Rosa Perez-Mora

Musical Perception and Enjoyment in Post-Lingual Patients With Cochlear Implants

OBJECTIVES To evaluate music perception and enjoyment following cochlear implantation and its impact on quality of life (QOL). MATERIAL AND METHOD Eighty-eight adult post-lingually deaf cochlear implant users entered the study. The music questionnaire analyzed musical background, listening habits, and quality of musical sound through the cochlear implant. Music perception was evaluated with the Primary Measures of Music Audiation (PMMA). The Glasgow Benefit Inventory evaluated the quality of life (QOL). The music questionnaires, the PMMA and the GBI were completed by 84 %, 74 %, and 82 % of patients, respectively. RESULTS Subjective enjoyment of music and listening habits decreased post-implantation when compared with prior to deafness. Mean scores for music perception were: tone 71 %, rhythm 78 %, timbre 61 %, songs 59 %, and melodies 23 %. The quality of music sound through the cochlear implant was associated with music enjoyment and with QOL. CONCLUSIONS Music enjoyment and perception are possible with a cochlear implant. The quality of music sound through the cochlear implant influences post-operative QOL.

Percepción y disfrute de la música en pacientes poslocutivos con implante coclear

Objetivos Evaluar la percepcion y el disfrute de la musica tras la implantacion coclear y su impacto en la calidad de vida. Material y metodo Participaron en el estudio 88 adultos con sordera poslocutiva y portadores de un implante coclear. El cuestionario de la musica analizo la experiencia musical, los habitos musicales y la calidad del sonido musical a traves del implante coclear. Para estudiar la percepcion de la musica se empleo el PMMA (Primary Measures of Music Audiation). La calidad de vida fue evaluada mediante el GBI (Glasgow Benefit Inventory). El cuestionario de la musica, el PMMA y el GBI fueron contestados por el 84, el 74, y el 82 % de los pacientes, respectivamente. Resultados El disfrute de la musica y los habitos musicales disminuyeron tras el implante coclear cuando se compararon con la situacion previa a la sordera. Los valores medios de percepcion de la musica fueron: tono, el 71 %; ritmo, el 78 %; timbre, el 61 %; canciones, el 59 %, y melodias, el 23 %. La calidad del sonido de la musica a traves del implante coclear se relaciono con el disfrute de la musica y con la calidad de vida. Conclusiones Es posible disfrutar y percibir la musica con un implante coclear. La calidad del sonido de la musica a traves del implante influye en la calidad de vida.

Pros and Cons of Round Window Vibroplasty in Open Cavities: Audiological, Surgical, and Quality of Life Outcomes.

Objective To evaluate the audiological, surgical, quality of life, and quality of sound outcomes in adults with open cavities implanted with the Vibrant Soundbridge (VSB) implant using round window (RW) vibroplasty approach. Study Design Retrospective study. Setting Otolaryngology department, tertiary referral hospital. Subjects and Methods Twelve adult patients with conductive or mixed hearing loss, all with previous middle ear surgery, underwent RW vibroplasty in an open cavity. Compound action potential thresholds were assessed during surgery. Surgical complications were recorded. Subjective benefit was evaluated using the Nijmegen Cochlear Implant Questionnaire (NCIQ), Glasgow Benefit Inventory (GBI), and Hearing Implant Sound Quality Index (HISQUI29) tests. Results Mean follow-up was 42 months (range 12–76). There was no significant change in bone conduction thresholds after surgery. Mean functional gain was 34.3 dB and speech discrimination score at 65 dB significantly improved from 14 to 83%. Extrusion of the wire link was the main surgical complication in four patients. All NCIQ domains improved after surgery. All patients had a positive overall GBI score (mean 35.0). Mean HISQUI29 score was 152.8, on average the quality of sound being defined as “very good.” Conclusion VSB is an effective method of hearing restoration for adults with open cavities suffering from conductive or mixed hearing loss. Intraoperative electrocochleography may be considered of significant help to check the coupling to the inner ear. The high rate of extrusion suggests that middle ear obliteration may be considered in these patients.

Reliability and validity of the Nijmegen Cochlear Implant Questionnaire in Spanish

The Nijmegen Cochlear Implant Questionnaire (NCIQ) is a specific and quantifiable self-assessment health-related quality of life (QoL) questionnaire. It was developed to determine the subjective benefits of a cochlear implant (CI). The present study aimed to determine the validity and reliability of the NCIQ in Spanish. Seventy-six adult, Spanish speaking, CI users and 28 control subjects answered the NCIQ. Reliability of the questionnaire was determined using Cronbach’s α coefficient and the validity established using Pearson’s correlation coefficient. All questionnaire respondents performed significantly better in all sub-domains with a cochlear implant than before cochlear implantation. The Cronbach’s α score exceeded 0.70 in most sub-domains and the total score. The objective measures: bisyllables tested without lip-reading and with masking; and bisyllables, tested without lip-reading and without masking were correlated with the sub-domain ‘advanced sound perception’. To determine health-related QoL the NCIQ in Spanish is a reliable self-assessment questionnaire and a valuable instrument in determining the subjective benefit of a CI.

Osteoblastoma of the Temporal Bone

Benign osteoblastoma is an uncommon primary tumor of the bone. Any area of the skeleton may be affected by this tumor, but its occurrence in the temporal bone and middle ear is extremely rare. Clinical symptoms are nonspecific, even in the middle ear, and the diagnosis is often difficult in spite a complete physical and radiological examination. A biopsy is usually necessary for definitive diagnosis. Because of its potential for recurrence, local invasion, and, rarely, malignant transformation, a complete surgical excision remains the treatment of choice for osteoblastoma. We report a case of benign osteoblastoma involving the temporal bone and the middle ear and a review of the literature.

Calidad de vida de pacientes implantados con el dispositivo BAHA según su indicación

INTRODUCTION AND OBJECTIVES Assess the improvement of quality of life in osseointegrated implanted patients, taking into account the indication as well as the use of the implant, and the presence of pre- and postoperative tinnitus. METHODS Sixty-nine patients implanted between June 2004 and November 2010 were included. The average age of the patients was 40 years. The instruments used to quantify the change in quality of life were the Glasgow Benefit Inventory and a questionnaire including open questions, bone anchored hearing aid (BAHA) use, change in tinnitus and postoperative pain. RESULTS The average total benefit score with the Glasgow Benefit Inventory was 38, and the general, social, and physical scores were 51, 15 and 7, respectively. There was no significant association between sex, age and bilaterality or unilaterality of the process with quality of life. Nevertheless, there were significantly better results in patients with conductive hearing loss than in those with unilateral deafness, the results were positive although in both groups. The tinnitus rate went from 37.5 to 20.8% following BAHA, with this difference being significant. CONCLUSIONS Our results show that the use of BAHA is associated with a great improvement in quality of life for patients with conductive hearing loss, whereas indications in unilateral deafness have to be individually studied. Moreover, the study shows that BAHA has a positive effect upon tinnitus.

Benefits from a mobile telephone adapter in Combi40+ cochlear implant users.

Conclusions. Telephone adapters can help cochlear implanted patients to enhance their telephonic conversations. However, these devices should be further developed to be useful for daily life. Objectives. To test a mobile telephone adapter to improve speech discrimination by mobile telephone in Combi40+ users. To evaluate the influence of the mobile telephone in communication. Subjects and methods. Seventeen Combi40+ implantees were tested with bisyllabic words presented through mobile telephones with and without a telephone adapter in quiet and noisy environments. Speech audiometries in open field were obtained for every patient. Results. Mean speech discrimination without the adapter in a quiet environment was 51.2%. In a noisy environment, mean discrimination increased significantly with the adapter from 30.3% to 42.9%. No statistically significant difference was found between speech discrimination in the quiet environment without the adapter and speech discrimination in the noisy environment with the adapter. When comparing speech discrimination in open field without lip-reading with equivalent telephonic conditions a statistically significant difference was found in favour of the open field.

Which ear should we choose for cochlear implantation in the elderly: The poorer or the better? Audiometric outcomes, quality of sound, and quality-of-life results

Abstract Conclusions: Cochlear implantation in the poorer ear of an elderly patient does not predict poorer post-operative audiological, quality-of-life (QoL), and quality of sound results. Objectives: To determine whether choosing the ‘better’ or the ‘poorer’ ear for cochlear implantation impacts performance outcome in an elderly population. Methods: Forty-two out of 73 elderly (≥ 60 years) cochlear implant users with some residual hearing in at least one ear were selected. Three criteria were used to group the patients as ‘better’ or ‘poorer’ ear implanted; (C1) based on previous use of hearing aid, (C2) pre-operative PTA, and (C3) pre-operative speech discrimination. The Glasgow Benefit Inventory (GBI) and the Hearing Implant Sound Quality Index (HISQUI) were used to measure QoL and quality of sound, respectively. Results: The mean post-operative PTA was 38.7 ± 7.2 dBHL. In quiet, the mean disyllabic SDS at 65dBSPL was 75.4 ± 18.5, whereas the discrimination of sentences was 95.0% ± 6.9. The mean total GBI score was 30.9 ± 21.8, 92.9% of patients reporting a positive score. The mean HISQUI score was 111.3 ± 36.0, which corresponds to ‘moderate’ sound quality. No significant differences were found between both groups in terms of audiological outcomes, HISQUI scores or GBI scores when considering each of the three criteria.

Validation of the Hearing Implant Sound Quality Index (HISQUI19) to assess Spanish-speaking cochlear implant users’ auditory abilities in everyday communication situations

Abstract Conclusion: The Spanish-language HISQUI19 is a reliable and easy-to-use tool for quantifying the self-perceived level of auditory benefit that cochlear implant (CI) users experience in everyday listening situations. Objectives: To validate the Spanish-language version of The Hearing Implant Sound Quality Index (HISQUI19), a questionnaire for quantifying the self-perceived level of auditory benefit that CI users experience in everyday listening situations. Methods: Adult Spanish-speaking subjects with a CI were asked to complete a Spanish-language version of the HISQUI19. Reliability of the questionnaire was determined using Cronbach’s α coefficient; exploratory factor analyses with a rotated (varimax) factor solution was applied to check construct validity; external validity was confirmed using Pearson’s correlation. Test–re-test analysis was also performed. The MED-EL Assessment Database was used to assist in the administration, reporting, and data collection. Results: Sixty-six of 77 subjects completed and returned the HISQUI19. The mean score auditory ability score (mean ± standard deviation) of the HISQUI19 was 79.9 ± 24.0, a ‘moderate’ auditory benefit. An inverse relationship was found between the HISQUI19 score and age at implantation. Gender and side of implantation did not influence self-perceived functioning. The objective measures (disyllables tested without lip-reading and in quiet) were correlated with the Total Score.

Is There an Age Limit for Cochlear Impantation

Objective: Evaluate quality of life following cochlear implantation in older postlocutive adults. Method: Postlingually deaf adults 60 years or older who underwent implantation in 3 institutions were included. Data concerning demographics and audiometric evaluation were collected and studied. Patients were divided in 2 groups (< 70 and ≥ 70 years). GBI was used to quantify quality of life. Results: Eighty-one patients were included. The mean age at implantation was 68 years (range, 60-82 years). A significant improvement in speech recognition after cochlear implantation was observed (P < .01). The results of the GBI questionnaire showed an important benefit on the total scale (mean, 40) and on the 3 different subscales (53, 24, and 4, respectively). These results were similar to those of younger postlocutive candidates. However, particular cases with decreased quality of life were identified, in spite of acceptable audiologic results. The difference between the <70 and ≥70 years groups was not significant. Conclusion: Elderly CI users improve their quality of life, with similar outcomes to those achieved by younger adults. Because of particular conditions of this population, care must be taken when indicating a CI. Cochlear implantation should not be denied on the basis of age alone.