Cochlear Implantation in Cases of Unilateral Hearing Loss: Initial Localization Abilities. 2017

Margaret T Dillon, and Emily Buss, and Meredith L Anderson, and English R King, and Ellen J Deres, and Craig A Buchman, and Kevin D Brown, and Harold C Pillsbury
1Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; 2Department of Audiology, UNC Healthcare, Chapel Hill, North Carolina, USA; and 3Department of Otolaryngology/Head & Neck Surgery, Washington University, Saint Louis, Missouri, USA.

The present study evaluated early auditory localization abilities of cochlear implant (CI) recipients with normal or near-normal hearing (NH) in the contralateral ear. The goal of the study was to better understand the effect of CI listening experience on localization in this population. Twenty participants with unilateral hearing loss enrolled in a prospective clinical trial assessing outcomes of cochlear implantation (ClinicalTrials.gov Identifier: NCT02203305). All participants received the MED-EL Standard electrode array, were fit with an ear-level audio processor, and listened with the FS4 coding strategy. Localization was assessed in the sound field using an 11-speaker array with speakers uniformly positioned on a horizontal, semicircular frame. Stimuli were 200-msec speech-shaped noise bursts. The intensity level (52, 62, and 72 dB SPL) and sound source were randomly interleaved across trials. Participants were tested preoperatively, and 1, 3, and 6 months after activation of the audio processor. Performance was evaluated in two conditions at each interval: (1) unaided (NH ear alone [NH-alone] condition), and (2) aided, with either a bone conduction hearing aid (preoperative interval; bone conduction hearing aid + NH condition) or a CI (postoperative intervals; CI + NH condition). Performance was evaluated by comparing root-mean-squared (RMS) error between listening conditions and between measurement intervals. Mean RMS error for the soft, medium, and loud levels were 66°, 64°, and 69° in the NH-alone condition and 72°, 66°, and 70° in the bone conduction hearing aid + NH condition. Participants experienced a significant improvement in localization in the CI + NH condition at the 1-month interval (38°, 35°, and 38°) as compared with the preoperative NH-alone condition. Localization in the CI + NH condition continued to improve through the 6-month interval. Mean RMS errors were 28°, 25°, and 28° in the CI + NH condition at the 6-month interval. Adult CI recipients with normal or near-normal hearing in the contralateral ear experienced significant improvement in localization after 1 month of device use, and continued to improve through the 6-month interval. The present results show that binaural acclimatization in CI users with unilateral hearing loss can progress rapidly, with marked improvements in performance observed after only 1 month of listening experience.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003054 Cochlear Implants Electronic hearing devices typically used for patients with normal outer and middle ear function, but defective inner ear function. In the COCHLEA, the hair cells (HAIR CELLS, VESTIBULAR) may be absent or damaged but there are residual nerve fibers. The device electrically stimulates the COCHLEAR NERVE to create sound sensation. Auditory Prosthesis,Cochlear Prosthesis,Implants, Cochlear,Auditory Prostheses,Cochlear Implant,Cochlear Prostheses,Implant, Cochlear,Prostheses, Auditory,Prostheses, Cochlear,Prosthesis, Auditory,Prosthesis, Cochlear
D006310 Hearing Aids Wearable sound-amplifying devices that are intended to compensate for impaired hearing. These generic devices include air-conduction hearing aids and bone-conduction hearing aids. (UMDNS, 1999) Ear Molds, Hearing Aid,Aid, Hearing,Aids, Hearing,Hearing Aid
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D013017 Sound Localization Ability to determine the specific location of a sound source. Auditory Localization,Auditory Localizations,Localization, Auditory,Localization, Sound,Localizations, Auditory,Localizations, Sound,Sound Localizations
D046088 Hearing Loss, Unilateral Partial or complete hearing loss in one ear. Deafness Unilateral,Unilateral Hearing Loss,Deafness, Unilateral,Unilateral Deafness,Unilateral, Deafness
D019929 Cochlear Implantation Surgical insertion of an electronic hearing device (COCHLEAR IMPLANTS) with electrodes to the COCHLEAR NERVE in the inner ear to create sound sensation in patients with residual nerve fibers. Cochlear Prosthesis Implantation,Cochlear Implantations,Cochlear Prosthesis Implantations,Implantation, Cochlear,Implantation, Cochlear Prosthesis,Implantations, Cochlear,Implantations, Cochlear Prosthesis,Prosthesis Implantation, Cochlear,Prosthesis Implantations, Cochlear

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