Factors influencing speech perception in adults with a cochlear implant
| Autor: | Willem-Jan van der Woude, Emmanuel A. M. Mylanus, Wendy J. Huinck, Floris Heutink, Berit M. Verbist, Jeroen J. Briaire, Johan H. M. Frijns, Tamara J Meulman, Priya Vart |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Speech perception genetic structures Hearing loss media_common.quotation_subject medicine.medical_treatment Explanatory factors Straight electrode Audiology 01 natural sciences Sensory disorders Donders Center for Medical Neuroscience [Radboudumc 12] Imaging 03 medical and health sciences Speech and Hearing 0302 clinical medicine Perception Cochlear implant 0103 physical sciences medicine otorhinolaryngologic diseases Humans University medical 030223 otorhinolaryngology Cochlear implantation 010301 acoustics media_common business.industry Cochlear Implantation Confidence interval Electrode position Cochlear Implants Cross-Sectional Studies Treatment Outcome Otorhinolaryngology ComputingMethodologies_DOCUMENTANDTEXTPROCESSING medicine.symptom Renal disorders Radboud Institute for Health Sciences [Radboudumc 11] business psychological phenomena and processes Research Article Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] |
| Zdroj: | Ear and Hearing, 42, 4, pp. 949-960 Ear and Hearing, 42(4), 949-960. LIPPINCOTT WILLIAMS & WILKINS Ear and Hearing Ear and Hearing, 42, 949-960 |
| ISSN: | 0196-0202 |
| Popis: | Supplemental Digital Content is available in the text. Objectives: The primary objective of this study is to identify the biographic, audiologic, and electrode position factors that influence speech perception performance in adult cochlear implant (CI) recipients implanted with a device from a single manufacturer. The secondary objective is to investigate the independent association of the type of electrode (precurved or straight) with speech perception. Design: In a cross-sectional study design, speech perception measures and ultrahigh-resolution computed tomography scans were performed in 129 experienced CI recipients with a postlingual onset of hearing loss. Data were collected between December 2016 and January 2018 in the Radboud University Medical Center, Nijmegen, the Netherlands. The participants received either a precurved electrode (N = 85) or a straight electrode (N = 44), all from the same manufacturer. The biographic variables evaluated were age at implantation, level of education, and years of hearing loss. The audiometric factors explored were preoperative and postoperative pure-tone average residual hearing and preoperative speech perception score. The electrode position factors analyzed, as measured from images obtained with the ultrahigh-resolution computed tomography scan, were the scalar location, angular insertion depth of the basal and apical electrode contacts, and the wrapping factor (i.e., electrode-to-modiolus distance), as well as the type of electrode used. These 11 variables were tested for their effect on three speech perception outcomes: consonant–vowel–consonant words in quiet tests at 50 dB SPL (CVC50) and 65 dB SPL (CVC65), and the digits-in-noise test. Results: A lower age at implantation was correlated with a higher CVC50 phoneme score in the straight electrode group. Other biographic variables did not correlate with speech perception. Furthermore, participants implanted with a precurved electrode and who had poor preoperative hearing thresholds performed better in all speech perception outcomes than the participants implanted with a straight electrode and relatively better preoperative hearing thresholds. After correcting for biographic factors, audiometric variables, and scalar location, we showed that the precurved electrode led to an 11.8 percentage points (95% confidence interval: 1.4–20.4%; p = 0.03) higher perception score for the CVC50 phonemes compared with the straight electrode. Furthermore, contrary to our initial expectations, the preservation of residual hearing with the straight electrode was poor, as the median preoperative and the postoperative residual hearing thresholds for the straight electrode were 88 and 122 dB, respectively. Conclusions: Cochlear implantation with a precurved electrode results in a significantly higher speech perception outcome, independent of biographic factors, audiometric factors, and scalar location. |
| Databáze: | OpenAIRE |
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