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      Cochlear implant in prelingually hearing-impaired adults: prognostic factors and results Translated title: L’impianto cocleare nei pazienti adulti con sordità prelinguale: fattori prognostici e risultati

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          SUMMARY

          Objectives

          The aim of present study is to evaluate the impact of prognostic factors on the outcome in a group of prelingually hearing-impaired patients submitted to cochlear implantation (CI) at an adult age.

          Methods

          This is a retrospective study on a cohort of prelingually severe-to-profound hearing-impaired patients cochlear implanted in adulthood and followed by a single audiology centre. We correlated post-CI results in term of speech perception with patients’ speech perception with hearing aids before implantation, history of progression of hearing loss (HL), and levels of education and cognition. The study group was composed of 49 patients.

          Results

          Post-CI open-set recognition score in silence and noise was significantly correlated with pre-CI open-set recognition score in silence and with background noise. Patients with a history of progression of HL gained significantly better results. Furthermore, we found higher improvements in patients with a higher level of education.

          Conclusions

          Prelingually deafened patients implanted in adulthood achieved satisfactory results. Significantly better results were achieved by patients with better pre-operative speech perception scores, progressive HL and higher level of education.

          RIASSUNTO

          Obiettivo

          L’obiettivo di questo studio è valutare l’impatto di alcuni fattori prognostici sui risultati post impianto cocleare in un gruppo di pazienti affetti da sordità prelinguale sottoposti ad impianto cocleare (IC) in età adulta.

          Metodi

          È stato fatto uno studio retrospettivo su una coorte di pazienti con sordità prelinguale sottoposti a IC e seguiti da un unico centro impianti cocleari, andando ad analizzare i risultati post-impianto in termini di percezione verbale e correlando questi risultati alle capacità di discriminazione verbale pre-impianto, la presenza di una sordità prelinguale ma ad andamento progressivo, i livelli cognitivi e di istruzione.

          Risultati

          I risultati percettivi post-IC sono stati significativamente correlati con le capacità di percezione verbale pre-IC; inoltre, migliori risultati sono stati ottenuti dai pazienti con una storia di sordità progressiva. Infine, un miglioramento significativamente più cospicuo si è verificato nei pazienti più scolarizzati.

          Conclusioni

          I pazienti con sordità prelinguale impiantati in età adulta possono raggiungere buoni risultati in termine di percezione verbale. Migliori risultati sono ottenibili nei pazienti con storia di progressione della sordità, buone abilità percettive pre-IC, buon livello di scolarizzazione.

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          Most cited references26

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          Neuronal Development of Hearing and Language: Cochlear Implants and Critical Periods

          The modern cochlear implant (CI) is the most successful neural prosthesis developed to date. CIs provide hearing to the profoundly hearing impaired and allow the acquisition of spoken language in children born deaf. Results from studies enabled by the CI have provided new insights into (a) minimal representations at the periphery for speech reception, (b) brain mechanisms for decoding speech presented in quiet and in acoustically adverse conditions, (c) the developmental neuroscience of language and hearing, and (d) the mechanisms and time courses of intramodal and cross-modal plasticity. Additionally, the results have underscored the interconnectedness of brain functions and the importance of top-down processes in perception and learning. The findings are described in this review with emphasis on the developing brain and the acquisition of hearing and spoken language.
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            Cognitive Functions in Adults Receiving Cochlear Implants: Predictors of Speech Recognition and Changes After Implantation

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              Speech Recognition in Adults With Cochlear Implants: The Effects of Working Memory, Phonological Sensitivity, and Aging

              Purpose Models of speech recognition suggest that “top-down” linguistic and cognitive functions, such as use of phonotactic constraints and working memory, facilitate recognition under conditions of degradation, such as in noise. The question addressed in this study was what happens to these functions when a listener who has experienced years of hearing loss obtains a cochlear implant. Method Thirty adults with cochlear implants and 30 age-matched controls with age-normal hearing underwent testing of verbal working memory using digit span and serial recall of words. Phonological capacities were assessed using a lexical decision task and nonword repetition. Recognition of words in sentences in speech-shaped noise was measured. Results Implant users had only slightly poorer working memory accuracy than did controls and only on serial recall of words; however, phonological sensitivity was highly impaired. Working memory did not facilitate speech recognition in noise for either group. Phonological sensitivity predicted sentence recognition for implant users but not for listeners with normal hearing. Conclusion Clinical speech recognition outcomes for adult implant users relate to the ability of these users to process phonological information. Results suggest that phonological capacities may serve as potential clinical targets through rehabilitative training. Such novel interventions may be particularly helpful for older adult implant users.
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                Author and article information

                Journal
                Acta Otorhinolaryngol Ital
                Acta Otorhinolaryngol Ital
                AOI
                Acta Otorhinolaryngologica Italica
                Pacini Editore Srl
                0392-100X
                1827-675X
                14 May 2021
                April 2021
                : 41
                : 2
                : 173-179
                Affiliations
                [1 ] Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa , Pisa, Italy
                [2 ] Section of Statistics, University Hospital of Pisa , Italy
                [3 ] Department of Clinical Science, Intervention and Technology, Karolinska Institutet , Stockholm, Sweden
                Author notes
                Correspondence Francesca Forli ENT Audiology and Phoniatrics Unit, Pisa University Hospital, via Paradisa 2, 56120 Pisa, Italy E-mail: francesca.forli@ 123456gmail.com

                Funding

                None.

                Conflict of interest

                The Authors declare no conflict of interest.

                Article
                10.14639/0392-100X-N1146
                8142735
                34028463
                d9bb5804-4a72-4b9b-8311-7f944577c537
                Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy

                This is an open access article distributed in accordance with the CC-BY-NC-ND (Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International) license. The article can be used by giving appropriate credit and mentioning the license, but only for non-commercial purposes and only in the original version. For further information: https://creativecommons.org/licenses/by-nc-nd/4.0/deed.en

                History
                : 29 September 2020
                : 27 November 2020
                Page count
                Figures: 4, Tables: 1, Equations: 0, References: 26, Pages: 7
                Categories
                Audiology

                Otolaryngology
                prelingual deafness,cochlear implant,cognitive aspects,speech perception,educational achievement,sordità prelinguale,impianto cocleare,aspetti cognitivi,percezione verbale,livelli educativi

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