Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2023
Development of an Optimized Protocol for Cochlear Implant Care to Increase Cochlear Implant Access.
СтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод пока не подготовлен
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Berg Katelyn A, Holder Jourdan T, Gifford René H
Аннотация
OBJECTIVE: To develop an evidence-based protocol for audiology-based, cochlear implant (CI) programming in the first year after activation.
STUDY DESIGN: Retrospective case review.
SETTING: CI program at a tertiary medical center.
PATIENTS: One-hundred seventy-one patients (178 ears; mean age at implantation, 62.3 yr; 44.4% female) implanted between 2016 and 2021 with postlingual onset of deafness and no history of CI revision surgery. Patients included here had confirmed CI programming optimization based on CI-aided thresholds in the 20- to 30-dB-HL range as well as upper stimulation levels guided by electrically evoked stapedial reflex thresholds.
MAIN OUTCOME MEASURES: Consonant-nucleus-consonant monosyllabic word recognition scores in the CI-alone and bilateral best-aided conditions at five time points: preoperative evaluation, and 1, 3, 6, and 12 months after activation.
RESULTS: For both the CI-alone and bilateral best-aided conditions, consonant-nucleus-consonant word recognition significantly improved from preoperative evaluation to all postactivation time points. For the CI-alone condition, no significant differences were observed between 3 and 6 months, or from 6 to 12 months after activation. In contrast, for the bilateral best-aided condition, significant differences were observed between 1 and 3 months, and 3 and 6 months, but no difference in scores between 6 and 12 months.
CONCLUSIONS: Based on the current data set and associated analyses, CI centers programming adult patients could eliminate either the 3- or 6-month visit from their clinical follow-up schedule if patient mapping of lower and upper stimulation levels is validated via CI-aided audiometric thresholds and electrically evoked stapedial reflex thresholds, respectively.
STUDY DESIGN: Retrospective case review.
SETTING: CI program at a tertiary medical center.
PATIENTS: One-hundred seventy-one patients (178 ears; mean age at implantation, 62.3 yr; 44.4% female) implanted between 2016 and 2021 with postlingual onset of deafness and no history of CI revision surgery. Patients included here had confirmed CI programming optimization based on CI-aided thresholds in the 20- to 30-dB-HL range as well as upper stimulation levels guided by electrically evoked stapedial reflex thresholds.
MAIN OUTCOME MEASURES: Consonant-nucleus-consonant monosyllabic word recognition scores in the CI-alone and bilateral best-aided conditions at five time points: preoperative evaluation, and 1, 3, 6, and 12 months after activation.
RESULTS: For both the CI-alone and bilateral best-aided conditions, consonant-nucleus-consonant word recognition significantly improved from preoperative evaluation to all postactivation time points. For the CI-alone condition, no significant differences were observed between 3 and 6 months, or from 6 to 12 months after activation. In contrast, for the bilateral best-aided condition, significant differences were observed between 1 and 3 months, and 3 and 6 months, but no difference in scores between 6 and 12 months.
CONCLUSIONS: Based on the current data set and associated analyses, CI centers programming adult patients could eliminate either the 3- or 6-month visit from their clinical follow-up schedule if patient mapping of lower and upper stimulation levels is validated via CI-aided audiometric thresholds and electrically evoked stapedial reflex thresholds, respectively.