Browsing by Author "Dowell, Richard"

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    Factors affecting auditory performance of postlinguistically deaf adults using cochlear implants: An update with 2251 patients
    (Karger, 2013-01) Blamey, Peter; Artieres, Françoise; Başkent, Deniz; Bergeron, François; Beynon, Andy; Burke, Elaine; Dillier, Norbert; Dowell, Richard; Fraysse, Bernard; Gallégo, Stéphane; Govaerts, Paul; Green, Kevin; Huber, Alexander; Kleine-Punte, Andrea; Maat, Bert; Marx, Mathieu; Mawman, Deborah; Mosnier, Isabelle; O’Connor, Alec; O’Leary, Stephen; Rousset, Alexandra; Schauwers, Karen; Skarzynski, Henryk; Skarzynski, Piotr; Sterkers, Olivier; Terranti, Assia; Truy, Eric; Van de Heyning, Paul; Venail, Fréderic; Vincent, Christophe; Lazard, Diane
    Objective: To update a 15-year-old study of 800 postlinguistically deaf adult patients showing how duration of severe to profound hearing loss, age at cochlear implantation (CI), age at onset of severe to profound hearing loss, etiology and CI experience affected CI outcome. Study Design: Retrospective multicenter study. Methods: Data from 2251 adult patients implanted since 2003 in 15 international centers were collected and speech scores in quiet were converted to percentile ranks to remove differences between centers. Results: The negative effect of long duration of severe to profound hearing loss was less important in the new data than in 1996; the effects of age at CI and age at onset of severe to profound hearing loss were delayed until older ages; etiology had a smaller effect, and the effect of CI experience was greater with a steeper learning curve. Patients with longer durations of severe to profound hearing loss were less likely to improve with CI experience than patients with shorter duration of severe to profound hearing loss. Conclusions: The factors that were relevant in 1996 were still relevant in 2011, although their relative importance had changed. Relaxed patient selection criteria, improved clinical management of hearing loss, modifications of surgical practice, and improved devices may explain the differences.
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    Pre-, per- and postoperative factors affecting performance of postlinguistically deaf adults using cochlear implants: A new conceptual model over time
    (PLOS, 2012-11) Lazard, Diane; Vincent, Christophe; Venail, Frédéric; Van de Heyning, Paul; Truy, Eric; Sterkers, Olivier; Skarzynski, Piotr; Skarzynski, Henryk; Schauwers, Karen; O’Leary, Stephen; Mawman, Deborah; Maat, Bert; Kleine-Punte, Andrea; Huber, Alexander; Green, Kevin; Govaerts, Paul; Fraysse, Bernard; Dowell, Richard; Dillier, Norbert; Burke, Elaine; Beynon, Andy; Bergeron, Franćois; Başken, Deniz; Artiéres, Franćoise; Blamey, Peter
    OBJECTIVE: To test the influence of multiple factors on cochlear implant (CI) speech performance in quiet and in noise for postlinguistically deaf adults, and to design a model of predicted auditory performance with a CI as a function of the significant factors. STUDY DESIGN: Retrospective multi-centre study. METHODS: Data from 2251 patients implanted since 2003 in 15 international centres were collected. Speech scores in quiet and in noise were converted into percentile ranks to remove differences between centres. The influence of 15 pre-, per- and postoperative factors, such as the duration of moderate hearing loss (mHL), the surgical approach (cochleostomy or round window approach), the angle of insertion, the percentage of active electrodes, and the brand of device were tested. The usual factors, duration of profound HL (pHL), age, etiology, duration of CI experience, that are already known to have an influence, were included in the statistical analyses. RESULTS: The significant factors were: the pure tone average threshold of the better ear, the brand of device, the percentage of active electrodes, the use of hearing aids (HAs) during the period of pHL, and the duration of mHL. CONCLUSIONS: A new model was designed showing a decrease of performance that started during the period of mHL, and became faster during the period of pHL. The use of bilateral HAs slowed down the related central reorganization that is the likely cause of the decreased performance.
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    A Retrospective Multicenter Study Comparing Speech Perception Outcomes for Bilateral Implantation and Bimodal Rehabilitation
    (Wolters Kluwer Health, 2015-08) Blamey, Peter; Maat, Bert; Baskent, Deniz; Mawman, Deborah; Burke, Elaine; Dillier, Norbert; Beynon, Andy; Kleine-Punte, Andrea; Govaerts, Paul; Skarzynski, Piotr; Huber, Alexander; Sterkers-Artieres, Francoise; Van de Heyning, Paul; O'Leary, Stephen; Fraysse, Bernard; Green, Kevin; Sterkers, Olivier; Venail, Frédéric; Skarzynski, Henryk; Vincent, Christophe; Truy, Eric; Dowell, Richard; Bergeron, François; Lazard, Diane
    OBJECTIVES: To compare speech perception outcomes between bilateral implantation (cochlear implants [CIs]) and bimodal rehabilitation (one CI on one side plus one hearing aid [HA] on the other side) and to explore the clinical factors that may cause asymmetric performances in speech intelligibility between the two ears in case of bilateral implantation. DESIGN: Retrospective data from 2247 patients implanted since 2003 in 15 international centers were collected. Intelligibility scores, measured in quiet and in noise, were converted into percentile ranks to remove differences between centers. The influence of the listening mode among three independent groups, one CI alone (n = 1572), bimodal listening (CI/HA, n = 589), and bilateral CIs (CI/CI, n = 86), was compared in an analysis taking into account the influence of other factors such as duration of profound hearing loss, age, etiology, and duration of CI experience. No within-subject comparison (i.e., monitoring outcome modifications in CI/HA subjects becoming CI/CI) was possible from this dataset. Further analyses were conducted on the CI/CI subgroup to investigate a number of factors, such as implantation side, duration of hearing loss, amount of residual hearing, and use of HAs that may explain asymmetric performances of this subgroup. RESULTS: Intelligibility ranked scores in quiet and in noise were significantly greater with both CI/CI and CI/HA than with a CI-alone group, and improvement with CI/CI (+11% and +16% in quiet and in noise, respectively) was significantly better than with CI/HA (+6% and +9% in quiet and in noise, respectively). From the CI/HA group, only subjects with ranked preoperative aided speech scores >60% performed as well as CI/CI participants. Furthermore, CI/CI subjects displayed significantly lower preoperative aided speech scores on average compared with that displayed by CI/HA subjects. Routine clinical data available from the present database did not explain the asymmetrical results of bilateral implantation. CONCLUSIONS: This retrospective study, based on basic speech audiometry (no lateralization cues), indicates that, on average, a second CI is likely to provide slightly better postoperative speech outcome than an additional HA for people with very low preoperative performance. These results may be taken into consideration to refine surgical indications for CIs.
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    Speech Perception Outcomes for Adult Cochlear Implant Recipients Using a Lateral Wall or Perimodiolar Array
    (Wolters Kluwer Health, Inc, 2019-04) Moran, Michelle; Vandali, Andrew; Briggs, Robert; Dettman, Shani; Cowan, Robert; Dowell, Richard
    AIM: To assess the speech perception outcomes of adult CI recipients with significant preimplant low frequency hearing, examining differences between perimodiolar and lateral wall electrode placement in order to provide clinical guidance for clinicians and surgeons. METHODS: A prospective cohort study was undertaken identifying all adults who received a thin straight electrode array (TSEA) at the Royal Victorian Eye & Ear Hospital (RVEEH) from 2010 to 2015 and who had a preimplant low frequency pure tone median