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      [Audiological results with cochlear implants for single-sided deafness].

      Author(s): 1 , , ,
      Publication date (Electronic):
      Journal: HNO
      Publisher: Springer Science and Business Media LLC

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          Abstract

          Single-sided deafness has a strong impact on quality of life. Besides the difficulties in sound localization, patients also require increased effort to hear. The latter makes it difficult to follow conversations for an extended period, leading to social isolation. Cochlear implantation (CI) represents a possible treatment option for deafness in one ear.

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          Comparison of pseudobinaural hearing to real binaural hearing rehabilitation after cochlear implantation in patients with unilateral deafness and tinnitus.

          Susan Arndt, Antje Aschendorff, Roland Laszig … (2011)
          Up to now, treatment modalities of unilateral deafness consist of no treatment, conventional contralateral routing of signal (CROS), or Bone-Anchored Hearing Aid (BAHA) hearing aid. Cochlear implantation makes a new treatment modality available for patients with single-sided deafness. The aim of this study is to evaluate the use of unilateral electrical stimulation with normal hearing on the contralateral side after a period of 6 months compared with the preoperative unaided situation, conventional CROS, or BAHA hearing aids. Prospective design. Tertiary referral center; cochlear implant (CI) program. Eleven adult subjects with unilateral deafness of various causes were enrolled in the study. Only those patients were included in whom therapy with CROS hearing aid or BAHA was not successful and in whom the auditory nerve was found to be intact and the cochlea patent for cochlear implantation. All subjects were fitted in random order with a BAHA Intenso mounted on the softband/tension clamp or with a CROS hearing aid. After test periods with both devices, the subjects received a CI. The Hochmair-Schulz-Moser sentence test and the Oldenburg sentence test were used to test speech comprehension in 3 presentation configurations in the unaided situation, with conventional CROS and BAHA hearing aids before cochlear implantation as well as after 6 months with CI. Localization was assessed using an array of 7 speakers at head level in a frontal semicircle. Subjective improvement in daily life was evaluated using the Speech, Spatial and Qualities of Hearing Scale, the Health Utilities Index 3 and the International Outcome Inventory for Hearing Aids questionnaires. Tinnitus distress was measured with a tinnitus scale before and after CI implantation. The results show significant improvement in localization ability as well as in speech comprehension in most presentation configurations with the CI. Especially, there is no negative effect on speech comprehension if the noise is presented to the CI ear and speech to the normal hearing ear. With the CI, the summation and squelch effects are not significant, but a significant combined head shadow effect is seen. Speech, Spatial and Qualities of Hearing results show an overall benefit of wearing the CI compared with the other treatment options. The tinnitus scale revealed a positive effect of CI stimulation in cases of preoperative tinnitus. The results in these patients suggest that cochlear implantation improves hearing abilities in people with single-sided deafness and is superior to the alternative treatment options. The use of the CI does not interfere with speech understanding in the normal hearing ear. Our data suggest that the binaural integration of electric and acoustic stimulation is possible even with unilateral normal hearing.
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            Speech-language and educational consequences of unilateral hearing loss in children.

            Judith E Cho Lieu (2004)
            In the past, unilateral hearing loss (UHL) in children was thought to have little consequence because speech and language presumably developed appropriately with one normal-hearing ear. Some studies from the 1980s and 1990s have suggested that a significantly increased proportion of children with UHL may have educational and/or behavioral problems, compared with their normal-hearing peers. Limited data exist about the effect of UHL on acquisition of speech and language skills. To review the current literature about the impact UHL has on the development of speech and language and educational achievement. MEDLINE search between 1966 and June 1, 2003, using the medical subject heading "hearing loss," combined with the textword "unilateral." Studies were limited to those written in English, reporting speech-language and/or educational results in children. Articles were read with attention to study design, population, recruitment of subjects, and outcomes measured. Problems in school included a 22% to 35% rate of repeating at least one grade, and 12% to 41% receiving additional educational assistance. Speech and language delays have been reported in some but not all studies. School-age children with UHL appear to have increased rates of grade failures, need for additional educational assistance, and perceived behavioral issues in the classroom. Speech and language delays may occur in some children with UHL, but it is unclear if children "catch up" as they grow older. Research into this area is necessary to clarify these issues and to determine whether interventions may prevent potential problems.
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              Binaural hearing after cochlear implantation in subjects with unilateral sensorineural deafness and tinnitus.

              Katrien Vermeire, Paul Van de Heyning (2009)
              The aim of this clinical study was to assess speech recognition in noise after cochlear implantation in subjects with single-sided deafness and incapacitating tinnitus. 20 subjects complaining of severe intractable tinnitus unresponsive to treatment received a MED-EL cochlear implant (CI). 11 subjects had normal hearing (NH group) on the contralateral side, while 9 used a hearing aid (HA group). The subjects were tested in noise in two listening conditions, i.e. with their acoustic hearing only and with adding the CI to the acoustic hearing (binaural). Subjective improvement in daily life was evaluated using the Speech Spatial and Qualities Hearing Scale (SSQ). The summation effect (3.3 dB for the HA group and 0.6 dB for the NH group) is not significant in both groups. A significant squelch effect of adding the CI was seen for the HA users (3.8 dB), but not for the NH group (1.2 dB). Additionally, a significant effect of adding the CI was found for the spatial configuration where noise is presented in front and speech on the CI side for both the HA group (6.5 dB) and the NH group (1.7 dB). Results of the SSQ show a significant overall benefit of wearing the CI for both groups. The preliminary results of these 20 subjects suggest that cochlear implantation can improve hearing in people suffering from single-sided deafness combined with tinnitus. Copyright 2008 S. Karger AG, Basel.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): HNO
                Title: HNO
                Publisher: Springer Science and Business Media LLC
                ISSN (Electronic): 1433-0458
                ISSN (Print): 0017-6192
                Publication date (Electronic): May 2011
                Volume: 59
                Issue: 5
                Affiliations
                [1 ] Abt V HNO, Bundeswehrzentralkrankenhaus Koblenz, Rübenacher Str. 170, 56072, Koblenz, Deutschland. rolandjacob@bundeswehr.org
                Article
                DOI: 10.1007/s00106-011-2321-0
                PubMed ID: 21533601
                SO-VID: d2fdac9e-5695-46db-8176-f20100523a3d
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