RESUMEN
Speech perception test results were obtained from a group of 40 pediatric cochlear implant users. Half of the children participated in oral-only habilitation programs, which included both traditional oral and auditory-verbal approaches, and half participated in programs that used a combination of oral and manual communication referred to as total communication (TC). Analysis of the scores showed that children enrolled in oral-only habilitation programs scored significantly higher on the speech perception measures than did children who were enrolled in total communication based programs. These results were inconsistent with those of other reports, which suggested that communication methods had little effect on implant outcomes. To further examine the reasons for the differences in performance, we analyzed 7 additional factors, including length of implant use, age at surgery, device type, socioeconomic status, bilingualism, school setting, and participation in private therapy, which may affect implant performance. Multiple-regression analysis again showed communication mode to be the factor most highly correlated with speech perception abilities among this group of children.
Asunto(s)
Implantes Cocleares , Percepción del Habla , Adolescente , Factores de Edad , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Masculino , Factores Socioeconómicos , Factores de TiempoRESUMEN
This article presents case studies in which single-channel mapping was used with patients who were experiencing discomfort while using their cochlear implant devices. Repeated psychophysical testing together with integrity testing had failed to locate the source of the problem in each of the described cases. Single-channel mapping was then used as another means of device troubleshooting. Single-channel maps were created for each electrode across the array. In each case, the patient was able to identify the offending electrode(s) during the presentation of speech stimuli, whereas the problem had not been evident during psychophysical testing with pulse stimuli. Eliminating these electrodes from the map alleviated the problems experienced by these implant users in each case.
Asunto(s)
Implantación Coclear , Sordera/cirugía , Adulto , Estimulación Eléctrica/instrumentación , Electrodos , Femenino , Humanos , Percepción Sonora , Falla de PrótesisRESUMEN
Programming of multichannel cochlear implants (CIs) requires subjective responses to a series of sophisticated psychophysical percepts. It is often difficult for young prelinguistically deaf children to provide adequate responses for device fitting. This is especially true in setting levels of maximum comfortable loudness, whereby failure to indicate growth of loudness may result in elevation of stimulus levels to the threshold of pain. The acoustic or stapedial muscle reflex has been used previously to provide objective confirmation of acoustic stimulation, and there have been attempts to use the reflex in hearing aid fitting. It has also been suggested that electrically elicited middle ear muscle reflexes (eMEMR) may have applicability in confirming and quantifying electrical stimulation through a CI. To assess the relationship between eMEMR characteristics and levels of loudness perception with CIs, determine reliability of the response, and investigate potential use of eMEMR in CI programming, 25 postlinguistically deafened adult CI users were evaluated. Reflexes have also been attempted on 40 children, with responses present in 31 (71%). Comfort levels predicted by eMEMR were highly correlated with those obtained through subjective judgments in the adult subjects. The eMEMR provides an objective, accurate, and rapid method of estimating maximum comfortable loudness levels, which may be useful in the initial programming of young implant recipients.