Gonzalo CB, Raquel CM

Language: Spanish
References: 10
Page: 31-38
PDF size: 236.58 Kb.

ABSTRACT

Background: Studies in patients who got a late implant show a significant difference favorable to young children, but they do not make it clear enough whether implantation is really justified or not. Therefore it is important to establish whether the benefit of the implant in this population segment outweighs the risks and costs compared with the alternative of not implanting.
Objective: To determine, in comparison with patients that did no receive implants, whether cochlear implants significantly benefit quality of life, listening skills, expressive language and socialization of prelingual patients between 8 and 12 years old.
Methodology: The study consisted of two groups: one of 23 prelingual participants of 18 years of age and older who received implants when they were 8 and 12, and another of 17 similar patients but without the device. We assessed social skills and expressive language through questions designed and implemented earlier. In addition, part of the Meaningful Auditory Integration Scale (MAIS) and the Personal Wellbeing Index-Adult (PWI-A) were used to assess auditory skills and quality of life respectively. We applied the Wilcoxon rank test to determine whether both groups differed significantly and found significant differences in auditory skills, expressive language and quality of life.
Results: Regarding the methods of rehabilitation prior to cochlear implantation, most resorted to auditory verbal therapy (48%) and oral therapy (39%), with lip-reading; 4% underwent the whole method, and 9% tried the manual one. After implantation, 83% were rehabilitated with an auditory verbal approach (MAV), and 17% with the oral one, which coincided with the fact that the AVM promoted best that the patient integrated hearing to their personality in order to develop social and communication skills. In conclusion, there were significant differences in favor of the non-implanted, possibly indicating that there is greater cohesion in the silent community; however, by eliminating non-users the difference narrowed to the point of no longer being significant. Regarding compliance with previous expectations, for 26% of the individuals the implant resulted much better than they thought, for 32% was better than they thought, for another 26% were more or less what they thought it would, 13% thought it was a little less than they expected and only for 4% it was much less than they expected. 78% of the cochlear implant group said they would widely recommend the implant and 22% said they would recommend it but with reservations.
Conclusions: One can say that we recommend a cochlear implant in patients over eight years with deep prelingual hypoacusis who have been encouraged and enabled previously with hearing aids and methods to promote communication through listening and spoken language, as the implant improves their quality of life by bringing them benefits in terms of sound awareness, discrimination of stimuli without noise, personal comfort, satisfaction with life in general, and expressive language.

REFERENCES

1. Fallon JB, Irvine DR, Shepherd RK. Cochlear implants and brain plasticity. Hear Res 2008;238(1-2):110-117.

2. Schramm D, Fitzpatrick E, Séguin C. Cochlear implantation for adolescents and adults with prelinguistic deafness. Otol Neurotol 2002;23(5):698-703.

3. Teoh SW, Pisoni DB, Miyamoto RT. Cochlear implantation in adults with prelingual deafness. Part I. Clinical results. Laryngoscope 2004;114(9):1536-1540.

4. Wheeler A, Archbold S, Gregory S, Skipp A. Cochlear implants: the young people’s perspective. J Deaf Stud Deaf Educ 2007;12(3):303-316.

5. Kos MI, Deriaz M, Guyot JP, Pelizzone M. What can be expected from a late cochlear implantation? Int J Pediatr Otorhinolaryngol 2009;73(2):189-193.

6. Kral A, Eggermont JJ. What’s to lose and what’s to learn: development Ander auditory deprivation, cochlear implants and limits of cortical plasticity. Brain Res Rev 2007;56(1):259-269.

7. Santarelli R, De Filippi R, Genovese E, Arslan E. Cochlear implantation outcome in prelingually deafened young adults. A speech perception study. Audiol Neurootol 2008;13(4):257-265.

8. Padilla Romero MJ, Sainz Quevedo M, Roldán Segura C, García Negro AS, Camacho Castro AC. [Subjetive benefits and limitations in relation with the cochlear implant reported by adolescent and adult patients]. Acta Otorrinolaringol Esp 2006;57(10):455-461.

9. Grekou MF, Mavroidakos S, Economides M, Lira X, Vathilakis J. Preliminary results of adult patients with digisonic SP cochlear implant system. Int Adv Otol 2009;5(1):93-99.

10. Most T, Shrem H, Duvdevani I. Cochlear implantation in late-implanted adults with prelingual deafness. Am J Otolaryngol 2010;31(6):418-423.