Cochlear Implant

In contemporary medical discourse as well as in the field of Disability Studies, the problems concerning the Cochlear implant (CI) gave rise to a series of controversies. While medical discourses or viscourses imply a natural process of hearing, the counterargument is that “normal hearing” is a social and cultural construction, which depends on a corresponding “thought style”. However, such constructions of normality, disability, inclusion and exclusion are not only produced or criticized by scientific or journalistic mediatizations but also to a large degree by popular narrative media. Consequently, this paper analyzes the specific filmic-narrative appropriation, reworking and interpretation of discourses on the CI in popular media formations such as TV series, medical-technological viscourses in documentaries and Youtube videos. The thesis is that narrative media cannot be considered a mere reproduction of scientific or social discourses, but instead functions as productions of reality. Thus, narrative media is capable of (co)producing (in mutual exchange with social and medical discourses) interpretations, evaluations of normality and disability.

English abstract: This article deals with recent developments in the discourse on Cochlear Implants (CI) and the appropriation of the implant as an enhancing cyborg device. The article will first consider developments in medicinal, technological and cultural histories of the CI: While medical experts originally designed the CI to “cure” deafness, some members of Deaf communities do not agree. In their perspective, deafness is not a “disability,” but a certain cultural lifestyle. Hence, forcing people to “hear” with a CI needed to be considered a threat to the culture of sign language. Apart from these discussions, self-appointed “cyborgs” such as German Enno Park consider the CI not only a way of becoming “normal,” but instead claim that the CI bears the potential of raising the human body and its sensory capacities to a posthuman level.

Magnet displacement is recognized as an uncommon, major complication following cochlear implant surgery. This complication necessitates operative intervention exposing patients to further surgical risk and morbidity. The purpose of this paper is to describe a unique surgical technique for securing internal magnets which have dislodged from their silicone housing within the internal receiver-stimulator. A case involving a 5-year old cochlear implant patient is reviewed. This patient experienced magnet displacement on two separate occasions. A new lasso technique for re-securing the internal implant magnet is described in detail. The patient's implant remains fully functional with a securely placed internal magnet 36 months post-operatively. When compared to other surgical options, the "lasso" technique represents a simple, safe, efficient and cost-effective surgical option with minimal morbidity.

Children with severe to profound sensorineural hearing loss due to GJB2 mutations have often been deemed good cochlear implant candidates. Studies on children with GJB2 mutations and cochlear implants have typically excluded children with additional disabilities. To investigate the presence of additional disabilities among children with and without GJB2 mutations in a cochlear implant population. A retrospective chart review was performed of children with non-syndromic sensorineural hearing loss (SNHL) who received a cochlear implant between 1993 and 2004. Among 108 children within the cochlear implant database; 46 patients met the inclusion criteria of idiopathic non-syndromic hearing loss. Sixteen children had GJB2 mutations, 12 were GJB2 negative, and 17 did not receive GJB2 testing but had no other identifiable etiology or risk factor contributing to hearing loss. The proportion of children with additional disabilities that would affect either pre-operative assessments or post-o...

Bilingualism is common throughout the world, and bilingual children regularly develop into fluently bilingual adults. In contrast, children with cochlear implants (CIs) are frequently encouraged to focus on a spoken language to the exclusion of sign language. Here, we investigate the spoken English language skills of 5 children with CIs who also have deaf signing parents, and so receive exposure to a full natural sign language (American Sign Language, ASL) from birth, in addition to spoken English after implantation. We compare their language skills with hearing ASL/English bilingual children of deaf parents. Our results show comparable English scores for the CI and hearing groups on a variety of standardized language measures, exceeding previously reported scores for children with CIs with the same age of implantation and years of CI use. We conclude that natural sign language input does no harm and may mitigate negative effects of early auditory deprivation for spoken language development.

An important speech-language outcome for deaf people with cochlear implants is speech intelligibility—how well their speech is understood by others, which also affects social functioning. Beyond simply uttering recognizable words, other speech-language skills may affect communicative competence, including rate-matching or converging toward interlocutors’ speech rates. This initial report examines speech rate-matching and its relations to intelligibility in 91 prelingually deaf cochlear implant users and 93 typically-hearing peers age 3 to 27. Live-8 voice spoken sentences were repeated and later transcribed by multiple hearing listeners. Speech intelligibility was calculated as proportions of words correctly transcribed. For speech rate-matching measures, speech rates (syllables/second) were normalized as percentages faster or slower than examiners’ speech rates. Cochlear implant users had slower speech rates, less accurate and less consistent rate-matching, and poorer speech intelligibility than hearing peers. Among cochlear implant users, speech rate and rate-matching were correlated with intelligibility: faster talkers and better rate-matchers were more intelligible. Rate-matching and intelligibility improved during preschool, with cochlear implant users delayed by about a year compared to hearing peers. By school-age, rate-matching and intelligibility were good overall, but delays persisted for many cochlear implant users. Interventions targeting rate-matching skills are therefore warranted in speech-language therapy for this population.

Numerous complications have been described following cochlear implantation. Most of them are post-operative and benign, but some are intra-operative and can be more difficult to manage. Case report of a pediatric case of misplaced cochlear electrode in the carotid canal and literature review. Post-operative CT-scan allowed the diagnosis. The misplaced cochlear implant in the carotid canal was successfully removed and a successful re-implantation followed immediately. Anatomy of the interval between the cochlea and the carotid canal is reviewed, together with information regarding the neural telemetry response. In each case, specific anatomical landmarks must be identified to perform the cochleostomy in the right position. If not, or if surgery proves itself difficult, the surgeon should intra-operatively control the position of the electrode.

The purpose of this study was to compare vowel productions by deaf cochlear implant (CI) children, hearing-impaired hearing aid (HA) children and normal-hearing (NH) children. 73 children [mean age: 9;14 years (years;months)] participated: 40 deaf CI children, 34 moderately to profoundly hearing-impaired HA children and 42 NH children. For the 3 corner vowels [a], [i] and [u], F(1), F(2) and the intrasubject SD were measured using the Praat software. Spectral separation between these vowel formants and vowel space were calculated. The significant effects in the CI group all pertain to a higher intrasubject variability in formant values, whereas the significant effects in the HA group all pertain to lower formant values. Both hearing-impaired subgroups showed a tendency toward greater intervowel distances and vowel space. Several subtle deviations in the vowel production of deaf CI children and hearing-impaired HA children could be established, using a well-defined acoustic analysis....

ObjectivesWith more children receiving cochlear implants during infancy, there is a need for validated assessments of pre-verbal and early verbal auditory skills. The LittlEARS® Auditory Questionnaire is presented here as the first module of the LittlEARS® test battery. The LittlEARS® Auditory Questionnaire was developed and piloted to assess the auditory behaviour of normal hearing children and hearing impaired children who

To compare speech development following unilateral cochlear implant (CI) between a group of prelingually deaf children who have been educated exclusively using spoken language and another group who have used two languages (spoken and sign language). A simple group quasi-experimental design was used with a control group. The sample comprised 7 girls and 11 boys, aged between 4 and 8 years old, who received a CI between the ages of 15 months and 5 years old. The sample was divided into two groups, G1-bilingual and G2-spoken language. In both groups, aspects such as speech intelligibility, receptive vocabulary, psycho-linguistic skills, adaptive behaviour and behavioural problems were measured. The children in Group 1 (bilingual) had better verbal and manual expression whereas those in Group 2 (spoken) achieved better results in terms of speech intelligibility, auditory reception and grammatical closure. These differences were confirmed statistically using Analysis of Variance. No sign...

Very few assessment measures exist for evaluating progress in young deaf children with hearing aids and cochlear implants. To introduce and describe an early assessment package that covers auditory perception, communication/language development, and speech production in very young deaf children. Seven of the assessment measures (Listening Progress Profile, Categories of Auditory Performance, Tait Video Analysis, Stories-Narratives Assessment Procedure, Profile of Actual Linguistic Skills, Speech Intelligibility Rating, and the Profile of Actual Speech Skills) have been specifically developed at the Nottingham Cochlear Implant Programme, and a further one (Meaningful Auditory Integration Scale) was modified for use within the package. Moreover, two commercially available tests (Pragmatics Profile of Everyday Communication Skills and Preschool Language Scale) are included to complete the package. The present paper describes each measure, how to use it, and its time frame. In addition,...

Authors: Skarżyński P.H., Tomanek E., Król B., Piłka A.

Nowa Audiofonologia, 2(5), 2013: 25-29, ISSN 2084-946X

Background: Zespół Ushera to choroba rzadka, charakteryzująca się rozpowszechnieniem, w zależności od populacja, na poziomie od 3,5 do 6,2 na 10.000 osób. Do najbardziej charakterystycznych cech zaliczamy: różnego rodzaju głuchotę lub częściową głuchotę, zaburzenia układu równowagi i ślepotę występującą w różnym wieku.Cel: Celem niniejszej pracy było przeanalizowanie zachowania resztek słuchowych w procedurze leczenia częściowej głuchoty (Partial Deafness Treatment). Material and Methods: Operacje wszczepienia implantu ślimakowego zostały przeprowadzone według metody 6 kroków wg. Skarżyńskiego. Insercji dokonano przez okienko okrągłe, ale w niektórych przypadkach ze względów anatomicznych, zastosowano dojście przez kochleostomię. Wyniki zachowania resztek słuchowych były porównywane na podstawie wyników badania audiometrii tonalnej. Results: W analizach badań audiometrii tonalnej, wykonanych w tych samych warunkach, przed i po zabiegu operacyjnym wykazały zachowanie słuchu w wyniku wszczepienia elektrody do ślimaka. Conclusions: Zespół Ushera charakteryzuje się, w większości przypadków, progresywnym niedosłuchem. W wyniku dalszej obserwacji pacjentów, może się okazać, że będzie potrzebna zmiana sposobu kodowania dźwięku w zależności od kanału elektrody. Rekomendowana jest głębsza insercja elektrody, w zależności od wielkości ślimaka, od 25mm do 28mm.

Despite their clear benefits and the relative maturity of the underlying technology, cochlear implants continue to generate debate especially as to their safety and their potential contraindication in the context of MRI diagnostic/screening. We provide here a brief workable plain-English summary of a recently (August 2014) completed review of the literature on these issues of efficacy, safety, MRI compatibility, and Quality-of-Life (Qol) for implant patients.

RESUMEN Los avances técnicos y quirúrgicos en el proceso de implantación coclear deben acompañarse con una rehabilitación logopédica que pueda maximizar las ventajas de los dispositivos actuales y de las nuevas indicaciones en los implantes cocleares. La rehabilitación logopédica en implantes cocleares avanza en nuevas áreas como el entrenamiento para la combinación de diferentes señales (acústico-eléctricas), para la obtención de los beneficios de la binauralidad, tanto en niños con implantaciones bilaterales precoces y en pacientes con pérdidas asimétricas y unilaterales, incluyendo la localización de los sonidos. Explorar las nuevas posibilidades de rehabilitación a distancia (telerehabilitación), la autorehabilitación haciendo uso de las nuevas tecnologías, como apps para tablets o teléfonos, programas informáticos, o la utili-zación de dispositivos wireless. El paciente con una discapacidad auditiva puede bene-ficiarse de muchas opciones terapéuticas desde el punto de vista audiológico y éstas deben acompañarse de un tratamiento logopédico de excelencia. SUMMARY Technical and surgical advances in cochlear implantation process must be accompanied with a speech therapy rehabilitation that can maximize the benefits of existing devices and new indications in cochlear implants. The rehabilitation advances into new areas as auditory training for the combination of different signals (acoustic-electric), to obtain the binaural benefit, both pediatric bilateral implants and in patients with asymmetric and unilateral loss including sound localization. Exploring the new possibilities of remote rehabilitation (tele-rehabilitación), auto-rehabilitación using new technologies, such as apps for tablets or mobile phones, software, or using wireless devices. The patient with a hearing impairment can benefit from many therapeutic options from the audiological perspective and these must be accompanied by a speech therapy treatment of excellence.

Summary
Since the year 2000 over 125 patients received a cochlear im- plant at the LUMC in Leiden, the Netherlands. Based upon edu- cational psychological insights, linguistic knowledge and field experience, the Cochlear Learningmodel for speech perception training has been developed for the postlingually deafened adults. From educational psychological perspective the impor- tance of training details, repetition, and the role of the three- track growth potential for the methodological sequence is demonstrated. From linguistic perspective it is shown how to vary the difficulty of the exercises at different linguistic levels by adjusting the acoustic, prosodic and semantic properties. Next we elaborate on the 10 levels within our model. Finally the CVC and speechtracking-test scores are used to illustrate the results.

ÖZET Müzikal deneyimler, koklear implantları (CI) olan çocukların yaşamlarının önemli bir parçasıdır. Müzikal aktivitelerin dinleme beynini geliştirebileceğini ve dil yetenekleri de dâhil olmak üzere daha yüksek bilişsel işlevler geliştirebileceğini düşündürmektedir. Müzik tarafından sağlanan zevk ilişkiler ve duygusal dışavuruma ek olarak, yaşam boyu gelişim ve öğrenme için kritik olan diğer işitsel ve bilişsel becerileri geliştirmeye hizmet eder. CI'lı çocukların normal işiten (Nİ) yaşıtlarına göre sürekli olarak daha düşük müzik algısı puanlarına sahip oldukları belgelenmiştir. Fakat müzikal terapinin bu algı skorlarını yükselttiği gözlemlenmiştir. Öte yandan müzik işitme kayıplı çocuklarda, Nİ çocuklarda olduğu gibi, gelişimsel bir hız kazandırmak, dil öğrenme aracı, bilişsel zenginleştirici, motivasyon aracı ve dikkat arttırıcı olarak görülür. Bu amaca yönelik bu makalede, koklear implantları (CI) olan çocukların müzikal eğitimler doğrultusunda gösterdiği gelişimsel süreçten bahsedilmiştir. Yaşıtlarının gelişimsel becerilerine yaklaşmak ve bunun için gerekli yöntemlerinin neler olduğu hakkında bilgiler verilmiştir.