Jeril, (2022) Assessment of Outcomes of Hearing and Speech in Cochlear Implant Recipients. Masters thesis, P.S.G. Institute of Medical Sciences and Research, Coimbatore.
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Abstract
AIM OF THE STUDY: This project is aimed at focusing on evaluating the post-operative outcomes of the children in speech and hearing capability of the Cochlear implant recipients. The level of improvement in terms of speech and hearing aspects are assessed to correlate as to how the Cochlear implant can stimulate the speech capability of the impaired children, while detailing the historical development of the Cochlear implants and its successful applications of the modern medical aid and technique. OBJECTIVE: The objective is to undertake data analysis pertaining to hearing aid implant done for the children and detailed study evaluating the post-operative outcomes of the children in speech and hearing in Cochlear implant recipients on the basis of the primary data sourced from the health records from the hospital and subsequent evaluation and analysis with appropriate interpretations thereon. MATERIALS AND METHODS: STUDY DESIGN: More than 150 pediatric patients with bilateral severe-to-profound sensorineural deafness who received Cochlear implantation were evaluated for speech and hearing improvement by audiovisual team with regular monthly assessment of improvement. All patients were followed up for a period of one year for hearing and speech performance after the surgery. The CAP and SIR hearing and speech assessments and rating materials were used for assessment after surgery on a monthly basis after implant activation. CATEGORIES OF AUDITORY PERFORMANCE AND SPEECH INTELLIGIBILITY RATING. The University of Nottingham developed the Categories of Auditory Performance (CAP) and the Speech Intelligibility Rating (SIR) for assessing children's daily auditory and speech ability (Han [et al.], 2007), which have been widely used in the evaluation of the effect of speech rehabilitation after Cochlear implantation in young children (Li et al., 2014; Archbold [et al.], 1998; Nikolopoulos et al.], 2005). The CAP and SIR criteria is shown in tables 3 and 4 respectively. CONCLUSION: Assessment methodology and evaluation techniques based observations and findings are summarised here below to arrive at appropriate and more relevant conclusions on the subject research. CAP and SIR rating at each time point after surgery was the major parameter and input for the assessment as a whole along with the other medical information of the patient both Group A (Children - Babies upto2 Year) and Group B (Children - above 2 Year to 6 Years). The Mann – Whitney U test was used to examine the CAP and SIR results of each group after the surgery. The differences among groups were not statistically significant before the surgery or at 1 month after the device activation. From 4 months after activation, the CAP started to increase and SIR scores started to show significant increase from 9th month post implant among CI recipients younger than 2 yrs of age. This research findings are further narrowing down the conclusion in terms of the post-implant outcomes for the children patient age groups. The scores of patients in the open-set speech assessment, CAP and SIR significantly improved after Cochlear implantation as it is evident form this research data and its associated add-on information pertaining to the subject matter. ❖ The results showed that hearing and speech abilities of Groups A patients (Children - Babies upto 2 Year) are significantly better than that of Group B (Children - above 2 Year to 6 Years), indicating that the younger the age at implantation yields better the outcomes. Compared with Group B (Children - above 2 Year to 6 Years), the better performance of Group A (Children - Babies upto 2 Year) is contributed by many factors including better cooperation of the parents and their dedicated commitment, cooperation and post implant care of that age group children. ❖ The younger the age at implantation, the better the results. Moreover, the hearing and speech performance of Cochlear implant recipients gradually improved with the extension of rehabilitation time. ❖ There is substantial evidence that Cochlear implant is beneficial to children with residual hearing. Preoperative residual hearing is also valuable to predict speech perception outcomes after Cochlear implantation. There is more extensive research being conducted worldwide in order to make recommendations and to set prognosis for Cochlear implants based on children preoperative residual hearing. ❖ Early implantation has positive effects on hearing capability which in turn results in better speech and language skills development, which is very significant as it is evident from the analysis on the subject. ❖ Also, the regular CI use, which is defined as using the CI for 8 hours or greater per day, proved higher benefits. It is also worth noting that high rates of regular CI use are sustained after childhood implantation, which is also an encouraging factual to go for Cochlear implant at young childhood age that would be more useful and beneficial by all means. ❖ As per auditory perception assessment and open speech assessment, suggesting Cochlear implantation can substantially improve children's hearing and speech ability and even improve their speech perception and cognitive abilities, social activities, and therefore have a better quality of life. Cochlear implantation can improve the hearing and speech performance of patients with bilateral severe-toprofound sensorineural deafness. ❖ Utilizing the opportunities available in the local State in terms of financial aids by the Tamil Nadu State government for Cochlear implant, the parents shall come forward with open mind to avail the opportunity for the betterment of the children with hearing loss to bring them up in the present day competitive environment to succeed in their future at par with their piers having no profound hearing deficiencies. All the above significant benefits are the outcomes identified through the subject research as a conclusion.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221914402 |
| Uncontrolled Keywords: | Assessment, Outcomes, Hearing and Speech, Cochlear Implant Recipients. |
| Subjects: | MEDICAL > Otolaryngology > MEDICAL > Otolaryngology |
| Depositing User: | Subramani R |
| Date Deposited: | 22 Apr 2022 16:52 |
| Last Modified: | 17 Dec 2023 15:16 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/19391 |
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