Long Term Outcomes of Early Cochlear Implantation in Korea

서명환,김봉직,장선오,김종선,오승하,Eung Kyung Cho 대한이비인후과학회 2009 Clinical and Experimental Otorhinolaryngology Vol.2 No.3

Objectives. The objective of this study was to compare the long-term auditory performance and language skill depending on the age of cochlear implantation in the Korean population. We especially tried to separate the effect of maturation/ development from that of the age at implantation. Methods. Eighty-six pre-lingual children with profound hearing loss who underwent a cochlear implantation before the age of six and had been followed for more than 3 yr were included in this study prospectively. Categories of Auditory Performance (CAP) and Korean Picture Vocabulary Test (K-PVT) were serially followed up. In order to separate the age at implantation effect, K-PVT results were readjusted to the child’s chronological age in the normal hearing population. Results. When the CAP and K-PVT scores were directly compared without chronological readjustment, we failed to show a significant difference for improvements according to the age at implantation. Early cochlear implantation was associated with better language development, only when the K-PVT scores were readjusted to percentile scores of their chronological age. Conclusion. Early cochlear implantation was associated with better language development even within the critical period. This advantage may be recognized only when the effect of the age at implantation is separated from the effect of maturation/development. Objectives. The objective of this study was to compare the long-term auditory performance and language skill depending on the age of cochlear implantation in the Korean population. We especially tried to separate the effect of maturation/ development from that of the age at implantation. Methods. Eighty-six pre-lingual children with profound hearing loss who underwent a cochlear implantation before the age of six and had been followed for more than 3 yr were included in this study prospectively. Categories of Auditory Performance (CAP) and Korean Picture Vocabulary Test (K-PVT) were serially followed up. In order to separate the age at implantation effect, K-PVT results were readjusted to the child’s chronological age in the normal hearing population. Results. When the CAP and K-PVT scores were directly compared without chronological readjustment, we failed to show a significant difference for improvements according to the age at implantation. Early cochlear implantation was associated with better language development, only when the K-PVT scores were readjusted to percentile scores of their chronological age. Conclusion. Early cochlear implantation was associated with better language development even within the critical period. This advantage may be recognized only when the effect of the age at implantation is separated from the effect of maturation/development.

선천성 난청 소아들의 인공와우 이식 후 언어 발달: 장기 추적 관찰 결과

류진현,정다정,조현호,이재호,이상흔,이규엽 대한이비인후과학회 2016 대한이비인후과학회지 두경부외과학 Vol.59 No.7

Background and Objectives It is well established that cochlear implantation provides significant benefits for prelingually profound deaf children. However, there are few studies that examined the long-term outcome of cochlear implantation beyond 10 years in prelingually deaf children. The purpose of this study was to examine the long-term benefit of cochlear implantation for children with more than 10 years of experience of using cochlear implantation, regarding auditory performance and academic status. We then determined the age effect of cochlear implantation on auditory performance for prelingually deaf children. Subjects and Method The longitudinal development of auditory performance of 119 deaf children was analyzed after cochlear implantation. Among the 119 children, 58 were included for analysis. Results The children who received cochlear implanst at younger age showed significantly better auditory performance. Age at which implantation had been performed had a significant effect on the development of auditory performance before 4 years of age. Many children continued to demonstrate improvements of auditory performance upto five years of implant use. Some showed development of auditory performance upto 10 years cochlear implantation. Conclusion The present result indicates that speech perception and performance for children continue to improve over time from 5 upto 10 years while using cochlear implant. The use of earlier cochlear implantation was demonstrated to provide better auditory performance. The age at which implantation was performed was one of the important factors influencing the long-term outcome of cochlear implantation. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(7):502-9

청각재활 - 와우이식

이준호 한양대학교 의과대학 2015 Hanyang Medical Reviews Vol.35 No.2

The first cochlear implant was approved about 30 years ago. It just provided a limited sensation of sound and facilitated lip-reading based communication. Recent advances in the cochlear implant system and surgical techniques have enabled the majority of recipients to communicate orally without visual cues. The cochlear implantation has become a standard means of auditory rehabilitation for profound sensorineural deafness. To evaluate candidacy for cochlear implantation, an objective and behavioural audiological test, imaging and functional studies to identify the status of the cochlea and the auditory nerve, and evaluation of additional medical conditions are needed. Although the cochlear implantation can restore auditory function, sound perceived with the cochlear implant is different from normal hearing. Therefore postoperative rehabilitation is crucial for good speech performance. Nowadays, the indications for cochlear implantation have been extended. Hearing loss patients with residual low-frequency hearing could be candidates for cochlear implantation. Therefore, residual hearing preservation during cochlear implantation has been an important issue. In addition, bilateral cochlear implantation, cochlear implantation for single-sided deafness and fully implantable cochlear implant systems have been receiving more attention. The purpose of this article is to review current knowledge concerning the cochlear implantation.

정상 내이도를 가진 난청 아동에서 와우신경부전으로 인한 인공와우이식 실패 1예

김소향,정성욱,김리석 대한이비인후과학회 2010 대한이비인후과학회지 두경부외과학 Vol.53 No.11

The cochlear nerve, which propagates electrical signals to the auditory cortex, must function well for successful cochlear implantation. A narrow internal auditory canal (IAC) increases the risk of hypoplasia or aplasia of cochlear nerve, which may result in the failure of cochlear implantation. Therefore, a functioning cochlear nerve must be verified before deciding to do cochlear implantation by means of behavioral audiometry, electrophysiologic tests, or imaging studies in cases with narrow IAC. On the other hand, a candidate with a normal IAC can be overlooked in investigating the presence of functioning cochlear nerve. Because normal IAC does not always guarantee the presence of normal cochlear nerve, the functioning cochlear nerve should be proved prior to cochlear implantation in those cases. We report on a child, who had normal IAC and cochlea but failed auditory stimulation after cochlear implantation, and who was diagnosed as having cochlear nerve deficiency through retrospective review. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:729-32

측두골 자기공명영상 와우신경 저형성증 및 무형성증에서의 인공와우 이식술

김종양,이정현,이성원,오수희,정종우,이광선 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.11

Background and Objectives:Identifying cochlear nerve hypoplasia or aplasia is dependent on temporal bone magnetic reso-nance imaging (TBMRI) providing information on the cochlea, internal auditory canal, and the cochlear nerve. The purpose of this study was to review the results of cochlear implantation (CI)TBMRI. Subjects and Method:From April 1999 to April 2005, 321 patients were fited with cochlear implants in our department by two surgeons. The present study focused on four prelingual patients who underwent CI in ears with cochlear nerve hypoplasia or aplasia as sugested by TBMRI. The perceptive and linguistic results were evaluated based on speech perception and production at preimplantation and at 1, 3, 6, 9, 12, and 24 months postimplantation. Results:Pre-operative auditory brainstem responses were ls in 10% and their categories of auditory performance scores were 4 or above. Conclusion:We confirmed cochlear nerve presence in cases of cochlear nerve hypoplasia or aplasia as sugested by TBMRI and made their auditory habilitation posible with cochlear implantation. However, even in cases of cochlear nerve hypoplasia or aplasia suggested by TBMRI, physicians need to confirm coch-lear nerve presence before implantation and to predict the outcome of cochlear implantation. Neck Surg 2007 ;50 :978-82)

현재 인공와우를 착용하지 않는 청각장애 청년들이 인식하는 인공와우 경험에 관한 연구

고혜정(Hye Jung Ko),김경미(Kyung Mee Kim) 한국장애인복지학회 2021 한국장애인복지학 Vol.52 No.52

지금까지 인공와우 관련 선행연구들은 말지각력과 말산출력에 초점을 두어 인공와우 시술을 받은 청각장애 아동들의 인공와우 관련 삶을 살펴보지 못하였다. 이에 본 연구는 청소년기 이전에 인공와우 시술을 받았으나 현재 인공와우를 사용하지 않는 청각장애인들의 인공와우 관련 경험을 탐색해보고자 하였다. 이를 위해 20~30대 청각장애 청년 7명을 대상으로 심층면담을 통해 자료를 수집하였다. Colaizzi의 방법으로 분석한 결과 다음과 같은 5가지의 주제를 도출하였다. 그 주제는『인공와우 시술에 대한 낙관적인 안내』,『인공와우에 대한 적응기』,『인공와우로 인한 갈등기』,『손상을 바라보는 새로운 시각』, 『인공와우로부터 해방』이다. 이를 기반으로 실천적 함의를 다음과 같이 제시하였다. 첫째, 의료계에서는 청각장애인의 의사소통에 도움을 주는 공식적인 수어통역 및 문자통역을 의무적으로 활용하여 제3자가 아닌 청각장애인 당사자에게 부작용과 결함 그리고 청각장애의 원인에 따른 인공와우의 정확한 시술 결과 등을 포함한 인공와우 관련 정보를 충분히 제공해야 한다. 그리고 의사의 권유가 아닌 청각장애인 당사자가 결정을 내리도록 지원해야 한다. 둘째, 인공와우는 소리가 들린다 해도 의사소통의 어려움을 해소해주는 완전한 기기가 아니다. 그러므로 인공와우에 대한 건청인의 인식개선이 필요하다. 또한 인공와우를 착용한 청각장애인들은 정확한 의사소통을 위해 수어와 필담이 필요하므로 청각장애인의 개개인의 의사소통 방법에 따라 필요시 수어통역 및 문자통역 서비스를 제공하여야 한다. 셋째, 인공와우를 통해 손실된 청력을 회복시킨다 해도 청각장애의 속성은 온전히 고칠 수 없다. 따라서 청각장애인에게 개인적 책임을 지우는 것이 아니라, 국가와 사회에서 장애를 발생시키는 제반환경에 대해 인식하고 이를 해결해야 하는 사회적 책임을 인식할 필요가 있다. Many studies on cochlear implants were focused on improvement in ability to hear and on speech perception and production. Therefore, there are few studies that have explored the experiences of deaf people who got cochlear implant as children and side effects from cochlear implants. For study, the interviews were conducted with 7 deaf people in depth. The participants got cochlear implants as children, but they don t use it now. The themes are 1) Having expectation for cochlear implants 2) Trying to adapt myself to cochlear implants 3) Raising a question about cochlear implants 4) Looking at deafness in a new way 5) Deciding to stop cochlear implants. It suggests several implications on the findings. First, Doctors must give all information, including any side effects, defects, effects of inner ear anomaly, and so on. For this, it is very important to provide sign language interpreters and communication access realtime translation services for deaf people. Second, deaf people with cochlear implants can hear anything. However, cochlear implants are only a device which can t make deaf people into hearing people. It is important to increase awareness of cochlear implant for hearing people who think that deaf people with cochlear implants might be able to communicate easily. If necessary, deaf people using cochlear implants should be given sign language interpreters and communication access realtime translation services for communication. Third, even thought deafness can be restored with cochlear implants, the nature of deafness can never be fixed. This is not a personal responsibility, but it is our responsibility as a society, and the society need to pay attention to the social issues in the deaf people lives.

보청기와 인공와우 기기에 대한 대학생들의 인식 및 태도: 보청기 효과와 인공와우 효과

허민정 ( Min Jung Heo ),김리석 ( Lee Suk Kim ),안성우 ( Seong Woo Ahn ),부성현 ( Sung Hyun Boo ) 대구대학교 한국특수교육문제연구소 2008 특수교육저널 : 이론과 실천 Vol.9 No.3

This study aims to investigate the perception and attitude of university students about hearing aid and cochlear implant, and to examine the variables related to their attitudes towards hearing aid and cochlear implant. The subjects were 114 university students, who were asked to see the pictures on wearing conditions and non-wearing conditions of hearing aid and cochlear implant and complete the adjective format scale . Also, they saw the pictures of hearing aid wearer and cochlear implant wearer, and completed the questionnaires about attitude for hearing aid and cochlear implant. Results show that university students show more negative perception about wearing conditions than non-wearing conditions on appearance, personality, and achievement for both hearing aid and cochlear implant. Attitude for cochlear implant was more negative than that for hearing aid on social stigma, viewpoint, and knowledge. As a result of analyzing related factors for attitude about hearing aid and cochlear implant, sex and wearing glasses or contact lenses were related to the social stigma for cochlear implant users. These results show that there exist ‘hearing aid effect’ and ‘cochlear implant effect’ in Korean university students, and their attitudes are more negative for cochlear implant than for hearing aid.

Health-Related Quality of Life in Children With Cochlear Implants From Parents’ Perspective

Rochd Sara,Benhoummad Othmane,Lakhdar Youssef,Salhi Salma,Lhadj Mohamed Amine Ait,Rochdi Youssef,Raji Abdelaziz 대한청각학회 2023 Journal of Audiology & Otology Vol.27 No.3

Background and Objectives: To evaluate the health-related quality of life (HRQoL) in parents of children with cochlear implants and assess influencing factors. These data can enable practitioners to support patients and their families in utilizing the cochlear implant and its benefits to the fullest extent.Subjects and Methods: A retrospective descriptive and analytic study was conducted at the Implantation center Mohammed VI. Parents of cochlear implant patients were asked to fill out forms and answer a questionnaire. Participants included parents of children <15 years old who underwent unilateral cochlear implantation between January 2009 and December 2019, presenting with bilateral severe to profound neurosensory deafness. Participants completed the children with cochlear implantation: parent’s perspective (CCIPP) HRQoL questionnaire.Results: The mean age of the children was 6.49±2.55 years. The mean time between implantation for each patient and this study was calculated as 4.33±2.05 years. There was a positive correlation between this variable and the following subscales: communication, well-being and happiness, and the process of implantation. For these subscales, the score was higher as the delay was greater. Parents of children who received speech therapy before implantation were more satisfied on the following subscales: communication, general functioning, well-being and happiness, implantation process, implantation effectiveness, and support for the child.Conclusions: The HRQoL is better in families of children who received their implant at an early age. This finding raises awareness of the importance of systemic screening in newborns.

개방형 유양동을 가진 환자에서의 인공와우 이식술

최전하,백훈희,조현상,김춘동 대한이비인후과학회 부산,울산,경남 지부회 2016 임상이비인후과 Vol.27 No.1

Background and Objectives:Performing cochlear implantation is a difficult process for those patients who have received radical mastoidectomy due to chronic otitis media. However, we could perform a single stage operation successfully without external auditory meatus and mastoid complete obliteration. Materials and Methods:The authors performed 13 cases of cochlear implantation in open cavity mastoidectomy state patients without obliteration of mastoid or with the partial obliteration of mastoid from July 2011 to July 2015. Of these thirteen patients, eight patients received cochlear implantation in the site of open mastoid cavity and others in opposite site. The medical records and radiological findings were reviewed retrospectively. Results:Three of eight patients who had undergone open cavity mastoidectomy did not perform mastoid cavity obliteration during cochlear implantation. Another five patients with an open cavity mastoid had undergone the partial obliteration of mastoid during cochlear implantation. There were no postoperative medical complications such as infections of mastoid cavity, recurrence of cholesteatoma and necrosis of skin flap during following up periods except for 1 case of delayed electrode extrusion. Conclusions:The advantages for this procedure as the following. First, we could overcome the difficulty of radiological diagnosis for primary or recurrent cholesteatoma due to mastoid obliteration. Second, a single-stage procedure allowed the implantation as safe as two-stage procedures. At last, non-obliterative or partial obliterative procedures may replace the typical mastoid obliteration process during cochlear implantation for it allows a safe procedure for open cavity patients reducing complications such as electrode extrusion or infection.

만성중이염 환자에서 와우이식술

김종선,심우섭,장선오,오승하,김영호,이효정,최병윤 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.8

Background and Objectives:Profound hearing los can be folowed by the process of chronic otitis media. The aim of the study is to evaluate management options in cochlear implantation in patients with chronic midle ear disease. Materials and Method:Two senior authors performed a total of 367 cases of cochlear implantation from November 1988 to August 2003. Among these, nine patients with chronic middle ear disease received cochlear implantation. The medical records and radiological findings were reviewed retrospectively. Results:Of these nine patients, three patients with active inflammation underwent two open cavity and one closed cavity tympanomastoidectomy. Cochlear implantation was followed after a 3 to 6 months interval. Six patients who had undergone a prior tympanomastoidectomy showed no active inflamation. Two of these patients (case 4, 5) months interval. Another four patients had well-obliterated mastoid cavity by previous surgery, and received cochlear implantation as a single-stage procedure. To date, no patient has experienced postoperative wound problems. Conclusion:It is mandatory to secure an infection-free ear before implantation. Two-stage procedures must be performed if there is any doubt concerning the eradication of disease. It is also essential to create a strong protective layer of tissue capable of covering the electrode array