gms | German Medical Science

82nd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

01.06. - 05.06.2011, Freiburg

Cochlear implantation for single-sided deafness: procedure and results of a child-case

Meeting Abstract

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 82nd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Freiburg, 01.-05.06.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11hno35

doi: 10.3205/11hno35, urn:nbn:de:0183-11hno356

Published: August 3, 2011

© 2011 Mons-Bajorath et al.
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Outline

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Introduction: Every year there are about 16000 new cases of single-sided deafness in Germany http://www.hear-it.org/. A treatment with a cochlear implant (CI) gives these patients a sense of hearing. However, a special therapy for children is not a part of the clinical routine, though the binaural hearing is very important.

Material and Methods: Twenty-two patients with a unilateral deafness have been implanted with a CI at MHH till now. One of them is a nine years old child. Resulting from an accident he lost his hearing with eight, after what he was provided with a CI. No further physical and cognitive disorder were diagnosed, and we observed a standard spoken language development. The post-implantation therapy was set up weekly. It includes the regular fitting of the technical functions of the CI, a special hearing training and the speech audiometry, done both in free field and via direct coupling.

Results: Six month after the first fitting the patient shows good hearing results with “Freiburger” monosyllabic word test as well as with the “HSM” sentence test in quiet and in noise. Furthermore a localisation test was done. The test was performed in a loudspeaker-circle (360°). The Patient listend to a repeating four-syllabic HSM sentence, which was offered at 65 dB and was each time performed from a different loudspeaker. The subject had to tell from which loudspeaker the signal is coming out. The test resulted no significant difference. We also performed the adaptive “Oldenburg Sentence test” whereby from a combination of 50 words meaningless sentences (subject, verb, number, adjective and object) are made and spoken. The speech loudness is variable but the noise is fixed at 65 dB. The test starts with a signal to noise ratio (SNR) of 0 dB with S0N0. The results show a significant improvement with CI. In the best aided variation (CI + the normal hearing ear) a 50% correctness was achieved even with a –5,3 dB SNR. The patient and his family are highly satisfied with the development.

Discussion: The “young age” of a single-sided deaf patient should not be a contra-indication for a CI, provided that an appropriate post-implantation therapy is available. In addition, competent lingual role models can help to achieve a positive lingual development in learning ages. Especially in their school life, single-sided deaf students have considerable disadvantages to learn, because their debilitated hearing demands for a higher concentration.