long-term evaluaon of cochlear implantaon in subjects … · griet mertens, phd paul van de...
TRANSCRIPT
Long-TermEvalua0onofCochlearImplanta0on
inSubjectswithAcquiredUnilateralHearingLossupto10Years
FocusonBinauralAuditoryOutcomes
GrietMertens,PhD
PaulVandeHeyning,MD,PhD
Relevantfinancialrela0onshipswithcommercialinterests
thatpertaintothecontentofthispresenta0on:
Company:
GrantMED-EL(Innsbruck,Austria)paidtoUZA.
SpeechPercep0onSubjects SoundLocaliza0on Conclusion
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
✗Single-sideddeafear ✓NormalHearingEar
✗ ✓CI
n= 23
✗ ✓CI
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
Allsubjectswere:
Adults+Implantedbecauseoftheirmajorcomplaint:
ipsilateralincapacita0ng'nnitus
n= 23 ✗Single-sideddeafear ✓NormalHearingEar
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
SSD n= 12
AHL n= 11
0 20 40 60 80
100 120
0 20 40 60 80
100 120
Single Sided Deafness
Asymmetric Hearing Loss
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
Summa0onEffect
SquelchEffect
Headshadow+SquelchEffect
Spa0alReleasefrommasking
Configura0on
(A)aided–(B)aided
redundancybenefit:sameacous0c
s0mulusispresentedtobothears
2-6dB
‘Extrac0ng’inputofnon-informa0vebackgroundnoise.
2-3dB
Acous0cShadow5dB
Abilitytousespa0alsepara0onbetweenspeechandnoise
S+N S
N S
N
(A) (B) (C) (D)
SpeechPercep0on SoundLocaliza0on ConclusionSubjects
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
dBSNR** dBSNR dBSNR** dBSNR**
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
1. TheInterferencecaused bythe0nnitustospeechsignals
2. ORtotheaccompaniedHearingloss
Underlyingbasisforthecommunica'onproblems
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
ContralateralSpe
echPe
rcep
'on
ContralateralSpe
echPe
rcep
'on
Unaidedtestcondi'on
Aidedtestcondi'on
Mertens,etal.OtolNeurotol,2013.
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
-10
-5
0Speechpercep0
oninnoise(d
BSN
R)
UnaidedTinnitusON
AidedTinnitusOFF
Mertens,etal.OtolNeurotol,2013.
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
-10
-5
0Speechpercep0
oninnoise(d
BSN
R)
UnaidedTinnitusON
AidedTinnitusOFF
Mertens,etal.OtolNeurotol,2013.
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
-10
-5
0Speechpercep0
oninnoise(d
BSN
R)
UnaidedTinnitusON
AidedTinnitusOFF
*2dBSNR
Mertens,etal.OtolNeurotol,2013.
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
Set-up- Soundisolatedbooth- S0mulus=Broadbandnoise- 9BroadbandFostexloudspeakers- Frontalsemicircleinahorizontalplane- 0.8mfromsubject- S0muluscoordinatesranged-90°-+90°- 22.5°intervals- 27trials
!!
! ! ! !! ! ! ! !
!! !
! !! ! ! ! ! Figure!4.!Localiza
tion*set-u
p:*9*Broad
band
*Fostex*6301*loud
speakers*at*intervals*of*
22.5°,*located*in*a*fron
tal*horizo
ntal*se
micircle*at*the*su
bject's*head*level.**
*
0.80!m!
0.8!m!
0°!
22.5
°!
45°!
67.5°! 90°!
322.5°!
345°!
367.5°!
390°!
Broadb
and!Fostex!630
1!loud
speakers!
1!2!
3!
4!5!
6!
7!
8!
!
9!
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
10 30 50 70 90 10
30
50
70
90
BeKer
MAE
(°)
AHonlyCIonly
SSD n= 12
AHL n= 11
0
20
40
60
80
100
120
125H
z 25
0Hz
500H
z 10
00H
z 20
00H
z 30
00H
z 40
00H
z 60
00H
z 80
00H
z
0
20
40
60
80
100
120
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
10 30 50 70 90 10
30
50
70
90
BeKer
MAE
(°)
AHonlyCIonly
SSD n= 12
AHL n= 11
0
20
40
60
80
100
120
125H
z 25
0Hz
500H
z 10
00H
z 20
00H
z 30
00H
z 40
00H
z 60
00H
z 80
00H
z
0
20
40
60
80
100
120
CI+AH
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
Cochlearimplanta'oninUnilateralHearingLoss
ü Improvedhearingcapabili'es-Speechpercep0oninnoise-Soundlocaliza0on
ü Decreasingthe'nnitusloudnessanddistress
Unilateralhearinglossandincapacita'ng'nnitusisanewindica'onforCI.
Subjects SpeechPercep0on SoundLocaliza0on Conclusion
Cochlearimplanta'oninUnilateralHearingLoss
ü Improvedhearingcapabili0es-Speechpercep0oninnoise
-Soundlocaliza0on
ü Decreasingthe0nnitusloudnessanddistress
Unilateralhearinglossandincapacita'ng'nnitusisanewindica'onforCI.
