Long-term evolution of the electrical stimulation for cochlear implant adult patients. The role of a progressive adaptation method

Abstract

Background: In clinical experience patients who do not frequently check the cochlear implant (CI) maps have poor auditory performance and poor acceptance of map variations over time.

Aims: The aim of the present study was to evaluate the effect of CI map optimization on both speech perception and subjective hearing in a group of CI patients with a long-standing map.

Material and methods: 14 patients (6 females and 8 males; age range 16–77, mean age 45.86 ± 23.85 years) fitted with a unilateral CI (Cochlear Ltd, Sydney, Australia) and a map unchanged for at least 12 months were evaluated. All CIs were remapped using mapping method with progressive adaptation. The speech discrimination in noise and subjective hearing perception (SSQ questionnaire) were evaluated with old and new map.

Results: The differences in electrode level with old and new map were significantly different both for T and C- Levels (p < .001). Speech discrimination in noise was significantly better (22.9%; p < .0001) after map optimization. The SSQ questionnaire showed no statistically significant difference in the overall scores, except the listening effort sub-scale.

Conclusions: Longstanding MAPs are associated with poor speech discrimination. Degradation of electrical stimulation is associated with increased mental effort.

Chinese abstract

背景：在临床经验中, 不经常检查人工耳蜗植入（CI）调设的患者听力表现差, 对随时间变化而变化的调设接受度差。

目的：本研究的目的是评估CI调设优化对一组有长期调设的CI患者的语音感知和主观听觉的影响。

材料与方法：对植入单侧耳蜗（澳大利亚悉尼耳蜗有限公司）和至少12个月不变的调设的14例患者（6例女性, 8例男性, 年龄16-77岁, 平均45.86±23.85 岁）进行评估。所有CI均采用渐进适应的调设法重新调设。用新旧调设评价噪声中的言语辨别能力和主观听觉能力（SSQ问卷）。

结果：新、旧调设电极水平在T、C-水平上差异有显著性（p<0.001）。经过调设优化后, 噪声中的语音识别率显著提高（22.9%；p<0.0001）。SSQ问卷除听力努力度量表外, 其余各分值均无显著性差异。

结论：长时间不变的调设与较差的语音识别有关。电刺激的减弱与自身努力的提高是相关的。

Keywords:

• Cochlear Implant
• MAP
• Fitting
• behavioural map
• speech discrimination in noise
• quality of hearing
• Adaptation
• Programming

Disclosure statement

No potential conflict of interest was reported by the author(s).