Temporal coding and music perception in bimodal listeners

Objective: Limited low frequency (LF) pitch and temporal fine structure (TFS) sensitivity have been thought to contribute significantly to poor music perception in cochlear implant (CI) lis- teners. Thus, this study aimed to evaluate music perception in relation to LF pitch perception and temporal coding, specifically in people with bimodal stimulation as a promising approach to improve spectro-temporal sensitivity in CI listeners. Methods: Eleven postlingually deafened bimodal listeners participated in the study (mean age = 55.5 years, range 36–75 years, SD = 11.7). LF pitch/TFS sensitivity was evaluated by using two recently developed tests: Harmonic Intonation (HI) and Disharmonic Intonation (DI). The music perception protocol was based on three audio files in the genres of Classical, Jazz and Soul music and a music quality questionnaire regarding four subjective aspects: Clarity, Pleasantness, Naturalness and General Quality of Sounds. Results: CI alone and bimodal findings showed statistically significant differences for both temporal coding and music perception. DI findings showed statistically significant correlations with music quality ratings (p < 0.05). Conclusion: Bimodal music quality ratings were significantly better, indicating a significant improvement in the quality of music towards being significantly more clear, more natural, more pleasant, and better quality. Similarly, bimodal HI/DI findings improved significantly, although the amount of benefit was greater for the DI task with spectral information only below 300 Hz. Significant DI correlations with music quality ratings supported the test to be more indicative of better temporal coding of LF residual hearing and its effects on music perception

On the Effectiveness of Interventions in Hearing-impaired Elders: A Review of Findings for Psychosocial Wellness and Quality of Life

Objectives: Hearing loss has been the most common sensory impairment and one of the most challenging disabilities in the elderly population, with a multitude of consequences for quality of life and psychosocial well-being. The present work was a narrative review on the effectiveness of communicative/psychosocial interventions that were designed for the elderly with hearing impairment. Methods: A search of academic database identified relevant articles based upon seven search facets (“quality of life”, “psychological”, “psychosocial wellbeing”, “hearing impaired”, “deaf”, “elderly”) up to November 2019. Inclusion criteria concerned the combined following terms: “quality of life”, “psychological” and “psychosocial wellbeing”, with the terms “hearing impaired” “deaf”, “elderly” and “interventions” and their possible variations. Results: Only 9 out of 950 identified studies explicitly focused on the psychosocial wellness and/or quality of life. Outcomes were sometimes contradictory in terms of the efficacy in quality of life and psychological wellbeing improvements. Conclusion: Findings were promising in terms of quality-of-life improvement but did not allow for definitive conclusions, since study populations were heterogeneous and primary outcome measures did not always focus on deafness. Future research is needed to define effective protocols and evaluation measures that will be able to enlighten benefits in terms of psychosocial wellness and quality of life in hearing impaired elderly population

Long-term speech perception and morphosyntactic outcomes in adolescents and young adults implanted in childhood

Background: Long-term assessments of children with cochlear implants (CI) are important inputs to help guide families and professionals in therapeutic and counselling processes. Based on these premises, the primary aim of the present study was to assess the long-term speech and language outcomes in a sample of prelingually deaf or hard of hearing (DHH) adolescents and young adults with unilateral or bilateral implantation in childhood. The secondary aim was to investigate the correlations of age at implantation with long-term speech and language outcomes. Materials and Methods: Retrospective observational study on 54 long-term CI users, 33 unilateral and 21 bilateral (mean age at CI surgery 38.1 ± 24.6 months; mean age at last follow-up assessment 19.1 ± 4.3 years of age and mean follow-up time 16 ± 3.7 years). Means and standards were used to describe speech perception (in quiet, in fixed noise and in adaptive noise using It-Matrix) and morphosyntactic comprehension (TROG-2) outcomes. A univariate analysis was used to evaluate outcome differences between unilateral and bilateral patients. Bivariate analysis was performed to investigate the relationships between age at CI, audiological variables, and language outcomes. Finally, multivariate analysis was performed to quantify the relationship between It-Matrix, sentence recognition in quiet and at SNR+10 and TROG-2. Results: The participants showed good speech recognition performance in quiet (94% for words and 89% for sentences) whilst their speech-in-noise scores decreased significantly. For the It- Matrix, only 9.2% of the participants showed scores within the normative range. This value was 60% for TROG-2 performance. For both auditory and language skills, group differences for unilateral versus bilateral CI users were not statistically significant (p >0.05). Bivariate analysis showed that age at CI correlated significantly with overall results at TROG-2 (r = -0.6; p <0.001) and with It-Matrix (r =0.5; p <0.001). TROG-2 was negatively correlated with results for It-Matrix (r = -0.5; p <0.001). In the multivariate analysis with It-Matrix as a dependent variable, the model explained 63% of the variance, of which 60% was related to sentence recognition and 3% to morphosyntax. Conclusions: These data contribute to the definition of average long-term outcomes expected in subjects implanted during childhood whilst increasing our knowledge of the effects of variables such as age at CI and morphosyntactic comprehension on speech perception. Although the majority of this prelingually DHH cohort did not achieve scores within a normative range, remarkably better It-Matrix scores were observed when compared to those from postlingually deafened adult CI users

Cochlear implant and tinnitus: a narrative literature review and evidence for clinical use

INTRODUCTION: Tinnitus is one of the major complaints in patients with bilateral hearing loss or single-sided deafness (SSD). Several studies describe that cochlear implantation may play a role in tinnitus suppression. Results in the literature are heterogeneous for the role and level of success that Cochlear Implants (CI) plays in tinnitus suppression. The purpose of this review is to summarize all of the significant evidence and outcomes documented as to CI effects on tinnitus perception in unilateral/bilateral CI users and SSD patients, as well as to report on tinnitus findings and fitting strategies currently used to optimize the results for supporting a clear counselling process. EVIDENCE ACQUISITION: A comprehensive literature search was undertaken using the following databases: PubMed, Embase, Cochrane Library, Scopus, CINAHL and Web of Science. Included articles are published through to November 2022 and referenced by relevant literature. The eligible studies and data results were summarized in this narrative review. EVIDENCE SYNTHESIS: The review was organized to deliver a summary of: CI pathophysiologic mechanisms and prognostic factors in- volved in tinnitus suppression; CI outcomes for both unilateral and bilateral implantation in bilateral symmetrical hearing loss, as well as in asymmetrical hearing loss and in SSD patients; the relevant findings concerning CI fitting in managing tinnitus suppression. Finally, the effects of CI on quality of life and psychological status of patients with tinnitus were addressed. CONCLUSIONS: The present review is a targeted contribution to support clinical procedures regarding the applicability and the outcomes of CI in tinnitus treatment. Further studies and specific guidelines are needed to broaden knowledge and understanding in this specific research field

Low-frequency pitch perception in children with cochlear implants in comparison to normal hearing peers

The aim of the present study was to investigate the application of two new pitch perception tests in children with cochlear implants (CI) and to compare CI outcomes to normal hearing (NH) children, as well as investigating the effect of chronological age on performance. The tests were believed to be linked to the availability of Temporal Fine Structure (TFS) cues. 20 profoundly deaf children with CI (5-17 years) and 31 NH peers participated in the study. Harmonic Intonation (HI) and Disharmonic Intonation (DI) tests were used to measure low-frequency pitch perception. HI/DI outcomes were found poorer in children with CI. CI and NH groups showed a statistically significant difference (p < 0.001). HI scores were better than those of DI test (p < 0.001). Chronological age had a significant effect on DI performance in NH group (p < 0.05); children under the age of 8.5 years showed larger inter-subject-variability; however, the majority of NH children showed outcomes that were considered normal at adult-level. For the DI test, bimodal listeners had better performance than when listening with CI alone. HI/DI tests were applicable as clinical tools in the pediatric population. The majority of CI users showed abnormal outcomes on both tests confirming poor TFS processing in the hearing-impaired population. Findings indicated that the DI test provided more differential low-frequency pitch perception outcomes in that it reflected phase locking and TFS processing capacities of the ear, whereas HI test provided information of its place coding capacity as well