Клинические публикации

The Oticon Medical Neuro Zti cochlear implant and the Neuro 2 sound processor: multicentric evaluation of outcomes in adults and children

Franco-Vidal V, Parietti-Winkler C, Guevara N, Truy E, Loundon N, Bailleux S, Ardoint M, Saaï S, Hoen M, Mosnier I, Laplante-Lévesque A, Bordure P, Vincent C. In Press. The Oticon Medical Neuro Zti cochlear implant and the Neuro 2 sound processor: Multicentric evaluation of outcomes in adults and children. International Journal of Audiology. September 2019

 
Objective: This study evaluated the outcomes of the Oticon Medical Neuro Zti cochlear implant and the Neuro 2 sound processor. Design: Neuro One users were upgraded to Neuro 2. Monosyllabic word identification was evaluated in adults with Neuro One after ≥ 5 months, with Neuro 2 at upgrade, and with Neuro 2 after 3 months. Self-reported listening ability, satisfaction, and usability were measured in adults and children. Study sample: Participants were 44 adults and 26 children.
Results: Speech identification scores in quiet and noise were 58% and 45% with Neuro One and 67% and 55% with Neuro 2 after 3 months, respectively. Hearing impairment duration and number of active electrodes significantly predicted speech identification in noise with Neuro 2. Significantly higher questionnaire ratings were obtained for Neuro 2 than Neuro One regarding listening ability in complex listening situations, comfort and music, as well as nine aspects of satisfaction and usability. Conclusion: This study demonstrates the clinical superiority of the Neuro 2 sound processor over Neuro One in terms of speech identification in quiet and in noise and reported patient benefit and satisfaction. Given the study design, sources of improvement may include factors unrelated to the sound processor itself.

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Effects of unilateral cochlear implantation on balance control and sensory organisation in adult patients with profound hearing loss: a pilot study

Parietti-Winkler, C., Lion, A., Montaut-Vérient, B., Grosjean, R. and Gauchard, G.C. Biomed Research International, October 2015.
This study, conducted at the Nancy University Hospital in France, evaluated the impact of cochlear implantation on balance control. Ten patients with severe-to-profound hearing loss (aged 55 +/- 20 years on average) who were candidates for a cochlear implantation received posturographic and vestibular evaluations both before and after the surgery. Patient scores were compared to those of a group of ten normal-hearing participants (63 ± 16 years) who received the same evaluations. Prior to cochlear implant surgery, the patients with severe-to-profound hearing loss showed a posturographic deficit compared to the normal-hearing participants. This deficit progressively diminished after cochlear implantation, and scores were close to normal in the cochlear implant group within a year of implantation. Unilateral cochlear implantation can stimulate a mechanism of vestibular compensation, improving the static and dynamic balance of recipients.

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Improvement of Cognitive Function After Cochlear Implantation in Elderly Patients

Mosnier, I., Bébéar, J.P., Marx, M., Fraysse, B., Truy, E., Lina-Granade, G., Mondain, M., Sterkers-Artières, F., Bordure, P., Robier, A., Godey, B., Meyer, B., Frachet, B., Poncet-Wallet, C., Bouccara, D. and Sterkers, O. JAMA Otolaryngology — Head Neck & Surgery, May 2015. 
This large multicentre study is a prospective longitudinal study involving ten different tertiary referral centres. Its objective was to analyse the relationship between cognitive function and hearing restoration with a cochlear implant in elderly patients. The evaluations were conducted in 94 patients (aged 65 to 85), including 29 Oticon Medical Digisonic SP patients — the most represented cochlear implant brand in this study. Study patients had been diagnosed with a profound post-lingual hearing loss and were evaluated before surgery and both 6 and 12 months following cochlear implantation. Hearing restoration was evaluated through speech perception scores in quiet and in noise, and patients also received a detailed cognitive evaluation that included six different tests to evaluate attention, memory, orientation, executive function, mental flexibility and fluency. Cochlear implantation had a positive impact on quality of life and speech perception in quiet and in noise, and it was correlated with a decreased proportion of participants with responses indicating a depressive state. 80% of the patients with abnormal cognitive scores before cochlear implantation showed improved global cognitive function after cochlear implantation, with improvements observed as early as 6 months after surgery.

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A Retrospective Multicentre Study Comparing Speech Perception Outcomes for Bilateral Implantation and Bimodal Rehabilitation

Blamey, P.J., Maat, B., Başkent, D., Mawman, D., Burke, E., Dillier, N., Beynon, A., Kleine-Punte, A., Govaerts, P.J., Skarzynski, P.H., Huber, A.M., Sterkers-Artières, F., Van de Heyning, P., O’Leary, S., Fraysse, B., Green, K., Sterkers, O., Venail, F., Skarzynski, H., Vincent, C., Truy, E., Dowell, R., Bergeron, F. & Lazard, D.S. Ear & Hearing, August 2015. 
This international multicentre study (15 international CI centres) analysed retrospective data from 2,247 patients (4 brands represented, including Oticon Medical Digisonic SP patients). The goal was to compare speech perception outcomes in three different groups of users: those with a unilateral cochlear implant (CI/-), bimodal users with one cochlear implant and a hearing aid on the other side (CI/HA), and bilateral CI users with two CIs (CI/CI). Results showed that speech intelligibility in quiet and in noise was significantly better in both bilateral (CI/CI) and bimodal (CI/HA) users when compared to unilateral CI users (CI/-). Bilateral CI users showed an improvement of +11% in quiet and +16% in noise compared to unilateral CI users. Bimodal (CI/HA) users showed improvements of +6% in quiet and +9% in noise. This data again establishes the advantages of bilateral cochlear implantation over unilateral CI use. The authors conclude by saying that on average, for patients with very low preoperative performance, a second CI is likely to provide slightly better post-operative speech intelligibility outcomes than an additional HA.

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