Design and Testing of a Bending-Resistant Transparent Nanocoating for Optoacoustic Cochlear Implants.
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ABSTRACT:
SUBMITTER: Griffo A
PROVIDER: S-EPMC6682933 | biostudies-literature | 2019 Aug
REPOSITORIES: biostudies-literature
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Design and Testing of a Bending-Resistant Transparent Nanocoating for Optoacoustic Cochlear Implants.
Griffo Alessandra A Liu Yingying Y Mahlberg Riitta R Alakomi Hanna-L HL Johansson Leena-S LS Milani Roberto R
ChemistryOpen 20190806 8
A nanosized coating was designed to reduce fouling on the surface of a new type of cochlear implant relying on optoacoustic stimulation. This kind of device imposes novel design principles for antifouling coatings, such as optical transparency and resistance to significant constant bending. To reach this goal we deposited on poly(dimethylsiloxane) a PEO-based layer with negligible thickness compared to the curvature radius of the cochlea. Its antifouling performance was monitored upon storage by ...[more]
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Project description:ObjectivesPrevious research has demonstrated the feasibility of programming cochlear implants (CIs) via telepractice. To effectively use telepractice in a comprehensive manner, all components of a clinical CI visit should be validated using remote technology. Speech-perception testing is important for monitoring outcomes with a CI, but it has yet to be validated for remote service delivery. The objective of this study, therefore, was to evaluate the feasibility of using direct audio input (DAI) as an alternative to traditional sound-booth speech-perception testing for serving people with CIs via telepractice. Specifically, our goal was to determine whether there was a significant difference in speech-perception scores between the remote DAI (telepractice) and the traditional (in-person) sound-booth conditions.DesignThis study used a prospective, split-half-design to test speech perception in the remote DAI and in-person sound-booth conditions. Thirty-two adults and older children with CIs participated; all had a minimum of 6 months of experience with their device. Speech-perception tests included the consonant-nucleus-consonant (CNC) words, Hearing-in-Noise test (HINT) sentences, and Arizona Biomedical Institute at Arizona State University (AzBio) sentences. All three tests were administered at levels of 50 and 60 dBA in quiet. Sentence stimuli were also presented in 4-talker babble at signal to noise ratios (SNRs) of +10 and +5 dB for both the 50- and 60-dBA presentation levels. A repeated-measures analysis of variance was used to assess the effects of location (remote, in person), stimulus level (50, 60 dBA), and SNR (if applicable; quiet, +10, +5 dB) on each outcome measure (CNC, HINT, AzBio).ResultsThe results showed no significant effect of location for any of the tests administered (p > 0.1). There was no significant effect of presentation level for CNC words or phonemes (p > 0.2). There was, however, a significant effect of level (p < 0.001) for both HINT and AzBio sentences, but the direction of the effect was opposite of what was expected-scores were poorer for 60 dBA than for 50 dBA. For both sentence tests, there was a significant effect of SNR, with poorer performance for worsening SNRs, as expected.ConclusionsThe present study demonstrated that speech-perception testing via telepractice is feasible using DAI. There was no significant difference in scores between the remote and in-person conditions, which suggests that DAI testing can be used as a valid alternative to standard sound-booth testing. The primary limitation is that the calibration tools are presently not commercially available.
| S-EPMC9165643 | biostudies-literature
Project description:Despite the growing use of cochlear implants in deaf patients, there is a lack of data on their knowledge, attitude, and practice (KAP) toward cochlear implants. This study aimed to investigate the KAP toward cochlear implants among deaf patients who received cochlear implants. A web-based cross-sectional study was conducted between August 2022 and December 2022 among deaf patients who had received cochlear implants. A self-administered questionnaire was used to collect demographic characteristics and KAP scores. A total of 526 participants were enrolled; 54.18% were female, 65.40% were above 60 years old, and 61.03% were surveyed at less than 3 years after implantation. The mean knowledge, attitude, and practice scores were 8.15 ± 2.18 (possible range: 0-10), 43.63 ± 6.98 (possible range: 12-60), and 41.11 ± 7.42 (possible range: 11-55), respectively, indicating good knowledge, moderate attitude and practice. Multivariable logistic regression analysis showed that attitude [odd ratio (OR) = 1.24, 95% confidence interval (CI) 1.18-1.29, P < 0.001] and unemployment (OR = 0.33, 95% CI 0.17-0.63, P = 0.001) were independently associated with practice. Path analysis showed that knowledge directly influenced attitude (β = 0.93, 95% CI 0.61-1.19, P < 0.001), attitude directly influenced practice (β = 0.53, 95% CI 0.46-0.61, P < 0.001), and knowledge directly (β = 0.77, 95% CI 0.53-1.01, P < 0.001) and indirectly (β = 0.50, 95% CI 0.34-0.66, P < 0.001) influenced practice. Deaf patients who received cochlear implants showed good knowledge, moderate attitude and practice toward cochlear implants. Knowledge should be strengthened to improve attitude and practice toward cochlear implants, which could translate into realistic expectations toward cochlear implants devices and proper care and maintenance.
| S-EPMC10891060 | biostudies-literature
Project description:A modified version of the child's Montreal Battery of Evaluation of Amusia (cMBEA) was used to assess music perception in children using bilateral cochlear implants. Our overall aim was to promote better performance by children with CIs on the cMBEA by modifying the complement of instruments used in the test and adding pieces transposed in frequency. The 10 test trials played by piano were removed and two high and two low frequency trials added to each of five subtests (20 additional). The modified cMBEA was completed by 14 children using bilateral cochlear implants and 23 peers with normal hearing. Results were compared with performance on the original version of the cMBEA previously reported in groups of similar aged children: 2 groups with normal hearing (n = 23: Hopyan et al., 2012; n = 16: Polonenko et al., 2017), 1 group using bilateral cochlear implants (CIs) (n = 26: Polonenko et al., 2017), 1 group using bimodal (hearing aid and CI) devices (n = 8: Polonenko et al., 2017), and 1 group using unilateral CI (n = 23: Hopyan et al., 2012). Children with normal hearing had high scores on the modified version of the cMBEA and there were no significant score differences from children with normal hearing who completed the original cMBEA. Children with CIs showed no significant improvement in scores on the modified cMBEA compared to peers with CIs who completed the original version of the test. The group with bilateral CIs who completed the modified cMBEA showed a trend toward better abilities to remember music compared to children listening through a unilateral CI but effects were smaller than in previous cohorts of children with bilateral CIs and bimodal devices who completed the original cMBEA. Results confirmed that musical perception changes with the type of instrument and is better for music transposed to higher rather than lower frequencies for children with normal hearing but not for children using bilateral CIs. Overall, the modified version of the cMBEA revealed that modifications to music do not overcome the limitations of the CI to improve music perception for children.
| S-EPMC6985588 | biostudies-literature
Project description:Direct stimulation of the auditory nerve via a Cochlear Implant (CI) enables profoundly hearing-impaired people to perceive sounds. Many CI users find language comprehension satisfactory, but music perception is generally considered difficult. However, music contains different dimensions which might be accessible in different ways. We aimed to highlight three main dimensions of music processing in CI users which rely on different processing mechanisms: (1) musical discrimination abilities, (2) access to meaning in music, and (3) subjective music appreciation. All three dimensions were investigated in two CI user groups (post- and prelingually deafened CI users, all implanted as adults) and a matched normal hearing control group. The meaning of music was studied by using event-related potentials (with the N400 component as marker) during a music-word priming task while music appreciation was gathered by a questionnaire. The results reveal a double dissociation between the three dimensions of music processing. Despite impaired discrimination abilities of both CI user groups compared to the control group, appreciation was reduced only in postlingual CI users. While musical meaning processing was restorable in postlingual CI users, as shown by a N400 effect, data of prelingual CI users lack the N400 effect and indicate previous dysfunctional concept building.
| S-EPMC4997320 | biostudies-literature
Project description:ObjectiveTo investigate the value of scalp surface potentials to identify and manage partial short circuits to ground in cochlear implant electrodes.DesignA retrospective review of patients with suspected partial short circuits.Main outcome measureElectrical output of individual electrodes was measured using scalp surface potentials for patients reporting a change in hearing function. Electrical output was compared to functional performance and impedance measurements to determine if devices with suspected partial short circuits were experiencing a decrease in performance as a result of reduced electrical output. Electrical output was checked in an artificial cochlea for two implants following explant surgery to confirm scalp surface potential results.ResultsAll patients with suspected partial short circuits (n = 49) had reduced electrical output, a drop in impedances to approximately ½ of previously stable measurements or to below 2 kΩ, an atypical electrical field measurement (EFI) and a decline in hearing function. Only devices with an atypical EFI showed reduced electrical output. Results of scalp based surface potentials could be replicated in an artificial cochlea following explantation of the device. All explant reports received to date (n = 42) have confirmed partial short circuits, with an additional four devices failing integrity tests.ConclusionSurface potential measurements can detect partial shorts and had 100% correlation with atypical EFI measurements, which are characteristic of a partial short to ground in this device. Surface potentials can help determine the degree to which the electrode array is affected, particularly when behavioural testing is limited or not possible.
| S-EPMC9804715 | biostudies-literature
Project description:Optical stimulation of the cochlea with laser light has been suggested as an alternative to conventional treatment of sensorineural hearing loss with cochlear implants. The underlying mechanisms are controversially discussed: The stimulation can either be based on a direct excitation of neurons, or it is a result of an optoacoustic pressure wave acting on the basilar membrane. Animal studies comparing the intra-cochlear optical stimulation of hearing and deafened guinea pigs have indicated that the stimulation requires intact hair cells. Therefore, optoacoustic stimulation seems to be the underlying mechanism. The present study investigates optoacoustic characteristics using pulsed laser stimulation for in vivo experiments on hearing guinea pigs and pressure measurements in water. As a result, in vivo as well as pressure measurements showed corresponding signal shapes. The amplitude of the signal for both measurements depended on the absorption coefficient and on the maximum of the first time-derivative of laser pulse power (velocity of heat deposition). In conclusion, the pressure measurements directly demonstrated that laser light generates acoustic waves, with amplitudes suitable for stimulating the (partially) intact cochlea. These findings corroborate optoacoustic as the basic mechanism of optical intra-cochlear stimulation.
| S-EPMC4908384 | biostudies-literature
Project description:IntroductionMost cochlear implants are currently compatible with magnetic resonance imaging (MRI) up to 3 T. Nevertheless, this does not completely eliminate the risk of serious accidents. Implant displacements and other adverse events with compatible implants have been reported in the literature.Case reportsAmong the six patients who had MRI after receiving implants at our center, we report three cases with adverse events related to the examination. The first case was complicated by magnet displacement with partial demagnetization. The second case showed total demagnetization, which necessitated removal and reimplantation of the implant. The third case involved severe pain sensation which disrupted the MRI scan. The smallest artifact was found with 3D MRI angiography, and largest artifact was found with diffusion and T2 FLASH.DiscussionMoving the patient into the MRI apparatus must be supervised by an otorhinolaryngology specialist or an experienced radiologist. It is important to consider the magnetic field directions, so that angle between the implant magnetic fields and the MRI B0 always remains less than or equal to 90°. In addition, we recommend the use of an "arrow drawing" to facilitate the orientation of the magnetic field directions. Furthermore, to prevent magnet displacement, we recommend systematic use of a protective splint in addition to bandaging.
| S-EPMC6424707 | biostudies-literature
Project description:ObjectiveA key ingredient to academic success is being able to read. Deaf individuals have historically failed to develop literacy skills comparable with those of their normal-hearing (NH) peers, but early identification and cochlear implants (CIs) have improved prospects such that these children can learn to read at the levels of their peers. The goal of this study was to examine early, or emergent, literacy in these children.MethodTwenty-seven deaf children with CIs, who had just completed kindergarten were tested on emergent literacy, and on cognitive and linguistic skills that support emergent literacy, specifically ones involving phonological awareness, executive functioning, and oral language. Seventeen kindergartners with NH and eight with hearing loss, but who used hearing aids served as controls. Outcomes were compared for these three groups of children, regression analyses were performed to see whether predictor variables for emergent literacy differed for children with NH and those with CIs, and factors related to the early treatment of hearing loss and prosthesis configuration were examined for children with CIs.ResultsThe performance of children with CIs was roughly 1 SD or more below the mean performance of children with NH on all tasks, except for syllable counting, reading fluency, and rapid serial naming. Oral language skills explained more variance in emergent literacy for children with CIs than for children with NH. Age of first implant explained moderate amounts of variance for several measures. Having one or two CIs had no effect, but children who had some amount of bimodal experience outperformed children who had none on several measures.ConclusionsEven deaf children who have benefitted from early identification, intervention, and implantation are still at risk for problems with emergent literacy that could affect their academic success. This finding means that intensive language support needs to continue through at least the early elementary grades. Also, a period of bimodal stimulation during the preschool years can help boost emergent literacy skills to some extent.
| S-EPMC3419773 | biostudies-literature
Project description:ImportanceChildren who receive a cochlear implant (CI) for early severe to profound sensorineural hearing loss may achieve age-appropriate spoken language skills not possible before implantation. Despite these advances, reduced access to auditory experience may have downstream effects on fundamental neurocognitive processes for some children with CIs.ObjectiveTo determine the relative risk (RR) of clinically significant executive functioning deficits in children with CIs compared with children with normal hearing (NH).Design, setting, and participantsIn this prospective, cross-sectional study, 73 children at a hospital-based clinic who received their CIs before 7 years of age and 78 children with NH, with average to above average mean nonverbal IQ scores, were recruited in 2 age groups: preschool age (age range, 3-5 years) and school age (age range, 7-17 years). No children presented with other developmental, cognitive, or neurologic diagnoses.InterventionsParent-reported checklist measures of executive functioning were completed during psychological testing sessions.Main outcomes and measuresEstimates of the RR of clinically significant deficits in executive functioning (≥1 SDs above the mean) for children with CIs compared with children with NH were obtained based on 2 parent-reported child behavior checklists of everyday problems with executive functioning.ResultsIn most domains of executive functioning, children with CIs were at 2 to 5 times greater risk of clinically significant deficits compared with children with NH. The RRs for preschoolers and school-aged children, respectively, were greatest in the areas of comprehension and conceptual learning (RR [95% CI], 3.56 [1.71-7.43] and 6.25 [2.64-14.77]), factual memory ( 4.88 [1.58-15.07] and 5.47 [2.03-14.77]), attention (3.38 [1.03-11.04] and 3.13 [1.56-6.26]), sequential processing (11.25 [1.55-81.54] and 2.44 [1.24-4.76]), working memory (4.13 [1.30-13.06] and 3.64 [1.61-8.25] for one checklist and 1.77 [0.82-3.83] and 2.78 [1.18-6.51] for another checklist), and novel problem-solving (3.93 [1.50-10.34] and 3.13 [1.46-6.67]). No difference between the CI and NH samples was found for visual-spatial organization (2.63 [0.76-9.03] and 1.04 [0.45-2.40] on one checklist and 2.86 [0.98-8.39] for school-aged children on the other checklist).Conclusions and relevanceA large proportion of children with CIs are at risk for clinically significant deficits across multiple domains of executive functioning, a rate averaging 2 to 5 times that of children with NH for most domains. Screening for risk of executive functioning deficits should be a routine part of the clinical evaluation of all children with deafness and CIs.
| S-EPMC5701781 | biostudies-literature
Project description:ObjectivesWhile the costs and outcomes of cochlear implantation (CI) have been widely assessed, most of these analyses were solely performed from the perspective of healthcare costs. This study assesses the costs and benefits of CI in the Netherlands from a broader societal perspective, including health outcomes, healthcare cost, educational cost, and productivity losses and gains.DesignThe cost and benefits of CI were analyzed in this cost-benefit analysis, in which a monetary value is put on both the resources needed and the outcomes of CI. The costs and benefits were analyzed by prototypical instances of three groups, representing the majority of cochlear implant patients: prelingually deaf children implanted at the age of 1, adults with progressive profound hearing loss implanted at the age of 40 and seniors implanted at the age of 70 with progressive profound hearing loss. Costs and benefits were estimated over the expected lifetimes of the members of each group, using a Markov state transition model. Model parameters and assumptions were based on published literature. Probabilistic and one-way sensitivity analyses were performed.ResultsIn all three patient groups, the total benefits of CI exceeded the total cost, leading to a net benefit of CI. Prelingually deaf children with a bilateral CI had a lifetime positive outcome net benefit of €433,000. Adults and seniors with progressive profound hearing loss and a unilateral CI had a total net benefit of €275,000 and €76,000, respectively. These results ensue from health outcomes expressed in monetary terms, reduced educational cost, and increased productivity.ConclusionsBased on estimates from modeling, the increased healthcare costs due to CI were more than compensated by the value of the health benefits and by savings in educational and productivity costs. In particular, for children and working adults, the societal benefit was positive even without taking health benefits into account. Therefore, CI generates an advantage for both patients and society.
| S-EPMC8378541 | biostudies-literature