scholarly journals Factors Affecting Speech Discrimination in Children with Cochlear Implants: Evidence from Early-Implanted Infants

2016 ◽  
Vol 27 (06) ◽  
pp. 480-488 ◽  
Author(s):  
Jennifer Phan ◽  
Derek M. Houston ◽  
Chad Ruffin ◽  
Jonathan Ting ◽  
Rachael Frush Holt
Keyword(s):  
Speech Perception ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Pure Tone ◽  
Early Period ◽  
Discrimination Performance ◽  
Speech Discrimination ◽  
Communication Mode ◽  
Factors Affecting ◽  
Pure Tone Average

Background: To learn words and acquire language, children must be able to discriminate and correctly perceive phonemes. Although there has been much research on the general language outcomes of children with cochlear implants (CIs), little is known about the development of speech perception with regard to specific speech processes, such as speech discrimination. Purpose: The purpose of this study was to investigate the development of speech discrimination in infants with CIs and identify factors that might correlate with speech discrimination skills. Research Design: Using a Hybrid Visual Habituation procedure, we tested infants with CIs on their ability to discriminate the vowel contrast /i/-/u/. We also gathered demographic and audiological information about each infant. Study Sample: Children who had received CIs before 2 yr of age served as participants. We tested the children at two post cochlear implantation intervals: 2–4 weeks post CI stimulation (N = 17) and 6–9 mo post CI stimulation (N = 10). Data Collection and Analysis: The infants’ mean looking times during the novel versus old trials of the experiment were measured. A linear regression model was used to evaluate the relationship between the normalized looking time difference and the following variables: chronological age, age at CI stimulation, gender, communication mode, and best unaided pure-tone average. Results: We found that the best unaided pure-tone average predicted speech discrimination at the early interval. In contrast to some previous speech perception studies that included children implanted before 3 yr of age, age at CI stimulation did not predict speech discrimination performance. Conclusions: The results suggest that residual acoustic hearing before implantation might facilitate speech discrimination during the early period post cochlear implantation; with more hearing experience, communication mode might have a greater influence on the ability to discriminate speech. This and other studies on age at cochlear implantation suggest that earlier implantation might not have as large an effect on speech perception as it does on other language skills.

Evaluation of Pure Tone and Speech Discrimination Changes in Usher's Syndrome

1989 ◽  
Vol 98 (5) ◽  
pp. 364-368 ◽  
Author(s):  
Dianne H. Meyer ◽  
Lawrence Piazza ◽  
Gerald A. Fishman
Keyword(s):  
Pure Tone ◽  
Statistical Significance ◽  
Discrimination Performance ◽  
Adult Patients ◽  
Speech Discrimination ◽  
Discrete Frequency ◽  
Pure Tone Average ◽  
The Average Range ◽  
Usher’S Syndrome

Twenty-three adult patients with type 2 Usher's syndrome were evaluated for changes in pure tone average (PTA), discrete frequency thresholds, and speech discrimination scores. These patients were evaluated over a period of 5 years on the average (range, 2 to 9 years). Analyses of ear data showed a <10-dB change on PTA and discrete frequency thresholds for most ears. Of the ears that showed a threshold change ≥ 10 dB, statistical significance was reached only at 4,000 Hz (p < .01), where 11 ears representing ten patients dropped 10 to 15 dB. Speech discrimination data showed a ≥ 16% change in score for 18 ears (12 patients). Sixteen of those ears (ten patients) had a 16% to 52% decrease in score (p < .01), and the remaining two ears (two patients) showed a 20% and 30% improvement in score. These findings document little or no change in pure tone sensitivity for type 2 Usher's syndrome patients, but demonstrate the importance of monitoring their speech discrimination performance.

Speech Perception in Young Children Using Nucleus or Clarion Cochlear Implants: Effect of Communication Mode

2000 ◽  
Vol 109 (12_suppl) ◽  
pp. 77-79 ◽  
Author(s):  
Nancy M. Young ◽  
Kristine M. Grohne ◽  
Vincent N. Carrasco ◽  
Carolyn J. Brown
Keyword(s):  
Speech Perception ◽  
Young Children ◽  
Cochlear Implants ◽  
Communication Mode

Significance of Cochlear Dose in the Radiosurgical Treatment of Vestibular Schwannoma

Neurosurgery ◽  
2014 ◽  
Vol 74 (5) ◽  
pp. 466-474 ◽  
Author(s):  
Jeffrey T. Jacob ◽  
Matthew L. Carlson ◽  
Terry K. Schiefer ◽  
Bruce E. Pollock ◽  
Colin L. Driscoll ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Vestibular Schwannoma ◽  
Pure Tone ◽  
Interobserver Reliability ◽  
Univariate Analysis ◽  
Hearing Preservation ◽  
Neck Surgery ◽  
Tumor Control ◽  
Speech Discrimination ◽  
Pure Tone Average

Abstract BACKGROUND: Cochlear dose has been identified as a potentially modifiable contributor to hearing loss after stereotactic radiosurgery (SRS) for vestibular schwannoma (VS). OBJECTIVE: To evaluate the association between computed tomography-based volumetric cochlear dose and loss of serviceable hearing after SRS, to assess intraobserver and interobserver reliability when determining modiolar point dose with the use of magnetic resonance imaging and computed tomography, and to discuss the clinical significance of the cochlear dose with regard to radiosurgical planning strategy. METHODS: Patients with serviceable pretreatment hearing who underwent SRS for sporadic VS between the use of Gamma Knife Perfexion were studied. Univariate and multivariate associations with the primary outcome of time to nonserviceable hearing were evaluated. RESULTS: A total of 105 patients underwent SRS for VS during the study period, and 59 (56%) met study criteria and were analyzed. Twenty-one subjects (36%) developed nonserviceable hearing at a mean of 2.2 years after SRS (SD, 1.0 years; median, 2.1 years; range 0.6-3.8 years). On univariate analysis, pretreatment pure tone average, speech discrimination score, American Academy of Otolaryngology-Head and Neck Surgery hearing class, marginal dose, and mean dose to the cochlear volume were statistically significantly associated with time to nonserviceable hearing. However, after adjustment for baseline differences, only pretreatment pure tone average was statistically significantly associated with time to nonserviceable hearing in a multivariable model. CONCLUSION: Cochlear dose is one of many variables associated with hearing preservation after SRS for VS. Until further studies demonstrate durable tumor arrest with reduced dose protocols, routine tumor dose planning should not be modified to limit cochlear dose at the expense of tumor control.

A Comparative Study of Speech Perception in Young Severely Retarded Children and Normally Developing Infants

1980 ◽  
Vol 23 (2) ◽  
pp. 419-428 ◽  
Author(s):  
Rebecca E. Eilers ◽  
D. Kimbrough Oller
Keyword(s):  
Steady State ◽  
Speech Perception ◽  
School Children ◽  
Elementary School Children ◽  
Discrimination Performance ◽  
Spectral Information ◽  
Speech Discrimination ◽  
Head Turn ◽  
Spectral Changes ◽  
Spectral Cues

The discrimination of minimally paired speech sounds by seven retarded children with a mean age of 3 years, 2 months and a mean IQ of 38.4 was compared with the discrimination performance of eight normally developing 7-month-old infants. Children and infants were tested using the Visually Reinforced Infant Speech Discrimination (VRISD) paradigm in which they were taught to respond with a head turn to a change in a repeating background auditory stimulus. Responses were reinforced by activation of an animated toy. All children proved to be conditionable and both groups evidenced discrimination of the speech contrasts tested. The data suggest that the retarded children have more difficulty processing a contrast cued by rapid spectral changes (often associated with consonant discrimination) than they do a contrast cued by steady-state spectral information (often associated with the perception of slowly articulated vowels): The normally developing infants did not find rapid spectral cues more difficult than steady-state cues. These results parallel those of Tallal (1976) who found that dynamic cues were specifically difficult for dysphasic children (with normal nonverbal intelligence), but not for linguistically-normal elementary school children.

Intratympanic Steroid Injection for Treatment of Idiopathic Sudden Hearing Loss

2005 ◽  
Vol 133 (2) ◽  
pp. 251-259 ◽  
Author(s):  
William H. Slattery ◽  
Laurel M. Fisher ◽  
Zarina Iqbal ◽  
Rick A. Friedman ◽  
Nancy Liu
Keyword(s):  
Clinical Trial ◽  
Hearing Loss ◽  
Adverse Events ◽  
Pure Tone ◽  
Steroid Injection ◽  
Sudden Hearing Loss ◽  
Oral Steroid ◽  
Speech Discrimination ◽  
Open Label ◽  
Pure Tone Average

Objective. To conduct a clinical trial of intratympanic steroid injection for idiopathic sudden sensorineural hearing loss in subjects who failed oral steroid therapy. Study Design and Setting. Open-label methylprednisolone injection clinical trial in a tertiary neurotologic referral center. Twenty subjects (14 males; 6 females) received 4 injections within a 2-week period (4 days apart). Hearing, dizziness/p, and tinnitus were evaluated before and after treatment. Results. There were no serious unexpected adverse events and 2 types of expected adverse events (tympanic membrane perforation, nausea after injection). No increases in dizziness or tinnitus lasting longer than 24 hours were observed after injections. One of 20 (5%) improved to near-normal hearing. In addition, there was statistically significant improvement in 4-frequency pure-tone average and speech discrimination score at 1 month after treatment. Conclusion. Four intratympanic injections of methylprednisolone improved pure-tone average or speech discrimination scores for a subset of sudden hearing loss subjects that failed to benefit from oral steroids. Significance. A clinical trial of intratympanic injections for idiopathic sudden hearing loss was successfully completed and promising results were found.

Effects of Electrode Array Length on Frequency-Place Mismatch and Speech Perception with Cochlear Implants

2015 ◽  
Vol 20 (2) ◽  
pp. 102-111 ◽  
Author(s):  
Frederic Venail ◽  
Caroline Mathiolon ◽  
Sophie Menjot de Champfleur ◽  
Jean Pierre Piron ◽  
Marielle Sicard ◽  
...  
Keyword(s):  
Speech Perception ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Electrode Array ◽  
Electrode Arrays ◽  
Frequency Map

Frequency-place mismatch often occurs after cochlear implantation, yet its effect on speech perception outcome remains unclear. In this article, we propose a method, based on cochlea imaging, to determine the cochlear place-frequency map. We evaluated the effect of frequency-place mismatch on speech perception outcome in subjects implanted with 3 different lengths of electrode arrays. A deeper insertion was responsible for a larger frequency-place mismatch and a decreased and delayed speech perception improvement by comparison with a shallower insertion, for which a similar but slighter effect was noticed. Our results support the notion that selecting an electrode array length adapted to each individual's cochlear anatomy may reduce frequency-place mismatch and thus improve speech perception outcome.

Stapes fixation surgery: stapedectomy versus stapedotomy

2010 ◽  
Vol 4 (3) ◽  
pp. 429-434 ◽  
Author(s):  
Taweekiat Thamjarayakul ◽  
Pakpoom Supiyaphun ◽  
Kornkiat Snidvongs
Keyword(s):  
Success Rate ◽  
Pure Tone ◽  
Bone Conduction ◽  
Surgical Techniques ◽  
Speech Discrimination ◽  
Stapes Fixation ◽  
Pure Tone Average ◽  
Window Opening ◽  
Hearing Outcomes ◽  
Air Conduction

Abstract Background: Stapedectomy and stapedotomy are the standard techniques for stapes fixation surgery. Both techniques depend on the size of window opening (total, partial stapedectomy and small-hole stapedotomy) and the type of prosthesis used. Outcome of technique and prosthesis are controversy. Objective: Evaluate the outcomes of the two surgical techniques (stapedectomy/stapedotomy) and two sizes of prosthesis (Cawthorn 0.6mm/0.3mm) in terms of effectiveness and safety. Material and methods: Sixty-four medical records of patients undergoing stapedectomy or stapedotomy between the year 1995 and 2005 were reviewed. The subjects were classified into three groups including 0.6-mm stapedectomy, 0.6-mm and 0.3-mm stapedotomy group. The pre and post operative air-conduction threshold (AC) and air-bone gap (A-B gap) were compared for each group. The pre-and post-operative differences in pure tone average of AC, pure tone average of bone conduction threshold (BC), AB gap, AC at 4KHz, BC at 4KHz, AC at 8KHz, and speech discrimination score (SDS) were analyzed. The surgical complications were also compared. Results: Means of post-operative AC, and A-B gap were significantly better in all three groups. The mean of postoperative AC at 4KHz was significantly improved only in stapedotomy groups (0.6-mm and 0.3-mm stapedotomy). To compare the hearing outcomes among the three groups, there were no statistically significant differences between 0.6-mm stapedectomy vs. 0.6-mm stapedotomy, and between 0.6- mm vs. 0.3-mm stapedotomy. The complications were found in all three groups. The 0.3-mm stapedotomy had the lowest rate. Conclusion: Stapedectomy versus stapedotomy yields comparable hearing outcomes but stapedotomy results had a better success rate than the stapedectomy. For 0.6-mm stapedotomy vs. 0.3-mm stapedotomy, the overall results in both groups are not significantly different, in terms of both the hearing outcomes and the success rate. In terms of complication rate, 0.6-mm stapedectomy had the highest rate, while 0.3-mm stapedotomy had the lowest.

Hearing preservation in surgery for large vestibular schwannomas

2009 ◽  
Vol 111 (4) ◽  
pp. 845-854 ◽  
Author(s):  
Masahiko Wanibuchi ◽  
Takanori Fukushima ◽  
John T. McElveen ◽  
Allan H. Friedman
Keyword(s):  
Pure Tone ◽  
Hearing Preservation ◽  
Hearing Level ◽  
Discrimination Score ◽  
Speech Discrimination ◽  
Pure Tone Average ◽  
Speech Discrimination Score ◽  
Class A ◽  
Abducent Nerve Palsy ◽  
Hearing Preservation Surgery

Object Hearing preservation remains a challenging problem in vestibular schwannoma (VS) surgery. The ability to preserve hearing in patients with large tumors is subject to particular difficulty. In this study, the authors focus on hearing preservation in patients harboring large VSs. Methods A total of 344 consecutive patients underwent surgical removal of VSs over the past 9 years. Of these 344 cases, 195 VSs were > 20 mm in maximum cisternal diameter. Of the 195 cases, hearing preservation surgery was attempted for 54 patients who had a Class A, B, C, or D preoperative hearing level; that is, a pure tone average ≤ 60 dB and speech discrimination score ≥ 50% according to the Sanna/Fukushima classification. The tumors were classified as moderately large (21–30 mm based on the largest extrameatal diameter), large (31–40 mm), and giant (≥ 41 mm) according to the international criteria. The authors categorized patients with Class A, B, C, D, or E hearing (pure tone average ≤ 80 dB and speech discrimination score ≥ 40%) as having preserved hearing postoperatively. Results Forty-one tumors (75.9%) were totally removed and 13 (24.1%) had near-total removal. Of the 54 patients, 29 maintained their hearing postoperatively; the overall hearing preservation rate was 53.7%. Analysis based on the preoperative hearing level showed that hearing was preserved in 14 (77.8%) of 18 cases for Class A; in 8 (47.1%) of 17 cases for Class B; in 4 (57.1%) of 7 cases for Class C; and in 3 (25.0%) of 12 cases for Class D. In addition, according to the analysis based on the tumor size, 20 (52.6%) of 38 patients with moderately large tumors retained their hearing, as did 5 (50.0%) of 10 patients with large tumors and 4 (66.7%) of 6 patients with giant tumors. Complications included 2 cases of bacterial meningitis that were cured by intravenous injection of antibiotics, 3 cases of subcutaneous CSF leakage that resolved without any surgical repair, and 1 case of temporary abducent nerve palsy. There were no deaths in this series. Conclusions The results indicate that successful hearing preservation surgery in large VSs is possible with meticulous technique and attention to adhesions between the tumor and the cochlear nerves.

scholarly journals Auditory rehabilitation of patients with neurofibromatosis Type 2 by using cochlear implants

2011 ◽  
Vol 115 (4) ◽  
pp. 827-834 ◽  
Author(s):  
Pamela C. Roehm ◽  
Jon Mallen-St. Clair ◽  
Daniel Jethanamest ◽  
John G. Golfinos ◽  
William Shapiro ◽  
...  
Keyword(s):  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Neurofibromatosis Type ◽  
Neurofibromatosis Type 2 ◽  
Speech Understanding ◽  
Speech Discrimination ◽  
Auditory Rehabilitation ◽  
Open Set ◽  
Cochlear Ossification

Object The aim of this study was to determine whether patients with neurofibromatosis Type 2 (NF2) who have intact ipsilateral cochlear nerves can have open-set speech discrimination following cochlear implantation. Methods Records of 7 patients with documented NF2 were reviewed to determine speech discrimination outcomes following cochlear implantation. Outcomes were measured using consonant-nucleus-consonant words and phonemes; Hearing in Noise Test sentences in quiet; and City University of New York sentences in quiet and in noise. Results Preoperatively, none of the patients had open-set speech discrimination. Five of the 7 patients had previously undergone excision of ipsilateral vestibular schwannoma (VS). One of the patients who received a cochlear implant had received radiation therapy for ipsilateral VS, and another was undergoing observation for a small ipsilateral VS. Following cochlear implantation, 4 of 7 patients with NF2 had open-set speech discrimination following cochlear implantation during extended follow-up (15–120 months). Two of the 3 patients without open-set speech understanding had a prolonged period between ipsilateral VS resection and cochlear implantation (120 and 132 months), and had cochlear ossification at the time of implantation. The other patient without open-set speech understanding had good contralateral hearing at the time of cochlear implantation. Despite these findings, 6 of the 7 patients were daily users of their cochlear implants, and the seventh is an occasional user, indicating that all of the patients subjectively gained some benefit from their implants. Conclusions Cochlear implantation can provide long-term auditory rehabilitation, with open-set speech discrimination for patients with NF2 who have intact ipsilateral cochlear nerves. Factors that can affect implant performance include the following: 1) a prolonged time between VS resection and implantation; and 2) cochlear ossification.

scholarly journals Correlation between Speech Perception Outcomes after Cochlear Implantation and Postoperative Acoustic and Electric Hearing Thresholds

2021 ◽  
Vol 10 (2) ◽  
pp. 324
Author(s):  
Ursina Rüegg ◽  
Adrian Dalbert ◽  
Dorothe Veraguth ◽  
Christof Röösli ◽  
Alexander Huber ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Speech Perception ◽  
Correlation Analysis ◽  
Cochlear Implantation ◽  
Pure Tone ◽  
Small Population ◽  
Reliable Prediction ◽  
Electric Hearing ◽  
Hearing Thresholds ◽  
Monosyllabic Words

The reliable prediction of cochlear implant (CI) speech perception outcomes is highly relevant and can facilitate the monitoring of postoperative hearing performance. To date, multiple audiometric, demographic, and surgical variables have shown some degree of correlation with CI speech perception outcomes. In the present study, postsurgical acoustic and electric hearing thresholds that are routinely assessed in clinical practice were compared to CI speech perception outcomes in order to reveal possible markers of postoperative cochlear health. A total of 237 CI recipients were included in this retrospective monocentric study. An analysis of the correlation of postoperative pure-tone averages (PTAs) and electric CI fitting thresholds (T-/C-levels) with speech perception scores for monosyllabic words in quiet was performed. Additionally, a correlation analysis was performed for postoperative acoustic thresholds in intracochlear electrocochleography (EcochG) and speech recognition scores in a smaller group (n = 14). The results show that neither postoperative acoustic hearing thresholds nor electric thresholds correlate with postoperative speech perception outcomes, and they do not serve as independent predictors of speech perception outcomes. By contrast, the postoperative intracochlear total EcochG response was significantly correlated with speech perception. Since the EcochG recordings were only performed in a small population, a large study is required to clarify the usefulness of this promising predictive parameter.

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