gms | German Medical Science

100 Jahre Phoniatrie in Deutschland
22. Wissenschaftliche Jahrestagung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie
24. Kongress der Union Europäischer Phoniater

Deutsche Gesellschaft für Phoniatrie und Pädaudiologie e. V.

16. bis 18.09.2005, Berlin

Cochlear implants in adults

Die Cochlea-Implantationen bei Erwachsenen

Poster

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  • corresponding author presenting/speaker Libor Cerny - Phoniatric Dept. of the 1st Medical Faculty of the Charles University, Prague 2, The Czech Republic
  • author Jiri Skrivan - ENT Dept. of the 1st Medical Faculty of the Charles University, Prague 5 - Motol, The Czech Republic

100 Jahre Phoniatrie in Deutschland. 22. Jahrestagung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie, 24. Kongress der Union der Europäischen Phoniater. Berlin, 16.-18.09.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05dgppP04

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Veröffentlicht: 15. September 2005

© 2005 Cerny et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Abstract

The study is an overview of results of all 46 adult patients (mean age 40.1 y., range 19 to 67 y.) implanted in the years 2000-2004 in our implant center with both Cochlear Implant (CI) and Brainstem Implant System (ABI) by Cochlear. In the CI group 5 patients were older than 60 years. There are results structured in correlation of patient's age in time of implantation, aetiology of hearing loss, pre-operative electrical stimulation, pre-operative hearing loss duration, pre-operative residual speech perception with hearing aids, lip-reading ability, minimal auditory capabilities. Post-operatively - number of inserted electrodes and the way of rehabilitation is mentioned. Post-operative successfulness is evaluated by means of objective audiological tests of speech perception (open-set and closed-set word identification tests in free field), pure tone audiometry, using the telephone ability, subjective quality of life assessment and there is a short summarisation in Nottingham scale too. The study is specially concentrated on long-time progressive hearing loss effectiveness of implantation and age-related post-operative performance as a contribution to predictors of cochlear implant performance detection.


Text

Introduction

Cochlear implantation become a standard therapeutic method for severe to profound sensorineural hearing loss. It may provide a hearing solution for people, who receive limited benefit from hearing aids. Initially, implantation was carried out only for adults but then with time the implantation of children became common practice and sometimes have overshadowed the fact that many adult and older people are ideal implant candidates. There were implanted more than 90 adult patients in our country and the number is rapidly growing in last 4 years. In connection with this development there is a widening or a narrowing of selection criteria more and more intensively discussed. We were also concentrated on predictive factors such as age, duration of hearing impairment or complete deafness.

Methods

The study is an overview of results of all 46 adult patients (mean age 40.1 y., range 19 to 67 y.) implanted in years 2000-2004 in our implant centre with both Cochlear Implant (N 43) and Brainstem Implant System (N 3) by Cochlear Nucleus 22 or 24. There was obtained a detail patient history, than an pre-operative and post-operative examination by pure tone audiometry, lip-reading ability video-test, tests of speech perception (open-set and closed set word identification - Czech Word Audiometry (CWA) - in free field) and quality of life assessment (adapted International Outcome Inventory). The results were obtained in periodical examinations (at least 1 year after implantation).

Results

All patients with cochlear implant included in the study (N 43) performed main score in Nottingham scale x=5.9 (maximal x=7 is in 17 cases, i.e. in 36.9%).

Patients with Brainstem Implant System (N 3, main age 32.3 y., main pre-operative lip-reading ability 16%, post-operative main PTA 48 dB, main score in adapted IOI 2.1) had main score in Nottingham scale x=2.10. None of them was able to understand without lip-reading in word-perception-test (CWA) in free field.

Cochlear implanted patients with long time progressive hearing loss i.e. sever hearing loss progressive from pre-school-age or from young-school-age (N 18, main age 37.6 y.) performed main pre-operative lip-reading ability 59.5%, post-operative main PTA 42.9 dB, post-operative max. CWA in free field 42.9%, main score in Nottingham scale x=5.5 and main score in adapted IOI 3.60.

Cochlear implanted patients with sudden deafness i.e. duration of profound hearing loss under 5 years due to meningitis (N 3), antibiotics, trauma and others, (all - N 14, main age 43.6 y.) performed main pre-operative lip-reading ability 31.9%, post-opertive main PTA 44.3 dB, post-operative max. CWA in free field 47.2%, main score in Nottingham scale x=5.9 and main score in adapted IOI 3.98.

Cohlear implanted patients in older age i.e. more than 60 y. (N 6, main age 62.6 y.) performed main pre-operative lip-reading ability 31.6%, post-operative main PTA 43.5 dB, post-operative max. CWA in free field 63.3%, main score in Nottingham scale x=6.3 and main score in adapted IOI 4.37.

Conclusions

We can see no risk of worse post-operative performance in elderly adults. There are better result in speech-understanding without lip-reading and subjective satisfaction than in other groups. Also results of patients with long-time-progressive hearing loss (implantation was carried out for well-developed-speaking patients only) are fully comparable with main results of all-implanted group.


References

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Cox, RM., Stephens, D., Kramer, SE. 2002. Translations of the International Outcome Inventory for Hearing Aids (IOI-HA). International Journal of Audiology, 41(1): 3-26
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Hogan, A., Hawthorne, G., Kethel, L., et al. 2001. Health-related quality-of-life outcomes from adult cochlear implantation: a cross-sectional survey. Cochlear Implants International, 2: 73-85
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Helms, J., Mueller, J. 1999. Die Auswahl eines Cochlea-Implants und die guten Ergebnisse der Implantation. Laryngorhinootologie, 78: 12-13
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