• Journal of Audiology & Otology
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• v.25 no.3
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• pp.138-145
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• 2021

Background and Objectives: This study aimed to evaluate the audiologic results after cochlear implantation (CI) in older patients and the degree of improvement in their quality of life (QoL). Subjects and Methods: Patients over 65 years old who underwent CI at implant center in Bozyaka Training and Research Hospital were included in this study (n=54; 34 males and 20 females). The control group was patient over 65 years old with normal hearing (n=54; 34 males and 20 females). We administered three questionnaires [World Health Organization Quality of Life-BREF (WHOQOL-BREF), World Health Organization Quality of Life-OLD (WHOQOL-OLD)], and Geriatric Depression Scale (GDS) to evaluate the QoL, CIrelated effects on activities of daily life, and social activities in all the subjects. Moreover, correlations between speech recognition and the QoL scores were evaluated. The duration of implant use and comorbidities were also examined as potential factors affecting QoL. Results: The patients had remarkable improvements (the mean score of postoperative speech perception 75.7%) in speech perception after CI. The scores for the WHOQOL-OLD and WHOQOL-BREF questionnaire responses were similar in both the study and control groups, except those for a two subdomains (social relations and social participation). The patients with longer-term CI had higher scores than those with short-term CI use. In general, the changes in GDS scores were not significant (p<0.05). Conclusions: The treatment of hearing loss with CI conferred significant improvement in patient's QoL (p<0.01). The evaluation of QoL can provide multidimensional insights into a geriatric patient's progress and, therefore, should be considered by audiologists.

• Proceedings of the KSPS conference
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• 2007.05a
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• pp.274-277
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• 2007

The purpose of this study is 1) to describe the phoneme inventories of cochlear implant(CI) children and 2) to describe their utterances using narrow phonetic transcription method. All the subjects had more than 2 year-experience with CI and showed more than 87% open-set sentence perception abilities. Average consonant accuracy was 81.36% and it was improved up to 87.41% when distortion errors were not counted. They showed different error patterns from hearing aid users. The prominent error pattern was weakening of consonants.

• Journal of Biomedical Engineering Research
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• v.28 no.5
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• pp.694-702
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• 2007

The adaptation effect originating from the chemical synapse between auditory nerve and inner hair cell gives advantage in accurate representation of temporal cues of incoming speech such as speech onset. Thus it is expected that the modification of conventional speech processing strategies of cochlear implant(CI) by incorporating the adaptation effect will result in considerable improvement of speech perception performance such as consonant perception score. Our purpose in this paper was to evaluate our new CI speech processing strategy incorporating the adaptation effect by the observation of auditory nerve responses. By classifying the presence or absence of speech from the auditory nerve responses, i. e. spike trains, we could quantitatively compare speech onset detection performances of conventional and improved strategies. We could verify the effectiveness of the adaptation effect in improving the speech onset representation characteristics.

• ETRI Journal
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• v.35 no.4
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• pp.697-705
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• 2013

Emerging trends in the area of digital very large scale integration (VLSI) signal processing can lead to a reduction in the cost of the cochlear implant. Digital signal processing algorithms are repetitively used in speech processors for filtering and encoding operations. The critical paths in these algorithms limit the performance of the speech processors. These algorithms must be transformed to accommodate processors designed to be high speed and have less area and low power. This can be realized by basing the design of the auditory filter banks for the processors on digital VLSI signal processing concepts. By applying a folding algorithm to the second-order digital gammatone filter (GTF), the number of multipliers is reduced from five to one and the number of adders is reduced from three to one, without changing the characteristics of the filter. Folded second-order filter sections are cascaded with three similar structures to realize the eighth-order digital GTF whose response is a close match to the human cochlea response. The silicon area is reduced from twenty to four multipliers and from twelve to four adders by using the folding architecture.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.644-649
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• 2018

Background and Objectives The objective of this study was to examine the effect of early cochlear implantation (CI) performed in infants less than 12 months of age. Subjects and Method Twenty-five children who received their first CI before 12 months of age were included in this study (infant group). The speech perception and language outcomes of these children were compared with those of 14 children who received their first CI between 13 and 24 months of age (older group). All children received sequential bilateral CI with the inter-stage interval of less than 2 years. Speech perception was measured using Categories of Auditory Performance, monosyllabic word test and sentence test, and language ability was measured using Sequenced Language Scale for Infants, Preschool Receptive-Expressive Language Scale, or Receptive & Expressive Vocavulary Test, depending on the age at the time of testing. Results There were no significant differences in speech perception abilities between the infant group and the older group. The mean expressive language score of infant group was higher than that of the older group, but the difference was not statistically significant. However, the receptive language score of infant group was significantly higher than that of the older group. Conclusion Children who received CI before 12 months of age achieved better receptive language ability than those who received it after 12 months of age. Thus CI should be performed as early as before 12 months of age to achieve better language ability.

• Journal of Biomedical Engineering Research
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• v.28 no.2
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• pp.271-279
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• 2007

We suggest a novel method for the evaluation of cochlear implant (CI) speech processing strategy based on neural spike train decoding. From formant trajectories of input speech and auditory nerve responses responding to the electrical pulse trains generated from a specific CI speech processing strategy, optimal linear decoding filter was obtained, and used to estimate formant trajectory of incoming speech. Performance of a specific strategy is evaluated by comparing true and estimated formant trajectories. We compared a newly-developed strategy rooted from a closer mimicking of auditory periphery using nonlinear time-varying filter, with a conventional linear-filter-based strategy. It was shown that the formant trajectories could be estimated more exactly in the case of the nonlinear time-varying strategy. The superiority was more prominent when background noise level is high, and the spectral characteristic of the background noise was close to that of speech signals. This confirms the superiority observed from other evaluation methods, such as acoustic simulation and spectral analysis.

• Phonetics and Speech Sciences
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• v.6 no.2
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• pp.55-64
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• 2014

This study measured formant bandwidths of profound hearing impaired children and examined the characteristics of their articulation. For this study, 10 cochlear implanted children(CI), 10 hearing aid children(HA) and 10 normal hearing children(NH) were asked to read 7 Korean vowels(/ɑ, ʌ, o, u, ɯ, i, ɛ/). The subjects' readings were recorded by NasalView and analyzed by Praat. The analysis of the formant bandwidths explains the degree of vocal fold opening and the characteristics of radiation. Through the analysis of formant bandwidth, we can see that the hearing-impaired maintain vocal fold tension when they speak high vowels and characteristics of radiation. Narrower B1 means better maintain vocal fold tension, wider B2 means more front and wider B3 means the rounder lips. CI's B1 was widest and NH's was narrowest. And females' B1 was wider than males'. Among vowels, B1 of /a/ was widest, and B1 of /i/ was narrowest. In the case of B2, HA and NH's B2 was wider than CI's. Females' B2 was wider than males'. And B2 of /i/ was widest, and B2 of /ʌ/ was narrowest. In the case of B3, NH's was widest, and CI's was narrowest. Males' was wider than females'. Among vowels, B3 of /o/ was widest, and B3 of /ɛ/ was narrowest. As a result, first, through the analysis of B1, we can find that NH and males could better maintain vocal fold tension than the hearing-impaired or females, and all children articulate /i/ with vocal fold tension than other vowels. Second, through the analysis of B2, NH and HA articulate vowels with the weaker rounded than CI does. And females articulate vowels with the weaker rounded than males do. Third, through the analysis of B3, NH articulate vowels with the rounder than HA or CI do, and males articulate vowels with the rounder than females do. Through the results, we can expect that the analysis of formant bandwidth will be applied to the therapy of articulation for the hearing-impaired with hearing aids or cochlear implant.

• Phonetics and Speech Sciences
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• v.1 no.4
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• pp.203-207
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• 2009

Electrically evoked compound action potentials (ECAP) have originated from the distal end of the auditory nerve. ECAP are characterized as the difference between the clearly large trough (N) and the following positive peak (P). N-wave occurs around $200-400\;{\mu}s$ after stimulus onset and P-wave at around $400-800\;{\mu}s$. Contrary to expectations, positive peaked ECAP (pp-ECAP) was dominated by a relatively large-amplitude positive following negative peak. pp-ECAP can be recorded from the sites on or near the surgically exposed nerve trunk in animal models and/or in cases of monophasic stimulation. This study will provide the causes of the appearance of pp-ECAP in cases of cochlear implant recipients using imaging studies and medical records and statistically analysis between N-P and P-N on the amplitude input-output function (amp-I/O) for the prediction of the possibilities of clinical tools. Thirteen children participated in the study and received a Cochlear CI-24RE (CA). ECAP was recorded using auto-NRT (Cochlear Ltd., Australia) at four to five weeks post surgery. pp-ECAP was measured from 36 electrodes and typical ECAP from 220 electrodes. There was no abnormality in the imaging study and operation finding in patients with typical ECAP. pp-ECAP was found at the inner ear anormaly and ossification in imaging study and gel-state inner ear fluid was observed in the operation finding. The amplitude of pp-ECAP increased depending on current intensities, but amp-I/O increase more gradually than in the case of typical ECAP (p=0.003). pp-ECAP is antidromic potential which can record from the inner ear anormaly and ossified cochlear. Amp-I/O also depends on current intensity as well typical ECAP. These results provide a useful tool for audiological evaluation for the spiral ganglion cell status to the value of pp-ECAP.

• Journal of Audiology & Otology
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• v.24 no.2
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• pp.61-70
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• 2020

Background and Objectives: To assess the academic performance, communication skills, and psychosocial development of prelingual deaf children with cochlear implants (CIs) attending mainstream schools, and to evaluate the impact of auditory speech perception on their classroom performance. Subjects and Methods: As participant, 67 children with CI attending mainstream schools were included. A survey was conducted using a structured questionnaire on academic performance in the native language, second language, mathematics, social studies, science, art, communication skills, self-esteem, and social relations. Additionally, auditory and speech performances on the last follow-up were reviewed retrospectively. Results: Most implanted children attending mainstream school appeared to have positive self-esteem and confidence, and had little difficulty in conversing in a quiet classroom. Also, half of the implanted children (38/67) scored above average in general academic achievement. However, academic achievement in the second language (English), social studies, and science were usually poorer than general academic achievement. Furthermore, half of the implanted children had difficulty in understanding the class content (30/67) or conversing with peers in a noisy classroom (32/67). These difficulties were significantly associated with poor speech perception. Conclusions: Improving the listening environment for implanted children attending mainstream schools is necessary.

• Korean Journal of Audiology
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• v.24 no.2
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• pp.61-70
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• 2020

Background and Objectives: To assess the academic performance, communication skills, and psychosocial development of prelingual deaf children with cochlear implants (CIs) attending mainstream schools, and to evaluate the impact of auditory speech perception on their classroom performance. Subjects and Methods: As participant, 67 children with CI attending mainstream schools were included. A survey was conducted using a structured questionnaire on academic performance in the native language, second language, mathematics, social studies, science, art, communication skills, self-esteem, and social relations. Additionally, auditory and speech performances on the last follow-up were reviewed retrospectively. Results: Most implanted children attending mainstream school appeared to have positive self-esteem and confidence, and had little difficulty in conversing in a quiet classroom. Also, half of the implanted children (38/67) scored above average in general academic achievement. However, academic achievement in the second language (English), social studies, and science were usually poorer than general academic achievement. Furthermore, half of the implanted children had difficulty in understanding the class content (30/67) or conversing with peers in a noisy classroom (32/67). These difficulties were significantly associated with poor speech perception. Conclusions: Improving the listening environment for implanted children attending mainstream schools is necessary.