Long-term experiences of cochlear implanta4on in adults with acquired single-sided deafness. and incapacita4ng 4nnitus.

Transcription

1 Long-term experiences of cochlear implanta4on in adults with acquired single-sided deafness and incapacita4ng 4nnitus. Griet Mertens, PhD Paul Van de Heyning, MD, PhD

2 Relevant financial rela4onships with commercial interests that pertain to the content of this presenta4on: Company: Grant MED-EL (Innsbruck, Austria) paid to UZA.

3 Single-sided deaf ear n= 23 Normal Hearing Ear CI

4 Single-sided deaf ear n= 23 Normal Hearing Ear All subjects were: Adults + Implanted because of CI their major complaint: ipsilateral incapacita4ng 'nnitus

5 SSD n= 12 AHL n= Single Sided Deafness Asymmetric Hearing Loss

6 SSD subjects Tinnitus as primary advantage of CI Hearing as primary advantage of CI % 83% AHL subjects Tinnitus as primary advantage of CI Hearing as primary advantage of CI 45% 55%

7 days a week 100% 5h / day CI Switch-on, as soon as they got up in the morning CI Switch-off, only before going to bed at night 4% 96%

8 VAS score Tinnitus Loudness pre-op 1M 3M 6M 1Y (3Y) LT LT_OFF

9 TQ total score pre-op 1M 3M 6M 1Y (3Y) LT

10 Summa4on Subjects Effect S+N redundancy benefit: same acous4c s4mulus is presented to both ears 2-6 db Squelch Effect S Headshadow + Squelch Effect Spa4al Release from masking Configura4on N S (A) aided (B) aided (A) (B) (C) (D) Extrac4ng input of non-informa4ve background noise. 2-3 db N Acous4c Shadow 5 db Ability to use spa4al separa4on between speech and noise

11 Subjects

12 Subjects db SNR** db SNR db SNR** db SNR**

13 Subjects Tinnitus Speech Localiza4on Conclusion Set-up Sound isolated booth - S4mulus = Broad band noise - 9 Broadband Fostex loudspeakers - Frontal semicircle in a horizontal plane m from subject - S4mulus coordinates ranged intervals - 27 trials m m 1 390

14 BeBer MAE ( ) CI only AH only SSD n= 12 AHL n= Hz 250Hz 500Hz 1000Hz 2000Hz 3000Hz 4000Hz 6000Hz 8000Hz

15 BeBer MAE ( ) CI only AH only CI + AH SSD n= 12 AHL n= Hz 250Hz 500Hz 1000Hz 2000Hz 3000Hz 4000Hz 6000Hz 8000Hz

16 Van de Heyning, P. et al. (2016). Towards a Unified Tes'ng Framework for Single-Sided Deafness Studies: A Consensus Paper. Audiol Neurootol, 21(6), Although several studies have shown: CI is a safe and effec've treatment for SSD à Clinical outcome measures in those studies and across CI centers vary greatly à Only with a consistent use of defined and agreed-upon outcome measures across centers à High-level evidence be generated to assess the safety and efficacy of CIs and alterna4ve treatments in recipients with SSD and AHL.

17 Van de Heyning, P. et al. (2016). Towards a Unified Tes'ng Framework for Single-Sided Deafness Studies: A Consensus Paper. Audiol Neurootol, 21(6), Speech Percep'on in Noise Sound Localiza'on Tes'ng Ques'onnaires to inves'gate QoL Ques'onniares Related to Tinnitus

18 Van de Heyning, P. et al. (2016). Towards a Unified Tes'ng Framework for Single-Sided Deafness Studies: A Consensus Paper. Audiol Neurootol, 21(6), A. Aided condi4on vs. Unaided condi4on S N S SN N Head Shadow Effect (db) Squelch Effect (db) Summa4on Effect (db) B. Spa4al Release from Masking S 0 N 0 aided S 0 N SSD aided Speech Percep'on in Noise Sound Localiza'on Tes'ng Localiza4on tes4ng should be conducted: In a sound-treated room With at least 7 loudspeakers Semicircle 90 and 90 azimuth Single noise bursts (1 sec) Spectral roving Loudness roving 1. Impact of hearing loss SSQ 12 ques*onnaire 2. Generic QoL ques4onnaire HUI3 3. Device use 4me Ques'onnaires to inves'gate QoL Ques'onniares Related to Tinnitus

19 Cochlear implanta'on in Unilateral Hearing Loss ü Improved hearing capabili'es - Speech percep4on in noise - Sound localiza4on ü Decreasing the 'nnitus loudness and distress Unilateral hearing loss and incapacita'ng 'nnitus is a new indica'on for CI.

20 Cochlear implanta'on in Unilateral Hearing Loss ü Improved hearing capabili'es - Speech percep4on in noise - Sound localiza4on ü Decreasing the 'nnitus loudness and distress Unilateral hearing loss and incapacita'ng 'nnitus is a new indica'on for CI.

21 Cochlear implanta'on in SSD children? Can we expect the same outcomes in children with acquired SSD? More research is needed: post-op rehabilita4on (adults & children) Tinnitus was major mo4va4on to wear the implant (100% LT use) Use of binaural cues takes 4me Excis'ng s'gma regarding hearing implants CI in SSD is promp4ng the development of fully implantable hearing aids Disadvantages associated with SSD, can be rehabilitated invisibly

22 27-30 June 2018 President: Prof. dr. Van de Heyning Griet_Mertens

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