Children with hearing impairment--living with cochlear implants or hearing aids

Objective

The aim of this study was to enhance knowledge about the life circumstances of children with cochlear implants or hearing aids, regarding daily functioning and attitude to the impairment.

Methods

Data were obtained from 36 children with cochlear implants and 38 children with hearing aids via study-specific questionnaires with fixed answer alternatives. The questions covered (1) usage of aids and related factors, (2) hearing in different everyday situations, (3) thoughts about the children's own hearing and others’ attitudes to it, and (4) choice of language. The data were analyzed using SPSS, and presented via the theoretical frame of the International Classification of Functioning, Disability and Health, Child and Youth version (ICF-CY).

Results

Children with CI and HA functioned equally well in daily life, but there were also certain differences. Symptoms from neck and shoulders were more common among children with hearing aids than among children with cochlear implants (p < .001). Children with hearing aids used their aids significantly less often than those with cochlear implants (p < .001). The participation variables showed that children with hearing aids had significantly more hearing problems in team sports (p = .033) and outdoor activities (p = .019), in comparison to children with cochlear implants. The two groups had similar thoughts regarding their own hearing, mostly considering it not to be a problem. They also did not generally think that other people found their hearing to be a problem.

Conclusions

Children with cochlear implants and children with hearing aids have, in some aspects, equally good functioning in everyday life situations. However, certain differences were found in dimensions of functioning, regarding neck and shoulder pain, usage of aids and sign language, and hearing problems in some activities.     

Mandarin lexical tones identification among children with cochlear implants or hearing aids

ObjectivesMandarin Chinese is a lexical tone language that has four tones, with a change in tone denoting a change in lexical meaning. There are few studies regarding lexical tone identification abilities in deafened children using either cochlear implants (CIs) or hearing aids (HAs). Furthermore, no study has compared the lexical tone identification abilities of deafened children with their hearing devices turned on and off. The present study aimed to investigate the lexical tone identification abilities of deafened children with CIs or HAs.MethodsForty prelingually deafened children (20 with CIs and 20 with HAs) participated in the study. In the HA group, 20 children were binaurally aided. In the CI group, all of the children were unilaterally implanted. All of the subjects completed a computerized lexical tone pairs test with their hearing devices turned on and off. The correct answers of all items were recorded as the total score and the correct answers of the tone pairs were recorded as subtotal scores.ResultsNo significant differences in the tone pair identification scores were found between the CI group and HA group either with the devices turned on or off (t = 1.62, p = 0.11; t = 1.863, p = 0.07, respectively). The scores in the aided condition were higher than in the unaided condition regardless of the device used (t = 22.09, p < 0.001, in the HA group; t = 20.20, p < 0.001, in the CI group). Significantly higher scores were found in the tone pairs that contained tone 4. Age at fitting of the devices was correlated with tone identification abilities in both the CI and HA groups. Other demographic factors were not correlated with tone identification ability.ConclusionsThe hearing device, whether a hearing aid or cochlear implant, is beneficial for tone identification. The lexical tone identification abilities were similar regardless of whether the subjects wore a HA or CI. Lexical tone pairs with different durations and dissimilar tone contour patterns are more easily identified. Receiving devices at earlier age tends to produce better lexical tone identification abilities in prelingually deafened children.     

Better defining best-aided condition: The role of hearing aids on cochlear implantation qualification rates

ObjectiveDescribe the effect of hearing aid type used during cochlear implantation evaluation on qualification rates.MethodsConsecutive adult patients at an academic cochlear implant program undergoing cochlear implantation evaluation were identified to determine cochlear implantation qualification rate according to history of hearing aid use and type of hearing aid used during evaluation.Results609 patients met criteria. 90.1% of patients reported prior use of a hearing aid, and 77.4% reported current use of a hearing aid. Patients were most likely to undergo cochlear implantation evaluation utilizing their own personal hearing aids exclusively (61.6%) followed by loaner hearing aids fitted at the time of the evaluation (28.2%). White patients were more likely to be tested using personal hearing aids (OR = 2.60, 95% CI 1.43 to 4.71). Married patients were more likely to be current hearing aid users (OR 1.62, 95% CI 1.04 to 2.51) and were more likely to be tested using personal hearing aids (OR = 1.68, 95% CI 1.10 to 2.56). Patients with a history of any hearing aid use (OR = 2.50, 95% CI 1.42 to 4.40) and current hearing aid use (OR = 1.62, 95% CI 1.06 to 2.49) were more likely to qualify for cochlear implantation. Patients tested using personal hearing aids were 1.5 times more likely to qualify for cochlear implantation (95% CI 0.99 to 2.27).ConclusionHistory of hearing amplification and current amplification predict cochlear implant qualification. Hearing aids fitted at the time of cochlear implantation evaluation may result in lower qualification rates.     

Reading skills in Persian deaf children with cochlear implants and hearing aids

ObjectivesReading skills are necessary for educational development in children. Many studies have shown that children with hearing loss often experience delays in reading. This study aimed to examine reading skills of Persian deaf children with cochlear implant and hearing aid and compare them with normal hearing counterparts.MethodThe sample consisted of 72 s and third grade Persian-speaking children aged 8–12 years. They were divided into three equal groups including 24 children with cochlear implant (CI), 24 children with hearing aid (HA), and 24 children with normal hearing (NH). Reading performance of participants was evaluated by the “Nama” reading test. “Nama” provides normative data for hearing and deaf children and consists of 10 subtests and the sum of the scores is regarded as reading performance score.ResultsResults of ANOVA on reading test showed that NH children had significantly better reading performance than deaf children with CI and HA in both grades (P < 0.001). Post-hoc analysis, using Tukey test, indicated that there was no significant difference between HA and CI groups in terms of non-word reading, word reading, and word comprehension skills (respectively, P = 0.976, P = 0.988, P = 0.998).ConclusionConsidering the findings, cochlear implantation is not significantly more effective than hearing aid for improvement of reading abilities. It is clear that even with considerable advances in hearing aid technology, many deaf children continue to find literacy a challenging struggle.     

Parent versus child assessment of quality of life in children using cochlear implants

Objective

Children with hearing loss who use cochlear implants have lower quality of life (QoL) in social situations and lower self-esteem than hearing peers. The child's QoL has been assessed primarily by asking the parent rather than asking the child. This poses a problem because parents have difficulty judging less observable aspects like self-esteem and socio-emotional functioning, the domains most affected by hearing loss.

Methods

This case-control study evaluated QoL in 50 preschoolers using a cochlear implant and their parents with the Kiddy KINDL^®, an established QoL measure. Children's responses were compared to a hearing control group and correlated with demographic variables. We used a questionnaire for parents and a face-to-face interview with children. T-tests were used to compare (a) paired parent-child ratings and (b) children with cochlear implants versus normal hearing. Pearson rank correlations were used to compare QoL with demographic variables.

Results

Children using cochlear implants rated overall QoL significantly more positively than their parents (M_Difference = 4.22, p = .03). Child rating of QoL did not differ significantly by auditory status (cochlear implant (82.8) vs. hearing (80.8), p = .42). Overall QoL correlated inversely with cochlear implant experience and chronologic age, but did not correlate with implantation age.

Conclusions

Preschool children using cochlear implants can assess adequately their own QoL, but parents afford valuable complementary perspective on the child's socio-emotional and physical well-being. Preschool children using cochlear implants rate overall QoL measures similar to hearing peers. A constellation of QoL measures should be collected to yield a better understanding of general QoL as well as specific domains centered on hearing loss.     

Psychosocial health of cochlear implant users compared to that of adults with and without hearing aids: Results of a nationwide cohort study

Objectives

This study aimed to examine the psychosocial health status of adult cochlear implant (CI) users, compared to that of hearing aid (HA) users, hearing‐impaired adults without hearing aids and normally hearing adults.

Design

Cross‐sectional observational study, using both self‐reported survey data and a speech‐in‐noise test.

Setting

Data as collected within the Netherlands Longitudinal Study on Hearing (NL‐SH) between September 2011 and June 2016 were used.

Participants

Data from 1254 Dutch adults (aged 23‐74), selected in a convenience sample design, were included for analyses.

Mean outcome measures

Psychosocial health measures included emotional and social loneliness, anxiety, depression, distress and somatisation. Psychosocial health, hearing status, use of hearing technology and covariates were measured by self‐report; hearing ability was assessed through an online digit triplet speech‐in‐noise test.

Results

After adjusting for the degree of hearing impairment, HA users (N = 418) and hearing‐impaired adults (N = 247) had significantly worse scores on emotional loneliness than CI users (N = 37). HA users had significantly higher anxiety scores than CI users in some analyses. Non‐significant differences were found between normally hearing (N = 552) and CI users for all psychosocial outcomes.

Conclusions

Psychosocial health of CI users is not worse than that of hearing‐impaired adults with or without hearing aids. CI users’ level of emotional loneliness is even lower than that of their hearing‐impaired peers using hearing aids. A possible explanation is that CI patients receive more professional and family support, and guidance along their patient journey than adults who are fitted with hearing aids.     

Knowledge about cochlear implantation: A parental perspective

Objectives: Cochlear implantation (CI) is used for children with severe to profound hearing loss who show little or no improvement using hearing aids. This study explored parental knowledge of their children’s CI.

Methods: A cross-sectional study involving the parents of 115 pediatric CI patients was conducted at King Abdullah Specialized Children’s Hospital in Riyadh, Saudi Arabia. Parents were interviewed by telephone using a 50-question validated questionnaire.

Results: Most parents of children with CI reported being comfortable in using the internet (68.7%) and social media (40.9%) to obtain information regarding CI. Although most parents of children with CI relied on health professionals and websites as their main sources of information, they were also able to obtain necessary information at meetings for CI patients and health professionals. Parents of children with CI felt they had sufficient information regarding the impact of hearing loss (78%) and CI (71%) on speech understanding and language development; however, they had insufficient information regarding criteria for CI candidacy, available brands of CI devices, and the advantages and disadvantages of each.

Conclusion: Parents reported that health professionals were the ideal source of information regarding hearing loss and CI. Moreover, our study showed that parents should learn more about cochlear implant devices, the post-implantation process, and candidacy criteria.     

Comparison of the overall intelligibility,articulation, resonance,and voice characteristics between children using cochlear implants and those using bilateral hearing aids: A pilot study

The purpose of this study was to determine and to compare the overall intelligibility, articulation, resonance, and voice characteristics in children using cochlear implants (CI) and children using conventional hearing aids (HA). Nine prelingually deaf children using CI and six children with a prelingual severe hearing loss using HA, were selected to participate. Objective (DSI, nasalance scores) as well as subjective assessment techniques (perceptual evaluations) were used. Both the CI and HA children demonstrated normal vocal quality and resonance but showed the presence of articulation disorders. In the CI children, intelligibility was significantly better compared to the HA children. Significantly more phonetic and phonological disorders were present in the HA children. The results of this study show a poorer intelligibility of the HA children in comparison with the CI children which is probably due to the occurrence of significantly more phonetic and phonological disorders. Future detailed analysis in a larger sample of CI and HA children may help further clarify the issue of speech and voice characteristics and may demonstrate an important prognostic value.     

Tone identification in Mandarin-speaking children with profound hearing impairment

ObjectivesLittle is known about the tone identification ability of Mandarin-speaking children with profound hearing impairment (HI) and fitted with hearing aids (HAs). The present study aimed to evaluate the Mandarin tone identification ability in children with profound HI and fitted with HAs, and explore the effects of hearing thresholds, the age of first HA fitting and the duration of HA use on Mandarin tone identification ability.MethodsSubjects were Mandarin-speaking children aged 5;4–12;6 years with profound HI (n = 41). The Mandarin Tone Identification Test was administered in five test conditions: in −10, −5, 0 and 5 dB signal-to-noise ratios (S/Ns) and quiet. Hearing aids were in the usual user's settings, optimized for the best speech reception, and the volume was set to comfortable listening level.ResultsTwo-way repeated measures ANOVA showed significant effects of test conditions and tone contrasts in Mandarin tone identification. Post-hoc pairwise comparisons showed significant difference in performance among the five test conditions. Results also indicated that, among the six tone contrasts, the Tone 1/Tone 2 and Tone 2/Tone 3 contrasts were the most difficult tone contrasts in quiet. No significant difference in performance was found among the six tone contrasts in noise. Pearson product-moment correlation showed that the age of first HA fitting, the duration of HA use, aided and unaided average thresholds as well as the aided hearing thresholds in the low frequency region were not significantly correlated with tone identification ability in the five test conditions.ConclusionsConsistent with previous findings, the Tone 1/Tone 2 and Tone 2/Tone 3 contrasts were the most difficult to identify in quiet; but the presence of noise resulted in these tone contrasts being equally difficult. Findings also suggest that the tone identification ability of children with profound HI needs to be improved. Although the age of first HA fitting and the duration of HA use were not significantly correlated with tone identification performance in children with profound HI, this finding does not preclude the importance of early HA fitting.     

Cochlear implant in a subject affected by the Chudley-McCullough Syndrome

Objectives: The Chudley-McCullough Syndrome (CMS) is a rare autosomal-recessively inherited disorder caused by mutations in the GPSM2 gene, characterised by deafness and brain anomalies. The purpose of this paper is to report about a case of cochlear implant (CI) procedure in a subject affected by CMS.

Methods: A 31-year-old subject affected by CMS referred to our centre requiring an evaluation for a CI, as the results with her hearing aids, which she had been using since she was 2-years-old, were unsatisfactory. A profound bilateral sensorineural hearing loss was pointed out. Pure tone audiometry in free field with hearing aids and speech perception results were poor. The subject was counselled about the surgical procedure and the surgery was performed with no complications.

Results: The cochlear implant was switched on 22 days after surgery and the subject began speech therapy training. After 1 year, hearing and speech perception results were satisfactory. The hearing threshold in free field with the CI was around 30?dB, and the open set speech perception score reached 55% in silence.

Conclusions: The reported case demonstrates that CI is a feasible and safe procedure in subjects with CMS. Furthermore, since satisfactory hearing and speech perception results were achieved we recognise that cochlear implant should be considered the best option for hearing restoration in subjects with CMS and profound sensorineural hearing loss.     

Social hearing measured with the Performance Inventory for Profound and Severe Loss: a comparison between adult multichannel cochlear implant patients and users of acoustical hearing aids

The objective of this study was to investigate social hearing in successful users of multichannel cochlear implants (CIs) and to compare the scores with those of a group of hearing-impaired adults using acoustical hearing aids (HAs). Out of 88 patients who had undergone surgery, 75 CI users with a mean age of 55 years and a mean pre-operative hearing level of 113dB in the better ear were compared with 59 users of acoustical HAs with a mean age of 56 years and a mean hearing level of 82dB in the better ear. Seven CI patients were non-users and were excluded from the study. The Performance Inventory for Profound and Severe Loss, a questionnaire that measures different aspects of hearing handicap, was used. The CI group scored significantly better than the HA group in three of six evaluated categories, measuring subjective intensity of sounds, speech with visual cues, and response to auditory failure. Awareness of environmental sounds, speech with no visual cues and personal reactions did not differ significantly. The group of successful CI users scored higher on a self-report measure than did a group of users of acoustical HAs with moderate- severe-profound deafness. The best CI users scored better than the best HA users, and the worst CI users scored worse than the worst HA users.     

In-home auditory training using audiovisual stimuli on a tablet computer: Feasibility and preliminary results

ObjectiveTo examine the feasibility and possible effects of in-home auditory training using audiovisual speech stimuli on a tablet computer for patients with hearing loss using a hearing aid (HA) or a cochlear implant (CI).MethodsIn total, 11 patients with hearing loss (mean age, 60.2 ± 13.7 years) who had been using an HA or CI for more than 1 year were examined. As auditory training, the participants listened repeatedly to audiovisual speech stimuli on a tablet computer for 3 months. Speech intelligibility for trained words, untrained words, and monosyllables presented at a sound pressure level of 70 dB were assessed before and at 1, 2, and 3 months after training.ResultsEight out the 11 patients completed 3 months of in-home auditory training. Three of these patients withdrew from the training before completing the protocol, mainly because of “boredom from recurring simple tasks”. Significant improvements in speech intelligibility were found for the trained and untrained words after the 3-month training period (p < 0.05), but no significant differences were found for monosyllables.ConclusionIn-home auditory training using a tablet computer could help improve auditory quality of life in patients with hearing loss using an HA or CI. But the further comparative studies using other existing method will be necessary to establish the practical importance of the present method.     

Task force Guideline of Brazilian Society of Otology – hearing loss in children – Part II — Treatment

ObjectivesTo provide an overview of the main evidence-based recommendations for the diagnosis of hearing loss in children and adolescents aged 0–18 years.MethodsTask force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on childhood hearing loss were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions.ResultsThe topics were divided into 2 parts: (1) treatment of sensorineural hearing loss: individual hearing aids, bilateral cochlear implants, cochlear implants in young children, unilateral hearing loss, and auditory neuropathy spectrum disorder; and (2) treatment of conductive/mixed hearing loss: external/middle ear malformations, ventilation tube insertion, and tympanoplasty in children.ConclusionsIn children with hearing loss, in addition to speech therapy, Hearing AIDS (HAs) or implantable systems may be indicated. Even in children with profound hearing loss, both the use of HAs and behavioral assessments while using the device are important.     

Comparison of primary musicality development between children with cochlear implants and children with normal hearing

Abstract

Background: It is beneficial for CI patients listen to music. However it is necessary to take steps to improve the musicality of CI patients.

Objectives: The aims of the study were to evaluate the primary musicality of children with cochlear implants versus those with normal hearing.

Material and methods: Children participating in this study were divided into two groups: the cochlear implant group (CI group) and the normal hearing group (NH group). The ‘Musical Ears Evaluation Form for Professionals’ was used to evaluate the subjects’ primary musicality.

Results: The scores for overall and the three subcategories of primary musicality in children with cochlear implants and in those with normal hearing also improved significantly over time (p?<?.05). The score for overall primary musicality was not significantly different between CI and NH groups in the same hearing age (p?>?.05). There were significant differences between the two groups in the same chronological age (p?<?.05).

Conclusions and significance: The primary musicality in children with cochlear implants was not significantly different from normal hearing ones at the same hearing age. The primary musicality in children with cochlear implants was significantly lower than that of children with normal hearing at the same chronological age.     

The skull vibration-induced nystagmus test: A useful vestibular screening test in children with hearing loss

IntroductionSkull-Vibration-Induced-Nystagmus Test (SVINT), a non-invasive first line examination test, stimulates both otolith and canal structures and shows instantaneously a vestibular asymmetry. This study aimed to analyze the SVINT results observed in children with hearing loss (HL) amplified with hearing aids (HA) or unilateral cochlear implant (uCI) and healthy children.Material and methodsThis case-control study compared the results of SVINT, caloric test (CaT) and video head-impulse-test (VHIT) in 120 controls to 30 children with HA and 30 with uCI, aged 5-18 years old. SVINT was recorded with videonystagmography after very high frequency (VHF) stimulation of mastoids and vertex.ResultsSVINT results were non-pathological in 98% of the control group but modified in the HL group (P-value = 0.04). In uCI participants, 13.3% had a bilateral weakness (BW) and 16.7% had a unilateral weakness (UW). In the HA group, 26.7% had BW, 10% had UW. SVINT was efficient to show a UW (6 out of 7 confirmed cases) but not efficient to show BW (1/12 confirmed cases).ConclusionSVINT can detect unilateral vestibular deficit in the VHF with a sensitivity of 86% and specificity of 96%. The positive predictive value is 75% and negative predictive value is 98%. In the case of bilateral deficit, the SVINT is inoperant. In amplified participants, a UW was equally detected whether using SVINT, CaT or VHIT. SVINT is a well-tolerated and useful test to screen vestibular asymmetry in children with HL when combined with other vestibular tests and shows its complementary at very high frequencies.     

Evaluation of the impact of hearing loss in adults: Validation of a quality of life questionnaire

ObjectivesThe impact of hearing loss and of auditory rehabilitation (hearing aid, cochlear implant) on quality of life is a crucial issue. Commonly used questionnaires to assess quality of life in these patients (Nijmegen, APHAB, GBI) are time-consuming, difficult for patients to fill out, and show poor sensitivity to small improvements or deterioration. The objective of the present study was to validate a dedicated quality of life scale for hearing-impaired adults with or without auditory rehabilitation.Material and methodsERSA (Évaluation du Retentissement de la Surdité chez l’Adulte: Evaluation of the Impact of Hearing Loss in Adults) is a self-administered questionnaire. It is divided into 4 domains, each comprising 5 questions graded from 1 to 10. The questions are simple, and formulated so patients will answer according to how they feel at the actual time of the session. Test-retest reliability was measured in 38 patients. Internal coherence and validity against the APHAB questionnaire as gold standard and in relation to hearing performance were measured in 122 patients at auditory assessment. Sensitivity to change in hearing was measured in 36 cochlear implant patients, before and 6 or 12 months after implantation.ResultsTest-retest reliability was very satisfactory (ρ = 0.88). Internal coherence was good for all questions. External validity, comparing ERSA to APHAB scores in the same non-implanted hearing-impaired patients, was good (ρ = 0.52). Additionally, ERSA scores correlated with hearing performance in adverse conditions (monosyllabic words: ρ = 0.22; sentences in noise: ρ = 0.19). In patients tested before and after cochlear implantation, improvement in hearing performance in silence and in noise correlated with an improvement in ERSA score (ρ = 0.37 to 0.59, depending on the test), but not to GBI score.ConclusionThe ERSA questionnaire is easy and quick to use, reliable, and sensitive to change in hearing performance after cochlear implantation.     

Prevalence of usage of hearing aids and its association with cognitive impairment in Japanese community-dwelling elders with hearing loss

ObjectiveHearing loss is a risk factor for cognitive impairment, and the use of a hearing aid (HA) may prevent cognitive decline alongside hearing loss. We aimed to elucidate the prevalence of self-reported HA usage in Japanese community-dwelling elders with hearing loss, and the effect of hearing and HA on cognitive impairment.MethodsA total of 1193 participants, who had audiometric defined hearing loss and were aged 60 years or over, had their cumulative 3260 observations followed up for 10 years from a large cohort of a Japanese study. Association between hearing (pure-tone average threshold level at 500, 1000, 2000, and 4000 Hz from the better hearing ear: PTABHE) and HA usage with cognitive impairment (total score of Mini-Mental State Estimation was under 27 or diagnosed as dementia) was analyzed using generalized estimating equations.ResultsThe HA usage rate of the 1193 community-dwelling elders with hearing loss was 6% during the first involvement. The majority (59.2%) of HA users always used an HA. HA usage rate was 0.7% for the mild hearing loss group and 32.4% for the moderate or greater hearing loss group in the latest participating wave. PTABHE was significantly associated with cognitive impairment (odds ratio for every 10 dB 1.36; 95% CI 1.21–1.53, p<0.0001) after adjusting for age, sex, education, depressed mood, smoking status, alcohol intake, income, activity, obesity, histories of hypertension, dyslipidemia, ischemic heart disease, diabetes, stroke, ear disease, and occupational noise exposure. PTABHE was also significantly associated with cognitive impairment in the mild hearing loss group (odds ratio for every 10 dB 1.34; 95% CI 1.05–1.72, p = 0.020) and moderate hearing loss group (odds ratio for every 10 dB 1.82; 95% CI 1.27–2.61, p = 0.001). HA use showed a significant suppressive effect on cognitive impairment in those with moderate hearing loss who always use an HA (odds ratio 0.54; 95% CI 0.30–1.00, p = 0.049).ConclusionThe prevalence of HA usage among Japanese community-dwelling elders with hearing loss is consistent, at around 10%. The hearing level remained a primary risk factor for cognitive impairment among elders with hearing loss after adjusting for several confounding factors. Regular HA use may have a protective effect on cognitive impairment in those with moderate hearing loss.     

Nasalance in Cochlear Implantees

Objectives

Speech intelligibility is severely affected in children with congenital profound hearing loss. Hypernasality is a problem commonly encountered in their speech. Auditory information received from cochlear implants is expected to be far superior to that from hearing aids. Our study aimed at comparing the percentages of nasality in the speech of the cochlear implantees with hearing aid users and also with children with normal hearing.

Methods

Three groups of subjects took part in the study. Groups I and II comprised 12 children each, in the age range of 4-10 years, with prelingual bilateral profound hearing loss, using multichannel cochlear implants and digital hearing aids respectively. Both groups had received at least one year of speech therapy intervention since cochlear implant surgery and hearing aid fitting respectively. The third group consisted of age-matched and sex-matched children with normal hearing. The subjects were asked to say a sentence which consisted of only oral sounds and no nasal sounds ("Buy baby a bib"). The nasalance score as a percentage was calculated.

Results

Statistical analysis revealed that the children using hearing aids showed a high percentage of nasalance in their speech. The cochlear implantees showed a lower percentage of nasalance compared to children using hearing aids, but did not match with their normal hearing peers.

Conclusion

The quality of speech of the cochlear implantees was superior to that of the hearing aid users, but did not match with the normal controls. The study suggests that acoustic variables still exist after cochlear implantation in children, with hearing impairments at deviant levels, which needs attention. Further research needs to be carried out to explore the effect of the age at implantation as a variable in reducing nasality in the speech and attaining normative values in cochlear implantees, and also between unilateral versus bilateral implantees.     

Post-lingual deafness: benefits of cochlear implants vs. conventional hearing aids

The technological advances in cochlear implants and processing strategies have enabled subjects affected by severe to profound hearing loss to hear sounds and recognize speech in various different degrees. The variability of hearing outcomes in subjects with post-lingual deafness has been significant and cochlear implant indications have been extended to include an ever larger population.ObjectiveThis paper aims to look into the groups of post-lingual deafness patients to find where cochlear implants have yielded better outcomes than conventional hearing aids.Materials and MethodsReview the literature available on databases SciELO, Cochrane, MEDLINE, and LILACS-BIREME. The publications selected for review were rated as A or B on evidence strength on the day of the review. Their authors analyzed and compared hearing aids and cochlear implants in populations of post-lingually deaf patients. Study Design: Systematic review.ResultsEleven out of the 2,169 papers searched were found to be pertinent to the topic and were rated B for evidence strength. Six studies were prospective cohort trials, four were cross-sectional studies and one was a clinical trial.ConclusionThe assessment done on the benefits yielded by post-lingually deaf subjects from cochlear implants showed that they are effective and provide for better results than conventional hearing aids.