMA), radiating arterioles, and the stria vascularis of the cochlea. Antidromic electrical or chemical stimulation of trigeminal sensory nerves results in neurogenic plasma extravasation in inner ear tissues. The primary aim of this study was to reveal the possible morphological basis of cochlear vascular changes mediated by capsaicin-sensitive sensory nerves. Therefore, the distribution of SP and capsaicin receptor (transient receptor potential vanilloid type 1—TRPV1) was investigated by double immunolabeling to demonstrate the anatomical relationships between the cochlear and vertebro-basilar blood vessels and the trigeminal sensory fiber system. Extensive TRPV1 and SP expression and co-localization were observed in axons within the adventitial layer of the basilar artery, the anterior inferior cerebellar artery, the SMA, and the radiating arterioles of the cochlea. There appears to be a functional relationship between the trigeminal ganglion and the cochlear blood vessels since electrical stimulation of the trigeminal ganglion induced significant plasma extravasation from the SMA and the radiating arterioles. The findings suggest that stimulation of paravascular afferent nerves may result in permeability changes in the basilar and cochlear vascular bed and may contribute to the mechanisms of vertebro-basilar type of headache through the release of SP and stimulation of TPVR1, respectively. We propose that vertigo, tinnitus, and hearing deficits associated with migraine may arise from perturbations of capsaicin-sensitive trigeminal sensory ganglion neurons projecting to the cochlea. PMID:15026132

Assessing the immunization status of pediatric cochlear implant recipients using a state-maintained immunization registry.

PubMed

Ou, Henry; Cleary, Patricia; Sie, Kathleen

2010-10-01

To demonstrate the use of a state-maintained database (CHILD Profile) to monitor immunization status of pediatric cochlear implant recipients, and to assess compliance with current vaccination recommendations for cochlear implant users managed at Seattle Children's Hospital. Cross-sectional study. Tertiary academic pediatric hospital. Subjects were 260 patients with cochlear implants managed at Seattle Children's Hospital between July 1, 1995, and May 1, 2008. Patients were stratified by age groups (0-2 years, 2-5 years, 5-10 years, > 10 years). Using a statewide children's immunization registry (CHILD Profile), subjects were assessed with regard to their immunization status for Haemophilus influenzae type B vaccination (HiB), 7-valent pneumococcal conjugate vaccination (PCV-7), and 23-valent pneumococcal polysaccharide vaccine (PPV-23). Two hundred twenty-five of 260 subjects (87%) were registered in CHILD Profile; 126 of 225 (56%) were up to date with CDC recommendations for patients with cochlear implants. PPV-23 was the vaccination most likely to be incomplete. Age was predictive of immunization status only with HiB vaccination. A statewide immunization registry can be used to monitor the immunization status of cochlear implant recipients. Subjects were significantly more likely to be incomplete for PPV-23 than for either PCV-7 or HiB vaccinations. Copyright © 2010 American Academy of Otolaryngology–Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

Relationship between auditory perception and vocal production in cochlear implantees: a systematic review.

PubMed

Cysneiros, Helena Renata Silva; Leal, Mariana de Carvalho; Lucena, Jonia Alves; Muniz, Lilian Ferreira

To conduct a systematic review of the scientific literature studying the relationship between vocal production and auditory perception in cochlear implant users. This is an integrative systematic review. The plattforms/databases Bireme, SciELO, Cochrane, Scopus and Web of Science were consulted and the descriptors used were voice, cochlear implant and auditory perception. Original papers published in English, French, Spanish or Portuguese involving the study of vocal production and auditory perception in cochlear implant users were selected and there was no restriction about year of publication of the articles. The studies selected were analyzed according to the author, location, year and publication of the article, as well as for their sample size, type of vocal production and auditory perception assessment and for its major findings and recommendation grade/level of scientific evidence. The results suggest the existence of positive relationship between vocal production and auditory perception in cochlear implant users, and indicate that the deployment time has a positive influence in this relationship. None of the selected studies were rated at level 1 of scientific evidence or grade A of recommendation, which is related to the methodological approach that can go with this subject matter. There is great lack of publications relating auditory perception and speech production in cochlear implant users. This gap is even greater when it comes to the adult population.

Mandarin Chinese Tone Identification in Cochlear Implants: Predictions from Acoustic Models

PubMed Central

Morton, Kenneth D.; Torrione, Peter A.; Throckmorton, Chandra S.; Collins, Leslie M.

2015-01-01

It has been established that current cochlear implants do not supply adequate spectral information for perception of tonal languages. Comprehension of a tonal language, such as Mandarin Chinese, requires recognition of lexical tones. New strategies of cochlear stimulation such as variable stimulation rate and current steering may provide the means of delivering more spectral information and thus may provide the auditory fine structure required for tone recognition. Several cochlear implant signal processing strategies are examined in this study, the continuous interleaved sampling (CIS) algorithm, the frequency amplitude modulation encoding (FAME) algorithm, and the multiple carrier frequency algorithm (MCFA). These strategies provide different types and amounts of spectral information. Pattern recognition techniques can be applied to data from Mandarin Chinese tone recognition tasks using acoustic models as a means of testing the abilities of these algorithms to transmit the changes in fundamental frequency indicative of the four lexical tones. The ability of processed Mandarin Chinese tones to be correctly classified may predict trends in the effectiveness of different signal processing algorithms in cochlear implants. The proposed techniques can predict trends in performance of the signal processing techniques in quiet conditions but fail to do so in noise. PMID:18706497

Speech perception for adult cochlear implant recipients in a realistic background noise: effectiveness of preprocessing strategies and external options for improving speech recognition in noise.

PubMed

Gifford, René H; Revit, Lawrence J

2010-01-01

Although cochlear implant patients are achieving increasingly higher levels of performance, speech perception in noise continues to be problematic. The newest generations of implant speech processors are equipped with preprocessing and/or external accessories that are purported to improve listening in noise. Most speech perception measures in the clinical setting, however, do not provide a close approximation to real-world listening environments. To assess speech perception for adult cochlear implant recipients in the presence of a realistic restaurant simulation generated by an eight-loudspeaker (R-SPACE) array in order to determine whether commercially available preprocessing strategies and/or external accessories yield improved sentence recognition in noise. Single-subject, repeated-measures design with two groups of participants: Advanced Bionics and Cochlear Corporation recipients. Thirty-four subjects, ranging in age from 18 to 90 yr (mean 54.5 yr), participated in this prospective study. Fourteen subjects were Advanced Bionics recipients, and 20 subjects were Cochlear Corporation recipients. Speech reception thresholds (SRTs) in semidiffuse restaurant noise originating from an eight-loudspeaker array were assessed with the subjects' preferred listening programs as well as with the addition of either Beam preprocessing (Cochlear Corporation) or the T-Mic accessory option (Advanced Bionics). In Experiment 1, adaptive SRTs with the Hearing in Noise Test sentences were obtained for all 34 subjects. For Cochlear Corporation recipients, SRTs were obtained with their preferred everyday listening program as well as with the addition of Focus preprocessing. For Advanced Bionics recipients, SRTs were obtained with the integrated behind-the-ear (BTE) mic as well as with the T-Mic. Statistical analysis using a repeated-measures analysis of variance (ANOVA) evaluated the effects of the preprocessing strategy or external accessory in reducing the SRT in noise. In addition, a standard t-test was run to evaluate effectiveness across manufacturer for improving the SRT in noise. In Experiment 2, 16 of the 20 Cochlear Corporation subjects were reassessed obtaining an SRT in noise using the manufacturer-suggested "Everyday," "Noise," and "Focus" preprocessing strategies. A repeated-measures ANOVA was employed to assess the effects of preprocessing. The primary findings were (i) both Noise and Focus preprocessing strategies (Cochlear Corporation) significantly improved the SRT in noise as compared to Everyday preprocessing, (ii) the T-Mic accessory option (Advanced Bionics) significantly improved the SRT as compared to the BTE mic, and (iii) Focus preprocessing and the T-Mic resulted in similar degrees of improvement that were not found to be significantly different from one another. Options available in current cochlear implant sound processors are able to significantly improve speech understanding in a realistic, semidiffuse noise with both Cochlear Corporation and Advanced Bionics systems. For Cochlear Corporation recipients, Focus preprocessing yields the best speech-recognition performance in a complex listening environment; however, it is recommended that Noise preprocessing be used as the new default for everyday listening environments to avoid the need for switching programs throughout the day. For Advanced Bionics recipients, the T-Mic offers significantly improved performance in noise and is recommended for everyday use in all listening environments. American Academy of Audiology.

Comparison of various treatment modalities for acute tinnitus.

PubMed

Shim, Hyun Joon; Song, Seong Jun; Choi, A Young; Hyung Lee, Rae; Yoon, Sang Won

2011-12-01

Because in most cases the development of tinnitus is triggered by cochlear damage, there exists the opportunity to eliminate tinnitus while the cochlear lesion is still reversible. Therefore, we evaluated the therapeutic effects of various treatment modalities on acute subjective idiopathic tinnitus (SIT) and investigated prognostic factors affecting the treatment outcome. Prospective, controlled, double-blind trial. A total 107 patients who underwent treatment for unilateral SIT that had developed within the previous 3 months completed the study. The patients were randomly assigned into three groups according to the treatment modality: group I (n = 32), alprazolam orally for 3 months; group II (n = 35), as for group I plus four intratympanic dexamethasone (ITD) injections; and group III (n = 40), as for group II plus four intravenous injections of lipo-prostaglandin E(1) . The improvement rate of group II (75.8%) was significantly higher than that of group I (40.3%; P < .05), and there was no significant difference in the improvement rate of group III (50.0%) compared with groups I and II (P > .05). The cure rates of group II (25.8%) and group III (20.0%) were significantly higher than that of group I (9.8%; P < .05). There was a significant correlation between the cure rate and duration of symptoms. The results of the present study indicate that ITD injection plus alprazolam medication is the best treatment choice for acute SIT within 3 months of development. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

Deletion of PDZD7 disrupts the Usher syndrome type 2 protein complex in cochlear hair cells and causes hearing loss in mice.

PubMed

Zou, Junhuang; Zheng, Tihua; Ren, Chongyu; Askew, Charles; Liu, Xiao-Ping; Pan, Bifeng; Holt, Jeffrey R; Wang, Yong; Yang, Jun

2014-05-01

Usher syndrome type 2 (USH2) is the predominant form of USH, a leading genetic cause of combined deafness and blindness. PDZD7, a paralog of two USH causative genes, USH1C and USH2D (WHRN), was recently reported to be implicated in USH2 and non-syndromic deafness. It encodes a protein with multiple PDZ domains. To understand the biological function of PDZD7 and the pathogenic mechanism caused by PDZD7 mutations, we generated and thoroughly characterized a Pdzd7 knockout mouse model. The Pdzd7 knockout mice exhibit congenital profound deafness, as assessed by auditory brainstem response, distortion product otoacoustic emission and cochlear microphonics tests, and normal vestibular function, as assessed by their behaviors. Lack of PDZD7 leads to the disorganization of stereocilia bundles and a reduction in mechanotransduction currents and sensitivity in cochlear outer hair cells. At the molecular level, PDZD7 determines the localization of the USH2 protein complex, composed of USH2A, GPR98 and WHRN, to ankle links in developing cochlear hair cells, likely through its direct interactions with these three proteins. The localization of PDZD7 to the ankle links of cochlear hair bundles also relies on USH2 proteins. In photoreceptors of Pdzd7 knockout mice, the three USH2 proteins largely remain unchanged at the periciliary membrane complex. The electroretinogram responses of both rod and cone photoreceptors are normal in knockout mice at 1 month of age. Therefore, although the organization of the USH2 complex appears different in photoreceptors, it is clear that PDZD7 plays an essential role in organizing the USH2 complex at ankle links in developing cochlear hair cells. GenBank accession numbers: KF041446, KF041447, KF041448, KF041449, KF041450, KF041451.

Experience Changes How Emotion in Music Is Judged: Evidence from Children Listening with Bilateral Cochlear Implants, Bimodal Devices, and Normal Hearing

PubMed Central

Papsin, Blake C.; Paludetti, Gaetano; Gordon, Karen A.

2015-01-01

Children using unilateral cochlear implants abnormally rely on tempo rather than mode cues to distinguish whether a musical piece is happy or sad. This led us to question how this judgment is affected by the type of experience in early auditory development. We hypothesized that judgments of the emotional content of music would vary by the type and duration of access to sound in early life due to deafness, altered perception of musical cues through new ways of using auditory prostheses bilaterally, and formal music training during childhood. Seventy-five participants completed the Montreal Emotion Identification Test. Thirty-three had normal hearing (aged 6.6 to 40.0 years) and 42 children had hearing loss and used bilateral auditory prostheses (31 bilaterally implanted and 11 unilaterally implanted with contralateral hearing aid use). Reaction time and accuracy were measured. Accurate judgment of emotion in music was achieved across ages and musical experience. Musical training accentuated the reliance on mode cues which developed with age in the normal hearing group. Degrading pitch cues through cochlear implant-mediated hearing induced greater reliance on tempo cues, but mode cues grew in salience when at least partial acoustic information was available through some residual hearing in the contralateral ear. Finally, when pitch cues were experimentally distorted to represent cochlear implant hearing, individuals with normal hearing (including those with musical training) switched to an abnormal dependence on tempo cues. The data indicate that, in a western culture, access to acoustic hearing in early life promotes a preference for mode rather than tempo cues which is enhanced by musical training. The challenge to these preferred strategies during cochlear implant hearing (simulated and real), regardless of musical training, suggests that access to pitch cues for children with hearing loss must be improved by preservation of residual hearing and improvements in cochlear implant technology. PMID:26317976

Experience Changes How Emotion in Music Is Judged: Evidence from Children Listening with Bilateral Cochlear Implants, Bimodal Devices, and Normal Hearing.

PubMed

Giannantonio, Sara; Polonenko, Melissa J; Papsin, Blake C; Paludetti, Gaetano; Gordon, Karen A

2015-01-01

Children using unilateral cochlear implants abnormally rely on tempo rather than mode cues to distinguish whether a musical piece is happy or sad. This led us to question how this judgment is affected by the type of experience in early auditory development. We hypothesized that judgments of the emotional content of music would vary by the type and duration of access to sound in early life due to deafness, altered perception of musical cues through new ways of using auditory prostheses bilaterally, and formal music training during childhood. Seventy-five participants completed the Montreal Emotion Identification Test. Thirty-three had normal hearing (aged 6.6 to 40.0 years) and 42 children had hearing loss and used bilateral auditory prostheses (31 bilaterally implanted and 11 unilaterally implanted with contralateral hearing aid use). Reaction time and accuracy were measured. Accurate judgment of emotion in music was achieved across ages and musical experience. Musical training accentuated the reliance on mode cues which developed with age in the normal hearing group. Degrading pitch cues through cochlear implant-mediated hearing induced greater reliance on tempo cues, but mode cues grew in salience when at least partial acoustic information was available through some residual hearing in the contralateral ear. Finally, when pitch cues were experimentally distorted to represent cochlear implant hearing, individuals with normal hearing (including those with musical training) switched to an abnormal dependence on tempo cues. The data indicate that, in a western culture, access to acoustic hearing in early life promotes a preference for mode rather than tempo cues which is enhanced by musical training. The challenge to these preferred strategies during cochlear implant hearing (simulated and real), regardless of musical training, suggests that access to pitch cues for children with hearing loss must be improved by preservation of residual hearing and improvements in cochlear implant technology.

The Coxsackievirus and Adenovirus Receptor: a new adhesion protein in cochlear development.

PubMed

Excoffon, Katherine J D A; Avenarius, Matthew R; Hansen, Marlan R; Kimberling, William J; Najmabadi, Hossein; Smith, Richard J H; Zabner, Joseph

2006-05-01

The Coxsackievirus and Adenovirus Receptor (CAR) is an essential regulator of cell growth and adhesion during development. The gene for CAR, CXADR, is located within the genomic locus for Usher syndrome type 1E (USH1E). Based on this and a physical interaction with harmonin, the protein responsible for USH1C, we hypothesized that CAR may be involved in cochlear development and that mutations in CXADR may be responsible for USH1E. The expression of CAR in the cochlea was determined by PCR and immunofluorescence microscopy. We found that CAR expression is highly regulated during development. In neonatal mice, CAR is localized to the junctions of most cochlear cell types but is restricted to the supporting and strial cells in adult cochlea. A screen of two populations consisting of non-syndromic deaf and Usher 1 patients for mutations in CXADR revealed one haploid mutation (P356S). Cell surface expression, viral receptor activity, and localization of the mutant form of CAR were indistinguishable from wild-type CAR. Although we were unable to confirm a role for CAR in autosomal recessive, non-syndromic deafness, or Usher syndrome type 1, based on its regulation, localization, and molecular interactions, CAR remains an attractive candidate for genetic deafness.

Concurrent gradients of ribbon volume and AMPA-receptor patch volume in cochlear afferent synapses on gerbil inner hair cells.

PubMed

Zhang, Lichun; Engler, Sina; Koepcke, Lena; Steenken, Friederike; Köppl, Christine

2018-07-01

The Mongolian gerbil is a classic animal model for age-related hearing loss. As a prerequisite for studying age-related changes, we characterized cochlear afferent synaptic morphology in young adult gerbils, using immunolabeling and quantitative analysis of confocal microscopic images. Cochlear wholemounts were triple-labeled with a hair-cell marker, a marker of presynaptic ribbons, and a marker of postsynaptic AMPA-type glutamate receptors. Seven cochlear positions covering an equivalent frequency range from 0.5 - 32 kHz were evaluated. The spatial positions of synapses were determined in a coordinate system with reference to their individual inner hair cell. Synapse numbers confirmed previous reports for gerbils (on average, 20-22 afferents per inner hair cell). The volumes of presynaptic ribbons and postsynaptic glutamate receptor patches were positively correlated: larger ribbons associated with larger receptor patches and smaller ribbons with smaller patches. Furthermore, the volumes of both presynaptic ribbons and postsynaptic receptor patches co-varied along the modiolar-pillar and the longitudinal axes of their hair cell. The gradients in ribbon volume are consistent with previous findings in cat, guinea pig, mouse and rat and further support a role in differentiating the physiological properties of type I afferents. However, the positive correlation between the volumes of pre- and postsynaptic elements in the gerbil is different to the opposing gradients found in the mouse, suggesting species-specific differences in the postsynaptic AMPA receptors that are unrelated to the fundamental classes of type I afferents. Copyright © 2018 Elsevier B.V. All rights reserved.

IGF-1 deficiency causes atrophic changes associated with upregulation of VGluT1 and downregulation of MEF2 transcription factors in the mouse cochlear nuclei.

PubMed

Fuentes-Santamaría, V; Alvarado, J C; Rodríguez-de la Rosa, L; Murillo-Cuesta, S; Contreras, J; Juiz, J M; Varela-Nieto, I

2016-03-01

Insulin-like growth factor 1 (IGF-1) is a neurotrophic protein that plays a crucial role in modulating neuronal function and synaptic plasticity in the adult brain. Mice lacking the Igf1 gene exhibit profound deafness and multiple anomalies in the inner ear and spiral ganglion. An issue that remains unknown is whether, in addition to these peripheral abnormalities, IGF-1 deficiency also results in structural changes along the central auditory pathway that may contribute to an imbalance between excitation and inhibition, which might be reflected in abnormal auditory brainstem responses (ABR). To assess such a possibility, we evaluated the morphological and physiological alterations in the cochlear nucleus complex of the adult mouse. The expression and distribution of the vesicular glutamate transporter 1 (VGluT1) and the vesicular inhibitory transporter (VGAT), which were used as specific markers for labeling excitatory and inhibitory terminals, and the involvement of the activity-dependent myocyte enhancer factor 2 (MEF2) transcription factors in regulating excitatory synapses were assessed in a 4-month-old mouse model of IGF-1 deficiency and neurosensorial deafness (Igf1 (-/-) homozygous null mice). The results demonstrate decreases in the cochlear nucleus area and cell size along with cell loss in the cochlear nuclei of the deficient mouse. Additionally, our results demonstrate that there is upregulation of VGluT1, but not VGAT, immunostaining and downregulation of MEF2 transcription factors together with increased wave II amplitude in the ABR recording. Our observations provide evidence of an abnormal neuronal cytoarchitecture in the cochlear nuclei of Igf1 (-/-) null mice and suggest that the increased efficacy of glutamatergic synapses might be mediated by MEF2 transcription factors.

Cortical Auditory Evoked Potentials with Simple (Tone Burst) and Complex (Speech) Stimuli in Children with Cochlear Implant

PubMed Central

Martins, Kelly Vasconcelos Chaves; Gil, Daniela

2017-01-01

Introduction  The registry of the component P1 of the cortical auditory evoked potential has been widely used to analyze the behavior of auditory pathways in response to cochlear implant stimulation. Objective  To determine the influence of aural rehabilitation in the parameters of latency and amplitude of the P1 cortical auditory evoked potential component elicited by simple auditory stimuli (tone burst) and complex stimuli (speech) in children with cochlear implants. Method  The study included six individuals of both genders aged 5 to 10 years old who have been cochlear implant users for at least 12 months, and who attended auditory rehabilitation with an aural rehabilitation therapy approach. Participants were submitted to research of the cortical auditory evoked potential at the beginning of the study and after 3 months of aural rehabilitation. To elicit the responses, simple stimuli (tone burst) and complex stimuli (speech) were used and presented in free field at 70 dB HL. The results were statistically analyzed, and both evaluations were compared. Results  There was no significant difference between the type of eliciting stimulus of the cortical auditory evoked potential for the latency and the amplitude of P1. There was a statistically significant difference in the P1 latency between the evaluations for both stimuli, with reduction of the latency in the second evaluation after 3 months of auditory rehabilitation. There was no statistically significant difference regarding the amplitude of P1 under the two types of stimuli or in the two evaluations. Conclusion  A decrease in latency of the P1 component elicited by both simple and complex stimuli was observed within a three-month interval in children with cochlear implant undergoing aural rehabilitation. PMID:29018498

Auditory Cortex Basal Activity Modulates Cochlear Responses in Chinchillas

PubMed Central

León, Alex; Elgueda, Diego; Silva, María A.; Hamamé, Carlos M.; Delano, Paul H.

2012-01-01

Background The auditory efferent system has unique neuroanatomical pathways that connect the cerebral cortex with sensory receptor cells. Pyramidal neurons located in layers V and VI of the primary auditory cortex constitute descending projections to the thalamus, inferior colliculus, and even directly to the superior olivary complex and to the cochlear nucleus. Efferent pathways are connected to the cochlear receptor by the olivocochlear system, which innervates outer hair cells and auditory nerve fibers. The functional role of the cortico-olivocochlear efferent system remains debated. We hypothesized that auditory cortex basal activity modulates cochlear and auditory-nerve afferent responses through the efferent system. Methodology/Principal Findings Cochlear microphonics (CM), auditory-nerve compound action potentials (CAP) and auditory cortex evoked potentials (ACEP) were recorded in twenty anesthetized chinchillas, before, during and after auditory cortex deactivation by two methods: lidocaine microinjections or cortical cooling with cryoloops. Auditory cortex deactivation induced a transient reduction in ACEP amplitudes in fifteen animals (deactivation experiments) and a permanent reduction in five chinchillas (lesion experiments). We found significant changes in the amplitude of CM in both types of experiments, being the most common effect a CM decrease found in fifteen animals. Concomitantly to CM amplitude changes, we found CAP increases in seven chinchillas and CAP reductions in thirteen animals. Although ACEP amplitudes were completely recovered after ninety minutes in deactivation experiments, only partial recovery was observed in the magnitudes of cochlear responses. Conclusions/Significance These results show that blocking ongoing auditory cortex activity modulates CM and CAP responses, demonstrating that cortico-olivocochlear circuits regulate auditory nerve and cochlear responses through a basal efferent tone. The diversity of the obtained effects suggests that there are at least two functional pathways from the auditory cortex to the cochlea. PMID:22558383

Experiences from Auditory Brainstem Implantation (ABIs) in four paediatric patients.

PubMed

Lundin, Karin; Stillesjö, Fredrik; Nyberg, Gunnar; Rask-Andersen, Helge

2016-01-01

Indications for auditory brainstem implants (ABIs) have been widened from patients with neurofibromatosis type 2 (NF2) to paediatric patients with congenital cochlear malformations, cochlear nerve hypoplasia/aplasia, or cochlear ossification after meningitis. We present four ABI surgeries performed in children at Uppsala University Hospital in Sweden since 2009. Three children were implanted with implants from Cochlear Ltd. (Lane Cove, Australia) and one child with an implant from MedEl GMBH (Innsbruck, Austria). A boy with Goldenhar syndrome was implanted with a Cochlear Nucleus ABI24M at age 2 years (patient 1). Another boy with CHARGE syndrome was implanted with a Cochlear Nucleus ABI541 at age 2.5 years (patient 2). Another boy with post-ossification meningitis was implanted with a Cochlear Nucleus ABI24M at age 4 years (patient 3). A girl with cochlear aplasia was implanted with a MedEl Synchrony ABI at age 3 years (patient 4). In patients 1, 2, and 3, the trans-labyrinthine approach was used, and in patient 4 the retro-sigmoid approach was used. Three of the four children benefited from their ABIs and use it full time. Two of the full time users had categories of auditory performance (CAP) score of 4 at their last follow up visit (6 and 2.5 years postoperative) which means they can discriminate consistently any combination of two of Ling's sounds. One child has not been fully evaluated yet, but is a full time user and had CAP 2 (responds to speech sounds) after 3 months of ABI use. No severe side or unpleasant stimulation effects have been observed so far. There was one case of immediate electrode migration and one case of implant device failure after 6.5 years. ABI should be considered as an option in the rehabilitation of children with similar diagnoses.

Application of Curved MPR Algorithm to High Resolution 3 Dimensional T2 Weighted CISS Images for Virtual Uncoiling of Membranous Cochlea as an Aid for Cochlear Morphometry.

PubMed

Kumar, Joish Upendra; Kavitha, Y

2017-02-01

With the use of various surgical techniques, types of implants, the preoperative assessment of cochlear dimensions is becoming increasingly relevant prior to cochlear implantation. High resolution CISS protocol MRI gives a better assessment of membranous cochlea, cochlear nerve, and membranous labyrinth. Curved Multiplanar Reconstruction (MPR) algorithm provides better images that can be used for measuring dimensions of membranous cochlea. To ascertain the value of curved multiplanar reconstruction algorithm in high resolution 3-Dimensional T2 Weighted Gradient Echo Constructive Interference Steady State (3D T2W GRE CISS) imaging for accurate morphometry of membranous cochlea. Fourteen children underwent MRI for inner ear assessment. High resolution 3D T2W GRE CISS sequence was used to obtain images of cochlea. Curved MPR reconstruction algorithm was used to virtually uncoil the membranous cochlea on the volume images and cochlear measurements were done. Virtually uncoiled images of membranous cochlea of appropriate resolution were obtained from the volume data obtained from the high resolution 3D T2W GRE CISS images, after using curved MPR reconstruction algorithm mean membranous cochlear length in the children was 27.52 mm. Maximum apical turn diameter of membranous cochlea was 1.13 mm, mid turn diameter was 1.38 mm, basal turn diameter was 1.81 mm. Curved MPR reconstruction algorithm applied to CISS protocol images facilitates in getting appropriate quality images of membranous cochlea for accurate measurements.

Predicting round window niche visibility via the facial recess using high-resolution computed tomography.

PubMed

Kashio, Akinori; Sakamoto, Takashi; Karino, Shotaro; Kakigi, Akinobu; Iwasaki, Shinichi; Yamasoba, Tatsuya

2015-01-01

To predict round window niche (RWN) visibility using high-resolution computed tomography (HRCT). Case series with chart review. Academic tertiary care center. We retrospectively reviewed 70 cochlear implant ears that underwent presurgical axial HRCT with a surgical video recorder. The visibility of the RWN was classified into three types: 17 as invisible or nearly invisible, 22 as partially visible, and 31 as fully visible. Next, we measured the following three radiologic parameters: 1) the angle of the external auditory canal (EAC) relative to the cochlear basal turn, 2) the width of the facial recess, and 3) the relative location of the facial nerve (FN) to the cochlear basal turn. These were compared with the RWN visibility. Subsequently, to predict the RWN visibility, a line was created parallel to the EAC line and along the anterior lateral FN. The location of the line relative to the round window membrane was compared with the RWN view. In cases that had poor RWN visibility, the angle of the posterior canal wall portion of the EAC relative to the cochlear basal turn was significantly smaller and the location of the FN to the cochlear basal turn was closer. The location of the prediction line to the round window membrane highly predicted the RWN view during the surgery. The RWN visibility and the preoperative HRCT findings showed a high correlation. Drawing the prediction line is a simple and useful way for preoperatively predicting the RWN visibility in cochlear implant surgery.

Modeling the electrode-neuron interface of cochlear implants: effects of neural survival, electrode placement, and the partial tripolar configuration.

PubMed

Goldwyn, Joshua H; Bierer, Steven M; Bierer, Julie Arenberg

2010-09-01

The partial tripolar electrode configuration is a relatively novel stimulation strategy that can generate more spatially focused electric fields than the commonly used monopolar configuration. Focused stimulation strategies should improve spectral resolution in cochlear implant users, but may also be more sensitive to local irregularities in the electrode-neuron interface. In this study, we develop a practical computer model of cochlear implant stimulation that can simulate neural activation in a simplified cochlear geometry and we relate the resulting patterns of neural activity to basic psychophysical measures. We examine how two types of local irregularities in the electrode-neuron interface, variations in spiral ganglion nerve density and electrode position within the scala tympani, affect the simulated neural activation patterns and how these patterns change with electrode configuration. The model shows that higher partial tripolar fractions activate more spatially restricted populations of neurons at all current levels and require higher current levels to excite a given number of neurons. We find that threshold levels are more sensitive at high partial tripolar fractions to both types of irregularities, but these effects are not independent. In particular, at close electrode-neuron distances, activation is typically more spatially localized which leads to a greater influence of neural dead regions. Copyright (c) 2010 Elsevier B.V. All rights reserved.

Speech Perception for Adult Cochlear Implant Recipients in a Realistic Background Noise: Effectiveness of Preprocessing Strategies and External Options for Improving Speech Recognition in Noise

PubMed Central

Gifford, René H.; Revit, Lawrence J.

2014-01-01

Background Although cochlear implant patients are achieving increasingly higher levels of performance, speech perception in noise continues to be problematic. The newest generations of implant speech processors are equipped with preprocessing and/or external accessories that are purported to improve listening in noise. Most speech perception measures in the clinical setting, however, do not provide a close approximation to real-world listening environments. Purpose To assess speech perception for adult cochlear implant recipients in the presence of a realistic restaurant simulation generated by an eight-loudspeaker (R-SPACE™) array in order to determine whether commercially available preprocessing strategies and/or external accessories yield improved sentence recognition in noise. Research Design Single-subject, repeated-measures design with two groups of participants: Advanced Bionics and Cochlear Corporation recipients. Study Sample Thirty-four subjects, ranging in age from 18 to 90 yr (mean 54.5 yr), participated in this prospective study. Fourteen subjects were Advanced Bionics recipients, and 20 subjects were Cochlear Corporation recipients. Intervention Speech reception thresholds (SRTs) in semidiffuse restaurant noise originating from an eight-loudspeaker array were assessed with the subjects’ preferred listening programs as well as with the addition of either Beam™ preprocessing (Cochlear Corporation) or the T-Mic® accessory option (Advanced Bionics). Data Collection and Analysis In Experiment 1, adaptive SRTs with the Hearing in Noise Test sentences were obtained for all 34 subjects. For Cochlear Corporation recipients, SRTs were obtained with their preferred everyday listening program as well as with the addition of Focus preprocessing. For Advanced Bionics recipients, SRTs were obtained with the integrated behind-the-ear (BTE) mic as well as with the T-Mic. Statistical analysis using a repeated-measures analysis of variance (ANOVA) evaluated the effects of the preprocessing strategy or external accessory in reducing the SRT in noise. In addition, a standard t-test was run to evaluate effectiveness across manufacturer for improving the SRT in noise. In Experiment 2, 16 of the 20 Cochlear Corporation subjects were reassessed obtaining an SRT in noise using the manufacturer-suggested “Everyday,” “Noise,” and “Focus” preprocessing strategies. A repeated-measures ANOVA was employed to assess the effects of preprocessing. Results The primary findings were (i) both Noise and Focus preprocessing strategies (Cochlear Corporation) significantly improved the SRT in noise as compared to Everyday preprocessing, (ii) the T-Mic accessory option (Advanced Bionics) significantly improved the SRT as compared to the BTE mic, and (iii) Focus preprocessing and the T-Mic resulted in similar degrees of improvement that were not found to be significantly different from one another. Conclusion Options available in current cochlear implant sound processors are able to significantly improve speech understanding in a realistic, semidiffuse noise with both Cochlear Corporation and Advanced Bionics systems. For Cochlear Corporation recipients, Focus preprocessing yields the best speech-recognition performance in a complex listening environment; however, it is recommended that Noise preprocessing be used as the new default for everyday listening environments to avoid the need for switching programs throughout the day. For Advanced Bionics recipients, the T-Mic offers significantly improved performance in noise and is recommended for everyday use in all listening environments. PMID:20807480

The mechanical waveform of the basilar membrane. IV. Tone and noise stimuli

NASA Astrophysics Data System (ADS)

de Boer, Egbert; Nuttall, Alfred L.

2002-02-01

Analysis of mechanical cochlear responses to wide bands of random noise clarifies many effects of cochlear nonlinearity. The previous paper [de Boer and Nuttall, J. Acoust. Soc. Am. 107, 1497-1507 (2000)] illustrates how closely results of computations in a nonlinear cochlear model agree with responses from physiological experiments. In the present paper results for tone stimuli are reported. It was found that the measured frequency response for pure tones differs little from the frequency response associated with a noise signal. For strong stimuli, well into the nonlinear region, tones have to be presented at a specific level with respect to the noise for this to be true. In this report the nonlinear cochlear model originally developed for noise analysis was modified to accommodate pure tones. For this purpose the efficiency with which outer hair cells modify the basilar-membrane response was made into a function of cochlear location based on local excitation. For each experiment, the modified model is able to account for the experimental findings, within 1 or 2 dB. Therefore, the model explains why the type of filtering that tones undergo in the cochlea is essentially the same as that for noise signals (provided the tones are presented at the appropriate level).

Pediatric Auditory Brainstem Implant Surgery: A New Option for Auditory Habilitation in Congenital Deafness?

PubMed

Shah, Parth V; Kozin, Elliott D; Kaplan, Alyson B; Lee, Daniel J

2016-01-01

The auditory brainstem implant (ABI) is a neuroprosthetic device that provides sound sensations to individuals with profound hearing loss who are not candidates for a cochlear implant (CI) because of anatomic constraints. Herein we describe the ABI for family physicians. PubMed was searched to identify articles relevant to the ABI, as well as articles that contain outcomes data for pediatric patients (age <18 years) who have undergone ABI surgery. The ABI was originally developed for patients with neurofibromatosis type 2 (NF2) who become deaf from bilateral vestibular schwannomas. Over the past decade, indications for an ABI have expanded to adult patients without tumors (without NF2) who cannot receive a CI and children with no cochlea or cochlear nerve. Outcomes among NF2 ABI users are modest compared to cochlear implant patients, but recent studies from Europe suggest that some non-tumor adult and pediatric ABI users achieve speech perception. The ABI is a reasonable surgical option for children with profound hearing loss due to severe cochlear or cochlear nerve deformities. Continued prospective data collection from several clinical trials in the U.S. will provide greater understanding on long term outcomes that focus on speech intelligibility. © Copyright 2016 by the American Board of Family Medicine.

Cochlear implants: a remarkable past and a brilliant future

PubMed Central

Wilson, Blake S.; Dorman, Michael F.

2013-01-01

The aims of this paper are to (i) provide a brief history of cochlear implants; (ii) present a status report on the current state of implant engineering and the levels of speech understanding enabled by that engineering; (iii) describe limitations of current signal processing strategies and (iv) suggest new directions for research. With current technology the “average” implant patient, when listening to predictable conversations in quiet, is able to communicate with relative ease. However, in an environment typical of a workplace the average patient has a great deal of difficulty. Patients who are “above average” in terms of speech understanding, can achieve 100% correct scores on the most difficult tests of speech understanding in quiet but also have significant difficulty when signals are presented in noise. The major factors in these outcomes appear to be (i) a loss of low-frequency, fine structure information possibly due to the envelope extraction algorithms common to cochlear implant signal processing; (ii) a limitation in the number of effective channels of stimulation due to overlap in electric fields from electrodes, and (iii) central processing deficits, especially for patients with poor speech understanding. Two recent developments, bilateral implants and combined electric and acoustic stimulation, have promise to remediate some of the difficulties experienced by patients in noise and to reinstate low-frequency fine structure information. If other possibilities are realized, e.g., electrodes that emit drugs to inhibit cell death following trauma and to induce the growth of neurites toward electrodes, then the future is very bright indeed. PMID:18616994

Tinnitus and Sleep Difficulties After Cochlear Implantation.

PubMed

Pierzycki, Robert H; Edmondson-Jones, Mark; Dawes, Piers; Munro, Kevin J; Moore, David R; Kitterick, Pádraig T

To estimate and compare the prevalence of and associations between tinnitus and sleep difficulties in a sample of UK adult cochlear implant users and those identified as potential candidates for cochlear implantation. The study was conducted using the UK Biobank resource, a population-based cohort of 40- to 69-year olds. Self-report data on hearing, tinnitus, sleep difficulties, and demographic variables were collected from cochlear implant users (n = 194) and individuals identified as potential candidates for cochlear implantation (n = 211). These "candidates" were selected based on (i) impaired hearing sensitivity, inferred from self-reported hearing aid use and (ii) impaired hearing function, inferred from an inability to report words accurately at negative signal to noise ratios on an unaided closed-set test of speech perception. Data on tinnitus (presence, persistence, and related distress) and on sleep difficulties were analyzed using logistic regression models controlling for gender, age, deprivation, and neuroticism. The prevalence of tinnitus was similar among implant users (50%) and candidates (52%; p = 0.39). However, implant users were less likely to report that their tinnitus was distressing at its worst (41%) compared with candidates (63%; p = 0.02). The logistic regression model suggested that this difference between the two groups could be explained by the fact that tinnitus was less persistent in implant users (46%) compared with candidates (72%; p < 0.001). Self-reported difficulties with sleep were similar among implant users (75%) and candidates (82%; p = 0.28), but participants with tinnitus were more likely to report sleep difficulties than those without (p < 0.001). The prevalence of sleep difficulties was not related to tinnitus persistence (p = 0.28) or the extent to which tinnitus was distressing (p = 0.55). The lack of association between tinnitus persistence and sleep difficulties is compatible with the notion that tinnitus is suppressed in implant users primarily during active electrical stimulation and may return when the implant is switched off at night time. This explanation is supported by the similar prevalence of sleep problems among implant users and potential candidates for cochlear implantation, despite differences between the groups in tinnitus persistence and related emotional distress. Cochlear implantation may therefore not be an appropriate intervention where the primary aim is to alleviate sleep difficulties.

Cervical MRI scan

MedlinePlus

... you have: Brain aneurysm clips Certain types of artificial heart valves Heart defibrillator or pacemaker Inner ear (cochlear) implants Kidney disease or dialysis (you may not be able to receive contrast) Recently placed artificial joints Certain types of vascular stents Worked with ...

Lumbar MRI scan

MedlinePlus

... you have: Brain aneurysm clips Certain types of artificial heart valves Heart defibrillator or pacemaker Inner ear (cochlear) implants Kidney disease or dialysis (you may not be able to receive contrast) Recently placed artificial joints Certain types of vascular stents Worked with ...

Shoulder MRI scan

MedlinePlus

... you have: Brain aneurysm clips Certain types of artificial heart valves Heart defibrillator or pacemaker Inner ear (cochlear) implants Kidney disease or dialysis (you may not be able to receive contrast) Recently placed artificial joints Certain types of vascular stents Worked with ...

Simultaneous cochlear implantation as a therapeutic option in vestibular schwannoma surgery: case report.

PubMed

Dos Santos Neto, Pedro Helo; Zamponi, Johnni Oswaldo; Hamerschmidt, Rogério; Wiemes, Gislaine Richter Minhoto; Rassi, Marcio S; Borba, Luis A B

2018-03-01

Hearing loss is the most common symptom of vestibular schwannomas (VSs). The management of these lesions includes observation, radiosurgery, and microsurgical resection. Hearing preservation and rehabilitation are the major challenges after the tumor treatment. A 43-year-old man with previous left-sided profound hearing loss and tinnitus presented with a 2-mm left-sided intracanalicular VS. The decision was made to perform a simultaneous cochlear implantation (CI) and microsurgical resection of the tumor. The patient did well postoperatively, with significant improvement of tinnitus, sound localization, and speech recognition in noise. Previous reports of simultaneous CI and VS resection in patients with neurofibromatosis type 2 and sporadic VS in the only hearing ear have been described. The role of CI in patients with VS and normal contralateral hearing has been recently described, showing positive outcomes due to the binaural benefits. Tinnitus also can be treated by the implantation of the cochlear device. The simultaneous microsurgical removal of VS and implantation of a cochlear device is a feasible approach in patients with unilateral hearing loss and severe tinnitus.

Choline acetyltransferase (ChAT) immunoelectron microscopy distinguishes at least three types of efferent synapses in the organ of Corti.

PubMed

Eybalin, M; Pujol, R

1987-01-01

Using anatomical criteria, the olivo-cochlear fibers ending in the organ of Corti (efferent fibers) have recently been separated into two systems: a lateral system innervating principally the inner hair cell (IHC) area and a medial system innervating mainly the outer hair cells (OHCs). Electrophysiological and biochemical experiments suggest that acetylcholine may be a neurotransmitter of these efferent fibers. However, efferent synapses that use acetylcholine as neurotransmitter have not yet been identified at the electron microscopic level. Using a pre-embedding immunoelectron microscopic technique with a monoclonal antibody against choline acetyltransferase (ChAT), we localized ChAT-immunostained fibers below both the IHCs and OHCs. In the inner spiral bundle, one type of ChAT-immunostained fibers was vesiculated and formed axo-dendritic synapses with the afferent auditory dendrites contacting the inner hair cells. A second type of ChAT-immunostained fibers seen in the inner spiral bundle was unvesiculated. Unstained vesiculated varicosities synapsing with the auditory dendrites were also seen in the inner spiral bundle. At the OHC level, ChAT immunostaining was found in nearly all the terminals synapsing with the OHCs. The finding of two types of ChAT-immunostained efferent synapses in the organ of Corti, i.e. axo-dendritic synapses in the inner spiral bundle and axo-somatic synapses with the OHCs, supports the hypothesis that both the lateral and the medial olivo-cochlear systems use acetylcholine as a neurotransmitter. The finding of numerous unstained synapses in the inner spiral bundle, and some below OHCs, together with previous data about putative cochlear neurotransmitters, suggests the possibility of additional non-cholinergic olivo-cochlear systems. It might soon appear useful to reclassify efferents according to the nature of the different neurotransmitters/co-transmitters found in the various efferent synapses of the organ of Corti.

Evidence for vestibular regulation of autonomic functions in a mouse genetic model

NASA Technical Reports Server (NTRS)

Murakami, Dean M.; Erkman, Linda; Hermanson, Ola; Rosenfeld, Michael G.; Fuller, Charles A.

2002-01-01

Physiological responses to changes in the gravitational field and body position, as well as symptoms of patients with anxiety-related disorders, have indicated an interrelationship between vestibular function and stress responses. However, the relative significance of cochlear and vestibular information in autonomic regulation remains unresolved because of the difficulties in distinguishing the relative contributions of other proprioceptive and interoceptive inputs, including vagal and somatic information. To investigate the role of cochlear and vestibular function in central and physiological responses, we have examined the effects of increased gravity in wild-type mice and mice lacking the POU homeodomain transcription factor Brn-3.1 (Brn-3bPou4f3). The only known phenotype of the Brn-3.1(-/-) mouse is related to hearing and balance functions, owing to the failure of cochlear and vestibular hair cells to differentiate properly. Here, we show that normal physiological responses to increased gravity (2G exposure), such as a dramatic drop in body temperature and concomitant circadian adjustment, were completely absent in Brn-3.1(-/-) mice. In line with the lack of autonomic responses, the massive increase in neuronal activity after 2G exposure normally detected in wild-type mice was virtually abolished in Brn-3.1(-/-) mice. Our results suggest that cochlear and vestibular hair cells are the primary regulators of autonomic responses to altered gravity and provide genetic evidence that these cells are sufficient to alter neural activity in regions involved in autonomic and neuroendocrine control.

A global patient outcomes registry: Cochlear paediatric implanted recipient observational study (Cochlear(™) P-IROS).

PubMed

Sanderson, Georgina; Ariyaratne, Thathya V; Wyss, Josephine; Looi, Valerie

2014-01-01

Currently, there is a paucity of data concerning the long-term outcomes, educational placement and quality of life of children implanted with hearing devices from large and representative samples of the population. To address this concern, a large, prospective, multicentre, multinational patient-outcomes registry for paediatric recipients of implantable hearing devices was developed. The benefits of this registry, its approach and methodology are described. The Cochlear(™) Paediatric Implanted Recipient Observational Study (Cochlear P-IROS) is a prospective international patient-outcomes registry for children who are implanted in routine clinical practice with one or more hearing devices. The study aims to collect data on patient comorbidities, device use, auditory performance, quality of life and health-related utilities, across different types of implantable hearing devices from a range of manufacturers. Patients will be evaluated with a set of standardised and non-standardised questionnaires prior to initial device activation (baseline) and at six-monthly follow-up intervals up to 24 months and annually thereafter. The Cochlear P-IROS utilises a secure web interface to administer electronic case report forms to clinicians and families of implanted children. The web interface is currently available in five languages: English, Japanese, Korean, Mandarin and Russian. The interface also provides printable versions of the case report forms translated into 22 local languages for collection of data prior to entry online; additional languages may be added, as required. Participation in the Cochlear P-IROS registry is investigator-driven and voluntary. To date, the Cochlear P-IROS has recruited implant clinics across Australia, China, India, Indonesia, Turkey and Vietnam. The registry also aims to recruit multiple clinics in Cuba, Israel, Japan, Malaysia, Singapore, South Africa, South Korea and Russia. The use of a registry such as the Cochlear P-IROS will generate valuable data to support research interests of academics and clinicians around the globe. The data generated will be relevant for a wide range of stakeholders including regulators, payers, providers, policy makers, patients and their families, each with a different perspective for the acceptance and adoption of implantable hearing devices for the treatment of hearing loss.

A cochlear implant fabricated using a bulk silicon-surface micromachining process

NASA Astrophysics Data System (ADS)

Bell, Tracy Elizabeth

1999-11-01

This dissertation presents the design and fabrication of two generations of a silicon microelectrode array for use in a cochlear implant. A cochlear implant is a device that is inserted into the inner ear and uses electrical stimulation to provide sound sensations to the profoundly deaf. The first-generation silicon cochlear implant is a passive device fabricated using silicon microprobe technology developed at the University of Michigan. It contains twenty-two iridium oxide (IrO) stimulating sites that are 250 mum in diameter and spaced at 750 mum intervals. In-vivo recordings were made in guinea pig auditory cortex in response to electrical stimulation with this device, verifying its ability to electrically evoke an auditory response. Auditory thresholds as low as 78 muA were recorded. The second-generation implant is a thirty-two site, four-channel device with on-chip CMOS site-selection circuitry and integrated position sensing. It was fabricated using a novel bulk silicon surface micromachining process which was developed as a part of this dissertation work. While the use of semiconductor technology offers many advantages in fabricating cochlear implants over the methods currently used, it was felt that even further advantages could be gained by developing a new micromachining process which would allow circuitry to be distributed along the full length of the cochlear implant substrate. The new process uses electropolishing of an n+ bulk silicon sacrificial layer to undercut and release n- epitaxial silicon structures from the wafer. An extremely abrupt etch-stop between the n+ and n- silicon is obtained, with no electropolishing taking place in the n-type silicon that is doped lower than 1 x 1017 cm-3 in concentration. Lateral electropolishing rates of up to 50 mum/min were measured using this technique, allowing one millimeter-wide structures to be fully undercut in as little as 10 minutes. The new micromachining process was integrated with a standard p-well CMOS integrated circuit process to fabricate the second-generation active silicon cochlear implants.

Surgery of the head and neck in patient with Kniest dysplasia: Is wound healing an issue?

PubMed

Husain, Qasim; Cho, Jungsuk; Neugarten, Jay; Modi, Vikash K

2017-02-01

Kniest dysplasia is a type II collagen disorder that arises from a genetic mutation of the COL2A1 gene that results in short stature, midface anomalies, tracheomalacia, and hearing loss. Disruption of the normal collagen pathway can lead to many changes given its critical role in the body, and can cause complications with respect to wound healing. We present a case in which a patient with Kniest dysplasia successfully underwent multiple procedures in the head and neck region including cochlear implantation, mandibular distraction, palatoplasty, and laryngotracheal reconstruction. All procedures did not have any associated complications with respect to wound healing, indicating that surgery in this population can take place as indicated and surgery should not be contraindicated or delayed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Auditory Processing Disorders

MedlinePlus

... Loss Hearing Loss in Seniors Hearing Aids General Information Types Features Fittings Assistive Listening & Alerting Devices Cochlear Implants Aural Rehabilitation Auditory Processing Disorders (APDs) Common Conditions Dizziness Tinnitus Who Are ...

Challenging aspects of contemporary cochlear implant electrode array design.

PubMed

Mistrík, Pavel; Jolly, Claude; Sieber, Daniel; Hochmair, Ingeborg

2017-12-01

A design comparison of current perimodiolar and lateral wall electrode arrays of the cochlear implant (CI) is provided. The focus is on functional features such as acoustic frequency coverage and tonotopic mapping, battery consumption and dynamic range. A traumacity of their insertion is also evaluated. Review of up-to-date literature. Perimodiolar electrode arrays are positioned in the basal turn of the cochlea near the modiolus. They are designed to initiate the action potential in the proximity to the neural soma located in spiral ganglion. On the other hand, lateral wall electrode arrays can be inserted deeper inside the cochlea, as they are located along the lateral wall and such insertion trajectory is less traumatic. This class of arrays targets primarily surviving neural peripheral processes. Due to their larger insertion depth, lateral wall arrays can deliver lower acoustic frequencies in manner better corresponding to cochlear tonotopicity. In fact, spiral ganglion sections containing auditory nerve fibres tuned to low acoustic frequencies are located deeper than 1 and half turn inside the cochlea. For this reason, a significant frequency mismatch might be occurring for apical electrodes in perimodiolar arrays, detrimental to speech perception. Tonal languages such as Mandarin might be therefore better treated with lateral wall arrays. On the other hand, closer proximity to target tissue results in lower psychophysical threshold levels for perimodiolar arrays. However, the maximal comfort level is also lower, paradoxically resulting in narrower dynamic range than that of lateral wall arrays. Battery consumption is comparable for both types of arrays. Lateral wall arrays are less likely to cause trauma to cochlear structures. As the current trend in cochlear implantation is the maximal protection of residual acoustic hearing, the lateral wall arrays seem more suitable for hearing preservation CI surgeries. Future development could focus on combining the advantages of both types: perimodiolar location in the basal turn extended to lateral wall location for higher turn locations.

Relationship between changes in the cochlear blood flow and disorder of hearing function induced by blast injury in guinea pigs.

PubMed

Chen, Wei; Wang, Jianmin; Chen, Jing; Chen, Jichuan; Chen, Zhiqiang

2013-01-01

The auditory system is the most susceptible to damages from blast waves. Blast injuries always lead to varying degrees of hearing impairment. Although a disorder of the cochlear blood flow (CoBF) has been considered to be related to many pathological processes of the auditory system and to contribute to various types of hearing loss, changes in the CoBF induced by blast waves and the relationship between such changes and hearing impairment are undefined. To observe the changes in the cochlear microcirculation after exposure to an explosion blast, investigate the relationship between changes in the CoBF and hearing impairment and subsequently explore the mechanism responsible for the changes in the CoBF, we detected the perfusion of the cochlear microcirculation and hearing threshold shift after exposure to an explosion blast. Then, an N-nitro-L-arginine-methyl ester (L-NAME, NO synthase inhibitor) solution and artificial perilymph were applied to the round window (RW) of the cochlea before the blast exposure, followed by an evaluation of the CoBF and hearing function. The results indicated that the changes in the CoBF were correlated to the strength of the blast wave. The cochlear blood flow significantly increased when the peak value of the blast overpressure was greater than approximately 45 kPa, and there was no significant change in the cochlear blood flow when the peak value of the blast overpressure was less than approximately 35 kPa. Following local administration of the NO synthase inhibitor L-NAME, the increase in the CoBF induced by the blast was inhibited, and this reduction was significantly associated with the hearing threshold.

Hearing Preservation Outcomes With a Mid-Scala Electrode in Cochlear Implantation.

PubMed

Hunter, Jacob B; Gifford, René H; Wanna, George B; Labadie, Robert F; Bennett, Marc L; Haynes, David S; Rivas, Alejandro

2016-03-01

To evaluate hearing preservation (HP) outcomes in adult cochlear implant recipients with a mid-scala electrode. Tertiary academic center. Adult patients implanted with a mid-scala electrode between May 2013 and July 2015. Cochlear implantation. Age, sex, surgical approach, residual hearing changes post cochlear implantation, HP rates using different published classifications, and speech perception scores. Fifty ears for 47 patients (mean age, 58.2 yr; range, 23-86) were implanted with the electrode. Recognizing that not all patients were true HP candidates and/or underwent generally accepted HP surgical techniques, 39 ears had preoperative low-frequency hearing (audiometric threshold ≤ 85dB HL at 250Hz), 24 preserved acoustic hearing postoperatively (75.0%). Patients who had preserved acoustic hearing were implanted via round window (N = 18), extended round window (N = 4), or via cochleostomy (N = 2) approaches. Mean threshold elevation for low-frequency pure-tone average (125, 250, and 500  Hz) was 20.2  dB after surgery. 43.8% of patients had aidable low-frequency hearing at activation, 30.0% at 6-months postoperatively, and 30.8% 1-year postopera tively. Using a formula outlined by Skarzynski and colleagues, at 6-months postoperatively, 15.0% of patients had complete HP, whereas 40.0% had partial HP. At 1-year, these percentages decreased to 0% and 38.5%, respectively. Age, type of approach, and perioperative steroid use were not correlated with HP outcomes at activation and 6-months postoperatively (p > 0.05). The mid-scala electrode evaluated allows preservation of low-frequency hearing in patients undergoing cochlear implantation at rates and degrees of preservation close to other reports in the cochlear implant literature.

Vestibular sensory functional status of cochlear implanted ears versus non-implanted ears in bilateral profound deaf adults.

PubMed

Cozma, Romică Sebastian; Dima-Cozma, Lucia Corina; Rădulescu, Luminiţa Mihaela; Hera, Maria Cristina; Mârţu, Cristian; Olariu, Raluca; Cobzeanu, Bogdan Mihail; Bitere, Oana Roxana; Cobzeanu, Mihail Dan

2018-01-01

Patients with hearing loss who underwent cochlear implantation can present symptomatic or asymptomatic vestibular damages earlier or later after the surgery. The vestibular permanent lesions could be acute, produced by surgical trauma or could be progressive due to local morphological changes made by the presence of the portelectrode in the inner ear (fibrosis related, ossification, basilar membrane distortion, endolymphatic hydrops). Besides histopathological findings in inner ear of cochlear implanted patients, the vestibular permanent damages could be found by assessment of clinical vestibular status. This study reports the sensorial vestibular functional findings for adults in cochlear implanted ears related to the electrode insertion type (cochleostomy or round window approach) and comparing to non-implanted deaf ears. A total of 20 adult patients with 32 cochlear implanted ears (12 patients with binaural cochlear implant and eight with monoaural) were selected for postoperatory vestibular examination by cervical and ocular vestibular myogenic potentials and vestibular caloric tests. The same tests were made for a control group of 22 non-implanted deaf ears. Functional testing results were reported related to the electrode insertion approach. For the cochleostomy group, we found different deficits: in 40% for saccular function, 44% for utricular function, and 12% horizontal canal dysfunction. In round window group, the deficit was present in 14.29% for saccular function, 28.57% for utricular function, and 28.58% for horizontal canal. In 46.88% of implanted ears, the vestibular function was completely preserved on all tested sensors. In conclusion, the vestibular functional status after inner ear surgery presents sensorial damages in 53.12% ears compare with the vestibular dysfunction existing in 50% of deaf non-operated ears. Round window insertion allows for better conservation of the vestibular function.

NIDCD Glossary

MedlinePlus

... ears. Brainstem Implant - auditory prosthesis that bypasses the cochlea and auditory nerve. This type of implant helps individuals who cannot benefit from a cochlear implant because the auditory nerves are not working. ...

United Kingdom national paediatric bilateral project: Results of professional rating scales and parent questionnaires.

PubMed

Cullington, H E; Bele, D; Brinton, J C; Cooper, S; Daft, M; Harding, J; Hatton, N; Humphries, J; Lutman, M E; Maddocks, J; Maggs, J; Millward, K; O'Donoghue, G; Patel, S; Rajput, K; Salmon, V; Sear, T; Speers, A; Wheeler, A; Wilson, K

2017-01-01

This fourteen-centre project used professional rating scales and parent questionnaires to assess longitudinal outcomes in a large non-selected population of children receiving simultaneous and sequential bilateral cochlear implants. This was an observational non-randomized service evaluation. Data were collected at four time points: before bilateral cochlear implants or before the sequential implant, one year, two years, and three years after. The measures reported are Categories of Auditory Performance II (CAPII), Speech Intelligibility Rating (SIR), Bilateral Listening Skills Profile (BLSP) and Parent Outcome Profile (POP). Thousand and one children aged from 8 months to almost 18 years were involved, although there were many missing data. In children receiving simultaneous implants after one, two, and three years respectively, median CAP scores were 4, 5, and 6; median SIR were 1, 2, and 3. Three years after receiving simultaneous bilateral cochlear implants, 61% of children were reported to understand conversation without lip-reading and 66% had intelligible speech if the listener concentrated hard. Auditory performance and speech intelligibility were significantly better in female children than males. Parents of children using sequential implants were generally positive about their child's well-being and behaviour since receiving the second device; those who were less positive about well-being changes also generally reported their children less willing to wear the second device. Data from 78% of paediatric cochlear implant centres in the United Kingdom provide a real-world picture of outcomes of children with bilateral implants in the UK. This large reference data set can be used to identify children in the lower quartile for targeted intervention.

Modeling Sound Processing in Cochlear Nuclei

NASA Astrophysics Data System (ADS)

Meddis, Ray

2003-03-01

The cochlear nucleus is an obligatory relay nucleus between the ear and the rest of the brain. It consists of many different types of neurons each responding differently to the same stimulus. Much is known about the wiring diagram of the system but it has so far proved difficult to characterise the signal processing that is going on or what purpose it serves. The solution to this problem is a pre-requisite of any attempt to produce a practical electronic simulation that exploits the brain's unique capacity to recognise the significance of acoustic events and generate appropriate responses. This talk will explain the different types of neural cell and specify hypotheses as to their various functions. Cell-types vary in terms of their size and shape as well as the number and type of minute electrical currents that flow across the cell membranes. Computer models will also be used to illustrate how the physical substrate (the wet-ware) is used to achieve its signal-processing goals.

New Criteria of Indication and Selection of Patients to Cochlear Implant

PubMed Central

Sampaio, André L. L.; Araújo, Mercêdes F. S.; Oliveira, Carlos A. C. P.

2011-01-01

Numerous changes continue to occur in cochlear implant candidacy. In general, these have been accompanied by concomitant and satisfactory changes in surgical techniques. Together, this has advanced the utility and safety of cochlear implantation. Most devices are now approved for use in patients with severe to profound unilateral hearing loss rather then the prior requirement of a bilateral profound loss. Furthermore, studies have begun utilizing short electrode arrays for shallow insertion in patients with considerable low-frequency residual hearing. This technique will allow the recipient to continue to use acoustically amplified hearing for the low frequencies simultaneously with a cochlear implant for the high frequencies. The advances in design of, and indications for, cochlear implants have been matched by improvements in surgical techniques and decrease in complications. The resulting improvements in safety and efficacy have further encouraged the use of these devices. This paper will review the new concepts in the candidacy of cochlear implant. Medline data base was used to search articles dealing with the following topics: cochlear implant in younger children, cochlear implant and hearing preservation, cochlear implant for unilateral deafness and tinnitus, genetic hearing loss and cochlear implant, bilateral cochlear implant, neuropathy and cochlear implant and neural plasticity, and the selection of patients for cochlear implant. PMID:22013448

Categorization of common sounds by cochlear implanted and normal hearing adults.

PubMed

Collett, E; Marx, M; Gaillard, P; Roby, B; Fraysse, B; Deguine, O; Barone, P

2016-05-01

Auditory categorization involves grouping of acoustic events along one or more shared perceptual dimensions which can relate to both semantic and physical attributes. This process involves both high level cognitive processes (categorization) and low-level perceptual encoding of the acoustic signal, both of which are affected by the use of a cochlear implant (CI) device. The goal of this study was twofold: I) compare the categorization strategies of CI users and normal hearing listeners (NHL) II) investigate if any characteristics of the raw acoustic signal could explain the results. 16 experienced CI users and 20 NHL were tested using a Free-Sorting Task of 16 common sounds divided into 3 predefined categories of environmental, musical and vocal sounds. Multiple Correspondence Analysis (MCA) and Hierarchical Clustering based on Principal Components (HCPC) show that CI users followed a similar categorization strategy to that of NHL and were able to discriminate between the three different types of sounds. However results for CI users were more varied and showed less inter-participant agreement. Acoustic analysis also highlighted the average pitch salience and average autocorrelation peak as being important for the perception and categorization of the sounds. The results therefore show that on a broad level of categorization CI users may not have as many difficulties as previously thought in discriminating certain kinds of sound; however the perception of individual sounds remains challenging. Copyright © 2016 Elsevier B.V. All rights reserved.

[DPOAE in tinnitus patients with cochlear hearing loss considering hyperacusis and misophonia].

PubMed

Sztuka, Aleksandra; Pośpiech, Lucyna; Gawron, Wojciech; Dudek, Krzysztof

2006-01-01

The most probable place generating tinnitus in auditory pathway are outer hair cells (OHC) inside cochlea. To asses their activity otoacoustic emission is used. The goal of the investigation was estimation the features of otoemission DPOAE in groups with tinnitus patients with cochlear hearing loss, estimation of diagnostic value of DPOAE parameters for analysis of function of the cochlea in investigated patients emphasizing DPOAE parameters most useful in localizing tinnitus generators and estimation of hypothetic influence of hyperacusis and misophony on parameters of DPOAE in tinnitus patients with cochlear hearing loss. The material of the study were 42 tinnitus patients with cochlear hearing loss. In the control group there were 21 patients without tinnitus with the same type of hearing loss. Then tinnitus patients were divided into three subgroups--with hyperacusis, misophony and without both of them, based on audiologic findings. after taking view on tinnitus and physical examination in all the patients pure tone and impedance audiometry, supratreshold tests, ABR and audiometric average and discomfort level were evaluated. Then otoemission DPOAE was measured in three procedures. First the amplitudes of two points per octave were assessed, in second--"fine structure" method-- 16-20 points per octave (f2/f1 = 1.2, L1 = L2 = 70 dB). Third procedure included recording of growth rate function in three series for input tones of value f2 = 2002, 4004, 6006 Hz (f2/f1= 1.22) and levels L1=L2, growing by degrees of 5dB in each series. DPOAE amplitudes in recording of 2 points per octave and fine structure method are very valuable parameters for estimation of cochlear function in tinnitus patients with cochlear hearing loss. Decreasing of DPOAE amplitudes in patients with cochlear hearing loss and tinnitus suggests significant role of OHC pathology, unbalanced by IHC injury in generation of tinnitus in patients with hearing loss of cochlear localization. DPOAE fine structure provides us the additional information about DPOAE amplitude recorded in two points per octave, spreading the amount of frequencies f2, where differences are noticed in comparison of two groups--tinnitus patients and control. Function growth rate cannot be the only parameter in estimation of DPOAE in tinnitus patients with cochlear hearing loss, also including subjects with hyperacusis and misophony. Hyperacusis has important influence on DPOAE amplitude, increases essentially amplitude of DPOAE in the examined group of tinnitus patients.

A new cochlear implant electrode with a "cork"-type stopper for inner ear malformations.

PubMed

Sennaroğlu, Levent; Atay, Gamze; Bajin, Münir Demir

2014-08-01

Gusher in inner ear malformations is common in patients with incomplete partition type I and type III. It is also common in less severe form as oozing in incomplete partition type II and large vestibular aqueduct. It is important to prevent cerebrospinal fluid (CSF) escape around the electrode to prevent meningitis. The custom-made device was produced by Med-El Company. It has a "cork"-like stopper instead of the usual silicon ring to prevent gusher. There are two types of electrodes of different lengths. The standard one is 25mm (contact space 1.7mm) and the short one is 20mm (contact space 1.3mm). It was used in 50 patients with different inner ear malformations. Thirteen patients had gusher, and 11 patients oozing during cochleostomy. One patient with initial prototype of the cork electrode had to be revised because of persistent oozing around the electrode. Another patient had slow extrusion of the electrode most probably due to CSF pulsation and had to be revised. Both patients had no more CSF fistula. CSF fistula in inner ear malformations is a serious situation which may lead to recurrent meningitis. The new electrode with "cork" stopper looks promising in preventing the postoperative CSF leak around the electrode. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Comprehensive analysis of cochlear implant failure: usefulness of clinical symptom-based algorithm combined with in situ integrity testing.

PubMed

Yamazaki, Hiroshi; O'Leary, Stephen; Moran, Michelle; Briggs, Robert

2014-04-01

Accurate diagnosis of cochlear implant failures is important for management; however, appropriate strategies to assess possible device failures are not always clear. The purpose of this study is to understand correlation between causes of device failure and the presenting clinical symptoms as well as results of in situ integrity testing and to propose effective strategies for diagnosis of device failure. Retrospective case review. Cochlear implant center at a tertiary referral hospital. Twenty-seven cases with suspected device failure of Cochlear Nucleus systems (excluding CI512 failures) on the basis of deterioration in auditory perception from January 2000 to September 2012 in the Melbourne cochlear implant clinic. Clinical presentations and types of abnormalities on in situ integrity testing were compared with modes of device failure detected by returned device analysis. Sudden deterioration in auditory perception was always observed in cases with "critical damage": either fracture of the integrated circuit or most or all of the electrode wires. Subacute or gradually progressive deterioration in auditory perception was significantly associated with a more limited number of broken electrode wires. Cochlear implant mediated auditory and nonauditory symptoms were significantly associated with an insulation problem. An algorithm based on the time course of deterioration in auditory perception and cochlear implant-mediated auditory and nonauditory symptoms was developed on the basis of these retrospective analyses, to help predict the mode of device failure. In situ integrity testing, which included close monitoring of device function in routine programming sessions as well as repeating the manufacturer's integrity test battery, was sensitive enough to detect malfunction in all suspected device failures, and each mode of device failure showed a characteristic abnormality on in situ integrity testing. Our clinical manifestation-based algorithm combined with in situ integrity testing may be useful for accurate diagnosis and appropriate management of device failure. Close monitoring of device function in routine programming sessions as well as repeating the manufacturer's integrity test battery is important if the initial in situ integrity testing is inconclusive because objective evidence of failure in the implanted device is essential to recommend explantation/reimplantation.

Importance of age and postimplantation experience on speech perception measures in children with sequential bilateral cochlear implants.

PubMed

Peters, B Robert; Litovsky, Ruth; Parkinson, Aaron; Lake, Jennifer

2007-08-01

Clinical trials in which children received bilateral cochlear implants in sequential operations were conducted to analyze the extent to which bilateral implantation offers benefits on a number of measures. The present investigation was particularly focused on measuring the effects of age at implantation and experience after activation of the second implant on speech perception performance. Thirty children aged 3 to 13 years were recipients of 2 cochlear implants, received in sequential operations, a minimum of 6 months apart. All children received their first implant before 5 years of age and had acquired speech perception capabilities with the first device. They were divided into 3 age groups on the basis of age at time of second ear implantation: Group I, 3 to 5 years; Group II, 5.1 to 8 years; and Group III, 8.1 to 13 years. Speech perception measures in quiet included the Multisyllabic Lexical Neighborhood Test (MLNT) for Group I, the Lexical Neighborhood Test (LNT) for Groups II and III, and the Hearing In Noise Test for Children (HINT-C) sentences in quiet for Group III. Speech perception in noise was assessed using the Children's Realistic Intelligibility and Speech Perception (CRISP) test. Testing was performed preoperatively and again postactivation of the second implant at 3, 6, and 12 months (CRISP at 3 and 9 mo) in both the unilateral and bilateral conditions in a repeated-measures study design. Two-way repeated-measures analysis of variance was used to analyze statistical significance among device configurations and performance over time. US Multicenter. Results for speech perception in quiet show that children implanted sequentially acquire open-set speech perception in the second ear relatively quickly (within 6 mo). However, children younger than 8 years do so more rapidly and to a higher level of speech perception ability at 12 months than older children (mean second ear MLNT/LNT scores at 12 months: Group I, 83.9%; range, 71-96%; Group II, 59.5%; range, 40-88%; Group III, 32%; range, 12-56%). The second-ear mean HINT-C score for Group III children remained far less than that of the first ear even after 12 months of device use (44 versus 89%; t, 6.48; p<0.001; critical value, 0.025). Speech intelligibility for spondees in noise was significantly better under bilateral conditions than with either ear alone when all children were analyzed as a single group and for Group III children. At the 9-month test interval, performance in the bilateral configuration was significantly better for all noise conditions (13.2% better for noise at first cochlear implant, 6.8% better for the noise front and noise at second cochlear implant conditions, t=2.32, p=0.024, critical level=0.05 for noise front; t=3.75, p<0.0001, critical level=0.05 for noise at first implant; t=2.73, p = 0.008, critical level=0.05 for noise at second implant side). The bilateral benefit in noise increased with time from 3 to 9 months after activation of the second implant. This bilateral advantage is greatest when noise is directed toward the first implanted ear, indicating that the head shadow effect is the most effective binaural mechanism. The bilateral condition produced small improvements in speech perception in quiet and for individual Group I and Group II patient results in noise that, in view of the relatively small number of subjects tested, do not reach statistical significance. Sequential bilateral cochlear implantation in children of diverse ages has the potential to improve speech perception abilities in the second implanted ear and to provide access to the use of binaural mechanisms such as the head shadow effect. The improvement unfolds over time and continues to grow during the 6 to 12 months after activation of the second implant. Younger children in this study achieved higher open-set speech perception scores in the second ear, but older children still demonstrate bilateral benefit in noise. Determining the long-term impact and cost-effectiveness that results from such potential capabilities in bilaterally implanted children requires additional study with larger groups of subjects and more prolonged monitoring.

Distortion product otoacoustic emission (2f1-f2) amplitude growth in human adults and neonates.

PubMed

Abdala, C

2000-01-01

Distortion product otoacoustic emissions (DPOAEs) are thought to be by-products of an active amplification process in the cochlea and thus serve as a metric for evaluating the integrity of this process. Because the cochlear amplifier functions in a level-dependent fashion, DPOAEs recorded as a function of stimulus level (i.e., a DPOAE growth function) may provide important information about the range and operational characteristics of the cochlear amplifier. The DPOAE growth functions recorded in human adults and neonates may provide information about the maturation of these active cochlear processes. Two experiments were conducted. Experiment I included normal-hearing adults and term-born neonates. The 2f1-f2 DPOAE growth functions were recorded for both age groups at three f2 frequencies. Experiment II was an extension of the first experiment but added a subject group of premature neonates. The results of these studies indicate that DPOAE growth functions most often show amplitude saturation and nonmonotonic growth for all age groups. However, premature neonates show monotonic growth and the absence of amplitude saturation more often than adults. Those premature neonates who do show saturation also show an elevated threshold for amplitude saturation relative to adults. In contrast, term neonates are adultlike for most measures except that they show a larger percentage of nonsaturating growth functions than adults. These results may indicate immaturity in cochlear amplifier function prior to term birth in humans. Outer hair cell function and/or efferent regulation of outer hair cell function are hypothesized sources of this immaturity, although some contribution from the immature middle ear cannot be ruled out.

Usefulness of Intravital Multiphoton Microscopy in Visualizing Study of Mouse Cochlea and Volume Changes in the Scala Media

PubMed Central

Ju, Hyun Mi; Lee, Sun Hee; Kong, Tae Hoon; Kwon, Seung-Hae; Choi, Jin Sil; Seo, Young Joon

2017-01-01

Conventional microscopy has limitations in viewing the cochlear microstructures due to three-dimensional spiral structure and the overlying bone. But these issues can be overcome by imaging the cochlea in vitro with intravital multiphoton microscopy (MPM). By using near-infrared lasers for multiphoton excitation, intravital MPM can detect endogenous fluorescence and second harmonic generation of tissues. In this study, we used intravital MPM to visualize various cochlear microstructures without any staining and non-invasively analyze the volume changes of the scala media (SM) without removing the overlying cochlear bone. The intravital MPM images revealed various tissue types, ranging from thin membranes to dense bone, as well as the spiral ganglion beneath the cochlear bone. The two-dimensional, cross-sectional, and serial z-stack intravital MPM images also revealed the spatial dilation of the SM in the temporal bone of pendrin-deficient mice. These findings suggest that intravital MPM might serve as a new method for obtaining microanatomical information regarding the cochlea, similar to standard histopathological analyses in the animal study for the cochlea. Given the capability of intravital MPM for detecting an increase in the volume of the SM in pendrin-deficient mice, it might be a promising new tool for assessing the pathophysiology of hearing loss in the future. PMID:28824523

A novel mechanism of cochlear excitation during simultaneous stimulation and pressure relief through the round window

PubMed Central

Weddell, Thomas D.; Yarin, Yury M.; Drexl, Markus; Russell, Ian J.; Elliott, Stephen J.; Lukashkin, Andrei N.

2014-01-01

The round window (RW) membrane provides pressure relief when the cochlea is excited by sound. Here, we report measurements of cochlear function from guinea pigs when the cochlea was stimulated at acoustic frequencies by movements of a miniature magnet which partially occluded the RW. Maximum cochlear sensitivity, corresponding to subnanometre magnet displacements at neural thresholds, was observed for frequencies around 20 kHz, which is similar to that for acoustic stimulation. Neural response latencies to acoustic and RW stimulation were similar and taken to indicate that both means of stimulation resulted in the generation of conventional travelling waves along the cochlear partition. It was concluded that the relatively high impedance of the ossicles, as seen from the cochlea, enabled the region of the RW not occluded by the magnet, to act as a pressure shunt during RW stimulation. We propose that travelling waves, similar to those owing to acoustic far-field pressure changes, are driven by a jet-like, near-field component of a complex pressure field, which is generated by the magnetically vibrated RW. Outcomes of research described here are theoretical and practical design principles for the development of new types of hearing aids, which use near-field, RW excitation of the cochlea. PMID:24501274

Usefulness of Intravital Multiphoton Microscopy in Visualizing Study of Mouse Cochlea and Volume Changes in the Scala Media.

PubMed

Ju, Hyun Mi; Lee, Sun Hee; Kong, Tae Hoon; Kwon, Seung-Hae; Choi, Jin Sil; Seo, Young Joon

2017-01-01

Conventional microscopy has limitations in viewing the cochlear microstructures due to three-dimensional spiral structure and the overlying bone. But these issues can be overcome by imaging the cochlea in vitro with intravital multiphoton microscopy (MPM). By using near-infrared lasers for multiphoton excitation, intravital MPM can detect endogenous fluorescence and second harmonic generation of tissues. In this study, we used intravital MPM to visualize various cochlear microstructures without any staining and non-invasively analyze the volume changes of the scala media (SM) without removing the overlying cochlear bone. The intravital MPM images revealed various tissue types, ranging from thin membranes to dense bone, as well as the spiral ganglion beneath the cochlear bone. The two-dimensional, cross-sectional, and serial z-stack intravital MPM images also revealed the spatial dilation of the SM in the temporal bone of pendrin-deficient mice. These findings suggest that intravital MPM might serve as a new method for obtaining microanatomical information regarding the cochlea, similar to standard histopathological analyses in the animal study for the cochlea. Given the capability of intravital MPM for detecting an increase in the volume of the SM in pendrin-deficient mice, it might be a promising new tool for assessing the pathophysiology of hearing loss in the future.

Proteomics, bioinformatics and targeted gene expression analysis reveals up-regulation of cochlin and identifies other potential biomarkers in the mouse model for deafness in usher syndrome type 1F

PubMed Central

Chance, Mark R.; Chang, Jinsook; Liu, Shuqing; Gokulrangan, Giridharan; Chen, Daniel H.-C.; Lindsay, Aaron; Geng, Ruishuang; Zheng, Qing Y.; Alagramam, Kumar

2010-01-01

Proteins and protein networks associated with cochlear pathogenesis in the Ames waltzer (av) mouse, a model for deafness in Usher syndrome 1F (USH1F), were identified. Cochlear protein from wild-type and av mice at postnatal day 30, a time point in which cochlear pathology is well established, was analyzed by quantitative 2D gel electrophoresis followed by mass spectrometry (MS). The analytic gel resolved 2270 spots; 69 spots showed significant changes in intensity in the av cochlea compared with the control. The cochlin protein was identified in 20 peptide spots, most of which were up-regulated, while a few were down-regulated. Analysis of MS sequence data showed that, in the av cochlea, a set of full-length isoforms of cochlin was up-regulated, while isoforms missing the N-terminal FCH/LCCL domain were down-regulated. Protein interaction network analysis of all differentially expressed proteins was performed with Metacore software. That analysis revealed a number of statistically significant candidate protein networks predicted to be altered in the affected cochlea. Quantitative PCR (qPCR) analysis of select candidates from the proteomic and bioinformatic investigations showed up-regulation of Coch mRNA and those of p53, Brn3a and Nrf2, transcription factors linked to stress response and survival. Increased mRNA of Brn3a and Nrf2 has previously been associated with increased expression of cochlin in human glaucomatous trabecular meshwork. Our report strongly suggests that increased level of cochlin is an important etiologic factor leading to the degeneration of cochlear neuroepithelia in the USH1F model. PMID:20097680

Inner ear changes in mucopolysaccharidosis type I/Hurler syndrome.

PubMed

Kariya, Shin; Schachern, Patricia A; Nishizaki, Kazunori; Paparella, Michael M; Cureoglu, Sebahattin

2012-10-01

Mucopolysaccharidosis type I/Hurler syndrome is an autosomal recessive disease caused by a deficiency of α-L-iduronidase activity. Recurrent middle ear infections and hearing loss are common complications in Hurler syndrome. Although sensorineural and conductive components occur, the mechanism of sensorineural hearing loss has not been determined. The purpose of this study is to evaluate the quantitative inner ear histopathology of the temporal bones of patients with Hurler syndrome. Eleven temporal bones from 6 patients with Hurler syndrome were examined. Age-matched healthy control samples consisted of 14 temporal bones from 7 cases. Temporal bones were serially sectioned in the horizontal plane and stained with hematoxylin and eosin. The number of spiral ganglion cells, loss of cochlear hair cells, area of stria vascularis, and cell density of spiral ligament were evaluated using light microscopy. There was no significant difference between Hurler syndrome and healthy controls in the number of spiral ganglion cells, area of stria vascularis, or cell density of spiral ligament. The number of cochlear hair cells in Hurler syndrome was significantly decreased compared with healthy controls. Auditory pathophysiology in the central nerve system in Hurler syndrome remains unknown; however, decreased cochlear hair cells may be one of the important factors for the sensorineural component of hearing loss.

Development of the mouse cochlea database (MCD).

PubMed

Santi, Peter A; Rapson, Ian; Voie, Arne

2008-09-01

The mouse cochlea database (MCD) provides an interactive, image database of the mouse cochlea for learning its anatomy and data mining of its resources. The MCD website is hosted on a centrally maintained, high-speed server at the following URL: (http://mousecochlea.umn.edu). The MCD contains two types of image resources, serial 2D image stacks and 3D reconstructions of cochlear structures. Complete image stacks of the cochlea from two different mouse strains were obtained using orthogonal plane fluorescence optical microscopy (OPFOS). 2D images of the cochlea are presented on the MCD website as: viewable images within a stack, 2D atlas of the cochlea, orthogonal sections, and direct volume renderings combined with isosurface reconstructions. In order to assess cochlear structures quantitatively, "true" cross-sections of the scala media along the length of the basilar membrane were generated by virtual resectioning of a cochlea orthogonal to a cochlear structure, such as the centroid of the basilar membrane or the scala media. 3D images are presented on the MCD website as: direct volume renderings, movies, interactive QuickTime VRs, flythrough, and isosurface 3D reconstructions of different cochlear structures. 3D computer models can also be used for solid model fabrication by rapid prototyping and models from different cochleas can be combined to produce an average 3D model. The MCD is the first comprehensive image resource on the mouse cochlea and is a new paradigm for understanding the anatomy of the cochlea, and establishing morphometric parameters of cochlear structures in normal and mutant mice.

Lactate dilates cochlear capillaries via type V fibrocyte-vessel coupling signaled by nNOS.

PubMed

Dai, Min; Yang, Yue; Shi, Xiaorui

2011-10-01

Transduction of sound in the inner ear demands tight control over delivery of oxygen and glucose. However, the mechanisms underlying the control of regional blood flow are not yet fully understood. In this study, we report a novel local control mechanism that regulates cochlear blood flow to the stria vascularis, a high energy-consuming region of the inner ear. We found that extracellular lactate had a vasodilatory effect on the capillaries of the spiral ligament under both in vitro and in vivo conditions. The lactate, acting through monocarboxylate transporter 1 (MCT1), initiated neuronal nitric oxide (NO) synthase (nNOS) and catalyzed production of NO for the vasodilation. Blocking MCT1 with the MCT blocker, α-cyano-4-hydroxycinnamate (CHC), or a suppressing NO production with either the nonspecific inhibitor of NO synthase, N(G)-nitro-L-arginine methyl ester (L-NAME), or either of two selective nNOS inhibitors, 3-bromo-7-nitroindazole or (4S)-N-(4-amino-5[aminoethyl]aminopentyl)-N'-nitroguanidine (TFA), totally abolished the lactate-induced vasodilation. Pretreatment with the selective endothelial NO synthase inhibitor, L-N(5)-(1-iminoethyl)ornithine (L-NIO), eliminated the inhibition of lactate-induced vessel dilation. With immunohistochemical labeling, we found the expression of MCT1 and nNOS in capillary-coupled type V fibrocytes. The data suggest that type V fibrocytes are the source of the lactate-induced NO. Cochlear microvessel tone, regulated by lactate, is mediated by an NO-signaled coupling of fibrocytes and capillaries.

[Inspecting the cochlear scala tympanic with flexible and semi-flexible micro-endoscope].

PubMed

Zhang, Daoxcing; Zhang, Yankun

2006-02-01

Flexible and semi-flexible micro-endoscopes were used in cochlear scala tympani inspection , to explore their application in inner ear examination. Fifteen profound hearing loss patients preparing for cochlear implant were included in this study. During the operation, micro-endoscopy was performed after opening the cochlear scala tympani. And 1 mm diameter semi-flexible micro-endoscope could go as deep as 9 mm into the cochlear scala tympani, while 0. 5 mm diameter flexible micro-endoscope could go as deep as 25 mm. The inspecting results were compared with video recording. Using 0.5 mm flexible micro-endoscope, we canould check cochlear scala tympani with depth range of 15-25 mm, but the video imaging was not clear enough to examine the microstructure in the cochlear. With 1 mm diameter semi-flexible micro-endoscope, we could reach 9 mm deep into the cochlear. During the examination, we found 3 cases with calcification deposit in osseous spiral lamina, l case with granulation tissue in the lateral wall of scala tympani, no abnormal findings in the other 11 cases. Inspecting the cochlear scala tympani with 0.5 mm flexible micro-endoscope, even though we can reach the second circuit of the cochlear, it is difficult to find the pathology in the cochlear because of the poor video imaging. With 1 mm semi-flexible micro-endoscope, we can identify the microstructure of the cochlear clearly and find the pathologic changes, but the inserting depth was limited to 9 mm with limitation to examine the whole cochlear.

What Does Music Sound Like for a Cochlear Implant User?

PubMed

Jiam, Nicole T; Caldwell, Meredith T; Limb, Charles J

2017-09-01

Cochlear implant research and product development over the past 40 years have been heavily focused on speech comprehension with little emphasis on music listening and enjoyment. The relatively little understanding of how music sounds in a cochlear implant user stands in stark contrast to the overall degree of importance the public places on music and quality of life. The purpose of this article is to describe what music sounds like to cochlear implant users, using a combination of existing research studies and listener descriptions. We examined the published literature on music perception in cochlear implant users, particularly postlingual cochlear implant users, with an emphasis on the primary elements of music and recorded music. Additionally, we administered an informal survey to cochlear implant users to gather first-hand descriptions of music listening experience and satisfaction from the cochlear implant population. Limitations in cochlear implant technology lead to a music listening experience that is significantly distorted compared with that of normal hearing listeners. On the basis of many studies and sources, we describe how music is frequently perceived as out-of-tune, dissonant, indistinct, emotionless, and weak in bass frequencies, especially for postlingual cochlear implant users-which may in part explain why music enjoyment and participation levels are lower after implantation. Additionally, cochlear implant users report difficulty in specific musical contexts based on factors including but not limited to genre, presence of lyrics, timbres (woodwinds, brass, instrument families), and complexity of the perceived music. Future research and cochlear implant development should target these areas as parameters for improvement in cochlear implant-mediated music perception.

Progress in Cochlear Physiology after Békésy

PubMed Central

Guinan, John J.; Salt, Alec; Cheatham, Mary Ann

2012-01-01

In the fifty years since Békésy was awarded the Nobel Prize, cochlear physiology has blossomed. Many topics that are now current are things Békésy could not have imagined. In this review we start by describing progress in understanding the origin of cochlear gross potentials, particularly the cochlear microphonic, an area in which Békésy had extensive experience. We then review progress in areas of cochlear physiology that were mostly unknown to Békésy, including: (1) stereocilia mechano-electrical transduction, force production, and response amplification, (2) outer hair cell (OHC) somatic motility and its molecular basis in prestin, (3) cochlear amplification and related micromechanics, including the evidence that prestin is the main motor for cochlear amplification, (4) the influence of the tectorial membrane, (5) cochlear micromechanics and the mechanical drives to inner hair cell stereocilia, (6) otoacoustic emissions, and (7) olivocochlear efferents and their influence on cochlear physiology. We then return to a subject that Békésy knew well: cochlear fluids and standing currents, as well as our present understanding of energy dependence on the lateral wall of the cochlea. Finally, we touch on cochlear pathologies including noise damage and aging, with an emphasis on where the field might go in the future. PMID:22633944

The intensity-pitch relation revisited: monopolar versus bipolar cochlear stimulation.

PubMed

Arnoldner, Christoph; Riss, Dominik; Kaider, Alexandra; Mair, Alois; Wagenblast, Jens; Baumgartner, Wolf-Dieter; Gstöttner, Wolfgang; Hamzavi, Jafar-Sasan

2008-09-01

The very high speech perception scores now being achieved with cochlear implants have led to demands for similar levels of achievement in music perception and perception in noisy environments. One of the crucial factors in these fields is pitch perception. The aim of the present study was to investigate the extent to which pitch perception is influenced by the intensity of the stimulus, through the use of different stimulation modes (monopolar, bipolar) and different electrodes (lateral and perimodiolar). Sixteen postlingually deafened patients with an average implant use of 3.1 years were included in this study. All patients were using a Cochlear (CI24M, CI24R, CI24RE) cochlear implant. Subjects were asked to compare the pitch of an intensity-constant reference tone with the pitch of a test tone of varying intensity. The test was repeated for apical, mediocochlear, and basal channel locations, and also for monopolar and bipolar stimulation. It was found that in monopolar stimulation 87.5% and in bipolar stimulation 85.7% of the patients perceived a clear pitch change with changing intensity of the stimulus (Spearman correlation coefficients r < -0.3 or r > 0.3, respectively). A total of 73.1% of these patients perceived lower pitches with increasing intensity, 26.9% reported the opposite effect. No statistically significant difference in the intensity-pitch correlation could be found between mono- and bipolar stimulation. Neither the mean dynamic range nor the type of electrode used was found to be related to the correlation coefficient. Although the majority of today's cochlear implant recipients perform well and the intensity-pitch relation in cochlear implant recipients is still poorly understood, rising demands on speech-coding strategies may soon make a compensation of the pitch shifts desirable. Although the results of our study tend to argue against a peripheral mechanism, the exact origin of this phenomenon remains unclear.

The subcellular distribution of aquaporin 5 in the cochlea reveals a water shunt at the perilymph-endolymph barrier.

PubMed

Hirt, B; Penkova, Z H; Eckhard, A; Liu, W; Rask-Andersen, H; Müller, M; Löwenheim, H

2010-07-28

Aquaporins are membrane water channel proteins that have also been identified in the cochlea. Auditory function critically depends on the homeostasis of the cochlear fluids perilymph and endolymph. In particular, the ion and water regulation of the endolymph is essential for sensory transduction. Within the cochlear duct the lateral wall epithelium has been proposed to secrete endolymph by an aquaporin-mediated flow of water across its epithelial tight junction barrier. This study identifies interspecies differences in the cellular distribution of aquaporin 5 (AQP5) in the cochlear lateral wall of mice, rats, gerbils and guinea pigs. In addition the cellular expression pattern of AQP5 is described in the human cochlea. Developmental changes in rats demonstrate longitudinal and radial gradients along the cochlear duct. During early postnatal development a pancochlear expression is detected. However a regression to the apical quadrant and limitation to outer sulcus cells (OSCs) is observed in the adult. This developmental loss of AQP5 expression in the basal cochlear segments coincides with a morphological loss of contact between OSCs and the endolymph. At the subcellular level, AQP5 exhibits polarized expression in the apical plasma membrane of the OSCs. Complementary, the basolateral membrane in the root processes of the OSCs exhibits AQP4 expression. This differential localization of AQP5 and AQP4 in the apical and basolateral membranes of the same epithelial cell type suggests a direct aquaporin-mediated transcellular water shunt between the perilymph and endolymph in the OSCs of the cochlear lateral wall. In the human cochlea these findings may have pathophysiological implications attributed to a dysfunctional water regulation by AQP5 such as endolymphatic hydrops (i.e. in Meniere's disease) or sensorineural hearing loss (i.e. in Sjögren's syndrome). Copyright (c) 2010 IBRO. Published by Elsevier Ltd. All rights reserved.

Cochlear implantation in adults: a systematic review and meta-analysis.

PubMed

Gaylor, James M; Raman, Gowri; Chung, Mei; Lee, Jounghee; Rao, Madhumathi; Lau, Joseph; Poe, Dennis S

2013-03-01

Sensorineural hearing loss is the third leading cause of years lived with disability worldwide. Cochlear implants may provide a viable alternative to hearing aids for this type of hearing loss. The Coverage and Analysis Group at the Centers for Medicare & Medicaid Services was interested in an evaluation of recently published literature on this topic. In addition, this meta-analysis is to our knowledge the first to evaluate quality-of-life (QOL) outcomes in adults with cochlear implants. To evaluate the communication-related outcomes and health-related QOL outcomes after unilateral or bilateral cochlear implantation in adults with sensorineural hearing loss. MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, and previous reports from January 1, 2004, through May 31, 2012. Published studies of adult patients undergoing unilateral or bilateral procedures with multichannel cochlear implants and assessments using open-set sentence tests, multisyllable word tests, or QOL measures. Five researchers extracted information on population characteristics, outcomes of interest, and study design and assessed the studies for risk of bias. Discrepancies were resolved by consensus. A total of 42 studies met the inclusion criteria. Most unilateral implant studies showed a statistically significant improvement in mean speech scores as measured by open-set sentence or multisyllable word tests; meta-analysis revealed a significant improvement in QOL after unilateral implantation. Results from studies assessing bilateral implantation showed improvement in communication-related outcomes compared with unilateral implantation and additional improvements in sound localization compared with unilateral device use or implantation only. Based on a few studies, the QOL outcomes varied across tests after bilateral implantation. Unilateral cochlear implants provide improved hearing and significantly improve QOL, and improvements in sound localization are noted for bilateral implantation. Future studies of longer duration, higher-quality reporting, and large databases or registries of patients with long-term follow-up data are needed to yield stronger evidence.

A Psychophysics experimental software to evaluate electrical pitch discrimination in Nucleus cochlear implanted patients

NASA Astrophysics Data System (ADS)

Pérez Zaballos, M. T.; Ramos de Miguel, A.; Killian, M.; Ramos Macías, A.

2016-02-01

Multichannel electrode array design in cochlear implants has evolved into two major categories: straight and perimodiolar electrodes. When implanted, the former lies along the outer wall of the scala tympani, while the later are located closer to the modiolus, where the neural ends are. Therefore, a perimodiolar position of the electrode array could be expected to result in reduced stimulus thresholds and stimulating currents, increased dynamic range, and more localized stimulation of the neural elements. However, their advantage for pitch discrimination has not been conclusively stated. Therefore, in order to study electrode independence, a psychophysical software has been developed, making use of Nucleus Implant Communicator tools provided by Cochlear company under a research agreement. The application comprises a graphical interface to facilitate its use, since previous software has always required some type of computer language skills. It allows for customization of electrical pulse parameters, measurement of threshold and comfort levels, loudness balancing and alternative forced choice experiments to determine electrode discrimination in Nucleus© users.

Views of elementary school teachers towards students with cochlear implants inclusion in the process of education.

PubMed

Dulcić, Adinda; Bakota, Koraljka

2009-06-01

The paper reveals views of teachers in some regular elementary schools in the Republic of Croatia where students with cochlear implants, who are also rehabilitants of SUVAG Polyclinic, are educated. Survey aimed to research the views of teachers towards education. Survey included 98 teachers. Likert type scale was applied in order to identify the views of teachers towards students with hearing impairment. The survey was carried out in May 2007. Data were processed by SPSS for Windows program, version 13. Methods of descriptive statistics were applied to process frequencies of responds on variables for total sample and 3 statistically significant factors emerged by factor analysis. Results of this survey reveal that teachers have positive views towards inclusive education as a process which offers students with cochlear implants the possibility to socialize and achieve intellectual and emotional development. The survey suggests that the way of inclusion enforcement mostly satisfies the criteria specified for successful inclusion.

The effect of different cochlear implant microphones on acoustic hearing individuals’ binaural benefits for speech perception in noise

PubMed Central

Aronoff, Justin M.; Freed, Daniel J.; Fisher, Laurel M.; Pal, Ivan; Soli, Sigfrid D.

2011-01-01

Objectives Cochlear implant microphones differ in placement, frequency response, and other characteristics such as whether they are directional. Although normal hearing individuals are often used as controls in studies examining cochlear implant users’ binaural benefits, the considerable differences across cochlear implant microphones make such comparisons potentially misleading. The goal of this study was to examine binaural benefits for speech perception in noise for normal hearing individuals using stimuli processed by head-related transfer functions (HRTFs) based on the different cochlear implant microphones. Design HRTFs were created for different cochlear implant microphones and used to test participants on the Hearing in Noise Test. Experiment 1 tested cochlear implant users and normal hearing individuals with HRTF-processed stimuli and with sound field testing to determine whether the HRTFs adequately simulated sound field testing. Experiment 2 determined the measurement error and performance-intensity function for the Hearing in Noise Test with normal hearing individuals listening to stimuli processed with the various HRTFs. Experiment 3 compared normal hearing listeners’ performance across HRTFs to determine how the HRTFs affected performance. Experiment 4 evaluated binaural benefits for normal hearing listeners using the various HRTFs, including ones that were modified to investigate the contributions of interaural time and level cues. Results The results indicated that the HRTFs adequately simulated sound field testing for the Hearing in Noise Test. They also demonstrated that the test-retest reliability and performance-intensity function were consistent across HRTFs, and that the measurement error for the test was 1.3 dB, with a change in signal-to-noise ratio of 1 dB reflecting a 10% change in intelligibility. There were significant differences in performance when using the various HRTFs, with particularly good thresholds for the HRTF based on the directional microphone when the speech and masker were spatially separated, emphasizing the importance of measuring binaural benefits separately for each HRTF. Evaluation of binaural benefits indicated that binaural squelch and spatial release from masking were found for all HRTFs and binaural summation was found for all but one HRTF, although binaural summation was less robust than the other types of binaural benefits. Additionally, the results indicated that neither interaural time nor level cues dominated binaural benefits for the normal hearing participants. Conclusions This study provides a means to measure the degree to which cochlear implant microphones affect acoustic hearing with respect to speech perception in noise. It also provides measures that can be used to evaluate the independent contributions of interaural time and level cues. These measures provide tools that can aid researchers in understanding and improving binaural benefits in acoustic hearing individuals listening via cochlear implant microphones. PMID:21412155

Music Perception of Cochlear Implant Recipients with Implications for Music Instruction: A Review of Literature

PubMed Central

Hsiao, Feilin; Gfeller, Kate

2013-01-01

This review of literature presents a systematic analysis of the capabilities and limitations of cochlear implant recipients regarding music perception. Specifically, it a) analyzes individual components of music (e.g., rhythm, timbre, and pitch) as they interface with the technical characteristics of cochlear implants and the perceptual abilities of cochlear implant recipients; and b) describes accommodations for music instruction that support successful participation of children with cochlear implants. This article consolidates research studies from various disciplines (audiology, hearing science, speech-language pathology, cochlear implants, and music therapy) to provide practical recommendations for educators in fostering the musical growth of children with cochlear implants. PMID:23469365

Outcomes of cochlear implantation in deaf children of deaf parents: comparative study.

PubMed

Hassanzadeh, S

2012-10-01

This retrospective study compared the cochlear implantation outcomes of first- and second-generation deaf children. The study group consisted of seven deaf, cochlear-implanted children with deaf parents. An equal number of deaf children with normal-hearing parents were selected by matched sampling as a reference group. Participants were matched based on onset and severity of deafness, duration of deafness, age at cochlear implantation, duration of cochlear implantation, gender, and cochlear implant model. We used the Persian Auditory Perception Test for the Hearing Impaired, the Speech Intelligibility Rating scale, and the Sentence Imitation Test, in order to measure participants' speech perception, speech production and language development, respectively. Both groups of children showed auditory and speech development. However, the second-generation deaf children (i.e. deaf children of deaf parents) exceeded the cochlear implantation performance of the deaf children with hearing parents. This study confirms that second-generation deaf children exceed deaf children of hearing parents in terms of cochlear implantation performance. Encouraging deaf children to communicate in sign language from a very early age, before cochlear implantation, appears to improve their ability to learn spoken language after cochlear implantation.

Parental expectations and outcomes of pediatric cochlear implantation.

PubMed

Piazza, Elizabeth; Kandathil, Cherian; Carron, Jeffrey D

2009-10-01

Cochlear implants have been used with increasing frequency over the past twenty years, including very young patients. To determine if parents are satisfied with their children's performance after cochlear implantation. Survey mailed to parents of children receiving cochlear implants. 31 questionnaires were returned out of 69 mailed (45 %). The vast majority of responding parents felt that their children benefited substantially from cochlear implant surgery. Cochlear implantation is effective in helping children develop auditory-oral communication skills. Access to auditory/oral communication programs in this state remains an obstacle in postoperative habilitation.

Working memory, short-term memory and reading proficiency in school-age children with cochlear implants.

PubMed

Bharadwaj, Sneha V; Maricle, Denise; Green, Laura; Allman, Tamby

2015-10-01

The objective of the study was to examine short-term memory and working memory through both visual and auditory tasks in school-age children with cochlear implants. The relationship between the performance on these cognitive skills and reading as well as language outcomes were examined in these children. Ten children between the ages of 7 and 11 years with early-onset bilateral severe-profound hearing loss participated in the study. Auditory and visual short-term memory, auditory and visual working memory subtests and verbal knowledge measures were assessed using the Woodcock Johnson III Tests of Cognitive Abilities, the Wechsler Intelligence Scale for Children-IV Integrated and the Kaufman Assessment Battery for Children II. Reading outcomes were assessed using the Woodcock Reading Mastery Test III. Performance on visual short-term memory and visual working memory measures in children with cochlear implants was within the average range when compared to the normative mean. However, auditory short-term memory and auditory working memory measures were below average when compared to the normative mean. Performance was also below average on all verbal knowledge measures. Regarding reading outcomes, children with cochlear implants scored below average for listening and passage comprehension tasks and these measures were positively correlated to visual short-term memory, visual working memory and auditory short-term memory. Performance on auditory working memory subtests was not related to reading or language outcomes. The children with cochlear implants in this study demonstrated better performance in visual (spatial) working memory and short-term memory skills than in auditory working memory and auditory short-term memory skills. Significant positive relationships were found between visual working memory and reading outcomes. The results of the study provide support for the idea that WM capacity is modality specific in children with hearing loss. Based on these findings, reading instruction that capitalizes on the strengths in visual short-term memory and working memory is suggested for young children with early-onset hearing loss. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Early postnatal virus inoculation into the scala media achieved extensive expression of exogenous green fluorescent protein in the inner ear and preserved auditory brainstem response thresholds.

PubMed

Wang, Yunfeng; Sun, Yu; Chang, Qing; Ahmad, Shoeb; Zhou, Binfei; Kim, Yeunjung; Li, Huawei; Lin, Xi

2013-01-01

Gene transfer into the inner ear is a promising approach for treating sensorineural hearing loss. The special electrochemical environment of the scala media raises a formidable challenge for effective gene delivery at the same time as keeping normal cochlear function intact. The present study aimed to define a suitable strategy for preserving hearing after viral inoculation directly into the scala media performed at various postnatal developmental stages. We assessed transgene expression of green fluorescent protein (GFP) mediated by various types of adeno-associated virus (AAV) and lentivirus (LV) in the mouse cochlea. Auditory brainstem responses were measured 30 days after inoculation to assess effects on hearing. Patterns of GFP expression confirmed extensive exogenous gene expression in various types of cells lining the endolymphatic space. The use of different viral vectors and promoters resulted in specific cellular GFP expression patterns. AAV2/1 with cytomegalovirus promoter apparently gave the best results for GFP expression in the supporting cells. Histological examination showed normal cochlear morphology and no hair cell loss after either AAV or LV injections. We found that hearing thresholds were not significantly changed when the injections were performed in mice younger than postnatal day 5, regardless of the type of virus tested. Viral inoculation and expression in the inner ear for the restoration of hearing must not damage cochlear function. Using normal hearing mice as a model, we have achieved this necessary step, which is required for the treatment of many types of congenital deafness that require early intervention. Copyright © 2013 John Wiley & Sons, Ltd.

Drug delivery into the cochlear apex: Improved control to sequentially affect finely spaced regions along the entire length of the cochlear spiral.

PubMed

Lichtenhan, J T; Hartsock, J; Dornhoffer, J R; Donovan, K M; Salt, A N

2016-11-01

Administering pharmaceuticals to the scala tympani of the inner ear is a common approach to study cochlear physiology and mechanics. We present here a novel method for in vivo drug delivery in a controlled manner to sealed ears. Injections of ototoxic solutions were applied from a pipette sealed into a fenestra in the cochlear apex, progressively driving solutions along the length of scala tympani toward the cochlear aqueduct at the base. Drugs can be delivered rapidly or slowly. In this report we focus on slow delivery in which the injection rate is automatically adjusted to account for varying cross sectional area of the scala tympani, therefore driving a solution front at uniform rate. Objective measurements originating from finely spaced, low- to high-characteristic cochlear frequency places were sequentially affected. Comparison with existing methods(s): Controlled administration of pharmaceuticals into the cochlear apex overcomes a number of serious limitations of previously established methods such as cochlear perfusions with an injection pipette in the cochlear base: The drug concentration achieved is more precisely controlled, drug concentrations remain in scala tympani and are not rapidly washed out by cerebrospinal fluid flow, and the entire length of the cochlear spiral can be treated quickly or slowly with time. Controlled administration of solutions into the cochlear apex can be a powerful approach to sequentially effect objective measurements originating from finely spaced cochlear regions and allows, for the first time, the spatial origin of CAPs to be objectively defined. Copyright © 2016 Elsevier B.V. All rights reserved.

Drug delivery into the cochlear apex: Improved control to sequentially affect finely spaced regions along the entire length of the cochlear spiral

PubMed Central

Lichtenhan, JT; Hartsock, J; Dornhoffer, JR; Donovan, KM; Salt, AN

2016-01-01

Background Administering pharmaceuticals to the scala tympani of the inner ear is a common approach to study cochlear physiology and mechanics. We present here a novel method for in vivo drug delivery in a controlled manner to sealed ears. New method Injections of ototoxic solutions were applied from a pipette sealed into a fenestra in the cochlear apex, progressively driving solutions along the length of scala tympani toward the cochlear aqueduct at the base. Drugs can be delivered rapidly or slowly. In this report we focus on slow delivery in which the injection rate is automatically adjusted to account for varying cross sectional area of the scala tympani, therefore driving a solution front at uniform rate. Results Objective measurements originating from finely spaced, low- to high-characteristic cochlear frequency places were sequentially affected. Comparison with existing methods(s): Controlled administration of pharmaceuticals into the cochlear apex overcomes a number of serious limitations of previously established methods such as cochlear perfusions with an injection pipette in the cochlear base: The drug concentration achieved is more precisely controlled, drug concentrations remain in scala tympani and are not rapidly washed out by cerebrospinal fluid flow, and the entire length of the cochlear spiral can be treated quickly or slowly with time. Conclusions Controlled administration of solutions into the cochlear apex can be a powerful approach to sequentially effect objective measurements originating from finely spaced cochlear regions and allows, for the first time, the spatial origin of CAPs to be objectively defined. PMID:27506463

HRCT Correlation with Round Window Identification during Cochlear Implantation in Children.

PubMed

Pendem, Sai Kiran; Rangasami, Rajeswaran; Arunachalam, Ravi Kumar; Mohanarangam, Venkata Sai Pulivadulu; Natarajan, Paarthipan

2014-01-01

To determine the accuracy of High Resolution Computer Tomography (HRCT) temporal bone measurements in predicting the actual visualization of round window niche as viewed through posterior tympanotomy (i.e. facial recess). This is a prospective study of 37 cochlear implant candidates, aged between 1and 6 years, who were referred for HRCT temporal bone during the period December 2013 to July 2014. Cochlear implantation was done in 37 children (25 in the right ear and 12 in the left ear). The distance between the short process of incus and the round window niche and the distance between the oval window and the round window niche were measured preoperatively on sub-millimeter (0.7 mm) HRCT images. We classified the visibility of round window niche based on the surgical view (i.e. through posterior tympanotomy) during surgery into three types: 1) Type 1- fully visible, 2) Type 2- partially visible, and 3) Type 3- difficult to visualize. The preoperative HRCT measurements were used to predict the type of visualization of round window niche before surgery and correlated with the findings during surgery. The mean and standard deviation for the distance between the short process of incus and the round window niche and for the distance between the oval window and the round window niche for Types 1, 2, and 3 were 8.5 ± 0.2 mm and 3.2 ± 0.2 mm, 8.0 ± 0.4 mm and 3.8 ± 0.2 mm, 7.5 ± 0.2 mm and 4.4 ± 0.2 mm respectively, and showed statistically significant difference (P < 0.01) between them. The preoperative HRCT measurements had a sensitivity and specificity of 92.3% and 96.2%, respectively, in determining the actual visualization of round window niche. This study shows preoperative HRCT temporal bone measurements are useful in predicting the actual visualization of round window niche as viewed through posterior tympanotomy.

Serotonin projection patterns to the cochlear nucleus.

PubMed

Thompson, A M; Thompson, G C

2001-07-13

The cochlear nucleus is well known as an obligatory relay center for primary auditory nerve fibers. Perhaps not so well known is the neural input to the cochlear nucleus from cells containing serotonin that reside near the midline in the midbrain raphe region. Although the specific locations of the main, if not sole, sources of serotonin within the dorsal cochlear nucleus subdivision are known to be the dorsal and median raphe nuclei, sources of serotonin located within other cochlear nucleus subdivisions are not currently known. Anterograde tract tracing was used to label fibers originating from the dorsal and median raphe nuclei while fluorescence immunohistochemistry was used to simultaneously label specific serotonin fibers in cat. Biotinylated dextran amine was injected into the dorsal and median raphe nuclei and was visualized with Texas Red, while serotonin was visualized with fluorescein. Thus, double-labeled fibers were unequivocally identified as serotoninergic and originating from one of the labeled neurons within the dorsal and median raphe nuclei. Double-labeled fiber segments, typically of fine caliber with oval varicosities, were observed in many areas of the cochlear nucleus. They were found in the molecular layer of the dorsal cochlear nucleus, in the small cell cap region, and in the granule cell and external regions of the cochlear nuclei, bilaterally, of all cats. However, the density of these double-labeled fiber segments varied considerably depending upon the exact region in which they were found. Fiber segments were most dense in the dorsal cochlear nucleus (especially in the molecular layer) and the large spherical cell area of the anteroventral cochlear nucleus; they were moderately dense in the small cell cap region; and fiber segments were least dense in the octopus and multipolar cell regions of the posteroventral cochlear nucleus. Because of the presence of labeled fiber segments in subdivisions of the cochlear nucleus other than the dorsal cochlear nucleus, we concluded that the serotoninergic projection pattern to the cochlear nucleus is divergent and non-specific. Double-labeled fiber segments were also present, but sparse, in the superior olive, localized mainly in periolivary regions; this indicated that the divergence of dorsal and median raphe neurons that extends throughout regions of the cochlear nucleus also extended well beyond the cochlear nucleus to include at least the superior olivary complex as well.

Synaptic Proteins Are Tonotopically Graded in Postnatal and Adult Type I and Type II Spiral Ganglion Neurons

PubMed Central

Flores-Otero, Jacqueline; Davis, Robin L.

2011-01-01

Inherent in the design of the mammalian auditory system is the precision necessary to transduce complex sounds and transmit the resulting electrical signals to higher neural centers. Unique specializations in the organ of Corti are required to make this conversion, such that mechanical and electrical properties of hair cell receptors are tailored to their specific role in signal coding. Electrophysiological and immunocytochemical characterizations have shown that this principle also applies to neurons of the spiral ganglion, as evidenced by distinctly different firing features and synaptic protein distributions of neurons that innervate high- and low-frequency regions of the cochlea. However, understanding the fine structure of how these properties are distributed along the cochlear partition and within the type I and type II classes of spiral ganglion neurons is necessary to appreciate their functional significance fully. To address this issue, we assessed the localization of the postsynaptic AMPA receptor subunits GluR2 and GluR3 and the presynaptic protein synaptophysin by using immunocytochemical labeling in both postnatal and adult tissue. We report that these presynaptic and postsynaptic proteins are distributed oppositely in relation to the tonotopic map and that they are equally distributed in each neuronal class, thus having an overall gradation from one end of the cochlea to the other. For synaptophysin, an additional layer of heterogeneity was superimposed orthogonal to the tonotopic axis. The highest anti-synaptophysin antibody levels were observed within neurons located close to the scala tympani compared with those located close to the scala vestibuli. Furthermore, we noted that the protein distribution patterns observed in postnatal preparations were largely retained in adult tissue sections, indicating that these features characterize spiral ganglion neurons in the fully developed ear. PMID:21452215

Qualitative Assessment of Speech Perception Performance of Early and Late Cochlear Implantees.

PubMed

Kant, Anjali R; Pathak, Sonal

2015-09-01

The present study aims to provide a qualitative description and comparison of speech perception performance using model based tests like multisyllabic lexical neighborhood test (MLNT) and lexical neighborhood test (LNT), in early and late implanted (prelingual) hearing impaired children using cochlear implants. The subjects comprised of cochlear implantees; Group I (early implantees)-n = 15, 3-6 years of age; mean age at implantation-3½ years. Group II (late implantees)-n = 15, 7-13 years of age; mean age at implantation-5 years. The tests were presented in a sound treated room at 70 dBSPL. The children were instructed to repeat the words on hearing them. Responses were scored as percentage of words correctly repeated. Their means were computed. The late implantees achieved higher scores for words on MLNT than those on LNT. This may imply that late implantees are making use of length cues in order to aid them in speech perception. The major phonological process used by early implantees was deletion and by the late implantees was substitution. One needs to wait until the child achieves a score of 20 % on LNT before assessing other aspects of his/her speech perception abilities. There appears to be a need to use speech perception tests which are based on theoretical empirical models, in order to enable us to give a descriptive analysis of post implant speech perception performance.

Photochemically induced focal cochlear lesions in the guinea pig: II. A transmission electron microscope study.

PubMed

Miyashita, H; Iwasaki, S; Hoshino, T

1998-05-15

Photochemically induced focal lesions in guinea pig cochleas were studied by light microscopy and transmission electron microscopy. The lesions were induced in the second cochlear turns of 35 adult guinea pigs by illumination for 10 minutes with a focused green light immediately after a rose bengal solution was injected into the jugular vein. The cochlear lateral wall and organ of Corti were examined 5, 10, 20, 30, and 90 minutes, 12 and 24 hours, and 3, 7, and 30 days after the procedure. Aggregations of platelets and red blood cells were found in strial capillaries at 5 minutes after illumination. After 30 minutes, marginal cell surfaces protruded into the endolymphatic space; surface membranes were ruptured and the cytoplasm was expelled into the space. In outer hair cells, disruption of the cellular membrane was found near the cuticular plate 12 hours after the procedure. All cellular elements of the lateral wall and organ of Corti were markedly degenerated in the 30-day specimens. Histological changes found in the stria vascularis were consistent with cell damage caused by active oxygen species. It is likely that the stria vascularis is more sensitive to the photochemical reaction than other parts of the cochlea. Cell damage in other parts of the cochlea seemed to have been caused by local microvascular ischemia in addition to the action of active oxygen species induced by the photochemical reaction.

Cochlear implantation in patients with bilateral cochlear trauma.

PubMed

Serin, Gediz Murat; Derinsu, Ufuk; Sari, Murat; Gergin, Ozgül; Ciprut, Ayça; Akdaş, Ferda; Batman, Cağlar

2010-01-01

Temporal bone fracture, which involves the otic capsule, can lead to complete loss of auditory and vestibular functions, whereas the patients without fractures may experience profound sensorineural hearing loss due to cochlear concussion. Cochlear implant is indicated in profound sensorineural hearing loss due to cochlear trauma but who still have an intact auditory nerve. This is a retrospective review study. We report 5 cases of postlingually deafened patients caused by cochlear trauma, who underwent cochlear implantation. Preoperative and postoperative hearing performance will be presented. These patients are cochlear implanted after the cochlear trauma in our department between 2001 and 2006. All patients performed very well with their implants, obtained open-set speech understanding. They all became good telephone users after implantation. Their performance in speech understanding was comparable to standard postlingual adult patients implanted. Cochlear implantation is an effective aural rehabilitation in profound sensorineural hearing loss caused by temporal bone trauma. Preoperative temporal bone computed tomography, magnetic resonance imaging, and promontorium stimulation testing are necessary to make decision for the surgery and to determine the side to be implanted. Surgery could be challenging and complicated because of anatomical irregularity. Moreover, fibrosis and partial or total ossification within the cochlea must be expected. Copyright 2010. Published by Elsevier Inc.

Cost-effectiveness analysis of cochlear dose reduction by proton beam therapy for medulloblastoma in childhood.

PubMed

Hirano, Emi; Fuji, Hiroshi; Onoe, Tsuyoshi; Kumar, Vinay; Shirato, Hiroki; Kawabuchi, Koichi

2014-03-01

The aim of this study is to evaluate the cost-effectiveness of proton beam therapy with cochlear dose reduction compared with conventional X-ray radiotherapy for medulloblastoma in childhood. We developed a Markov model to describe health states of 6-year-old children with medulloblastoma after treatment with proton or X-ray radiotherapy. The risks of hearing loss were calculated on cochlear dose for each treatment. Three types of health-related quality of life (HRQOL) of EQ-5D, HUI3 and SF-6D were used for estimation of quality-adjusted life years (QALYs). The incremental cost-effectiveness ratio (ICER) for proton beam therapy compared with X-ray radiotherapy was calculated for each HRQOL. Sensitivity analyses were performed to model uncertainty in these parameters. The ICER for EQ-5D, HUI3 and SF-6D were $21 716/QALY, $11 773/QALY, and $20 150/QALY, respectively. One-way sensitivity analyses found that the results were sensitive to discount rate, the risk of hearing loss after proton therapy, and costs of proton irradiation. Cost-effectiveness acceptability curve analysis revealed a 99% probability of proton therapy being cost effective at a societal willingness-to-pay value. Proton beam therapy with cochlear dose reduction improves health outcomes at a cost that is within the acceptable cost-effectiveness range from the payer's standpoint.

Children's language development after cochlear implantation: a literature review.

PubMed

Monteiro, Clarice Gomes; Cordeiro, Ana Augusta de Andrade; Silva, Hilton Justino da; Queiroga, Bianca Arruda Manchester de

2016-01-01

review the literature for studies that describe the language development of children after they receive cochlear implants. Literature review on the PubMed, Web of Science, Scopus, and Science Direct databases, tracing the selection and critical analysis stages in the journals found and selected. We selected original articles looking at children with cochlear implants, which mentioned language development after surgery. Case studies, dissertations, books chapters, editorials, and original articles that did not mention aspects of oral communication development, perception of sounds and speech, and other stages of human development, in the title, abstract, or text, were excluded. A protocol was created for this study including the following points: author, year, location, sample, type of study, objectives, methods used, main results, and conclusion. 5,052 articles were found based on the search descriptors and free terms. Of this total, 3,414 were excluded due to the title, 1,245 due to the abstract, and 358 from reading the full text; we selected 35, of which 28 were repeated. In the end, seven articles were analyzed in this review. We conclude that cochlear implant users have slower linguistic and educational development than their peers with normal hearing - though they are better than conventional prostheses users - and they are able to match them over time. There is great variability in the test methodologies, thus reducing the effectiveness and reliability of the results found.

Cochlear implant in Hong Kong Cantonese.

PubMed

Tang, S O; Luk, W S; Lau, C C; So, K W; Wong, C M; Yiu, M L; Kwok, C L

1990-11-01

Cochlear implant surgery was performed in four Cantonese-speaking postlingually deaf Chinese adults, using the House/3M single channel device. This article outlines the methodology, including preoperative assessment and postoperative rehabilitation; and explains the necessary modifications in speech and audiologic work-up in Cantonese-speaking patients. Salient features of Cantonese phonetics, especially its tonal characteristics, are described. The findings of the study are presented. The results of the cochlear implant would suggest a performance superior to that of the hearing aid. Furthermore, the cochlear implant is able to detect tonal cues. This quality of the cochlear implant may prove to be a valuable asset to a tonal language-speaking cochlear implantee.

Visualization and contractile activity of cochlear pericytes in the capillaries of the spiral ligament.

PubMed

Dai, Min; Nuttall, Alfred; Yang, Yue; Shi, Xiaorui

2009-08-01

Pericytes, mural cells located on microvessels, are considered to play an important role in the formation of the vasculature and the regulation of local blood flow in some organs. Little is known about the physiology of cochlear pericytes. In order to investigate the function of cochlear pericytes, we developed a method to visualize cochlear pericytes using diaminofluorescein-2 diacetate (DAF-2DA) and intravital fluorescence microscopy. This method can permit the study of the effect of vasoactive agents on pericytes under the in vivo and normal physiological condition. The specificity of the labeling method was verified by the immunofluorescence labeling of pericyte maker proteins such as desmin, neural proteoglycan (NG2), and thymocyte differentiation antigen 1 (Thy-1). Superfused K(+) and Ca(2+) to the cochlear lateral wall resulted in localized constriction of capillaries at pericyte locations both in vivo and in vitro, while there was no obvious change in cochlear capillary diameters with application of the adrenergic neurotransmitter noradrenaline. The method could be an effective way to visualize cochlear pericytes and microvessels and study lateral wall vascular physiology. Moreover, we demonstrate for the first time that cochlear pericytes have contractility, which may be important for regulation of cochlear blood flow.

Risk of Bacterial Meningitis in Children with Cochlear Implants

MedlinePlus

... Hearing Loss Homepage Basics Noise-Induced Hearing Loss Genetics of Hearing Loss Screening & Diagnosis Types of Hearing Loss About Sound Treatment & Intervention Services Learning Language Bacterial Meningitis Studies Data & Statistics EHDI Annual Data 2016 2015 2014 2013 ...

Cochlear implants: system design, integration, and evaluation.

PubMed

Zeng, Fan-Gang; Rebscher, Stephen; Harrison, William; Sun, Xiaoan; Feng, Haihong

2008-01-01

As the most successful neural prosthesis, cochlear implants have provided partial hearing to more than 120000 persons worldwide; half of which being pediatric users who are able to develop nearly normal language. Biomedical engineers have played a central role in the design, integration and evaluation of the cochlear implant system, but the overall success is a result of collaborative work with physiologists, psychologists, physicians, educators, and entrepreneurs. This review presents broad yet in-depth academic and industrial perspectives on the underlying research and ongoing development of cochlear implants. The introduction accounts for major events and advances in cochlear implants, including dynamic interplays among engineers, scientists, physicians, and policy makers. The review takes a system approach to address critical issues in cochlear implant research and development. First, the cochlear implant system design and specifications are laid out. Second, the design goals, principles, and methods of the subsystem components are identified from the external speech processor and radio frequency transmission link to the internal receiver, stimulator and electrode arrays. Third, system integration and functional evaluation are presented with respect to safety, reliability, and challenges facing the present and future cochlear implant designers and users. Finally, issues beyond cochlear implants are discussed to address treatment options for the entire spectrum of hearing impairment as well as to use the cochlear implant as a model to design and evaluate other similar neural prostheses such as vestibular and retinal implants.

Sound-direction identification with bilateral cochlear implants.

PubMed

Neuman, Arlene C; Haravon, Anita; Sislian, Nicole; Waltzman, Susan B

2007-02-01

The purpose of this study was to compare the accuracy of sound-direction identification in the horizontal plane by bilateral cochlear implant users when localization was measured with pink noise and with speech stimuli. Eight adults who were bilateral users of Nucleus 24 Contour devices participated in the study. All had received implants in both ears in a single surgery. Sound-direction identification was measured in a large classroom by using a nine-loudspeaker array. Localization was tested in three listening conditions (bilateral cochlear implants, left cochlear implant, and right cochlear implant), using two different stimuli (a speech stimulus and pink noise bursts) in a repeated-measures design. Sound-direction identification accuracy was significantly better when using two implants than when using a single implant. The mean root-mean-square error was 29 degrees for the bilateral condition, 54 degrees for the left cochlear implant, and 46.5 degrees for the right cochlear implant condition. Unilateral accuracy was similar for right cochlear implant and left cochlear implant performance. Sound-direction identification performance was similar for speech and pink noise stimuli. The data obtained in this study add to the growing body of evidence that sound-direction identification with bilateral cochlear implants is better than with a single implant. The similarity in localization performance obtained with the speech and pink noise supports the use of either stimulus for measuring sound-direction identification.

Cochlear Implants Special Issue Article: Vocal Emotion Recognition by Normal-Hearing Listeners and Cochlear Implant Users

PubMed Central

Luo, Xin; Fu, Qian-Jie; Galvin, John J.

2007-01-01

The present study investigated the ability of normal-hearing listeners and cochlear implant users to recognize vocal emotions. Sentences were produced by 1 male and 1 female talker according to 5 target emotions: angry, anxious, happy, sad, and neutral. Overall amplitude differences between the stimuli were either preserved or normalized. In experiment 1, vocal emotion recognition was measured in normal-hearing and cochlear implant listeners; cochlear implant subjects were tested using their clinically assigned processors. When overall amplitude cues were preserved, normal-hearing listeners achieved near-perfect performance, whereas listeners with cochlear implant recognized less than half of the target emotions. Removing the overall amplitude cues significantly worsened mean normal-hearing and cochlear implant performance. In experiment 2, vocal emotion recognition was measured in listeners with cochlear implant as a function of the number of channels (from 1 to 8) and envelope filter cutoff frequency (50 vs 400 Hz) in experimental speech processors. In experiment 3, vocal emotion recognition was measured in normal-hearing listeners as a function of the number of channels (from 1 to 16) and envelope filter cutoff frequency (50 vs 500 Hz) in acoustic cochlear implant simulations. Results from experiments 2 and 3 showed that both cochlear implant and normal-hearing performance significantly improved as the number of channels or the envelope filter cutoff frequency was increased. The results suggest that spectral, temporal, and overall amplitude cues each contribute to vocal emotion recognition. The poorer cochlear implant performance is most likely attributable to the lack of salient pitch cues and the limited functional spectral resolution. PMID:18003871

Function and expression pattern of nonsyndromic deafness genes

PubMed Central

Hilgert, Nele; Smith, Richard J.H.; Van Camp, Guy

2010-01-01

Hearing loss is the most common sensory disorder, present in 1 of every 500 newborns. To date, 46 genes have been identified that cause nonsyndromic hearing loss, making it an extremely heterogeneous trait. This review provides a comprehensive overview of the inner ear function and expression pattern of these genes. In general, they are involved in hair bundle morphogenesis, form constituents of the extracellular matrix, play a role in cochlear ion homeostasis or serve as transcription factors. During the past few years, our knowledge of genes involved in hair bundle morphogenesis has increased substantially. We give an up-to-date overview of both the nonsyndromic and Usher syndrome genes involved in this process, highlighting proteins that interact to form macromolecular complexes. For every gene, we also summarize its expression pattern and impact on hearing at the functional level. Gene-specific cochlear expression is summarized in a unique table by structure/cell type and is illustrated on a cochlear cross-section, which is available online via the Hereditary Hearing Loss Homepage. This review should provide auditory scientists the most relevant information for all identified nonsyndromic deafness genes. PMID:19601806

Prediction and control of neural responses to pulsatile electrical stimulation

NASA Astrophysics Data System (ADS)

Campbell, Luke J.; Sly, David James; O'Leary, Stephen John

2012-04-01

This paper aims to predict and control the probability of firing of a neuron in response to pulsatile electrical stimulation of the type delivered by neural prostheses such as the cochlear implant, bionic eye or in deep brain stimulation. Using the cochlear implant as a model, we developed an efficient computational model that predicts the responses of auditory nerve fibers to electrical stimulation and evaluated the model's accuracy by comparing the model output with pooled responses from a group of guinea pig auditory nerve fibers. It was found that the model accurately predicted the changes in neural firing probability over time to constant and variable amplitude electrical pulse trains, including speech-derived signals, delivered at rates up to 889 pulses s-1. A simplified version of the model that did not incorporate adaptation was used to adaptively predict, within its limitations, the pulsatile electrical stimulus required to cause a desired response from neurons up to 250 pulses s-1. Future stimulation strategies for cochlear implants and other neural prostheses may be enhanced using similar models that account for the way that neural responses are altered by previous stimulation.

Speech perception of young children using nucleus 22-channel or CLARION cochlear implants.

PubMed

Young, N M; Grohne, K M; Carrasco, V N; Brown, C

1999-04-01

This study compares the auditory perceptual skill development of 23 congenitally deaf children who received the Nucleus 22-channel cochlear implant with the SPEAK speech coding strategy, and 20 children who received the CLARION Multi-Strategy Cochlear Implant with the Continuous Interleaved Sampler (CIS) speech coding strategy. All were under 5 years old at implantation. Preimplantation, there were no significant differences between the groups in age, length of hearing aid use, or communication mode. Auditory skills were assessed at 6 months and 12 months after implantation. Postimplantation, the mean scores on all speech perception tests were higher for the Clarion group. These differences were statistically significant for the pattern perception and monosyllable subtests of the Early Speech Perception battery at 6 months, and for the Glendonald Auditory Screening Procedure at 12 months. Multiple regression analysis revealed that device type accounted for the greatest variance in performance after 12 months of implant use. We conclude that children using the CIS strategy implemented in the Clarion implant may develop better auditory perceptual skills during the first year postimplantation than children using the SPEAK strategy with the Nucleus device.

Visualization of spiral ganglion neurites within the scala tympani with a cochlear implant in situ

PubMed Central

Chikar, Jennifer A.; Batts, Shelley A.; Pfingst, Bryan E.; Raphael, Yehoash

2009-01-01

Current cochlear histology methods do not allow in situ processing of cochlear implants. The metal components of the implant preclude standard embedding and mid-modiolar sectioning, and whole mounts do not have the spatial resolution needed to view the implant within the scala tympani. One focus of recent auditory research is the regeneration of structures within the cochlea, particularly the ganglion cells and their processes, and there are multiple potential benefits to cochlear implant users from this work. To facilitate experimental investigations of auditory nerve regeneration performed in conjunction with cochlear implantation, it is critical to visualize the cochlear tissue and the implant together to determine if the nerve has made contact with the implant. This paper presents a novel histological technique that enables simultaneous visualization of the in situ cochlear implant and neurofilament – labeled nerve processes within the scala tympani, and the spatial relationship between them. PMID:19428528

Visualization of spiral ganglion neurites within the scala tympani with a cochlear implant in situ.

PubMed

Chikar, Jennifer A; Batts, Shelley A; Pfingst, Bryan E; Raphael, Yehoash

2009-05-15

Current cochlear histology methods do not allow in situ processing of cochlear implants. The metal components of the implant preclude standard embedding and mid-modiolar sectioning, and whole mounts do not have the spatial resolution needed to view the implant within the scala tympani. One focus of recent auditory research is the regeneration of structures within the cochlea, particularly the ganglion cells and their processes, and there are multiple potential benefits to cochlear implant users from this work. To facilitate experimental investigations of auditory nerve regeneration performed in conjunction with cochlear implantation, it is critical to visualize the cochlear tissue and the implant together to determine if the nerve has made contact with the implant. This paper presents a novel histological technique that enables simultaneous visualization of the in situ cochlear implant and neurofilament-labeled nerve processes within the scala tympani, and the spatial relationship between them.

[Emotional response to music by postlingually-deafened adult cochlear implant users].

PubMed

Wang, Shuo; Dong, Ruijuan; Zhou, Yun; Li, Jing; Qi, Beier; Liu, Bo

2012-10-01

To assess the emotional response to music by postlingually-deafened adult cochlear implant users. Munich music questionnaire (MUMU) was used to match the music experience and the motivation of use of music between 12 normal-hearing and 12 cochlear implant subjects. Emotion rating test in Musical Sounds in Cochlear Implants (MuSIC) test battery was used to assess the emotion perception ability for both normal-hearing and cochlear implant subjects. A total of 15 pieces of music phases were used. Responses were given by selecting the rating scales from 1 to 10. "1" represents "very sad" feeling, and "10" represents "very happy feeling. In comparison with normal-hearing subjects, 12 cochlear implant subjects made less active use of music for emotional purpose. The emotion ratings for cochlear implant subjects were similar to normal-hearing subjects, but with large variability. Post-lingually deafened cochlear implant subjects on average performed similarly in emotion rating tasks relative to normal-hearing subjects, but their active use of music for emotional purpose was obviously less than normal-hearing subjects.

The cochlear size of bats and rodents derived from MRI images and histology.

PubMed

Hsiao, Chun Jen; Jen, Philip Hung-Sun; Wu, Chung Hsin

2015-05-27

From the evolutionary perspective, the ear of each animal species is built for effective processing of the biologically relevant signals used for communication and acoustically guided orientation. Because the sound pulses used by echolocating bats for orientation and rodents for communication are quite different, the basic design of the mammalian auditory system commonly shared by echolocating bats must be specialized in some manner to effectively process their species-specific sounds. The present study examines the difference in the cochlea of these animal species using MRI images and histological techniques. We report here that, although all these animal species share a similar cochlear structure, they vary in their cochlear size and turns. Bats using constant frequency-frequency-modulated pulses (CF-FM bats) and frequency-modulated pulses (FM bats) for echolocation have a larger cochlear size and more cochlear turns than rodents (mice and rats). However, CF-FM bats have the largest cochlear size and most cochlear turns. This difference in cochlear size and turns of these animal species is discussed in relation to their biologically relevant sounds and acoustic behavior.

Guideline on cochlear implants.

PubMed

Manrique, Manuel; Ramos, Ángel; de Paula Vernetta, Carlos; Gil-Carcedo, Elisa; Lassaleta, Luis; Sanchez-Cuadrado, Isabel; Espinosa, Juan Manuel; Batuecas, Ángel; Cenjor, Carlos; Lavilla, María José; Núñez, Faustino; Cavalle, Laura; Huarte, Alicia

2018-03-26

In the last decade numerous hospitals have started to work with patients who are candidates for a cochlear implant (CI) and there have been numerous and relevant advances in the treatment of sensorineural hearing loss that extended the indications for cochlear implants. To provide a guideline on cochlear implants to specialists in otorhinolaryngology, other medical specialities, health authorities and society in general. The Scientific Committees of Otology, Otoneurology and Audiology from the Spanish Society of Otolaryngology and Head and Neck Surgery (SEORL-CCC), in a coordinated and agreed way, performed a review of the current state of CI based on the existing regulations and in the scientific publications referenced in the bibliography of the document drafted. The clinical guideline on cochlear implants provides information on: a) Definition and description of Cochlear Implant; b) Indications for cochlear implants; c) Organizational requirements for a cochlear implant programme. A clinical guideline on cochlear implants has been developed by a Committee of Experts of the SEORL-CCC, to help and guide all the health professionals involved in this field of CI in decision-making to treathearing impairment. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

Cochlear implants in children implanted in Jordan: A parental overview.

PubMed

Alkhamra, Rana A

2015-07-01

Exploring the perspective of parents on the cochlear implant process in Jordan. Sixty parents of deaf children were surveyed on the information gathering process prior to cochlear implant surgery, and their implant outcome expectations post-surgery. Whether child or parent characteristics may impact parents' post-surgical expectations was explored. Although parents used a variety of information sources when considering a cochlear implant, the ear, nose and throat doctor comprised their major source of information (60%). Parents received a range of information prior to cochlear implant but agreed (93.3%) on the need for a multidisciplinary team approach. Post-surgically, parents' expected major developments in the areas of spoken language (97%), and auditory skills (100%). Receiving education in mainstream schools (92%) was expected too. Parents perceived the cochlear implant decision as the best decision they can make for their child (98.3%). A significant correlation was found between parents contentment with the cochlear implant decision and expecting developments in the area of reading and writing (r=0.7). Child's age at implantation and age at hearing loss diagnosis significantly affected parents' post-implant outcome expectations (p<0.05). Despite the general satisfaction from the information quantity and quality prior to cochlear implant, parents agree on the need for a comprehensive multidisciplinary team approach during the different stages of the cochlear implant process. Parents' education about cochlear implants prior to the surgery can affect their post-surgical outcome expectations. The parental perspective presented in this study can help professionals develop better understanding of parents' needs and expectations and henceforth improve their services and support during the different stages of the cochlear implant process. Copyright © 2015. Published by Elsevier Ireland Ltd.

A global patient outcomes registry: Cochlear paediatric implanted recipient observational study (Cochlear™ P-IROS)

PubMed Central

2014-01-01

Background Currently, there is a paucity of data concerning the long-term outcomes, educational placement and quality of life of children implanted with hearing devices from large and representative samples of the population. To address this concern, a large, prospective, multicentre, multinational patient-outcomes registry for paediatric recipients of implantable hearing devices was developed. The benefits of this registry, its approach and methodology are described. Methods/Design The Cochlear™ Paediatric Implanted Recipient Observational Study (Cochlear P-IROS) is a prospective international patient-outcomes registry for children who are implanted in routine clinical practice with one or more hearing devices. The study aims to collect data on patient comorbidities, device use, auditory performance, quality of life and health-related utilities, across different types of implantable hearing devices from a range of manufacturers. Patients will be evaluated with a set of standardised and non-standardised questionnaires prior to initial device activation (baseline) and at six-monthly follow-up intervals up to 24 months and annually thereafter. The Cochlear P-IROS utilises a secure web interface to administer electronic case report forms to clinicians and families of implanted children. The web interface is currently available in five languages: English, Japanese, Korean, Mandarin and Russian. The interface also provides printable versions of the case report forms translated into 22 local languages for collection of data prior to entry online; additional languages may be added, as required. Participation in the Cochlear P-IROS registry is investigator-driven and voluntary. To date, the Cochlear P-IROS has recruited implant clinics across Australia, China, India, Indonesia, Turkey and Vietnam. The registry also aims to recruit multiple clinics in Cuba, Israel, Japan, Malaysia, Singapore, South Africa, South Korea and Russia. Discussion The use of a registry such as the Cochlear P-IROS will generate valuable data to support research interests of academics and clinicians around the globe. The data generated will be relevant for a wide range of stakeholders including regulators, payers, providers, policy makers, patients and their families, each with a different perspective for the acceptance and adoption of implantable hearing devices for the treatment of hearing loss. PMID:25317075

In vivo imaging of mammalian cochlear blood flow using fluorescence microendoscopy.

PubMed

Monfared, Ashkan; Blevins, Nikolas H; Cheung, Eunice L M; Jung, Juergen C; Popelka, Gerald; Schnitzer, Mark J

2006-02-01

We sought to develop techniques for visualizing cochlear blood flow in live mammalian subjects using fluorescence microendoscopy. Inner ear microcirculation appears to be intimately involved in cochlear function. Blood velocity measurements suggest that intense sounds can alter cochlear blood flow. Disruption of cochlear blood flow may be a significant cause of hearing impairment, including sudden sensorineural hearing loss. However, inability to image cochlear blood flow in a nondestructive manner has limited investigation of the role of inner ear microcirculation in hearing function. Present techniques for imaging cochlear microcirculation using intravital light microscopy involve extensive perturbations to cochlear structure, precluding application in human patients. The few previous endoscopy studies of the cochlea have suffered from optical resolution insufficient for visualizing cochlear microvasculature. Fluorescence microendoscopy is an emerging minimally invasive imaging modality that provides micron-scale resolution in tissues inaccessible to light microscopy. In this article, we describe the use of fluorescence microendoscopy in live guinea pigs to image capillary blood flow and movements of individual red blood cells within the basal turn of the cochlea. We anesthetized eight adult guinea pigs and accessed the inner ear through the mastoid bulla. After intravenous injection of fluorescein dye, we made a limited cochleostomy and introduced a compound doublet gradient refractive index endoscope probe 1 mm in diameter into the inner ear. We then imaged cochlear blood flow within individual vessels in an epifluorescence configuration using one-photon fluorescence microendoscopy. We observed single red blood cells passing through individual capillaries in several cochlear structures, including the round window membrane, spiral ligament, osseous spiral lamina, and basilar membrane. Blood flow velocities within inner ear capillaries varied widely, with observed speeds reaching up to approximately 500 microm/s. Fluorescence microendoscopy permits visualization of cochlear microcirculation with micron-scale optical resolution and determination of blood flow velocities through analysis of video sequences.

Stem/progenitor cells derived from the cochlear sensory epithelium give rise to spheres with distinct morphologies and features.

PubMed

Diensthuber, Marc; Oshima, Kazuo; Heller, Stefan

2009-06-01

Nonmammalian vertebrates regenerate lost sensory hair cells by means of asymmetric division of supporting cells. Inner ear or lateral line supporting cells in birds, amphibians, and fish consequently serve as bona fide stem cells resulting in high regenerative capacity of hair cell-bearing organs. Hair cell regeneration does not happen in the mammalian cochlea, but cells with proliferative capacity can be isolated from the neonatal cochlea. These cells have the ability to form clonal floating colonies, so-called spheres, when cultured in nonadherent conditions. We noticed that the sphere population derived from mouse cochlear sensory epithelium cells was heterogeneous, consisting of morphologically distinct sphere types, hereby classified as solid, transitional, and hollow. Cochlear sensory epithelium-derived stem/progenitor cells initially give rise to small solid spheres, which subsequently transition into hollow spheres, a change that is accompanied by epithelial differentiation of the majority of sphere cells. Only solid spheres, and to a lesser extent, transitional spheres, appeared to harbor self-renewing stem cells, whereas hollow spheres could not be consistently propagated. Solid spheres contained significantly more rapidly cycling Pax-2-expressing presumptive otic progenitor cells than hollow spheres. Islet-1, which becomes upregulated in nascent sensory patches, was also more abundant in solid than in hollow spheres. Likewise, hair cell-like cells, characterized by the expression of multiple hair cell markers, differentiated in significantly higher numbers in cell populations derived from solid spheres. We conclude that cochlear sensory epithelium cell populations initially give rise to small solid spheres that have self-renewing capacity before they subsequently convert into hollow spheres, a process that is accompanied by loss of stemness and reduced ability to spontaneously give rise to hair cell-like cells. Solid spheres might, therefore, represent the most suitable sphere type for cell-based assays or animal model transplantation studies aimed at development of cell replacement therapies.

PubMed Central

Turchetti, G.; Bellelli, S.; Palla, I.; Forli, F.

2011-01-01

SUMMARY The aim of the study consists in a systematic review concerning the economic evaluation of cochlear implant (CI) in children by searching the main international clinical and economic electronic databases. All primary studies published in English from January 2000 to May 2010 were included. The types of studies selected concerned partial economic evaluation, including direct and indirect costs of cochlear implantation; complete economic evaluation, including minimization of costs, cost-effectiveness analysis (CEA), cost-utility analysis (CUA) and cost-benefit analysis (CBA) performed through observational and experimental studies. A total of 68 articles were obtained from the database research. Of these, 54 did not meet the inclusion criteria and were eliminated. After reading the abstracts of the 14 articles selected, 11 were considered eligible. The articles were then read in full text. Furthermore, 5 articles identified by bibliography research were added manually. After reading 16 of the selected articles, 9 were included in the review. With regard to the studies included, countries examined, objectives, study design, methodology, prospect of analysis adopted, temporal horizon, the cost categories analyzed strongly differ from one study to another. Cost analysis, cost-effectiveness analysis and an analysis of educational costs associated with cochlear implants were performed. Regarding the cost analysis, only two articles reported both direct cost and indirect costs. The direct cost ranged between € 39,507 and € 68,235 (2011 values). The studies related to cost-effectiveness analysis were not easily comparable: one study reported a cost per QALY ranging between $ 5197 and $ 9209; another referred a cost of $ 2154 for QALY if benefits were not discounted, and $ 16,546 if discounted. Educational costs are significant, and increase with the level of hearing loss and type of school attended. This systematic review shows that the healthcare costs are high, but savings in terms of indirect and quality of life costs are also significant. Cochlear implantation in a paediatric age is cost-effective. The exiguity and heterogeneity of studies did not allow detailed comparative analysis of the studies included in the review. PMID:22287822

Bilateral cochlear implantation in a patient with bilateral temporal bone fractures.

PubMed

Chung, Jae Ho; Shin, Myung Chul; Min, Hyun Jung; Park, Chul Won; Lee, Seung Hwan

2011-01-01

With the emphasis on bilateral hearing nowadays, bilateral cochlear implantation has been tried out for bilateral aural rehabilitation. Bilateral sensorineural hearing loss caused by head trauma can get help from cochlear implantation. We present the case of a 44-year-old man with bilateral otic capsule violating temporal bone fractures due to head trauma. The patient demonstrated much improved audiometric and psychoacoustic performance after bilateral cochlear implantation. We believe bilateral cochlear implantation in such patient can be a very effective tool for rehabilitation. Copyright © 2011 Elsevier Inc. All rights reserved.

Systematic Review of Nontumor Pediatric Auditory Brainstem Implant Outcomes.

PubMed

Noij, Kimberley S; Kozin, Elliott D; Sethi, Rosh; Shah, Parth V; Kaplan, Alyson B; Herrmann, Barbara; Remenschneider, Aaron; Lee, Daniel J

2015-11-01

The auditory brainstem implant (ABI) was initially developed for patients with deafness as a result of neurofibromatosis type 2. ABI indications have recently extended to children with congenital deafness who are not cochlear implant candidates. Few multi-institutional outcome data exist. Herein, we aim to provide a systematic review of outcomes following implantation of the ABI in pediatric patients with nontumor diagnosis, with a focus on audiometric outcomes. PubMed, Embase, and Cochrane. A systematic review of literature was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) recommendations. Variables assessed included age at implantation, diagnosis, medical history, cochlear implant history, radiographic findings, ABI device implanted, surgical approach, complications, side effects, and auditory outcomes. The initial search identified 304 articles; 21 met inclusion criteria for a total of 162 children. The majority of these patients had cochlear nerve aplasia (63.6%, 103 of 162). Cerebrospinal fluid leak occurred in up to 8.5% of cases. Audiometric outcomes improved over time. After 5 years, almost 50% of patients reached Categories of Auditory Performance scores >4; however, patients with nonauditory disabilities did not demonstrate a similar increase in scores. ABI surgery is a reasonable option for the habilitation of deaf children who are not cochlear implant candidates. Although improvement in Categories of Auditory Performance scores was seen across studies, pediatric ABI users with nonauditory disabilities have inferior audiometric outcomes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

The Role of Telemedicine in Auditory Rehabilitation: A Systematic Review.

PubMed

Bush, Matthew L; Thompson, Robin; Irungu, Catherine; Ayugi, John

2016-12-01

The purpose of this study was to assess the feasibility and effectiveness of live telemedicine applications in hearing amplification and cochlear implantation. A systematic search was performed in PubMed, MEDLINE, PsychINFO, CINALH, and Web of Science to identify peer-reviewed research. Inclusion criteria were titles containing words from the search terms 1) audiology, otolaryngology, and hearing impairment, 2) rehabilitative methods, and 3) telemedicine. Exclusion criteria were: 1) non-English articles, and 2) non-original research. Twelve eligible studies were identified. The studies employed a prospective design in nine of the articles and retrospective case series in three. The use of telemedicine for the provision of cochlear implant services was examined in eight of the articles and with hearing aids in four of the articles. The types of services include intraoperative cochlear implant telemetry; implant programming and assessment of electrode-specific measures and speech recognition after implantation. Hearing aid programming and remote gain assessments were also reported. Many studies assess patient and provider satisfaction along with encounter time comparison. The studies occurred from 2009 to 2014 and took place in seven countries. This review examined the feasibility of remote telemedicine connection to provide in auditory rehabilitation services through hearing aids and cochlear implants. There are significant concerns regarding Internet bandwidth limitations for remote clinics. There is a paucity of research examining reimbursement and cost-effectiveness for services. Further prospective research investigating cost-effectiveness and bandwidth limitations is warranted to assess long-term sustainability of remote audiological rehabilitative service delivery.

Cochlear Implant Electrode Localization Using an Ultra-High Resolution Scan Mode on Conventional 64-Slice and New Generation 192-Slice Multi-Detector Computed Tomography.

PubMed

Carlson, Matthew L; Leng, Shuai; Diehn, Felix E; Witte, Robert J; Krecke, Karl N; Grimes, Josh; Koeller, Kelly K; Bruesewitz, Michael R; McCollough, Cynthia H; Lane, John I

2017-08-01

A new generation 192-slice multi-detector computed tomography (MDCT) clinical scanner provides enhanced image quality and superior electrode localization over conventional MDCT. Currently, accurate and reliable cochlear implant electrode localization using conventional MDCT scanners remains elusive. Eight fresh-frozen cadaveric temporal bones were implanted with full-length cochlear implant electrodes. Specimens were subsequently scanned with conventional 64-slice and new generation 192-slice MDCT scanners utilizing ultra-high resolution modes. Additionally, all specimens were scanned with micro-CT to provide a reference criterion for electrode position. Images were reconstructed according to routine temporal bone clinical protocols. Three neuroradiologists, blinded to scanner type, reviewed images independently to assess resolution of individual electrodes, scalar localization, and severity of image artifact. Serving as the reference standard, micro-CT identified scalar crossover in one specimen; imaging of all remaining cochleae demonstrated complete scala tympani insertions. The 192-slice MDCT scanner exhibited improved resolution of individual electrodes (p < 0.01), superior scalar localization (p < 0.01), and reduced blooming artifact (p < 0.05), compared with conventional 64-slice MDCT. There was no significant difference between platforms when comparing streak or ring artifact. The new generation 192-slice MDCT scanner offers several notable advantages for cochlear implant imaging compared with conventional MDCT. This technology provides important feedback regarding electrode position and course, which may help in future optimization of surgical technique and electrode design.

Targeted Mutation of the Gene for Cellular Glutathione Peroxidase (Gpx1) Increases Noise-Induced Hearing Loss in Mice

PubMed Central

McFadden, Sandra L.; Ding, Da-Lian; Lear, Patricia M.; Ho, Ye-Shih

2000-01-01

Reactive oxygen species (ROS) and oxidative stress have been implicated in cochlear injury following loud noise and ototoxins. Genetic mutations that impair antioxidant defenses would be expected to increase cochlear injury following acute insults and to contribute to cumulative injury that presents as age-related hearing loss. We examined whether genetically based deficiency of cellular glutathione peroxidase, a major antioxidant enzyme, increases noise-induced hearing loss in mice. Two-month-old "knockout" mice with a targeted inactivating mutation of the gene coding for glutathione peroxidase (Gpx1) and wild type controls were exposed to broadband noise for one hour at 110 dB SPL. Auditory brainstem response (ABR) thresholds at test frequencies ranging from 5 to 40 kHz were obtained two and four weeks after exposure to determine the stable permanent component of the hearing loss. Depending on test frequency, Gpx1 knockout mice showed up to 16 dB higher ABR thresholds prior to noise exposure, and up to 15 dB greater noise-induced hearing loss, compared with controls. Within the cochlear base, there was also a significant contribution of the knockout to inner and outer hair cell loss, as well as nerve fiber loss. Our results support a link between genetic impairment of antioxidant defenses, vulnerability of the cochlea injury, and cochlear degeneration. Such impairment produces characteristics expected of some mutations associated with age-related hearing loss and offers one possible mechanism for their action. PMID:11545230

Auditory Midbrain Implant: Research and Development Towards a Second Clinical Trial

PubMed Central

Lim, Hubert H.; Lenarz, Thomas

2015-01-01

The cochlear implant is considered one of the most successful neural prostheses to date, which was made possible by visionaries who continued to develop the cochlear implant through multiple technological and clinical challenges. However, patients without a functional auditory nerve or implantable cochlea cannot benefit from a cochlear implant. The focus of the paper is to review the development and translation of a new type of central auditory prosthesis for this group of patients, which is known as the auditory midbrain implant (AMI) and is designed for electrical stimulation within the inferior colliculus. The rationale and results for the first AMI clinical study using a multi-site single-shank array will be presented initially. Although the AMI has achieved encouraging results in terms of safety and improvements in lip-reading capabilities and environmental awareness, it has not yet provided sufficient speech perception. Animal and human data will then be presented to show that a two-shank AMI array can potentially improve hearing performance by targeting specific neurons of the inferior colliculus. Modifications to the AMI array design, stimulation strategy, and surgical approach have been made that are expected to improve hearing performance in the patients implanted with a two-shank array in an upcoming clinical trial funded by the National Institutes of Health. Positive outcomes from this clinical trial will motivate new efforts and developments toward improving central auditory prostheses for those who cannot sufficiently benefit from cochlear implants. PMID:25613994

Close-field electroporation gene delivery using the cochlear implant electrode array enhances the bionic ear.

PubMed

Pinyon, Jeremy L; Tadros, Sherif F; Froud, Kristina E; Y Wong, Ann C; Tompson, Isabella T; Crawford, Edward N; Ko, Myungseo; Morris, Renée; Klugmann, Matthias; Housley, Gary D

2014-04-23

The cochlear implant is the most successful bionic prosthesis and has transformed the lives of people with profound hearing loss. However, the performance of the "bionic ear" is still largely constrained by the neural interface itself. Current spread inherent to broad monopolar stimulation of the spiral ganglion neuron somata obviates the intrinsic tonotopic mapping of the cochlear nerve. We show in the guinea pig that neurotrophin gene therapy integrated into the cochlear implant improves its performance by stimulating spiral ganglion neurite regeneration. We used the cochlear implant electrode array for novel "close-field" electroporation to transduce mesenchymal cells lining the cochlear perilymphatic canals with a naked complementary DNA gene construct driving expression of brain-derived neurotrophic factor (BDNF) and a green fluorescent protein (GFP) reporter. The focusing of electric fields by particular cochlear implant electrode configurations led to surprisingly efficient gene delivery to adjacent mesenchymal cells. The resulting BDNF expression stimulated regeneration of spiral ganglion neurites, which had atrophied 2 weeks after ototoxic treatment, in a bilateral sensorineural deafness model. In this model, delivery of a control GFP-only vector failed to restore neuron structure, with atrophied neurons indistinguishable from unimplanted cochleae. With BDNF therapy, the regenerated spiral ganglion neurites extended close to the cochlear implant electrodes, with localized ectopic branching. This neural remodeling enabled bipolar stimulation via the cochlear implant array, with low stimulus thresholds and expanded dynamic range of the cochlear nerve, determined via electrically evoked auditory brainstem responses. This development may broadly improve neural interfaces and extend molecular medicine applications.

Predicting social functioning in children with a cochlear implant and in normal-hearing children: the role of emotion regulation.

PubMed

Wiefferink, Carin H; Rieffe, Carolien; Ketelaar, Lizet; Frijns, Johan H M

2012-06-01

The purpose of the present study was to compare children with a cochlear implant and normal hearing children on aspects of emotion regulation (emotion expression and coping strategies) and social functioning (social competence and externalizing behaviors) and the relation between emotion regulation and social functioning. Participants were 69 children with cochlear implants (CI children) and 67 normal hearing children (NH children) aged 1.5-5 years. Parents answered questionnaires about their children's language skills, social functioning, and emotion regulation. Children also completed simple tasks to measure their emotion regulation abilities. Cochlear implant children had fewer adequate emotion regulation strategies and were less socially competent than normal hearing children. The parents of cochlear implant children did not report fewer externalizing behaviors than those of normal hearing children. While social competence in normal hearing children was strongly related to emotion regulation, cochlear implant children regulated their emotions in ways that were unrelated with social competence. On the other hand, emotion regulation explained externalizing behaviors better in cochlear implant children than in normal hearing children. While better language skills were related to higher social competence in both groups, they were related to fewer externalizing behaviors only in cochlear implant children. Our results indicate that cochlear implant children have less adequate emotion-regulation strategies and less social competence than normal hearing children. Since they received their implants relatively recently, they might eventually catch up with their hearing peers. Longitudinal studies should further explore the development of emotion regulation and social functioning in cochlear implant children. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

[The development of musicality in children after cochlear implantation].

PubMed

Zheng, Yan; Liu, Bo; Dong, Ruijuan; Xu, Tianqiu; Chen, Jing; Chen, Xuejing; Zhong, Yan; Meng, Chao; Wang, Hong; Chen, Xueqing

2014-08-01

The purpose of this study is to analyze the development of musicality in children after cochlear implantation, and provide a clinical database for the evaluation of their musicality. Twenty-six children with cochlear implants (CI group) participated in this research. They received cochlear implants at the age of 11 to 68 months with a mean of 35.6 months. Seventy-six infants as a control group aged from 1 to 24 months with a mean of 6.1 months participated in this study, whose hearing were considered normal by passing the case history collection, high-risk registers for hearing loss and hearing screening using DPOAE. The music and young children with CIs: Musicality Rating Scale was used to evaluate their musicality. The evaluation was performed before cochlear implantation and 1, 3, 6, 9, 12, 24 months after cochlear implantation for children with cochlear implants. The evaluation was also performed at 1, 3, 6, 9, 12, 24 months for children with normal hearing. The mean scores of musicality showed significant improvements with time of CI use for CI group (P<0.05). The mean scores of musicality also showed significant improvements with time for control group (P<0.05). There were no significant differences in mean scores between CI group and control group at 1, 3, 6, 9, 12 months of hearing age by rank sum test (P>0.05). Significant difference was noted between the two groups at 24 months (P<0.05). The musicality of children with cochlear implants improved significantly with time after cochlear implantation. The most rapid growth was found in the first year after cochlear implantation.

Cochlear Implants:System Design, Integration and Evaluation

PubMed Central

Rebscher, Stephen; Harrison, William V.; Sun, Xiaoan; Feng, Haihong

2009-01-01

As the most successful neural prosthesis, cochlear implants have provided partial hearing to more than 120,000 persons worldwide; half of which being pediatric users who are able to develop nearly normal language. Biomedical engineers have played a central role in the design, integration and evaluation of the cochlear implant system, but the overall success is a result of collaborative work with physiologists, psychologists, physicians, educators, and entrepreneurs. This review presents broad yet in-depth academic and industrial perspectives on the underlying research and ongoing development of cochlear implants. The introduction accounts for major events and advances in cochlear implants, including dynamic interplays among engineers, scientists, physicians, and policy makers. The review takes a system approach to address critical issues from design and specifications to integration and evaluation. First, the cochlear implant system design and specifications are laid out. Second, the design goals, principles, and methods of the subsystem components are identified from the external speech processor and radio frequency transmission link to the internal receiver, stimulator and electrode arrays. Third, system integration and functional evaluation are presented with respect to safety, reliability, and challenges facing the present and future cochlear implant designers and users. Finally, issues beyond cochlear implants are discussed to address treatment options for the entire spectrum of hearing impairment as well as to use the cochlear implant as a model to design and evaluate other similar neural prostheses such as vestibular and retinal implants. PMID:19946565

Remote programming of cochlear implants: a telecommunications model.

PubMed

McElveen, John T; Blackburn, Erin L; Green, J Douglas; McLear, Patrick W; Thimsen, Donald J; Wilson, Blake S

2010-09-01

Evaluate the effectiveness of remote programming for cochlear implants. Retrospective review of the cochlear implant performance for patients who had undergone mapping and programming of their cochlear implant via remote connection through the Internet. Postoperative Hearing in Noise Test and Consonant/Nucleus/Consonant word scores for 7 patients who had undergone remote mapping and programming of their cochlear implant were compared with the mean scores of 7 patients who had been programmed by the same audiologist over a 12-month period. Times required for remote and direct programming were also compared. The quality of the Internet connection was assessed using standardized measures. Remote programming was performed via a virtual private network with a separate software program used for video and audio linkage. All 7 patients were programmed successfully via remote connectivity. No untoward patient experiences were encountered. No statistically significant differences could be found in comparing postoperative Hearing in Noise Test and Consonant/Nucleus/Consonant word scores for patients who had undergone remote programming versus a similar group of patients who had their cochlear implant programmed directly. Remote programming did not require a significantly longer programming time for the audiologist with these 7 patients. Remote programming of a cochlear implant can be performed safely without any deterioration in the quality of the programming. This ability to remotely program cochlear implant patients gives the potential to extend cochlear implantation to underserved areas in the United States and elsewhere.

Protective role of hydrogen sulfide against noise-induced cochlear damage: a chronic intracochlear infusion model.

PubMed

Li, Xu; Mao, Xiao-Bo; Hei, Ren-Yi; Zhang, Zhi-Bin; Wen, Li-Ting; Zhang, Peng-Zhi; Qiu, Jian-Hua; Qiao, Li

2011-01-01

A reduction in cochlear blood flow plays an essential role in noise-induced hearing loss (NIHL). The timely regulation of cochlear perfusion determines the progression and prognosis of NIHL. Hydrogen sulfide (H(2)S) has attracted increasing interest as a vasodilator in cardiovascular systems. This study identified the role of H(2)S in cochlear blood flow regulation and noise protection. The gene and protein expression of the H(2)S synthetase cystathionine-γ-lyase (CSE) in the rat cochlea was examined using immunofluorescence and real-time PCR. Cochlear CSE mRNA levels varied according to the duration of noise exposure. A chronic intracochlear infusion model was built and artificial perilymph (AP), NaHS or DL-propargylglycine (PPG) were locally administered. Local sodium hydrosulfide (NaHS) significantly increased cochlear perfusion post-noise exposure. Cochlear morphological damage and hearing loss were alleviated in the NaHS group as measured by conventional auditory brainstem response (ABR), cochlear scanning electron microscope (SEM) and outer hair cell (OHC) count. The highest percentage of OHC loss occurred in the PPG group. Our results suggest that H(2)S plays an important role in the regulation of cochlear blood flow and the protection against noise. Further studies may identify a new preventive and therapeutic perspective on NIHL and other blood supply-related inner ear diseases.

Cochlear Patency After Transmastoid Labyrinthectomy for Ménière's Syndrome.

PubMed

Sargent, Eric W; Liao, Eric; Gonda, Roger L

2016-08-01

Labyrinthectomy is considered the "gold standard" in the treatment of intractable vertigo attacks because of Ménière's Disease (MD) but sacrifices all residual hearing. Interest in auditory rehabilitation has lead to cochlear implantation in some patients. Concern remains that the cochlear lumen may fill with tissue or bone after surgery. This study sought to determine the incidence of obliteration of the cochlea after transmastoid labyrinthectomy. Retrospective observational study. Tertiary referral center. Eighteen patients with intractable vertigo from MD who underwent surgery. Transmastoid labyrinthectomy between 2008 and 2013. Cochleas were imaged with unenhanced, heavily T2-weighted magnetic resonance imaging (MRI). Presence of symmetrical cochlear fluid signals on MRI. There was no loss of fluid signal in the cochleas of operated ear compared with the contralateral, unoperated ear in any subject an average of 3 years (standard deviation [SD]: 1.2) after surgery. Five of 18 patients had the vestibule blocked with bone wax at the time of surgery. Blocking the vestibule with bone wax did not change the cochlear fluid signal. The risk of cochlear obstruction after labyrinthectomy for MD is very low. The significance of this finding is that patients with MD who undergo labyrinthectomy will likely remain candidates for cochlear implantation in the labyrinthectomized ear long after surgery if this becomes needed. Immediate cochlear implantation or placement of a cochlear lumen keeper during labyrinthectomy for MD is probably not necessary.

Music mixing preferences of cochlear implant recipients: a pilot study.

PubMed

Buyens, Wim; van Dijk, Bas; Moonen, Marc; Wouters, Jan

2014-05-01

Music perception and appraisal are generally poor in cochlear implant recipients. Simple musical structures, lyrics that are easy to follow, and clear rhythm/beat have been reported among the top factors to enhance music enjoyment. The present study investigated the preference for modified relative instrument levels in music with normal-hearing and cochlear implant subjects. In experiment 1, test subjects were given a mixing console and multi-track recordings to determine their most enjoyable audio mix. In experiment 2, a preference rating experiment based on the preferred relative level settings in experiment 1 was performed. Experiment 1 was performed with four postlingually deafened cochlear implant subjects, experiment 2 with ten normal-hearing and ten cochlear implant subjects. A significant difference in preference rating was found between normal-hearing and cochlear implant subjects. The latter preferred an audio mix with larger vocals-to-instruments ratio. In addition, given an audio mix with clear vocals and attenuated instruments, cochlear implant subjects preferred the bass/drum track to be louder than the other instrument tracks. The original audio mix in real-world music might not be suitable for cochlear implant recipients. Modifying the relative instrument level settings potentially improves music enjoyment.

Betahistine metabolites, aminoethylpyridine, and hydroxyethylpyridine increase cochlear blood flow in guinea pigs in vivo.

PubMed

Bertlich, Mattis; Ihler, Fritz; Sharaf, Kariem; Weiss, Bernhard G; Strupp, Michael; Canis, Martin

2014-10-01

Betahistine is a histamine-like drug that is used in the treatment of Ménière's disease. It is commonly believed that betahistine increases cochlear blood flow and thus decreases the endolymphatic hydrops that is the cause of Ménière's. Despite common clinical use, there is little understanding of the kinetics or effects of its metabolites. This study investigated the effect of the betahistine metabolites aminoethylpyridine, hydroxyethylpyridine, and pyridylacetic acid on cochlear microcirculation. Guinea pigs were randomly assigned to one of the groups: placebo, betahistine, or equimolar amounts of aminoethylpyridine, hydroxyethylpyridine, or pyridylacetic acid. Cochlear blood flow and mean arterial pressure were recorded for three minutes before and 15 minutes after treatment. Thirty Dunkin-Hartley guinea pigs assigned to one of five groups with six guinea pigs per group. Betahistine, aminoethylpyridine, and hydroxyethylpyridine caused a significant increase in cochlear blood flow in comparison to placebo. The effect seen under aminoethylpyridin was greatest. The group treated with pyridylacetic acid showed no significant effect on cochlear blood flow. Aminoethylpyridine and hydroxyethylpyridine are, like betahistine, able to increase cochlear blood flow significantly. The effect of aminoethylpyridine was greatest. Pyridylacetic acid had no effect on cochlear microcirculation.

Histaminergic H3-Heteroreceptors as a Potential Mediator of Betahistine-Induced Increase in Cochlear Blood Flow.

PubMed

Bertlich, Mattis; Ihler, Friedrich; Freytag, Saskia; Weiss, Bernhard G; Strupp, Michael; Canis, Martin

2015-01-01

Betahistine is a histamine-like drug that is considered beneficial in Ménière's disease by increasing cochlear blood flow. Acting as an agonist at the histamine H1-receptor and as an inverse agonist at the H3-receptor, these receptors as well as the adrenergic α2-receptor were investigated for betahistine effects on cochlear blood flow. A total of 54 Dunkin-Hartley guinea pigs were randomly assigned to one of nine groups treated with a selection of H1-, H3- or α2-selective agonists and antagonists together with betahistine. Cochlear blood flow and mean arterial pressure were recorded for 3 min before and 15 min after infusion. Blockage of the H3- or α2-receptors caused a suppression of betahistine-mediated typical changes in cochlear blood flow or blood pressure. Activation of H3-receptors caused a drop in cochlear blood flow and blood pressure. H1-receptors showed no involvement in betahistine-mediated changes of cochlear blood flow. Betahistine most likely affects cochlear blood flow through histaminergic H3-heteroreceptors. © 2015 S. Karger AG, Basel.

Fingolimod (FTY-720) is Capable of Reversing Tumor Necrosis Factor Induced Decreases in Cochlear Blood Flow.

PubMed

Bertlich, Mattis; Ihler, Friedrich; Weiss, Bernhard G; Freytag, Saskia; Jakob, Mark; Strupp, Michael; Pellkofer, Hannah; Canis, Martin

2017-09-01

The potential of Fingolimod (FTY-720), a sphingosine-1-phosphate analogue, to revoke the changes in cochlear blood flow induced by tumor necrosis factor (TNF) was investigated. Impairment of cochlear blood flow has often been considered as the common final pathway of various inner ear pathologies. TNF, an ubiquitous cytokine, plays a major role in these pathologies, reducing cochlear blood flow via sphingosine-1-phosphate-signaling. Fifteen Dunkin-Hartley guinea pigs were randomly assigned to one of three groups (placebo/placebo, TNF/placebo, TNF/FTY-720). Cochlear microcirculation was quantified over 60 minutes by in vivo fluorescence microscopy before and after topical application of placebo or TNF (5 ng/ml) and after subsequent application of placebo or FTY-720 (200 μg/ml). Treatment with TNF led to a significant decrease of cochlear blood flow.Following this, application of placebo caused no significant changes while application of FTY-720 caused a significant rise in cochlear blood flow. FTY-720 is capable of reversing changes in cochlear blood flow induced by application of TNF. This makes FTY-720 a valid candidate for potential treatment of numerous inner ear pathologies.

[Cochlear implantation through the middle fossa approach].

PubMed

Szyfter, W; Colletti, V; Pruszewicz, A; Kopeć, T; Szymiec, E; Kawczyński, M; Karlik, M

2001-01-01

The inner part of cochlear implant is inserted into inner ear during surgery through mastoid and middle ear. It is a classical method, used in the majority cochlear centers in the world. This is not a suitable method in case of chronic otitis media and middle ear malformation. In these cases Colletti proposed the middle fossa approach and cochlear implant insertion omitting middle ear structures. In patient with bilateral chronic otitis media underwent a few ears operations without obtaining dry postoperative cavity. Cochlear implantation through the middle fossa approach was performed in this patient. The bone fenster was cut, temporal lobe was bent and petrosus pyramid upper surface was exposed. When the superficial petrosal greater nerve, facial nerve and arcuate eminence were localised, the cochlear was open in the basal turn and electrode were inserted. The patient achieves good results in the postoperative speech rehabilitation. It confirmed Colletti tesis that deeper electrode insertion in the cochlear implantation through the middle fossa approach enable use of low and middle frequencies, which are very important in speech understanding.

United Kingdom national paediatric bilateral cochlear implant audit: preliminary results.

PubMed

Cullington, Helen; Bele, Devyanee; Brinton, Julie; Lutman, Mark

2013-11-01

Prior to 2009, United Kingdom (UK) public funding was mainly only available for children to receive unilateral cochlear implants. In 2009, the National Institute for Health and Care Excellence published guidance for cochlear implantation following their review. According to these guidelines, all suitable children are eligible to have simultaneous bilateral cochlear implants or a sequential bilateral cochlear implant if they had received the first before the guidelines were published. Fifteen UK cochlear implant centres formed a consortium to carry out a multi-centre audit. The audit involves collecting data from simultaneously and sequentially implanted children at four intervals: before bilateral cochlear implants or before the sequential implant, 1, 2, and 3 years after bilateral implants. The measures include localization, speech recognition in quiet and background noise, speech production, listening, vocabulary, parental perception, quality of life, and surgical data including complications. The audit has now passed the 2-year point, and data have been received on 850 children. This article provides a first view of some data received up until March 2012.

Musical ear syndrome in adult cochlear implant patients.

PubMed

Low, W-K; Tham, C A; D'Souza, V-D; Teng, S-W

2013-09-01

Except for a single case report, musical ear syndrome in cochlear implantees has not been studied. We aimed to study the prevalence and nature of musical ear syndrome among adult cochlear implant patients, as well as the effect on their emotional well-being. STUDY DESIGN, PATIENTS AND INTERVENTION: A cross-sectional survey of patients aged 18 years and above who had received cochlear implants for profound hearing loss between 1997 and 2010. Of the 82 patients studied, 18 (22 per cent) were found to have experienced musical ear syndrome. Seven and 11 patients had musical ear syndrome prior to and after cochlear implantation, respectively. The character of musical ear syndrome symptoms was described as instrumental music (n = 2), singing (6) or both (10). Fourteen patients reported an adverse emotional effect, with three expressing ‘intolerance’. In this study, 22 per cent of cochlear implantees experienced musical ear syndrome. These symptoms affected patients’ emotional state, but most coped well. Musical ear syndrome can occur prior to and after cochlear implantation.

Importance of cochlear health for implant function.

PubMed

Pfingst, Bryan E; Zhou, Ning; Colesa, Deborah J; Watts, Melissa M; Strahl, Stefan B; Garadat, Soha N; Schvartz-Leyzac, Kara C; Budenz, Cameron L; Raphael, Yehoash; Zwolan, Teresa A

2015-04-01

Amazing progress has been made in providing useful hearing to hearing-impaired individuals using cochlear implants, but challenges remain. One such challenge is understanding the effects of partial degeneration of the auditory nerve, the target of cochlear implant stimulation. Here we review studies from our human and animal laboratories aimed at characterizing the health of the implanted cochlea and the auditory nerve. We use the data on cochlear and neural health to guide rehabilitation strategies. The data also motivate the development of tissue-engineering procedures to preserve or build a healthy cochlea and improve performance obtained by cochlear implant recipients or eventually replace the need for a cochlear implant. This article is part of a Special Issue entitled . Copyright © 2014 Elsevier B.V. All rights reserved.

The influence of cochlear shape on low-frequency hearing.

PubMed

Manoussaki, Daphne; Chadwick, Richard S; Ketten, Darlene R; Arruda, Julie; Dimitriadis, Emilios K; O'Malley, Jen T

2008-04-22

The conventional theory about the snail shell shape of the mammalian cochlea is that it evolved essentially and perhaps solely to conserve space inside the skull. Recently, a theory proposed that the spiral's graded curvature enhances the cochlea's mechanical response to low frequencies. This article provides a multispecies analysis of cochlear shape to test this theory and demonstrates that the ratio of the radii of curvature from the outermost and innermost turns of the cochlear spiral is a significant cochlear feature that correlates strongly with low-frequency hearing limits. The ratio, which is a measure of curvature gradient, is a reflection of the ability of cochlear curvature to focus acoustic energy at the outer wall of the cochlear canal as the wave propagates toward the apex of the cochlea.

Prickle1 regulates neurite outgrowth of apical spiral ganglion neurons but not hair cell polarity in the murine cochlea

PubMed Central

Kersigo, Jennifer; Wu, Shu; Fritzsch, Bernd; Bassuk, Alexander G.

2017-01-01

In the mammalian organ of Corti (OC), the stereocilia on the apical surface of hair cells (HCs) are uniformly organized in a neural to abneural axis (or medial-laterally). This organization is regulated by planar cell polarity (PCP) signaling. Mutations of PCP genes, such as Vangl2, Dvl1/2, Celsr1, and Fzd3/6, affect the formation of HC orientation to varying degrees. Prickle1 is a PCP signaling gene that belongs to the prickle / espinas / testin family. Prickle1 protein is shown to be asymmetrically localized in the HCs of the OC, and this asymmetric localization is associated with loss of PCP in Smurf mutants, implying that Prickle1 is involved in HC PCP development in the OC. A follow-up study found no PCP polarity defects after loss of Prickle1 (Prickle1-/-) in the cochlea. We show here strong Prickle1 mRNA expression in the spiral ganglion by in situ hybridization and β-Gal staining, and weak expression in the OC by β-Gal staining. Consistent with this limited expression in the OC, cochlear HC PCP is unaffected in either Prickle1C251X/C251X mice or Prickle1f/f; Pax2-cre conditional null mice. Meanwhile, type II afferents of apical spiral ganglion neurons (SGN) innervating outer hair cells (OHC) have unusual neurite growth. In addition, afferents from the apex show unusual collaterals in the cochlear nuclei that overlap with basal turn afferents. Our findings argue against the role of Prickle1 in regulating hair cell polarity in the cochlea. Instead, Prickle1 regulates the polarity-related growth of distal and central processes of apical SGNs. PMID:28837644

Implications of High-Frequency Cochlear Dead Regions for Fitting Hearing Aids to Adults with Mild to Moderately-Severe Hearing Loss

PubMed Central

Cox, Robyn M.; Johnson, Jani A.; Alexander, Genevieve C.

2012-01-01

Short Summary It has been suggested that existence of high-frequency cochlear dead regions (DRs) has implications for hearing aid fitting, and that the optimal amount of high-frequency gain is reduced for these patients. This investigation used laboratory and field measurements to examine the effectiveness of reduced high-frequency gain in typical hearing aid users with high-frequency DRs. Both types of data revealed that speech understanding was better with the evidence-based prescription than with reduced high-frequency gain, and that this was seen for listeners with and without DRs. Nevertheless, subjects did not always prefer the amplification condition that produced better speech understanding. PMID:22555183

Multilayered tissues model for wave propagation loss assessment in cochlear implants

NASA Astrophysics Data System (ADS)

Paun, Maria-Alexandra; Dehollain, Catherine

2017-05-01

In this paper, a study of the power loss attenuation of the plane wave travelling through the tissue layers, from the outside to the inside of the skull within a cochlear implant, is performed. Different implantation depths of the internal antenna from 10 to 30 mm are considered. To this purpose, the gain and attenuation in dB are studied. A multilayer tissue model is developed, consisting of mainly skin, mastoid bone and brain. An s-parameter analysis is also carried out, using loop antennas and simulated head tissue. Ansoft Ansys® HFSS software is used for electro-magnetic simulations of the antennas, placed in different types of human tissues. Smith charts for antenna placed in both skin and multi-tissue model are included.

Physiopathology of the cochlear microcirculation.

PubMed

Shi, Xiaorui

2011-12-01

Normal blood supply to the cochlea is critically important for establishing the endocochlear potential and sustaining production of endolymph. Abnormal cochlear microcirculation has long been considered an etiologic factor in noise-induced hearing loss, age-related hearing loss (presbycusis), sudden hearing loss or vestibular function, and Meniere's disease. Knowledge of the mechanisms underlying the pathophysiology of cochlear microcirculation is of fundamental clinical importance. A better understanding of cochlear blood flow (CoBF) will enable more effective management of hearing disorders resulting from aberrant blood flow. This review focuses on recent discoveries and findings related to the physiopathology of the cochlear microvasculature. Published by Elsevier B.V.

Physiopathology of the Cochlear Microcirculation

PubMed Central

Shi, Xiaorui

2011-01-01

Normal blood supply to the cochlea is critically important for establishing the endocochlear potential and sustaining production of endolymph. Abnormal cochlear microcirculation has long been considered an etiologic factor in noise-induced hearing loss, age-related hearing loss (presbycusis), sudden hearing loss or vestibular function, and Meniere's disease. Knowledge of the mechanisms underlying the pathophysiology of cochlear microcirculation is of fundamental clinical importance. A better understanding of cochlear blood flow (CoBF) will enable more effective management of hearing disorders resulting from aberrant blood flow. This review focuses on recent discoveries and findings related to the physiopathology of the cochlear microvasculature. PMID:21875658

Hearing Loss in Adults.

ERIC Educational Resources Information Center

House, John W.

1997-01-01

This article discusses hearing loss in adults. It begins with an explanation of the anatomy of the ear and then explains the three types of hearing loss: conductive hearing loss, sensorineural hearing loss, and mixed conductive-sensorineural hearing loss. Tinnitus, hearing aids, and cochlear implants are also addressed. (CR)

Working memory in Farsi-speaking children with normal development and cochlear implant.

PubMed

Soleymani, Zahra; Amidfar, Meysam; Dadgar, Hooshang; Jalaie, Shohre

2014-04-01

Working memory has an important role in language acquisition and development of cognition skills. The ability of encoding, storage and retrieval of phonological codes, as activities of working memory, acquired by audition sense. Children with cochlear implant experience a period that they are not able to perceive sounds. In order to assess the effect of hearing on working memory, we investigated working memory as a cognition skill in children with normal development and cochlear implant. Fifty students with normal hearing and 50 students with cochlear implant aged 5-7 years participated in this study. Children educated in the preschool, the first and second grades. Children with normal development were matched based on age, gender, and grade of education with cochlear implant. Two components of working memory including phonological loop and central executive were compared between two groups. Phonological loop assessed by nonword repetition task and forward digit span. To assess central executive component backward digit span was used. The developmental trend was studied in children with normal development and cochlear implant as well. The effect of age at implantation in children with cochlear implants on components of working memory was investigated. There are significant differences between children with normal development and cochlear implant in all tasks that assess working memory (p < 0.001). The children's age at implantation was negatively correlated with all tasks (p < 0.001). In contrast, duration of usage of cochlear implant set was positively correlated with all tasks (p < 0.001). The comparison of working memory between different grades showed significant differences both in children with normal development and in children with cochlear implant (p < 0.05). These results implied that children with cochlear implant may experience difficulties in working memory. Therefore, these children have problems in encoding, practicing, and repeating phonological units. The results also suggested working memory develops when the child grows up. In cochlear implant children, with decreasing age at implantation and increasing their experience in perceiving sound, working memory skills improved. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Lack of financial barriers to pediatric cochlear implantation: impact of socioeconomic status on access and outcomes.

PubMed

Chang, David T; Ko, Alvin B; Murray, Gail S; Arnold, James E; Megerian, Cliff A

2010-07-01

(1) To analyze if socioeconomic status influences access to cochlear implantation in an environment with adequate Medicaid reimbursement. (2) To determine the impact of socioeconomic status on outcomes after unilateral cochlear implantation. Retrospective cohort study. University Hospitals Case Medical Center and Rainbow Babies and Children's Hospital (tertiary referral center), Cleveland, Ohio. Pediatric patients (age range, newborn to 18 years) who received unilateral cochlear implantation during the period 1996 to 2008. Access to cochlear implantation after referral to a cochlear implant center, postoperative complications, compliance with follow-up appointments, and access to sequential bilateral cochlear implantation. A total of 133 pediatric patients were included in this study; 64 were Medicaid-insured patients and 69 were privately insured patients. There was no statistical difference in the odds of initial cochlear implantation, age at referral, or age at implantation between the 2 groups. The odds of prelingual Medicaid-insured patients receiving sequential bilateral cochlear implantation was less than half that of the privately insured group (odds ratio [OR], 0.43; P = .03). The odds of complications in Medicaid-insured children were almost 5-fold greater than the odds for privately insured children (OR, 4.6; P = .03). There were 10 complications in 51 Medicaid-insured patients (19.6%) as opposed to 3 in 61 privately insured patients (4.9%). Medicaid-insured patients missed substantially more follow-up appointments overall (35% vs 23%) and more consecutive visits (1.9 vs 1.1) compared with privately insured patients. In an environment with adequate Medicaid reimbursement, eligible children have equal access to cochlear implantation, regardless of socioeconomic background. However, lower socioeconomic background is associated with higher rates of postoperative complications, worse follow-up compliance, and lower rates of sequential bilateral implantation, observed herein in Medicaid-insured patients. These findings present opportunities for cochlear implant centers to create programs to address such downstream disparities.

Benefit and predictive factors for speech perception outcomes in pediatric bilateral cochlear implant recipients.

PubMed

Chang, Young-Soo; Hong, Sung Hwa; Kim, Eun Yeon; Choi, Ji Eun; Chung, Won-Ho; Cho, Yang-Sun; Moon, Il Joon

2018-05-18

Despite recent advancement in the prediction of cochlear implant outcome, the benefit of bilateral procedures compared to bimodal stimulation and how we predict speech perception outcomes of sequential bilateral cochlear implant based on bimodal auditory performance in children remain unclear. This investigation was performed: (1) to determine the benefit of sequential bilateral cochlear implant and (2) to identify the associated factors for the outcome of sequential bilateral cochlear implant. Observational and retrospective study. We retrospectively analyzed 29 patients with sequential cochlear implant following bimodal-fitting condition. Audiological evaluations were performed; the categories of auditory performance scores, speech perception with monosyllable and disyllables words, and the Korean version of Ling. Audiological evaluations were performed before sequential cochlear implant with the bimodal fitting condition (CI1+HA) and one year after the sequential cochlear implant with bilateral cochlear implant condition (CI1+CI2). The good Performance Group (GP) was defined as follows; 90% or higher in monosyllable and bisyllable tests with auditory-only condition or 20% or higher improvement of the scores with CI1+CI2. Age at first implantation, inter-implant interval, categories of auditory performance score, and various comorbidities were analyzed by logistic regression analysis. Compared to the CI1+HA, CI1+CI2 provided significant benefit in categories of auditory performance, speech perception, and Korean version of Ling results. Preoperative categories of auditory performance scores were the only associated factor for being GP (odds ratio=4.38, 95% confidence interval - 95%=1.07-17.93, p=0.04). The children with limited language development in bimodal condition should be considered as the sequential bilateral cochlear implant and preoperative categories of auditory performance score could be used as the predictor in speech perception after sequential cochlear implant. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

A comparison of speech intonation production and perception abilities of Farsi speaking cochlear implanted and normal hearing children.

PubMed

Moein, Narges; Khoddami, Seyyedeh Maryam; Shahbodaghi, Mohammad Rahim

2017-10-01

Cochlear implant prosthesis facilitates spoken language development and speech comprehension in children with severe-profound hearing loss. However, this prosthesis is limited in encoding information about fundamental frequency and pitch that are essentially for recognition of speech prosody. The purpose of the present study is to investigate the perception and production of intonation in cochlear implant children and comparison with normal hearing children. This study carried out on 25 cochlear implanted children and 50 children with normal hearing. First, using 10 action pictures statements and questions sentences were extracted. Fundamental frequency and pitch changes were identified using Praat software. Then, these sentences were judged by 7 adult listeners. In second stage 20 sentences were played for child and he/she determined whether it was in a question form or statement one. Performance of cochlear implanted children in perception and production of intonation was significantly lower than children with normal hearing. The difference between fundamental frequency and pitch changes in cochlear implanted children and children with normal hearing was significant (P < 0/05). Cochlear implanted children performance in perception and production of intonation has significant correlation with child's age surgery and duration of prosthesis use (P < 0/05). The findings of the current study show that cochlear prostheses have limited application in facilitating the perception and production of intonation in cochlear implanted children. It should be noted that the child's age at the surgery and duration of prosthesis's use is important in reduction of this limitation. According to these findings, speech and language pathologists should consider intervention of intonation in treatment program of cochlear implanted children. Copyright © 2017 Elsevier B.V. All rights reserved.

The Role of MRI in Diagnosing Neurovascular Compression of the Cochlear Nerve Resulting in Typewriter Tinnitus.

PubMed

Bae, Y J; Jeon, Y J; Choi, B S; Koo, J-W; Song, J-J

2017-06-01

Typewriter tinnitus, a symptom characterized by paroxysmal attacks of staccato sounds, has been thought to be caused by neurovascular compression of the cochlear nerve, but the correlation between radiologic evidence of neurovascular compression of the cochlear nerve and symptom presentation has not been thoroughly investigated. The purpose of this study was to examine whether radiologic evidence of neurovascular compression of the cochlear nerve is pathognomonic in typewriter tinnitus. Fifteen carbamazepine-responding patients with typewriter tinnitus and 8 control subjects were evaluated with a 3D T2-weighted volume isotropic turbo spin-echo acquisition sequence. Groups 1 (16 symptomatic sides), 2 (14 asymptomatic sides), and 3 (16 control sides) were compared with regard to the anatomic relation between the vascular loop and the internal auditory canal and the presence of neurovascular compression of the cochlear nerve with/without angulation/indentation. The anatomic location of the vascular loop was not significantly different among the 3 groups (all, P > .05). Meanwhile, neurovascular compression of the cochlear nerve on MR imaging was significantly higher in group 1 than in group 3 ( P = .032). However, considerable false-positive (no symptoms with neurovascular compression of the cochlear nerve on MR imaging) and false-negative (typewriter tinnitus without demonstrable neurovascular compression of the cochlear nerve) findings were also observed. Neurovascular compression of the cochlear nerve was more frequently detected on the symptomatic side of patients with typewriter tinnitus compared with the asymptomatic side of these patients or on both sides of control subjects on MR imaging. However, considering false-positive and false-negative findings, meticulous history-taking and the response to the initial carbamazepine trial should be regarded as more reliable diagnostic clues than radiologic evidence of neurovascular compression of the cochlear nerve. © 2017 by American Journal of Neuroradiology.

Trends in cochlear implants.

PubMed

Zeng, Fan-Gang

2004-01-01

More than 60,000 people worldwide use cochlear implants as a means to restore functional hearing. Although individual performance variability is still high, an average implant user can talk on the phone in a quiet environment. Cochlear-implant research has also matured as a field, as evidenced by the exponential growth in both the patient population and scientific publication. The present report examines current issues related to audiologic, clinical, engineering, anatomic, and physiologic aspects of cochlear implants, focusing on their psychophysical, speech, music, and cognitive performance. This report also forecasts clinical and research trends related to presurgical evaluation, fitting protocols, signal processing, and postsurgical rehabilitation in cochlear implants. Finally, a future landscape in amplification is presented that requires a unique, yet complementary, contribution from hearing aids, middle ear implants, and cochlear implants to achieve a total solution to the entire spectrum of hearing loss treatment and management.

Comparison of Social Interaction between Cochlear-Implanted Children with Normal Intelligence Undergoing Auditory Verbal Therapy and Normal-Hearing Children: A Pilot Study.

PubMed

Monshizadeh, Leila; Vameghi, Roshanak; Sajedi, Firoozeh; Yadegari, Fariba; Hashemi, Seyed Basir; Kirchem, Petra; Kasbi, Fatemeh

2018-04-01

A cochlear implant is a device that helps hearing-impaired children by transmitting sound signals to the brain and helping them improve their speech, language, and social interaction. Although various studies have investigated the different aspects of speech perception and language acquisition in cochlear-implanted children, little is known about their social skills, particularly Persian-speaking cochlear-implanted children. Considering the growing number of cochlear implants being performed in Iran and the increasing importance of developing near-normal social skills as one of the ultimate goals of cochlear implantation, this study was performed to compare the social interaction between Iranian cochlear-implanted children who have undergone rehabilitation (auditory verbal therapy) after surgery and normal-hearing children. This descriptive-analytical study compared the social interaction level of 30 children with normal hearing and 30 with cochlear implants who were conveniently selected. The Raven test was administered to the both groups to ensure normal intelligence quotient. The social interaction status of both groups was evaluated using the Vineland Adaptive Behavior Scale, and statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 21. After controlling age as a covariate variable, no significant difference was observed between the social interaction scores of both the groups (p > 0.05). In addition, social interaction had no correlation with sex in either group. Cochlear implantation followed by auditory verbal rehabilitation helps children with sensorineural hearing loss to have normal social interactions, regardless of their sex.

Effects of early auditory experience on the spoken language of deaf children at 3 years of age.

PubMed

Nicholas, Johanna Grant; Geers, Ann E

2006-06-01

By age 3, typically developing children have achieved extensive vocabulary and syntax skills that facilitate both cognitive and social development. Substantial delays in spoken language acquisition have been documented for children with severe to profound deafness, even those with auditory oral training and early hearing aid use. This study documents the spoken language skills achieved by orally educated 3-yr-olds whose profound hearing loss was identified and hearing aids fitted between 1 and 30 mo of age and who received a cochlear implant between 12 and 38 mo of age. The purpose of the analysis was to examine the effects of age, duration, and type of early auditory experience on spoken language competence at age 3.5 yr. The spoken language skills of 76 children who had used a cochlear implant for at least 7 mo were evaluated via standardized 30-minute language sample analysis, a parent-completed vocabulary checklist, and a teacher language-rating scale. The children were recruited from and enrolled in oral education programs or therapy practices across the United States. Inclusion criteria included presumed deaf since birth, English the primary language of the home, no other known conditions that interfere with speech/language development, enrolled in programs using oral education methods, and no known problems with the cochlear implant lasting more than 30 days. Strong correlations were obtained among all language measures. Therefore, principal components analysis was used to derive a single Language Factor score for each child. A number of possible predictors of language outcome were examined, including age at identification and intervention with a hearing aid, duration of use of a hearing aid, pre-implant pure-tone average (PTA) threshold with a hearing aid, PTA threshold with a cochlear implant, and duration of use of a cochlear implant/age at implantation (the last two variables were practically identical because all children were tested between 40 and 44 mo of age). Examination of the independent influence of these predictors through multiple regression analysis revealed that pre-implant-aided PTA threshold and duration of cochlear implant use (i.e., age at implant) accounted for 58% of the variance in Language Factor scores. A significant negative coefficient associated with pre-implant-aided threshold indicated that children with poorer hearing before implantation exhibited poorer language skills at age 3.5 yr. Likewise, a strong positive coefficient associated with duration of implant use indicated that children who had used their implant for a longer period of time (i.e., who were implanted at an earlier age) exhibited better language at age 3.5 yr. Age at identification and amplification was unrelated to language outcome, as was aided threshold with the cochlear implant. A significant quadratic trend in the relation between duration of implant use and language score revealed a steady increase in language skill (at age 3.5 yr) for each additional month of use of a cochlear implant after the first 12 mo of implant use. The advantage to language of longer implant use became more pronounced over time. Longer use of a cochlear implant in infancy and very early childhood dramatically affects the amount of spoken language exhibited by 3-yr-old, profoundly deaf children. In this sample, the amount of pre-implant intervention with a hearing aid was not related to language outcome at 3.5 yr of age. Rather, it was cochlear implantation at a younger age that served to promote spoken language competence. The previously identified language-facilitating factors of early identification of hearing impairment and early educational intervention may not be sufficient for optimizing spoken language of profoundly deaf children unless it leads to early cochlear implantation.

Dopaminergic modulation of the voltage-gated sodium current in the cochlear afferent neurons of the rat.

PubMed

Valdés-Baizabal, Catalina; Soto, Enrique; Vega, Rosario

2015-01-01

The cochlear inner hair cells synapse onto type I afferent terminal dendrites, constituting the main afferent pathway for auditory information flow. This pathway receives central control input from the lateral olivocochlear efferent neurons that release various neurotransmitters, among which dopamine (DA) plays a salient role. DA receptors activation exert a protective role in the over activation of the afferent glutamatergic synapses, which occurs when an animal is exposed to intense sound stimuli or during hypoxic events. However, the mechanism of action of DA at the cellular level is still not completely understood. In this work, we studied the actions of DA and its receptor agonists and antagonists on the voltage-gated sodium current (INa) in isolated cochlear afferent neurons of the rat to define the mechanisms of dopaminergic control of the afferent input in the cochlear pathway. Experiments were performed using the voltage and current clamp techniques in the whole-cell configuration in primary cultures of cochlear spiral ganglion neurons (SGNs). Recordings of the INa showed that DA receptor activation induced a significant inhibition of the peak current amplitude, leading to a significant decrease in cell excitability. Inhibition of the INa was produced by a phosphorylation of the sodium channels as shown by the use of phosphatase inhibitor that produced an inhibition analogous to that caused by DA receptor activation. Use of specific agonists and antagonists showed that inhibitory action of DA was mediated both by activation of D1- and D2-like DA receptors. The action of the D1- and D2-like receptors was shown to be mediated by a Gαs/AC/cAMP/PKA and Gαq/PLC/PKC pathways respectively. These results showed that DA receptor activation constitutes a significant modulatory input to SGNs, effectively modulating their excitability and information flow in the auditory pathway.

Use of suprathreshold stochastic resonance in cochlear implant coding

NASA Astrophysics Data System (ADS)

Allingham, David; Stocks, Nigel G.; Morse, Robert P.

2003-05-01

In this article we discuss the possible use of a novel form of stochastic resonance, termed suprathreshold stochastic resonance (SSR), to improve signal encoding/transmission in cochlear implants. A model, based on the leaky-integrate-and-fire (LIF) neuron, has been developed from physiological data and use to model information flow in a population of cochlear nerve fibers. It is demonstrated that information flow can, in principle, be enhanced by the SSR effect. Furthermore, SSR was found to enhance information transmission for signal parameters that are commonly encountered in cochlear implants. This, therefore, gives hope that SSR may be implemented in cochlear implants to improve speech comprehension.

Round-window delivery of neurotrophin 3 regenerates cochlear synapses after acoustic overexposure.

PubMed

Suzuki, Jun; Corfas, Gabriel; Liberman, M Charles

2016-04-25

In acquired sensorineural hearing loss, such as that produced by noise or aging, there can be massive loss of the synaptic connections between cochlear sensory cells and primary sensory neurons, without loss of the sensory cells themselves. Because the cell bodies and central projections of these cochlear neurons survive for months to years, there is a long therapeutic window in which to re-establish functional connections and improve hearing ability. Here we show in noise-exposed mice that local delivery of neurotrophin-3 (NT-3) to the round window niche, 24 hours after an exposure that causes an immediate loss of up to 50% loss of synapses in the cochlear basal region, can regenerate pre- and post-synaptic elements at the hair cell / cochlear nerve interface. This synaptic regeneration, as documented by confocal microscopy of immunostained cochlear sensory epithelia, was coupled with a corresponding functional recovery, as seen in the suprathreshold amplitude of auditory brainstem response Wave 1. Cochlear delivery of neurotrophins in humans is likely achievable as an office procedure via transtympanic injection, making our results highly significant in a translational context.

Programmable shunt valve interactions with osseointegrated hearing devices.

PubMed

Pierson, Matthew J; Wehrmann, Daniel; Albers, J Andrew; El Tecle, Najib E; Costa, Dary; Elbabaa, Samer K

2017-04-01

OBJECTIVE Patients with ventriculoperitoneal (VP) shunts with programmable valves who would benefit from osseointegrated hearing devices (OIHDs) represent a unique population. The aim of this study was to evaluate the magnetic field strengths of 4 OIHDs and their interactions with 5 programmable VP shunt valves. METHODS Magnetic field strength was measured as a function of distance for each hearing device (Cochlear Baha 5, Cochlear Baha BP110, Oticon Ponto Plus Power, and Medtronic Sophono) in the following modes: inactive, active in quiet, and active in 60 decibels of background noise in the sound booth. The hearing devices were introduced to each shunt valve (Aesculap proGAV, Aesculap proGAV 2.0, Codman Hakim, Codman Certas, and Medtronic Strata II) also as a function of distance in these identical 3 settings. Each trial was repeated 5 times. Between each trial, the valves were assessed for a change in setting. Finally, using a skull model, the devices were introduced to each other in standard anatomical locations and the valves were assessed for a change in settings. RESULTS The maximum magnetic field strengths generated by the Cochlear Baha 5, BP110, and Oticon OIHDs were 1.1, 36.2, and 48.7 gauss (G), respectively. The maximum strength generated by the Sophono device was > 800 G. The magnetic field strength of the hearing devices decreased markedly with increasing distance from the device. The strength of the Sophono's magnetic attachment decreased to 34.8 G at 5 mm. The Codman Hakim, Codman Certas, and Medtronic Strata II valve settings changed when rotating the valves next to the Sophono abutment. No other changes in valve settings occurred in the distance or anatomical models for any other trials. CONCLUSIONS This is the first study evaluating the interaction between OIHDs and programmable VP shunt valves. The findings suggest that it is safe to use these devices together without having to switch to a nonprogrammable valve or move the shunt valve to a more distant location. Still, care should be taken if the Sophono device is used to ensure that the valve is ≥ 5 mm away from the magnetic attachment.

Olivocochlear neuron central anatomy is normal in alpha 9 knockout mice.

PubMed

Brown, M Christian; Vetter, Douglas E

2009-03-01

Olivocochlear (OC) neurons were studied in a transgenic mouse with deletion of the alpha 9 nicotinic acetylcholine receptor subunit. In this alpha 9 knockout mouse, the peripheral effects of OC stimulation are lacking and the peripheral terminals of OC neurons under outer hair cells have abnormal morphology. To account for this mouse's apparently normal hearing, it has been proposed to have central compensation via collateral branches to the cochlear nucleus. We tested this idea by staining OC neurons for acetylcholinesterase and examining their morphology in knockout mice, wild-type mice of the same background strain, and CBA/CaJ mice. Knockout mice had normal OC systems in terms of numbers of OC neurons, dendritic patterns, and numbers of branches to the cochlear nucleus. The branch terminations were mainly to edge regions and to a lesser extent the core of the cochlear nucleus, and were similar among the strains in terms of the distribution and staining density. These data demonstrate that there are no obvious changes in the central morphology of the OC neurons in alpha 9 knockout mice and make less attractive the idea that there is central compensation for deletion of the peripheral receptor in these mice.

Frequency modulation detection in cochlear implant subjects

NASA Astrophysics Data System (ADS)

Chen, Hongbin; Zeng, Fan-Gang

2004-10-01

Frequency modulation (FM) detection was investigated in acoustic and electric hearing to characterize cochlear-implant subjects' ability to detect dynamic frequency changes and to assess the relative contributions of temporal and spectral cues to frequency processing. Difference limens were measured for frequency upward sweeps, downward sweeps, and sinusoidal FM as a function of standard frequency and modulation rate. In electric hearing, factors including electrode position and stimulation level were also studied. Electric hearing data showed that the difference limen increased monotonically as a function of standard frequency regardless of the modulation type, the modulation rate, the electrode position, and the stimulation level. In contrast, acoustic hearing data showed that the difference limen was nearly a constant as a function of standard frequency. This difference was interpreted to mean that temporal cues are used only at low standard frequencies and at low modulation rates. At higher standard frequencies and modulation rates, the reliance on the place cue is increased, accounting for the better performance in acoustic hearing than for electric hearing with single-electrode stimulation. The present data suggest a speech processing strategy that encodes slow frequency changes using lower stimulation rates than those typically employed by contemporary cochlear-implant speech processors. .

Prevention of Noise Damage to Cochlear Synapses

DTIC Science & Technology

2015-10-01

AWARD NUMBER: W81XWH-14-1-0494 TITLE: Prevention of Noise Damage to Cochlear Synapses PRINCIPAL INVESTIGATOR: Steven Green CONTRACTING...to Cochlear Synapses 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-1-0494 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Steven Green 5d. PROJECT...ABSTRACT Noise-induced synaptopathy is the result of excitotoxic trauma to cochlear synapses due to glutamate released from the hair cells. Excitotoxic

Preventing Ototoxic Synergy of Prior Noise Trauma During Aminoglycoside Therapy

DTIC Science & Technology

2015-12-01

cochlear blood flow . Hearing Research 313, 38-46 (2014). 12. Koo, J.-W. et al. Endotoxemia-mediated inflammation potentiates cochlear uptake of...event in response to a need for higher cochlear blood flow . A 3.7% dilation was adequate for a 20% increase of blood flow 10. On the contrary...summation of the two insults. We have found that prior sound exposure enhances cochlear uptake of aminoglycosides, providing a mechanistic basis for the

Scala vestibuli cochlear implantation in patients with partially ossified cochleas.

PubMed

Berrettini, Stefano; Forli, Francesca; Neri, Emanuele; Segnini, Giovanni; Franceschini, Stefano Sellari

2002-11-01

Partial cochlear obstruction is a relatively common finding in candidates for cochlear implants and frequently involves the inferior segment of the scala tympani in the basal turn of the cochlea. In such patients, the scala vestibuli is often patent and offers an alternative site for implantation. The current report describes two patients with such partial obstruction of the inferior segment of the basal cochlear turn, caused in one case by systemic vasculitis (Takayasu's disease) and in the other by obliterative otosclerosis. A scala vestibuli implantation allowed for complete insertion of the electrode array. No problems were encountered during the surgical procedures and the good post-operative hearing and communicative outcomes achieved were similar to those reported in patients without cochlear ossification. The importance of accurate pre-operative radiological study of the inner ear is underscored, to disclose the presence and define the features of the cochlear ossification and ultimately to properly plan the surgical approach.

Hearing rehabilitation with a binaural cochlear implant in a patient with Erdheim-Chester disease.

PubMed

Querat, Charlotte; Thai-Van, Hung; Durand, Denis Vital; Cotton, François; Gallego, Stéphane; Truy, Eric

2015-09-01

Erdheim-Chester disease (ECD) is a rare non-Langerhans form of histiocytosis. This paper reports an exceptional case of bilateral neural involvement, responsible for profound hearing loss. Bilateral cochlear implantation was performed. We present a 57-year-old man affected by ECD with profound bilateral hearing loss. The patient underwent cochlear implantation with a binaural Digisonic(®) cochlear implant, 7 years after the initial diagnosis. Speech intelligibility rose to a plateau after about 6 months of cochlear implant use. The average outcome of speech intelligibility over time was 55% for dissyllabic words without lip reading, and 70% for sentences. Perception score decreased before the patient died from ECD. A description of the ECD and its otological manifestations is presented. This paper reports the effective hearing rehabilitation of profound bilateral hearing loss by the means of a binaural Digisonic(®) cochlear implant.

Spiral Form of the Human Cochlea Results from Spatial Constraints.

PubMed

Pietsch, M; Aguirre Dávila, L; Erfurt, P; Avci, E; Lenarz, T; Kral, A

2017-08-08

The human inner ear has an intricate spiral shape often compared to shells of mollusks, particularly to the nautilus shell. It has inspired many functional hearing theories. The reasons for this complex geometry remain unresolved. We digitized 138 human cochleae at microscopic resolution and observed an astonishing interindividual variability in the shape. A 3D analytical cochlear model was developed that fits the analyzed data with high precision. The cochlear geometry neither matched a proposed function, namely sound focusing similar to a whispering gallery, nor did it have the form of a nautilus. Instead, the innate cochlear blueprint and its actual ontogenetic variants were determined by spatial constraints and resulted from an efficient packing of the cochlear duct within the petrous bone. The analytical model predicts well the individual 3D cochlear geometry from few clinical measures and represents a clinical tool for an individualized approach to neurosensory restoration with cochlear implants.

Trends in Cochlear Implants

PubMed Central

Zeng, Fan-Gang

2004-01-01

More than 60,000 people worldwide use cochlear implants as a means to restore functional hearing. Although individual performance variability is still high, an average implant user can talk on the phone in a quiet environment. Cochlear-implant research has also matured as a field, as evidenced by the exponential growth in both the patient population and scientific publication. The present report examines current issues related to audiologic, clinical, engineering, anatomic, and physiologic aspects of cochlear implants, focusing on their psychophysical, speech, music, and cognitive performance. This report also forecasts clinical and research trends related to presurgical evaluation, fitting protocols, signal processing, and postsurgical rehabilitation in cochlear implants. Finally, a future landscape in amplification is presented that requires a unique, yet complementary, contribution from hearing aids, middle ear implants, and cochlear implants to achieve a total solution to the entire spectrum of hearing loss treatment and management. PMID:15247993

Ion flow in cochlear hair cells and the regulation of hearing sensitivity.

PubMed

Patuzzi, Robert

2011-10-01

This paper discusses how ion transport proteins in the hair cells of the mammalian cochlea work to produce a sensitive but stable hearing organ. The transport proteins in the inner and outer hair cells are summarized (including their current voltage characteristics), and the roles of these proteins in determining intracellular Ca(2+), membrane potential, and ultimately cochlear sensitivity are discussed. The paper also discusses the role of the Ca(2+) sequestration sacs in outer hair cells in the autoregulation of hair cell membrane potential and cochlear gain, and how the underdamped control of Ca(2+) within these sacs may produce the observed slow oscillations in cochlear sensitivity and otoacoustic emissions after cochlear perturbations, including perilymphatic perfusions and prolonged low-frequency tones. The relative insensitivity of cochlear gain to short-term changes in the endocochlear potential is also discussed. Copyright © 2011 Elsevier B.V. All rights reserved.

Should children who use cochlear implants wear hearing aids in the opposite ear?

PubMed

Ching, T Y; Psarros, C; Hill, M; Dillon, H; Incerti, P

2001-10-01

The aim of this study was to investigate 1) whether a hearing aid needs to be adjusted differently depending on whether a child wears a cochlear implant or another hearing aid in the contralateral ear; 2) whether the use of a hearing aid and a cochlear implant in opposite ears leads to binaural interference; and 3) whether the use of a hearing aid and a cochlear implant in opposite ears leads to binaural benefits in speech perception, localization, and communicative functioning in real life. Sixteen children participated in this study. All children used a Nucleus 22 or Nucleus 24 cochlear implant system programmed with the SPEAK strategy in one ear. The hearing aid amplification requirements in the nonimplanted ear of these children were determined using two procedures. A paired comparison technique was used to identify the frequency response that was best for speech intelligibility in quiet, and a loudness balancing technique was used to match the loudness of speech in the ear with a hearing aid to that with a cochlear implant. Eleven of the 16 children participated in the investigation of binaural effects. Performance in speech perception, localization, and communicative functioning was assessed under four aided conditions: cochlear implant with hearing aid as worn, cochlear implant alone, hearing aid alone, and cochlear implant with hearing aid adjusted according to individual requirements. Fifteen of the 16 children whose amplification requirements were determined preferred a hearing aid frequency response that was within +/-6 dB/octave of the NAL-RP prescription. On average, the children required 6 dB more gain than prescribed to balance the loudness of the implanted ear for a speech signal presented at 65 dB SPL. For all 11 children whose performance was evaluated for investigating binaural effects, there was no indication of significantly poorer performance under bilaterally aided conditions compared with unilaterally aided conditions. On average, there were significant benefits in speech perception, localization, and aural/oral function when the children used cochlear implants with adjusted hearing aids than when they used cochlear implants alone. All individuals showed benefits in at least one of the measures. Hearing aids for children who also use cochlear implants can be selected using the NAL-RP prescription. Adjustment of hearing aid gain to match loudness in the implanted ear can facilitate integration of signals from both ears, leading to better speech perception. Given that there are binaural advantages from using cochlear implants with hearing aids in opposite ears, clinicians should advise parents and other professionals about these potential advantages, and facilitate bilateral amplification by adjusting hearing aids after stable cochlear implant MAPs are established.

Standardization of reliability reporting for cochlear implants: an interim report.

PubMed

Backous, Douglas D; Watson, Stacey D

2007-04-01

To propose a standard definition of "out of specification" for cochlear implants and a paradigm for inclusion of category C of the ISO standard 5841-2:2000 for reporting in cumulative survival statistics. A standard definition of "out of specification" and consistent reporting by manufacturers of cochlear implants will create a fair and consistent representation of cumulative survival. This will allow discernment of differences between manufacturers for reliability and for detection of trends in reliability between model types from the same manufacturer. Three separate meetings with representatives of the three manufacturers of cochlear implants marketed in the United States were staged over a 13-mo period. Standard questions, created by the authors, were addressed by each representative to determine the current state of device reliability reporting. Results were presented to clinicians at the William House Cochlear Implant study Group and the Implantable devices sub-committee of the American Academy of Otolaryngology (2004, 2005) and at the 8th International Cochlear Implant Conference (2004) for feedback. After assimilation of feedback by all parties, the standard was written and reviewed by representatives from each manufacturer for accuracy of data. A complaint-driven standard was developed. A "cochlear implant" as an internal device placed and skin closed in surgery. An internal device is "out of specification" when one or more technical characteristics is outside the limits of normal function and results in explantation or non-use by the patient." Children will be reported separately from adults, each model of device will be reported on annually, a minimum of 200 devices must be in each model group for Cumulative Survival Reporting (CSR). Confidence limits are set at 95%. Explants will be determined to be "biological" or "technical." Technical explants are included in CSR reports. Devices failing to meet specifications set by the manufacturer, not in use but still in situ due to patient choice not to be re-implanted are considered category C and included in CSR reports. Implants that cannot be classified at explant are placed in an "under investigation" category while evaluation is completed. If no classification is made by 6 months, these devices will be included in the CSR report. Notification to the implant center regarding "in" or "out of specification" will be made within 60 d of the explant arriving at the manufacturer with final root cause of failure reported to centers when complete. Information will be passed on to patients by members of the implant team. A standardized form will be created to provide the manufacturers with necessary patient information to guide reliability analysis, including performance after re-implant. The standard for reliability reporting described in this paper improves patient care by presenting data which are understandable to clinicians delivering cochlear implant services. It fosters fair and accurate reporting without discriminating or granting perceived advantage to any manufacturer. This standard provides a basis for reporting research related to or including device reliability in the medical literature.

Cell migration, intercalation and growth regulate mammalian cochlear extension.

PubMed

Driver, Elizabeth Carroll; Northrop, Amy; Kelley, Matthew W

2017-10-15

Developmental remodeling of the sensory epithelium of the cochlea is required for the formation of an elongated, tonotopically organized auditory organ, but the cellular processes that mediate these events are largely unknown. We used both morphological assessments of cellular rearrangements and time-lapse imaging to visualize cochlear remodeling in mouse. Analysis of cell redistribution showed that the cochlea extends through a combination of radial intercalation and cell growth. Live imaging demonstrated that concomitant cellular intercalation results in a brief period of epithelial convergence, although subsequent changes in cell size lead to medial-lateral spreading. Supporting cells, which retain contact with the basement membrane, exhibit biased protrusive activity and directed movement along the axis of extension. By contrast, hair cells lose contact with the basement membrane, but contribute to continued outgrowth through increased cell size. Regulation of cellular protrusions, movement and intercalation within the cochlea all require myosin II. These results establish, for the first time, many of the cellular processes that drive the distribution of sensory cells along the tonotopic axis of the cochlea. © 2017. Published by The Company of Biologists Ltd.

Effects of central nervous system residua on cochlear implant results in children deafened by meningitis.

PubMed

Francis, Howard W; Pulsifer, Margaret B; Chinnici, Jill; Nutt, Robert; Venick, Holly S; Yeagle, Jennifer D; Niparko, John K

2004-05-01

This study explored factors associated with speech recognition outcomes in postmeningitic deafness (PMD). The results of cochlear implantation may vary in children with PMD because of sequelae that extend beyond the auditory periphery. To determine which factors might be most determinative of outcome of cochlear implantation in children with PMD. Retrospective chart review. A referral center for pediatric cochlear implantation and rehabilitation. Thirty children with cochlear implants who were deafened by meningitis were matched with subjects who were deafened by other causes based on the age at diagnosis, age at cochlear implantation, age at which hearing aids were first used, and method of communication used at home or in the classroom. Speech perception performance within the first 2 years after cochlear implantation and its relationship with presurgical cognitive measures and medical history. There was no difference in the overall cognitive or postoperative speech perception performance between the children with PMD and those deafened by other causes. The presence of postmeningitic hydrocephalus, however, posed greater challenges to the rehabilitation process, as indicated by significantly smaller gains in speech perception and a predilection for behavioral problems. By comparison, cochlear scarring and incomplete electrode insertion had no impact on speech perception results. Although the results demonstrated no significant delay in cognitive or speech perception performance in the PMD group, central nervous system residua, when present, can impede the acquisition of speech perception with a cochlear implant. Central effects associated with PMD may thus impact language learning potential; cognitive and behavioral therapy should be considered in rehabilitative planning and in establishing expectations of outcome.

A Preliminary Investigation of the Air-Bone Gap: Changes in Intracochlear Sound Pressure With Air- and Bone-conducted Stimuli After Cochlear Implantation.

PubMed

Banakis Hartl, Renee M; Mattingly, Jameson K; Greene, Nathaniel T; Jenkins, Herman A; Cass, Stephen P; Tollin, Daniel J

2016-10-01

A cochlear implant electrode within the cochlea contributes to the air-bone gap (ABG) component of postoperative changes in residual hearing after electrode insertion. Preservation of residual hearing after cochlear implantation has gained importance as simultaneous electric-acoustic stimulation allows for improved speech outcomes. Postoperative loss of residual hearing has previously been attributed to sensorineural changes; however, presence of increased postoperative ABG remains unexplained and could result in part from altered cochlear mechanics. Here, we sought to investigate changes to these mechanics via intracochlear pressure measurements before and after electrode implantation to quantify the contribution to postoperative ABG. Human cadaveric heads were implanted with titanium fixtures for bone conduction transducers. Velocities of stapes capitulum and cochlear promontory between the two windows were measured using single-axis laser Doppler vibrometry and fiber-optic sensors measured intracochlear pressures in scala vestibuli and tympani for air- and bone-conducted stimuli before and after cochlear implant electrode insertion through the round window. Intracochlear pressures revealed only slightly reduced responses to air-conducted stimuli consistent with previous literature. No significant changes were noted to bone-conducted stimuli after implantation. Velocities of the stapes capitulum and the cochlear promontory to both stimuli were stable after electrode placement. Presence of a cochlear implant electrode causes alterations in intracochlear sound pressure levels to air, but not bone, conducted stimuli and helps to explain changes in residual hearing noted clinically. These results suggest the possibility of a cochlear conductive component to postoperative changes in hearing sensitivity.

Mutations in the VLGR1 Gene Implicate G-Protein Signaling in the Pathogenesis of Usher Syndrome Type II

PubMed Central

Weston, Michael D.; Luijendijk, Mirjam W. J.; Humphrey, Kurt D.; Möller, Claes; Kimberling, William J.

2004-01-01

Usher syndrome type II (USH2) is a genetically heterogeneous autosomal recessive disorder with at least three genetic subtypes (USH2A, USH2B, and USH2C) and is classified phenotypically as congenital hearing loss and progressive retinitis pigmentosa. The VLGR1 (MASS1) gene in the 5q14.3-q21.1 USH2C locus was considered a likely candidate on the basis of its protein motif structure and expressed-sequence-tag representation from both cochlear and retinal subtracted libraries. Denaturing high-performance liquid chromatography and direct sequencing of polymerase-chain-reaction products amplified from 10 genetically independent patients with USH2C and 156 other patients with USH2 identified four isoform-specific VLGR1 mutations (Q2301X, I2906FS, M2931FS, and T6244X) from three families with USH2C, as well as two sporadic cases. All patients with VLGR1 mutations are female, a significant deviation from random expectations. The ligand(s) for the VLGR1 protein is unknown, but on the basis of its potential extracellular and intracellular protein-protein interaction domains and its wide mRNA expression profile, it is probable that VLGR1 serves diverse cellular and signaling processes. VLGR1 mutations have been previously identified in both humans and mice and are associated with a reflex-seizure phenotype in both species. The identification of additional VLGR1 mutations to test whether a phenotype/genotype correlation exists, akin to that shown for other Usher syndrome disease genes, is warranted. PMID:14740321

The Role of Telemedicine in Auditory Rehabilitation: A Systematic Review

PubMed Central

Bush, Matthew L.; Thompson, Robin; Irungu, Catherine; Ayugi, John

2016-01-01

Objective The purpose of this study was to assess the feasibility and effectiveness of live telemedicine applications in hearing amplification and cochlear implantation. Data Sources and Study Selection A systematic search was performed in PubMed, MEDLINE, PsychINFO, CINALH, and Web of Science to identify peer-reviewed research. Inclusion criteria were titles containing words from the search terms (1) audiology, otolaryngology, and hearing impairment, (2) rehabilitative methods, and (3) telemedicine. Exclusion criteria were 1) non-English articles, and 2) non-original research. Data Extraction and Synthesis Twelve eligible studies were identified. The studies employed a prospective design in nine of the articles and retrospective case series in three. The use of telemedicine for the provision of cochlear implant services was examined in eight of the articles and with hearing aids in four of the articles. The types of services include intraoperative cochlear implant telemetry; implant programming and assessment of electrode-specific measures and speech recognition after implantation. Hearing aid programming and remote gain assessments were also reported. Many studies assess patient and provider satisfaction along with encounter time comparison. The studies occurred from 2009–2014 and took place in seven countries. Conclusions This review examined the feasibility of remote telemedicine connection to provide in auditory rehabilitation services through hearing aids and cochlear implants. There are significant concerns regarding Internet bandwidth limitations for remote clinics. There is a paucity of research examining reimbursement and cost-effectiveness for services. Further prospective research investigating cost-effectiveness and bandwidth limitations is warranted to assess long-term sustainability of remote audiological rehabilitative service delivery. PMID:27755363

Neural Stem Cells Injected into the Sound-Damaged Cochlea Migrate Throughout the Cochlea and Express Markers of Hair Cells, Supporting Cells, and Spiral Ganglion Cells

PubMed Central

Corliss, Deborah A.; Gray, Brianna; Anderson, Julia K.; Bobbin, Richard P.; Snyder, Evan Y.; Cotanche, Douglas A.

2007-01-01

Most cases of hearing loss are caused by the death or dysfunction of one of the many cochlear cell types. We examined whether cells from a neural stem cell line could replace cochlear cell types lost after exposure to intense noise. For this purpose, we transplanted a clonal stem cell line into the scala tympani of sound damaged mice and guinea pigs. Utilizing morphological, protein expression and genetic criteria, stem cells were found with characteristics of both neural tissues (satellite, spiral ganglion and Schwann cells) and cells of the organ of Corti (hair cells, supporting cells). Additionally, noise-exposed, stem cell-injected animals exhibited a small but significant increase in the number of satellite cells and Type I spiral ganglion neurons compared to non-injected noise-exposed animals. These results indicate that cells of this neural stem cell line migrate from the scala tympani to Rosenthal's canal and the organ of Corti. Moreover, it suggests that cells of this neural stem cell line may derive some information needed from the microenvironment of the cochlea to differentiate into replacement cells in the cochlea. PMID:17659854

The music perception abilities of prelingually deaf children with cochlear implants.

PubMed

Stabej, Katja Kladnik; Smid, Lojze; Gros, Anton; Zargi, Miha; Kosir, Andrej; Vatovec, Jagoda

2012-10-01

To investigate the music perception abilities of prelingually deaf children with cochlear implants, in comparison to a group of normal-hearing children, and to consider the factors that contribute to music perception. The music perception abilities of 39 prelingually deaf children with unilateral cochlear implants were compared to the abilities of 39 normal hearing children. To assess the music listening abilities, the MuSIC perception test was adopted. The influence of the child's age, age at implantation, device experience and type of sound-processing strategy on the music perception were evaluated. The effects of auditory performance, nonverbal intellectual abilities, as well as the child's additional musical education on music perception were also considered. Children with cochlear implants and normal hearing children performed significantly differently with respect to rhythm discrimination (55% vs. 82%, p<0.001), instrument identification (57% vs. 88%, p<0.001) and emotion rating (p=0.022). However we found no significant difference in terms of melody discrimination and dissonance rating between the two groups. There was a positive correlation between auditory performance and melody discrimination (r=0.27; p=0.031), between auditory performance and instrument identification (r=0.20; p=0.059) and between the child's grade (mark) in school music classes and melody discrimination (r=0.34; p=0.030). In children with cochlear implant only, the music perception ability assessed by the emotion rating test was negatively correlated to the child's age (r(S)=-0.38; p=0.001), age at implantation (r(S)=-0.34; p=0.032), and device experience (r(S)=-0.38; p=0.019). The child's grade in school music classes showed a positive correlation to music perception abilities assessed by rhythm discrimination test (r(S)=0.46; p<0.001), melody discrimination test (r(S)=0.28; p=0.018), and instrument identification test (r(S)=0.23; p=0.05). As expected, there was a marked difference in the music perception abilities of prelingually deaf children with cochlear implants in comparison to the group of normal hearing children, but not for all the tests of music perception. Additional multi-centre studies, including a larger number of participants and a broader spectrum of music subtests, considering as many as possible of the factors that may contribute to music perception, seem reasonable. Copyright © 2012. Published by Elsevier Ireland Ltd.

Cochlear implants in Waardenburg syndrome.

PubMed

Cullen, Robert D; Zdanski, Carlton; Roush, Patricia; Brown, Carolyn; Teagle, Holly; Pillsbury, Harold C; Buchman, Craig

2006-07-01

Waardenburg syndrome is an autosomal-dominant syndrome characterized by dystopia canthorum, hyperplasia of the eyebrows, heterochromia irides, a white forelock, and sensorineural hearing loss in 20% to 55% of patients. This patient population accounts for approximately 2% of congenitally deaf children. The purpose of this retrospective case review was to describe the outcomes for those children with Waardenburg syndrome who have undergone cochlear implantation. Pediatric cochlear implant recipients with documented evidence of Waardenburg syndrome underwent retrospective case review. All patients received their cochlear implants at the study institution followed by outpatient auditory habilitation. Charts were reviewed for etiology and duration of deafness, age at time of cochlear implantation, perioperative complications, duration of use, and performance outcomes. Results of standard tests batteries for speech perception and production administered as a part of the patients' auditory habilitation were reviewed. Seven patients with Waardenburg syndrome and cochlear implants were identified. The average age at implantation was 37 months (range, 18-64 months) and the average duration of use was 69 months (range, 12-143 months). All of these patients are active users of their devices and perform very well after implantation. There were no major complications in this small group of patients. Children with congenital sensorineural hearing loss without other comorbidities (e.g., developmental delay, inner ear malformations) perform well when they receive cochlear implantation and auditory habilitation. Patients with Waardenburg syndrome can be expected to have above-average performance after cochlear implantation.

Cognitive development in children with cochlear implants: relations to reading and communication.

PubMed

Lyxell, Björn; Sahlén, Birgitta; Wass, Malin; Ibertsson, Tina; Larsby, Birgitta; Hällgren, Mathias; Mäki-Torkko, Elina

2008-11-01

The purpose of the present article is to present an overview of a set of studies conducted in our own laboratory on cognitive and communicative development in children with cochlear implants (CI). The results demonstrate that children with CIs perform at significantly lower levels on the majority of the cognitive tasks. The exceptions to this trend are tasks with relatively lower demands on phonological processing. A fairly high proportion of the children can reach a level of reading comprehension that matches hearing children, despite the fact that they have relatively poor phonological skills. General working memory capacity is further correlated with the type of questions asked in a referential communication task. The results are discussed with respect to issues related to education and rehabilitation.

Surgical Management of the Pediatric Cochlear Implant Patient.

ERIC Educational Resources Information Center

Cohen, Seth M.; Haynes, David S.

2003-01-01

This article discusses the surgical management of children receiving cochlear implants. It identifies preoperative considerations to select patients likely to benefit, contraindications, some new surgical techniques, complications, special considerations (otitis media, meningitis, head growth, inner ear malformations, and cochlear obstruction).…

Benefits of Localization and Speech Perception with Multiple Noise Sources in Listeners with a Short-electrode Cochlear Implant

PubMed Central

Dunn, Camille C.; Perreau, Ann; Gantz, Bruce; Tyler, Richard

2009-01-01

Background Research suggests that for individuals with significant low-frequency hearing, implantation of a short-electrode cochlear implant may provide benefits of improved speech perception abilities. Because this strategy combines acoustic and electrical hearing within the same ear while at the same time preserving low-frequency residual acoustic hearing in both ears, localization abilities may also be improved. However, very little research has focused on the localization and spatial hearing abilities of users with a short-electrode cochlear implant. Purpose The purpose of this study was to evaluate localization abilities for listeners with a short-electrode cochlear implant who continue to wear hearing aids in both ears. A secondary purpose was to document speech perception abilities using a speech in noise test with spatially-separate noise sources. Research Design Eleven subjects that utilized a short-electrode cochlear implant and bilateral hearing aids were tested on localization and speech perception with multiple noise locations using an eight-loudspeaker array. Performance was assessed across four listening conditions using various combinations of cochlear implant and/or hearing aid use. Results Results for localization showed no significant difference between using bilateral hearing aids and bilateral hearing aids plus the cochlear implant. However, there was a significant difference between the bilateral hearing aid condition and the implant plus use of a contralateral hearing aid for all eleven subjects. Results for speech perception showed a significant benefit when using bilateral hearing aids plus the cochlear implant over use of the implant plus only one hearing aid. Conclusion Combined use of both hearing aids and the cochlear implant show significant benefits for both localization and speech perception in noise for users with a short-electrode cochlear implant. These results emphasize the importance of low-frequency information in two ears for the purpose of localization and speech perception in noise. PMID:20085199

Benefits of localization and speech perception with multiple noise sources in listeners with a short-electrode cochlear implant.

PubMed

Dunn, Camille C; Perreau, Ann; Gantz, Bruce; Tyler, Richard S

2010-01-01

Research suggests that for individuals with significant low-frequency hearing, implantation of a short-electrode cochlear implant may provide benefits of improved speech perception abilities. Because this strategy combines acoustic and electrical hearing within the same ear while at the same time preserving low-frequency residual acoustic hearing in both ears, localization abilities may also be improved. However, very little research has focused on the localization and spatial hearing abilities of users with a short-electrode cochlear implant. The purpose of this study was to evaluate localization abilities for listeners with a short-electrode cochlear implant who continue to wear hearing aids in both ears. A secondary purpose was to document speech perception abilities using a speech-in-noise test with spatially separate noise sources. Eleven subjects that utilized a short-electrode cochlear implant and bilateral hearing aids were tested on localization and speech perception with multiple noise locations using an eight-loudspeaker array. Performance was assessed across four listening conditions using various combinations of cochlear implant and/or hearing aid use. Results for localization showed no significant difference between using bilateral hearing aids and bilateral hearing aids plus the cochlear implant. However, there was a significant difference between the bilateral hearing aid condition and the implant plus use of a contralateral hearing aid for all 11 subjects. Results for speech perception showed a significant benefit when using bilateral hearing aids plus the cochlear implant over use of the implant plus only one hearing aid. Combined use of both hearing aids and the cochlear implant show significant benefits for both localization and speech perception in noise for users with a short-electrode cochlear implant. These results emphasize the importance of low-frequency information in two ears for the purpose of localization and speech perception in noise.

Quantitative polarized light microscopy of unstained mammalian cochlear sections

NASA Astrophysics Data System (ADS)

Kalwani, Neil M.; Ong, Cheng Ai; Lysaght, Andrew C.; Haward, Simon J.; McKinley, Gareth H.; Stankovic, Konstantina M.

2013-02-01

Hearing loss is the most common sensory deficit in the world, and most frequently it originates in the inner ear. Yet, the inner ear has been difficult to access for diagnosis because of its small size, delicate nature, complex three-dimensional anatomy, and encasement in the densest bone in the body. Evolving optical methods are promising to afford cellular diagnosis of pathologic changes in the inner ear. To appropriately interpret results from these emerging technologies, it is important to characterize optical properties of cochlear tissues. Here, we focus on that characterization using quantitative polarized light microscopy (qPLM) applied to unstained cochlear sections of the mouse, a common animal model of human hearing loss. We find that the most birefringent cochlear materials are collagen fibrils and myelin. Retardance of the otic capsule, the spiral ligament, and the basilar membrane are substantially higher than that of other cochlear structures. Retardance of the spiral ligament and the basilar membrane decrease from the cochlear base to the apex, compared with the more uniform retardance of other structures. The intricate structural details revealed by qPLM of unstained cochlear sections ex vivo strongly motivate future application of polarization-sensitive optical coherence tomography to human cochlea in vivo.

Quantitative polarized light microscopy of unstained mammalian cochlear sections

PubMed Central

Kalwani, Neil M.; Ong, Cheng Ai; Lysaght, Andrew C.; Haward, Simon J.; McKinley, Gareth H.

2013-01-01

Abstract. Hearing loss is the most common sensory deficit in the world, and most frequently it originates in the inner ear. Yet, the inner ear has been difficult to access for diagnosis because of its small size, delicate nature, complex three-dimensional anatomy, and encasement in the densest bone in the body. Evolving optical methods are promising to afford cellular diagnosis of pathologic changes in the inner ear. To appropriately interpret results from these emerging technologies, it is important to characterize optical properties of cochlear tissues. Here, we focus on that characterization using quantitative polarized light microscopy (qPLM) applied to unstained cochlear sections of the mouse, a common animal model of human hearing loss. We find that the most birefringent cochlear materials are collagen fibrils and myelin. Retardance of the otic capsule, the spiral ligament, and the basilar membrane are substantially higher than that of other cochlear structures. Retardance of the spiral ligament and the basilar membrane decrease from the cochlear base to the apex, compared with the more uniform retardance of other structures. The intricate structural details revealed by qPLM of unstained cochlear sections ex vivo strongly motivate future application of polarization-sensitive optical coherence tomography to human cochlea in vivo. PMID:23407909

Glutamate co-transmission from developing medial nucleus of the trapezoid body - Lateral superior olive synapses is cochlear dependent in kanamycin-treated rats

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Jae Ho; Pradhan, Jonu; Maskey, Dhiraj

Research highlights: {yields} Glutamate co-transmission is enhanced in kanamycin-treated rats. {yields} VGLUT3 expression is increased in kanamycin-treated rats. {yields} GlyR expression is decreased in kanamycin-treated rats. {yields} GlyR, VGLUT3 expression patterns are asymmetric in unilaterally cochlear ablated rat. -- Abstract: Cochlear dependency of glutamate co-transmission at the medial nucleus of the trapezoid body (MNTB) - the lateral superior olive (LSO) synapses was investigated using developing rats treated with high dose kanamycin. Rats were treated with kanamycin from postnatal day (P) 3 to P8. A scanning electron microscopic study on P9 demonstrated partial cochlear hair cell damage. A whole cell voltagemore » clamp experiment demonstrated the increased glutamatergic portion of postsynaptic currents (PSCs) elicited by MNTB stimulation in P9-P11 kanamycin-treated rats. The enhanced VGLUT3 immunoreactivities (IRs) in kanamycin-treated rats and asymmetric VGLUT3 IRs in the LSO of unilaterally cochlear ablated rats supported the electrophysiologic data. Taken together, it is concluded that glutamate co-transmission is cochlear-dependent and enhanced glutamate co-transmission in kanamycin-treated rats is induced by partial cochlear damage.« less

Acute hyperfibrinogenemia impairs cochlear blood flow and hearing function in guinea pigs in vivo.

PubMed

Ihler, Fritz; Strieth, Sebastian; Pieri, Nicos; Göhring, Peter; Canis, Martin

2012-03-01

Impairment of microcirculation is a possible cause of sudden sensorineural hearing loss (SSNHL). Fibrinogen is known as a risk factor for both microvascular dysfunction and SSNHL. Therefore, the aim of this study was to investigate the effect of elevated serum levels of fibrinogen on cochlear blood flow and hearing function in vivo. One group of guinea pigs received two consecutive injections of 100 mg fibrinogen while a control group received equimolar doses of albumin. Measurements of cochlear microcirculation by intravital microscopy and of hearing thresholds by auditory brainstem response (ABR) recordings were carried out before, after first and after second injection. Ten healthy guinea pigs were randomly assigned to a treatment group or a control group of five animals each. Serum fibrinogen levels were elevated after the first and second injections of fibrinogen compared to basal values and control group respectively. Increasing levels of fibrinogen were paralleled by decreasing cochlear blood flow as well as increasing hearing thresholds. Hearing threshold correlated negatively with cochlear blood flow. The effect of microcirculatory impairment on hearing function could be explained by a malfunction of the cochlear amplifier. Further investigation is needed to quantify cochlear potentials under elevated serum fibrinogen levels.

Meningitis following cochlear implantation: pathomechanisms, clinical symptoms, conservative and surgical treatments.

PubMed

Arnold, W; Bredberg, G; Gstöttner, W; Helms, J; Hildmann, H; Kiratzidis, T; Müller, J; Ramsden, R T; Roland, P; Walterspiel, J N

2002-01-01

Pneumococcal otogenic meningitis is a rare postsurgical complication that can develop following stapedectomy or after cochlear implantation. The bacterial infection can be fatal in some instances. A recent increase in the incidence of otogenic meningitis among cochlear implant wearers is of concern. The majority of meningitis cases are associated with a 2-component electrode manufactured by one cochlear implant company. The device with the added 'positioner' component has been withdrawn from the market (FDA Public Health Web Notification: Cochlear Implant Recipients may be at Greater Risk for Meningitis, Updated: August 29, 2002, www.fda.gov/cdrh/safety/cochlear.html). Not all cases have been subsequent to otitis media and symptoms have developed from less than 24 h up to a few years after implantation. The purpose of this paper is to review and discuss the pathogenesis, pathology/bacteriology and to elaborate on some clinical features of otogenic meningitis in implanted children and adults. Essential aspects of surgery, electrode design, and cochleostomy seal are discussed. Conclusions are drawn from the available data and recommendations are made for good practice in cochlear implantation and follow-up. Copyright 2002 S. Karger AG, Basel

The development of the Nucleus Freedom Cochlear implant system.

PubMed

Patrick, James F; Busby, Peter A; Gibson, Peter J

2006-12-01

Cochlear Limited (Cochlear) released the fourth-generation cochlear implant system, Nucleus Freedom, in 2005. Freedom is based on 25 years of experience in cochlear implant research and development and incorporates advances in medicine, implantable materials, electronic technology, and sound coding. This article presents the development of Cochlear's implant systems, with an overview of the first 3 generations, and details of the Freedom system: the CI24RE receiver-stimulator, the Contour Advance electrode, the modular Freedom processor, the available speech coding strategies, the input processing options of Smart Sound to improve the signal before coding as electrical signals, and the programming software. Preliminary results from multicenter studies with the Freedom system are reported, demonstrating better levels of performance compared with the previous systems. The final section presents the most recent implant reliability data, with the early findings at 18 months showing improved reliability of the Freedom implant compared with the earlier Nucleus 3 System. Also reported are some of the findings of Cochlear's collaborative research programs to improve recipient outcomes. Included are studies showing the benefits from bilateral implants, electroacoustic stimulation using an ipsilateral and/or contralateral hearing aid, advanced speech coding, and streamlined speech processor programming.

Cochlear Implantation after Bilateral Transverse Temporal Bone Fractures

PubMed Central

Shin, Jong-Heon; Park, SooChan; Baek, Sam-Hyun

2008-01-01

Patients deafened by a severe head injury are rarely encountered. We report a case of a 65-yr-old man with bilateral transverse temporal bone fractures due to head injury. He underwent cochlear implant and achieved a satisfactory auditory rehabilitation. Imaging studies of temporal bone before performing a cochlear implantation provide important information on a patient with bilateral temporal bone fractures. Cochlear implantations with careful planning in such a patient may be a very effective method for aural rehabilitation. PMID:19434252

[Cochlear implant in children: rational, indications and cost/efficacy].

PubMed

Martini, A; Bovo, R; Trevisi, P; Forli, F; Berrettini, S

2013-06-01

A cochlear implant (CI) is a partially implanted electronic device that can help to provide a sense of sound and support speech to severely to profoundly hearing impaired patients. It is constituted by an external portion, that usually sits behind the ear and an internal portion surgically placed under the skin. The external components include a microphone connected to a speech processor that selects and arranges sounds pucked up by the microphone. This is connected to a transmitter coil, worn on the side of the head, which transmits data to an internal receiver coil placed under the skin. The received data are delivered to an array of electrodes that are surgically implanted within the cochlea. The primary neural targets of the electrodes are the spiral ganglion cells which innervate fibers of the auditory nerve. When the electrodes are activated by the signal, they send a current along the auditory nerve and auditory pathways to the auditory cortex. Children and adults who are profoundly or severely hearing impaired can be fitted with cochlear implants. According to the Food and Drug Administration, approximately 188,000 people worldwide have received implants. In Italy it is extimated that there are about 6-7000 implanted patients, with an average of 700 CI surgeries per year. Cochlear implantation, followed by intensive postimplantation speech therapy, can help young children to acquire speech, language, and social skills. Early implantation provides exposure to sounds that can be helpful during the critical period when children learn speech and language skills. In 2000, the Food and Drug Administration lowered the age of eligibility to 12 months for one type of CI. With regard to the results after cochlear implantation in relation to early implantation, better linguistic results are reported in children implanted before 12 months of life, even if no sufficient data exist regarding the relation between this advantage and the duration of implant use and how long this advantage persists in the subsequent years. With regard to cochlear implantation in children older than 12 months the studies show better hearing and linguistic results in children implanted at earlier ages. A sensitive period under 24-36 months has been identified over which cochlear implantation is reported to be less effective in terms of improvement in speech and hearing results. With regard to clinical effectiveness of bilateral cochlear implantation, greater benefits from bilateral implants compared to monolateral ones when assessing hearing in quiet and in noise and in sound localization abilities are reported to be present in both case of simultaneous or sequential bilateral implantation. However, with regard to the delay between the surgeries in sequential bilateral implantation, although benefit is reported to be present even after very long delays, on average long delays between surgeries seems to negatively affect the outcome with the second implant. With regard to benefits after cochlear implantation in children with multiple disabilities, benefits in terms of speech perception and communication as well as in quality of the daily life are reported even if benefits are slower and lower in comparison to those generally attained by implanted children without additional disabilities. Regarding the costs/efficacy ratio, the CI is expensive, in particular because of the cost of the high technological device, long life support, but even if healthcare costs are high, the savings in terms of indirect costs and quality of life are important. The CI, in fact, has a positive impact in terms of quality of life.

A preliminary investigation of the air-bone gap: Changes in intracochlear sound pressure with air- and bone-conducted stimuli after cochlear implantation

PubMed Central

Banakis Hartl, Renee M.; Mattingly, Jameson K.; Greene, Nathaniel T.; Jenkins, Herman A.; Cass, Stephen P.; Tollin, Daniel J.

2016-01-01

Hypothesis A cochlear implant electrode within the cochlea contributes to the air-bone gap (ABG) component of postoperative changes in residual hearing after electrode insertion. Background Preservation of residual hearing after cochlear implantation has gained importance as simultaneous electric-acoustic stimulation allows for improved speech outcomes. Postoperative loss of residual hearing has previously been attributed to sensorineural changes; however, presence of increased postoperative air-bone gap remains unexplained and could result in part from altered cochlear mechanics. Here, we sought to investigate changes to these mechanics via intracochlear pressure measurements before and after electrode implantation to quantify the contribution to postoperative air-bone gap. Methods Human cadaveric heads were implanted with titanium fixtures for bone conduction transducers. Velocities of stapes capitulum and cochlear promontory between the two windows were measured using single-axis laser Doppler vibrometry and fiber-optic sensors measured intracochlear pressures in scala vestibuli and tympani for air- and bone-conducted stimuli before and after cochlear implant electrode insertion through the round window. Results Intracochlear pressures revealed only slightly reduced responses to air-conducted stimuli consistent with prior literature. No significant changes were noted to bone-conducted stimuli after implantation. Velocities of the stapes capitulum and the cochlear promontory to both stimuli were stable following electrode placement. Conclusion Presence of a cochlear implant electrode causes alterations in intracochlear sound pressure levels to air, but not bone, conducted stimuli and helps to explain changes in residual hearing noted clinically. These results suggest the possibility of a cochlear conductive component to postoperative changes in hearing sensitivity. PMID:27579835

Recognition and localization of speech by adult cochlear implant recipients wearing a digital hearing aid in the nonimplanted ear (bimodal hearing).

PubMed

Potts, Lisa G; Skinner, Margaret W; Litovsky, Ruth A; Strube, Michael J; Kuk, Francis

2009-06-01

The use of bilateral amplification is now common clinical practice for hearing aid users but not for cochlear implant recipients. In the past, most cochlear implant recipients were implanted in one ear and wore only a monaural cochlear implant processor. There has been recent interest in benefits arising from bilateral stimulation that may be present for cochlear implant recipients. One option for bilateral stimulation is the use of a cochlear implant in one ear and a hearing aid in the opposite nonimplanted ear (bimodal hearing). This study evaluated the effect of wearing a cochlear implant in one ear and a digital hearing aid in the opposite ear on speech recognition and localization. A repeated-measures correlational study was completed. Nineteen adult Cochlear Nucleus 24 implant recipients participated in the study. The participants were fit with a Widex Senso Vita 38 hearing aid to achieve maximum audibility and comfort within their dynamic range. Soundfield thresholds, loudness growth, speech recognition, localization, and subjective questionnaires were obtained six-eight weeks after the hearing aid fitting. Testing was completed in three conditions: hearing aid only, cochlear implant only, and cochlear implant and hearing aid (bimodal). All tests were repeated four weeks after the first test session. Repeated-measures analysis of variance was used to analyze the data. Significant effects were further examined using pairwise comparison of means or in the case of continuous moderators, regression analyses. The speech-recognition and localization tasks were unique, in that a speech stimulus presented from a variety of roaming azimuths (140 degree loudspeaker array) was used. Performance in the bimodal condition was significantly better for speech recognition and localization compared to the cochlear implant-only and hearing aid-only conditions. Performance was also different between these conditions when the location (i.e., side of the loudspeaker array that presented the word) was analyzed. In the bimodal condition, the speech-recognition and localization tasks were equal regardless of which side of the loudspeaker array presented the word, while performance was significantly poorer for the monaural conditions (hearing aid only and cochlear implant only) when the words were presented on the side with no stimulation. Binaural loudness summation of 1-3 dB was seen in soundfield thresholds and loudness growth in the bimodal condition. Measures of the audibility of sound with the hearing aid, including unaided thresholds, soundfield thresholds, and the Speech Intelligibility Index, were significant moderators of speech recognition and localization. Based on the questionnaire responses, participants showed a strong preference for bimodal stimulation. These findings suggest that a well-fit digital hearing aid worn in conjunction with a cochlear implant is beneficial to speech recognition and localization. The dynamic test procedures used in this study illustrate the importance of bilateral hearing for locating, identifying, and switching attention between multiple speakers. It is recommended that unilateral cochlear implant recipients, with measurable unaided hearing thresholds, be fit with a hearing aid.

Relationships among Professionals' Knowledge, Experience, and Expectations Regarding Cochlear Implants

ERIC Educational Resources Information Center

Ben-Itzhak, D.; Most, T.; Weisel, A.

2005-01-01

The present study examined the relationships between teachers' and communication clinicians' self-reported knowledge on cochlear implants and their expectations of CIs. The authors also explored these professionals' views regarding the child's communication mode, educational setting, and social options following cochlear implantation. The…

The Relationship between Cochlear Implants and Deaf Identity

ERIC Educational Resources Information Center

Chapman, Madeline; Dammeyer, Jesper

2017-01-01

The degree to which individuals with cochlear implants (CIs) experience communication difficulties has implications for social participation and identity development. However, few studies have examined the relationship between cochlear implantation, identity, and social participation. Using data from a Danish national survey of deaf adults, the…

Changing patterns of peanut agglutinin labelling in the dorsal cochlear nucleus correspond to axonal ingrowth.

PubMed Central

Riggs, G H; Schweitzer, L

1994-01-01

Various studies have suggested that glycoconjugates may influence connectivity and lamination in the developing central nervous system and may function as barriers to neuritic extension. It has been proposed that the peanut agglutinin lectin labels a glycoconjugate subserving a barrier function. We chose to investigate the distribution of this peanut-agglutinin-labelled glycoconjugate in the dorsal cochlear nucleus of the developing hamster since the development of the dorsal cochlear nucleus is well characterised and its axons obey laminar boundaries. The distribution of peanut agglutinin label throughout the cochlear nucleus delineated zones that cochlear axons fail to invade. In the dorsal cochlear nucleus, laminar differences were reduced on postnatal d 13 and virtually disappearing by postnatal d 23. Label in the molecular layer dissipated as axons and dendrites grew into this layer. These patterns of peanut agglutinin binding correspond to axonal ingrowth and are consistent with a barrier function for glycoconjugates in the molecular layer. Images Fig. 1 Fig. 2 Fig. 4 PMID:7961144

Modulation of Mcl-1 expression reduces age-related cochlear degeneration

PubMed Central

Yang, Wei Ping; Xu, Yang; Guo, Wei Wei; Liu, Hui Zhan; Hu, Bo Hua

2013-01-01

Mcl-1 is an anti-apoptotic member of the Bcl-2 family that modulates apoptosis-related signaling pathways and promotes cell survival. We have previously demonstrated a reduction of Mcl-1 expression in aging cochleae. To investigate whether restoring Mcl-1 expression would reduce aging-related cochlear degeneration, we developed a rat model of Mcl-1 overexpression. A plasmid encoding human Mcl-1/enhanced green fluorescent protein was applied to the round window of the cochlea. This in vivo treatment transfected both the sensory and supporting cells of the cochlear sensory epithelium and enhanced Mcl-1 expression at both the mRNA and the protein level. The upregulation of Mcl-1 expression reduced the progression of age-related cochlear dysfunction and sensory cell death. Furthermore, the transfection of Mcl-1 exerted its protective effect by suppressing cochlear apoptosis at the mitochondrial level. This study demonstrates that the genetic modulation of Mcl-1 expression reduces the progression of age-related cochlear degeneration. PMID:23790646

Gain and frequency tuning within the mouse cochlear apex

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oghalai, John S.; Raphael, Patrick D.; Gao, Simon

Normal mammalian hearing requires cochlear outer hair cell active processes that amplify the traveling wave with high gain and sharp tuning, termed cochlear amplification. We have used optical coherence tomography to study cochlear amplification within the apical turn of the mouse cochlea. We measured not only classical basilar membrane vibratory tuning curves but also vibratory responses from the rest of the tissues that compose the organ of Corti. Basilar membrane tuning was sharp in live mice and broad in dead mice, whereas other regions of the organ of Corti demonstrated phase shifts consistent with additional filtering beyond that provided bymore » basilar membrane mechanics. We use these experimental data to support a conceptual framework of how cochlear amplification is tuned within the mouse cochlear apex. We will also study transgenic mice with targeted mutations that affect different biomechanical aspects of the organ of Corti in an effort to localize the underlying processes that produce this additional filtering.« less

Evidence of across-channel processing for spectral-ripple discrimination in cochlear implant listeners.

PubMed

Won, Jong Ho; Jones, Gary L; Drennan, Ward R; Jameyson, Elyse M; Rubinstein, Jay T

2011-10-01

Spectral-ripple discrimination has been used widely for psychoacoustical studies in normal-hearing, hearing-impaired, and cochlear implant listeners. The present study investigated the perceptual mechanism for spectral-ripple discrimination in cochlear implant listeners. The main goal of this study was to determine whether cochlear implant listeners use a local intensity cue or global spectral shape for spectral-ripple discrimination. The effect of electrode separation on spectral-ripple discrimination was also evaluated. Results showed that it is highly unlikely that cochlear implant listeners depend on a local intensity cue for spectral-ripple discrimination. A phenomenological model of spectral-ripple discrimination, as an "ideal observer," showed that a perceptual mechanism based on discrimination of a single intensity difference cannot account for performance of cochlear implant listeners. Spectral modulation depth and electrode separation were found to significantly affect spectral-ripple discrimination. The evidence supports the hypothesis that spectral-ripple discrimination involves integrating information from multiple channels. © 2011 Acoustical Society of America

Evidence of across-channel processing for spectral-ripple discrimination in cochlear implant listeners a

PubMed Central

Ho Won, Jong; Jones, Gary L.; Drennan, Ward R.; Jameyson, Elyse M.; Rubinstein, Jay T.

2011-01-01

Spectral-ripple discrimination has been used widely for psychoacoustical studies in normal-hearing, hearing-impaired, and cochlear implant listeners. The present study investigated the perceptual mechanism for spectral-ripple discrimination in cochlear implant listeners. The main goal of this study was to determine whether cochlear implant listeners use a local intensity cue or global spectral shape for spectral-ripple discrimination. The effect of electrode separation on spectral-ripple discrimination was also evaluated. Results showed that it is highly unlikely that cochlear implant listeners depend on a local intensity cue for spectral-ripple discrimination. A phenomenological model of spectral-ripple discrimination, as an “ideal observer,” showed that a perceptual mechanism based on discrimination of a single intensity difference cannot account for performance of cochlear implant listeners. Spectral modulation depth and electrode separation were found to significantly affect spectral-ripple discrimination. The evidence supports the hypothesis that spectral-ripple discrimination involves integrating information from multiple channels. PMID:21973363

Factors associated with Hearing Loss in a Normal-Hearing Guinea Pig Model of Hybrid Cochlear Implants

PubMed Central

Tanaka, Chiemi; Nguyen-Huynh, Anh; Loera, Katherine; Stark, Gemaine; Reiss, Lina

2014-01-01

The Hybrid cochlear implant (CI), also known as Electro- Acoustic Stimulation (EAS), is a new type of CI that preserves residual acoustic hearing and enables combined cochlear implant and hearing aid use in the same ear. However, 30-55% of patients experience acoustic hearing loss within days to months after activation, suggesting that both surgical trauma and electrical stimulation may cause hearing loss. The goals of this study were to: 1) determine the contributions of both implantation surgery and EAS to hearing loss in a normal-hearing guinea pig model; 2) determine which cochlear structural changes are associated with hearing loss after surgery and EAS. Two groups of animals were implanted (n=6 per group), with one group receiving chronic acoustic and electric stimulation for 10 weeks, and the other group receiving no direct acoustic or electric stimulation during this time frame. A third group (n=6) was not implanted, but received chronic acoustic stimulation. Auditory brainstem response thresholds were followed over time at 1, 2, 6, and 16 kHz. At the end of the study, the following cochlear measures were quantified: hair cells, spiral ganglion neuron density, fibrous tissue density, and stria vascularis blood vessel density; the presence or absence of ossification around the electrode entry was also noted. After surgery, implanted animals experienced a range of 0-55 dB of threshold shifts in the vicinity of the electrode at 6 and 16 kHz. The degree of hearing loss was significantly correlated with reduced stria vascularis vessel density and with the presence of ossification, but not with hair cell counts, spiral ganglion neuron density, or fibrosis area. After 10 weeks of stimulation, 67% of implanted, stimulated animals had more than 10 dB of additional threshold shift at 1 kHz, compared to 17% of implanted, non-stimulated animals and 0% of non-implanted animals. This 1-kHz hearing loss was not associated with changes in any of the cochlear measures quantified in this study. The variation in hearing loss after surgery and electrical stimulation in this animal model is consistent with the variation in human patients. Further, these findings illustrate an advantage of a normal-hearing animal model for quantification of hearing loss and damage to cochlear structures without the confounding effects of chemical- or noise-induced hearing loss. Finally, this study is the first to suggest a role of the stria vascularis and damage to the lateral wall in implantation-induced hearing loss. Further work is needed to determine the mechanisms of implantation- and electrical-stimulation-induced hearing loss. PMID:25128626

International classification of reliability for implanted cochlear implant receiver stimulators.

PubMed

Battmer, Rolf-Dieter; Backous, Douglas D; Balkany, Thomas J; Briggs, Robert J S; Gantz, Bruce J; van Hasselt, Andrew; Kim, Chong Sun; Kubo, Takeshi; Lenarz, Thomas; Pillsbury, Harold C; O'Donoghue, Gerard M

2010-10-01

To design an international standard to be used when reporting reliability of the implanted components of cochlear implant systems to appropriate governmental authorities, cochlear implant (CI) centers, and for journal editors in evaluating manuscripts involving cochlear implant reliability. The International Consensus Group for Cochlear Implant Reliability Reporting was assembled to unify ongoing efforts in the United States, Europe, Asia, and Australia to create a consistent and comprehensive classification system for the implanted components of CI systems across manufacturers. All members of the consensus group are from tertiary referral cochlear implant centers. None. A clinically relevant classification scheme adapted from principles of ISO standard 5841-2:2000 originally designed for reporting reliability of cardiac pacemakers, pulse generators, or leads. Standard definitions for device failure, survival time, clinical benefit, reduced clinical benefit, and specification were generated. Time intervals for reporting back to implant centers for devices tested to be "out of specification," categorization of explanted devices, the method of cumulative survival reporting, and content of reliability reports to be issued by manufacturers was agreed upon by all members. The methodology for calculating Cumulative survival was adapted from ISO standard 5841-2:2000. The International Consensus Group on Cochlear Implant Device Reliability Reporting recommends compliance to this new standard in reporting reliability of implanted CI components by all manufacturers of CIs and the adoption of this standard as a minimal reporting guideline for editors of journals publishing cochlear implant research results.

Evaluation of Mandarin Chinese Speech Recognition in Adults with Cochlear Implants Using the Spectral Ripple Discrimination Test

PubMed Central

Dai, Chuanfu; Zhao, Zeqi; Zhang, Duo; Lei, Guanxiong

2018-01-01

Background The aim of this study was to explore the value of the spectral ripple discrimination test in speech recognition evaluation among a deaf (post-lingual) Mandarin-speaking population in China following cochlear implantation. Material/Methods The study included 23 Mandarin-speaking adult subjects with normal hearing (normal-hearing group) and 17 deaf adults who were former Mandarin-speakers, with cochlear implants (cochlear implantation group). The normal-hearing subjects were divided into men (n=10) and women (n=13). The spectral ripple discrimination thresholds between the groups were compared. The correlation between spectral ripple discrimination thresholds and Mandarin speech recognition rates in the cochlear implantation group were studied. Results Spectral ripple discrimination thresholds did not correlate with age (r=−0.19; p=0.22), and there was no significant difference in spectral ripple discrimination thresholds between the male and female groups (p=0.654). Spectral ripple discrimination thresholds of deaf adults with cochlear implants were significantly correlated with monosyllabic recognition rates (r=0.84; p=0.000). Conclusions In a Mandarin Chinese speaking population, spectral ripple discrimination thresholds of normal-hearing individuals were unaffected by both gender and age. Spectral ripple discrimination thresholds were correlated with Mandarin monosyllabic recognition rates of Mandarin-speaking in post-lingual deaf adults with cochlear implants. The spectral ripple discrimination test is a promising method for speech recognition evaluation in adults following cochlear implantation in China. PMID:29806954

Evaluation of Mandarin Chinese Speech Recognition in Adults with Cochlear Implants Using the Spectral Ripple Discrimination Test.

PubMed

Dai, Chuanfu; Zhao, Zeqi; Shen, Weidong; Zhang, Duo; Lei, Guanxiong; Qiao, Yuehua; Yang, Shiming

2018-05-28

BACKGROUND The aim of this study was to explore the value of the spectral ripple discrimination test in speech recognition evaluation among a deaf (post-lingual) Mandarin-speaking population in China following cochlear implantation. MATERIAL AND METHODS The study included 23 Mandarin-speaking adult subjects with normal hearing (normal-hearing group) and 17 deaf adults who were former Mandarin-speakers, with cochlear implants (cochlear implantation group). The normal-hearing subjects were divided into men (n=10) and women (n=13). The spectral ripple discrimination thresholds between the groups were compared. The correlation between spectral ripple discrimination thresholds and Mandarin speech recognition rates in the cochlear implantation group were studied. RESULTS Spectral ripple discrimination thresholds did not correlate with age (r=-0.19; p=0.22), and there was no significant difference in spectral ripple discrimination thresholds between the male and female groups (p=0.654). Spectral ripple discrimination thresholds of deaf adults with cochlear implants were significantly correlated with monosyllabic recognition rates (r=0.84; p=0.000). CONCLUSIONS In a Mandarin Chinese speaking population, spectral ripple discrimination thresholds of normal-hearing individuals were unaffected by both gender and age. Spectral ripple discrimination thresholds were correlated with Mandarin monosyllabic recognition rates of Mandarin-speaking in post-lingual deaf adults with cochlear implants. The spectral ripple discrimination test is a promising method for speech recognition evaluation in adults following cochlear implantation in China.

The Modified Rambo Transcanal Approach for Cochlear Implantation in CHARGE Syndrome.

PubMed

Wick, Cameron C; Moore, Amy M; Killeen, Daniel E; Isaacson, Brandon

2017-10-01

CHARGE syndrome is associated with a variety of temporal bone anomalies and deafness. The lack of surgical landmarks and facial nerve irregularities make cochlear implantation in this population a challenging endeavor. This study aims to describe a safe and efficacious transcanal approach for cochlear implantation that obviates the need to perform a mastoidectomy and facial recess. Three children with profound hearing loss secondary to CHARGE syndrome. Transcanal cochlear implantation with closure of the ear canal via a modified Rambo meatoplasty. Retrospective chart review of temporal bone anomalies associated with CHARGE syndrome, technical nuances of this transcanal approach, and cochlear implant outcomes. The mean patient age was 2.5 years (range 1.5-3.8 yr). Two were male and two were left ears. All patients had a hypoplastic mastoid, semicircular canal aplasia, and had some degree of cochlear dysplasia. A full cochlear implant insertion was achieved in all cases, even in the presence of grossly abnormal middle ear and facial nerve anatomy. There were no intraoperative or postoperative complications. The mean follow-up was 12.4 months (range, 3.9-25.2 mo). All three patients use their device daily. Their guardians report improved vocalization and environmental awareness. The modified Rambo transcanal approach provides a safe corridor for cochlear implantation in patients with CHARGE syndrome. This approach minimizes the anatomical variations associated with the syndrome and may reduce the risk of electrode extrusion. Implant outcomes in this patient population remain highly variable based on the patient's global cognitive capacity.

Early Vocabulary Development in Children with Bilateral Cochlear Implants

ERIC Educational Resources Information Center

Välimaa, Taina; Kunnari, Sari; Laukkanen-Nevala, Päivi; Lonka, Eila

2018-01-01

Background: Children with unilateral cochlear implants (CIs) may have delayed vocabulary development for an extended period after implantation. Bilateral cochlear implantation is reported to be associated with improved sound localization and enhanced speech perception in noise. This study proposed that bilateral implantation might also promote…

Deafblind People's Experiences of Cochlear Implantation

ERIC Educational Resources Information Center

Soper, Janet

2006-01-01

Cochlear implants are electronic devices that create the sensation of hearing in those who cannot obtain any benefit from conventional hearing aids. This article examines the experience of cochlear implantation in a select group of individuals with acquired deafblindness, focusing on three key themes: access to communication, information and…

The benefits of remote microphone technology for adults with cochlear implants.

PubMed

Fitzpatrick, Elizabeth M; Séguin, Christiane; Schramm, David R; Armstrong, Shelly; Chénier, Josée

2009-10-01

Cochlear implantation has become a standard practice for adults with severe to profound hearing loss who demonstrate limited benefit from hearing aids. Despite the substantial auditory benefits provided by cochlear implants, many adults experience difficulty understanding speech in noisy environments and in other challenging listening conditions such as television. Remote microphone technology may provide some benefit in these situations; however, little is known about whether these systems are effective in improving speech understanding in difficult acoustic environments for this population. This study was undertaken with adult cochlear implant recipients to assess the potential benefits of remote microphone technology. The objectives were to examine the measurable and perceived benefit of remote microphone devices during television viewing and to assess the benefits of a frequency-modulated system for speech understanding in noise. Fifteen adult unilateral cochlear implant users were fit with remote microphone devices in a clinical environment. The study used a combination of direct measurements and patient perceptions to assess speech understanding with and without remote microphone technology. The direct measures involved a within-subject repeated-measures design. Direct measures of patients' speech understanding during television viewing were collected using their cochlear implant alone and with their implant device coupled to an assistive listening device. Questionnaires were administered to document patients' perceptions of benefits during the television-listening tasks. Speech recognition tests of open-set sentences in noise with and without remote microphone technology were also administered. Participants showed improved speech understanding for television listening when using remote microphone devices coupled to their cochlear implant compared with a cochlear implant alone. This benefit was documented both when listening to news and talk show recordings. Questionnaire results also showed statistically significant differences between listening with a cochlear implant alone and listening with a remote microphone device. Participants judged that remote microphone technology provided them with better comprehension, more confidence, and greater ease of listening. Use of a frequency-modulated system coupled to a cochlear implant also showed significant improvement over a cochlear implant alone for open-set sentence recognition in +10 and +5 dB signal to noise ratios. Benefits were measured during remote microphone use in focused-listening situations in a clinical setting, for both television viewing and speech understanding in noise in the audiometric sound suite. The results suggest that adult cochlear implant users should be counseled regarding the potential for enhanced speech understanding in difficult listening environments through the use of remote microphone technology.

Melodic contour identification by cochlear implant listeners.

PubMed

Galvin, John J; Fu, Qian-Jie; Nogaki, Geraldine

2007-06-01

While the cochlear implant provides many deaf patients with good speech understanding in quiet, music perception and appreciation with the cochlear implant remains a major challenge for most cochlear implant users. The present study investigated whether a closed-set melodic contour identification (MCI) task could be used to quantify cochlear implant users' ability to recognize musical melodies and whether MCI performance could be improved with moderate auditory training. The present study also compared MCI performance with familiar melody identification (FMI) performance, with and without MCI training. For the MCI task, test stimuli were melodic contours composed of 5 notes of equal duration whose frequencies corresponded to musical intervals. The interval between successive notes in each contour was varied between 1 and 5 semitones; the "root note" of the contours was also varied (A3, A4, and A5). Nine distinct musical patterns were generated for each interval and root note condition, resulting in a total of 135 musical contours. The identification of these melodic contours was measured in 11 cochlear implant users. FMI was also evaluated in the same subjects; recognition of 12 familiar melodies was tested with and without rhythm cues. MCI was also trained in 6 subjects, using custom software and melodic contours presented in a different frequency range from that used for testing. Results showed that MCI recognition performance was highly variable among cochlear implant users, ranging from 14% to 91% correct. For most subjects, MCI performance improved as the number of semitones between successive notes was increased; performance was slightly lower for the A3 root note condition. Mean FMI performance was 58% correct when rhythm cues were preserved and 29% correct when rhythm cues were removed. Statistical analyses revealed no significant correlation between MCI performance and FMI performance (with or without rhythmic cues). However, MCI performance was significantly correlated with vowel recognition performance; FMI performance was not correlated with cochlear implant subjects' phoneme recognition performance. Preliminary results also showed that the MCI training improved all subjects' MCI performance; the improved MCI performance also generalized to improved FMI performance. Preliminary data indicate that the closed-set MCI task is a viable approach toward quantifying an important component of cochlear implant users' music perception. The improvement in MCI performance and generalization to FMI performance with training suggests that MCI training may be useful for improving cochlear implant users' music perception and appreciation; such training may be necessary to properly evaluate patient performance, as acute measures may underestimate the amount of musical information transmitted by the cochlear implant device and received by cochlear implant listeners.

Negotiating Reassurance: Parents' Narratives on Follow-Up after Cochlear Implantation

ERIC Educational Resources Information Center

Bruin, Marieke; Ohna, Stein Erik

2015-01-01

This study presents an analysis of parental experiences on follow-up after cochlear implantation. Data were constructed in semi-structured, individual interviews with the parents of 14 children who use cochlear implants. Drawing on narrative analysis, the study explores parental responses to insecurity concerning children's learning and…

Concept Learning and Heuristic Classification in Weak-Theory Domains

DTIC Science & Technology

1990-03-01

age and noise-induced cochlear age..gt.60 noise-induced cochlear air(mild) age-induced cochlear history(noise) norma ]_ear speechpoor)acousticneuroma...Annual review of computer science. Machine Learning, 4, 1990. (to appear). [18] R.T. Duran . Concept learning with incomplete data sets. Master’s thesis

Challenges in Optimizing Oral Communication in Children with Cochlear Implants.

ERIC Educational Resources Information Center

Ertmer, David J.

2002-01-01

This article introduces a forum that provides information for assisting speech-language pathologists and audiologists in fulfilling their professional responsibilities in a variety of settings to children with hearing impairments who have cochlear implants. A preview of the following articles on services for children with cochlear implants is…

Agile Development of Advanced Prototypes

DTIC Science & Technology

2014-11-01

prostheses: retinal implants, cochlear implants, and neuroprosthetics (EEG controlled artificial limbs); an interactive, virtual experience...demonstrations allowing users to experience, from a patient’s perspective life with three different prostheses: retinal implants, cochlear implants...three experiences were researched and developed. The applications are interactive demonstrations of retinal implants, cochlear implants, and

Voice emotion perception and production in cochlear implant users.

PubMed

Jiam, N T; Caldwell, M; Deroche, M L; Chatterjee, M; Limb, C J

2017-09-01

Voice emotion is a fundamental component of human social interaction and social development. Unfortunately, cochlear implant users are often forced to interface with highly degraded prosodic cues as a result of device constraints in extraction, processing, and transmission. As such, individuals with cochlear implants frequently demonstrate significant difficulty in recognizing voice emotions in comparison to their normal hearing counterparts. Cochlear implant-mediated perception and production of voice emotion is an important but relatively understudied area of research. However, a rich understanding of the voice emotion auditory processing offers opportunities to improve upon CI biomedical design and to develop training programs benefiting CI performance. In this review, we will address the issues, current literature, and future directions for improved voice emotion processing in cochlear implant users. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluating cochlear implant trauma to the scala vestibuli.

PubMed

Adunka, O; Kiefer, J; Unkelbach, M H; Radeloff, A; Gstoettner, W

2005-04-01

Placement of cochlear implant electrodes into the scala vestibuli may be intentional, e.g. in case of blocked scala tympani or unintentional as a result of trauma to the basilar membrane or erroneous location of the cochieostomy. The aim of this study was to evaluate the morphological consequences and cochlear trauma after implantation of different cochlear implant electrode arrays in the scala vestibuli. Human temporal bone study with histological and radiological evaluation. Twelve human cadaver temporal bones were implanted with different cochlear implant electrodes. Implanted bones were processed using a special method to section undecalcified bone. Cochlear trauma and intracochlear positions. All implanted electrodes were implanted into the scala vestibuli using a special approach that allows direct scala vestibuli insertions. Fractures of the osseous spiral lamina were evaluated in some bones in the basal cochlear regions. In most electrodes, delicate structures of the organ of Corti were left intact, however, Reissner's membrane was destroyed in all specimens and the electrode lay upon the tectorial membrane. In some bones the organ of Corti was destroyed. Scala vestibuli insertions did not cause severe trauma to osseous or neural structures, thus preserving the basis for electrostimulation of the cochlea. However, destruction of Reissner's membrane and impact on the Organ of Corti can be assumed to destroy residual hearing.

Cochlear implantation for single-sided deafness and tinnitus suppression.

PubMed

Holder, Jourdan T; O'Connell, Brendan; Hedley-Williams, Andrea; Wanna, George

To quantify the potential effectiveness of cochlear implantation for tinnitus suppression in patients with single-sided deafness using the Tinnitus Handicap Inventory. The study included 12 patients with unilateral tinnitus who were undergoing cochlear implantation for single-sided deafness. The Tinnitus Handicap Inventory was administered at the patient's cochlear implant candidacy evaluation appointment prior to implantation and every cochlear implant follow-up appointment, except activation, following implantation. Patient demographics and speech recognition scores were also retrospectively recorded using the electronic medical record. A significant reduction was found when comparing Tinnitus Handicap Inventory score preoperatively (61.2±27.5) to the Tinnitus Handicap Inventory score after three months of cochlear implant use (24.6±28.2, p=0.004) and the Tinnitus Handicap Inventory score beyond 6months of CI use (13.3±18.9, p=0.008). Further, 45% of patients reported total tinnitus suppression. Mean CNC word recognition score improved from 2.9% (SD 9.4) pre-operatively to 40.8% (SD 31.7) by 6months post-activation, which was significantly improved from pre-operative scores (p=0.008). The present data is in agreement with previously published studies that have shown an improvement in tinnitus following cochlear implantation for the large majority of patients with single-sided deafness. Copyright © 2017 Elsevier Inc. All rights reserved.

Piribedil affects dopamine turnover in cochleas stimulated by white noise.

PubMed

Gil-Loyzaga, P; Vicente-Torres, M A; Fernández-Mateos, P; Arce, A; Esquifino, A

1994-09-01

The presence of dopamine (DA) within the cochlea has been previously reported, indicating that its turnover increases under noise stimulation. In the present report, piribedil, a dopaminergic D2 agonist, was used in order to provide evidence of the activity of D2 receptors in the turnover of DA under noise stimulation. Long-Evans rats were intraperitoneally injected with distilled water or with a solution of piribedil one hour previously to either noise or silence exposure. Noise stimulation was performed in an anechoic chamber at 70, 90 or 110 dB SPL for one hour. The animals were then sacrificed and the cochlear contents of DA and its metabolites dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) were quantified by HPLC with electrochemical detection. The administration of piribedil to animals kept in silence did not modify the cochlear DA, DOPAC and HVA content. Noise stimulation resulted in a decrease of the cochlear DA content and an increase of the cochlear DOPAC and HVA contents in vehicle treated animals. The administration of piribedil resulted in a blockade of this noise induced cochlear DA turnover. These results suggest that piribedil stimulates cochlear D2 receptors controlling the cochlear DA release. Piribedil action on D2 receptors could explain the improvement observed in some cochleo-vestibular diseases signs after piribedil treatment.

Considerations for Pediatric Cochlear Implant Recipients With Unilateral or Asymmetric Hearing Loss: Assessment, Device Fitting, and Habilitation.

PubMed

Greaver, Laura; Eskridge, Hannah; Teagle, Holly F B

2017-06-13

The purpose of this clinical report is to present case studies of children who are nontraditional candidates for cochlear implantation because they have significant residual hearing in 1 ear and to describe outcomes and considerations for their audiological management and habilitation. Case information is presented for 5 children with profound hearing loss in 1 ear and normal or mild-to-moderate hearing loss in the opposite ear and who have undergone unilateral cochlear implantation. Pre- and postoperative assessments were performed per typical clinic routines with modifications described. Postimplant habilitation was customized for each recipient using a combination of traditional methods, newer technologies, and commercial materials. The 5 children included in this report are consistent users of their cochlear implants and demonstrate speech recognition in the implanted ear when isolated from the better hearing ear. Candidacy criteria for cochlear implantation are evolving. Children with single-sided deafness or asymmetric hearing loss who have traditionally not been considered candidates for cochlear implantation should be evaluated on a case-by-case basis. Audiological management of these recipients is not vastly different compared with children who are traditional cochlear implant recipients. Assessment and habilitation techniques must be modified to isolate the implanted ear to obtain accurate results and to provide meaningful therapeutic intervention.

Spatiotemporal expression of Ezh2 in the developing mouse cochlear sensory epithelium.

PubMed

Chen, Yan; Li, Wenyan; Li, Wen; Chai, Renjie; Li, Huawei

2016-09-01

The enhancer of zeste 2 polycomb repressive complex 2 subunit (Ezh2) is a histone-lysine Nmethyltransferase enzyme that participates in DNA methylation. Ezh2 has also been reported to play crucial roles in stem cell proliferation and differentiation. However, the detailed expression profile of Ezh2 during mouse cochlear development has not been investigated. Here, we examined the spatiotemporal expression of Ezh2 in the cochlea during embryonic and postnatal development. Ezh2 expression began to be observed in the whole otocyst nuclei at embryonic day 9.5 (E9.5). At E12.5, Ezh2 was expressed in the nuclei of the cochlear prosensory epithelium. At E13.5 and E15.5, Ezh2 was expressed from the apical to the basal turns in the nuclei of the differentiating cochlear epithelium. At postnatal day (P) 0 and 7, the Ezh2 expression was located in the nuclei of the cochlear epithelium in all three turns and could be clearly seen in outer and inner hair cells, supporting cells, the stria vascularis, and spiral ganglion cells. Ezh2 continued to be expressed in the cochlear epithelium of adult mice. Our results provide the basic Ezh2 expression pattern and might be useful for further investigating the detailed role of Ezh2 during cochlear development.

Predicting the location of missing outer hair cells using the electrical signal recorded at the round window

PubMed Central

Chertoff, Mark E.; Earl, Brian R.; Diaz, Francisco J.; Sorensen, Janna L.; Thomas, Megan L. A.; Kamerer, Aryn M.; Peppi, Marcello

2014-01-01

The electrical signal recorded at the round window was used to estimate the location of missing outer hair cells. The cochlear response was recorded to a low frequency tone embedded in high-pass filtered noise conditions. Cochlear damage was created by either overexposure to frequency-specific tones or laser light. In animals with continuous damage along the partition, the amplitude of the cochlear response increased as the high-pass cutoff frequency increased, eventually reaching a plateau. The cochlear distance at the onset of the plateau correlated with the anatomical onset of outer hair cell loss. A mathematical model replicated the physiologic data but was limited to cases with continuous hair cell loss in the middle and basal turns. The neural contribution to the cochlear response was determined by recording the response before and after application of Ouabain. Application of Ouabain eliminated or reduced auditory neural activity from approximately two turns of the cochlea. The amplitude of the cochlear response was reduced for moderate signal levels with a limited effect at higher levels, indicating that the cochlear response was dominated by outer hair cell currents at high signal levels and neural potentials at low to moderate signal levels. PMID:25190395

[Audiophonological evaluation of 16 children fitted with cochlear implants for sensorineural hearing loss induced by bacterial meningitis].

PubMed

Teissier, N; Doehring, I; Noel-Petroff, N; Elmaleh-Bergès, M; Viala, P; François, M; Faye, A; Van Den Abbeele, T; Lorrot, M

2013-06-01

Bacterial meningitis (BM) is the primary etiology of acquired sensorineural hearing loss (SNHL) in children and may compromise language development. Since the 1990 s, cochlear implants (CIs) have become part of the management of children with profound SNHL with encouraging results. The aim of this study was to analyze the audiophonological performance of children before and after cochlear implantation for SNHL following bacterial meningitis. Retrospective study of all children fitted with CIs for bilateral severe to profound SNHL after bacterial meningitis in the Robert-Debré pediatric ENT department between August 1990 and March 2009. Audiophonological performance was assessed using the APCEI profile. Of the 283 children receiving implants during that period, 16 children (6%; 6 boys, 10 girls) underwent CI implantation after bacterial meningitis (Streptococcus pneumoniae in 8 cases, Neisseria meningitidis in 2 cases, and Haemophilus influenzae in 4 cases). The mean time from meningitis to SNHL was 8.3 months (median, 1.5 months; range, 1 day to 13 years). The mean time from meningitis to cochlear implantation was 2 years and 3 months (median, 7 months; range, 1 month to 13 years 3 months). Twelve children (75%) presented partial cochlear and/or vestibular ossification on presurgical CT scan. Three children received bilateral implants. Thirteen children (81%) developed early SNHL in the first 3 months, whereas 3 children developed SNHL more than 10 months after meningitis. As for the benefits of cochlear implantation, 11 children presented near to normal intelligibility and optimal use of their cochlear implant; 5 children presented partial benefits due to neurological sequelae (1), a long delay before implantation (1), technical problems (2), or a social problem in relation to low socioeconomic status (1). After bacterial meningitis, audiological evaluation must be made carefully during the first 3 months to detect early SNHL, but SNHL may also develop several years later. In case of profound SNHL and a modified signal of the labyrinth on the MRI, cochlear implantation must be performed without delay before cochlear and/or vestibular ossification. Cochlear implantation is an effective technique with good long-term audiologic results. The coexistence of neurological lesions may compromise the results, but it should not contraindicate a cochlear implantation. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Modeling open-set spoken word recognition in postlingually deafened adults after cochlear implantation: some preliminary results with the neighborhood activation model.

PubMed

Meyer, Ted A; Frisch, Stefan A; Pisoni, David B; Miyamoto, Richard T; Svirsky, Mario A

2003-07-01

Do cochlear implants provide enough information to allow adult cochlear implant users to understand words in ways that are similar to listeners with acoustic hearing? Can we use a computational model to gain insight into the underlying mechanisms used by cochlear implant users to recognize spoken words? The Neighborhood Activation Model has been shown to be a reasonable model of word recognition for listeners with normal hearing. The Neighborhood Activation Model assumes that words are recognized in relation to other similar-sounding words in a listener's lexicon. The probability of correctly identifying a word is based on the phoneme perception probabilities from a listener's closed-set consonant and vowel confusion matrices modified by the relative frequency of occurrence of the target word compared with similar-sounding words (neighbors). Common words with few similar-sounding neighbors are more likely to be selected as responses than less common words with many similar-sounding neighbors. Recent studies have shown that several of the assumptions of the Neighborhood Activation Model also hold true for cochlear implant users. Closed-set consonant and vowel confusion matrices were obtained from 26 postlingually deafened adults who use cochlear implants. Confusion matrices were used to represent input errors to the Neighborhood Activation Model. Responses to the different stimuli were then generated by the Neighborhood Activation Model after incorporating the frequency of occurrence counts of the stimuli and their neighbors. Model outputs were compared with obtained performance measures on the Consonant-Vowel Nucleus-Consonant word test. Information transmission analysis was used to assess whether the Neighborhood Activation Model was able to successfully generate and predict word and individual phoneme recognition by cochlear implant users. The Neighborhood Activation Model predicted Consonant-Vowel Nucleus-Consonant test words at levels similar to those correctly identified by the cochlear implant users. The Neighborhood Activation Model also predicted phoneme feature information well. The results obtained suggest that the Neighborhood Activation Model provides a reasonable explanation of word recognition by postlingually deafened adults after cochlear implantation. It appears that multichannel cochlear implants give cochlear implant users access to their mental lexicons in a manner that is similar to listeners with acoustic hearing. The lexical properties of the test stimuli used to assess performance are important to spoken-word recognition and should be included in further models of the word recognition process.

Auditory Performance and Electrical Stimulation Measures in Cochlear Implant Recipients With Auditory Neuropathy Compared With Severe to Profound Sensorineural Hearing Loss.

PubMed

Attias, Joseph; Greenstein, Tally; Peled, Miriam; Ulanovski, David; Wohlgelernter, Jay; Raveh, Eyal

The aim of the study was to compare auditory and speech outcomes and electrical parameters on average 8 years after cochlear implantation between children with isolated auditory neuropathy (AN) and children with sensorineural hearing loss (SNHL). The study was conducted at a tertiary, university-affiliated pediatric medical center. The cohort included 16 patients with isolated AN with current age of 5 to 12.2 years who had been using a cochlear implant for at least 3.4 years and 16 control patients with SNHL matched for duration of deafness, age at implantation, type of implant, and unilateral/bilateral implant placement. All participants had had extensive auditory rehabilitation before and after implantation, including the use of conventional hearing aids. Most patients received Cochlear Nucleus devices, and the remainder either Med-El or Advanced Bionics devices. Unaided pure-tone audiograms were evaluated before and after implantation. Implantation outcomes were assessed by auditory and speech recognition tests in quiet and in noise. Data were also collected on the educational setting at 1 year after implantation and at school age. The electrical stimulation measures were evaluated only in the Cochlear Nucleus implant recipients in the two groups. Similar mapping and electrical measurement techniques were used in the two groups. Electrical thresholds, comfortable level, dynamic range, and objective neural response telemetry threshold were measured across the 22-electrode array in each patient. Main outcome measures were between-group differences in the following parameters: (1) Auditory and speech tests. (2) Residual hearing. (3) Electrical stimulation parameters. (4) Correlations of residual hearing at low frequencies with electrical thresholds at the basal, middle, and apical electrodes. The children with isolated AN performed equally well to the children with SNHL on auditory and speech recognition tests in both quiet and noise. More children in the AN group than the SNHL group were attending mainstream educational settings at school age, but the difference was not statistically significant. Significant between-group differences were noted in electrical measurements: the AN group was characterized by a lower current charge to reach subjective electrical thresholds, lower comfortable level and dynamic range, and lower telemetric neural response threshold. Based on pure-tone audiograms, the children with AN also had more residual hearing before and after implantation. Highly positive coefficients were found on correlation analysis between T levels across the basal and midcochlear electrodes and low-frequency acoustic thresholds. Prelingual children with isolated AN who fail to show expected oral and auditory progress after extensive rehabilitation with conventional hearing aids should be considered for cochlear implantation. Children with isolated AN had similar pattern as children with SNHL on auditory performance tests after cochlear implantation. The lower current charge required to evoke subjective and objective electrical thresholds in children with AN compared with children with SNHL may be attributed to the contribution to electrophonic hearing from the remaining neurons and hair cells. In addition, it is also possible that mechanical stimulation of the basilar membrane, as in acoustic stimulation, is added to the electrical stimulation of the cochlear implant.

Recognition and Localization of Speech by Adult Cochlear Implant Recipients Wearing a Digital Hearing Aid in the Nonimplanted Ear (Bimodal Hearing)

PubMed Central

Potts, Lisa G.; Skinner, Margaret W.; Litovsky, Ruth A.; Strube, Michael J; Kuk, Francis

2010-01-01

Background The use of bilateral amplification is now common clinical practice for hearing aid users but not for cochlear implant recipients. In the past, most cochlear implant recipients were implanted in one ear and wore only a monaural cochlear implant processor. There has been recent interest in benefits arising from bilateral stimulation that may be present for cochlear implant recipients. One option for bilateral stimulation is the use of a cochlear implant in one ear and a hearing aid in the opposite nonimplanted ear (bimodal hearing). Purpose This study evaluated the effect of wearing a cochlear implant in one ear and a digital hearing aid in the opposite ear on speech recognition and localization. Research Design A repeated-measures correlational study was completed. Study Sample Nineteen adult Cochlear Nucleus 24 implant recipients participated in the study. Intervention The participants were fit with a Widex Senso Vita 38 hearing aid to achieve maximum audibility and comfort within their dynamic range. Data Collection and Analysis Soundfield thresholds, loudness growth, speech recognition, localization, and subjective questionnaires were obtained six–eight weeks after the hearing aid fitting. Testing was completed in three conditions: hearing aid only, cochlear implant only, and cochlear implant and hearing aid (bimodal). All tests were repeated four weeks after the first test session. Repeated-measures analysis of variance was used to analyze the data. Significant effects were further examined using pairwise comparison of means or in the case of continuous moderators, regression analyses. The speech-recognition and localization tasks were unique, in that a speech stimulus presented from a variety of roaming azimuths (140 degree loudspeaker array) was used. Results Performance in the bimodal condition was significantly better for speech recognition and localization compared to the cochlear implant–only and hearing aid–only conditions. Performance was also different between these conditions when the location (i.e., side of the loudspeaker array that presented the word) was analyzed. In the bimodal condition, the speech-recognition and localization tasks were equal regardless of which side of the loudspeaker array presented the word, while performance was significantly poorer for the monaural conditions (hearing aid only and cochlear implant only) when the words were presented on the side with no stimulation. Binaural loudness summation of 1–3 dB was seen in soundfield thresholds and loudness growth in the bimodal condition. Measures of the audibility of sound with the hearing aid, including unaided thresholds, soundfield thresholds, and the Speech Intelligibility Index, were significant moderators of speech recognition and localization. Based on the questionnaire responses, participants showed a strong preference for bimodal stimulation. Conclusions These findings suggest that a well-fit digital hearing aid worn in conjunction with a cochlear implant is beneficial to speech recognition and localization. The dynamic test procedures used in this study illustrate the importance of bilateral hearing for locating, identifying, and switching attention between multiple speakers. It is recommended that unilateral cochlear implant recipients, with measurable unaided hearing thresholds, be fit with a hearing aid. PMID:19594084

Malformation of stria vascularis in the developing inner ear of the German waltzing guinea pig.

PubMed

Jin, Zhe; Mannström, Paula; Järlebark, Leif; Ulfendahl, Mats

2007-05-01

Auditory function and cochlear morphology have previously been described in the postnatal German waltzing guinea pig, a strain with recessive deafness. In the present study, cochlear histopathology was further investigated in the inner ear of the developing German waltzing guinea pig (gw/gw). The lumen of the cochlear duct diminished progressively from embryonic day (E) 35 to E45 and was absent at E50 because of the complete collapse of Reissner's membrane onto the hearing organ. The embryonic stria vascularis, consisting of a simple epithelium, failed to transform into the complex trilaminar tissue seen in normal animals and displayed signs of degeneration. Subsequent degeneration of the sensory epithelium was observed from E50 and onwards. Defective and insufficient numbers of melanocytes were observed in the developing gw/gw stria vascularis. A gene involved in cochlear melanocyte development, Pax3, was markedly reduced in lateral wall tissue of the cochlea of both E40 and adult gw/gw individuals, whereas its expression was normal in the skin and diaphragm muscle of adult gw/gw animals. The Pax3 gene may thus be involved in the pathological process but is unlikely to be the primary mutated gene in the German waltzing guinea pig. TUNEL assay showed no signs of apoptotic cell death in the developing stria vascularis of this type of guinea pig. Thus, malformation of the stria vascularis appears to be the primary defect in the inner ear of the German waltzing guinea pig. Defective and insufficient numbers of melanocytes might migrate to the developing stria vascularis but fail to provide the proper support for the subsequent development of marginal and basal cells, thereby leading to stria vascularis malformation and dysfunction in the inner ear of the German waltzing guinea pig.

Lexico-semantic and acoustic-phonetic processes in the perception of noise-vocoded speech: implications for cochlear implantation

PubMed Central

McGettigan, Carolyn; Rosen, Stuart; Scott, Sophie K.

2014-01-01

Noise-vocoding is a transformation which, when applied to speech, severely reduces spectral resolution and eliminates periodicity, yielding a stimulus that sounds “like a harsh whisper” (Scott et al., 2000, p. 2401). This process simulates a cochlear implant, where the activity of many thousand hair cells in the inner ear is replaced by direct stimulation of the auditory nerve by a small number of tonotopically-arranged electrodes. Although a cochlear implant offers a powerful means of restoring some degree of hearing to profoundly deaf individuals, the outcomes for spoken communication are highly variable (Moore and Shannon, 2009). Some variability may arise from differences in peripheral representation (e.g., the degree of residual nerve survival) but some may reflect differences in higher-order linguistic processing. In order to explore this possibility, we used noise-vocoding to explore speech recognition and perceptual learning in normal-hearing listeners tested across several levels of the linguistic hierarchy: segments (consonants and vowels), single words, and sentences. Listeners improved significantly on all tasks across two test sessions. In the first session, individual differences analyses revealed two independently varying sources of variability: one lexico-semantic in nature and implicating the recognition of words and sentences, and the other an acoustic-phonetic factor associated with words and segments. However, consequent to learning, by the second session there was a more uniform covariance pattern concerning all stimulus types. A further analysis of phonetic feature recognition allowed greater insight into learning-related changes in perception and showed that, surprisingly, participants did not make full use of cues that were preserved in the stimuli (e.g., vowel duration). We discuss these findings in relation cochlear implantation, and suggest auditory training strategies to maximize speech recognition performance in the absence of typical cues. PMID:24616669

Modeling Spoken Word Recognition Performance by Pediatric Cochlear Implant Users using Feature Identification

PubMed Central

Frisch, Stefan A.; Pisoni, David B.

2012-01-01

Objective Computational simulations were carried out to evaluate the appropriateness of several psycholinguistic theories of spoken word recognition for children who use cochlear implants. These models also investigate the interrelations of commonly used measures of closed-set and open-set tests of speech perception. Design A software simulation of phoneme recognition performance was developed that uses feature identification scores as input. Two simulations of lexical access were developed. In one, early phoneme decisions are used in a lexical search to find the best matching candidate. In the second, phoneme decisions are made only when lexical access occurs. Simulated phoneme and word identification performance was then applied to behavioral data from the Phonetically Balanced Kindergarten test and Lexical Neighborhood Test of open-set word recognition. Simulations of performance were evaluated for children with prelingual sensorineural hearing loss who use cochlear implants with the MPEAK or SPEAK coding strategies. Results Open-set word recognition performance can be successfully predicted using feature identification scores. In addition, we observed no qualitative differences in performance between children using MPEAK and SPEAK, suggesting that both groups of children process spoken words similarly despite differences in input. Word recognition ability was best predicted in the model in which phoneme decisions were delayed until lexical access. Conclusions Closed-set feature identification and open-set word recognition focus on different, but related, levels of language processing. Additional insight for clinical intervention may be achieved by collecting both types of data. The most successful model of performance is consistent with current psycholinguistic theories of spoken word recognition. Thus it appears that the cognitive process of spoken word recognition is fundamentally the same for pediatric cochlear implant users and children and adults with normal hearing. PMID:11132784

Neural preservation underlies speech improvement from auditory deprivation in young cochlear implant recipients.

PubMed

Feng, Gangyi; Ingvalson, Erin M; Grieco-Calub, Tina M; Roberts, Megan Y; Ryan, Maura E; Birmingham, Patrick; Burrowes, Delilah; Young, Nancy M; Wong, Patrick C M

2018-01-30

Although cochlear implantation enables some children to attain age-appropriate speech and language development, communicative delays persist in others, and outcomes are quite variable and difficult to predict, even for children implanted early in life. To understand the neurobiological basis of this variability, we used presurgical neural morphological data obtained from MRI of individual pediatric cochlear implant (CI) candidates implanted younger than 3.5 years to predict variability of their speech-perception improvement after surgery. We first compared neuroanatomical density and spatial pattern similarity of CI candidates to that of age-matched children with normal hearing, which allowed us to detail neuroanatomical networks that were either affected or unaffected by auditory deprivation. This information enables us to build machine-learning models to predict the individual children's speech development following CI. We found that regions of the brain that were unaffected by auditory deprivation, in particular the auditory association and cognitive brain regions, produced the highest accuracy, specificity, and sensitivity in patient classification and the most precise prediction results. These findings suggest that brain areas unaffected by auditory deprivation are critical to developing closer to typical speech outcomes. Moreover, the findings suggest that determination of the type of neural reorganization caused by auditory deprivation before implantation is valuable for predicting post-CI language outcomes for young children.

Automatic localization of cochlear implant electrodes in CTs with a limited intensity range

NASA Astrophysics Data System (ADS)

Zhao, Yiyuan; Dawant, Benoit M.; Noble, Jack H.

2017-02-01

Cochlear implants (CIs) are neural prosthetics for treating severe-to-profound hearing loss. Our group has developed an image-guided cochlear implant programming (IGCIP) system that uses image analysis techniques to recommend patientspecific CI processor settings to improve hearing outcomes. One crucial step in IGCIP is the localization of CI electrodes in post-implantation CTs. Manual localization of electrodes requires time and expertise. To automate this process, our group has proposed automatic techniques that have been validated on CTs acquired with scanners that produce images with an extended range of intensity values. However, there are many clinical CTs acquired with a limited intensity range. This limitation complicates the electrode localization process. In this work, we present a pre-processing step for CTs with a limited intensity range and extend the methods we proposed for full intensity range CTs to localize CI electrodes in CTs with limited intensity range. We evaluate our method on CTs of 20 subjects implanted with CI arrays produced by different manufacturers. Our method achieves a mean localization error of 0.21mm. This indicates our method is robust for automatic localization of CI electrodes in different types of CTs, which represents a crucial step for translating IGCIP from research laboratory to clinical use.

Timing Discrepancies of Early Intervention Hearing Services in Urban and Rural Cochlear Implant Recipients

PubMed Central

Bush, Matthew L.; Burton, Mary; Loan, Ashley; Shinn, Jennifer B.

2013-01-01

Objective The purpose of this study was to examine the timing of early intervention diagnostic and therapeutic services in cochlear implant recipients from rural and urban areas. Study design Retrospective case series review Setting Tertiary referral center Patients Cochlear implant recipients from a single comprehensive hearing institute born with severe congenital sensorineural hearing loss were examined. Timing of diagnostic and therapeutic services was examined. Intervention(s) Diagnosis, amplification, and eventual cochlear implantation for all patients in the study Main outcome measure(s) Time points of definitive diagnosis, amplification, and cochlear implantation for children from urban and rural regions were examined. Correlation analysis of distance to testing center and timing of services was also assessed. Results 40 children born with congenital hearing loss were included in the study and were diagnosed at a median age of 13 weeks after birth. Children from rural regions obtained amplification at a median age of 47.7 weeks after birth, while urban children were amplified at 26 weeks after birth. Cochlear implantation was performed at a median age of 182 weeks after birth in those from rural areas and at 104 weeks after birth in urban-dwelling patients. A linear relationship was identified between distance to the implant center and timing of hearing aid amplification (r=0.5, p=0.033) and cochlear implantation (r=0.5, p=0.016). Conclusions Children residing outside of metro areas may be at higher risk of delayed rehabilitative services and cochlear implantation than those residing in urban areas that may be closer in proximity to tertiary care centers. PMID:24136305

The cochlear CRF signaling systems and their mechanisms of action in modulating cochlear sensitivity and protection against trauma

PubMed Central

Graham, Christine E.; Basappa, Johnvesly; Turcan, Sevin; Vetter, Douglas E.

2011-01-01

A key requirement for encoding the auditory environment is the ability to dynamically alter cochlear sensitivity. However, merely attaining a steady state of maximal sensitivity is not a viable solution since the sensory cells and ganglion cells of the cochlea are prone to damage following exposure to loud sound. Most often, such damage is via initial metabolic insult that can lead to cellular death. Thus, establishing the highest sensitivity must be balanced with protection against cellular metabolic damage that can lead to loss of hair cells and ganglion cells, resulting in loss of frequency representation. While feedback mechanisms are known to exist in the cochlea that alter sensitivity, they respond only after stimulus encoding, allowing potentially damaging sounds to impact the inner ear at times coincident with increased sensitivity. Thus, questions remain concerning the endogenous signaling systems involved in dynamic modulation of cochlear sensitivity and protection against metabolic stress. Understanding endogenous signaling systems involved in cochlear protection may lead to new strategies and therapies for prevention of cochlear damage and consequent hearing loss. We have recently discovered a novel cochlear signaling system that is molecularly equivalent to the classic hypothalamic-pituitary-adrenal (HPA) axis. This cochlear HPA-equivalent system functions to balance auditory sensitivity and susceptibility to noise-induced hearing loss, and also protects against cellular metabolic insults resulting from exposures to ototoxic drugs. We review the anatomy, physiology, and cellular signaling of this system, and compare it to similar signaling in other organs/tissues of the body. PMID:21909974

Preventing hearing damage using topical dexamethasone during reversible cochlear ischemia: an animal model.

PubMed

Morawski, Krzysztof; Telischi, Fred F; Bohorquez, Jorge; Niemczyk, Kazimierz

2009-09-01

Local application of dexamethasone to the round window (RW) niche prevents cochlear damage caused by local reversible ischemia. Cochlear ischemia induced by internal auditory artery (IAA) compression/stretching is thought to cause postoperative sensory hearing loss after attempted hearing preservation removal of acoustic neuroma tumors. Dexamethasone administered to the RW niche traveling through the membrane to the cochlear fluids may prevent ischemic damage. Ten young albino rabbits were used for this study. Ischemic episodes were induced by compressing the IAA. Laser Doppler cochlear blood flow was measured using a probe positioned at the RW niche. Transtympanic electrocochleography was measured at 4, 8, and 12 kHz. In 5 test ears, dexamethasone was administered topically at the RW for approximately 50 minutes before the IAA compressions, whereas in 5 control ears, saline was applied in the same way. Each ear underwent one 10-minute IAA compression with a 60-minute postischemic period of transtympanic electrocochleography monitoring. In both control- and dexamethasone-treated ears, ischemic episodes measured by Laser Doppler cochlear blood flow were comparable. Fifty minutes after IAA decompression, in dexamethasone-pretreated ears, cochlear microphonic and compound action potential amplitudes at all test frequencies were 10 to 15% less reduced than those in control ears. Compound action potential latencies in dexamethasone-pretreated ears resulted in shorter latency delay than in control ears. The RW seems to be an efficacious route for the administration of dexamethasone into the inner ear. Dexamethasone showed a protective effect on cochlear function after local ischemia. Transtympanic electrocochleography was found to be a sufficient and effective tool in monitoring hearing.

Quality-of-life benefit from cochlear implantation in the elderly.

PubMed

Vermeire, Katrien; Brokx, Jan P L; Wuyts, Floris L; Cochet, Ellen; Hofkens, Anouk; Van de Heyning, Paul H

2005-03-01

To compare the audiologic results of geriatric patients receiving cochlear implants with younger age groups and to evaluate the quality of life after cochlear implantation in the geriatric population by means of validated quality-of-life questionnaires. Cross-sectional study involving 89 postlingually deafened cochlear implant subjects. Tertiary referral center. A total of 89 postlingually deafened patients were included in the study, among which were 25 patients who were aged 70 years or older. All patients received a cochlear implant. Subjects were implanted with either the Laura, Nucleus 24, or Med-el Combi 40+ cochlear implant systems implementing the SPEAK, ACE, CIS, or CIS+ coding strategies. Speech recognition was determined by means of phonetically balanced monosyllabic word lists. The Hearing Handicap Inventory for Adults, the Glasgow Benefit Inventory, and the scale for the prediction of hearing disability in sensorineural hearing loss were used to quantify the quality of life. Mean audiologic performance for the three groups increased significantly after implantation (p < 0.001). Postoperative audiologic performance of the geriatric population led to useful hearing, but these scores were significantly lower than for the younger age groups (p = 0.002). However, the quality-of-life outcomes for the geriatric group were similar to those of the younger age groups (p = 0.411 for the Hearing Handicap Inventory for Adults; p = 0.886 for the Glasgow Benefit Inventory). The results of this study prove that cochlear implantation in the elderly provides improvements in quality of life and speech understanding, similar to those for younger adult cochlear implant recipients.

EEG frontal asymmetry related to pleasantness of music perception in healthy children and cochlear implanted users.

PubMed

Vecchiato, G; Maglione, A G; Scorpecci, A; Malerba, P; Marsella, P; Di Francesco, G; Vitiello, S; Colosimo, A; Babiloni, Fabio

2012-01-01

Interestingly, the international debate about the quality of music fruition for cochlear implanted users does not take into account the hypothesis that bilateral users could perceive music in a more pleasant way with respect to monolateral users. In this scenario, the aim of the present study was to investigate if cerebral signs of pleasantness during music perception in healthy child are similar to those observed in monolateral and in bilateral cochlear implanted users. In fact, previous observations in literature on healthy subjects have indicated that variations of the frontal EEG alpha activity are correlated with the perceived pleasantness of the sensory stimulation received (approach-withdrawal theory). In particular, here we described differences between cortical activities estimated in the alpha frequency band for a healthy child and in patients having a monolateral or a bilateral cochlear implant during the fruition of a musical cartoon. The results of the present analysis showed that the alpha EEG asymmetry patterns observed in a healthy child and that of a bilateral cochlear implanted patient are congruent with the approach-withdrawal theory. Conversely, the scalp topographic distribution of EEG power spectra in the alpha band resulting from the monolateral cochlear user presents a different EEG pattern from the normal and bilateral implanted patients. Such differences could be explained at the light of the approach-withdrawal theory. In fact, the present findings support the hypothesis that a monolateral cochlear implanted user could perceive the music in a less pleasant way when compared to a healthy subject or to a bilateral cochlear user.

Educational, employment, and social participation of young adult graduates from the paediatric Southern Cochlear Implant Programme, New Zealand.

PubMed

Goh, Terence; Bird, Philip; Pearson, John; Mustard, Jill

2016-01-01

The purpose of this study is to observe the education and vocational achievements and social participation of cochlear implant recipients as they graduate from a paediatric cochlear implant programme and identify any significant associations that might exist. This study identified 56 patients from the Southern Cochlear Implant Programme (SCIP) who received cochlear implants before the age of 19 (paediatric) and are now over the age of 19 (adult). A questionnaire investigated their education, employment, and identity with the hearing and deaf communities. Also included were the satisfaction with life scale and Hearing Participation Scale (HPS). Subjects ranged in age from 19 to 32. Twenty-six patients responded to the questionnaire, including one non-user. Twenty identified strongly or very strongly with the hearing community. There was weak evidence of a linear association between strong identity with the hearing community and a higher HPS score. No other statistically significant associations were detected. Interestingly, 12 out of 26 participants found employment through family. Positive outcome trends in education and employment were seen in this study although no statistical significance was achieved. There is a strong bias for those who use their cochlear implants regularly, and there are no data available for those who do not use their cochlear implants for comparison as only one non-user completed the survey, despite efforts to include this group. This study shows that there is perceived benefit in implantation for patients who use it regularly but further research is needed with a more diverse group of cochlear implant recipients.

Pediatric Cochlear Implants: An Overview of the Alternatives in Education and Rehabilitation.

ERIC Educational Resources Information Center

Barnes, Judith M., Ed.; And Others

This collection of 10 papers is intended as a resource book integrating information on pediatric cochlear implants for educators, parents, implant teams, and rehabilitation specialists. The papers focus on the importance of providing an oral educational environment to maximize cochlear implant success. An introduction notes controversies in the…

Realization of Complex Onsets by Pediatric Users of Cochlear Implants

ERIC Educational Resources Information Center

Chin, Steven B.

2006-01-01

This study examined variations in English complex onset realizations by children who use cochlear implants. Data consisted of 227 productions of two-segment onset clusters from 12 children. In general, onset cluster realizations of children with cochlear implants did not differ markedly from those reported for children with normal hearing: null…

Contribution of Family Environment to Pediatric Cochlear Implant Users' Speech and Language Outcomes: Some Preliminary Findings

ERIC Educational Resources Information Center

Holt, Rachael Frush; Beer, Jessica; Kronenberger, William G.; Pisoni, David B.; Lalonde, Kaylah

2012-01-01

Purpose: To evaluate the family environments of children with cochlear implants and to examine relationships between family environment and postimplant language development and executive function. Method: Forty-five families of children with cochlear implants completed a self-report family environment questionnaire (Family Environment Scale-Fourth…

Taxonomic Knowledge of Children with and without Cochlear Implants

ERIC Educational Resources Information Center

Lund, Emily; Dinsmoor, Jessica

2016-01-01

Purpose: The purpose of this study was to compare the taxonomic vocabulary knowledge and organization of children with cochlear implants to (a) children with normal hearing matched for age, and (b) children matched for vocabulary development. Method: Ten children with cochlear implants, 10 age-matched children with normal hearing, and 10…

Children with Cochlear Implants in Australia: Educational Settings, Supports, and Outcomes

ERIC Educational Resources Information Center

Punch, Renee; Hyde, Merv

2010-01-01

This Australian study examined the communication, academic, and social outcomes of pediatric cochlear implantation from the perspectives of teachers working with children with cochlear implants. The children were aged from 1 to 18 years and attended a range of educational settings in early intervention, primary, and secondary schooling. One…

Cochlear Implants in Children with Hearing Loss: Maternal Expectations and Impact on the Family

ERIC Educational Resources Information Center

Zaidman-Zait, Anat; Most, Tova

2005-01-01

To facilitate evaluations of cochlear implant candidates and to promote (re)habilitation efficacy and collaboration with families, this study examined the expectations of 35 mothers with typical hearing and their beliefs and difficulties related to their child's hearing loss and current or future cochlear implantation. Questionnaires measured…

Persistent Language Delay versus Late Language Emergence in Children with Early Cochlear Implantation

ERIC Educational Resources Information Center

Geers, Ann E.; Nicholas, Johanna; Tobey, Emily; Davidson, Lisa

2016-01-01

Purpose: The purpose of the present investigation is to differentiate children using cochlear implants (CIs) who did or did not achieve age-appropriate language scores by mid-elementary grades and to identify risk factors for persistent language delay following early cochlear implantation. Materials and Method: Children receiving unilateral CIs at…

Serving Deaf Students Who Have Cochlear Implants. PEPNet Tipsheet

ERIC Educational Resources Information Center

Searls, J. Matt, Comp.

2010-01-01

Cochlear implants (CIs) are complex electronic devices surgically implanted under the skin behind the ear. These devices utilize electrodes placed in the inner ear (the cochlea) to stimulate the auditory nerve of individuals with significant permanent hearing loss. Cochlear implants may not be suitable for everyone. They are designed to provide…

Verbal Working Memory in Children with Cochlear Implants

ERIC Educational Resources Information Center

Nittrouer, Susan; Caldwell-Tarr, Amanda; Low, Keri E.; Lowenstein, Joanna H.

2017-01-01

Purpose: Verbal working memory in children with cochlear implants and children with normal hearing was examined. Participants: Ninety-three fourth graders (47 with normal hearing, 46 with cochlear implants) participated, all of whom were in a longitudinal study and had working memory assessed 2 years earlier. Method: A dual-component model of…

Emotion Understanding in Deaf Children with a Cochlear Implant

ERIC Educational Resources Information Center

Wiefferink, Carin H.; Rieffe, Carolien; Ketelaar, Lizet; De Raeve, Leo; Frijns, Johan H. M.

2013-01-01

It is still largely unknown how receiving a cochlear implant affects the emotion understanding in deaf children. We examined indices for emotion understanding and their associations with communication skills in children aged 2.5-5 years, both hearing children (n = 52) and deaf children with a cochlear implant (n = 57). 2 aspects of emotion…

Evaluating the Feasibility of Using Remote Technology for Cochlear Implants

ERIC Educational Resources Information Center

Goehring, Jenny L.; Hughes, Michelle L.; Baudhuin, Jacquelyn L.

2012-01-01

The use of remote technology to provide cochlear implant services has gained popularity in recent years. This article contains a review of research evaluating the feasibility of remote service delivery for recipients of cochlear implants. To date, published studies have determined that speech-processor programming levels and other objective tests…

Scala tympani cochleostomy I: results of a survey.

PubMed

Adunka, Oliver F; Buchman, Craig A

2007-12-01

To assess current surgical techniques for scala tympani cochlear implantation among North American surgeons. A survey was distributed to all cochlear implant surgeons participating in the 2006 William House Cochlear Implant Study Group in Toronto, Canada. Participants were asked to anonymously identify their routine surgical practices. Images of trans-facial recess approaches to the round window and cochlear promontory were used in a multiple-choice fashion to assess the surgeon's typical exposure and cochleostomy location. Returned questionnaires were electronically processed and evaluated. Fifty-five (75%) of 73 returned surveys had adequate data validity and availability. Landmark identification and preferred cochleostomy locations varied greatly. About 20% of surgeons selected cochleostomy locations superior to the round window membrane. Cochleostomy size and location appeared to be influenced by surgical experience and whether or not the round window overhang was drilled off. This survey clearly documents marked variations in surgical techniques for scala tympani cochlear implantation. Future studies should more clearly define the surgical anatomy of this region for appropriate placement of a scala tympani cochleostomy. These findings may ultimately have an impact on hearing and neural preservation cochlear implant surgeries.

Cochlear Implants and Psychiatric Assessments: a Norrie Disease Case Report.

PubMed

Jacques, Denis; Dubois, Thomas; Zdanowicz, Nicolas; Gilain, Chantal; Garin, Pierre

2017-09-01

It is important to perform psychiatric assessments of adult patients who are candidates for cochlear implants both to screen them for psychiatric disorders and to assess their understanding and compliance with the procedure. Deafness is a factor of difficulty for conducting in-depth psychiatric interviews, but concomitant blindness may make it impossible. After a description of Norrie disease, a rare disease in which blindness and deafness may occur together, we propose a case report of a patient suffering from the disease and who consulted in view of a cochlear implant. Early information on cochlear implants appears to be necessary before total deafness occurs in patients suffering from Norrie disease. An inventory of digital communication tools that can be used by the patient is also highly valuable. Research should be supported for a more systematic use of psychiatric assessments prior to cochlear implants. In the special case of Norrie disease, we recommend early screening for mental retardation and related psychotic disorders and, depending on the patient's level of understanding, preventive information on the benefits and limits of cochlear implants before total deafness occurs.

Music activities and responses of young cochlear implant recipients.

PubMed

van Besouw, Rachel M; Grasmeder, Mary L; Hamilton, Mary E; Baumann, Sarah E

2011-05-01

The development of auditory receptive skills and spoken language is often delayed in children who use cochlear implants, which may affect their appreciation of and responses to music. This in turn may be interpreted as disinterest in music. A questionnaire was developed to determine whether differences in exposure and responses to music exist between young cochlear implant recipients and their normally hearing peers. The questionnaire was developed by a multidisciplinary team and distributed to parents of preschool children with normal hearing and to parents of preschool children who had been implanted at least one year prior. The cochlear implant group comprised 23 children and was gender and age matched (within ±2 months) to a group of children with normal hearing. Young cochlear implant recipients receive similar exposure to audiovisual music media, parental singing and musical instruments at home. However, the data suggest that they receive less exposure to children's music presented without visual stimuli. Parents also reported less sophisticated responses to music for this group. The findings of this study have important implications concerning the provision of age-appropriate music habilitation materials and activities for young cochlear implant recipients.

Evaluation of a cochlear-implant processing strategy incorporating phantom stimulation and asymmetric pulses

PubMed Central

Monstrey, Jolijn; Deeks, John M.; Macherey, Olivier

2014-01-01

Objective To evaluate a speech-processing strategy in which the lowest frequency channel is conveyed using an asymmetric pulse shape and “phantom stimulation”, where current is injected into one intra-cochlear electrode and where the return current is shared between an intra-cochlear and an extra-cochlear electrode. This strategy is expected to provide more selective excitation of the cochlear apex, compared to a standard strategy where the lowest-frequency channel is conveyed by symmetric pulses in monopolar mode. In both strategies all other channels were conveyed by monopolar stimulation. Design Within-subjects comparison between the two strategies. Four experiments: (1) discrimination between the strategies, controlling for loudness differences, (2) consonant identification, (3) recognition of lowpass-filtered sentences in quiet, (4) sentence recognition in the presence of a competing speaker. Study sample Eight users of the Advanced Bionics CII/Hi-Res 90k cochlear implant. Results Listeners could easily discriminate between the two strategies but no consistent differences in performance were observed. Conclusions The proposed method does not improve speech perception, at least in the short term. PMID:25358027

Evaluation of a cochlear-implant processing strategy incorporating phantom stimulation and asymmetric pulses.

PubMed

Carlyon, Robert P; Monstrey, Jolijn; Deeks, John M; Macherey, Olivier

2014-12-01

To evaluate a speech-processing strategy in which the lowest frequency channel is conveyed using an asymmetric pulse shape and "phantom stimulation", where current is injected into one intra-cochlear electrode and where the return current is shared between an intra-cochlear and an extra-cochlear electrode. This strategy is expected to provide more selective excitation of the cochlear apex, compared to a standard strategy where the lowest-frequency channel is conveyed by symmetric pulses in monopolar mode. In both strategies all other channels were conveyed by monopolar stimulation. Within-subjects comparison between the two strategies. Four experiments: (1) discrimination between the strategies, controlling for loudness differences, (2) consonant identification, (3) recognition of lowpass-filtered sentences in quiet, (4) sentence recognition in the presence of a competing speaker. Eight users of the Advanced Bionics CII/Hi-Res 90k cochlear implant. Listeners could easily discriminate between the two strategies but no consistent differences in performance were observed. The proposed method does not improve speech perception, at least in the short term.

The Interaction of Temporal and Spectral Acoustic Information with Word Predictability on Speech Intelligibility

NASA Astrophysics Data System (ADS)

Shahsavarani, Somayeh Bahar

High-level, top-down information such as linguistic knowledge is a salient cortical resource that influences speech perception under most listening conditions. But, are all listeners able to exploit these resources for speech facilitation to the same extent? It was found that children with cochlear implants showed different patterns of benefit from contextual information in speech perception compared with their normal-haring peers. Previous studies have discussed the role of non-acoustic factors such as linguistic and cognitive capabilities to account for this discrepancy. Given the fact that the amount of acoustic information encoded and processed by auditory nerves of listeners with cochlear implants differs from normal-hearing listeners and even varies across individuals with cochlear implants, it is important to study the interaction of specific acoustic properties of the speech signal with contextual cues. This relationship has been mostly neglected in previous research. In this dissertation, we aimed to explore how different acoustic dimensions interact to affect listeners' abilities to combine top-down information with bottom-up information in speech perception beyond the known effects of linguistic and cognitive capacities shown previously. Specifically, the present study investigated whether there were any distinct context effects based on the resolution of spectral versus slowly-varying temporal information in perception of spectrally impoverished speech. To that end, two experiments were conducted. In both experiments, a noise-vocoded technique was adopted to generate spectrally-degraded speech to approximate acoustic cues delivered to listeners with cochlear implants. The frequency resolution was manipulated by varying the number of frequency channels. The temporal resolution was manipulated by low-pass filtering of amplitude envelope with varying low-pass cutoff frequencies. The stimuli were presented to normal-hearing native speakers of American English. Our results revealed a significant interaction effect between spectral, temporal, and contextual information in the perception of spectrally-degraded speech. This suggests that specific types and degradation of bottom-up information combine differently to utilize contextual resources. These findings emphasize the importance of taking the listener's specific auditory abilities into consideration while studying context effects. These results also introduce a novel perspective for designing interventions for listeners with cochlear implants or other auditory prostheses.

Bringing Hearing to the Deaf

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shipsey, Ian

In his talk, Shipsey will discuss the cochlear implant, the first device to successfully allow the profoundly deaf to regain some sense of hearing. A cochlear implant is a small electronic apparatus. Unlike a normal hearing aid, which amplifies sound, a cochlear implant is surgically implanted behind the ear where it converts sound waves into electrical impulses. These implants have instigated a popular but controversial revolution in the treatment of deafness, and they serve as a model for research in neuroscience and biomedical engineering. Shipsey will discuss the physiology of natural hearing from the perspective of a physicist. He willmore » also touch on the function of cochlear implants in the context of historical treatments, electrical engineering, psychophysics, clinical evaluation of efficacy and personal experience. Finally, Shipsey will address the social implications of cochlear implantation and the future outlook for auditory prostheses.« less

Beyond generalized hair cells: Molecular cues for hair cell types

PubMed Central

Jahan, Israt; Pan, Ning; Kersigo, Jennifer; Fritzsch, Bernd

2012-01-01

Basic helix-loop-helix (bHLH) transcription factors (TFs) are crucial for inner ear neurosensory development. The proneural TF Atoh1 regulates the differentiation of hair cells (HCs) whereas Neurog1 and Neurod1 regulate specification and differentiation of neurons, respectively, but also affect HC development. Expression of Delta and Jagged ligands in nascent HCs and Notch receptors in supporting cells induce supporting cell differentiation through the regulation of neurogenic bHLH TFs (such as Hes1, Hes5) and suppression of limited Atoh1 expression. In sensorineural hearing loss, HCs are lost followed by supporting cells and progressive degeneration of neurons, at least in rodents. Regaining complete hearing may require reconstituting the organ of Corti (OC) from scratch, including the two types of HCs, inner (IHC) and outer (OHC) hair cells with the precise sorting of two types of afferent (type I and II) and efferent (lateral, LOC and medial, MOC olivo-cochlear) innervation. We review effects of bHLH TF dosage and their cross-regulation to differentiate HC types in the OC. We categorize findings of specific gene expressions in HCs: 1. as markers without meaning for the regeneration task, 2. as stabilizers who are needed to maintain or complete differentiation, and 3. as decision making genes, expressed and acting early enough to be useful in this process. Only one TF has been characterized that fits the last aspect: Atoh1. We propose that temporal and intensity variations of Atoh1 are naturally modulated to differentiate specific types of HCs. Importantly, the molecular means to modify the Atoh1 expression are at least partially understood and can be readily implemented in the attempts to regenerate specific types of HCs. PMID:23201032

Effect of age at cochlear implantation on auditory and speech development of children with auditory neuropathy spectrum disorder.

PubMed

Liu, Yuying; Dong, Ruijuan; Li, Yuling; Xu, Tianqiu; Li, Yongxin; Chen, Xueqing; Gong, Shusheng

2014-12-01

To evaluate the auditory and speech abilities in children with auditory neuropathy spectrum disorder (ANSD) after cochlear implantation (CI) and determine the role of age at implantation. Ten children participated in this retrospective case series study. All children had evidence of ANSD. All subjects had no cochlear nerve deficiency on magnetic resonance imaging and had used the cochlear implants for a period of 12-84 months. We divided our children into two groups: children who underwent implantation before 24 months of age and children who underwent implantation after 24 months of age. Their auditory and speech abilities were evaluated using the following: behavioral audiometry, the Categories of Auditory Performance (CAP), the Meaningful Auditory Integration Scale (MAIS), the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS), the Standard-Chinese version of the Monosyllabic Lexical Neighborhood Test (LNT), the Multisyllabic Lexical Neighborhood Test (MLNT), the Speech Intelligibility Rating (SIR) and the Meaningful Use of Speech Scale (MUSS). All children showed progress in their auditory and language abilities. The 4-frequency average hearing level (HL) (500Hz, 1000Hz, 2000Hz and 4000Hz) of aided hearing thresholds ranged from 17.5 to 57.5dB HL. All children developed time-related auditory perception and speech skills. Scores of children with ANSD who received cochlear implants before 24 months tended to be better than those of children who received cochlear implants after 24 months. Seven children completed the Mandarin Lexical Neighborhood Test. Approximately half of the children showed improved open-set speech recognition. Cochlear implantation is helpful for children with ANSD and may be a good optional treatment for many ANSD children. In addition, children with ANSD fitted with cochlear implants before 24 months tended to acquire auditory and speech skills better than children fitted with cochlear implants after 24 months. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Tinnitus after Simultaneous and Sequential Bilateral Cochlear Implantation.

PubMed

Ramakers, Geerte G J; Kraaijenga, Véronique J C; Smulders, Yvette E; van Zon, Alice; Stegeman, Inge; Stokroos, Robert J; Free, Rolien H; Frijns, Johan H M; Huinck, Wendy J; Van Zanten, Gijsbert A; Grolman, Wilko

2017-01-01

There is an ongoing global discussion on whether or not bilateral cochlear implantation should be standard care for bilateral deafness. Contrary to unilateral cochlear implantation, however, little is known about the effect of bilateral cochlear implantation on tinnitus. To investigate tinnitus outcomes 1 year after bilateral cochlear implantation. Secondarily, to compare tinnitus outcomes between simultaneous and sequential bilateral cochlear implantation and to investigate long-term follow-up (3 years). This study is a secondary analysis as part of a multicenter randomized controlled trial. Thirty-eight postlingually deafened adults were included in the original trial, in which the presence of tinnitus was not an inclusion criterion. All participants received cochlear implants (CIs) because of profound hearing loss. Nineteen participants received bilateral CIs simultaneously and 19 participants received bilateral CIs sequentially with an inter-implant interval of 2 years. The prevalence and severity of tinnitus before and after simultaneous and sequential bilateral cochlear implantation were measured preoperatively and each year after implantation with the Tinnitus Handicap Inventory (THI) and Tinnitus Questionnaire (TQ). The prevalence of preoperative tinnitus was 42% (16/38). One year after bilateral implantation, there was a median difference of -8 (inter-quartile range (IQR): -28 to 4) in THI score and -9 (IQR: -17 to -9) in TQ score in the participants with preoperative tinnitus. Induction of tinnitus occurred in five participants, all in the simultaneous group, in the year after bilateral implantation. Although the preoperative and also the postoperative median THI and TQ scores were higher in the simultaneous group, the median difference scores were equal in both groups. In the simultaneous group, tinnitus scores fluctuated in the 3 years after implantation. In the sequential group, four patients had an additional benefit of the second CI: a total suppression of tinnitus compared with their unilateral situation. While bilateral cochlear implantation can have a positive effect on preoperative tinnitus complaints, the induction of (temporary or permanent) tinnitus was also reported. Dutch Trial Register NTR1722.

[Effect of rehabilitation for prelingual deaf children who use cochlear implants in conjunction with hearing aids in the opposite ears].

PubMed

Tian, Yanjing; Zhou, Huifang; Zhang, Jing; Yang, Dong; Xu, Yi; Guo, Yuxi

2012-10-01

To compare the effect of rehabilitation of prelingual deaf children who used a cochlear implant (CI) in one ear and a hearing aids in the opposite ear while the hearing level of the opposite ears are different. Hearing ability, language ability and learning ability was included in the content. The aim of this research is to investigate better style of rehabilitation, and to offer the best help to the prelingual deaf children. Accord ing to the hearing level of the ear opposite to the one wearing a cochlear implant and whether the opposite ear wear a hearing aid or not, 30 prelingual deaf children were divided into three groups, including cochlear implant with opposite severe hearing loss and hearing aid ear (CI+SHA), cochlear implant with opposite profound hearing loss and hearing aid ear (CI+PHA), cochlear implant only (CI). The effect of rehabilitation was assessed in six different times (3,6,9,12,15 and 18 months after the cochlear implants and hearing aids began to work). The longer time the rehabilitation spends, the better the hearing ability,language ability and the learning ability were. The hearing ability of CI+SHA was better than those of CI+PHA (P<0.05) and CI (P<0.05). The language ability and learning ability of CI-SHA was nearly equal to those of the other two groups. The prelingual deaf children should take much more time on rehabilitation. The effect of rehabilitation for prelingual deaf children who used cochlear implant in one ear and hearing aid in the other depend on the residual hearing level of the other ear. If a prelingual deaf children still has any residual hearing level in the ear opposite to the cochlear implant ear, it is better for him/her to wear a hearing aid in the ear.

Altered vesicular glutamate transporter distributions in the mouse cochlear nucleus following cochlear insult

PubMed Central

Heeringa, Amarins N.; Stefanescu, Roxana A.; Raphael, Yehoash; Shore, Susan E.

2015-01-01

Vesicular glutamate transporters 1 and 2 (VGLUT1 and VGLUT2) have distinct distributions in the cochlear nucleus that correspond to the sources of the labeled terminals. VGLUT1 is mainly associated with terminals of auditory nerve fibers, whereas VGLUT2 is mainly associated with glutamatergic terminals deriving from other sources that project to the cochlear nucleus (CN), including somatosensory and vestibular terminals. Previous studies in guinea pig have shown that cochlear damage results in a decrease of VGLUT1-labeled puncta and an increase in VGLUT2-labeled puncta. This indicates cross-modal compensation that is of potential importance in somatic tinnitus. To examine whether this effect is consistent across species and to provide a background for future studies, using transgenesis, the current study examines VGLUT expression profiles upon cochlear insult by intracochlear kanamycin injections in the mouse. Intracochlear kanamycin injections abolished ipsilateral ABR responses in all animals and reduced ipsilateral spiral ganglion neuron densities in animals that were sacrificed after four weeks, but not in animals that were sacrificed after three weeks. In all unilaterally deafened animals, VGLUT1 density was decreased in CN regions that receive auditory nerve fiber terminals, i.e. in the deep layer of the dorsal cochlear nucleus (DCN), in the interstitial region where the auditory nerve enters the CN, and in the magnocellular region of the antero- and posteroventral CN. In contrast, density of VGLUT2 expression was upregulated in the fusiform cell layer of the DCN and in the granule cell lamina, which are known to receive somatosensory and vestibular terminals. These results show that a cochlear insult induces cross-modal compensation in the cochlear nucleus of the mouse, confirming previous findings in guinea pig, and that these changes are not dependent on the occurrence of spiral ganglion neuron degeneration. PMID:26705736

Altered vesicular glutamate transporter distributions in the mouse cochlear nucleus following cochlear insult.

PubMed

Heeringa, A N; Stefanescu, R A; Raphael, Y; Shore, S E

2016-02-19

Vesicular glutamate transporters 1 and 2 (VGLUT1 and VGLUT2) have distinct distributions in the cochlear nucleus that correspond to sources of the labeled terminals. VGLUT1 is mainly associated with terminals of auditory nerve fibers, whereas VGLUT2 is mainly associated with glutamatergic terminals deriving from other sources that project to the cochlear nucleus (CN), including somatosensory and vestibular terminals. Previous studies in guinea pig have shown that cochlear damage results in a decrease of VGLUT1-labeled puncta and an increase in VGLUT2-labeled puncta. This indicates cross-modal compensation that is of potential importance in somatic tinnitus. To examine whether this effect is consistent across species and to provide a background for future studies, using transgenesis, the current study examines VGLUT expression profiles upon cochlear insult by intracochlear kanamycin injections in the mouse. Intracochlear kanamycin injections abolished ipsilateral ABR responses in all animals and reduced ipsilateral spiral ganglion neuron densities in animals that were sacrificed after four weeks, but not in animals that were sacrificed after three weeks. In all unilaterally deafened animals, VGLUT1 density was decreased in CN regions that receive auditory nerve fiber terminals, i.e., in the deep layer of the dorsal cochlear nucleus (DCN), in the interstitial region where the auditory nerve enters the CN, and in the magnocellular region of the antero- and posteroventral CN. In contrast, density of VGLUT2 expression was upregulated in the fusiform cell layer of the DCN and in the granule cell lamina, which are known to receive somatosensory and vestibular terminals. These results show that a cochlear insult induces cross-modal compensation in the cochlear nucleus of the mouse, confirming previous findings in guinea pig, and that these changes are not dependent on the occurrence of spiral ganglion neuron degeneration. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

Bringing Hearing to the Deaf--Cochlear Implants: a Technical and Personal Account

NASA Astrophysics Data System (ADS)

Shipsey, Ian

2006-04-01

Cochlear implants are the first device to successfully restore neural function. They have instigated a popular but controversial revolution in the treatment of deafness, and they serve as a model for research in neuroscience and biomedical engineering. In this talk the physiology of natural hearing will be reviewed from the perspective of a physicist, and the function of cochlear implants will be described in the context of historical treatments, electrical engineering, psychophysics, clinical evaluation of efficacy and personal experience. The social implications of cochlear implantation and the future outlook for auditory prostheses will also be discussed.

Microphone directionality, pre-emphasis filter, and wind noise in cochlear implants.

PubMed

Chung, King; McKibben, Nicholas

2011-10-01

Wind noise can be a nuisance or a debilitating masker for cochlear implant users in outdoor environments. Previous studies indicated that wind noise at the microphone/hearing aid output had high levels of low-frequency energy and the amount of noise generated is related to the microphone directionality. Currently, cochlear implants only offer either directional microphones or omnidirectional microphones for users at-large. As all cochlear implants utilize pre-emphasis filters to reduce low-frequency energy before the signal is encoded, effective wind noise reduction algorithms for hearing aids might not be applicable for cochlear implants. The purposes of this study were to investigate the effect of microphone directionality on speech recognition and perceived sound quality of cochlear implant users in wind noise and to derive effective wind noise reduction strategies for cochlear implants. A repeated-measure design was used to examine the effects of spectral and temporal masking created by wind noise recorded through directional and omnidirectional microphones and the effects of pre-emphasis filters on cochlear implant performance. A digital hearing aid was programmed to have linear amplification and relatively flat in-situ frequency responses for the directional and omnidirectional modes. The hearing aid output was then recorded from 0 to 360° at flow velocities of 4.5 and 13.5 m/sec in a quiet wind tunnel. Sixteen postlingually deafened adult cochlear implant listeners who reported to be able to communicate on the phone with friends and family without text messages participated in the study. Cochlear implant users listened to speech in wind noise recorded at locations that the directional and omnidirectional microphones yielded the lowest noise levels. Cochlear implant listeners repeated the sentences and rated the sound quality of the testing materials. Spectral and temporal characteristics of flow noise, as well as speech and/or noise characteristics before and after the pre-emphasis filter, were analyzed. Correlation coefficients between speech recognition scores and crest factors of wind noise before and after pre-emphasis filtering were also calculated. Listeners obtained higher scores using the omnidirectional than the directional microphone mode at 13.5 m/sec, but they obtained similar speech recognition scores for the two microphone modes at 4.5 m/sec. Higher correlation coefficients were obtained between speech recognition scores and crest factors of wind noise after pre-emphasis filtering rather than before filtering. Cochlear implant users would benefit from both directional and omnidirectional microphones to reduce far-field background noise and near-field wind noise. Automatic microphone switching algorithms can be more effective if the incoming signal were analyzed after pre-emphasis filters for microphone switching decisions. American Academy of Audiology.

Exploring the Language and Literacy Outcomes of Pediatric Cochlear Implant Users

PubMed Central

Spencer, Linda J.; Barker, Brittan A.; Tomblin, J. Bruce

2011-01-01

Objective The principal goal of this study was to investigate the relationship between language and literacy (i.e., reading and writing) skills in pediatric cochlear implant users. A peripheral objective was to identify the children's skills that were in need of remediation and subsequently to provide suggestions for remedial programming. It was predicted that the robust language skills often associated with children who have cochlear implant experience would facilitate the development of literacy skills. It was further proposed that the language and literacy skills of pediatric cochlear implant users would approximate the language and literacy skills of children with normal hearing. Design Sixteen pediatric cochlear implant users' language and literacy skills were evaluated and then compared with a reference group of 16 age-matched, normal-hearing children. All 32 participants were educated in mainstream classes within the public school system in the Midwest. The “Sentence Formulation” and “Concepts and Directions” subtests of the Clinical Evaluation of Language Fundamentals-3 test were used to evaluate receptive and expressive language skills. Reading comprehension was evaluated with the “Paragraph Comprehension” subtest of the Woodcock Reading Mastery Test. Performance measures for the writing analyses included productivity, complexity and grammaticality measures. Results Children with cochlear implants performed within 1 SD of the normal-hearing, age-matched children on measures of language comprehension, reading comprehension and writing accuracy. However, the children with cochlear implants performed significantly poorer than the children with normal hearing on the expressive “Sentence Formulation” subtest. The cochlear implant users also produced fewer words on the written narrative task than did the normal-hearing children, although there was not a significant difference between groups with respect to total words per clause. Furthermore there was a strong correlation between language performance and reading performance, as well as language performance and total words produced on the written performance measure for the children using cochlear implants. Conclusions The results of this study suggest that the language skills of pediatric cochlear implant users are related to and correlated with the development of literacy skills within these children. Consequently, the performance of the cochlear implant users, on various language and literacy measures, compared favorably to an age-matched group of children with normal hearing. There were significant differences in the ability of the cochlear implant users to correctly utilize grammatical structures such as conjunctions and correct verb forms when they were required to formulate written and oral sentences. Given this information, it would be appropriate for their educational or remedial language programs to emphasize the use and development of these structures. PMID:12799546

Is there a best side for cochlear implants in post-lingual patients?

PubMed

Amaral, Maria Stella Arantes do; Damico, Thiago A; Gonçales, Alina S; Reis, Ana C M B; Isaac, Myriam de Lima; Massuda, Eduardo T; Hyppolito, Miguel Angelo

2017-07-29

Cochlear Implant is a sensory prosthesis capable of restoring hearing in patients with severe or profound bilateral sensorineural hearing loss. To evaluate if there is a better side to be implanted in post-lingual patients. Retrospective longitudinal study. Participants were 40 subjects, of both sex, mean age of 47 years, with post-lingual hearing loss, users of unilateral cochlear implant for more than 12 months and less than 24 months, with asymmetric auditor reserve between the ears (difference of 10dBNA, In at least one of the frequencies with a response, between the ears), divided into two groups. Group A was composed of individuals with cochlear implant in the ear with better auditory reserve and Group B with auditory reserve lower in relation to the contralateral side. There was no statistical difference for the tonal auditory threshold before and after cochlear implant. A better speech perception in pre-cochlear implant tests was present in B (20%), but the final results are similar in both groups. The cochlear implant in the ear with the worst auditory residue favors a bimodal hearing, which would allow the binaural summation, without compromising the improvement of the audiometric threshold and the speech perception. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Cochlear implants and medical tourism.

PubMed

McKinnon, Brian J; Bhatt, Nishant

2010-09-01

To compare the costs of medical tourism in cochlear implant surgery performed in India as compared to the United States. In addition, the cost savings of obtaining cochlear implant surgery in India were compare d to those of other surgical interventions obtained as a medical tourist. Searches were conducted on Medline and Google using the search terms: 'medical tourism', 'medical offshoring', 'medical outsourcing', 'cochlear implants' and 'cochlear implantation'. The information regarding cost of medical treatment was obtained from personal communication with individuals familiar with India's cochlear implantation medical tourism industry. The range of cost depended on length of stay as well as the device chosen. Generally the cost, inclusive of travel, surgery and device, was in the range of $21,000-30,000, as compared to a cost range of $40,000-$60,000 in the US. With the escalating cost of healthcare in the United States, it is not surprising that some patients would seek to obtain surgical care overseas at a fraction of the cost. Participants in medical tourism often have financial resources, but lack health insurance coverage. While cardiovascular and orthopedic surgery performed outside the United States in India at centers that cater to medical tourists are often performed at one-quarter to one-third of the cost that would have been paid in the United States, the cost differential for cochlear implants is not nearly as favorable.

[Water regulation in the cochlea : Do molecular water channels facilitate potassium-dependent sound transduction?].

PubMed

Eckhard, A; Löwenheim, H

2014-06-01

Sound transduction in the cochlea critically depends on the circulation of potassium ions (K(+)) along so-called "K(+) recycling routes" between the endolymph and perilymph. These K(+) currents generate high ionic and osmotic gradients, which potentially impair the excitability of sensory hair cells and threaten cell survival in the entire cochlear duct. Molecular water channels-aquaporins (AQP)-are expressed in all cochlear supporting cells along the K(+) recycling routes; however, their significance for osmotic equilibration in cochlear duct cells is unknown. The diffusive and osmotic water permeabilies of Reissner's membrane, the organ of Corti and the entire cochlear duct epithelium were determined. Expression of the potassium channel Kir4.1 and the water channel AQP4 in the cochlear duct was investigated by immunohistochemistry. The calculated water permeability values indicate the extent of AQP-facilitated water flux across the cochlear duct epithelium. Immunohistochemically, Kir4.1 and AQP4 were found to colocalize in distinct membrane domains of supporting cells along the K(+)-recycling routes. These observations suggest the presence of a rapid AQP-mediated water exchange between the endolymph, the cells of the cochlear duct and the perilymph. The subcellular colocalization of Kir4.1 and AQP4 in epithelial supporting cells indicates functional coupling of potassium and water flow in the cochlea. Finally, this offers an explanation for the hearing impairment observed in individuals with mutations in the AQP4 gene.

Bilateral cochlear implantation in the ferret: A novel animal model for behavioral studies

PubMed Central

Hartley, Douglas E.H.; Vongpaisal, Tara; Xu, Jin; Shepherd, Robert K.; King, Andrew J.; Isaiah, Amal

2010-01-01

Bilateral cochlear implantation has recently been introduced with the aim of improving both speech perception in background noise and sound localization. Although evidence suggests that binaural perception is possible with two cochlear implants, results in humans are variable. To explore potential contributing factors to these variable outcomes, we have developed a behavioral animal model of bilateral cochlear implantation in a novel species, the ferret. Although ferrets are ideally suited to psychophysical and physiological assessments of binaural hearing, cochlear implantation has not been previously described in this species. This paper describes the techniques of deafening with aminoglycoside administration, surgical implantation of an intracochlear array and chronic intracochlear electrical stimulation with monitoring for electrode integrity and efficacy of stimulation. Experiments have been presented elsewhere to show that the model can be used to study behavioral and electrophysiological measures of binaural hearing in chronically implanted animals. This paper demonstrates that cochlear implantation and chronic intracochlear electrical stimulation are both safe and effective in ferrets, opening up the possibility of using this model to study potential protective effects of bilateral cochlear implantation on the developing central auditory pathway. Since ferrets can be used to assess psychophysical and physiological aspects of hearing along with the structure of the auditory pathway in the same animals, we anticipate that this model will help develop novel neuroprosthetic therapies for use in humans. PMID:20576507

The Influence of Cochlear Mechanical Dysfunction, Temporal Processing Deficits, and Age on the Intelligibility of Audible Speech in Noise for Hearing-Impaired Listeners

PubMed Central

Johannesen, Peter T.; Pérez-González, Patricia; Kalluri, Sridhar; Blanco, José L.

2016-01-01

The aim of this study was to assess the relative importance of cochlear mechanical dysfunction, temporal processing deficits, and age on the ability of hearing-impaired listeners to understand speech in noisy backgrounds. Sixty-eight listeners took part in the study. They were provided with linear, frequency-specific amplification to compensate for their audiometric losses, and intelligibility was assessed for speech-shaped noise (SSN) and a time-reversed two-talker masker (R2TM). Behavioral estimates of cochlear gain loss and residual compression were available from a previous study and were used as indicators of cochlear mechanical dysfunction. Temporal processing abilities were assessed using frequency modulation detection thresholds. Age, audiometric thresholds, and the difference between audiometric threshold and cochlear gain loss were also included in the analyses. Stepwise multiple linear regression models were used to assess the relative importance of the various factors for intelligibility. Results showed that (a) cochlear gain loss was unrelated to intelligibility, (b) residual cochlear compression was related to intelligibility in SSN but not in a R2TM, (c) temporal processing was strongly related to intelligibility in a R2TM and much less so in SSN, and (d) age per se impaired intelligibility. In summary, all factors affected intelligibility, but their relative importance varied across maskers. PMID:27604779

Imitative Production of Rising Speech Intonation in Pediatric Cochlear Implant Recipients

PubMed Central

Peng, Shu-Chen; Tomblin, J. Bruce; Spencer, Linda J.; Hurtig, Richard R.

2011-01-01

Purpose This study investigated the acoustic characteristics of pediatric cochlear implant (CI) recipients' imitative production of rising speech intonation, in relation to the perceptual judgments by listeners with normal hearing (NH). Method Recordings of a yes–no interrogative utterance imitated by 24 prelingually deafened children with a CI were extracted from annual evaluation sessions. These utterances were perceptually judged by adult NH listeners in regard with intonation contour type (non-rise, partial-rise, or full-rise) and contour appropriateness (on a 5-point scale). Fundamental frequency, intensity, and duration properties of each utterance were also acoustically analyzed. Results Adult NH listeners' judgments of intonation contour type and contour appropriateness for each CI participant 's utterances were highly positively correlated. The pediatric CI recipients did not consistently use appropriate intonation contours when imitating a yes–no question. Acoustic properties of speech intonation produced by these individuals were discernible among utterances of different intonation contour types according to NH listeners' perceptual judgments. Conclusions These findings delineated the perceptual and acoustic characteristics of speech intonation imitated by prelingually deafened children and young adults with a CI. Future studies should address whether the degraded signals these individuals perceive via a CI contribute to their difficulties with speech intonation production. PMID:17905907

Parents' Views on Changing Communication after Cochlear Implantation

ERIC Educational Resources Information Center

Watson, Linda M.; Hardie, Tim; Archbold, Sue M.; Wheeler, Alexandra

2008-01-01

We sent questionnaires to families of all 288 children who had received cochlear implants at one center in the United Kingdom at least 5 years previously. Thus, it was a large, unselected group. We received 142 replies and 119 indicated that the child and family had changed their communication approach following cochlear implantation. In 113 cases…

Changes in Speech Production in an Early Deafened Adult with a Cochlear Implant

ERIC Educational Resources Information Center

Wong, Patrick C. M.

2007-01-01

Background and Aims: The current study is a first investigation reporting the speech production characteristics of an early deafened adult cochlear implant user after a course of speech-language treatment. Methods and Procedures: The participant is culturally deaf and received the cochlear implant when she was 43 years old. A 24-week ABCABC…

The Self-Regulation of a Child with Cochlear Implants within a School Environment

ERIC Educational Resources Information Center

Patton, Kristin L.

2013-01-01

The purpose of this qualitative research, which utilized a narrative design strategy, was to describe the process of self-regulation of a child who has bilateral cochlear implants within the social environment of school. The study investigated the use of self-regulatory strategies by the cochlear implant recipient. It also examined how the child…

Cochlear Implantation for Children with Hearing Loss and Multiple Disabilities: An Evaluation from an Educator's Perspective

ERIC Educational Resources Information Center

Bertram, Bodo

2004-01-01

In recent years, parents of children with hearing loss and various additional disabilities have shown increasing interest in cochlear implants. This article describes how the program in Hanover, Germany is attempting to respond to this interest. It discusses the selection process for children who receive cochlear implants who have multiple…

Spelling in Written Stories by School-Age Children with Cochlear Implants

ERIC Educational Resources Information Center

Straley, Sara G.; Werfel, Krystal L.; Hendricks, Alison Eisel

2016-01-01

This study evaluated the spelling of 3rd to 6th grade children with cochlear implants in written stories. Spelling was analysed using traditional correct/incorrect scoring as well as the Spelling Sensitivity Score, which provides linguistic information about spelling attempts. Children with cochlear implants spelled 86 per cent of words in stories…

Identification of Pure-Tone Audiologic Thresholds for Pediatric Cochlear Implant Candidacy: A Systematic Review.

PubMed

de Kleijn, Jasper L; van Kalmthout, Ludwike W M; van der Vossen, Martijn J B; Vonck, Bernard M D; Topsakal, Vedat; Bruijnzeel, Hanneke

2018-05-24

Although current guidelines recommend cochlear implantation only for children with profound hearing impairment (HI) (>90 decibel [dB] hearing level [HL]), studies show that children with severe hearing impairment (>70-90 dB HL) could also benefit from cochlear implantation. To perform a systematic review to identify audiologic thresholds (in dB HL) that could serve as an audiologic candidacy criterion for pediatric cochlear implantation using 4 domains of speech and language development as independent outcome measures (speech production, speech perception, receptive language, and auditory performance). PubMed and Embase databases were searched up to June 28, 2017, to identify studies comparing speech and language development between children who were profoundly deaf using cochlear implants and children with severe hearing loss using hearing aids, because no studies are available directly comparing children with severe HI in both groups. If cochlear implant users with profound HI score better on speech and language tests than those with severe HI who use hearing aids, this outcome could support adjusting cochlear implantation candidacy criteria to lower audiologic thresholds. Literature search, screening, and article selection were performed using a predefined strategy. Article screening was executed independently by 4 authors in 2 pairs; consensus on article inclusion was reached by discussion between these 4 authors. This study is reported according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Title and abstract screening of 2822 articles resulted in selection of 130 articles for full-text review. Twenty-one studies were selected for critical appraisal, resulting in selection of 10 articles for data extraction. Two studies formulated audiologic thresholds (in dB HLs) at which children could qualify for cochlear implantation: (1) at 4-frequency pure-tone average (PTA) thresholds of 80 dB HL or greater based on speech perception and auditory performance subtests and (2) at PTA thresholds of 88 and 96 dB HL based on a speech perception subtest. In 8 of the 18 outcome measures, children with profound HI using cochlear implants performed similarly to children with severe HI using hearing aids. Better performance of cochlear implant users was shown with a picture-naming test and a speech perception in noise test. Owing to large heterogeneity in study population and selected tests, it was not possible to conduct a meta-analysis. Studies indicate that lower audiologic thresholds (≥80 dB HL) than are advised in current national and manufacturer guidelines would be appropriate as audiologic candidacy criteria for pediatric cochlear implantation.

Modeling Open-Set Spoken Word Recognition in Postlingually Deafened Adults after Cochlear Implantation: Some Preliminary Results with the Neighborhood Activation Model

PubMed Central

Meyer, Ted A.; Frisch, Stefan A.; Pisoni, David B.; Miyamoto, Richard T.; Svirsky, Mario A.

2012-01-01

Hypotheses Do cochlear implants provide enough information to allow adult cochlear implant users to understand words in ways that are similar to listeners with acoustic hearing? Can we use a computational model to gain insight into the underlying mechanisms used by cochlear implant users to recognize spoken words? Background The Neighborhood Activation Model has been shown to be a reasonable model of word recognition for listeners with normal hearing. The Neighborhood Activation Model assumes that words are recognized in relation to other similar-sounding words in a listener’s lexicon. The probability of correctly identifying a word is based on the phoneme perception probabilities from a listener’s closed-set consonant and vowel confusion matrices modified by the relative frequency of occurrence of the target word compared with similar-sounding words (neighbors). Common words with few similar-sounding neighbors are more likely to be selected as responses than less common words with many similar-sounding neighbors. Recent studies have shown that several of the assumptions of the Neighborhood Activation Model also hold true for cochlear implant users. Methods Closed-set consonant and vowel confusion matrices were obtained from 26 postlingually deafened adults who use cochlear implants. Confusion matrices were used to represent input errors to the Neighborhood Activation Model. Responses to the different stimuli were then generated by the Neighborhood Activation Model after incorporating the frequency of occurrence counts of the stimuli and their neighbors. Model outputs were compared with obtained performance measures on the Consonant-Vowel Nucleus-Consonant word test. Information transmission analysis was used to assess whether the Neighborhood Activation Model was able to successfully generate and predict word and individual phoneme recognition by cochlear implant users. Results The Neighborhood Activation Model predicted Consonant-Vowel Nucleus-Consonant test words at levels similar to those correctly identified by the cochlear implant users. The Neighborhood Activation Model also predicted phoneme feature information well. Conclusion The results obtained suggest that the Neighborhood Activation Model provides a reasonable explanation of word recognition by postlingually deafened adults after cochlear implantation. It appears that multichannel cochlear implants give cochlear implant users access to their mental lexicons in a manner that is similar to listeners with acoustic hearing. The lexical properties of the test stimuli used to assess performance are important to spoken-word recognition and should be included in further models of the word recognition process. PMID:12851554

[Waardenburg's syndrome].

PubMed

Gimñenez, F; Carbonell, R; Pérez, F; Lozano, I

1994-01-01

Reporting one case of this condition type-2 with heterochromia iridis and cochlear deafness. The AA. review the syndrome's components and it nomenclature as well. They discuss about the convenience of including this deviation in the chapter of "diseases of the embryonic neural crest". The specific place of the gene responsibly in the chromosome-2 and the possibilities of genetic counselling are considered.

Scala tympani cochleostomy II: topography and histology.

PubMed

Adunka, Oliver F; Radeloff, Andreas; Gstoettner, Wolfgang K; Pillsbury, Harold C; Buchman, Craig A

2007-12-01

To assess intracochlear trauma using two different round window-related cochleostomy techniques in human temporal bones. Twenty-eight human temporal bones were included in this study. In 21 specimens, cochleostomies were initiated inferior to the round window (RW) annulus. In seven bones, cochleostomies were drilled anterior-inferior to the RW annulus. Limited cochlear implant electrode insertions were performed in 19 bones. In each specimen, promontory anatomy and cochleostomy drilling were photographically documented. Basal cochlear damage was assessed histologically and electrode insertion properties were documented in implanted bones. All implanted specimens showed clear scala tympani electrode placements regardless of cochleostomy technique. All 21 inferior cochleostomies were atraumatic. Anterior-inferior cochleostomies resulted in various degrees of intracochlear trauma in all seven bones. For atraumatic opening of the scala tympani using a cochleostomy approach, initiation of drilling should proceed from inferior to the round window annulus, with gradual progression toward the undersurface of the lumen. While cochleostomies initiated anterior-inferior to the round window annulus resulted in scala tympani opening, many of these bones displayed varying degrees of intracochlear trauma that may result in hearing loss. When intracochlear drilling is avoided, the anterior bony margin of the cochleostomy remains a significant intracochlear impediment to in-line electrode insertion.

Rate and onset cues can improve cochlear implant synthetic vowel recognition in noise

PubMed Central

Mc Laughlin, Myles; Reilly, Richard B.; Zeng, Fan-Gang

2013-01-01

Understanding speech-in-noise is difficult for most cochlear implant (CI) users. Speech-in-noise segregation cues are well understood for acoustic hearing but not for electric hearing. This study investigated the effects of stimulation rate and onset delay on synthetic vowel-in-noise recognition in CI subjects. In experiment I, synthetic vowels were presented at 50, 145, or 795 pulse/s and noise at the same three rates, yielding nine combinations. Recognition improved significantly if the noise had a lower rate than the vowel, suggesting that listeners can use temporal gaps in the noise to detect a synthetic vowel. This hypothesis is supported by accurate prediction of synthetic vowel recognition using a temporal integration window model. Using lower rates a similar trend was observed in normal hearing subjects. Experiment II found that for CI subjects, a vowel onset delay improved performance if the noise had a lower or higher rate than the synthetic vowel. These results show that differing rates or onset times can improve synthetic vowel-in-noise recognition, indicating a need to develop speech processing strategies that encode or emphasize these cues. PMID:23464025

Evaluation on health-related quality of life in deaf children with cochlear implant in China.

PubMed

Liu, Hong; Liu, Hong-Xiang; Kang, Hou-Yong; Gu, Zheng; Hong, Su-Ling

2016-09-01

Previous studies have shown that deaf children benefit considerably from cochlear implants. These improvements are found in areas such as speech perception, speech production, and audiology-verbal performance. Despite the increasing prevalence of cochlear implants in China, few studies have reported on health-related quality of life in children with cochlear implants. The main objective of this study was to explore health-related quality of life on children with cochlear implants in South-west China. A retrospective observational study of 213 CI users in Southwest China between 2010 and 2013. Participants were 213 individuals with bilateral severe-to-profound hearing loss who wore unilateral cochlear implants. The Nijmegen Cochlear Implant Questionnaire and Health Utility Index Mark III were used pre-implantation and 1 year post-implantation. Additionally, 1-year postoperative scores for Mandarin speech perception were compared with preoperative scores. Health-related quality of life improved post-operation with scores on the Nijmegen Cochlear Implant Questionnaire improving significantly in all subdomains, and the Health Utility Index 3 showing a significant improvement in the utility score and the subdomains of ''hearing," ''speech," and "emotion". Additionally, a significant improvement in speech recognition scores was found. No significant correlation was found between increased in quality of life and speech perception scores. Health-related quality of life and speech recognition in prelingual deaf children significantly improved post-operation. The lack of correlation between quality of life and speech perception suggests that when evaluating performance post-implantation in prelingual deaf children and adolescents, measures of both speech perception and quality of life should be used. Copyright © 2016. Published by Elsevier Ireland Ltd.

Jervell and Lange-Nielsen syndrome in cochlear implanted patients: our experience and a review of literature.

PubMed

Eftekharian, Ali; Mahani, Mozhgan Hosseinerezai

2015-09-01

To share our experience in cochlear implanted patients with Jervell and Lange-Nielsen syndrome (JLNS), to review the literature results and to disclose precautions which have to be taken dealing with these patients. Electrocardiograms (ECG) of 503 children with congenital bilateral profound hearing loss which were cochlear implanted in cochlear implant center of a tertiary hospital were evaluated for long QT syndrome. Clinical reports of the patients with JLNS were evaluated and a review of literature performed. The prevalence of disease was 0.79% (four cases) in our center which is in the range of literature reports (0-2.6%). None of our patients had a history of syncopal attack. Two patients (50%) were born from parents with consanguineous marriage. Considering all precautions their cochlear implant surgeries were done uneventfully. A review of the literature has identified sixteen reports on cochlear implantation in a total of 38 children with JLNS. Similar to our cases none of the authors reported cardiac events during device switch-on. Nine available reports about the outcome of cochlear implantation in these patients indicated good auditory outcome. It is recommended that all congenitally deaf patients have an ECG taken as a part of the evaluation. As auditory stimuli is reported to be a specific trigger, it is prudent to activate the processor with continuous heart monitoring even though there is no reported cardiac event during device switch-on. Cochlear implantation can be performed relatively safely in these patients if necessary precautions have been taken appropriately and their auditory outcome is good. Triggers of the cardiac events should be avoided throughout their life. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Assessment of the cochlear nerve to facial nerve size ratio using MR multiplanar reconstruction of the internal auditory canal in patients presenting with acquired long-standing hearing loss

PubMed Central

Hey, Constanze; Shaaban, Mohamed S; Elabd, Amr M; Hassan, Hebatallah H M; Gruber-Rouh, Tatjana; Kaltenbach, Benjamin; Harth, Marc; Ackermann, Hanns; Stöver, Timo; Vogl, Thomas J; Nour-Eldin, Nour-Eldin A

2017-01-01

Objective: To test using the facial nerve as a reference for assessment of the cochlear nerve size in patients with acquired long-standing sensorineural hearing loss (SNHL) using MRI multiplanar reconstruction. Methods: The study was retrospectively performed on 86 patients. Group 1 (study group, n = 53) with bilateral long-standing SNHL. Group 2 (control group, n = 33) without hearing loss. The nerve size was measured by drawing a region of interest around the cross-sectional circumference of the nerve in multiplanar reconstruction images. Results: No significant correlation was noted between the cochlear nerve and facial nerve size, and the patient's age, gender and weight (p > 0.05). In Group 1, the mean ratio of the cochlear to facial nerve size was 0.99 ± 0.30 (range: 0.52–1.86) and 1.12 ± 0.35 (range: 0.34–2.3) for the right and left sides, respectively. In Group 2, it was 1.18 ± 0.23 (range: 0.78–1.71) and 1.25 ± 0.25 (range: 0.85–1.94) for the right and left sides, respectively. The cochlear nerve size was statistically (p = 0.0004) smaller in Group 1 than in Group 2. Conclusion: The cochlear nerve size and the cochlear to facial nerve size ratio are significantly smaller in patients with acquired long-standing SNHL. Advances in knowledge: The facial nerve can be used as a reference for assessment of the cochlear nerve in patients with acquired long-standing SNHL. PMID:28368665

Cochlear microphonic broad tuning curves

NASA Astrophysics Data System (ADS)

Ayat, Mohammad; Teal, Paul D.; Searchfield, Grant D.; Razali, Najwani

2015-12-01

It is known that the cochlear microphonic voltage exhibits much broader tuning than does the basilar membrane motion. The most commonly used explanation for this is that when an electrode is inserted at a particular point inside the scala media, the microphonic potentials of neighbouring hair cells have different phases, leading to cancelation at the electrodes location. In situ recording of functioning outer hair cells (OHCs) for investigating this hypothesis is exceptionally difficult. Therefore, to investigate the discrepancy between the tuning curves of the basilar membrane and those of the cochlear microphonic, and the effect of phase cancellation of adjacent hair cells on the broadness of the cochlear microphonic tuning curves, we use an electromechanical model of the cochlea to devise an experiment. We explore the effect of adjacent hair cells (i.e., longitudinal phase cancellation) on the broadness of the cochlear microphonic tuning curves in different locations. The results of the experiment indicate that active longitudinal coupling (i.e., coupling with active adjacent outer hair cells) only slightly changes the broadness of the CM tuning curves. The results also demonstrate that there is a π phase difference between the potentials produced by the hair bundle and the soma near the place associated with the characteristic frequency based on place-frequency maps (i.e., the best place). We suggest that the transversal phase cancellation (caused by the phase difference between the hair bundle and the soma) plays a far more important role than longitudinal phase cancellation in the broadness of the cochlear microphonic tuning curves. Moreover, by increasing the modelled longitudinal resistance resulting the cochlear microphonic curves exhibiting sharper tuning. The results of the simulations suggest that the passive network of the organ of Corti determines the phase difference between the hair bundle and soma, and hence determines the sharpness of the cochlear microphonic tuning curves.

The auditory nerve overlapped waveform (ANOW): A new objective measure of low-frequency hearing

NASA Astrophysics Data System (ADS)

Lichtenhan, Jeffery T.; Salt, Alec N.; Guinan, John J.

2015-12-01

One of the most pressing problems today in the mechanics of hearing is to understand the mechanical motions in the apical half of the cochlea. Almost all available measurements from the cochlear apex of basilar membrane or other organ-of-Corti transverse motion have been made from ears where the health, or sensitivity, in the apical half of the cochlea was not known. A key step in understanding the mechanics of the cochlear base was to trust mechanical measurements only when objective measures from auditory-nerve compound action potentials (CAPs) showed good preparation sensitivity. However, such traditional objective measures are not adequate monitors of cochlear health in the very low-frequency regions of the apex that are accessible for mechanical measurements. To address this problem, we developed the Auditory Nerve Overlapped Waveform (ANOW) that originates from auditory nerve output in the apex. When responses from the round window to alternating low-frequency tones are averaged, the cochlear microphonic is canceled and phase-locked neural firing interleaves in time (i.e., overlaps). The result is a waveform that oscillates at twice the probe frequency. We have demonstrated that this Auditory Nerve Overlapped Waveform - called ANOW - originates from auditory nerve fibers in the cochlear apex [8], relates well to single-auditory-nerve-fiber thresholds, and can provide an objective estimate of low-frequency sensitivity [7]. Our new experiments demonstrate that ANOW is a highly sensitive indicator of apical cochlear function. During four different manipulations to the scala media along the cochlear spiral, ANOW amplitude changed when either no, or only small, changes occurred in CAP thresholds. Overall, our results demonstrate that ANOW can be used to monitor cochlear sensitivity of low-frequency regions during experiments that make apical basilar membrane motion measurements.

Cochlear implantation in autistic children with profound sensorineural hearing loss.

PubMed

Lachowska, Magdalena; Pastuszka, Agnieszka; Łukaszewicz-Moszyńska, Zuzanna; Mikołajewska, Lidia; Niemczyk, Kazimierz

2016-11-19

Cochlear implants have become the method of choice for the treatment of severe-to-profound hearing loss in both children and adults. Its benefits are well documented in the pediatric and adult population. Also deaf children with additional needs, including autism, have been covered by this treatment. The aim of this study was to assess the benefits from cochlear implantation in deafened children with autism as the only additional disability. This study analyzes data of six children. The follow-up time was at least 43 months. The following data were analyzed: medical history, reaction to music and sound, Ling's six sounds test, onomatopoeic word test, reaction to spoken child's name, response to requests, questionnaire given to parents, sound processor fitting sessions and data. After cochlear implantation each child presented other communication skills. In some children, the symptoms of speech understanding were observed. No increased hyperactivity associated with daily use cochlear implant was observed. The study showed that in autistic children the perception is very important for a child's sense of security and makes contact with parents easier. Our study showed that oral communication is not likely to be a realistic goal in children with cochlear implants and autism. The implantation results showed benefits that varied among those children. The traditional methods of evaluating the results of cochlear implantation in children with autism are usually insufficient to fully assess the functional benefits. These benefits should be assessed in a more comprehensive manner taking into account the limitations of communication resulting from the essence of autism. It is important that we share knowledge about these complex children with cochlear implants. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Auditory Speech Perception Development in Relation to Patient's Age with Cochlear Implant

PubMed Central

Ciscare, Grace Kelly Seixas; Mantello, Erika Barioni; Fortunato-Queiroz, Carla Aparecida Urzedo; Hyppolito, Miguel Angelo; Reis, Ana Cláudia Mirândola Barbosa dos

2017-01-01

Introduction  A cochlear implant in adolescent patients with pre-lingual deafness is still a debatable issue. Objective  The objective of this study is to analyze and compare the development of auditory speech perception in children with pre-lingual auditory impairment submitted to cochlear implant, in different age groups in the first year after implantation. Method  This is a retrospective study, documentary research, in which we analyzed 78 reports of children with severe bilateral sensorineural hearing loss, unilateral cochlear implant users of both sexes. They were divided into three groups: G1, 22 infants aged less than 42 months; G2, 28 infants aged between 43 to 83 months; and G3, 28 older than 84 months. We collected medical record data to characterize the patients, auditory thresholds with cochlear implants, assessment of speech perception, and auditory skills. Results  There was no statistical difference in the association of the results among groups G1, G2, and G3 with sex, caregiver education level, city of residence, and speech perception level. There was a moderate correlation between age and hearing aid use time, age and cochlear implants use time. There was a strong correlation between age and the age cochlear implants was performed, hearing aid use time and age CI was performed. Conclusion  There was no statistical difference in the speech perception in relation to the patient's age when cochlear implant was performed. There were statistically significant differences for the variables of auditory deprivation time between G3 - G1 and G2 - G1 and hearing aid use time between G3 - G2 and G3 - G1. PMID:28680487

[Pre-operation evaluation and intra-operation management of cochlear implantation].

PubMed

Zhang, Dao-xing; Hu, Bao-hua; Xiao, Yu-li; Shi, Bo-ning

2004-10-01

To summarize pre-operation evaluation experiences in cochlear implantation. Performing auditory evaluation and image analysis seriously in 158 severe hearing loss or total deaf cases before cochlear implantation, comparing their performance with the findings during and post operation. Among the total 158 cases, 116 cases with normal structure, 42 cases with the abnormal findings of the inner or middle ear. Stapedial gusher happened in 6 cases, 1 case was not predicted before operation. Except 1 case with serious malformation, the findings of other 157 cases in operation were consistent with the pre-operation evaluation. We helped all patients reconstruct auditory conduction with cochlear implantation, and the average hearing level up to 37.6 dB SPL. Performing image analysis seriously before operation and planning for operation according to HRCT can do great help to cochlear implantation. The operation under the HRCT instruction has less complications.

[Topographic anatomy of the hook region and its significance for the choice of the surgical technique for the cochlear implantation].

PubMed

Yanov, Yu K; Kuzovkov, V E; Lilenko, A S; Kostevich, I V; Sugarova, S B; Amonov, A Sh

The mode of the introduction of the active electrode of a cochlear implant into the cochlea remains a key issue as far as cochlear implantation is concerned. Especially much attention has recently been given to the relationship between the anatomical features of the basal region of the cochlea (the so-called 'fish hook') and the possibility to approach it. We have undertaken the attempt to optimize the approach to the tympanic canal (scala tympanica) of the cochlea with a view to reducing to a minimum the risk of an injury to the cochlear structures in the course of cochlear implantation. A total of 35 cadaveric temporal bones were examined to measure the fine structures of the hook region and evaluate the risk of their damages associated with various approaches to the tympanic canal.

Congenitally deafblind children and cochlear implants: effects on communication.

PubMed

Dammeyer, Jesper

2009-01-01

There has been much research conducted demonstrating the positive benefits of cochlear implantation (CI) in children who are deaf. Research on CI in children who are both deaf and blind, however, is lacking. The purpose of this article is to present a study of five congenitally deafblind children who received cochlear implants between 2.2 and 4.2 years of age. Ratings of video observations were used to measure the children's early communication development with and without the use of their cochlear implants. In addition, parental interviews were used to assess the benefits parents perceived regarding their children's cochlear implants. Two examples are included in this article to illustrate the parents' perspectives about CI in their deafblind children. Benefits of CI in this cohort of children included improved attention and emotional response as well as greater use of objects in interaction with adults. The best overall outcome of CI is not spoken language but better communication.

Deep brain stimulation with a pre-existing cochlear implant: Surgical technique and outcome.

PubMed

Eddelman, Daniel; Wewel, Joshua; Wiet, R Mark; Metman, Leo V; Sani, Sepehr

2017-01-01

Patients with previously implanted cranial devices pose a special challenge in deep brain stimulation (DBS) surgery. We report the implantation of bilateral DBS leads in a patient with a cochlear implant. Technical nuances and long-term interdevice functionality are presented. A 70-year-old patient with advancing Parkinson's disease and a previously placed cochlear implant for sensorineural hearing loss was referred for placement of bilateral DBS in the subthalamic nucleus (STN). Prior to DBS, the patient underwent surgical removal of the subgaleal cochlear magnet, followed by stereotactic MRI, frame placement, stereotactic computed tomography (CT), and merging of imaging studies. This technique allowed for successful computational merging, MRI-guided targeting, and lead implantation with acceptable accuracy. Formal testing and programming of both the devices were successful without electrical interference. Successful DBS implantation with high resolution MRI-guided targeting is technically feasible in patients with previously implanted cochlear implants by following proper precautions.

Disorders of cochlear blood flow.

PubMed

Nakashima, Tsutomu; Naganawa, Shinji; Sone, Michihiko; Tominaga, Mitsuo; Hayashi, Hideo; Yamamoto, Hiroshi; Liu, Xiuli; Nuttall, Alfred L

2003-09-01

The cochlea is principally supplied from the inner ear artery (labyrinthine artery), which is usually a branch of the anterior inferior cerebellar artery. Cochlear blood flow is a function of cochlear perfusion pressure, which is calculated as the difference between mean arterial blood pressure and inner ear fluid pressure. Many otologic disorders such as noise-induced hearing loss, endolymphatic hydrops and presbycusis are suspected of being related to alterations in cochlear blood flow. However, the human cochlea is not easily accessible for investigation because this delicate sensory organ is hidden deep in the temporal bone. In patients with sensorineural hearing loss, magnetic resonance imaging, laser-Doppler flowmetry and ultrasonography have been used to investigate the status of cochlear blood flow. There have been many reports of hearing loss that were considered to be caused by blood flow disturbance in the cochlea. However, direct evidence of blood flow disturbance in the cochlea is still lacking in most of the cases.

Characterization of slow-cycling cells in the mouse cochlear lateral wall

PubMed Central

Ogawa, Kaoru

2017-01-01

Cochlear spiral ligament fibrocytes (SLFs) play essential roles in the physiology of hearing including ion recycling and the generation of endocochlear potential. In adult animals, SLFs can repopulate after damages, yet little is known about the characteristics of proliferating cells that support SLFs’ self-renewal. Here we report in detail about the characteristics of cycling cells in the spiral ligament (SL). Fifteen P6 mice and six noise-exposed P28 mice were injected with 5-bromo-2′-deoxyuridine (BrdU) for 7 days and we chased BrdU retaining cells for as long as 60 days. Immunohistochemistry revealed that the BrdU positive IB4 (an endotherial marker) negative cells expressed an early SLF marker Pou3f4 but negative for cleaved-Caspase 3. Marker studies revealed that type 3 SLFs displayed significantly higher percentage of BrdU+ cells compared to other subtypes. Notably, the cells retained BrdU until P72, demonstrating they were dividing slowly. In the noise-damaged mice, in contrast to the loss of the other types, the number of type 3 SLFs did not altered and the BrdU incorporating- phosphorylated Histone H3 positive type 3 cells were increased from day 1 to 14 after noise exposure. Furthermore, the cells repopulating type 1 area, where the cells diminished profoundly after damage, were positive for the type 3 SLF markers. Collectively, in the latral wall of the cochlea, type 3 SLFs have the stem cell capacity and may contribute to the endogenous regeneration of lateral wall spiral ligament. Manipulating type 3 cells may be employed for potential regenerative therapies. PMID:28632772

[Prediction of round window visibility in cochlear implantation with temporal bone high resolution computed tomography].

PubMed

Sun, S P; Lu, W; Lei, Y B; Men, X M; Zuo, B; Ding, S G

2017-08-07

Objective: To discuss the prediction of round window(RW) visibility in cochlear implantation(CI) with temporal bone high resolution computed tomography(HRCT). Methods: From January 2013 to January 2017, 130 cases underwent both HRCT and CI in our hospital were analyzed. The distance from facial nerve to posterior canal wall(FWD), the angle between facial nerve and inner margin of round window(FRA), and the angle between facial nerve and tympanic anulus to inner margin of round window(FRAA) were detected at the level of round window on axial temporal bone HRCT. A line parallel to the posterior wall of ear canal was drawn from the anterior wall of facial nerve at the level of round window on axial temporal bone HRCT and its relationship with round window was detected (facial-round window line, FRL): type0-posterior to the round window, type1-between the round window, type2-anterior to the round window. Their(FWD, FRA, FRAA, FRL) relationships with intra-operative round window visibility were analyzed by SPSS 17.0 software. Results: FWD( F =18.76, P =0.00), FRA( F =34.57, P =0.00), FRAA ( F =14.24, P =0.00) could affect the intra-operative RW visibility significantly. RW could be exposed completely during CI when preoperative HRCT showing type0 FRL. RW might be partly exposed and not exposed when preoperative HRCT showing type1 and type2 FRL respectively. Conclusion: FWD, FRA, FRAA and FRL of temporal bone HRCT can predict intra-operative round window visibility effectively in CI surgery.

Language, Mental State Vocabulary, and False Belief Understanding in Children with Cochlear Implants

ERIC Educational Resources Information Center

Peters, Kimberly; Remmel, Ethan; Richards, Debra

2009-01-01

Purpose: This study examined false belief understanding and its predictors in school-age children who are deaf with cochlear implants and who use spoken language. Method: False belief understanding was measured through an explanation-of-action task in 30 children between the ages of 3 and 12 years who used cochlear implants. Children told a…

Cyborgization: Deaf Education for Young Children in the Cochlear Implantation Era

ERIC Educational Resources Information Center

Valente, Joseph Michael

2011-01-01

The author, who was raised oral deaf himself, recounts a visit to a school for young deaf children and discovers that young d/Deaf children and their rights are subverted by the cochlear implantation empire. The hypercapitalist, techno-manic times of cochlear implantation has wreaked havoc to the lives of not only young children with deafness but…

Cochlear Implants. National Institutes of Health Consensus Development Conference Statement (May 4, 1988). Volume 7, Number 2.

ERIC Educational Resources Information Center

National Institutes of Health (DHHS), Bethesda, MD.

This paper reports the results of a Consensus Development Conference on Cochlear Implants sponsored by the National Institutes of Health to improve the hearing of children and adults with hearing impairments. The following questions are addressed: (1) Who is a suitable candidate for a cochlear implant? (2) What are the advantages and disadvantages…

Auditory Environment across the Life Span of Cochlear Implant Users: Insights from Data Logging

ERIC Educational Resources Information Center

Busch, Tobias; Vanpoucke, Filiep; van Wieringen, Astrid

2017-01-01

Purpose: We describe the natural auditory environment of people with cochlear implants (CIs), how it changes across the life span, and how it varies between individuals. Method: We performed a retrospective cross-sectional analysis of Cochlear Nucleus 6 CI sound-processor data logs. The logs were obtained from 1,501 people with CIs (ages 0-96…

Congenitally Deafblind Children and Cochlear Implants: Effects on Communication

ERIC Educational Resources Information Center

Dammeyer, Jesper

2009-01-01

There has been much research conducted demonstrating the positive benefits of cochlear implantation (CI) in children who are deaf. Research on CI in children who are both deaf and blind, however, is lacking. The purpose of this article is to present a study of five congenitally deafblind children who received cochlear implants between 2.2 and 4.2…

Searching for Cochlear Implant Information on the Internet Maze: Implications for Parents and Professionals

ERIC Educational Resources Information Center

Zaidman-Zait, Anat; Jamieson, Janet R.

2004-01-01

The present study has three purposes: (a) to determine who disseminates information on cochlear implants on the Web; (b) to describe a representative sample of Web sites that disseminate information on cochlear implants, with a focus on the content topics and their relevance to parents of deaf children; and (c) to discuss the practical issues of…

Benefit of Wearing a Hearing Aid on the Unimplanted Ear in Adult Users of a Cochlear Implant

ERIC Educational Resources Information Center

Dunn, Camille C.; Tyler, Richard S.; Witt, Shelley A.

2005-01-01

The purpose of this investigation was to document performance of participants wearing a cochlear implant and hearing aid in opposite ears on speech-perception and localization tests. Twelve individuals who wore a cochlear implant and a hearing aid on contralateral ears were tested on their abilities to understand words in quiet and sentences in…

A Longitudinal Study in Children with Sequential Bilateral Cochlear Implants: Time Course for the Second Implanted Ear and Bilateral Performance

ERIC Educational Resources Information Center

Reeder, Ruth M.; Firszt, Jill B.; Cadieux, Jamie H.; Strube, Michael J.

2017-01-01

Purpose: Whether, and if so when, a second-ear cochlear implant should be provided to older, unilaterally implanted children is an ongoing clinical question. This study evaluated rate of speech recognition progress for the second implanted ear and with bilateral cochlear implants in older sequentially implanted children and evaluated localization…

Educational Interpreters: Meeting the Communication Needs of Children with Cochlear Implants

ERIC Educational Resources Information Center

Melton, Julie; Higbee, Renee

2013-01-01

Since the early 1990s, when the U.S. Food and Drug Administration approved cochlear implants for deaf and hard of hearing children, the number of children who have cochlear implants has increased in mainstream settings. Recent research suggests that these students, like their deaf and hard of hearing peers without implants who use sign language,…

Prevention and management of cochlear implant infections.

PubMed

Gluth, Michael B; Singh, Rajesh; Atlas, Marcus D

2011-11-01

Understanding the issues of infection related to an implantable medical device is crucial to all cochlear implant teams. Furthermore, given the risk of central nervous system complications and the relatively high quantity of underlying resource investment associated with cochlear implantation, the stakes of infection are high. The optimal strategies to prevent and manage such infections are still evolving as good-quality prospective data to guide such management decisions are not yet abundant within the medical literature and many recommendations are based on retrospective reviews or anecdotal evidence. We will outline a general strategy to deal with cochlear implant-related infection based on both the authors' experience and the published literature.

Development of a phase-sensitive Fourier domain optical coherence tomography system to measure mouse organ of Corti vibrations in two cochlear turns

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ramamoorthy, Sripriya; Zhang, Yuan; Jacques, Steven

In this study, we have developed a phase-sensitive Fourier-domain optical coherence tomography system to simultaneously measure the in vivo inner ear vibrations in the hook area and second turn of the mouse cochlea. This technical development will enable measurement of intra-cochlear distortion products at ideal locations such as the distortion product generation site and reflection site. This information is necessary to un-mix the complex mixture of intra-cochlear waves comprising the DPOAE and thus leads to the non-invasive identification of the local region of cochlear damage.

Use of Neural Response Telemetry for Pediatric Cochlear Implants: Current Practice.

PubMed

Almosnino, Galit; Anne, Samantha; Schwartz, Seth R

2018-06-01

Evaluate usage trends of neural response telemetry (NRT) in cochlear implant centers across the nation and assess reported benefits of intraoperative NRT for pediatric cochlear implant recipients. Survey. All US cochlear implant centers (n = 110). A 15-question multiple-choice survey was distributed electronically to all centers. The survey captured demographic information of all centers, practice patterns surrounding the use of NRT, and the extent to which intraoperative NRT is of benefit. Thirty-two invited participants (29%) completed the survey. A majority of participants reported practicing in an academic center (66%), followed by a hospital setting (19%) and private practice (16%). Seventy-two percent of survey participants reported using NRT for pediatric cochlear implant recipients. Sixty-three percent felt it improved the ability to program at initial activation, and 50% of participants felt that NRT improves satisfaction at initial activation. This study suggests that a majority of surgeons use intraoperative NRT for pediatric cochlear implantation as an additional measure to ensure appropriate electrode placement and improve device activation. Larger studies are needed to better establish the relationship between intraoperative NRT and postoperative outcomes and justify the additional costs associated with intraoperative NRT.

Topics in Modeling of Cochlear Dynamics: Computation, Response and Stability Analysis

NASA Astrophysics Data System (ADS)

Filo, Maurice G.

This thesis touches upon several topics in cochlear modeling. Throughout the literature, mathematical models of the cochlea vary according to the degree of biological realism to be incorporated. This thesis casts the cochlear model as a continuous space-time dynamical system using operator language. This framework encompasses a wider class of cochlear models and makes the dynamics more transparent and easier to analyze before applying any numerical method to discretize space. In fact, several numerical methods are investigated to study the computational efficiency of the finite dimensional realizations in space. Furthermore, we study the effects of the active gain perturbations on the stability of the linearized dynamics. The stability analysis is used to explain possible mechanisms underlying spontaneous otoacoustic emissions and tinnitus. Dynamic Mode Decomposition (DMD) is introduced as a useful tool to analyze the response of nonlinear cochlear models. Cochlear response features are illustrated using DMD which has the advantage of explicitly revealing the spatial modes of vibrations occurring in the Basilar Membrane (BM). Finally, we address the dynamic estimation problem of BM vibrations using Extended Kalman Filters (EKF). Due to the limitations of noninvasive sensing schemes, such algorithms are inevitable to estimate the dynamic behavior of a living cochlea.

Voice gender identification by cochlear implant users: The role of spectral and temporal resolution

NASA Astrophysics Data System (ADS)

Fu, Qian-Jie; Chinchilla, Sherol; Nogaki, Geraldine; Galvin, John J.

2005-09-01

The present study explored the relative contributions of spectral and temporal information to voice gender identification by cochlear implant users and normal-hearing subjects. Cochlear implant listeners were tested using their everyday speech processors, while normal-hearing subjects were tested under speech processing conditions that simulated various degrees of spectral resolution, temporal resolution, and spectral mismatch. Voice gender identification was tested for two talker sets. In Talker Set 1, the mean fundamental frequency values of the male and female talkers differed by 100 Hz while in Talker Set 2, the mean values differed by 10 Hz. Cochlear implant listeners achieved higher levels of performance with Talker Set 1, while performance was significantly reduced for Talker Set 2. For normal-hearing listeners, performance was significantly affected by the spectral resolution, for both Talker Sets. With matched speech, temporal cues contributed to voice gender identification only for Talker Set 1 while spectral mismatch significantly reduced performance for both Talker Sets. The performance of cochlear implant listeners was similar to that of normal-hearing subjects listening to 4-8 spectral channels. The results suggest that, because of the reduced spectral resolution, cochlear implant patients may attend strongly to periodicity cues to distinguish voice gender.

Verbal Working Memory in Children With Cochlear Implants

PubMed Central

Caldwell-Tarr, Amanda; Low, Keri E.; Lowenstein, Joanna H.

2017-01-01

Purpose Verbal working memory in children with cochlear implants and children with normal hearing was examined. Participants Ninety-three fourth graders (47 with normal hearing, 46 with cochlear implants) participated, all of whom were in a longitudinal study and had working memory assessed 2 years earlier. Method A dual-component model of working memory was adopted, and a serial recall task measured storage and processing. Potential predictor variables were phonological awareness, vocabulary knowledge, nonverbal IQ, and several treatment variables. Potential dependent functions were literacy, expressive language, and speech-in-noise recognition. Results Children with cochlear implants showed deficits in storage and processing, similar in size to those at second grade. Predictors of verbal working memory differed across groups: Phonological awareness explained the most variance in children with normal hearing; vocabulary explained the most variance in children with cochlear implants. Treatment variables explained little of the variance. Where potentially dependent functions were concerned, verbal working memory accounted for little variance once the variance explained by other predictors was removed. Conclusions The verbal working memory deficits of children with cochlear implants arise due to signal degradation, which limits their abilities to acquire phonological awareness. That hinders their abilities to store items using a phonological code. PMID:29075747

Social participation of children and adolescents with cochlear implants: a qualitative analysis of parent, teacher, and child interviews.

PubMed

Punch, Renée; Hyde, Merv

2011-01-01

Psychosocial factors, including socioemotional well-being, peer relationships, and social inclusion with hearing and deaf peers, are increasingly becoming a focus of research investigating children with cochlear implants. The study reported here extends the largely quantitative findings of previous research through a qualitative analysis of interviews with parents, teachers, and pediatric cochlear implant users themselves in three eastern states of Australia. We interviewed 24 parents, 15 teachers, and 11 children and adolescents. The findings displayed commonalities across the three groups of participants, indicating positive experiences around the children's psychosocial development with their cochlear implants, but also ongoing difficulties communicating in groups of people and problems related to social skills. Some children had little contact with other deaf children (with or without cochlear implants) despite parents and teachers perceiving such contact beneficial. Children attending schools where there were other deaf children valued friendships with both deaf and hearing peers. Adolescence was a particularly difficult time for some as they struggled with feelings of self-consciousness about their deafness and external cochlear implant equipment and worries around friendships, dating, and their future place in the world. Recommendations for practice and further research are made.

Auditory Speech Perception Tests in Relation to the Coding Strategy in Cochlear Implant.

PubMed

Bazon, Aline Cristine; Mantello, Erika Barioni; Gonçales, Alina Sanches; Isaac, Myriam de Lima; Hyppolito, Miguel Angelo; Reis, Ana Cláudia Mirândola Barbosa

2016-07-01

The objective of the evaluation of auditory perception of cochlear implant users is to determine how the acoustic signal is processed, leading to the recognition and understanding of sound. To investigate the differences in the process of auditory speech perception in individuals with postlingual hearing loss wearing a cochlear implant, using two different speech coding strategies, and to analyze speech perception and handicap perception in relation to the strategy used. This study is prospective cross-sectional cohort study of a descriptive character. We selected ten cochlear implant users that were characterized by hearing threshold by the application of speech perception tests and of the Hearing Handicap Inventory for Adults. There was no significant difference when comparing the variables subject age, age at acquisition of hearing loss, etiology, time of hearing deprivation, time of cochlear implant use and mean hearing threshold with the cochlear implant with the shift in speech coding strategy. There was no relationship between lack of handicap perception and improvement in speech perception in both speech coding strategies used. There was no significant difference between the strategies evaluated and no relation was observed between them and the variables studied.

Effects of a Word-Learning Training on Children With Cochlear Implants

PubMed Central

Lund, Emily

2014-01-01

Preschool children with hearing loss who use cochlear implants demonstrate vocabulary delays when compared to their peers without hearing loss. These delays may be a result of deficient word-learning abilities; children with cochlear implants perform more poorly on rapid word-learning tasks than children with normal hearing. This study explored the malleability of rapid word learning of preschoolers with cochlear implants by evaluating the effects of a word-learning training on rapid word learning. A single-subject, multiple probe design across participants measured the impact of the training on children’s rapid word-learning performance. Participants included 5 preschool children with cochlear implants who had an expressive lexicon of less than 150 words. An investigator guided children to identify, repeat, and learn about unknown sets of words in 2-weekly sessions across 10 weeks. The probe measure, a rapid word-learning task with a different set of words than those taught during training, was collected in the baseline, training, and maintenance conditions. All participants improved their receptive rapid word-learning performance in the training condition. The functional relation indicates that the receptive rapid word-learning performance of children with cochlear implants is malleable. PMID:23981321

The cochlear implant as a tinnitus treatment.

PubMed

Vallés-Varela, Héctor; Royo-López, Juan; Carmen-Sampériz, Luis; Sebastián-Cortés, José M; Alfonso-Collado, Ignacio

2013-01-01

Tinnitus is a symptom of high prevalence in patients with cochlear pathology. We studied the evolution of tinnitus in patients undergoing unilateral cochlear implantation for treatment of profound hearing loss. This was a longitudinal, retrospective study of patients that underwent unilateral cochlear implantation and who had bilateral tinnitus. Tinnitus was assessed quantitatively and qualitatively before surgery and at 6 and 12 months after surgery. We evaluated 20 patients that underwent unilateral cochlear implantation with a Nucleus(®) CI24RE Contour Advance™ electrode device. During the periods in which the device was in operation, improvement or disappearance of tinnitus was evidenced in the ipsilateral ear in 65% of patients, and in the contralateral ear, in 50%. In periods in which the device was disconnected, improvement or disappearance of tinnitus was found in the ipsilateral ear in 50% of patients, and in the ear contralateral to the implant in 45% of the patients. In 10% of the patients, a new tinnitus appeared in the ipsilateral ear. The patients with profound hearing loss and bilateral tinnitus treated with unilateral cochlear implantation improved in a high percentage of cases, in the ipsilateral ear and in the contralateral ear. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Cochlear implants and spoken language processing abilities: review and assessment of the literature.

PubMed

Peterson, Nathaniel R; Pisoni, David B; Miyamoto, Richard T

2010-01-01

Cochlear implants (CIs) process sounds electronically and then transmit electric stimulation to the cochlea of individuals with sensorineural deafness, restoring some sensation of auditory perception. Many congenitally deaf CI recipients achieve a high degree of accuracy in speech perception and develop near-normal language skills. Post-lingually deafened implant recipients often regain the ability to understand and use spoken language with or without the aid of visual input (i.e. lip reading). However, there is wide variation in individual outcomes following cochlear implantation, and some CI recipients never develop useable speech and oral language skills. The causes of this enormous variation in outcomes are only partly understood at the present time. The variables most strongly associated with language outcomes are age at implantation and mode of communication in rehabilitation. Thus, some of the more important factors determining success of cochlear implantation are broadly related to neural plasticity that appears to be transiently present in deaf individuals. In this article we review the expected outcomes of cochlear implantation, potential predictors of those outcomes, the basic science regarding critical and sensitive periods, and several new research directions in the field of cochlear implantation.

Clinical outcomes of scala vestibuli cochlear implantation in children with partial labyrinthine ossification.

PubMed

Lin, Yung-Song

2009-03-01

Cochlear implantation via the scala vestibuli is a viable approach in those with ossification in the scala tympani. With extended cochlear implant experience, there is no significant difference in the mapping parameters and auditory performance between those implanted via scala vestibuli and via scala tympani. To assess the clinical outcomes of cochlear implantation via scala vestibuli. In a cohort follow-up study, 11 prelingually deafened children who received cochlear implantation between age 3 and 10 years through the scala vestibuli served as participants. The mapping parameters (i.e. comfortable level (C), threshold level (T), dynamic range) and auditory performance of each participant were evaluated following initial cochlear implant stimulation, then at 3 month intervals for 2 years, then semi-annually. The follow-up period lasted for 9 years 9 months on average, with a minimum of 8 years 3 months. The clinical results of the mapping parameters and auditory performance of children implanted via the scala vestibuli were comparative to those who were implanted via the scala tympani. No balance problem was reported by any of these patients. One child exhibited residual low frequency hearing after implantation.

Current Research with Cochlear Implants at Arizona State University

PubMed Central

Dorman, Michael F.; Spahr, Anthony; Gifford, Rene H.; Cook, Sarah; Zhang, Ting; Loiselle, Louise; Yost, William; Cardy, Lara; Whittingham, JoAnne; Schramm, David

2013-01-01

In this article we review, and discuss the clinical implications of, five projects currently underway in the Cochlear Implant Laboratory at Arizona State University. The projects are (1) norming the AzBio sentence test, (2) comparing the performance of bilateral and bimodal cochlear implant (CI) patients in realistic listening environments, (3) accounting for the benefit provided to bimodal patients by low-frequency acoustic stimulation, (4) assessing localization by bilateral hearing aid patients and the implications of that work for hearing preservation patients, and (5) studying heart rate variability as a possible measure for quantifying the stress of listening via an implant. The long-term goals of the laboratory are to improve the performance of patients fit with cochlear implants and to understand the mechanisms, physiological or electronic, that underlie changes in performance. We began our work with cochlear implant patients in the mid-1980s and received our first grant from the National Institutes of Health (NIH) for work with implanted patients in 1989. Since that date our work with cochlear implant patients has been funded continuously by the NIH. In this report we describe some of the research currently being conducted in our laboratory. PMID:22668760

3D optical coherence tomography image registration for guiding cochlear implant insertion

NASA Astrophysics Data System (ADS)

Cheon, Gyeong-Woo; Jeong, Hyun-Woo; Chalasani, Preetham; Chien, Wade W.; Iordachita, Iulian; Taylor, Russell; Niparko, John; Kang, Jin U.

2014-03-01

In cochlear implant surgery, an electrode array is inserted into the cochlear canal to restore hearing to a person who is profoundly deaf or significantly hearing impaired. One critical part of the procedure is the insertion of the electrode array, which looks like a thin wire, into the cochlear canal. Although X-ray or computed tomography (CT) could be used as a reference to evaluate the pathway of the whole electrode array, there is no way to depict the intra-cochlear canal and basal turn intra-operatively to help guide insertion of the electrode array. Optical coherent tomography (OCT) is a highly effective way of visualizing internal structures of cochlea. Swept source OCT (SSOCT) having center wavelength of 1.3 micron and 2D Galvonometer mirrors was used to achieve 7-mm depth 3-D imaging. Graphics processing unit (GPU), OpenGL, C++ and C# were integrated for real-time volumetric rendering simultaneously. The 3D volume images taken by the OCT system were assembled and registered which could be used to guide a cochlear implant. We performed a feasibility study using both dry and wet temporal bones and the result is presented.

The importance of electrically evoked stapedial reflex in cochlear implant.

PubMed

Andrade, Kelly Cristina Lira de; Leal, Mariana de Carvalho; Muniz, Lilian Ferreira; Menezes, Pedro de Lemos; Albuquerque, Katia Maria Gomes de; Carnaúba, Aline Tenório Lins

2014-01-01

The most important stage in fitting a cochlear implant is the identification of its dynamic range. The use of objective measures, in particular the electrically elicited stapedius reflex, may provide suitable assistence for initial fitting of cochlear implant, especially in children or adult with multiple disorders, because they provide specific values that serve as the basis of early cochlear implant programming. Verify through a review the use of the electrically elicited stapedius reflex threshold during the activation and mapping process of cochlear implant. Bibliographical search on the Pubmed and Bireme plataforms, and also on Medline, LILACS and SciELO databases, with standard searches until September 2012, using specific keywords. For the selection and evaluation of scientific studies found in the search, criterias have been established, considering the following aspects: author, year/location, grade of recommendation/level of evidence, purpose, sample, age, mean age in years, evaluative testing, results and conclusion. Among 7,304 articles found, 7,080 were excluded from the title, 152 from the abstract, 17 from the article reading, 43 were repeated and 12 were selected for the study. The electrically elicited stapedius reflex may support when programming the cochlear implant, especially in patients with inconsistent responses.

[Applied anatomy of scala tympani inlet related to cochlear implantation].

PubMed

Zou, Tuanming; Guo, Menghe; Zhang, Hongzheng; Shu, Fan; Xie, Nanping

2012-06-01

To investigate the related parameters of the temporal bone structure for determining the position of implanting electrode into the scala tympani in cochlear implantation surgery through the facial recess and epitympanum approach. In a surgical simulation experiment, 20 human temporal bones were studied and measured to determine the related parameters of the temporal bone structure. The distance 5.91∓0.29 mm between the short process of the incus and the round window niche, 2.11∓0.18 mm between the stapes and the round window niche, 6.70∓0.19 mm between the facial nerve in the perpendicular paragraph and the round window niche, 2.22∓0.21 mm from the pyramidal eminence to the round window, and 2.16∓0.14 mm between the stapes and the round window. The minimal distance between the implanting electrode and the vestibular window was 2.12∓0.19 mm. The distance between the cochleariform process and the round window niche was 3.79∓0.17 mm. The position of the cochlear electrode array insertion into the second cochlear turn was 2.25∓0.13 mm under the stapes. The location of the cochlear electrode array insertion into the second cochlear turn was 2.28∓0.20 mm inferior to the pyramidal eminence. These parameters provide a reference value to determine the different positions of cochlear electrode array insertion into the scale tympani in different patients.

Electrophysiological evidence for altered visual, but not auditory, selective attention in adolescent cochlear implant users.

PubMed

Harris, Jill; Kamke, Marc R

2014-11-01

Selective attention fundamentally alters sensory perception, but little is known about the functioning of attention in individuals who use a cochlear implant. This study aimed to investigate visual and auditory attention in adolescent cochlear implant users. Event related potentials were used to investigate the influence of attention on visual and auditory evoked potentials in six cochlear implant users and age-matched normally-hearing children. Participants were presented with streams of alternating visual and auditory stimuli in an oddball paradigm: each modality contained frequently presented 'standard' and infrequent 'deviant' stimuli. Across different blocks attention was directed to either the visual or auditory modality. For the visual stimuli attention boosted the early N1 potential, but this effect was larger for cochlear implant users. Attention was also associated with a later P3 component for the visual deviant stimulus, but there was no difference between groups in the later attention effects. For the auditory stimuli, attention was associated with a decrease in N1 latency as well as a robust P3 for the deviant tone. Importantly, there was no difference between groups in these auditory attention effects. The results suggest that basic mechanisms of auditory attention are largely normal in children who are proficient cochlear implant users, but that visual attention may be altered. Ultimately, a better understanding of how selective attention influences sensory perception in cochlear implant users will be important for optimising habilitation strategies. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Sequential Bilateral Cochlear Implantation in a Patient with Bilateral Meniere’s Disease

PubMed Central

Holden, Laura K.; Neely, J. Gail; Gotter, Brenda D.; Mispagel, Karen M.; Firszt, Jill B.

2012-01-01

This case study describes a 45 year old female with bilateral, profound sensorineural hearing loss due to Meniere’s disease. She received her first cochlear implant in the right ear in 2008 and the second cochlear implant in the left ear in 2010. The case study examines the enhancement to speech recognition, particularly in noise, provided by bilateral cochlear implants. Speech recognition tests were administered prior to obtaining the second implant and at a number of test intervals following activation of the second device. Speech recognition in quiet and noise as well as localization abilities were assessed in several conditions to determine bilateral benefit and performance differences between ears. The results of the speech recognition testing indicated a substantial improvement in the patient’s ability to understand speech in noise and her ability to localize sound when using bilateral cochlear implants compared to using a unilateral implant or an implant and a hearing aid. In addition, the patient reported considerable improvement in her ability to communicate in daily life when using bilateral implants versus a unilateral implant. This case suggests that cochlear implantation is a viable option for patients who have lost their hearing to Meniere’s disease even when a number of medical treatments and surgical interventions have been performed to control vertigo. In the case presented, bilateral cochlear implantation was necessary for this patient to communicate successfully at home and at work. PMID:22463939

Electrical resistivity measurements in the mammalian cochlea after neural degeneration.

PubMed

Micco, Alan G; Richter, Claus-Peter

2006-08-01

In the present series of experiments, the effect of neural degeneration on the cochlear structure electrical resistivities was evaluated to test if it alters the current flow in the cochlea and if increased current levels are needed to stimulate the impaired cochlea. In cochlear implants, frequency information is encoded in part by stimulating discrete populations of spiral ganglion cells along the cochlea. However, electrical properties of the cochlear structures result in shunting of the current away from the auditory neurons. This consumes energy, makes cochlear implants less efficient, and drastically reduces battery life. Models of the electrically stimulated cochlea serve to make predictions on current paths using modified and improved cochlear implant electrodes. However, one of the model's shortcomings is that most of the values for tissue impedances are not direct measurements. They are derived from bulk impedance measurements, which are fitted to lumped-element models. The four-electrode reflection-coefficient technique was used to measure resistivities in the gerbil cochlea. In vivo and in vitro (the hemicochlea) models were used. Measurements were made in normal and in deafened animals. Cochlear damage was induced by neomycin injection into the animals' middle ears. Neural degeneration was allowed to occur over 2 months before performing the measurements in the deafened animals. The resistivity values in deafened animals were smaller than in the normal-hearing animals, thus altering the current flow within the cochlea. Resistivity changes and subsequent changes in current path should be considered in future designs of cochlear implants.

Speech Perception for Adults Who Use Hearing Aids in Conjunction with Cochlear Implants in Opposite Ears

ERIC Educational Resources Information Center

Mok, Mansze; Grayden, David; Dowell, Richard C.; Lawrence, David

2006-01-01

This study aimed to (a) investigate the effect of using a hearing aid in conjunction with a cochlear implant in opposite ears on speech perception in quiet and in noise, (b) identify the speech information obtained from a hearing aid that is additive to the information obtained from a cochlear implant, and (c) explore the relationship between…

Sirviendo a los estudiantes sordos que tienen Los implantes cocleares. Hoja de consejos de PEPNet (Serving Deaf Students Who Have Cochlear Implants. PEPNet Tipsheet)

ERIC Educational Resources Information Center

Clark, Catherine

2010-01-01

This version of "Serving Deaf Students Who Have Cochlear Implants. PEPNet Tipsheet," written in Spanish, describes how cochlear implants (CIs) work. CIs are complex electronic devices surgically implanted under the skin behind the ear. These devices utilize electrodes placed in the inner ear (the cochlea) to stimulate the auditory nerve of…

Sensitivity in Interactions between Hearing Mothers and their Toddlers with Hearing Loss: The Effect of Cochlear Implantation

ERIC Educational Resources Information Center

Bakar, Zaharah Abu; Brown, P. Margaret; Remine, Maria D.

2010-01-01

This study investigated the potential effects of cochlear implantation and age at implantation on maternal interactional sensitivity. Three groups of dyads were studied at two points over 1 year. The hearing aid (HA) group wore hearing aids throughout the study, the early cochlear implanted (ECI) group were implanted prior to 22 months of age, and…

The Relation Between Child Versus Parent Report of Chronic Fatigue and Language/Literacy Skills in School-Age Children with Cochlear Implants.

PubMed

Werfel, Krystal L; Hendricks, Alison Eisel

2016-01-01

Preliminary evidence suggests that children with hearing loss experience elevated levels of chronic fatigue compared with children with normal hearing. Chronic fatigue is associated with decreased academic performance in many clinical populations. Children with cochlear implants as a group exhibit deficits in language and literacy skills; however, the relation between chronic fatigue and language and literacy skills for children with cochlear implants is unclear. The purpose of this study was to explore subjective ratings of chronic fatigue by children with cochlear implants and their parents, as well as the relation between chronic fatigue and language and literacy skills in this population. Nineteen children with cochlear implants in grades 3 to 6 and one of their parents separately completed a subjective chronic fatigue scale, on which they rated how much the child experienced physical, sleep/rest, and cognitive fatigue over the past month. In addition, children completed an assessment battery that included measures of speech perception, oral language, word reading, and spelling. Children and parents reported different levels of chronic child physical and sleep/rest fatigue. In both cases, parents reported significantly less fatigue than did children. Children and parents did not report different levels of chronic child cognitive fatigue. Child report of physical fatigue was related to speech perception, language, reading, and spelling. Child report of sleep/rest and cognitive fatigue was related to speech perception and language but not to reading or spelling. Parent report of child fatigue was not related to children's language and literacy skills. Taken as a whole, results suggested that parents under-estimate the fatigue experienced by children with cochlear implants. Child report of physical fatigue was robustly related to language and literacy skills. Children with cochlear implants are likely more accurate at reporting physical fatigue than cognitive fatigue. Clinical practice should take fatigue into account when developing treatment plans for children with cochlear implants, and research should continue to develop a comprehensive model of fatigue in children with cochlear implants.

A Whole New World: Technology and Its Impact on Students Who Are Deaf or Hard-of-Hearing

ERIC Educational Resources Information Center

Miller, Kevin

2015-01-01

In this article, the author describes technology used with children or students who are deaf or hard-of-hearing. Specifically, three technological developments are highlighted: cochlear implants, universal newborn infant hearing screening, and telepractice. The positive impact of each type of technology on students who are deaf or hard-of-hearing…

Computing Support for Basic Research in Perception and Cognition

DTIC Science & Technology

1988-12-07

hearing aids and cochlear implants, this suggests that certain types of proposed coding schemes, specifically those employing periodicity tuning in...developing a computer model of the interaction of declarative and procedural knowledge in skill acquisition. In the Visual Psychophysics Laboratory... Psycholinguistics - Laboratory a computer model of text comprehension and recall has been constructed and several - experiments have been completed that verify basic

AUDITORY NUCLEI: DISTINCTIVE RESPONSE PATTERNS TO WHITE NOISE AND TONES IN UNANESTHETIZED CATS.

PubMed

GALIN, D

1964-10-09

Electrical responses to "white" noise and tonal stimuli were recorded from unanesthetized cats with permanently implanted bipolar electrodes. The cochlear nucleus, inferior colliculus, and medial geniculate each showed distinctive patterns of evoked activity. White noise and tones produced qualitatively different types of response. A decrease in activity characterized the response of the inferior colliculus to tonal stimuli.

Subcortical amplitude modulation encoding deficits suggest evidence of cochlear synaptopathy in normal-hearing 18-19 year olds with higher lifetime noise exposure.

PubMed

Paul, Brandon T; Waheed, Sajal; Bruce, Ian C; Roberts, Larry E

2017-11-01

Noise exposure and aging can damage cochlear synapses required for suprathreshold listening, even when cochlear structures needed for hearing at threshold remain unaffected. To control for effects of aging, behavioral amplitude modulation (AM) detection and subcortical envelope following responses (EFRs) to AM tones in 25 age-restricted (18-19 years) participants with normal thresholds, but different self-reported noise exposure histories were studied. Participants with more noise exposure had smaller EFRs and tended to have poorer AM detection than less-exposed individuals. Simulations of the EFR using a well-established cochlear model were consistent with more synaptopathy in participants reporting greater noise exposure.

Is the Cochlear Amplifier a Fluid Pump?

NASA Astrophysics Data System (ADS)

Karavitaki, K. D.; Mountain, D. C.

2003-02-01

We have visualized and quantified the effects of electrically evoked motility of outer hair cells (OHCs) within the organ of Corti using an excised cochlear preparation. We found that OHC motility induces oscillatory fluid flow in the tunnel of Corti (TC) and this flow is present at physiologically relevant frequencies. We also show, using a simple one-dimensional hydromechanical model of the TC, that a fluid wave within the tunnel can travel without significant attenuation for distances larger than the wavelength of the cochlear traveling wave. These results in combination with a recent hypothesis that fluid flow within the tunnel is necessary for cochlear amplification suggest that the function of the OHCs is to act as a fluid pump.

Imaging cochlear soft tissue displacement with coherent x-rays

NASA Astrophysics Data System (ADS)

Rau, Christoph; Richter, Claus-Peter

2015-10-01

At present, imaging of cochlear mechanics at mid-cochlear turns has not been accomplished. Although challenging, this appears possible with partially coherent hard x-rays. The present study shows results from stroboscopic x-ray imaging of a test object at audio frequencies. The vibration amplitudes were quantified. In a different set of experiments, an intact and calcified gerbil temporal bone was used to determine displacements of the reticular lamina, tectorial membrane, and Reissner’s membrane with the Lucas and Kanade video flow algorithm. The experiments validated high frequency x-ray imaging and imaging in a calcified cochlea. The present work is key for future imaging of cochlear micromechanics at a high spatial resolution.

Distinct capacity for differentiation to inner ear cell types by progenitor cells of the cochlea and vestibular organs

PubMed Central

McLean, Will J.; McLean, Dalton T.; Eatock, Ruth Anne

2016-01-01

Disorders of hearing and balance are most commonly associated with damage to cochlear and vestibular hair cells or neurons. Although these cells are not capable of spontaneous regeneration, progenitor cells in the hearing and balance organs of the neonatal mammalian inner ear have the capacity to generate new hair cells after damage. To investigate whether these cells are restricted in their differentiation capacity, we assessed the phenotypes of differentiated progenitor cells isolated from three compartments of the mouse inner ear – the vestibular and cochlear sensory epithelia and the spiral ganglion – by measuring electrophysiological properties and gene expression. Lgr5+ progenitor cells from the sensory epithelia gave rise to hair cell-like cells, but not neurons or glial cells. Newly created hair cell-like cells had hair bundle proteins, synaptic proteins and membrane proteins characteristic of the compartment of origin. PLP1+ glial cells from the spiral ganglion were identified as neural progenitors, which gave rise to neurons, astrocytes and oligodendrocytes, but not hair cells. Thus, distinct progenitor populations from the neonatal inner ear differentiate to cell types associated with their organ of origin. PMID:27789624

Hearing after congenital deafness: central auditory plasticity and sensory deprivation.

PubMed

Kral, A; Hartmann, R; Tillein, J; Heid, S; Klinke, R

2002-08-01

The congenitally deaf cat suffers from a degeneration of the inner ear. The organ of Corti bears no hair cells, yet the auditory afferents are preserved. Since these animals have no auditory experience, they were used as a model for congenital deafness. Kittens were equipped with a cochlear implant at different ages and electro-stimulated over a period of 2.0-5.5 months using a monopolar single-channel compressed analogue stimulation strategy (VIENNA-type signal processor). Following a period of auditory experience, we investigated cortical field potentials in response to electrical biphasic pulses applied by means of the cochlear implant. In comparison to naive unstimulated deaf cats and normal hearing cats, the chronically stimulated animals showed larger cortical regions producing middle-latency responses at or above 300 microV amplitude at the contralateral as well as the ipsilateral auditory cortex. The cortex ipsilateral to the chronically stimulated ear did not show any signs of reduced responsiveness when stimulating the 'untrained' ear through a second cochlear implant inserted in the final experiment. With comparable duration of auditory training, the activated cortical area was substantially smaller if implantation had been performed at an older age of 5-6 months. The data emphasize that young sensory systems in cats have a higher capacity for plasticity than older ones and that there is a sensitive period for the cat's auditory system.

Cochlear implantation in children with congenital cytomegalovirus infection accompanied by psycho-neurological disorders.

PubMed

Yamazaki, Hiroshi; Yamamoto, Rinko; Moroto, Saburo; Yamazaki, Tomoko; Fujiwara, Keizo; Nakai, Masako; Ito, Juichi; Naito, Yasushi

2012-04-01

Cochlear implantation was effective for deaf children with congenital cytomegalovirus (CMV) infection, but their cochlear implant (CI) outcomes were often impaired, depending on the types of CMV-associated psycho-neurological disorders. Evaluation of cognitive development and autistic tendency of implantees might be useful to predict their CI outcomes. To reveal the influence of CMV-associated psycho-neurological disorders on CI outcomes. This was a retrospective evaluation of 11 implantees with congenital CMV infection (CMV-CIs) and 14 implantees with autosomal recessive hearing loss (genetic-CIs). Nine of 11 CMV-CIs suffered from psycho-neurological disorders; one from attention deficit hyperactivity disorder, two from pervasive developmental disorder, and six from mental retardation. Aided hearing thresholds with CIs in the two groups did not differ, but two autistic and two mentally retarded CMV-CIs showed significantly low scores in speech discrimination tests. Language-Social (L-S) developmental quotients (DQs) evaluated by the Kyoto Scale of Psychological development were improved after the implantation in both groups, but the postoperative increase of L-S DQs was significantly smaller in the CMV-CIs than that of genetic-CIs. Interestingly, the postoperative L-S and Cognitive-Adaptive (C-A) DQs showed statistically significant correlation in all cases except for two autistic CMV-CIs whose L-S DQs were much lower than those expected from their C-A DQs.

Design and Evaluation of a Cochlear Implant Strategy Based on a “Phantom” Channel

PubMed Central

Nogueira, Waldo; Litvak, Leonid M.; Saoji, Aniket A.; Büchner, Andreas

2015-01-01

Unbalanced bipolar stimulation, delivered using charge balanced pulses, was used to produce “Phantom stimulation”, stimulation beyond the most apical contact of a cochlear implant’s electrode array. The Phantom channel was allocated audio frequencies below 300Hz in a speech coding strategy, conveying energy some two octaves lower than the clinical strategy and hence delivering the fundamental frequency of speech and of many musical tones. A group of 12 Advanced Bionics cochlear implant recipients took part in a chronic study investigating the fitting of the Phantom strategy and speech and music perception when using Phantom. The evaluation of speech in noise was performed immediately after fitting Phantom for the first time (Session 1) and after one month of take-home experience (Session 2). A repeated measures of analysis of variance (ANOVA) within factors strategy (Clinical, Phantom) and interaction time (Session 1, Session 2) revealed a significant effect for the interaction time and strategy. Phantom obtained a significant improvement in speech intelligibility after one month of use. Furthermore, a trend towards a better performance with Phantom (48%) with respect to F120 (37%) after 1 month of use failed to reach significance after type 1 error correction. Questionnaire results show a preference for Phantom when listening to music, likely driven by an improved balance between high and low frequencies. PMID:25806818

Waardenburg Syndrome: An Unusual Indication of Cochlear Implantation Experienced in 11 Patients.

PubMed

Bayrak, Feda; Çatlı, Tolgahan; Atsal, Görkem; Tokat, Taşkın; Olgun, Levent

2017-08-01

The aim of this study was to present the surgical findings of children with Waardenburg syndrome (WS) and investigate speech development after cochlear implantation in this unique group of patients. A retrospective chart review of the patients diagnosed with WS and implanted between 1998 and 2015 was performed. Categories of auditory performance (CAP) test were used to assess the auditory skills of these patients. CAP is a nonlinear hierarchical scale used to rate a child's developing auditory abilities. Preoperative test results and intraoperative surgical findings of these patients have been presented. In total, 1835 cases were implanted a tour institution, and 1210 of these were children. Among these implantees, 11 were diagnosed with WS (0.59% of all implantees). Four of the 11 patients showed incomplete partition type 2bony labyrinth abnormality (Mondini deformity) and all patients showed intraoperative gusher during cochleostomy, which was subsided through routine interventions. No other complications occurred during surgery, and all patients showed satisfactory CAP results in the late postoperative period. Our experiences with cochlear implantation in patients with WS showed that the procedure is safe and effective in this group of patients. Surgeons should be aware of possible labyrinth malformations and intraoperative problems such as gusher in these patients. In long term, auditory performances may exhibit satisfactory results with optimal postoperative educational and supportive measures.

Cochlear implantation with hearing preservation yields significant benefit for speech recognition in complex listening environments

PubMed Central

Gifford, René H.; Dorman, Michael F.; Skarzynski, Henryk; Lorens, Artur; Polak, Marek; Driscoll, Colin L. W.; Roland, Peter; Buchman, Craig A.

2012-01-01

Objective The aim of this study was to assess the benefit of having preserved acoustic hearing in the implanted ear for speech recognition in complex listening environments. Design The current study included a within subjects, repeated-measures design including 21 English speaking and 17 Polish speaking cochlear implant recipients with preserved acoustic hearing in the implanted ear. The patients were implanted with electrodes that varied in insertion depth from 10 to 31 mm. Mean preoperative low-frequency thresholds (average of 125, 250 and 500 Hz) in the implanted ear were 39.3 and 23.4 dB HL for the English- and Polish-speaking participants, respectively. In one condition, speech perception was assessed in an 8-loudspeaker environment in which the speech signals were presented from one loudspeaker and restaurant noise was presented from all loudspeakers. In another condition, the signals were presented in a simulation of a reverberant environment with a reverberation time of 0.6 sec. The response measures included speech reception thresholds (SRTs) and percent correct sentence understanding for two test conditions: cochlear implant (CI) plus low-frequency hearing in the contralateral ear (bimodal condition) and CI plus low-frequency hearing in both ears (best aided condition). A subset of 6 English-speaking listeners were also assessed on measures of interaural time difference (ITD) thresholds for a 250-Hz signal. Results Small, but significant, improvements in performance (1.7 – 2.1 dB and 6 – 10 percentage points) were found for the best-aided condition vs. the bimodal condition. Postoperative thresholds in the implanted ear were correlated with the degree of EAS benefit for speech recognition in diffuse noise. There was no reliable relationship among measures of audiometric threshold in the implanted ear nor elevation in threshold following surgery and improvement in speech understanding in reverberation. There was a significant correlation between ITD threshold at 250 Hz and EAS-related benefit for the adaptive SRT. Conclusions Our results suggest that (i) preserved low-frequency hearing improves speech understanding for CI recipients (ii) testing in complex listening environments, in which binaural timing cues differ for signal and noise, may best demonstrate the value of having two ears with low-frequency acoustic hearing and (iii) preservation of binaural timing cues, albeit poorer than observed for individuals with normal hearing, is possible following unilateral cochlear implantation with hearing preservation and is associated with EAS benefit. Our results demonstrate significant communicative benefit for hearing preservation in the implanted ear and provide support for the expansion of cochlear implant criteria to include individuals with low-frequency thresholds in even the normal to near-normal range. PMID:23446225

Relating the variability of tone-burst otoacoustic emission and auditory brainstem response latencies to the underlying cochlear mechanics

NASA Astrophysics Data System (ADS)

Verhulst, Sarah; Shera, Christopher A.

2015-12-01

Forward and reverse cochlear latency and its relation to the frequency tuning of the auditory filters can be assessed using tone bursts (TBs). Otoacoustic emissions (TBOAEs) estimate the cochlear roundtrip time, while auditory brainstem responses (ABRs) to the same stimuli aim at measuring the auditory filter buildup time. Latency ratios are generally close to two and controversy exists about the relationship of this ratio to cochlear mechanics. We explored why the two methods provide different estimates of filter buildup time, and ratios with large inter-subject variability, using a time-domain model for OAEs and ABRs. We compared latencies for twenty models, in which all parameters but the cochlear irregularities responsible for reflection-source OAEs were identical, and found that TBOAE latencies were much more variable than ABR latencies. Multiple reflection-sources generated within the evoking stimulus bandwidth were found to shape the TBOAE envelope and complicate the interpretation of TBOAE latency and TBOAE/ABR ratios in terms of auditory filter tuning.

Long latency auditory evoked potentials in children with cochlear implants: systematic review.

PubMed

Silva, Liliane Aparecida Fagundes; Couto, Maria Inês Vieira; Matas, Carla Gentile; Carvalho, Ana Claudia Martinho de

2013-11-25

The aim of this study was to analyze the findings on Cortical Auditory Evoked Potentials in children with cochlear implant through a systematic literature review. After formulation of research question and search of studies in four data bases with the following descriptors: electrophysiology (eletrofisiologia), cochlear implantation (implante coclear), child (criança), neuronal plasticity (plasticidade neuronal) and audiology (audiologia), were selected articles (original and complete) published between 2002 and 2013 in Brazilian Portuguese or English. A total of 208 studies were found; however, only 13 contemplated the established criteria and were further analyzed; was made data extraction for analysis of methodology and content of the studies. The results described suggest rapid changes in P1 component of Cortical Auditory Evoked Potentials in children with cochlear implants. Although there are few studies on the theme, cochlear implant has been shown to produce effective changes in central auditory path ways especially in children implanted before 3 years and 6 months of age.

Technical devices for hearing-impaired individuals: cochlear implants and brain stem implants - developments of the last decade

PubMed Central

Müller, Joachim

2005-01-01

Over the past two decades, the fascinating possibilities of cochlear implants for congenitally deaf or deafened children and adults developed tremendously and created a rapidly developing interdisciplinary research field. The main advancements of cochlear implantation in the past decade are marked by significant improvement of hearing and speech understanding in CI users. These improvements are attributed to the enhancement of speech coding strategies. The Implantation of more (and increasingly younger) children as well as the possibilities of the restoration of binaural hearing abilities with cochlear implants reflect the high standards reached by this development. Despite this progress, modern cochlear implants do not yet enable normal speech understanding, not even for the best patients. In particular speech understanding in noise remains problematic [1]. Until the mid 1990ies research concentrated on unilateral implantation. Remarkable and effective improvements have been made with bilateral implantation since 1996. Nowadays an increasing numbers of patients enjoy these benefits. PMID:22073052

Technical devices for hearing-impaired individuals: cochlear implants and brain stem implants - developments of the last decade.

PubMed

Müller, Joachim

2005-01-01

Over the past two decades, the fascinating possibilities of cochlear implants for congenitally deaf or deafened children and adults developed tremendously and created a rapidly developing interdisciplinary research field.The main advancements of cochlear implantation in the past decade are marked by significant improvement of hearing and speech understanding in CI users. These improvements are attributed to the enhancement of speech coding strategies.The Implantation of more (and increasingly younger) children as well as the possibilities of the restoration of binaural hearing abilities with cochlear implants reflect the high standards reached by this development. Despite this progress, modern cochlear implants do not yet enable normal speech understanding, not even for the best patients. In particular speech understanding in noise remains problematic [1]. Until the mid 1990ies research concentrated on unilateral implantation. Remarkable and effective improvements have been made with bilateral implantation since 1996. Nowadays an increasing numbers of patients enjoy these benefits.

A software tool for analyzing multichannel cochlear implant signals.

PubMed

Lai, Wai Kong; Bögli, Hans; Dillier, Norbert

2003-10-01

A useful and convenient means to analyze the radio frequency (RF) signals being sent by a speech processor to a cochlear implant would be to actually capture and display them with appropriate software. This is particularly useful for development or diagnostic purposes. sCILab (Swiss Cochlear Implant Laboratory) is such a PC-based software tool intended for the Nucleus family of Multichannel Cochlear Implants. Its graphical user interface provides a convenient and intuitive means for visualizing and analyzing the signals encoding speech information. Both numerical and graphic displays are available for detailed examination of the captured CI signals, as well as an acoustic simulation of these CI signals. sCILab has been used in the design and verification of new speech coding strategies, and has also been applied as an analytical tool in studies of how different parameter settings of existing speech coding strategies affect speech perception. As a diagnostic tool, it is also useful for troubleshooting problems with the external equipment of the cochlear implant systems.

A phone-assistive device based on Bluetooth technology for cochlear implant users.

PubMed

Qian, Haifeng; Loizou, Philipos C; Dorman, Michael F

2003-09-01

Hearing-impaired people, and particularly hearing-aid and cochlear-implant users, often have difficulty communicating over the telephone. The intelligibility of telephone speech is considerably lower than the intelligibility of face-to-face speech. This is partly because of lack of visual cues, limited telephone bandwidth, and background noise. In addition, cellphones may cause interference with the hearing aid or cochlear implant. To address these problems that hearing-impaired people experience with telephones, this paper proposes a wireless phone adapter that can be used to route the audio signal directly to the hearing aid or cochlear implant processor. This adapter is based on Bluetooth technology. The favorable features of this new wireless technology make the adapter superior to traditional assistive listening devices. A hardware prototype was built and software programs were written to implement the headset profile in the Bluetooth specification. Three cochlear implant users were tested with the proposed phone-adapter and reported good speech quality.

Cochlear implantation in Waardenburg syndrome: The Indian scenario.

PubMed

Deka, Ramesh Chandra; Sikka, Kapil; Chaturvedy, Gaurav; Singh, Chirom Amit; Venkat Karthikeyan, C; Kumar, Rakesh; Agarwal, Shivani

2010-10-01

Children with Waardenburg syndrome (WS) exhibiting normal inner ear anatomy, like those included in our cohort, derive significant benefit from cochlear implantation and results are comparable to those reported for the general population of implanted children. The patient population of WS accounts for approximately 2% of congenitally deaf children. The purpose of this retrospective case review was to describe the outcomes for those children with WS who have undergone cochlear implantation. On retrospective chart review, there were four cases with WS who underwent cochlear implantation. These cases were assessed for age at implantation, clinical and radiological features, operative and perioperative course, and performance outcomes. Auditory perception and speech production ability were evaluated using categories of auditory performance (CAP), meaningful auditory integration scales (MAIS), and speech intelligibility rating (SIR) during the follow-up period. In this group of children with WS, with a minimum follow-up of 12 months, the CAP score ranged from 3 to 5, MAIS from 25 to 30, and SIR was 3. These scores are comparable with those of other cochlear implantees.

Libyan cochlear implant programme: achievements, difficulties, and future goals

PubMed Central

Salamat, Ali; Esriti, Anwer; Ehtuish, Asia; El-Ogbi, Samya

2011-01-01

Cochlear implantation has become established worldwide as a safe and effective method of auditory rehabilitation of selected severely and profound deaf children and adults. Over 100,000 patients have received cochlear implants worldwide with the paediatric population proving to be the main beneficiaries. The Libyan cochlear implant programme was set up in 2004. Data relating to the patients who received cochlear implantation at Tripoli Medical Centre between October 2007 and February 2010 were analysed. Implant operations were performed on 37 patients. All patients received Med-El SONATATI100 devices. Thirty-four (91.9%) of these patients were children, whilst three (8.1%) were adults. Combined, congenital hearing loss (56.8%) and perinatal/neonatal (29.7%) were the two main aetiological factors in children. Seventeen patients (45.9%) had a positive family history of deafness. Sixteen patients (43.2%) were born to blood-related parents. The overall rate of minor and major complications was 16.2%, which is comparable to previous studies. PMID:21694783

Libyan cochlear implant programme: achievements, difficulties, and future goals.

PubMed

Salamat, Ali; Esriti, Anwer; Ehtuish, Asia; El-Ogbi, Samya

2011-01-01

Cochlear implantation has become established worldwide as a safe and effective method of auditory rehabilitation of selected severely and profound deaf children and adults. Over 100,000 patients have received cochlear implants worldwide with the paediatric population proving to be the main beneficiaries. The Libyan cochlear implant programme was set up in 2004. Data relating to the patients who received cochlear implantation at Tripoli Medical Centre between October 2007 and February 2010 were analysed. Implant operations were performed on 37 patients. All patients received Med-El SONATA(TI) (100) devices. Thirty-four (91.9%) of these patients were children, whilst three (8.1%) were adults. Combined, congenital hearing loss (56.8%) and perinatal/neonatal (29.7%) were the two main aetiological factors in children. Seventeen patients (45.9%) had a positive family history of deafness. Sixteen patients (43.2%) were born to blood-related parents. The overall rate of minor and major complications was 16.2%, which is comparable to previous studies.

Auditory Spatial Perception: Auditory Localization

DTIC Science & Technology

2012-05-01

cochlear nucleus, TB – trapezoid body, SOC – superior olivary complex, LL – lateral lemniscus, IC – inferior colliculus. Adapted from Aharonson and...Figure 5. Auditory pathways in the central nervous system. LE – left ear, RE – right ear, AN – auditory nerve, CN – cochlear nucleus, TB...fibers leaving the left and right inner ear connect directly to the synaptic inputs of the cochlear nucleus (CN) on the same (ipsilateral) side of

Sex Difference in Susceptibility and Resistance to Noise-Induced Hearing Loss in Chinchillas

DTIC Science & Technology

2000-10-01

Estradiol assays Blood samples were collected from deeply anesthetized chinchillas prior to cochlear histology. The blood samples were centrifuged to...pattern of hearing loss and cochlear damage for male and female chinchillas Gender differences have been reported in susceptibility to NIHL, both...Given the results of physiological testing (IC-EVPs and CDPs), the results of cochlear histology were somewhat surprising (see McFadden et al., 1999

Microsurgical Decompression of the Cochlear Nerve to Treat Disabling Tinnitus via an Endoscope-Assisted Retrosigmoid Approach: The Padua Experience.

PubMed

Di Stadio, Arianna; Colangeli, Roberta; Dipietro, Laura; Martini, Alessandro; Parrino, Daniela; Nardello, Ennio; D'Avella, Domenico; Zanoletti, Elisabetta

2018-05-01

The use of surgical cochlear nerve decompression is controversial. This study aimed at investigating the safety and validity of microsurgical decompression via an endoscope-assisted retrosigmoid approach to treat tinnitus in patients with neurovascular compression of the cochlear nerve. Three patients with disabling tinnitus resulting from a loop in the internal auditory canal were evaluated with magnetic resonance imaging and tests of pure tone auditory, tinnitus, and auditory brain response (ABR) to identify the features of the cochlear nerve involvement. We observed a loop with a caliber greater than 0.8 mm in all patients. Patients were treated via an endoscope-assisted retrosigmoid microsurgical decompression. After surgery, none of the patients reported short-term or long-term complications. After surgery, tinnitus resolved immediately in 2 patients, whereas in the other patient symptoms persisted although they improved; in all patients, hearing was preserved and ABR improved. Microsurgical decompression via endoscope-assisted retrosigmoid approach is a promising, safe, and valid procedure for treating tinnitus caused by cochlear nerve compression. This procedure should be considered in patients with disabling tinnitus who have altered ABR and a loop that has a caliber greater than 0.8 mm and is in contact with the cochlear nerve. Copyright © 2018 Elsevier Inc. All rights reserved.

Inner-ear sound pressures near the base of the cochlea in chinchilla: Further investigation

PubMed Central

Ravicz, Michael E.; Rosowski, John J.

2013-01-01

The middle-ear pressure gain GMEP, the ratio of sound pressure in the cochlear vestibule PV to sound pressure at the tympanic membrane PTM, is a descriptor of middle-ear sound transfer and the cochlear input for a given stimulus in the ear canal. GMEP and the cochlear partition differential pressure near the cochlear base ΔPCP, which determines the stimulus for cochlear partition motion and has been linked to hearing ability, were computed from simultaneous measurements of PV, PTM, and the sound pressure in scala tympani near the round window PST in chinchilla. GMEP magnitude was approximately 30 dB between 0.1 and 10 kHz and decreased sharply above 20 kHz, which is not consistent with an ideal transformer or a lossless transmission line. The GMEP phase was consistent with a roughly 50-μs delay between PV and PTM. GMEP was little affected by the inner-ear modifications necessary to measure PST. GMEP is a good predictor of ΔPCP at low and moderate frequencies where PV ⪢ PST but overestimates ΔPCP above a few kilohertz where PV ≈ PST. The ratio of PST to PV provides insight into the distribution of sound pressure within the cochlear scalae. PMID:23556590

TNF-α inhibition using etanercept prevents noise-induced hearing loss by improvement of cochlear blood flow in vivo.

PubMed

Arpornchayanon, Warangkana; Canis, Martin; Ihler, Friedrich; Settevendemie, Claudia; Strieth, Sebastian

2013-08-01

Exposure to loud noise can impair cochlear microcirculation and cause noise-induced hearing loss (NIHL). TNF-α signaling has been shown to be activated in NIHL and to control spiral modiolar artery vasoconstriction that regulates cochlear microcirculation. It was the aim of this experimental study to analyse the effects of the TNF-α inhibitor etanercept on cochlear microcirculation and hearing threshold shift in NIHL in vivo. After assessment of normacusis using ABR, loud noise (106 dB SPL, 30 minutes) was applied on both ears in guinea pigs. Etanercept was administered systemically after loud noise exposure while control animals received a saline solution. In vivo fluorescence microscopy of strial capillaries was performed after surgical exposure of the cochlea for microcirculatory analysis. ABR measurements were derived from the contralateral ear. Guinea pigs (n = 6, per group). Compared to controls, cochlear blood flow in strial capillary segments was significantly increased in etanercept-treated animals. Additionally, hearing threshold was preserved in animals receiving the TNF-α inhibitor in contrast to a significant threshold raising in controls. TNF-α inhibition using etanercept improves cochlear microcirculation and protects hearing levels after loud noise exposure and appears as a promising treatment strategy for human NIHL.

A prospective study evaluating cochlear implant management skills: development and validation of the Cochlear Implant Management Skills survey.

PubMed

Bennett, R J; Jayakody, D M P; Eikelboom, R H; Taljaard, D S; Atlas, M D

2016-02-01

To investigate the ability of cochlear implant (CI) recipients to physically handle and care for their hearing implant device(s) and to identify factors that may influence skills. To assess device management skills, a clinical survey was developed and validated on a clinical cohort of CI recipients. Survey development and validation. A prospective convenience cohort design study. Specialist hearing implant clinic. Forty-nine post-lingually deafened, adult CI recipients, at least 12 months postoperative. Survey test-retest reliability, interobserver reliability and responsiveness. Correlations between management skills and participant demographic, audiometric, clinical outcomes and device factors. The Cochlear Implant Management Skills survey was developed, demonstrating high test-retest reliability (0.878), interobserver reliability (0.972) and responsiveness to intervention (skills training) [t(20) = -3.913, P = 0.001]. Cochlear Implant Management Skills survey scores range from 54.69% to 100% (mean: 83.45%, sd: 12.47). No associations were found between handling skills and participant factors. This is the first study to demonstrate a range in cochlear implant device handling skills in CI recipients and offers clinicians and researchers a tool to systematically and objectively identify shortcomings in CI recipients' device handling skills. © 2015 John Wiley & Sons Ltd.

Comparison of auditory comprehension skills in children with cochlear implant and typically developing children.

PubMed

Mandal, Joyanta Chandra; Kumar, Suman; Roy, Sumit

2016-12-01

The main goal of this study was to obtain auditory comprehension skills of native Hindi speaking children with cochlear implant and typically developing children across the age of 3-7 years and compare the scores between two groups. A total of sixty Hindi speaking participants were selected for the study. They were divided into two groups- Group-A consisted of thirty children with normal hearing and Group-B thirty children using cochlear implants. To assess the auditory comprehension skills, Test of auditory comprehension in Hindi (TACH) was used. The participant was required to point to one of three pictures which would best correspond to the stimulus presented. Correct answers were scored as 1 and incorrect answers as 0. TACH was administered on for both groups. Independent t-test was applied and it was found that auditory comprehension scores of children using cochlear implant were significantly poorer than the score of children with normal hearing for all three subtests. Pearson's correlation coefficient revealed poor correlation between the scores of children with normal hearing and children using cochlear implant. The results of this study suggest that children using cochlear implant have poor auditory comprehension skills than children with normal hearing. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A longitudinal study of the bilateral benefit in children with bilateral cochlear implants.

PubMed

Asp, Filip; Mäki-Torkko, Elina; Karltorp, Eva; Harder, Henrik; Hergils, Leif; Eskilsson, Gunnar; Stenfelt, Stefan

2015-02-01

To study the development of the bilateral benefit in children using bilateral cochlear implants by measurements of speech recognition and sound localization. Bilateral and unilateral speech recognition in quiet, in multi-source noise, and horizontal sound localization was measured at three occasions during a two-year period, without controlling for age or implant experience. Longitudinal and cross-sectional analyses were performed. Results were compared to cross-sectional data from children with normal hearing. Seventy-eight children aged 5.1-11.9 years, with a mean bilateral cochlear implant experience of 3.3 years and a mean age of 7.8 years, at inclusion in the study. Thirty children with normal hearing aged 4.8-9.0 years provided normative data. For children with cochlear implants, bilateral and unilateral speech recognition in quiet was comparable whereas a bilateral benefit for speech recognition in noise and sound localization was found at all three test occasions. Absolute performance was lower than in children with normal hearing. Early bilateral implantation facilitated sound localization. A bilateral benefit for speech recognition in noise and sound localization continues to exist over time for children with bilateral cochlear implants, but no relative improvement is found after three years of bilateral cochlear implant experience.

[Immunolocalization of choline acetyltransferase in 2 types of efferent synapses of the organ of Corti].

PubMed

Eybalin, M; Pujol, R

1985-01-01

The efferent (olivo-cochlear) innervation of the organ of Corti was studied using a monoclonal antibody against choline acetyltransferase (ChAT). In the inner spiral bundle (ISB), below the inner hair cells (IHCs), the anti-ChAT immunoreactivity was observed within unvesiculated fibers and vesiculated varicosities. Unreactive varicosities, at least as numerous as the immunoreactive ones, were also detected. Both types of vesiculated varicosities synapsed with the dendrites of the primary auditory neurons (afferent fibers) connected to the IHCs. At the outer hair cell (OHC) level, nearly all the vesiculated terminals making axo-somatic synapses with the OHCs were anti-ChAT immunoreactive. Only few terminals synapsing with the OHCs were unreactive. These findings allowed the differentiation of at least three types of efferent synapses in the organ of Corti. In the ISB, a first population of axo-dendritic synapses seems to be cholinergic whereas a second population might use another neurotransmitter. At the OHC level, our results support the hypothesis that acetylcholine is the neurotransmitter of nearly all the large axo-somatic synapses. The rare unreactive axo-somatic synapses could constitute a fourth and minor type of efferent synapse. Thus, it would be helpful to subclassify the efferent innervations of the organ of Corti according to their neurochemical nature. A re-evaluation of the whole body of available electrophysiological data would be also necessary, as until now, acetylcholine was considered as being the only efferent cochlear neurotransmitter.

Musical experience sharpens human cochlear tuning.

PubMed

Bidelman, Gavin M; Nelms, Caitlin; Bhagat, Shaum P

2016-05-01

The mammalian cochlea functions as a filter bank that performs a spectral, Fourier-like decomposition on the acoustic signal. While tuning can be compromised (e.g., broadened with hearing impairment), whether or not human cochlear frequency resolution can be sharpened through experiential factors (e.g., training or learning) has not yet been established. Previous studies have demonstrated sharper psychophysical tuning curves in trained musicians compared to nonmusicians, implying superior peripheral tuning. However, these findings are based on perceptual masking paradigms, and reflect engagement of the entire auditory system rather than cochlear tuning, per se. Here, by directly mapping physiological tuning curves from stimulus frequency otoacoustic emissions (SFOAEs)-cochlear emitted sounds-we show that estimates of human cochlear tuning in a high-frequency cochlear region (4 kHz) is further sharpened (by a factor of 1.5×) in musicians and improves with the number of years of their auditory training. These findings were corroborated by measurements of psychophysical tuning curves (PTCs) derived via simultaneous masking, which similarly showed sharper tuning in musicians. Comparisons between SFOAE and PTCs revealed closer correspondence between physiological and behavioral curves in musicians, indicating that tuning is also more consistent between different levels of auditory processing in trained ears. Our findings demonstrate an experience-dependent enhancement in the resolving power of the cochlear sensory epithelium and the spectral resolution of human hearing and provide a peripheral account for the auditory perceptual benefits observed in musicians. Both local and feedback (e.g., medial olivocochlear efferent) mechanisms are discussed as potential mechanisms for experience-dependent tuning. Copyright © 2016 Elsevier B.V. All rights reserved.

Using Evoked Potentials to Match Interaural Electrode Pairs with Bilateral Cochlear Implants

PubMed Central

Delgutte, Bertrand

2007-01-01

Bilateral cochlear implantation seeks to restore the advantages of binaural hearing to the profoundly deaf by providing binaural cues normally important for accurate sound localization and speech reception in noise. Psychophysical observations suggest that a key issue for the implementation of a successful binaural prosthesis is the ability to match the cochlear positions of stimulation channels in each ear. We used a cat model of bilateral cochlear implants with eight-electrode arrays implanted in each cochlea to develop and test a noninvasive method based on evoked potentials for matching interaural electrodes. The arrays allowed the cochlear location of stimulation to be independently varied in each ear. The binaural interaction component (BIC) of the electrically evoked auditory brainstem response (EABR) was used as an assay of binaural processing. BIC amplitude peaked for interaural electrode pairs at the same relative cochlear position and dropped with increasing cochlear separation in either direction. To test the hypothesis that BIC amplitude peaks when electrodes from the two sides activate maximally overlapping neural populations, we measured multiunit neural activity along the tonotopic gradient of the inferior colliculus (IC) with 16-channel recording probes and determined the spatial pattern of IC activation for each stimulating electrode. We found that the interaural electrode pairings that produced the best aligned IC activation patterns were also those that yielded maximum BIC amplitude. These results suggest that EABR measurements may provide a method for assigning frequency–channel mappings in bilateral implant recipients, such as pediatric patients, for which psychophysical measures of pitch ranking or binaural fusion are unavailable. PMID:17225976

Using evoked potentials to match interaural electrode pairs with bilateral cochlear implants.

PubMed

Smith, Zachary M; Delgutte, Bertrand

2007-03-01

Bilateral cochlear implantation seeks to restore the advantages of binaural hearing to the profoundly deaf by providing binaural cues normally important for accurate sound localization and speech reception in noise. Psychophysical observations suggest that a key issue for the implementation of a successful binaural prosthesis is the ability to match the cochlear positions of stimulation channels in each ear. We used a cat model of bilateral cochlear implants with eight-electrode arrays implanted in each cochlea to develop and test a noninvasive method based on evoked potentials for matching interaural electrodes. The arrays allowed the cochlear location of stimulation to be independently varied in each ear. The binaural interaction component (BIC) of the electrically evoked auditory brainstem response (EABR) was used as an assay of binaural processing. BIC amplitude peaked for interaural electrode pairs at the same relative cochlear position and dropped with increasing cochlear separation in either direction. To test the hypothesis that BIC amplitude peaks when electrodes from the two sides activate maximally overlapping neural populations, we measured multiunit neural activity along the tonotopic gradient of the inferior colliculus (IC) with 16-channel recording probes and determined the spatial pattern of IC activation for each stimulating electrode. We found that the interaural electrode pairings that produced the best aligned IC activation patterns were also those that yielded maximum BIC amplitude. These results suggest that EABR measurements may provide a method for assigning frequency-channel mappings in bilateral implant recipients, such as pediatric patients, for which psychophysical measures of pitch ranking or binaural fusion are unavailable.

Intracochlear administration of steroids with a catheter during human cochlear implantation: a safety and feasibility study.

PubMed

Prenzler, Nils K; Salcher, Rolf; Timm, Max; Gaertner, Lutz; Lenarz, Thomas; Warnecke, Athanasia

2018-05-14

Suppression of foreign body reaction, improvement of electrode-nerve interaction, and preservation of residual hearing are essential research topics in cochlear implantation. Intracochlear pharmaco- or cell-based therapies can open new horizons in this field. Local drug delivery strategies are desirable as higher local concentrations of agents can be realized and side effects can be minimized compared to systemic administrations. When administered locally at accessible, basal parts of the cochlea, drugs reach apical regions later and in much lower concentrations due to poor diffusion patterns in cochlear fluids. Therefore, new devices are needed to warrant rapid distribution of agents into all parts of the cochlea. Five patients received a deep intracochlear injection of triamcinolone with a specifically designed cochlear catheter during cochlear implantation right before inserting a cochlear implant electrode. As a measure for formation of fibrous tissue around the electrode, electrical impedances were measured in the operation room and over 4 months thereafter. No adverse events were observed peri- and postoperatively. The handling of the device was easy. Severe damage to the microstructure of the cochlea was excluded as far as possible by cone beam computed tomography and vestibular testing. A delayed rise of the impedances was seen in the catheter group compared to controls over all regions of the cochlea. A statistical significance, however, was only obtained at the midregion of the cochlea. Consequently, the cochlear catheter is a safe and feasible device for local drug delivery of pharmaceutical agents into deeper regions of the cochlea.

Fabrication and evaluation of an improved polymer-based cochlear electrode array for atraumatic insertion.

PubMed

Gwon, Tae Mok; Min, Kyou Sik; Kim, Jin Ho; Oh, Seung Ha; Lee, Ho Sun; Park, Min-Hyun; Kim, Sung June

2015-04-01

An atraumatic cochlear electrode array has become indispensable to high-performance cochlear implants such as electric acoustic stimulation (EAS), wherein the preservation of residual hearing is significant. For an atraumatic implantation, we propose and demonstrate a new improved design of a cochlear electrode array based on liquid crystal polymer (LCP), which can be fabricated by precise batch processes and a thermal lamination process, in contrast to conventional wire-based cochlear electrode arrays. Using a thin-film process of LCP-film-mounted silicon wafer and thermal press lamination, we devise a multi-layered structure with variable layers of LCP films to achieve a sufficient degree of basal rigidity and a flexible tip. A peripheral blind via and self-aligned silicone elastomer molding process can reduce the width of the array. Measuring the insertion and extraction forces in a human scala tympani model, we investigate five human temporal bone insertion trials and record electrically evoked auditory brainstem responses (EABR) acutely in a guinea pig model. The diameters of the finalized electrode arrays are 0.3 mm (tip) and 0.75 mm (base). The insertion force with a displacement of 8 mm from a round window and the maximum extraction force are 2.4 mN and 34.0 mN, respectively. The electrode arrays can be inserted from 360° to 630° without trauma at the basal turn. The EABR data confirm the efficacy of the array. A new design of LCP-based cochlear electrode array for atraumatic implantation is fabricated. Verification indicates that foretells the development of an atraumatic cochlear electrode array and clinical implant.

Persistence, Distribution, and Impact of Distinctly Segmented Microparticles on Cochlear Health following In Vivo Infusion3*

PubMed Central

Ross, Astin M.; Rahmani, Sahar; Prieskorn, Diane M.; Dishman, Acacia F; Miller, Josef M.; Lahann, Joerg; Altschuler, Richard A.

2016-01-01

Delivery of pharmaceuticals to the cochleae of patients with auditory dysfunction could potentially have many benefits from enhancing auditory nerve survival to protecting remaining sensory cells and their neuronal connections. Treatment would require platforms to enable drug delivery directly to the cochlea and increase the potential efficacy of intervention. Cochlear implant recipients are a specific patient subset that could benefit from local drug delivery as more candidates have residual hearing; and since residual hearing directly contributes to post-implantation hearing outcomes, it requires protection from implant insertion-induced trauma. This study assessed the feasibility of utilizing microparticles for drug delivery into cochlear fluids, testing persistence, distribution, biocompatibility, and drug release characteristics. To allow for delivery of multiple therapeutics, particles were composed of two distinct compartments; one containing polylactide-co-glycolide (PLGA), and one composed of acetal-modified dextran and PLGA. Following in vivo infusion, image analysis revealed microparticle persistence in the cochlea for at least 7 days post-infusion, primarily in the first and second turns. The majority of subjects maintained or had only slight elevation in auditory brainstem response thresholds at 7 days post-infusion compared to pre-infusion baselines. There was only minor to limited loss of cochlear hair cells and negligible immune response based on CD45+ immunolabling. When Piribedil-loaded microparticles were infused, Piribedil was detectable within the cochlear fluids at 7 days post-infusion. These results indicate that segmented microparticles are relatively inert, can persist, release their contents, and be functionally and biologically compatible with cochlear function and therefore are promising vehicles for cochlear drug delivery. PMID:26841263

Prevention and management of vascular complications in middle ear and cochlear implant surgery.

PubMed

Di Lella, Filippo; Falcioni, Maurizio; Piccinini, Silvia; Iaccarino, Ilaria; Bacciu, Andrea; Pasanisi, Enrico; Cerasti, Davide; Vincenti, Vincenzo

2017-11-01

The objective of this study is to illustrate prevention strategies and management of vascular complications from the jugular bulb (JB) and internal carotid artery (ICA) during middle ear surgery or cochlear implantation. The study design is retrospective case series. The setting is tertiary referral university hospital. Patients were included if presented pre- or intraoperative evidence of high-risk anatomical anomalies of ICA or JB during middle ear or cochlear implant surgery, intraoperative vascular injury, or revision surgery after the previous iatrogenic vascular lesions. The main outcome measures are surgical outcomes and complications rate. Ten subjects were identified: three underwent cochlear implant surgery and seven underwent middle ear surgery. Among the cochlear implant patients, two presented with anomalies of the JB impeding access to the cochlear lumen and one underwent revision surgery for incorrect positioning of the array in the carotid canal. Subtotal petrosectomy was performed in all cases. Anomalies of the JB were preoperatively identified in two patients with attic and external auditory canal cholesteatoma, respectively. In a patient, a high and dehiscent JB was found during myringoplasty, while another underwent revision surgery after iatrogenic injury of the JB. A dehiscent ICA complicated middle ear effusion in one case, while in another case, a carotid aneurysm determined a cholesterol granuloma. Rupture of a pseudoaneurysm of the ICA occurred in a child during second-stage surgery and required permanent balloon occlusion without neurological complications. Knowledge of normal anatomy and its variants and preoperative imaging are the basis for prevention of vascular complications during middle ear or cochlear implant surgery.

Minocycline attenuates streptomycin-induced cochlear hair cell death by inhibiting protein nitration and poly (ADP-ribose) polymerase activation.

PubMed

Wang, Ping; Li, Haonan; Yu, Shuyuan; Jin, Peng; Hassan, Abdurahman; Du, Bo

2017-08-24

This study aimed to elucidate the protective effect of minocycline against streptomycin-induced damage of cochlear hair cells and its mechanism. Cochlear membranes were isolated from newborn Wistar rats and randomly divided into control, 500μmol/L streptomycin, 100μmol/L minocycline, and streptomycin and minocycline treatment groups. Hair cell survival was analyzed by detecting the expression of 3-nitrotyrosine (3-NT) in cochlear hair cells by immunofluorescence and an enzyme-linked immunosorbent assay. Expression of 3-NT and inducible nitric oxide synthase (iNOS), and poly (ADP-Ribose) polymerase (PARP) and caspase-3 activation were evaluated by western blotting. The results demonstrated hair cell loss at 24h after streptomycin treatment. No change was found in supporting cells of the cochleae. Minocycline pretreatment improved hair cell survival and significantly reduced the expression of iNOS and 3-NT in cochlear tissues compared with the streptomycin treatment group. PARP and caspase-3 activation was increased in the streptomycin treatment group compared with the control group, and pretreatment with minocycline decreased cleaved PARP and activated caspase-3 expression. Minocycline protected cochlear hair cells from injury caused by streptomycin in vitro. The mechanism underlying the protective effect may be associated with the inhibition of excessive formation of nitric oxide, reduction of the nitration stress reaction, and inhibition of PARP and caspase-3 activation in cochlear hair cells. Combined minocycline therapy can be applied to patients requiring streptomycin treatment. Copyright © 2017. Published by Elsevier B.V.

Cochlear Implantation After Partial or Subtotal Cochleoectomy for Intracochlear Schwannoma Removal-A Technical Report.

PubMed

Plontke, Stefan K; Kösling, Sabrina; Rahne, Torsten

2018-03-01

To describe the technique for surgical tumor removal, cochlear implant (CI) electrode placement and reconstruction of the surgical defect in patients with intracochlear schwannomas. Retrospective case review. Tertiary referral center. Ten patients (five men, five women, mean age 48 ± 12 yr) with profound or severe to profound hearing loss due to intralabyrinthine schwannomas with intracochlear location. Surgical tumor removal through extended round window approach, partial or subtotal cochleoectomy with or without labyrinthectomy and reconstruction of the surgical defect with cartilage, perichondrium or temporal muscle fascia, and bone pâté. Eight patients received a cochlear implant in the same procedure. Retrospective evaluation of clinical outcome including safety aspects (adverse events) and audiological performance at early follow up in cases of cochlear implantation. The tumor was successfully removed in all cases without macroscopic (operation microscope and endoscope) tumor remnants in the bony labyrinth apart from one case with initial transmodiolar growth. One patient needed revision surgery for labyrinthine fistula. At short-term follow up (3-month post-surgery), good hearing results with the cochlear implant were obtained in all but one patient with a word recognition score of 100% for numbers, and 64 ± 14% for monosyllables (at 65 dB SPL in quiet). Surgical tumor removal and cochlear implantation is a promising treatment strategy in the management of intralabyrinthine schwannoma with intracochlear location, further extending the indication range for cochlear implantation. It is, however, of importance to observe the long-term outcome in these patients and to address challenges like follow up with magnetic resonance imaging.

Cochlear implant with a non-removable magnet: preliminary research at 3-T MRI.

PubMed

Dubrulle, F; Sufana Iancu, A; Vincent, C; Tourrel, G; Ernst, O

2013-06-01

To perform preliminary tests in vitro and with healthy volunteers to determine the 3-T MRI compatibility of a cochlear implant with a non-removable magnet. In the in vitro phase, we tested six implants for temperature changes and internal malfunctioning. We measured the demagnetisation of 65 internal magnets with different tilt angles between the implant's magnetic field (bi) and the main magnetic field (b0). In the in vivo phase, we tested 28 operational implants attached to the scalps of volunteers with the head in three different positions. The study did not find significant temperature changes or electronic malfunction in the implants tested in vitro. We found considerable demagnetisation of the cochlear implant magnets in the in vitro and in vivo testing influenced by the position of the magnet in the main magnetic field. We found that if the bi/b0 angle is <90°, there is no demagnetisation; if the bi/b0 angle is >90°, there is demagnetisation in almost 60 % of the cases. When the angle is around 90°, the risk of demagnetisation is low (6.6 %). The preliminary results on cochlear implants with non-removable magnets indicate the need to maintain the contraindication of passage through 3-T MRI. • Magnetic resonance imaging can affect cochlear implants and vice versa. • Demagnetisation of cochlear implant correlates with the angle between bi and b0. • The position of the head in the MRI influences the demagnetisation. • Three-Tesla MRI for cochlear implants is still contraindicated. • However some future solutions are discussed.

Distortion products in auditory fMRI research: Measurements and solutions.

PubMed

Norman-Haignere, Sam; McDermott, Josh H

2016-04-01

Nonlinearities in the cochlea can introduce audio frequencies that are not present in the sound signal entering the ear. Known as distortion products (DPs), these added frequencies complicate the interpretation of auditory experiments. Sound production systems also introduce distortion via nonlinearities, a particular concern for fMRI research because the Sensimetrics earphones widely used for sound presentation are less linear than most high-end audio devices (due to design constraints). Here we describe the acoustic and neural effects of cochlear and earphone distortion in the context of fMRI studies of pitch perception, and discuss how their effects can be minimized with appropriate stimuli and masking noise. The amplitude of cochlear and Sensimetrics earphone DPs were measured for a large collection of harmonic stimuli to assess effects of level, frequency, and waveform amplitude. Cochlear DP amplitudes were highly sensitive to the absolute frequency of the DP, and were most prominent at frequencies below 300 Hz. Cochlear DPs could thus be effectively masked by low-frequency noise, as expected. Earphone DP amplitudes, in contrast, were highly sensitive to both stimulus and DP frequency (due to prominent resonances in the earphone's transfer function), and their levels grew more rapidly with increasing stimulus level than did cochlear DP amplitudes. As a result, earphone DP amplitudes often exceeded those of cochlear DPs. Using fMRI, we found that earphone DPs had a substantial effect on the response of pitch-sensitive cortical regions. In contrast, cochlear DPs had a small effect on cortical fMRI responses that did not reach statistical significance, consistent with their lower amplitudes. Based on these findings, we designed a set of pitch stimuli optimized for identifying pitch-responsive brain regions using fMRI. These stimuli robustly drive pitch-responsive brain regions while producing minimal cochlear and earphone distortion, and will hopefully aid fMRI researchers in avoiding distortion confounds. Copyright © 2016 Elsevier Inc. All rights reserved.

Spoken language development in children following cochlear implantation.

PubMed

Niparko, John K; Tobey, Emily A; Thal, Donna J; Eisenberg, Laurie S; Wang, Nae-Yuh; Quittner, Alexandra L; Fink, Nancy E

2010-04-21

Cochlear implantation is a surgical alternative to traditional amplification (hearing aids) that can facilitate spoken language development in young children with severe to profound sensorineural hearing loss (SNHL). To prospectively assess spoken language acquisition following cochlear implantation in young children. Prospective, longitudinal, and multidimensional assessment of spoken language development over a 3-year period in children who underwent cochlear implantation before 5 years of age (n = 188) from 6 US centers and hearing children of similar ages (n = 97) from 2 preschools recruited between November 2002 and December 2004. Follow-up completed between November 2005 and May 2008. Performance on measures of spoken language comprehension and expression (Reynell Developmental Language Scales). Children undergoing cochlear implantation showed greater improvement in spoken language performance (10.4; 95% confidence interval [CI], 9.6-11.2 points per year in comprehension; 8.4; 95% CI, 7.8-9.0 in expression) than would be predicted by their preimplantation baseline scores (5.4; 95% CI, 4.1-6.7, comprehension; 5.8; 95% CI, 4.6-7.0, expression), although mean scores were not restored to age-appropriate levels after 3 years. Younger age at cochlear implantation was associated with significantly steeper rate increases in comprehension (1.1; 95% CI, 0.5-1.7 points per year younger) and expression (1.0; 95% CI, 0.6-1.5 points per year younger). Similarly, each 1-year shorter history of hearing deficit was associated with steeper rate increases in comprehension (0.8; 95% CI, 0.2-1.2 points per year shorter) and expression (0.6; 95% CI, 0.2-1.0 points per year shorter). In multivariable analyses, greater residual hearing prior to cochlear implantation, higher ratings of parent-child interactions, and higher socioeconomic status were associated with greater rates of improvement in comprehension and expression. The use of cochlear implants in young children was associated with better spoken language learning than would be predicted from their preimplantation scores.

Distortion Products in Auditory fMRI Research: Measurements and Solutions

PubMed Central

Norman-Haignere, Sam; McDermott, Josh H.

2016-01-01

Nonlinearities in the cochlea can introduce audio frequencies that are not present in the sound signal entering the ear. Known as distortion products (DPs), these added frequencies complicate the interpretation of auditory experiments. Sound production systems also introduce distortion via nonlinearities, a particular concern for fMRI research because the Sensimetrics earphones widely used for sound presentation are less linear than most high-end audio devices (due to design constraints). Here we describe the acoustic and neural effects of cochlear and earphone distortion in the context of fMRI studies of pitch perception, and discuss how their effects can be minimized with appropriate stimuli and masking noise. The amplitude of cochlear and Sensimetrics earphone DPs were measured for a large collection of harmonic stimuli to assess effects of level, frequency, and waveform amplitude. Cochlear DP amplitudes were highly sensitive to the absolute frequency of the DP, and were most prominent at frequencies below 300 Hz. Cochlear DPs could thus be effectively masked by low-frequency noise, as expected. Earphone DP amplitudes, in contrast, were highly sensitive to both stimulus and DP frequency (due to prominent resonances in the earphone’s transfer function), and their levels grew more rapidly with increasing stimulus level than did cochlear DP amplitudes. As a result, earphone DP amplitudes often exceeded those of cochlear DPs. Using fMRI, we found that earphone DPs had a substantial effect on the response of pitch-sensitive cortical regions. In contrast, cochlear DPs had a small effect on cortical fMRI responses that did not reach statistical significance, consistent with their lower amplitudes. Based on these findings, we designed a set of pitch stimuli optimized for identifying pitch-responsive brain regions using fMRI. These stimuli robustly drive pitch-responsive brain regions while producing minimal cochlear and earphone distortion, and will hopefully aid fMRI researchers in avoiding distortion confounds. PMID:26827809

Cochlear implantation in adults with asymmetric hearing loss.

PubMed

Firszt, Jill B; Holden, Laura K; Reeder, Ruth M; Cowdrey, Lisa; King, Sarah

2012-01-01

Bilateral severe to profound sensorineural hearing loss is a standard criterion for cochlear implantation. Increasingly, patients are implanted in one ear and continue to use a hearing aid in the nonimplanted ear to improve abilities such as sound localization and speech understanding in noise. Patients with severe to profound hearing loss in one ear and a more moderate hearing loss in the other ear (i.e., asymmetric hearing) are not typically considered candidates for cochlear implantation. Amplification in the poorer ear is often unsuccessful because of limited benefit, restricting the patient to unilateral listening from the better ear alone. The purpose of this study was to determine whether patients with asymmetric hearing loss could benefit from cochlear implantation in the poorer ear with continued use of a hearing aid in the better ear. Ten adults with asymmetric hearing between ears participated. In the poorer ear, all participants met cochlear implant candidacy guidelines; seven had postlingual onset, and three had pre/perilingual onset of severe to profound hearing loss. All had open-set speech recognition in the better-hearing ear. Assessment measures included word and sentence recognition in quiet, sentence recognition in fixed noise (four-talker babble) and in diffuse restaurant noise using an adaptive procedure, localization of word stimuli, and a hearing handicap scale. Participants were evaluated preimplant with hearing aids and postimplant with the implant alone, the hearing aid alone in the better ear, and bimodally (the implant and hearing aid in combination). Postlingual participants were evaluated at 6 mo postimplant, and pre/perilingual participants were evaluated at 6 and 12 mo postimplant. Data analysis compared the following results: (1) the poorer-hearing ear preimplant (with hearing aid) and postimplant (with cochlear implant); (2) the device(s) used for everyday listening pre- and postimplant; and (3) the hearing aid-alone and bimodal listening conditions postimplant. The postlingual participants showed significant improvements in speech recognition after 6 mo cochlear implant use in the poorer ear. Five postlingual participants had a bimodal advantage over the hearing aid-alone condition on at least one test measure. On average, the postlingual participants had significantly improved localization with bimodal input compared with the hearing aid-alone. Only one pre/perilingual participant had open-set speech recognition with the cochlear implant. This participant had better hearing than the other two pre/perilingual participants in both the poorer and better ear. Localization abilities were not significantly different between the bimodal and hearing aid-alone conditions for the pre/perilingual participants. Mean hearing handicap ratings improved postimplant for all participants indicating perceived benefit in everyday life with the addition of the cochlear implant. Patients with asymmetric hearing loss who are not typical cochlear implant candidates can benefit from using a cochlear implant in the poorer ear with continued use of a hearing aid in the better ear. For this group of 10, the 7 postlingually deafened participants showed greater benefits with the cochlear implant than the pre/perilingual participants; however, further study is needed to determine maximum benefit for those with early onset of hearing loss.

Cochlear Implantation in Adults with Asymmetric Hearing Loss

PubMed Central

Firszt, Jill B.; Holden, Laura K.; Reeder, Ruth M.; Cowdrey, Lisa; King, Sarah

2012-01-01

Objective Bilateral severe-to-profound sensorineural hearing loss is a standard criterion for cochlear implantation. Increasingly, patients are implanted in one ear and continue to use a hearing aid in the non-implanted ear to improve abilities such as sound localization and speech understanding in noise. Patients with severe-to-profound hearing loss in one ear and a more moderate hearing loss in the other ear (i.e., asymmetric hearing) are not typically considered candidates for cochlear implantation. Amplification in the poorer ear is often unsuccessful due to limited benefit, restricting the patient to unilateral listening from the better ear alone. The purpose of this study was to determine if patients with asymmetric hearing loss could benefit from cochlear implantation in the poorer ear with continued use of a hearing aid in the better ear. Design Ten adults with asymmetric hearing between ears participated. In the poorer ear, all participants met cochlear implant candidacy guidelines; seven had postlingual onset and three had pre/perilingual onset of severe-to-profound hearing loss. All had open-set speech recognition in the better hearing ear. Assessment measures included word and sentence recognition in quiet, sentence recognition in fixed noise (four-talker babble) and in diffuse restaurant noise using an adaptive procedure, localization of word stimuli and a hearing handicap scale. Participants were evaluated pre-implant with hearing aids and post-implant with the implant alone, the hearing aid alone in the better ear and bimodally (the implant and hearing aid in combination). Postlingual participants were evaluated at six months post-implant and pre/perilingual participants were evaluated at six and 12 months post-implant. Data analysis compared results 1) of the poorer hearing ear pre-implant (with hearing aid) and post-implant (with cochlear implant), 2) with the device(s) used for everyday listening pre- and post-implant and, 3) between the hearing aid-alone and bimodal listening conditions post-implant. Results The postlingual participants showed significant improvements in speech recognition after six months cochlear implant use in the poorer ear. Five postlingual participants had a bimodal advantage over the hearing aid-alone condition on at least one test measure. On average, the postlingual participants had significantly improved localization with bimodal input compared to the hearing aid-alone. Only one pre/perilingual participant had open-set speech recognition with the cochlear implant. This participant had better hearing than the other two pre/perilingual participants in both the poorer and better ear. Localization abilities were not significantly different between the bimodal and hearing aid-alone conditions for the pre/perilingual participants. Mean hearing handicap ratings improved post-implant for all participants indicating perceived benefit in everyday life with the addition of the cochlear implant. Conclusions Patients with asymmetric hearing loss who are not typical cochlear implant candidates can benefit from using a cochlear implant in the poorer ear with continued use of a hearing aid in the better ear. For this group of ten, the seven postlingually deafened participants showed greater benefits with the cochlear implant than the pre/perilingual participants; however, further study is needed to determine maximum benefit for those with early onset of hearing loss. PMID:22441359

Improving speech perception in noise for children with cochlear implants.

PubMed

Gifford, René H; Olund, Amy P; Dejong, Melissa

2011-10-01

Current cochlear implant recipients are achieving increasingly higher levels of speech recognition; however, the presence of background noise continues to significantly degrade speech understanding for even the best performers. Newer generation Nucleus cochlear implant sound processors can be programmed with SmartSound strategies that have been shown to improve speech understanding in noise for adult cochlear implant recipients. The applicability of these strategies for use in children, however, is not fully understood nor widely accepted. To assess speech perception for pediatric cochlear implant recipients in the presence of a realistic restaurant simulation generated by an eight-loudspeaker (R-SPACE™) array in order to determine whether Nucleus sound processor SmartSound strategies yield improved sentence recognition in noise for children who learn language through the implant. Single subject, repeated measures design. Twenty-two experimental subjects with cochlear implants (mean age 11.1 yr) and 25 control subjects with normal hearing (mean age 9.6 yr) participated in this prospective study. Speech reception thresholds (SRT) in semidiffuse restaurant noise originating from an eight-loudspeaker array were assessed with the experimental subjects' everyday program incorporating Adaptive Dynamic Range Optimization (ADRO) as well as with the addition of Autosensitivity control (ASC). Adaptive SRTs with the Hearing In Noise Test (HINT) sentences were obtained for all 22 experimental subjects, and performance-in percent correct-was assessed in a fixed +6 dB SNR (signal-to-noise ratio) for a six-subject subset. Statistical analysis using a repeated-measures analysis of variance (ANOVA) evaluated the effects of the SmartSound setting on the SRT in noise. The primary findings mirrored those reported previously with adult cochlear implant recipients in that the addition of ASC to ADRO significantly improved speech recognition in noise for pediatric cochlear implant recipients. The mean degree of improvement in the SRT with the addition of ASC to ADRO was 3.5 dB for a mean SRT of 10.9 dB SNR. Thus, despite the fact that these children have acquired auditory/oral speech and language through the use of their cochlear implant(s) equipped with ADRO, the addition of ASC significantly improved their ability to recognize speech in high levels of diffuse background noise. The mean SRT for the control subjects with normal hearing was 0.0 dB SNR. Given that the mean SRT for the experimental group was 10.9 dB SNR, despite the improvements in performance observed with the addition of ASC, cochlear implants still do not completely overcome the speech perception deficit encountered in noisy environments accompanying the diagnosis of severe-to-profound hearing loss. SmartSound strategies currently available in latest generation Nucleus cochlear implant sound processors are able to significantly improve speech understanding in a realistic, semidiffuse noise for pediatric cochlear implant recipients. Despite the reluctance of pediatric audiologists to utilize SmartSound settings for regular use, the results of the current study support the addition of ASC to ADRO for everyday listening environments to improve speech perception in a child's typical everyday program. American Academy of Audiology.

Evoked otoacoustic emissions in workers exposed to noise: A review

PubMed Central

Alcarás, Patrícia Arruda de Souza; Lüders, Débora; França, Denise Maria Vaz Romano; Klas, Regina Maria; Lacerda, Adriana Bender Moreira de; Gonçalves, Cláudia Giglio de Oliveira

2012-01-01

Summary Introduction: The otoacoustic emissions test is an essential tool in the evaluation of auditory function, since it allows the early detection of cochlear damage of occupational origin. Objective: To present a review of the literature and analyze the effectiveness of the clinical application of the otoacoustic emissions test in workers exposed to noise. Methods: A bibliographical search covering a period of 10 years was performed in the Virtual Health Library including published articles in national and international journals indexed in the internationally recognized databases for the health sciences, LILACS, SCIELO, and MEDLINE, using the terms “otoacoustic emissions” and “occupational exposure.” The type of published article (national/international), the type and intensity of the stimulus most commonly used for the evoked otoacoustic emissions, the gender and age of the subjects, and the conclusions from the retrospective studies were all taken into consideration. Results and Conclusions: A total of 19 articles were analyzed, 7 national and 12 international, covering subjects from 17 to 77 years of age, mostly men. The type of stimulus most commonly used for the evoked otoacoustic emissions was the distortion method (12). Through this review, we have concluded that testing of evoked otoacoustic emissions in workers exposed to noise is an important tool in the early diagnosis of noise-induced cochlear hearing disorders. PMID:25991982

Alternating Current Delivered into the Scala Media Alters Sound Pressure at the Eardrum

NASA Astrophysics Data System (ADS)

Hubbard, Allyn E.; Mountain, David C.

1983-11-01

Alternating current delivered into the scala media of the gerbil cochlea modulates the amplitude of a test tone measured near the eardrum. Variations in the electromechanical effect with acoustic stimulus parameters and observed physiological vulnerability suggest that cochlear hair cells are the biophysical origin of the process. Cochlear hair cells have traditionally been thought of as passive receptor cells, but they may play an active role in cochlear micromechanics.

Investigation of Notch Signaling during Spontaneous Regeneration of Cochlear Hair Cells

DTIC Science & Technology

2016-10-01

AWARD NUMBER: W81XWH-15-1-0475 TITLE: Investigation of Notch Signaling during Spontaneous Regeneration of Cochlear Hair Cells PRINCIPAL...Sep 2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Investigation of Notch Signaling during Spontaneous Regeneration of Cochlear Hair Cells 5b...inherent to military settings. These noise exposures damage and kill sensory hair cells (HCs) found in the cochlea of the inner ear, resulting in permanent

In Vitro Studies and Preliminary Mathematical Model for Jet Fuel and Noise Induced Auditory Impairment

DTIC Science & Technology

2015-06-01

K.C. and Hu, B.H. 2006. The role of oxidative stress in noise-induced hearing loss. Ear Hear 27(1): 1-19. Hillerdal, M. 1987. Cochlear blood flow ...Larsen, H.C., Angelborg, C. and Slepecky, N. 1984. Determination of the regional cochlear blood flow in the rat cochlea using non-radioactive...24-Hour JP-8 Exposure using a Cochlear Cell Model and Cellular Pathway Modulation

Stanford Center for Military Photomedicine

DTIC Science & Technology

2014-09-08

cochlear implants after blast injury. A.2. WOUND HEALING. We have used several in vivo and in vitro models of wound healing to study the basic cell and...clinical information we will obtain has the potential to fundamentally alter the diagnosis and treatment of human cochlear pathology. Our microscope...of live guinea pigs, and have shown that FME can resolve cochlear structures in live subjects in a manner far superior to that of any other existing

Evaluation of Jet Fuel and Noise-Induced Hearing Loss in Rats (Rattus norvegicus)

DTIC Science & Technology

2014-05-13

product otoacoustic emissions (DPOAE) and compound action potential (CAP) testing of the cochlear nerve. Inner ear hair cell loss was also not affected...conclusion by revealing that exposure to JP-8 combined with noise may result in the loss of pre-neural cochlear sensitivity as shown by suppression of...distortion product otoacoustic emissions (DPOAE) and depletion of cochlear sensory cells as evidenced by cytocochleograms that plot the percentage of

Systemic Polyarteritis Nodosa as the Cause of Sudden Onset Bilateral Sensorineural Hearing Loss Following Lassa Virus Infection

DTIC Science & Technology

2016-07-05

occlusion of the anterior inferior cerebellar artery (AICA) and downstream vessels leading to cochlear hypoxia (18-24). Relevant to this work, PAN has...macaques showed moderate lymphoplasmacytic to chronic-active perivascular inflammation of the inner ear adjacent to the cochlear nerve The...inflammation occasionally surrounded smaller branches of the cochlear nerve, resembling pathological changes seen in humans diagnosed with PAN (Fig. 3B-E) (21

Cochlear Implantation in the Very Young Child: Issues Unique to the Under-1 Population

PubMed Central

Cosetti, Maura; Roland, J. Thomas

2010-01-01

Since the advent of cochlear implantation, candidacy criteria have slowly broadened to include increasingly younger patients. Spurred by evidence demonstrating both perioperative safety and significantly increased speech and language benefit with early auditory intervention, children younger than 12 months of age are now being successfully implanted at many centers. This review highlights the unique challenges involved in cochlear implantation in the very young child, specifically diagnosis and certainty of testing, anesthetic risk, surgical technique, intraoperative testing and postoperative programming, long-term safety, development of receptive and expressive language, and outcomes of speech perception. Overall, the current body of literature indicates that cochlear implantation prior to 1 year of age is both safe and efficacious. PMID:20483813

Dual Coding of Frequency Modulation in the Ventral Cochlear Nucleus.

PubMed

Paraouty, Nihaad; Stasiak, Arkadiusz; Lorenzi, Christian; Varnet, Léo; Winter, Ian M

2018-04-25

Frequency modulation (FM) is a common acoustic feature of natural sounds and is known to play a role in robust sound source recognition. Auditory neurons show precise stimulus-synchronized discharge patterns that may be used for the representation of low-rate FM. However, it remains unclear whether this representation is based on synchronization to slow temporal envelope (ENV) cues resulting from cochlear filtering or phase locking to faster temporal fine structure (TFS) cues. To investigate the plausibility of those encoding schemes, single units of the ventral cochlear nucleus of guinea pigs of either sex were recorded in response to sine FM tones centered at the unit's best frequency (BF). The results show that, in contrast to high-BF units, for modulation depths within the receptive field, low-BF units (<4 kHz) demonstrate good phase locking to TFS. For modulation depths extending beyond the receptive field, the discharge patterns follow the ENV and fluctuate at the modulation rate. The receptive field proved to be a good predictor of the ENV responses for most primary-like and chopper units. The current in vivo data also reveal a high level of diversity in responses across unit types. TFS cues are mainly conveyed by low-frequency and primary-like units and ENV cues by chopper and onset units. The diversity of responses exhibited by cochlear nucleus neurons provides a neural basis for a dual-coding scheme of FM in the brainstem based on both ENV and TFS cues. SIGNIFICANCE STATEMENT Natural sounds, including speech, convey informative temporal modulations in frequency. Understanding how the auditory system represents those frequency modulations (FM) has important implications as robust sound source recognition depends crucially on the reception of low-rate FM cues. Here, we recorded 115 single-unit responses from the ventral cochlear nucleus in response to FM and provide the first physiological evidence of a dual-coding mechanism of FM via synchronization to temporal envelope cues and phase locking to temporal fine structure cues. We also demonstrate a diversity of neural responses with different coding specializations. These results support the dual-coding scheme proposed by psychophysicists to account for FM sensitivity in humans and provide new insights on how this might be implemented in the early stages of the auditory pathway. Copyright © 2018 the authors 0270-6474/18/384123-15$15.00/0.

Accuracy of cochlear implant recipients on pitch perception, melody recognition, and speech reception in noise.

PubMed

Gfeller, Kate; Turner, Christopher; Oleson, Jacob; Zhang, Xuyang; Gantz, Bruce; Froman, Rebecca; Olszewski, Carol

2007-06-01

The purposes of this study were to (a) examine the accuracy of cochlear implant recipients who use different types of devices and signal processing strategies on pitch ranking as a function of size of interval and frequency range and (b) to examine the relations between this pitch perception measure and demographic variables, melody recognition, and speech reception in background noise. One hundred fourteen cochlear implant users and 21 normal-hearing adults were tested on a pitch discrimination task (pitch ranking) that required them to determine direction of pitch change as a function of base frequency and interval size. Three groups were tested: (a) long electrode cochlear implant users (N = 101); (b) short electrode users that received acoustic plus electrical stimulation (A+E) (N = 13); and (c) a normal-hearing (NH) comparison group (N = 21). Pitch ranking was tested at standard frequencies of 131 to 1048 Hz, and the size of the pitch-change intervals ranged from 1 to 4 semitones. A generalized linear mixed model (GLMM) was fit to predict pitch ranking and to determine if group differences exist as a function of base frequency and interval size. Overall significance effects were measured with Chi-square tests and individual effects were measured with t-tests. Pitch ranking accuracy was correlated with demographic measures (age at time of testing, length of profound deafness, months of implant use), frequency difference limens, familiar melody recognition, and two measures of speech reception in noise. The long electrode recipients performed significantly poorer on pitch discrimination than the NH and A+E group. The A+E users performed similarly to the NH listeners as a function of interval size in the lower base frequency range, but their pitch discrimination scores deteriorated slightly in the higher frequency range. The long electrode recipients, although less accurate than participants in the NH and A+E groups, tended to perform with greater accuracy within the higher frequency range. There were statistically significant correlations between pitch ranking and familiar melody recognition as well as with pure-tone frequency difference limens at 200 and 400 Hz. Low-frequency acoustic hearing improves pitch discrimination as compared with traditional, electric-only cochlear implants. These findings have implications for musical tasks such as familiar melody recognition.

AAC intervention using a VOCA for deaf children with multiple disabilities who received cochlear implantation.

PubMed

Lee, Youngmee; Jeong, Sung-Wook; Kim, Lee-Suk

2013-12-01

The aim of this study was to examine the efficacy of a new habilitation approach, augmentative and alternative communication (AAC) intervention using a voice output communication aid (VOCA), in improving speech perception, speech production, receptive vocabulary skills, and communicative behaviors in children with cochlear implants (CIs) who had multiple disabilities. Five children with mental retardation and/or cerebral palsy who had used CIs over two years were included in this study. Five children in the control group were matched to children who had AAC intervention on the basis of the type/severity of their additional disabilities and chronological age. They had limited oral communication skills after cochlear implantation because of their limited cognition and oromotor function. The children attended the AAC intervention with parents once a week for 6 months. We evaluated their performance using formal tests, including the monosyllabic word tests, the articulation test, and the receptive vocabulary test. We also assessed parent-child interactions. We analyzed the data using a one-group pretest and posttest design. The mean scores of the formal tests performed in these children improved from 26% to 48% in the phoneme scores of the monosyllabic word tests, from 17% to 35% in the articulation test, and from 11 to 18.4 in the receptive vocabulary test after AAC intervention (all p < .05). Some children in the control group showed improvement in the speech perception, speech production, and receptive vocabulary tests for 6 months, but the differences did not achieve statistical significance (all p > .05). The frequency of spontaneous communicative behaviors (i.e., vocalization, gestures, and words) and imitative words significantly increased after AAC intervention (p < .05). AAC intervention using a VOCA was very useful and effective on improving communicative skills in children with multiple disabilities who had very limited oral communication skills after cochlear implantation. Copyright © 2013. Published by Elsevier Ireland Ltd.

Stronger efferent suppression of cochlear neural potentials by contralateral acoustic stimulation in awake than in anesthetized chinchilla.

PubMed

Aedo, Cristian; Tapia, Eduardo; Pavez, Elizabeth; Elgueda, Diego; Delano, Paul H; Robles, Luis

2015-01-01

There are two types of sensory cells in the mammalian cochlea, inner hair cells, which make synaptic contact with auditory-nerve afferent fibers, and outer hair cells that are innervated by crossed and uncrossed medial olivocochlear (MOC) efferent fibers. Contralateral acoustic stimulation activates the uncrossed efferent MOC fibers reducing cochlear neural responses, thus modifying the input to the central auditory system. The chinchilla, among all studied mammals, displays the lowest percentage of uncrossed MOC fibers raising questions about the strength and frequency distribution of the contralateral-sound effect in this species. On the other hand, MOC effects on cochlear sensitivity have been mainly studied in anesthetized animals and since the MOC-neuron activity depends on the level of anesthesia, it is important to assess the influence of anesthesia in the strength of efferent effects. Seven adult chinchillas (Chinchilla laniger) were chronically implanted with round-window electrodes in both cochleae. We compared the effect of contralateral sound in awake and anesthetized condition. Compound action potentials (CAP) and cochlear microphonics (CM) were measured in the ipsilateral cochlea in response to tones in absence and presence of contralateral sound. Control measurements performed after middle-ear muscles section in one animal discarded any possible middle-ear reflex activation. Contralateral sound produced CAP amplitude reductions in all chinchillas, with suppression effects greater by about 1-3 dB in awake than in anesthetized animals. In contrast, CM amplitude increases of up to 1.9 dB were found in only three awake chinchillas. In both conditions the strongest efferent effects were produced by contralateral tones at frequencies equal or close to those of ipsilateral tones. Contralateral CAP suppressions for 1-6 kHz ipsilateral tones corresponded to a span of uncrossed MOC fiber innervation reaching at least the central third of the chinchilla cochlea.

Intraoperative Cochlear Implant Device Testing Utilizing an Automated Remote System: A Prospective Pilot Study.

PubMed

Lohmann, Amanda R; Carlson, Matthew L; Sladen, Douglas P

2018-03-01

Intraoperative cochlear implant device testing provides valuable information regarding device integrity, electrode position, and may assist with determining initial stimulation settings. Manual intraoperative device testing during cochlear implantation requires the time and expertise of a trained audiologist. The purpose of the current study is to investigate the feasibility of using automated remote intraoperative cochlear implant reverse telemetry testing as an alternative to standard testing. Prospective pilot study evaluating intraoperative remote automated impedance and Automatic Neural Response Telemetry (AutoNRT) testing in 34 consecutive cochlear implant surgeries using the Intraoperative Remote Assistant (Cochlear Nucleus CR120). In all cases, remote intraoperative device testing was performed by trained operating room staff. A comparison was made to the "gold standard" of manual testing by an experienced cochlear implant audiologist. Electrode position and absence of tip fold-over was confirmed using plain film x-ray. Automated remote reverse telemetry testing was successfully completed in all patients. Intraoperative x-ray demonstrated normal electrode position without tip fold-over. Average impedance values were significantly higher using standard testing versus CR120 remote testing (standard mean 10.7 kΩ, SD 1.2 vs. CR120 mean 7.5 kΩ, SD 0.7, p < 0.001). There was strong agreement between standard manual testing and remote automated testing with regard to the presence of open or short circuits along the array. There were, however, two cases in which standard testing identified an open circuit, when CR120 testing showed the circuit to be closed. Neural responses were successfully obtained in all patients using both systems. There was no difference in basal electrode responses (standard mean 195.0 μV, SD 14.10 vs. CR120 194.5 μV, SD 14.23; p = 0.7814); however, more favorable (lower μV amplitude) results were obtained with the remote automated system in the apical 10 electrodes (standard 185.4 μV, SD 11.69 vs. CR120 177.0 μV, SD 11.57; p value < 0.001). These preliminary data demonstrate that intraoperative cochlear implant device testing using a remote automated system is feasible. This system may be useful for cochlear implant programs with limited audiology support or for programs looking to streamline intraoperative device testing protocols. Future studies with larger patient enrollment are required to validate these promising, but preliminary, findings.

Tinnitus

MedlinePlus

... tinnitus in a significant number of study volunteers. Cochlear implants are sometimes used in people who have tinnitus along with severe hearing loss. A cochlear implant bypasses the damaged portion of the inner ...

Developmental Effects of Family Environment on Outcomes in Pediatric Cochlear Implant Recipients

PubMed Central

Holt, Rachael Frush; Beer, Jessica; Kronenberger, William G.; Pisoni, David B.

2012-01-01

Objective To examine and compare the family environment of preschool- and school-age children with cochlear implants and assess its influence on children’s executive function and spoken language skills. Study Design Retrospective between-subjects design. Setting Outpatient research laboratory. Patients Prelingually deaf children with cochlear implants and no additional disabilities, and their families. Intervention(s) Cochlear implantation and speech-language therapy. Main Outcome Measures Parents completed the Family Environment Scale and the Behavior Rating Inventory of Executive Function (or the preschool version). Children were tested using the Peabody Picture Vocabulary Test-4 and either the Preschool Language Scales-4 or the Clinical Evaluation of Language Fundamentals–4. Results The family environments of children with cochlear implants differed from normative data obtained from hearing children, but average scores were within one standard deviation of norms on all subscales. Families of school-age children reported higher levels of control than those of preschool-age children. Preschool-age children had fewer problems with emotional control when families reported higher levels of support and lower levels of conflict. School-age children had fewer problems with inhibition but more problems with shifting of attention when families reported lower levels of conflict. School-age children’s receptive vocabularies were enhanced by families with lower levels of control and higher levels of organization. Conclusions Family environment and its relation to language skills and executive function development differed across the age groups in this sample of children with cochlear implants. Because family dynamics is one developmental/environmental factor that can be altered with therapy and education, the present results have important clinical implications for family-based interventions for deaf children with cochlear implants. PMID:23151776

Development and evaluation of the Nurotron 26-electrode cochlear implant system.

PubMed

Zeng, Fan-Gang; Rebscher, Stephen J; Fu, Qian-Jie; Chen, Hongbin; Sun, Xiaoan; Yin, Li; Ping, Lichuan; Feng, Haihong; Yang, Shiming; Gong, Shusheng; Yang, Beibei; Kang, Hou-Yong; Gao, Na; Chi, Fanglu

2015-04-01

Although the cochlear implant has been widely acknowledged as the most successful neural prosthesis, only a fraction of hearing-impaired people who can potentially benefit from a cochlear implant have actually received one due to its limited awareness, accessibility, and affordability. To help overcome these limitations, a 26-electrode cochlear implant has been developed to receive China's Food and Drug Administration (CFDA) approval in 2011 and Conformité Européenne (CE) Marking in 2012. The present article describes design philosophy, system specification, and technical verification of the Nurotron device, which includes advanced digital signal processing and 4 current sources with multiple amplitude resolutions that not only are compatible with perceptual capability but also allow interleaved or simultaneous stimulation. The article also presents 3-year longitudinal evaluation data from 60 human subjects who have received the Nurotron device. The objective measures show that electrode impedance decreased within the first month of device use, but was stable until a slight increase at the end of two years. The subjective loudness measures show that electric stimulation threshold was stable while the maximal comfort level increased over the 3 years. Mandarin sentence recognition increased from the pre-surgical 0%-correct score to a plateau of about 80% correct with 6-month use of the device. Both indirect and direct comparisons indicate indistinguishable performance differences between the Nurotron system and other commercially available devices. The present 26-electrode cochlear implant has already helped to lower the price of cochlear implantation in China and will likely contribute to increased cochlear implant access and success in the rest of the world. This article is part of a Special Issue entitled . Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Across-site patterns of electrically evoked compound action potential amplitude-growth functions in multichannel cochlear implant recipients and the effects of the interphase gap.

PubMed

Schvartz-Leyzac, Kara C; Pfingst, Bryan E

2016-11-01

Electrically evoked compound action potential (ECAP) measures of peak amplitude, and amplitude-growth function (AGF) slope have been shown to reflect characteristics of cochlear health (primarily spiral ganglion density) in anesthetized cochlear-implanted guinea pigs. Likewise, the effect of increasing the interphase gap (IPG) in each of these measures also reflects SGN density in the implanted guinea pig. Based on these findings, we hypothesize that suprathreshold ECAP measures, and also how they change as the IPG is increased, have the potential to be clinically applicable in human subjects. However, further work is first needed in order to determine the characteristics of these measures in humans who use cochlear implants. The current study examined across-site patterns of suprathreshold ECAP measures in 10 bilaterally-implanted, adult cochlear implant users. Results showed that both peak amplitude and slope of the AGF varied significantly from electrode to electrode in ear-specific patterns across the subjects' electrode arrays. As expected, increasing the IPG on average increased the peak amplitude and slope. Across ears, there was a significant, negative correlation between the slope of the ECAP AGF and the duration of hearing loss. Across-site patterns of ECAP peak amplitude and AGF slopes were also compared with common ground impedance values and significant correlations were observed in some cases, depending on the subject and condition. The results of this study, coupled with previous studies in animals, suggest that it is feasible to measure the change in suprathreshold ECAP measures as the IPG increases on most electrodes. Further work is needed to investigate the relationship between these measures and cochlear implant outcomes, and determine how these measures might be used when programming a cochlear-implant processor. Published by Elsevier B.V.

Noise alters hair-bundle mechanics at the cochlear apex

NASA Astrophysics Data System (ADS)

Strimbu, C. Elliott; Fridberger, Anders

2015-12-01

Exposure to loud sounds can lead to both permanent and short term changes in auditory sensitivity. Permanent hearing loss is often associated with gross changes in cochlear morphology including the loss of hair cells and auditory nerve fibers while the mechanisms of short term threshold shifts are much less well understood and may vary at different locations across the cochlea. Previous reports suggest that exposure to loud sounds leads to a decrease in the cochlear microphonic potential and in the stiffness of the organ of Corti. Because the cochlear microphonic reflects changes in the membrane potential of the hair cells, this suggests that hair-bundle motion should be reversibly altered following exposure to loud sounds. Using an in vitro preparation of the guinea pig temporal bone we investigate changes in the micro-mechanical response near the cochlear apex following a brief (up to 10 - 20 minutes) exposure to loud (˜ 120 dB) tones near the best frequency at this location. We use time-resolved confocal imaging to record the motion of outer hair cell bundles before and after acoustic overstimulation. We have also recorded larger-scale structural views of the organ of Corti before and after exposure to the loud sound. Conventional electrophysiological techniques are used measure the cochlear microphonic potential. As has been previously reported, following acoustic overexposure the cochlear microphonic declines in value and typically recovers on the order of 30 - 60 minutes. Hair-bundle trajectories are affected following the loud sound and typically recover on a somewhat faster time scale than the microphonic potential, although the results vary considerably across preparations. Preliminary results also suggest reversible changes in the hair cell's resting potential following the loud sound.

Factors influencing the efficacy of round window dexamethasone protection of residual hearing post-cochlear implant surgery.

PubMed

Chang, Andrew; Eastwood, Hayden; Sly, David; James, David; Richardson, Rachael; O'Leary, Stephen

2009-09-01

To protect hearing in an experimental model of cochlear implantation by the application of dexamethasone to the round window prior to surgery. The present study examined the dosage and timing relationships required to optimise the hearing protection. Dexamethasone or saline (control) was absorbed into a pledget of the carboxymethylcellulose and hyaluronic acid and applied to the round window of the guinea pig prior to cochlear implantation. The treatment groups were 2% w/v dexamethasone for 30, 60 and 120min; 20% dexamethasone applied for 30min. Auditory sensitivity was determined pre-operatively, and at 1 week after surgery, with pure-tone auditory brainstem response audiometry (2-32kHz). Cochlear implantation was performed via a cochleostomy drilled into the basal turn of the cochlea, into which a miniature cochlear implant dummy electrode was inserted using soft-surgery techniques. ABR thresholds were elevated after cochlear implantation, maximally at 32kHz and to a lesser extent at lower frequencies. Thresholds were less elevated after dexamethasone treatment, and the hearing protection improved when 2% dexamethasone was applied to the round window for longer periods of time prior to implantation. The time that dexamethasone need be applied to achieve hearing protection could be reduced by increasing the concentration of steroid, with a 20% application for 30min achieving similar levels of protection to a 60min application of 2% dexamethasone. Hearing protection is improved by increasing the time that dexamethasone is applied to the round window prior to cochlear implantation, and the waiting time can be reduced by increasing the steroid concentration. These results suggest that the diffusion dexamethasone through the cochlea is the prime determinant of the extent of hearing protection.

The impact of cochlear implantation on speech understanding, subjective hearing performance, and tinnitus perception in patients with unilateral severe to profound hearing loss.

PubMed

Távora-Vieira, Dayse; Marino, Roberta; Acharya, Aanand; Rajan, Gunesh P

2015-03-01

This study aimed to determine the impact of cochlear implantation on speech understanding in noise, subjective perception of hearing, and tinnitus perception of adult patients with unilateral severe to profound hearing loss and to investigate whether duration of deafness and age at implantation would influence the outcomes. In addition, this article describes the auditory training protocol used for unilaterally deaf patients. This is a prospective study of subjects undergoing cochlear implantation for unilateral deafness with or without associated tinnitus. Speech perception in noise was tested using the Bamford-Kowal-Bench speech-in-noise test presented at 65 dB SPL. The Speech, Spatial, and Qualities of Hearing Scale and the Abbreviated Profile of Hearing Aid Benefit were used to evaluate the subjective perception of hearing with a cochlear implant and quality of life. Tinnitus disturbance was measured using the Tinnitus Reaction Questionnaire. Data were collected before cochlear implantation and 3, 6, 12, and 24 months after implantation. Twenty-eight postlingual unilaterally deaf adults with or without tinnitus were implanted. There was a significant improvement in speech perception in noise across time in all spatial configurations. There was an overall significant improvement on the subjective perception of hearing and quality of life. Tinnitus disturbance reduced significantly across time. Age at implantation and duration of deafness did not influence the outcomes significantly. Cochlear implantation provided significant improvement in speech understanding in challenging situations, subjective perception of hearing performance, and quality of life. Cochlear implantation also resulted in reduced tinnitus disturbance. Age at implantation and duration of deafness did not seem to influence the outcomes.

The Role of the World Health Organization's International Classification of Functioning, Health and Disability in Models of Infant Cochlear Implant Management

PubMed Central

Psarros, Colleen; Love, Sarah

2016-01-01

Newborn hearing screening has led to the early diagnosis of hearing loss in neonates and early device fitting is common, based primarily on electrophysiologic and radiologic information, with some supplementary behavioral measures. Such early fitting of hearing devices, in particular cochlear implants (CIs), has been beneficial to the majority of children implanted under the age of 12 months who meet the cochlear implant candidacy criteria. Comorbidities are common in children with hearing loss, although they may not be evident in neonates and may not emerge until later in infants. Evidence suggests that the child's outcomes are strongly influenced by a range of environmental factors including emotional and social support from the immediate and extended family. Consequently, such factors are important in service planning and service delivery for babies and children receiving CIs. The World Health Organization's International Classification of Functioning, Health and Disability (ICF) can provide a framework to facilitate the holistic management of pediatric cochlear implant recipients. The ICF also can be used to map the progress of recipients over time to highlight emerging issues that require intervention. This article will discuss our preliminary use of the ICF to establish clinical practice; develop advocacy skills among clients and their families; identify eligibility for services such as support in educational settings; enable access to modes of service delivery such as telepractice; provide a conceptual framework for policy and program development for pediatric cochlear implant recipients (i.e., in both disability and health services); and, most importantly, establish a clear pathway for the longitudinal management of the cochlear implant in a child's future. It is anticipated that this model will be applied to other populations receiving cochlear implants through our program. PMID:27489404

Developmental and cross-modal plasticity in deafness: evidence from the P1 and N1 event related potentials in cochlear implanted children.

PubMed

Sharma, Anu; Campbell, Julia; Cardon, Garrett

2015-02-01

Cortical development is dependent on extrinsic stimulation. As such, sensory deprivation, as in congenital deafness, can dramatically alter functional connectivity and growth in the auditory system. Cochlear implants ameliorate deprivation-induced delays in maturation by directly stimulating the central nervous system, and thereby restoring auditory input. The scenario in which hearing is lost due to deafness and then reestablished via a cochlear implant provides a window into the development of the central auditory system. Converging evidence from electrophysiologic and brain imaging studies of deaf animals and children fitted with cochlear implants has allowed us to elucidate the details of the time course for auditory cortical maturation under conditions of deprivation. Here, we review how the P1 cortical auditory evoked potential (CAEP) provides useful insight into sensitive period cut-offs for development of the primary auditory cortex in deaf children fitted with cochlear implants. Additionally, we present new data on similar sensitive period dynamics in higher-order auditory cortices, as measured by the N1 CAEP in cochlear implant recipients. Furthermore, cortical re-organization, secondary to sensory deprivation, may take the form of compensatory cross-modal plasticity. We provide new case-study evidence that cross-modal re-organization, in which intact sensory modalities (i.e., vision and somatosensation) recruit cortical regions associated with deficient sensory modalities (i.e., auditory) in cochlear implanted children may influence their behavioral outcomes with the implant. Improvements in our understanding of developmental neuroplasticity in the auditory system should lead to harnessing central auditory plasticity for superior clinical technique. Copyright © 2014 Elsevier B.V. All rights reserved.

Will They Catch Up? The Role of Age at Cochlear Implantation in the Spoken Language Development of Children with Severe to Profound Hearing Loss

ERIC Educational Resources Information Center

Nicholas, Johanna Grant; Geers, Ann E.

2007-01-01

Purpose: The authors examined the benefits of younger cochlear implantation, longer cochlear implant use, and greater pre-implant aided hearing to spoken language at 3.5 and 4.5 years of age. Method: Language samples were obtained at ages 3.5 and 4.5 years from 76 children who received an implant by their 3rd birthday. Hierarchical linear modeling…

Biomechanical Modeling and Measurement of Blast Injury and Hearing Protection Mechanisms

DTIC Science & Technology

2015-10-01

12 software into Workbench V. 15 in CFX/ANSYS; 2) building the geometry of the ear model with ossicular chain and cochlear load in CFX; 3...the ear canal to middle ear. The model consists of the ear canal, TM, middle ear ossicles and suspensory ligaments, middle ear cavity, and cochlear ...the TM, ossicles, and ligaments/muscle tendons with the cochlear load applied on the stapes footplate. 17 Fig. 21. Time-history plots of

Sensory-motor relationships in speech production in post-lingually deaf cochlear-implanted adults and normal-hearing seniors: Evidence from phonetic convergence and speech imitation.

PubMed

Scarbel, Lucie; Beautemps, Denis; Schwartz, Jean-Luc; Sato, Marc

2017-07-01

Speech communication can be viewed as an interactive process involving a functional coupling between sensory and motor systems. One striking example comes from phonetic convergence, when speakers automatically tend to mimic their interlocutor's speech during communicative interaction. The goal of this study was to investigate sensory-motor linkage in speech production in postlingually deaf cochlear implanted participants and normal hearing elderly adults through phonetic convergence and imitation. To this aim, two vowel production tasks, with or without instruction to imitate an acoustic vowel, were proposed to three groups of young adults with normal hearing, elderly adults with normal hearing and post-lingually deaf cochlear-implanted patients. Measure of the deviation of each participant's f 0 from their own mean f 0 was measured to evaluate the ability to converge to each acoustic target. showed that cochlear-implanted participants have the ability to converge to an acoustic target, both intentionally and unintentionally, albeit with a lower degree than young and elderly participants with normal hearing. By providing evidence for phonetic convergence and speech imitation, these results suggest that, as in young adults, perceptuo-motor relationships are efficient in elderly adults with normal hearing and that cochlear-implanted adults recovered significant perceptuo-motor abilities following cochlear implantation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cued Speech for Enhancing Speech Perception and First Language Development of Children With Cochlear Implants

PubMed Central

Leybaert, Jacqueline; LaSasso, Carol J.

2010-01-01

Nearly 300 million people worldwide have moderate to profound hearing loss. Hearing impairment, if not adequately managed, has strong socioeconomic and affective impact on individuals. Cochlear implants have become the most effective vehicle for helping profoundly deaf children and adults to understand spoken language, to be sensitive to environmental sounds, and, to some extent, to listen to music. The auditory information delivered by the cochlear implant remains non-optimal for speech perception because it delivers a spectrally degraded signal and lacks some of the fine temporal acoustic structure. In this article, we discuss research revealing the multimodal nature of speech perception in normally-hearing individuals, with important inter-subject variability in the weighting of auditory or visual information. We also discuss how audio-visual training, via Cued Speech, can improve speech perception in cochlear implantees, particularly in noisy contexts. Cued Speech is a system that makes use of visual information from speechreading combined with hand shapes positioned in different places around the face in order to deliver completely unambiguous information about the syllables and the phonemes of spoken language. We support our view that exposure to Cued Speech before or after the implantation could be important in the aural rehabilitation process of cochlear implantees. We describe five lines of research that are converging to support the view that Cued Speech can enhance speech perception in individuals with cochlear implants. PMID:20724357

Breaking the sound barrier: exploring parents' decision-making process of cochlear implants for their children.

PubMed

Chang, Pamara F

2017-08-01

To understand the dynamic experiences of parents undergoing the decision-making process regarding cochlear implants for their child(ren). Thirty-three parents of d/Deaf children participated in semi-structured interviews. Interviews were digitally recorded, transcribed, and coded using iterative and thematic coding. The results from this study reveal four salient topics related to parents' decision-making process regarding cochlear implantation: 1) factors parents considered when making the decision to get the cochlear implant for their child (e.g., desire to acculturate child into one community), 2) the extent to which parents' communities influence their decision-making (e.g., norms), 3) information sources parents seek and value when decision-making (e.g., parents value other parent's experiences the most compared to medical or online sources), and 4) personal experiences with stigma affecting their decision to not get the cochlear implant for their child. This study provides insights into values and perspectives that can be utilized to improve informed decision-making, when making risky medical decisions with long-term implications. With thorough information provisions, delineation of addressing parents' concerns and encompassing all aspects of the decision (i.e., medical, social and cultural), health professional teams could reduce the uncertainty and anxiety for parents in this decision-making process for cochlear implantation. Copyright © 2017 Elsevier B.V. All rights reserved.

Noise-induced cochlear synaptopathy: Past findings and future studies.

PubMed

Kobel, Megan; Le Prell, Colleen G; Liu, Jennifer; Hawks, John W; Bao, Jianxin

2017-06-01

For decades, we have presumed the death of hair cells and spiral ganglion neurons are the main cause of hearing loss and difficulties understanding speech in noise, but new findings suggest synapse loss may be the key contributor. Specifically, recent preclinical studies suggest that the synapses between inner hair cells and spiral ganglion neurons with low spontaneous rates and high thresholds are the most vulnerable subcellular structures, with respect to insults during aging and noise exposure. This cochlear synaptopathy can be "hidden" because this synaptic loss can occur without permanent hearing threshold shifts. This new discovery of synaptic loss opens doors to new research directions. Here, we review a number of recent studies and make suggestions in two critical future research directions. First, based on solid evidence of cochlear synaptopathy in animal models, it is time to apply molecular approaches to identify the underlying molecular mechanisms; improved understanding is necessary for developing rational, effective therapies against this cochlear synaptopathy. Second, in human studies, the data supporting cochlear synaptopathy are indirect although rapid progress has been made. To fully identify changes in function that are directly related this hidden synaptic damage, we argue that a battery of tests including both electrophysiological and behavior tests should be combined for diagnosis of "hidden hearing loss" in clinical studies. This new approach may provide a direct link between cochlear synaptopathy and perceptual difficulties. Copyright © 2016 Elsevier B.V. All rights reserved.

Analysis of electrically evoked compound action potential of the auditory nerve in children with bilateral cochlear implants.

PubMed

Caldas, Fernanda Ferreira; Cardoso, Carolina Costa; Barreto, Monique Antunes de Souza Chelminski; Teixeira, Marina Santos; Hilgenberg, Anacléia Melo da Silva; Serra, Lucieny Silva Martins; Bahmad Junior, Fayez

2016-01-01

The cochlear implant device has the capacity to measure the electrically evoked compound action potential of the auditory nerve. The neural response telemetry is used in order to measure the electrically evoked compound action potential of the auditory nerve. To analyze the electrically evoked compound action potential, through the neural response telemetry, in children with bilateral cochlear implants. This is an analytical, prospective, longitudinal, historical cohort study. Six children, aged 1-4 years, with bilateral cochlear implant were assessed at five different intervals during their first year of cochlear implant use. There were significant differences in follow-up time (p=0.0082) and electrode position (p=0.0019) in the T-NRT measure. There was a significant difference in the interaction between time of follow-up and electrode position (p=0.0143) when measuring the N1-P1 wave amplitude between the three electrodes at each time of follow-up. The electrically evoked compound action potential measurement using neural response telemetry in children with bilateral cochlear implants during the first year of follow-up was effective in demonstrating the synchronized bilateral development of the peripheral auditory pathways in the studied population. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Pediatric cochlear implants: additional disabilities prevalence, risk factors, and effect on language outcomes.

PubMed

Birman, Catherine S; Elliott, Elizabeth J; Gibson, William P R

2012-10-01

To determine the prevalence of additional disabilities in a pediatric cochlear population, to identify medical and radiologic conditions associated with additional disabilities, and to identify the effect of additional disabilities on speech perception and language at 12 months postoperatively. Retrospective case review. Tertiary referral center and cochlear implant program. Records were reviewed for children 0 to 16 years old inclusive, who had cochlear implant-related operations over a 12-month period. Diagnostic and rehabilitative. Additional disabilities prevalence; medical history and radiologic abnormalities; and the effect on Categories of Auditory Performance (CAP) score at 12 months postoperatively. Eighty-eight children having 96 operations were identified. The overall prevalence of additional disabilities (including developmental delay, cerebral palsy, visual impairment, autism and attention deficit disorder) was 33%. The main conditions associated with additional disabilities were syndromes and chromosomal abnormalities (87%), jaundice (86%), prematurity (62%), cytomegalovirus (60%), and inner ear abnormalities including cochlea nerve hypoplasia or aplasia (75%) and semicircular canal anomalies (56%). At 12 months postoperatively, almost all (96%) of the children without additional disabilities had a CAP score of 5 or greater (speech), compared with 52% of children with additional disabilities. Children with developmental delay had a median CAP score of 4, at 12 months compared with 6 for those without developmental delay. Additional disabilities are prevalent in approximately a third of pediatric cochlear implant patients. Additional disabilities significantly affect the outcomes of cochlear implants.

Variation analysis of transcriptome changes reveals cochlear genes and their associated functions in cochlear susceptibility to acoustic overstimulation.

PubMed

Yang, Shuzhi; Cai, Qunfeng; Bard, Jonathan; Jamison, Jennifer; Wang, Jianmin; Yang, Weiping; Hu, Bo Hua

2015-12-01

Individual variation in the susceptibility of the auditory system to acoustic overstimulation has been well-documented at both the functional and structural levels. However, the molecular mechanism responsible for this variation is unclear. The current investigation was designed to examine the variation patterns of cochlear gene expression using RNA-seq data and to identify the genes with expression variation that increased following acoustic trauma. This study revealed that the constitutive expressions of cochlear genes displayed diverse levels of gene-specific variation. These variation patterns were altered by acoustic trauma; approximately one-third of the examined genes displayed marked increases in their expression variation. Bioinformatics analyses revealed that the genes that exhibited increased variation were functionally related to cell death, biomolecule metabolism, and membrane function. In contrast, the stable genes were primarily related to basic cellular processes, including protein and macromolecular syntheses and transport. There was no functional overlap between the stable and variable genes. Importantly, we demonstrated that glutamate metabolism is related to the variation in the functional response of the cochlea to acoustic overstimulation. Taken together, the results indicate that our analyses of the individual variations in transcriptome changes of cochlear genes provide important information for the identification of genes that potentially contribute to the generation of individual variation in cochlear responses to acoustic overstimulation. Copyright © 2015 Elsevier B.V. All rights reserved.

The effect of cochlear implantation in development of intelligence quotient of 6-9 deaf children in comparison with normal hearing children (Iran, 2009-2011).

PubMed

Hashemi, Seyed Basir; Monshizadeh, Leila

2012-06-01

Before the introduction of cochlear implant (CI) in 1980, hearing aids were the only means by which profoundly deaf children had access to auditory stimuli. Nowadays, CI is firmly established as effective option in speech and language rehabilitation of deaf children, but much of the literature regarding outcomes for children after CI are focused on development of speech and less is known about language acquisition. So, the main aim of this study is the evaluation of verbal intelligence quotient (IQ) of cochlear implanted children in comparison with normal children. 30 cochlear implanted and 30 normal hearing children with similar socio-economic level at the same age were compared by a revised version (in Persian) of WISC test (Wechsler, 1991). Then the data were analyzed through SPSS software 16. In spite of the fact that cochlear implanted children did well in different parameters of WISC test, the average scores of this group was less than normal hearing children. But in similarities (one of the parameters of WISC test) 2 group's performance was approximately the same. CI plays an important role in development of verbal IQ and language acquisition of deaf children. Different researches indicate that most of the cochlear implanted children show less language delay during the time. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Contribution of Family Environment to Pediatric Cochlear Implant Users’ Speech and Language Outcomes: Some Preliminary Findings

PubMed Central

Holt, Rachael Frush; Beer, Jessica; Kronenberger, William G.; Pisoni, David B.; Lalonde, Kaylah

2012-01-01

Purpose To evaluate the family environments of children with cochlear implants and to examine relationships between family environment and post-implant language development and executive function. Method Forty-five families of children with cochlear implants completed a self-report family environment questionnaire (FES) and an inventory of executive function (BRIEF/BRIEF-P). Children’s receptive vocabulary (PPVT-4) and global language skills (PLS-4/CELF-4) were also evaluated. Results The family environments of children with cochlear implants differed from those of normal-hearing children, but not in clinically significant ways. Language development and executive function were found to be atypical, but not uncharacteristic of this clinical population. Families with higher levels of self-reported control had children with smaller vocabularies. Families reporting a higher emphasis on achievement had children with fewer executive function and working memory problems. Finally, families reporting a higher emphasis on organization had children with fewer problems related to inhibition. Conclusions Some of the variability in cochlear implantation outcomes that have protracted periods of development is related to family environment. Because family environment can be modified and enhanced by therapy or education, these preliminary findings hold promise for future work in helping families to create robust language-learning environments that can maximize their child’s potential with a cochlear implant. PMID:22232387

Etanercept prevents decrease of cochlear blood flow dose-dependently caused by tumor necrosis factor alpha.

PubMed

Ihler, Friedrich; Sharaf, Kariem; Bertlich, Mattis; Strieth, Sebastian; Reichel, Christoph A; Berghaus, Alexander; Canis, Martin

2013-07-01

Tumor necrosis factor alpha (TNF-alpha) is a mediator of inflammation and microcirculation in the cochlea. This study aimed to quantify the effect of a local increase of TNF-alpha and study the effect of its interaction with etanercept on cochlear microcirculation. Cochlear lateral wall vessels were exposed surgically and assessed by intravital microscopy in guinea pigs in vivo. First, 24 animals were randomly distributed into 4 groups of 6 each. Exposed vessels were superfused repeatedly either with 1 of 3 different concentrations of TNF-alpha (5.0, 0.5, and 0.05 ng/mL) or with placebo (0.9% saline solution). Second, 12 animals were randomly distributed into 2 groups of 6 each. Vessels were pretreated with etanercept (1.0 microg/ mL) or placebo (0.9% saline solution), and then treated by repeated superfusion with TNF-alpha (5.0 ng/mL). TNF-alpha was shown to be effective in decreasing cochlear blood flow at a dose of 5.0 ng/mL (p < 0.01, analysis of variance on ranks). Lower concentrations or placebo treatment did not lead to significant changes. After pretreatment with etanercept, TNF-alpha at a dose of 5.0 ng/mL no longer led to a change in cochlear blood flow. The decreasing effect that TNF-alpha has on cochlear blood flow is dose-dependent. Etanercept abrogates this effect.

Noise reduction technologies implemented in head-worn preprocessors for improving cochlear implant performance in reverberant noise fields.

PubMed

Chung, King; Nelson, Lance; Teske, Melissa

2012-09-01

The purpose of this study was to investigate whether a multichannel adaptive directional microphone and a modulation-based noise reduction algorithm could enhance cochlear implant performance in reverberant noise fields. A hearing aid was modified to output electrical signals (ePreprocessor) and a cochlear implant speech processor was modified to receive electrical signals (eProcessor). The ePreprocessor was programmed to flat frequency response and linear amplification. Cochlear implant listeners wore the ePreprocessor-eProcessor system in three reverberant noise fields: 1) one noise source with variable locations; 2) three noise sources with variable locations; and 3) eight evenly spaced noise sources from 0° to 360°. Listeners' speech recognition scores were tested when the ePreprocessor was programmed to omnidirectional microphone (OMNI), omnidirectional microphone plus noise reduction algorithm (OMNI + NR), and adaptive directional microphone plus noise reduction algorithm (ADM + NR). They were also tested with their own cochlear implant speech processor (CI_OMNI) in the three noise fields. Additionally, listeners rated overall sound quality preferences on recordings made in the noise fields. Results indicated that ADM+NR produced the highest speech recognition scores and the most preferable rating in all noise fields. Factors requiring attention in the hearing aid-cochlear implant integration process are discussed. Copyright © 2012 Elsevier B.V. All rights reserved.

Feed-forward and feed-backward amplification model from cochlear cytoarchitecture: an interspecies comparison.

PubMed

Yoon, Yong-Jin; Steele, Charles R; Puria, Sunil

2011-01-05

The high sensitivity and wide bandwidth of mammalian hearing are thought to derive from an active process involving the somatic and hair-bundle motility of the thousands of outer hair cells uniquely found in mammalian cochleae. To better understand this, a biophysical three-dimensional cochlear fluid model was developed for gerbil, chinchilla, cat, and human, featuring an active "push-pull" cochlear amplifier mechanism based on the cytoarchitecture of the organ of Corti and using the time-averaged Lagrangian method. Cochlear responses are simulated and compared with in vivo physiological measurements for the basilar membrane (BM) velocity, V(BM), frequency tuning of the BM vibration, and Q₁₀ values representing the sharpness of the cochlear tuning curves. The V(BM) simulation results for gerbil and chinchilla are consistent with in vivo cochlea measurements. Simulated mechanical tuning curves based on maintaining a constant V(BM) value agree with neural-tuning threshold measurements better than those based on a constant displacement value, which implies that the inner hair cells are more sensitive to V(BM) than to BM displacement. The Q₁₀ values of the V(BM) tuning curve agree well with those of cochlear neurons across species, and appear to be related in part to the width of the basilar membrane. Copyright © 2011 Biophysical Society. Published by Elsevier Inc. All rights reserved.

Outcomes and special considerations of cochlear implantation in waardenburg syndrome.

PubMed

Kontorinis, Georgios; Lenarz, Thomas; Giourgas, Alexandros; Durisin, Martin; Lesinski-Schiedat, Anke

2011-08-01

The objective of this study was a state-of-the-art analysis of cochlear implantation in patients with Waardenburg syndrome (WS). Twenty-five patients with WS treated with cochlear implants in our department from 1990 to 2010. The 25 patients with WS underwent 35 cochlear implantations. Hearing outcome was evaluated using HSM sentence test in 65 dB in quiet, Freiburg Monosyllabic Test, and categories of auditory performance for children and compared with that of a control group. Anatomic abnormalities of the inner ear were examined using magnetic resonance imaging and computed tomography of the temporal bones. The mean follow-up time was 8.3 years (range, 0.3-18.3 yr). The majority achieved favorable postimplantation performance with mean HSM scores of 75.3% (range, 22.6%-99%) and Freiburg Monosyllabic Test scores of 67.8% (range, 14%-95%). However, in 4 cases, the results were less satisfactory. The comparison with the control group did not reveal any statistical significance (p = 0.56). In 6 patients (24%), behavioral disorders caused temporary difficulties during the rehabilitation procedure. Except of isolated large vestibule in 1 patient, the radiological assessment of the 50 temporal bones did not reveal any temporal bone abnormalities. Most patients with WS performed well with cochlear implants. However, WS is related to behavioral disorders that may cause temporary rehabilitation difficulties. Finally, temporal bone malformations that could affect cochlear implantation are notcharacteristic of WS.

Football match spectator sound exposure and effect on hearing: a pretest-post-test study.

PubMed

Swanepoel, De Wet; Hall, James W

2010-03-30

To determine (i) noise exposure levels of spectators at a FIFA 2010 designated training stadium during a premier soccer league match; and (ii) changes in auditory functioning after the match. This was a one-group pretest-post-test design of football spectators attending a premier soccer league match at a designated FIFA 2010 training stadium in Gauteng, South Africa. Individual spectator noise exposure for the duration of the football match and post-match changes in hearing thresholds were measured with pure-tone audiometry, and cochlear functioning was measured with distortion product oto-acoustic emissions (DPOAEs). The average sound exposure level during the match was 100.5 LAeq (dBA), with peak intensities averaging 140.4 dB(C). A significant (p=0.005) deterioration of post-match hearing thresholds was evident at 2 000 Hz, and post-match DPOAE amplitudes were significantly reduced at 1,266, 3,163 and 5,063 Hz (p=0.011, 0.019, 0.013, respectively). Exposure levels exceeded limits of permissible average and peak sound levels. Significant changes in post-match hearing thresholds and cochlear responsiveness highlight the possible risk for noise-induced hearing loss. Public awareness and personal hearing protection should be prioritized as preventive measures.

Interpulse interval discrimination within and across channels: comparison of monopolar and tripolar mode of stimulation.

PubMed

Fielden, Claire A; Kluk, Karolina; McKay, Colette M

2014-05-01

Perception of temporal patterns is crucial to speech understanding and music perception in normal hearing, and is fundamental in the design and implementation of processing strategies for cochlear implants. Two experiments described here investigated the effect of stimulation mode (monopolar versus tripolar) on interpulse interval discrimination using single-electrode stimulation (experiment 1) and dual-electrode stimulation (experiment 2). Experiment 1 required participants to discriminate stimuli containing different interpulse intervals and experiment 2 required listeners to discriminate between two dual-electrode stimuli that had the same temporal pattern on each electrode, but differed in inter-electrode timing. The hypotheses were that (i) stimulation mode would affect the ability to distinguish interpulse interval patterns on a single electrode and (ii) the electrode separation range in which subjects were sensitive to inter-electrode timing would be more restricted in tripolar than in monopolar stimulation. Results in nine cochlear implant users showed that mode did not have a significant mean effect on either the ability to discriminate interpulse intervals in single-electrode stimulation or the range of electrode separation in dual-electrode stimulation in which participants were sensitive to inter-electrode timing. In conclusion, tripolar stimulation did not show any advantage in delivering temporal information within or across channels in this group.

Profound hearing loss associated with hydrocodone/acetaminophen abuse.

PubMed

Friedman, R A; House, J W; Luxford, W M; Gherini, S; Mills, D

2000-03-01

To describe profound hearing loss associated with hydrocodone overuse and the successful rehabilitation of these patients with cochlear implantation. Retrospective review. A tertiary otologic referral center. Twelve patients with rapidly progressive hearing loss and a concurrent history of hydrocodone overuse. Comprehensive medical histories, physical findings, audiometric tests, and, in those patients undergoing cochlear implantation, postimplantation performance data were reviewed. Clinical characteristics of hydrocodone-related hearing loss and open set word and sentence performance in those patients undergoing cochlear implantation. Hydrocodone overuse was associated with rapidly progressive sensorineural hearing loss in 12 patients. In four patients the initial presentation was unilateral, and two of the patients experienced vestibular symptoms. None of the 12 patients experienced improved thresholds after high-dose prednisone. Seven of the eight patients undergoing cochlear implantation have demonstrated early success with their devices. Hydrocodone is frequently prescribed in combination with acetaminophen for the relief of pain and has a side effects profile similar to other medications in its class. Although not described previously, overuse or abuse can be associated with a rapidly progressive sensorineural hearing loss. These patients can be successfully rehabilitated with cochlear implantation.

Distribution of Vesicular Glutamate Transporter 2 and Ionotropic Glutamate Receptors in the Auditory Ganglion and Cochlear Nuclei of Pigeons (Columba livia).

PubMed

Karim, M R; Atoji, Y

2016-02-01

Glutamate is a principal excitatory neurotransmitter in the auditory system. Our previous studies revealed localization of glutamate receptor mRNAs in the pigeon cochlear nuclei, suggesting the existence of glutamatergic input from the auditory nerve to the brainstem. This study demonstrated localization of mRNAs for vesicular glutamate transporter 2 (vGluT2) and ionotropic glutamate receptors (AMPA, kainate and NMDA) in the auditory ganglion (AG) and cochlear nuclei (magnocellular, angular and laminar nuclei). VGluT2 mRNA was intensely expressed in AG and intensely or moderately in the cochlear nuclei. The AG and cochlear nuclei showed intense-to-moderate mRNA signals for GluA2, GluA3, GluA4, GluK4 and GluN1. These results suggest that the pigeon AG neurons receives glutamatergic input from hair cells and in turn projects to the magnocellular and angular nuclei. Glutamate may play a pivotal role in the excitatory synapse transmission in the peripheral auditory pathway of birds. © 2015 Blackwell Verlag GmbH.

Challenges in Improving Cochlear Implant Performance and Accessibility.

PubMed

Zeng, Fan-Gang

2017-08-01

Here I identify two gaps in cochlear implants that have been limiting their performance and acceptance. First, cochlear implant performance has remained largely unchanged, despite the number of publications tripling per decade in the last 30 years. Little has been done so far to address a fundamental limitation in the electrode-to-neuron interface, with the electrode size being a thousand times larger than the neuron diameter while the number of electrodes being a thousand times less. Both the small number and the large size of electrodes produce broad spatial activation and poor frequency resolution that limit current cochlear implant performance. Second, a similarly rapid growth in cochlear implant volume has not produced an expected decrease in unit price in the same period. The high cost contributes to low market penetration rate, which is about 20% in developed countries and less than 1% in developing countries. I will discuss changes needed in both research strategy and business practice to close the gap between prosthetic and normal hearing as well as that between haves and have-nots.

Resistance of Gerbil Auditory Function to Reversible Decrease in Cochlear Blood Flow.

PubMed

El Afia, Fahd; Giraudet, Fabrice; Gilain, Laurent; Mom, Thierry; Avan, Paul

2017-01-01

The objective was to design in gerbils a model of reversible decrease in cochlear blood flow (CBF) and analyze its influence on cochlear function. In Mongolian gerbils injected with ferromagnetic microbeads, a magnet placed near the porus acusticus allowed CBF to be manipulated. The cochlear microphonic potential (CM) from the basal cochlea was monitored by a round-window electrode. In 13 of the 20 successfully injected gerbils, stable CBF reduction was obtained for 11.5 min on average. The CM was affected only when CBF fell to less than 60% of its baseline, yet remained >40% of its initial level in about 2/3 of such cases. After CBF restoration, CM recovery was fast and usually complete. Reduced CM came with a 35- to 45-dB threshold elevation of neural responses determined by compound action potentials. This method allowing reversible changes of CBF confirms the robustness of cochlear function to decreased CBF. It can be used to study whether a hypovascularized cochlea is abnormally sensitive to stress. © 2017 S. Karger AG, Basel.

Blood flow to the promontory in cochlear otosclerosis.

PubMed

Nakashima, T; Sone, M; Fujii, H; Teranishi, M; Yamamoto, H; Otake, H; Sugiura, M; Naganawa, S

2006-04-01

To investigate Schwartze sign with measurements of blood flow to the promontory in patients with cochlear otosclerosis. Prospective clinical study. Tertiary referral centre. Five patients with cochlear otosclerosis and five control subjects. Significant decalcification around the cochlea was observed by computed tomography (CT) in patients with cochlear otosclerosis. However, no recognizable lesion was observed at the oval window in two patients. One patient had mixed hearing loss and four patients had sensorineural hearing loss without an air-bone gap. The relationship between CT findings and the presence or absence of Schwartze sign was investigated. Blood flow to the promontory was measured through the tympanic membrane using laser speckle flowgraphy and laser Doppler flowmetry. The Schwartze sign correlated significantly with otosclerotic lesions invading the promontory. Patients with otosclerosis exhibited elevated and pulsating blood flow to the promontory with the Schwartze sign. Computed tomography demonstrated that cochlear otosclerosis can exist without the oval window lesion. Schwartze sign can be used as a sign of the otosclerotic invasion to the promontory. The reddening of the Schwartze sign is likely due to increased blood flow.

Microsurgical laser Doppler probe for simultaneous intraoperative monitoring of cochlear blood flow and electrocochleography from the round window

NASA Astrophysics Data System (ADS)

Abiy, Lidet; Telischi, Fred; Parel, Jean-Marie A.; Manns, Fabrice; Saettele, Ralph; Morawski, Krzysztof; Ozdamar, Ozcan; Borgos, John; Delgado, Rafael; Miskiel, Edward; Yavuz, Erdem

2003-06-01

The aim of this project is the development of a microsurgical laser Doppler (LD) probe that simultaneously monitors blood flow and Electrocochleography (ECochG) from the round window of the ear. The device will prevent neurosensory hearing loss during acoustic neuroma surgery by preventing damage to the internal auditory nerve and to the cochlear blood flow supply. A commercially available 0.5 mm diameter Laser-Doppler velocimetry probe (LaserFlo, Vasamedics) was modified to integrate an ECochG electrode. A tube for suction and irrigation was incorporated into a sheath of the probe shaft, to facilitate cleaning of the round window (RW) and allow drug delivery to the round window membrane. The prototype microprobe was calibrated on a single vessel model and tested in vivo in a rabbit model. Preliminary results indicate that the microprobe was able to measure changes in cochlear blood flow (CBF) and ECochG potentials from the round window of rabbits in vivo. The microprobe is suitable for monitoring cochlear blood flow and auditory cochlear potentials during human surgery.

Cochlear Modeling Using Time-Averaged Lagrangian" Method:. Comparison with VBM, PST, and ZC Measurements

NASA Astrophysics Data System (ADS)

Yoon, Y.; Kim, N.; Puria, S.; Steele, C. R.

2009-02-01

In this work, basilar membrane velocity (VBM), scala tympani intracochlear pressure (PST), and cochlear input impedances (Zc) for gerbil and chinchilla are implemented using a three-dimensional hydro-dynamic cochlear model using 1) time-averaged Lagrangian, 2) push-pull mechanism in active case, and 3) the complex anatomy of cochlear scalae by micro computed tomography (μCT) scanning and 3-D reconstructions of gerbil and chinchilla temporal bones. The objective of this work is to compare the calculations and the physiological measurements of gerbil and chinchilla cochlear such as VBM (Ren and Nuttall [1]), PST (Olson [2]), and ZC (Decraemer et al. [3], Songer and Rosowski [4], Ruggero et al. [5]) with present model. A WKB asymptotic method combined with Fourier series expansions is used to provide an efficient simulation. VBM and PST simulation results for the gerbil cochlea show good agreement both in the magnitude and the phase for the physiological measurements without larger phase excursion. ZC simulation from the gerbil and chinchilla model show reasonably good agreement with measurement.

Modeling and segmentation of intra-cochlear anatomy in conventional CT

NASA Astrophysics Data System (ADS)

Noble, Jack H.; Rutherford, Robert B.; Labadie, Robert F.; Majdani, Omid; Dawant, Benoit M.

2010-03-01

Cochlear implant surgery is a procedure performed to treat profound hearing loss. Since the cochlea is not visible in surgery, the physician uses anatomical landmarks to estimate the pose of the cochlea. Research has indicated that implanting the electrode in a particular cavity of the cochlea, the scala tympani, results in better hearing restoration. The success of the scala tympani implantation is largely dependent on the point of entry and angle of electrode insertion. Errors can occur due to the imprecise nature of landmark-based, manual navigation as well as inter-patient variations between scala tympani and the anatomical landmarks. In this work, we use point distribution models of the intra-cochlear anatomy to study the inter-patient variations between the cochlea and the typical anatomic landmarks, and we implement an active shape model technique to automatically localize intra-cochlear anatomy in conventional CT images, where intra-cochlear structures are not visible. This fully automatic segmentation could aid the surgeon to choose the point of entry and angle of approach to maximize the likelihood of scala tympani insertion, resulting in more substantial hearing restoration.

Minimally invasive surgical method to detect sound processing in the cochlear apex by optical coherence tomography

NASA Astrophysics Data System (ADS)

Ramamoorthy, Sripriya; Zhang, Yuan; Petrie, Tracy; Fridberger, Anders; Ren, Tianying; Wang, Ruikang; Jacques, Steven L.; Nuttall, Alfred L.

2016-02-01

Sound processing in the inner ear involves separation of the constituent frequencies along the length of the cochlea. Frequencies relevant to human speech (100 to 500 Hz) are processed in the apex region. Among mammals, the guinea pig cochlear apex processes similar frequencies and is thus relevant for the study of speech processing in the cochlea. However, the requirement for extensive surgery has challenged the optical accessibility of this area to investigate cochlear processing of signals without significant intrusion. A simple method is developed to provide optical access to the guinea pig cochlear apex in two directions with minimal surgery. Furthermore, all prior vibration measurements in the guinea pig apex involved opening an observation hole in the otic capsule, which has been questioned on the basis of the resulting changes to cochlear hydrodynamics. Here, this limitation is overcome by measuring the vibrations through the unopened otic capsule using phase-sensitive Fourier domain optical coherence tomography. The optically and surgically advanced method described here lays the foundation to perform minimally invasive investigation of speech-related signal processing in the cochlea.

Cochlear Implants

MedlinePlus

... newsroom@entnet.org . A cochlear implant is an electronic device that restores partial hearing to individuals with ... An internal component that consists of a small electronic device that is surgically implanted under the skin ...

Simultaneous bilateral cochlear implantation in a five-month-old child with Usher syndrome.

PubMed

Alsanosi, A A

2015-09-01

To report a rare case of simultaneous bilateral cochlear implantation in a five-month-old child with Usher syndrome. Case report. A five-month-old boy with Usher syndrome and congenital profound bilateral deafness underwent simultaneous bilateral cochlear implantation. The decision to perform implantation in such a young child was based on his having a supportive family and the desire to foster his audiological development before his vision deteriorated. The subject experienced easily resolvable intra- and post-operative adverse events, and was first fitted with an externally worn audio processor four weeks after implantation. At 14 months of age, his audiological development was age-appropriate. Simultaneous bilateral cochlear implantation is possible, and even advisable, in children as young as five months old when performed by an experienced implantation team.

Parametric model of the scala tympani for haptic-rendered cochlear implantation.

PubMed

Todd, Catherine; Naghdy, Fazel

2005-01-01

A parametric model of the human scala tympani has been designed for use in a haptic-rendered computer simulation of cochlear implant surgery. It will be the first surgical simulator of this kind. A geometric model of the Scala Tympani has been derived from measured data for this purpose. The model is compared with two existing descriptions of the cochlear spiral. A first approximation of the basilar membrane is also produced. The structures are imported into a force-rendering software application for system development.

Music Therapy for Preschool Cochlear Implant Recipients

PubMed Central

Gfeller, Kate; Driscoll, Virginia; Kenworthy, Maura; Van Voorst, Tanya

2010-01-01

This paper provides research and clinical information relevant to music therapy for preschool children who use cochlear implants (CI). It consolidates information from various disciplinary sources regarding (a) cochlear implantation of young prelingually-deaf children (~age 2-5), (b) patterns of auditory and speech-language development, and (c) research regarding music perception of children with CIs. This information serves as a foundation for the final portion of the article, which describes typical music therapy goals and examples of interventions suitable for preschool children. PMID:23904691

Parallel Human and Animal Models of Blast- and Concussion-Induced Tinnitus and Related Traumatic Brain Injury (TBI)

DTIC Science & Technology

2014-01-01

2013b), increase expression of deafness genes (Valiyaveettil et al., 2012), and alter cochlear blood flow (Chen et al., 2013b), as well as result in...Intense noise exposure has been shown to reduce partial oxygen pressure and cochlear blood flow (Scheibe et al., 1992, 1993, Lamm and Arnold, 1999...found in the cochlear microvasculature and spiral ganglia (Gosepath, 1997; Franz, 1996) and has been shown to maintain cerebral blood flow and blood

A Rare Complication of Cochlear Implantation After Magnetic Resonance Imaging: Reversion of the Magnet.

PubMed

Öztürk, Erkan; Doruk, Can; Orhan, Kadir Serkan; Çelik, Mehmet; Polat, Beldan; Güldiken, Yahya

2017-06-01

Cochlear implants are mechanical devices used for patients with severe sensory-neural hearing loss, which has an inner magnet. It is proven that 1.5 Tesla magnetic resonance imaging (MRI) scanners are safe to use in patients with cochlear implant. In our patient, the authors aim to introduce a rare complication caused after a 1.5 Tesla MRI scanning and the management of this situation; the reversion of the magnet of the implant without displacement and significance of surgery in management.

Benefits and Risks of Cochlear Implants

MedlinePlus

... The cochlear implant stimulates the nerves directly with electrical currents. Although this stimulation appears to be safe, the long term effect of these electrical currents on the nerves is unknown. May not ...

Cochlear Implant Outcomes and Genetic Mutations in Children with Ear and Brain Anomalies

PubMed Central

Busi, Micol; Rosignoli, Monica; Minazzi, Federica; Trevisi, Patrizia; Aimoni, Claudia; Calzolari, Ferdinando; Martini, Alessandro

2015-01-01

Background. Specific clinical conditions could compromise cochlear implantation outcomes and drastically reduce the chance of an acceptable development of perceptual and linguistic capabilities. These conditions should certainly include the presence of inner ear malformations or brain abnormalities. The aims of this work were to study the diagnostic value of high resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in children with sensorineural hearing loss who were candidates for cochlear implants and to analyse the anatomic abnormalities of the ear and brain in patients who underwent cochlear implantation. We also analysed the effects of ear malformations and brain anomalies on the CI outcomes, speculating on their potential role in the management of language developmental disorders. Methods. The present study is a retrospective observational review of cochlear implant outcomes among hearing-impaired children who presented ear and/or brain anomalies at neuroimaging investigations with MRI and HRCT. Furthermore, genetic results from molecular genetic investigations (GJB2/GJB6 and, additionally, in selected cases, SLC26A4 or mitochondrial-DNA mutations) on this study group were herein described. Longitudinal and cross-sectional analysis was conducted using statistical tests. Results. Between January 1, 1996 and April 1, 2012, at the ENT-Audiology Department of the University Hospital of Ferrara, 620 cochlear implantations were performed. There were 426 implanted children at the time of the present study (who were <18 years). Among these, 143 patients (64 females and 79 males) presented ear and/or brain anomalies/lesions/malformations at neuroimaging investigations with MRI and HRCT. The age of the main study group (143 implanted children) ranged from 9 months and 16 years (average = 4.4; median = 3.0). Conclusions. Good outcomes with cochlear implants are possible in patients who present with inner ear or brain abnormalities, even if central nervous system anomalies represent a negative prognostic factor that is made worse by the concomitant presence of cochlear malformations. Common cavity and stenosis of the internal auditory canal (less than 2 mm) are negative prognostic factors even if brain lesions are absent. PMID:26236732

Cochlear Implant Outcomes and Genetic Mutations in Children with Ear and Brain Anomalies.

PubMed

Busi, Micol; Rosignoli, Monica; Castiglione, Alessandro; Minazzi, Federica; Trevisi, Patrizia; Aimoni, Claudia; Calzolari, Ferdinando; Granieri, Enrico; Martini, Alessandro

2015-01-01

Specific clinical conditions could compromise cochlear implantation outcomes and drastically reduce the chance of an acceptable development of perceptual and linguistic capabilities. These conditions should certainly include the presence of inner ear malformations or brain abnormalities. The aims of this work were to study the diagnostic value of high resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in children with sensorineural hearing loss who were candidates for cochlear implants and to analyse the anatomic abnormalities of the ear and brain in patients who underwent cochlear implantation. We also analysed the effects of ear malformations and brain anomalies on the CI outcomes, speculating on their potential role in the management of language developmental disorders. The present study is a retrospective observational review of cochlear implant outcomes among hearing-impaired children who presented ear and/or brain anomalies at neuroimaging investigations with MRI and HRCT. Furthermore, genetic results from molecular genetic investigations (GJB2/GJB6 and, additionally, in selected cases, SLC26A4 or mitochondrial-DNA mutations) on this study group were herein described. Longitudinal and cross-sectional analysis was conducted using statistical tests. Between January 1, 1996 and April 1, 2012, at the ENT-Audiology Department of the University Hospital of Ferrara, 620 cochlear implantations were performed. There were 426 implanted children at the time of the present study (who were <18 years). Among these, 143 patients (64 females and 79 males) presented ear and/or brain anomalies/lesions/malformations at neuroimaging investigations with MRI and HRCT. The age of the main study group (143 implanted children) ranged from 9 months and 16 years (average = 4.4; median = 3.0). Good outcomes with cochlear implants are possible in patients who present with inner ear or brain abnormalities, even if central nervous system anomalies represent a negative prognostic factor that is made worse by the concomitant presence of cochlear malformations. Common cavity and stenosis of the internal auditory canal (less than 2 mm) are negative prognostic factors even if brain lesions are absent.

Cochlear Implantation in Older Adults

PubMed Central

Lin, Frank R.; Chien, Wade W.; Li, Lingsheng; Niparko, John K.; Francis, Howard W.

2012-01-01

Cochlear implants allow individuals with severe-to-profound hearing loss access to sound and spoken language. The number of older adults in the United States who are potential candidates for cochlear implantation is approximately 150,000 and will continue to increase with the aging of the population. Should cochlear implantation (CI) be routinely recommended for these older adults, and do these individuals benefit from CI? We reviewed our 12 year experience with cochlear implantation in adults ≥60 years (n = 445) at Johns Hopkins to investigate the impact of CI on speech understanding and to identify factors associated with speech performance. Complete data on speech outcomes at baseline and 1 year post-CI were available for 83 individuals. Our results demonstrate that cochlear implantation in adults ≥60 years consistently improved speech understanding scores with a mean increase of 60. 0% (S. D. 24. 1) on HINT sentences in quiet . The magnitude of the gain in speech scores was negatively associated with age at implantation such that for every increasing year of age at CI the gain in speech scores was 1. 3 percentage points less (95% CI: 0. 6 – 1. 9) after adjusting for age at hearing loss onset. Conversely, individuals with higher pre-CI speech scores (HINT scores between 40–60%) had significantly greater post-CI speech scores by a mean of 10. 0 percentage points (95% CI: 0. 4 – 19. 6) than those with lower pre-CI speech scores (HINT <40%) after adjusting for age at CI and age at hearing loss onset. These results suggest that older adult CI candidates who are younger at implantation and with higher preoperative speech scores obtain the highest speech understanding scores after cochlear implantation with possible implications for current Medicare policy. Finally, we provide an extended discussion of the epidemiology and impact of hearing loss in older adults. Future research of CI in older adults should expand beyond simple speech outcomes to take into account the broad cognitive, social, and physical functioning outcomes that are likely detrimentally impacted by hearing loss and may be mitigated by cochlear implantation. PMID:22932787

Auditory cortical responses in patients with cochlear implants

PubMed Central

Burdo, S; Razza, S; Di Berardino, F; Tognola, G

2006-01-01

Summary Currently, the most commonly used electrophysiological tests for cochlear implant evaluation are Averaged Electrical Voltages (AEV), Electrical Advisory Brainstem Responses (EABR) and Neural Response Telemetry (NRT). The present paper focuses on the study of acoustic auditory cortical responses, or slow vertex responses, which are not widely used due to the difficulty in recording, especially in young children. Aims of this study were validation of slow vertex responses and their possible applications in monitoring postimplant results, particularly restoration of hearing and auditory maturation. In practice, the use of tone-bursts, also through hearing aids or cochlear implants, as in slow vertex responses, allows many more frequencies to be investigated and louder intensities to be reached than with other tests based on a click as stimulus. Study design focused on latencies of N1 and P2 slow vertex response peaks in cochlear implants. The study population comprised 45 implant recipients (aged 2 to 70 years), divided into 5 different homogeneous groups according to chronological age, age at onset of deafness, and age at implantation. For each subject, slow vertex responses and free-field auditory responses (PTAS) were recorded for tone-bursts at 500 and 2000 Hz before cochlear implant surgery (using hearing aid amplification) and during scheduled sessions at 3rd and 12th month after implant activation. Results showed that N1 and P2 latencies decreased in all groups starting from 3rd through 12th month after activation. Subjects implanted before school age or at least before age 8 yrs showed the widest latency changes. All subjects showed a reduction in the gap between subjective thresholds (obtained with free field auditory responses) and objective thresholds (obtained with slow vertex responses), obtained in presurgery stage and after cochlear implant. In conclusion, a natural evolution of neurophysiological cortical activities of the auditory pathway, over time, was found especially in young children with prelingual deafness and implanted in preschool age. Cochlear implantation appears to provide hearing restoration, demonstrated by the sharp reduction of the gap between subjective free field auditory responses and slow vertex responses threshold obtained with hearing aids vs. cochlear implant. PMID:16886849

Cadaveric feasibility study of da Vinci Si-assisted cochlear implant with augmented visual navigation for otologic surgery.

PubMed

Liu, Wen P; Azizian, Mahdi; Sorger, Jonathan; Taylor, Russell H; Reilly, Brian K; Cleary, Kevin; Preciado, Diego

2014-03-01

To our knowledge, this is the first reported cadaveric feasibility study of a master-slave-assisted cochlear implant procedure in the otolaryngology-head and neck surgery field using the da Vinci Si system (da Vinci Surgical System; Intuitive Surgical, Inc). We describe the surgical workflow adaptations using a minimally invasive system and image guidance integrating intraoperative cone beam computed tomography through augmented reality. To test the feasibility of da Vinci Si-assisted cochlear implant surgery with augmented reality, with visualization of critical structures and facilitation with precise cochleostomy for electrode insertion. Cadaveric case study of bilateral cochlear implant approaches conducted at Intuitive Surgical Inc, Sunnyvale, California. Bilateral cadaveric mastoidectomies, posterior tympanostomies, and cochleostomies were performed using the da Vinci Si system on a single adult human donor cadaveric specimen. Radiographic confirmation of successful cochleostomies, placement of a phantom cochlear implant wire, and visual confirmation of critical anatomic structures (facial nerve, cochlea, and round window) in augmented stereoendoscopy. With a surgical mean time of 160 minutes per side, complete bilateral cochlear implant procedures were successfully performed with no violation of critical structures, notably the facial nerve, chorda tympani, sigmoid sinus, dura, or ossicles. Augmented reality image overlay of the facial nerve, round window position, and basal turn of the cochlea was precise. Postoperative cone beam computed tomography scans confirmed successful placement of the phantom implant electrode array into the basal turn of the cochlea. To our knowledge, this is the first study in the otolaryngology-head and neck surgery literature examining the use of master-slave-assisted cochleostomy with augmented reality for cochlear implants using the da Vinci Si system. The described system for cochleostomy has the potential to improve the surgeon's confidence, as well as surgical safety, efficiency, and precision by filtering tremor. The integration of augmented reality may be valuable for surgeons dealing with complex cases of congenital anatomic abnormality, for revision cochlear implant with distorted anatomy and poorly pneumatized mastoids, and as a method of interactive teaching. Further research into the cost-benefit ratio of da Vinci Si-assisted otologic surgery, as well as refinements of the proposed workflow, are required before considering clinical studies.

A speech processing study using an acoustic model of a multiple-channel cochlear implant

NASA Astrophysics Data System (ADS)

Xu, Ying

1998-10-01

A cochlear implant is an electronic device designed to provide sound information for adults and children who have bilateral profound hearing loss. The task of representing speech signals as electrical stimuli is central to the design and performance of cochlear implants. Studies have shown that the current speech- processing strategies provide significant benefits to cochlear implant users. However, the evaluation and development of speech-processing strategies have been complicated by hardware limitations and large variability in user performance. To alleviate these problems, an acoustic model of a cochlear implant with the SPEAK strategy is implemented in this study, in which a set of acoustic stimuli whose psychophysical characteristics are as close as possible to those produced by a cochlear implant are presented on normal-hearing subjects. To test the effectiveness and feasibility of this acoustic model, a psychophysical experiment was conducted to match the performance of a normal-hearing listener using model- processed signals to that of a cochlear implant user. Good agreement was found between an implanted patient and an age-matched normal-hearing subject in a dynamic signal discrimination experiment, indicating that this acoustic model is a reasonably good approximation of a cochlear implant with the SPEAK strategy. The acoustic model was then used to examine the potential of the SPEAK strategy in terms of its temporal and frequency encoding of speech. It was hypothesized that better temporal and frequency encoding of speech can be accomplished by higher stimulation rates and a larger number of activated channels. Vowel and consonant recognition tests were conducted on normal-hearing subjects using speech tokens processed by the acoustic model, with different combinations of stimulation rate and number of activated channels. The results showed that vowel recognition was best at 600 pps and 8 activated channels, but further increases in stimulation rate and channel numbers were not beneficial. Manipulations of stimulation rate and number of activated channels did not appreciably affect consonant recognition. These results suggest that overall speech performance may improve by appropriately increasing stimulation rate and number of activated channels. Future revision of this acoustic model is necessary to provide more accurate amplitude representation of speech.

Distribution of NTPDase5 and NTPDase6 and the regulation of P2Y receptor signalling in the rat cochlea

PubMed Central

O’Keeffe, Mary G.; Thorne, Peter R.; Housley, Gary D.; Robson, Simon C.

2010-01-01

Membrane-bound ectonucleoside triphosphate diphosphohydrolases (E-NTPDases) in the inner ear regulate complex extracellular purinergic type-2 (P2) receptor signalling pathways through hydrolysis of extracellular nucleoside 5′-triphosphates and diphosphates. This study investigated the distribution of NTPDase5 and NTPDase6, two intracellular members of the E-NTPDase family, and linked this to regulation of P2 receptor signalling in the adult rat cochlea. These extracellular ectonucleotidases preferentially hydrolyse nucleoside 5′-diphosphates such as UDP and GDP. Expression of both enzymes at mRNA and protein level was detected in cochlear tissues and there was in vivo release of soluble NTPDase5 and 6 into cochlear fluids. Strong NTPDase5 immunostaining was found in the spiral ganglion neurones and supporting Deiters’ cells of the organ of Corti, while NTPDase6 was confined to the inner hair cells. Upregulation of NTPDase5 after exposure to loud sound indicates a dynamic role for NTPDase5 in cochlear response to stress, whereas NTPDase6 may have more limited extracellular roles. Noise-induced upregulation of co-localised UDP-preferring P2Y6 receptors in the spiral ganglion neurons further supports the involvement of NTPDase5 in regulation of P2Y receptor signalling. Noise stress also induced P2Y14 (UDP- and UDP-glucose preferring) receptor expression in the root processes of the outer sulcus cells, but this was not associated with localization of the E-NTPDases. PMID:20806016

Imaging Characteristics of Children with Auditory Neuropathy Spectrum Disorder

PubMed Central

Roche, Joseph P.; Huang, Benjamin Y.; Castillo, Mauricio; Bassim, Marc K.; Adunka, Oliver F.; Buchman, Craig A.

2013-01-01

Objective To identify and define the imaging characteristics of children with auditory neuropathy spectrum disorder (ANSD). Design Retrospective medical records review and analysis of both temporal bone computed tomography (CT) and magnetic resonance images (MRI) in from children with the diagnosis of ANSD. Setting Tertiary referral center. Patients 118 children with the electrophysiological characteristics of ANSD with available imaging studies for review. Interventions Two neuroradiologists and a neurotologist reviewed each study and consensus descriptions were established. Main outcome measures The type and number of imaging findings were tabulated. Results Sixty-eight (64%) MRIs revealed at least one imaging abnormality while selective use of CT identified 23 (55%) with anomalies. The most prevalent MRI findings included cochlear nerve deficiency (n=51; 28% of 183 nerves), brain abnormalities (n=42; 40% of 106 brains) and prominent temporal horns (n=33, 16% of 212 temporal lobes). The most prevalent CT finding from selective use of CT was cochlear dysplasia (n=13; 31%). Conclusions MRI will identify many abnormalities in children with ANSD that are not readily discernable on CT. Specifically, both developmental and acquired abnormalities of the brain, posterior cranial fossa, and cochlear nerves are not uncommonly seen in this patient population. Inner ear anomalies are well delineated using either imaging modality. Since many of the central nervous system findings identified in this study using MRI can alter the treatment and prognosis for these children, we believe that MRI should be the initial imaging study of choice for children with ANSD. PMID:20593543

Thin and open vessel windows for intra-vital fluorescence imaging of murine cochlear blood flow

PubMed Central

Shi, Xiaorui; Zhang, Fei; Urdang, Zachary; Dai, Min; Neng, Lingling; Zhang, Jinhui; Chen, Songlin; Ramamoorthy, Sripriya; Nuttall, Alfred L.

2014-01-01

Normal microvessel structure and function in the cochlea is essential for maintaining the ionic and metabolic homeostasis required for hearing function. Abnormal cochlear microcirculation has long been considered an etiologic factor in hearing disorders. A better understanding of cochlear blood flow (CoBF) will enable more effective amelioration of hearing disorders that result from aberrant blood flow. However, establishing the direct relationship between CoBF and other cellular events in the lateral wall and response to physio-pathological stress remains a challenge due to the lack of feasible interrogation methods and difficulty in accessing the inner ear. Here we report on new methods for studying the CoBF in a mouse model using a thin or open vessel-window in combination with fluorescence intra-vital microscopy (IVM). An open vessel-window enables investigation of vascular cell biology and blood flow permeability, including pericyte (PC) contractility, bone marrow cell migration, and endothelial barrier leakage, in wild type and fluorescent protein-labeled transgenic mouse models with high spatial and temporal resolution. Alternatively, the thin vessel-window method minimizes disruption of the homeostatic balance in the lateral wall and enables study CoBF under relatively intact physiological conditions. A thin vessel-window method can also be used for time-based studies of physiological and pathological processes. Although the small size of the mouse cochlea makes surgery difficult, the methods are sufficiently developed for studying the structural and functional changes in CoBF under normal and pathological conditions. PMID:24780131

Label-Free Ferrocene-Loaded Nanocarrier Engineering for In Vivo Cochlear Drug Delivery and Imaging.

PubMed

Youm, Ibrahima; Musazzi, Umberto M; Gratton, Michael Anne; Murowchick, James B; Youan, Bi-Botti C

2016-10-01

It is hypothesized that ferrocene (FC)-loaded nanocarriers (FC-NCs) are safe label-free contrast agents for cochlear biodistribution study by transmission electron microscopy (TEM). To test this hypothesis, after engineering, the poly(epsilon-caprolactone)/polyglycolide NCs are tested for stability with various types and ratios of sugar cryoprotectants during freeze-drying. Their physicochemical properties are characterized by UV-visible spectroscopy, dynamic light scattering, Fourier transform infrared spectroscopy, and scanning electron microscopy coupled with energy dispersive X-ray spectroscopy (SEM/EDS). The biodistribution of the FC-NCs in the cochlear tissue after intratympanic injection in guinea pigs is visualized by TEM. Auditory brainstem responses are measured before and after 4-day treatments. These FC-NCs have 153.4 ± 8.7 nm, 85.5 ± 11.2%, and -22.1 ± 1.1 mV as mean diameters, percent drug association efficiency, and zeta potential, respectively (n = 3). The incorporation of FC into the NCs is confirmed by Fourier transform infrared spectroscopy and SEM/EDS spectra. Lactose (3:1 ratio, v/v) is the most effective stabilizer after a 12-day study. The administered NCs are visible by TEM in the scala media cells of the cochlea. Based on auditory brainstem response data, FC-NCs do not adversely affect hearing. Considering the electrondense, radioactive, and magnetic properties of iron inside FC, FC-NCs are promising nanotemplate for future inner ear theranostics. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Spectrum of temporal bone abnormalities in patients with Waardenburg syndrome and SOX10 mutations.

PubMed

Elmaleh-Bergès, M; Baumann, C; Noël-Pétroff, N; Sekkal, A; Couloigner, V; Devriendt, K; Wilson, M; Marlin, S; Sebag, G; Pingault, V

2013-01-01

Waardenburg syndrome, characterized by deafness and pigmentation abnormalities, is clinically and genetically heterogeneous, consisting of 4 distinct subtypes and involving several genes. SOX10 mutations have been found both in types 2 and 4 Waardenburg syndrome and neurologic variants. The purpose of this study was to evaluate both the full spectrum and relative frequencies of inner ear malformations in these patients. Fifteen patients with Waardenburg syndrome and different SOX10 mutations were studied retrospectively. Imaging was performed between February 2000 and March 2010 for cochlear implant work-up, diagnosis of hearing loss, and/or evaluation of neurologic impairment. Eleven patients had both CT and MR imaging examinations, 3 had MR imaging only, and 1 had CT only. Temporal bone abnormalities were bilateral. The most frequent pattern associated agenesis or hypoplasia of ≥1 semicircular canal, an enlarged vestibule, and a cochlea with a reduced size and occasionally an abnormal shape, but with normal partition in the 13/15 cases that could be analyzed. Three patients lacked a cochlear nerve, bilaterally in 2 patients. In addition, associated abnormalities were found when adequate MR imaging sequences were available: agenesis of the olfactory bulbs (7/8), hypoplastic or absent lacrimal glands (11/14), hypoplastic parotid glands (12/14), and white matter signal anomalies (7/13). In the appropriate clinical context, bilateral agenesis or hypoplasia of the semicircular canals or both, associated with an enlarged vestibule and a cochlear deformity, strongly suggests a diagnosis of Waardenburg syndrome linked to a SOX10 mutation.

Cochlear hair cell regeneration after noise-induced hearing loss: does regeneration follow development?

PubMed Central

Zheng, Fei; Zuo, Jian

2017-01-01

Noise-induced hearing loss (NIHL) affects a large number of military personnel and civilians. Regenerating inner-ear cochlear hair cells (HCs) is a promising strategy to restore hearing after NIHL. In this review, we first summarize recent transcriptome profile analysis of zebrafish lateral lines and chick utricles where spontaneous HC regeneration occurs after HC damage. We then discuss recent studies in other mammalian regenerative systems such as pancreas, heart and central nervous system. Both spontaneous and forced HC regeneration occurs in mammalian cochleae in vivo involving proliferation and direct lineage conversion. However, both processes are inefficient and incomplete, and decline with age. For direct lineage conversion in vivo in cochleae and in other systems, further improvement requires multiple factors, including transcription, epigenetic and trophic factors, with appropriate stoichiometry in appropriate architectural niche. Increasing evidence from other systems indicates that the molecular paths of direct lineage conversion may be different from those of normal developmental lineages. We therefore hypothesize that HC regeneration does not have to follow HC development and that epigenetic memory of supporting cells influences the HC regeneration, which may be a key to successful cochlear HC regeneration. Finally, we discuss recent efforts in viral gene therapy and drug discovery for HC regeneration. We hope that combination therapy targeting multiple factors and epigenetic signaling pathways will provide promising avenues for HC regeneration in humans with NIHL and other types of hearing loss. PMID:28034617

Evaluation of cochlear involvement by distortion product otoacoustic emission in Behçet's disease.

PubMed

Dagli, Muharrem; Eryilmaz, Adil; Tanrikulu, Salih; Aydin, Acar; Gonul, Muzeyyen; Gul, Ulker; Gocer, Celil

2008-09-01

The aim of this study was to investigate cochlear involvement in patients with Behçet's disease. Twenty-six Behçet's disease patients (52 ears) and 24 sex and age-matched healthy control subjects (48 ears) were included in the study. Pure-tone audiometry at frequencies 250, 500, 1000, 2000, 4000, 6000 Hz, immittance measures including tympanometry and acoustic reflex testing and DPOAE (distortion product otoacoustic emission) testing were performed in the patients and controls. A sensorineural hearing loss was found in eight patients (30.7%) as it was bilateral in five and unilateral in three patients. Although no typical audiometric configuration was found, one patient had a flat type audiogram, and the others had a high frequency hearing loss. The DPOAE responses of the patients and controls were significantly different in all frequencies (p<0.05). These results indicate that cochlea is affected by damage of outer hair cells in Behçet's disease.

Sources of variability in language development of children with cochlear implants: age at implantation, parental language, and early features of children's language construction.

PubMed

Szagun, Gisela; Schramm, Satyam A

2016-05-01

The aim of the present study was to analyze the relative influence of age at implantation, parental expansions, and child language internal factors on grammatical progress in children with cochlear implants (CI). Data analyses used two longitudinal corpora of spontaneous speech samples, one with twenty-two and one with twenty-six children, implanted between 0;6 and 3;10. Analyses were performed on the combined and separate samples. Regression analyses indicate that early child MLU is the strongest predictor of child MLU two and two-and-a-half years later, followed by parental expansions and age at implantation. Associations between earliest MLU gains and MLU two years later point to stability of individual differences. Early type and token frequencies of determiners predict MLU two years later more strongly than early frequency of lexical words. We conclude that features of CI children's very early language have considerable predictive value for later language outcomes.

Inner ear development: building a spiral ganglion and an organ of Corti out of unspecified ectoderm.

PubMed

Fritzsch, Bernd; Pan, Ning; Jahan, Israt; Elliott, Karen L

2015-07-01

The mammalian inner ear develops from a placodal thickening into a complex labyrinth of ducts with five sensory organs specialized to detect position and movement in space. The mammalian ear also develops a spiraled cochlear duct containing the auditory organ, the organ of Corti (OC), specialized to translate sound into hearing. Development of the OC from a uniform sheet of ectoderm requires unparalleled precision in the topological developmental engineering of four different general cell types, namely sensory neurons, hair cells, supporting cells, and general otic epithelium, into a mosaic of ten distinctly recognizable cell types in and around the OC, each with a unique distribution. Moreover, the OC receives unique innervation by ear-derived spiral ganglion afferents and brainstem-derived motor neurons as efferents and requires neural-crest-derived Schwann cells to form myelin and neural-crest-derived cells to induce the stria vascularis. This transformation of a sheet of cells into a complicated interdigitating set of cells necessitates the orchestrated expression of multiple transcription factors that enable the cellular transformation from ectoderm into neurosensory cells forming the spiral ganglion neurons (SGNs), while simultaneously transforming the flat epithelium into a tube, the cochlear duct, housing the OC. In addition to the cellular and conformational changes forming the cochlear duct with the OC, changes in the surrounding periotic mesenchyme form passageways for sound to stimulate the OC. We review molecular developmental data, generated predominantly in mice, in order to integrate the well-described expression changes of transcription factors and their actions, as revealed in mutants, in the formation of SGNs and OC in the correct position and orientation with suitable innervation. Understanding the molecular basis of these developmental changes leading to the formation of the mammalian OC and highlighting the gaps in our knowledge might guide in vivo attempts to regenerate this most complicated cellular mosaic of the mammalian body for the reconstitution of hearing in a rapidly growing population of aging people suffering from hearing loss.

Contralateral Effects and Binaural Interactions in Dorsal Cochlear Nucleus

PubMed Central

2005-01-01

The dorsal cochlear nucleus (DCN) receives afferent input from the auditory nerve and is thus usually thought of as a monaural nucleus, but it also receives inputs from the contralateral cochlear nucleus as well as descending projections from binaural nuclei. Evidence suggests that some of these commissural and efferent projections are excitatory, whereas others are inhibitory. The goals of this study were to investigate the nature and effects of these inputs in the DCN by measuring DCN principal cell (type IV unit) responses to a variety of contralateral monaural and binaural stimuli. As expected, the results of contralateral stimulation demonstrate a mixture of excitatory and inhibitory influences, although inhibitory effects predominate. Most type IV units are weakly, if at all, inhibited by tones but are strongly inhibited by broadband noise (BBN). The inhibition evoked by BBN is also low threshold and short latency. This inhibition is abolished and excitation is revealed when strychnine, a glycine-receptor antagonist, is applied to the DCN; application of bicuculline, a GABAA-receptor antagonist, has similar effects but does not block the onset of inhibition. Manipulations of discrete fiber bundles suggest that the inhibitory, but not excitatory, inputs to DCN principal cells enter the DCN via its output pathway, and that the short latency inhibition is carried by commissural axons. Consistent with their respective monaural effects, responses to binaural tones as a function of interaural level difference are essentially the same as responses to ipsilateral tones, whereas binaural BBN responses decrease with increasing contralateral level. In comparison to monaural responses, binaural responses to virtual space stimuli show enhanced sensitivity to the elevation of a sound source in ipsilateral space but reduced sensitivity in contralateral space. These results show that the contralateral inputs to the DCN are functionally relevant in natural listening conditions, and that one role of these inputs is to enhance DCN processing of spectral sound localization cues produced by the pinna. PMID:16075189

Sox10 Expressing Cells in the Lateral Wall of the Aged Mouse and Human Cochlea

PubMed Central

Hao, Xinping; Xing, Yazhi; Moore, Michael W.; Zhang, Jianning; Han, Demin; Schulte, Bradley A.; Dubno, Judy R.; Lang, Hainan

2014-01-01

Age-related hearing loss (presbycusis) is a common human disorder, affecting one in three Americans aged 60 and over. Previous studies have shown that presbyacusis is associated with a loss of non-sensory cells in the cochlear lateral wall. Sox10 is a transcription factor crucial to the development and maintenance of neural crest-derived cells including some non-sensory cell types in the cochlea. Mutations of the Sox10 gene are known to cause various combinations of hearing loss and pigmentation defects in humans. This study investigated the potential relationship between Sox10 gene expression and pathological changes in the cochlear lateral wall of aged CBA/CaJ mice and human temporal bones from older donors. Cochlear tissues prepared from young adult (1–3 month-old) and aged (2–2.5 year-old) mice, and human temporal bone donors were examined using quantitative immunohistochemical analysis and transmission electron microscopy. Cells expressing Sox10 were present in the stria vascularis, outer sulcus and spiral prominence in mouse and human cochleas. The Sox10+ cell types included marginal and intermediate cells and outer sulcus cells, including those that border the scala media and those extending into root processes (root cells) in the spiral ligament. Quantitative analysis of immunostaining revealed a significant decrease in the number of Sox10+ marginal cells and outer sulcus cells in aged mice. Electron microscopic evaluation revealed degenerative alterations in the surviving Sox10+ cells in aged mice. Strial marginal cells in human cochleas from donors aged 87 and older showed only weak immunostaining for Sox10. Decreases in Sox10 expression levels and a loss of Sox10+ cells in both mouse and human aged ears suggests an important role of Sox10 in the maintenance of structural and functional integrity of the lateral wall. A loss of Sox10+ cells may also be associated with a decline in the repair capabilities of non-sensory cells in the aged ear. PMID:24887110

75 FR 51467 - ASK (Assess Specific Kinds of CHILDREN Challenges for Neurologic Devices) Study Children Workshop...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-20

..., including cochlear implants, deep brain stimulators, hydrocephalus shunts, spinal cord stimulators, and... pediatric populations, including cochlear implants, deep brain stimulators, hydrocephalus shunts, spinal...

Cochlear Implants (For Parents)

MedlinePlus

... nerve, and send it to the brain. The cochlear implant package is made up of: a receiver-stimulator that contains all of the electronic circuits that control the flow of electrical pulses into the ear an antenna ...

Are There Treatments That Can Help Me?

MedlinePlus

... tinnitus in a significant number of study volunteers. Cochlear implants are sometimes used in people who have tinnitus along with severe hearing loss. A cochlear implant bypasses the damaged portion of the inner ...

Scala vestibuli insertion in cochlear implantation: a valuable alternative for cases with obstructed scala tympani.

PubMed

Kiefer, J; Weber, A; Pfennigdorff, T; von Ilberg, C

2000-01-01

Insertion of a sufficient number of electrodes is important for a successful use of cochlear implants. We investigated the results of scala vestibuli insertion for cochlear implantation in cases of obstructed scala tympani. In a series of 200 cochlear implantations, scala vestibuli insertion was successfully performed in 4 cases with obstruction of the scala tympani. Etiologies included a temporal bone fracture, severe otosclerosis and malformations of the cochlea. The maximum insertion depth obtained via the scala vestibuli was 30 mm. Postoperative results were comparable to patients in whom conventional scala tympani insertion was performed. No adverse effects related to the site of insertion were observed. Scala vestibuli insertion offers a valuable alternative in cases of obstructed scala tympani that can be employed for a variety of etiologies. Copyright 2000 S. Karger AG, Basel

Intraoperative seizure and cerebrospinal fluid leak during adult cochlear implant surgery.

PubMed

Musser, Alexander B; Golub, Justin S; Samy, Ravi N; Phero, James C

2016-01-01

To report a rare case of cerebrospinal fluid gusher and subsequent seizure immediately after cochlear implant electrode insertion. After the cochlear implant electrode was inserted, brisk flow of 10 mL of cerebrospinal fluid was seen. The electrode was promptly inserted and the leak was additionally sealed with fascia. Seconds later, the patient had a tonic-clonic seizure lasting 30 seconds. Two additional episodes occurred during the case. Her postoperative course was uneventful with no subsequent seizures. The device has been successfully activated. Intervention & Technique: Postoperative imaging showed correct intracochlear placement of the electrode as well as an incidental enlarged vestibular aqueduct. Neurology consultation including electroencephalogram was unremarkable. To our knowledge, this is the first report of a seizure temporally associated with cochlear implant electrode insertion. The significance and possible casual relationship between these two events is discussed.

A new disease: pregnancy-induced sudden sensorineural hearing loss?

PubMed

Hou, Zhi-Qiang; Wang, Qiu-Ju

2011-07-01

Sudden sensorineural hearing loss (SSNHL) may occur during pregnancy, but its prevalence is very low. It is conjectured that SSNHL is closely related to the changes in the cardiovascular system, hematological system, endocrine system, and/or some other systems due to pregnancy. These changes possibly evoke disorders of cochlear circulation or cochlear fluid homeostasis leading to SSNHL. Two SSNHL cases were observed in our clinic, and their clinical features were analyzed. In one patient the SSNHL was likely to be related to the disturbance of cochlear fluid homestasis and in the other it might be induced by some disorders in cochlear circulation. Based on their distinct clinic profiles, we defined a new disease, called "pregnancy-induced sudden sensorineural hearing loss," similar to the definition of "pregnancy-induced hypertension." This study also deepened our understanding of the etiology of SSNHL.

The early days of the multi channel cochlear implant: efforts and achievement in France.

PubMed

Chouard, C H

2015-04-01

On September 10th 2013, the clinical medical research Lasker award winners were rewarded for their work on multichannel cochlear implant. It has been my pleasure to see that such a major topic had caught the attention of the Members of the Jury for this prestigious award. That is why I accepted an invitation to participate in a special issue of Hearing Research devoted to the three winners. Here I highlight four scientific contributions made by the French team in late 1970s and early 1980s to modern multichannel cochlear implant development. 1) Chouard and MacLeod plotted an approximate frequency map of the whole length of the human cochlea, including its "hidden face" corresponding to speech frequencies. Moreover MacLeod suggested a sequential display of electrical stimulation as a function of each electrode, a precursor to today's electrodogram and interleaved stimulation. 2) Chouard performed total cochlear implantation in a deaf adult male with 8 electrically independent electrodes that were evenly distributed along the cochlea. 3) Chouard and MacLeod described in a patent detailed sound signal processing for a functional multichannel cochlear implant and reported speech discrimination without help of lip reading in some totally deafened patients. 4) Chouard experimentally demonstrated in the guinea pig the advantage of early cochlear implantation in treating profound neonatal deafness. This article is part of a Special Issue entitled . Copyright © 2014 Elsevier B.V. All rights reserved.

Modifying cochlear implant design: advantages of placing a return electrode in the modiolus.

PubMed

Ho, Steven Y; Wiet, Richard J; Richter, Claus-Peter

2004-07-01

A modiolar return electrode significantly increases the current flow across spiral ganglion cells into the modiolus, and may decrease the cochlear implant's power requirements. Ideal cochlear implants should maximize current flow into the modiolus to stimulate auditory neurons. Previous efforts to facilitate current flow through the modiolus included the fabrication and use of precurved electrodes designed to "hug" the modiolus and silastic positioners designed to place the electrodes closer to the modiolus. In contrast to earlier efforts, this study explores the effects of return electrode placement on current distributions in the modiolus. The effects of return electrode positioning on current flow in the modiolus were studied in a Plexiglas model of the cochlea. Results of model measurements were confirmed by measurements in the modiolus of human temporal bones. The return electrode was placed either within the modiolus, or remotely, outside the temporal bone, simulating contemporary cochlear implant configurations using monopolar stimulation. Cochlear model results clearly show that modiolar current amplitudes can be influenced significantly by the location of the return electrode, being larger when placed into the modiolus. Temporal bone data show similar findings. Voltages recorded in the modiolus are, on average, 2.8 times higher with the return electrode in the modiolus compared with return electrode locations outside the temporal bone. Placing a cochlear implant's return electrode in the modiolus should significantly reduce its power consumption. Reducing power requirements should lead to improved efficiency, safer long-term use, and longer device life.

Outcomes and benefits of pediatric cochlear implantation in children with additional disabilities: a review and report of family influences on outcomes.

PubMed

Cejas, Ivette; Hoffman, Michael F; Quittner, Alexandra L

2015-01-01

The number of children with hearing loss with additional disabilities receiving cochlear implantation has increased dramatically over the past decade. However, little is known about their auditory and speech and language development following implantation. The purpose of this review is to evaluate the effects of cochlear implantation on the most common genetic and developmental disorders in children with hearing loss. Benefits of cochlear implantation for children with autism spectrum disorder, developmental delay, CHARGE syndrome, cerebral palsy, learning disorders, Usher syndrome, Waardenburg syndrome, and attention deficit/hyperactivity disorder are reviewed. Our review indicates that children with hearing loss and additional disabilities benefit from cochlear implantation, especially when implanted early. Thus, early interventions seem as important for these children as for deaf children without additional disabilities. Comparisons of outcomes across these disabilities indicate that children with little to no cognitive impairment (eg, Waardenburg sydrome, attention deficit hyperactivity disorder) have better outcomes than those with greater deficits in intellectual functioning (eg, autism, CHARGE syndrome). In addition, parents of children with hearing loss and additional disabilities report higher levels of parenting stress and greater child behavior problems than those without comorbid diagnoses. However, these parents are as sensitive when interacting with their children as parents with typically developing children using cochlear implantation. Given these results, it is critical to evaluate these children's developmental milestones to provide early implantation and intervention, appropriately counsel families regarding realistic expectations for the implant, and facilitate family adaptation.

Outcomes and benefits of pediatric cochlear implantation in children with additional disabilities: a review and report of family influences on outcomes

PubMed Central

Cejas, Ivette; Hoffman, Michael F; Quittner, Alexandra L

2015-01-01

The number of children with hearing loss with additional disabilities receiving cochlear implantation has increased dramatically over the past decade. However, little is known about their auditory and speech and language development following implantation. The purpose of this review is to evaluate the effects of cochlear implantation on the most common genetic and developmental disorders in children with hearing loss. Benefits of cochlear implantation for children with autism spectrum disorder, developmental delay, CHARGE syndrome, cerebral palsy, learning disorders, Usher syndrome, Waardenburg syndrome, and attention deficit/hyperactivity disorder are reviewed. Our review indicates that children with hearing loss and additional disabilities benefit from cochlear implantation, especially when implanted early. Thus, early interventions seem as important for these children as for deaf children without additional disabilities. Comparisons of outcomes across these disabilities indicate that children with little to no cognitive impairment (eg, Waardenburg sydrome, attention deficit hyperactivity disorder) have better outcomes than those with greater deficits in intellectual functioning (eg, autism, CHARGE syndrome). In addition, parents of children with hearing loss and additional disabilities report higher levels of parenting stress and greater child behavior problems than those without comorbid diagnoses. However, these parents are as sensitive when interacting with their children as parents with typically developing children using cochlear implantation. Given these results, it is critical to evaluate these children’s developmental milestones to provide early implantation and intervention, appropriately counsel families regarding realistic expectations for the implant, and facilitate family adaptation. PMID:29388595

Speech Intelligibility and Prosody Production in Children with Cochlear Implants

PubMed Central

Chin, Steven B.; Bergeson, Tonya R.; Phan, Jennifer

2012-01-01

Objectives The purpose of the current study was to examine the relation between speech intelligibility and prosody production in children who use cochlear implants. Methods The Beginner's Intelligibility Test (BIT) and Prosodic Utterance Production (PUP) task were administered to 15 children who use cochlear implants and 10 children with normal hearing. Adult listeners with normal hearing judged the intelligibility of the words in the BIT sentences, identified the PUP sentences as one of four grammatical or emotional moods (i.e., declarative, interrogative, happy, or sad), and rated the PUP sentences according to how well they thought the child conveyed the designated mood. Results Percent correct scores were higher for intelligibility than for prosody and higher for children with normal hearing than for children with cochlear implants. Declarative sentences were most readily identified and received the highest ratings by adult listeners; interrogative sentences were least readily identified and received the lowest ratings. Correlations between intelligibility and all mood identification and rating scores except declarative were not significant. Discussion The findings suggest that the development of speech intelligibility progresses ahead of prosody in both children with cochlear implants and children with normal hearing; however, children with normal hearing still perform better than children with cochlear implants on measures of intelligibility and prosody even after accounting for hearing age. Problems with interrogative intonation may be related to more general restrictions on rising intonation, and the correlation results indicate that intelligibility and sentence intonation may be relatively dissociated at these ages. PMID:22717120

Communication benefits of bilateral cochlear implantation. Retrospective study in 12-year-old children.

PubMed

Guerra-Jiménez, Gloria; Viera Artiles, Jaime; Mateos, Mar; González Aguado, Rocío; Falcón González, Juan Carlos; Borkoski Barreiro, Silvia; Ramos Macías, Angel

2013-01-01

Some studies suggest that simultaneous or sequential cochlear implantation in a short period of time offers additional benefits. There is controversy regarding the existence of an age limit after which a second implantation offers less benefit for the acquisition of communication skills. The objectives of this study were to confirm that sequential cochlear implantation offers benefits compared to unilateral implantation and to study whether, at 12 years of age, there are significant differences regarding the age at the time of the second implantation. Descriptive and observational study of a population of 12-year-old children carrying cochlear implants (n=69). A liminal pure tone audiometry and an open-field verbal discrimination test (disyllables, common phrases in an open context, with and without noise) were conducted to evaluate audiological benefits. Verbal discrimination results were better among patients who had been implanted before the age of 2 years, although the differences were not statistically significant (P>.5). Children who had received bilateral cochlear implants before the age of 2 years and with a period less than 4 years between both implants presented better verbal discrimination percentages (P<.05). In our sample, early cochlear implantation with a short period between both implants provided significant benefits regarding intelligibility. There seem to be a specific age and interimplant period, after which the auditory benefit on the first implant becomes reduced. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Assessment of Appalachian region pediatric hearing healthcare disparities and delays.

PubMed

Bush, Matthew L; Osetinsky, Mariel; Shinn, Jennifer B; Gal, Thomas J; Ding, Xiuhua; Fardo, David W; Schoenberg, Nancy

2014-07-01

The purpose of this study was to examine the timing of diagnostic and therapeutic services in cochlear implant recipients from a rural Appalachian region with healthcare disparity. Retrospective analysis. Cochlear implant recipients from a tertiary referral center born with severe congenital sensorineural hearing loss were examined. Rural status and Appalachian status of their county of origin were recorded. A log-rank test was used to examine differences in the distributions of time to definitive diagnosis of hearing loss, initial amplification fitting, and cochlear implantation in these children. Correlation analysis of the rural status of each county and the timing of services was assessed. A total of 53 children born with congenital hearing loss were included in the study (36 from rural counties and 17 from urban/suburban counties). The distribution of weeks after birth to diagnosis (P=.006), amplification (P=.030), and cochlear implantation (P=.002) was delayed in rural children compared with urban children. An analysis factoring in the effect of implementation of mandatory infant hearing screening in 2000 demonstrated a similar delay in rural children for weeks to diagnosis (P=.028), amplification (P=.087), and cochlear implantation (P<.0001). Children with severe hearing loss in very rural areas, such as Appalachia, may have significant delays in diagnostic and rehabilitative services. Further investigation is warranted to assess causative factors in delays of cochlear implantation and to develop interventions to promote timely diagnosis and care. 3b. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

A sustainable model for cochlear implantation in the developing world: perspectives from the Indian subcontinent.

PubMed

Sampath Kumar, Raghunandhan; Kameswaran, Mohan

2018-06-01

The overall prevalence of deafness in India is 0.2%, but the prevalence in the southern state of Tamil Nadu is much higher (around 0.6%) because of consanguinity. Especially in India, establishing cochlear implantation as a treatment modality for hearing loss has been a daunting task, but in the last decade, the cochlear implantation program has emerged as an unqualified success in many states, with over 20 000 cochlear implantations done till date. Several states are sponsoring free implants to children under the age of 6 years and below poverty line. Nearly 3000 cochlear implantations have been performed in Tamil Nadu under the Chief Minister's Comprehensive Health Insurance Scheme, with the goal to have a 'deafness free Tamil Nadu' by 2025. This scheme covers nearly 40 million people in rural areas. Valuable lessons have been learnt from this social experiment. One of the cornerstones of this scheme is the method to deliver habilitation via satellite centers in rural areas at the doorstep of the patient. The outcomes in peripheral centers were found to be statistically similar to those in the main center and correlated well with duration of habilitation. Opening up satellite centers for habilitation across the state of Tamil Nadu has greatly helped to improve the attendance and outcomes. The Indian model has been hugely successful and has helped start similar cochlear implantation programs in neighboring countries such as Nepal, Sri Lanka and Bangladesh.

Comparative study between unilateral and bilateral cochlear implantation in children of 1 and 2 years of age.

PubMed

Escorihuela García, Vicente; Pitarch Ribas, María Ignacia; Llópez Carratalá, Ignacio; Latorre Monteagudo, Emilia; Morant Ventura, Antonio; Marco Algarra, Jaime

2016-01-01

The studies that have evaluated the effectiveness of bilateral cochlear implantation in children suggest an improvement in hearing about sound localization and speech discrimination. In this paper we show the differences in audio-linguistic achievements with early bilateral cochlear implantation versus unilateral, and differences between simultaneous and sequential bilateral implantation. We present 88 children with bilateral profound sensorineural hearing loss, treated with bilateral cochlear implantation in 32 cases and unilateral in 56 cases, during the first 12 months (27 children) of life and between 12 and 24 months (61 children). We conducted a statistical comparison of both groups in the audiometry, IT-Mais, Nottingham, LittlEars scales and verbal tests. No significant differences in hearing thresholds and questionnaires between unilateral and bilateral implantation were detected in either the first or second year. Verbal tests do show statistically significant differences: children with bilateral cochlear implant obtain 100% recognition of disyllabic and phrases within 2-3 years after implantation whilst children with one implant do not obtain those results at 5 years after surgery. No differences between simultaneous and sequential bilateral implantation were detected. We emphasize the importance of ensuring good early audiological screening, to carry out an early and bilateral cochlear implantation with the consequent development of audio-language skills similar to normal hearing children. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.