Cochlear Implantation for Children and Adults with Severe-to-Profound Hearing Loss

Lavin K. Entwisle; Sarah E. Warren; Jessica J. Messersmith

doi:10.1055/s-0038-1670705

Seminars in Hearing, Table of Contents

Semin Hear 2018; 39(04): 390-404
DOI: 10.1055/s-0038-1670705

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Cochlear Implantation for Children and Adults with Severe-to-Profound Hearing Loss

Authors

Lavin K. Entwisle

¹Department of Communication Sciences and Disorders, University of South Dakota, Vermillion, South Dakota

³Department of Otolaryngology, New York University School of Medicine, New York, New York
Sarah E. Warren

²School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee
Jessica J. Messersmith

¹Department of Communication Sciences and Disorders, University of South Dakota, Vermillion, South Dakota

Abstract

Cochlear implants (CIs) have proven to be a useful treatment option for individuals with severe-to-profound hearing loss by providing improved access to one's surrounding auditory environment. CIs differ from traditional acoustic amplification by providing information to the auditory system via electrical stimulation. Both postlingually deafened adults and prelingually deafened children can benefit from a CI; however, outcomes with a CI can vary. Numerous factors can impact performance outcomes with a CI. It is important for the audiologist to understand what factors might play a role and impact performance outcomes with a CI so that they can effectively counsel the recipient and their family, as well as establish appropriate and realistic expectations with a CI. This review article will discuss the CI candidacy process, CI programming and postoperative follow-up care, as well as considerations across the lifespan that may affect performance outcomes with a CI.

Keywords

cochlear implant - cochlear implant candidacy - cochlear implant outcomes

Full Text

References

References
1 Van de Heyning P, Vermeire K, Diebl M, Nopp P, Anderson I, De Ridder D. Incapacitating unilateral tinnitus in single-sided deafness treated by cochlear implantation. Ann Otol Rhinol Laryngol 2008; 117 (09) 645-652
2 Firszt JB, Holden LK, Reeder RM, Waltzman SB, Arndt S. Auditory abilities after cochlear implantation in adults with unilateral deafness: a pilot study. Otol Neurotol 2012; 33 (08) 1339-1346
3 Hansen MR, Gantz BJ, Dunn C. Outcomes after cochlear implantation for patients with single-sided deafness, including those with recalcitrant Ménière's disease. Otol Neurotol 2013; 34 (09) 1681-1687
4 Rahne T, Plontke SK. Functional result after cochlear implantation in children and adults with single-sided deafness. Otol Neurotol 2016; 37 (09) e332-e340
5 Zeitler DM, Dorman MF, Natale SJ, Loiselle L, Yost WA, Gifford RH. Sound source localization and speech understanding in complex listening environments by single-sided deaf listeners after cochlear implantation. Otol Neurotol 2015; 36 (09) 1467-1471
6 Mertens G, Desmet J, De Bodt M, Van de Heyning P. Prospective case-controlled sound localisation study after cochlear implantation in adults with single-sided deafness and ipsilateral tinnitus. Clin Otolaryngol 2016; 41 (05) 511-518
7 Sladen DP, Frisch CD, Carlson ML, Driscoll CL, Torres JH, Zeitler DM. Cochlear implantation for single-sided deafness: a multicenter study. Laryngoscope 2017; 127 (01) 223-228
8 Gernandes NF, Morettin M, Yamagutti EH. , et al. Performance of hearing skills in children with auditory neuropathy spectrum disorder using cochlear implants: a systematic review. Braz J Otorhinolarynol 2015; 81 (01) 85-96
9 Caposecco A, Hickson L, Pedley K. Cochlear implant outcomes in adults and adolescents with early-onset hearing loss. Ear Hear 2012; 33 (02) 209-220
10 Niparko JK, Tobey EA, Thal DJ. , et al; CDaCI Investigative Team. Spoken language development in children following cochlear implantation. JAMA 2010; 303 (15) 1498-1506
11 Nicholas JG, Geers AE. Effects of early auditory experience on the spoken language of deaf children at 3 years of age. Ear Hear 2006; 27 (03) 286-298
12 Sharma A, Dorman MF, Kral A. The influence of a sensitive period on central auditory development in children with unilateral and bilateral cochlear implants. Hear Res 2005; 203 (1-2): 134-143
13 Dowell RC, Dettman SJ, Blamey PJ, Barker EJ, Clark GM. Speech perception in children using cochlear implants: prediction of long-term outcomes. Cochlear Implants Int 2002; 3 (01) 1-18
14 Vincenti V, Bacciu A, Guida M. , et al. Pediatric cochlear implantation: an update. Ital J Pediatr 2014; 40: 72
15 Philippon D, Bergeron F, Ferron P, Bussières R. Cochlear implantation in postmeningitic deafness. Otol Neurotol 2010; 31 (01) 83-87
16 Mylanus EA, Rotteveel LJ, Leeuw RL. Congenital malformation of the inner ear and pediatric cochlear implantation. Otol Neurotol 2004; 25 (03) 308-317
17 Corrales CE, Oghalai JS. Cochlear implant considerations in children with additional disabilities. Curr Otorhinolaryngol Rep 2013; 1 (02) 61-68
18 Meinzen-Derr J, Wiley S, Grether S, Choo DI. Children with cochlear implants and developmental disabilities: a language skills study with developmentally matched hearing peers. Res Dev Disabil 2011; 32 (02) 757-767
19 Minimum Speech Test Battery (MSTB). Minimum speech test battery for adult cochlear implant users 2011; Available at: http://www.auditorypotential.com/MSTBfiles/MSTBManual2011-06-20%20.pdf Accessed September 5, 2018
20 Lehiste I, Peterson G. Linguistic considerations in the study of speech intelligibility. J Acoust Soc Am 1959; 31 (03) 280-286
21 Spahr AJ, Dorman MF, Litvak LM. , et al. Development and validation of the AzBio sentence lists. Ear Hear 2012; 33 (01) 112-117
22 Bench J, Kowal A, Bamford J. The BKB (Bamford-Kowal-Bench) sentence lists for partially-hearing children. Br J Audiol 1979; 13 (03) 108-112
23 Uhler K, Warner-Czyz A, Gifford R, Working Group P. Pediatric minimum speech test battery. J Am Acad Audiol 2017; 28 (03) 232-247
24 Vaerenburg B, Smits C, Ceulaer G. , et al. Cochlear implant programming: a survey on the state of the art. Sci World J 2014 . Available at: https://www.hindawi.com/journals/tswj/2014/501738 . Accessed September 5, 2018
25 Hemmingson C, Messersmith JJ. Cochlear implant practice patterns: the U.S. trends with pediatric patients. J Am Acad Audiol 2017; 00 (00) 1-12
26 Shapiro WH, Bradham TS. Cochlear implant programming. Otolaryngol Clin North Am 2012; 45 (01) 111-127
27 Sainz M, de la Torre A, Roldán C, Ruiz JM, Vargas JL. Analysis of programming maps and its application for balancing multichannel cochlear implants. Int J Audiol 2003; 42 (01) 43-51
28 Baudhuin J, Cadieux J, Firszt JB, Reeder RM, Maxson JL. Optimization of programming parameters in children with the advanced bionics cochlear implant. J Am Acad Audiol 2012; 23 (05) 302-312
29 Gordon KA, Papsin BC, Harrison RV. Toward a battery of behavioral and objective measures to achieve optimal cochlear implant stimulation levels in children. Ear Hear 2004; 25 (05) 447-463
30 Wolfe J, Schafer EC. Programming cochlear implants: a volume in the core clinical concepts in audiology series. San Diego, CA: Plural Publishing; 2010
31 Walkowiak A, Lorens A, Polak M. , et al. Evoked stapedius reflex and compound action potential thresholds versus most comfortable loudness level: assessment of their relation for charge-based fitting strategies in implant users. ORL J Otorhinolaryngol Relat Spec 2011; 73 (04) 189-195
32 Waltzman SB, Roland JT. Cochlea Implants. New York, NY: Thieme; 2014
33 Caner G, Olgun L, Gültekin G, Balaban M. Optimizing fitting in children using objective measures such as neural response imaging and electrically evoked stapedius reflex threshold. Otol Neurotol 2007; 28 (05) 637-640
34 Wolfe J, Schafer EC. Programming cochlear implants in children. In: Eisenberg LS. , ed. Clinical Management of Children with Cochlear Implants. San Diego, CA: Plural Publishing; 2017: 105-153
35 DeVos JJ, Biesheuvel JD, Briaire JJ. , et al. Use of electrically evoked compound action potentials for cochlear implant fitting: a systematic review. Ear Hear 2018; 39 (03) 401-411
36 Gross A. Fitting Techniques for the pediatric cochlear implant patient 2003. Available at: http://www.audiologyonline.com/articles/fitting-techniques-for-pediatric-cochlear-1128 . Accessed March 13, 2018
37 Hodges AV, Balkany TJ, Ruth RA, Lambert PR, Dolan-Ash S, Schloffman JJ. Electrical middle ear muscle reflex: use in cochlear implant programming. Otolaryngol Head Neck Surg 1997; 117 (3, Pt 1): 255-261
38 Jerger J, Jenkins H, Fifer R, Mecklenburg D. Stapedius reflex to electrical stimulation in a patient with a cochlear implant. Ann Otol Rhinol Laryngol 1986; 95 (2, Pt 1): 151-157
39 Kosaner J, Anderson I, Turan Z. , et al. The use of ESRT in fitting children with cochlear implants. Int Adv Otol 2009; 5 (01) 70-79
40 Andrade KC, Leal MdeC, Muniz LF, Menezes PdeL, Albuquerque KM, Carnaúba AT. The importance of electrically evoked stapedial reflex in cochlear implant. Rev Bras Otorrinolaringol (Engl Ed) 2014; 80 (01) 68-77
41 Lorens A, Walkowiak A, Piotrowska A, Skarzynski H, Anderson I. ESRT and MCL correlations in experienced paediatric cochlear implant users. Cochlear Implants Int 2004; 5 (01) 28-37
42 Polak M, Hodges AV, King JE, Payne SL, Balkany TJ. Objective methods in postlingually and prelingually deafened adults for programming cochlear implants: ESR and NRT. Cochlear Implants Int 2006; 7 (03) 125-141
43 Potts LG, Skinner MW, Gotter BD, Strube MJ, Brenner CA. Relation between neural response telemetry thresholds, T- and C-levels, and loudness judgments in 12 adult nucleus 24 cochlear implant recipients. Ear Hear 2007; 28 (04) 495-511
44 Wolfe J, Kasulis H. Relationships among objective measures and speech perception in adult users of the HiResolution Bionic Ear. Cochlear Implants Int 2008; 9 (02) 70-81
45 Spivak LG, Chute PM, Popp AL, Parisier SC. Programming the cochlear implant based on electrical acoustic reflex thresholds: patient performance. Laryngoscope 1994; 104 (10) 1225-1230
46 Van Den Abbeele T, Noël-Petroff N, Akin I. , et al. Multicentre investigation on electrically evoked compound action potential and stapedius reflex: how do these objective measures relate to implant programming parameters?. Cochlear Implants Int 2012; 13 (01) 26-34
47 Gordon K, Papsin BC, Harrison RV. Programming cochlear implant stimulation levels in infants and children with a combination of objective measures. Int J Audiol 2004; 43 (Suppl. 01) S28-S32
48 Wolfe J, Gilbert M, Schafer E. , et al. Optimizations for the electrically-evoked stapedial reflex threshold measurement in cochlear implant recipients. Ear Hear 2017; 38 (02) 255-261
49 Wolfe J, Gifford R, Schafer E. Measurement of the electrically evoked stapedial reflex response with wideband acoustic reflectance measurement. J Am Acad Audiol 2018; 29 (04) 337-347
50 Moore B. An Introduction to the Psychology of Hearing. Bingley, UK: Emerald Group Publishing Limited; 2013
51 Dawson PW, Skok M, Clark GM. The effect of loudness imbalance between electrodes in cochlear implant users. Ear Hear 1997; 18 (02) 156-165
52 Bionics A. . (2011). SoundWave 2.1: Quick reference cards. Available at: http://www.advancedbionics.com/content/dam/ab/Global/en_ce/documents/professional/AB_SoundWave_2.1_Quick_Reference_Cards.pdf . Accessed March 13, 2018
53 Cochlear. (2010). Clinical guidance document. Available at: http://cochlear-cee-training.org/wordpress/wp-content/uploads/2011/12/231495_ISS3_EN_CSS_Clinical_Guidance_Document. pdf . Accessed March 13, 2018
54 MED-EL. Maestro System Software Version 3.0, User Manual. Innsbruck, Austria: 2008
55 Cochlear Corporation. Custom Sound software version 5.0 user guide. Sydney, Australia: 2017
56 Plant K, Law MA, Whitford L. , et al. Evaluation of streamlined programming procedures for the Nucleus cochlear implant with the Contour electrode array. Ear Hear 2005; 26 (06) 651-668
57 Hughes ML, Vander Werff KR, Brown CJ. , et al. A longitudinal study of electrode impedance, the electrically evoked compound action potential, and behavioral measures in nucleus 24 cochlear implant users. Ear Hear 2001; 22 (06) 471-486
58 Shapiro W, Waltzman S. Changes in electrical thresholds over time in young children implanted with the Nucleus cochlear prosthesis. Ann Otol Rhinol Laryngol Suppl 1995; 166: 177-178
59 Henkin Y, Kaplan-Neeman R, Muchnik C, Kronenberg J, Hildesheimer M. Changes over time in electrical stimulation levels and electrode impedance values in children using the Nucleus 24M cochlear implant. Int J Pediatr Otorhinolaryngol 2003; 67 (08) 873-880
60 Uhler K, Gifford RH. Current trends in pediatric cochlear implant candidate selection and postoperative follow-up. Am J Audiol 2014; 23 (03) 309-325
61 Svirsky MA, Robbins AM, Kirk KI, Pisoni DB, Miyamoto RT. Language development in profoundly deaf children with cochlear implants. Psychol Sci 2000; 11 (02) 153-158
62 Tomblin JB, Spencer L, Flock S, Tyler R, Gantz B. A comparison of language achievement in children with cochlear implants and children using hearing aids. J Speech Lang Hear Res 1999; 42 (02) 497-509
63 de Hoog BE, Langereis MC, van Weerdenburg M, Keuning J, Knoors H, Verhoeven L. Auditory and verbal memory predictors of spoken language skills in children with cochlear implants. Res Dev Disabil 2016; 57: 112-124
64 Manrique M, Cervera-Paz FJ, Huarte A, Molina M. Advantages of cochlear implantation in prelingual deaf children before 2 years of age when compared with later implantation. Laryngoscope 2004; 114 (08) 1462-1469
65 Nicholas JG, Geers AE. Will they catch up? The role of age at cochlear implantation in the spoken language development of children with severe to profound hearing loss. J Speech Lang Hear Res 2007; 50 (04) 1048-1062
66 McConkey Robbins A, Koch DB, Osberger MJ, Zimmerman-Phillips S, Kishon-Rabin L. Effect of age at cochlear implantation on auditory skill development in infants and toddlers. Arch Otolaryngol Head Neck Surg 2004; 130 (05) 570-574
67 Tobey EA, Thal D, Niparko JK, Eisenberg LS, Quittner AL, Wang NY. ; CDaCI Investigative Team. Influence of implantation age on school-age language performance in pediatric cochlear implant users. Int J Audiol 2013; 52 (04) 219-229
68 Geers AE. Speech, language, and reading skills after early cochlear implantation. Arch Otolaryngol Head Neck Surg 2004; 130 (05) 634-638
69 Geers AE, Nicholas JG, Sedey AL. Language skills of children with early cochlear implantation. Ear Hear 2003; 24 (1, Suppl): 46S-58S
70 Colletti L, Mandalà M, Colletti V. Cochlear implants in children younger than 6 months. Otolaryngol Head Neck Surg 2012; 147 (01) 139-146
71 Dettman SJ, Pinder D, Briggs RJS, Dowell RC, Leigh JR. Communication development in children who receive the cochlear implant younger than 12 months: risks versus benefits. Ear Hear 2007; 28 (2, Suppl): 11S-18S
72 Govaerts PJ, De Beukelaer C, Daemers K. , et al. Outcome of cochlear implantation at different ages from 0 to 6 years. Otol Neurotol 2002; 23 (06) 885-890
73 McConkey Robbins A, Koch DB, Osberger MJ, Zimmerman-Phillips S, Kishon-Rabin L. Effect of age at cochlear implantation on auditory skill development in infants and toddlers. Arch Otolaryngol Head Neck Surg 2004; 130 (05) 570-574
74 Connor CM, Craig HK, Raudenbush SW, Heavner K, Zwolan TA. The age at which young deaf children receive cochlear implants and their vocabulary and speech-production growth: is there an added value for early implantation?. Ear Hear 2006; 27 (06) 628-644
75 Schauwers K, Gillis S, Daemers K, De Beukelaer C, Govaerts PJ. Cochlear implantation between 5 and 20 months of age: the onset of babbling and the audiologic outcome. Otol Neurotol 2004; 25 (03) 263-270
76 Zwolan TA, Ashbaugh CM, Alarfaj A. , et al. Pediatric cochlear implant patient performance as a function of age at implantation. Otol Neurotol 2004; 25 (02) 112-120
77 Houston DM, Stewart J, Moberly A, Hollich G, Miyamoto RT. Word learning in deaf children with cochlear implants: effects of early auditory experience. Dev Sci 2012; 15 (03) 448-461
78 Tait M, De Raeve L, Nikolopoulos TP. Deaf children with cochlear implants before the age of 1 year: comparison of preverbal communication with normally hearing children. Int J Pediatr Otorhinolaryngol 2007; 71 (10) 1605-1611
79 Sharma A, Dorman MF, Spahr AJ. A sensitive period for the development of the central auditory system in children with cochlear implants: implications for age of implantation. Ear Hear 2002; 23 (06) 532-539
80 Dorman MF, Sharma A, Gilley P, Martin K, Roland P. Central auditory development: evidence from CAEP measurements in children fit with cochlear implants. J Commun Disord 2007; 40 (04) 284-294
81 Sharma A, Gilley PM, Dorman MF, Baldwin R. Deprivation-induced cortical reorganization in children with cochlear implants. Int J Audiol 2007; 46 (09) 494-499
82 Sharma A, Nash AA, Dorman M. Cortical development, plasticity and re-organization in children with cochlear implants. J Commun Disord 2009; 42 (04) 272-279
83 Cosetti M, Roland Jr JT. Cochlear implantation in the very young child: issues unique to the under-1 population. Trends Amplif 2010; 14 (01) 46-57
84 Waltzman SB, Roland Jr JT. Cochlear implantation in children younger than 12 months. Pediatrics 2005; 116 (04) e487-e493
85 Friedland DR, Runge-Samuelson C, Baig H, Jensen J. Case-control analysis of cochlear implant performance in elderly patients. Arch Otolaryngol Head Neck Surg 2010; 136 (05) 432-438
86 Hay-McCutcheon MJ, Pisoni DB, Kirk KI. Audiovisual speech perception in elderly cochlear implant recipients. Laryngoscope 2005; 115 (10) 1887-1894
87 Wexler M, Miller LW, Berliner KI, Crary WG. Psychological effects of cochlear implant: patient and “index relative” perceptions. Ann Otol Rhinol Laryngol Suppl 1982; 91 (2, Pt 3): 59-61
88 Nakajima S, Iwaki S, Fujisawa N. , et al. Speech discrimination in elderly cochlear implant users. Adv Otorhinolaryngol 2000; 57: 368-369
89 Orabi AA, Mawman D, Al-Zoubi F, Saeed SR, Ramsden RT. Cochlear implant outcomes and quality of life in the elderly: Manchester experience over 13 years. Clin Otolaryngol 2006; 31 (02) 116-122
90 Poissant SF, Beaudoin F, Huang J, Brodsky J, Lee DJ. Impact of cochlear implantation on speech understanding, depression, and loneliness in the elderly. J Otolaryngol Head Neck Surg 2008; 37 (04) 488-494
91 Noble W, Tyler RS, Dunn CC, Bhullar N. Younger- and older-age adults with unilateral and bilateral cochlear implants: speech and spatial hearing self-ratings and performance. Otol Neurotol 2009; 30 (07) 921-929
92 Hwang JH, Li CW, Wu CW, Chen JH, Liu TC. Aging effects on the activation of the auditory cortex during binaural speech listening in white noise: an fMRI study. Audiol Neurootol 2007; 12 (05) 285-294
93 Kim S, Frisina RD, Mapes FM. , et al. Effect of age on binaural speech intelligibility in normal hearing adults. Speech Commun 2006; 48: 591-597
94 Mukari SZ, Mamat WH. Medial olivocochlear functioning and speech perception in noise in older adults. Audiol Neurootol 2008; 13 (05) 328-334
95 Yeagle JD, Ceh KM, Francis HW. Geriatric cochlear implantation. Operative Techniques Otorhinolaryngol Head Neck Surg 2010; 4 (21) 266-271
96 Clark JH, Yeagle J, Arbaje AI, Lin FR, Niparko JK, Francis HW. Cochlear implant rehabilitation in older adults: literature review and proposal of a conceptual framework. J Am Geriatr Soc 2012; 60 (10) 1936-1945
97 Vermeire K, Brokx JP, Wuyts FL, Cochet E, Hofkens A, Van de Heyning PH. Quality-of-life benefit from cochlear implantation in the elderly. Otol Neurotol 2005; 26 (02) 188-195
98 Chen DS, Clarrett DM, Li L, Bowditch SP, Niparko JK, Lin FR. Cochlear implantation in older adults: long-term analysis of complications and device survival in a consecutive series. Otol Neurotol 2013; 34 (07) 1272-1277
99 David EE, Ostroff JM, Shipp D. , et al. Speech coding strategies and revised cochlear implant candidacy: an analysis of post-implant performance. Otol Neurotol 2003; 24 (02) 228-233
100 Skinner MW, Arndt PL, Staller SJ. Nucleus 24 advanced encoder conversion study: performance versus preference. Ear Hear 2002; 23 (1, Suppl): 2S-17S
101 Arnoldner C, Riss D, Brunner M, Durisin M, Baumgartner WD, Hamzavi JS. Speech and music perception with the new fine structure speech coding strategy: preliminary results. Acta Otolaryngol 2007; 127 (12) 1298-1303
102 Kiefer J, Hohl S, Stürzebecher E, Pfennigdorff T, Gstöettner W. Comparison of speech recognition with different speech coding strategies (SPEAK, CIS, and ACE) and their relationship to telemetric measures of compound action potentials in the nucleus CI 24M cochlear implant system. Audiology 2001; 40 (01) 32-42
103 Wolfe J, Morais M, Schafer E, Agrawal S, Koch D. Evaluation of speech recognition of cochlear implant recipients using adaptive, digital remote microphone technology and a speech enhancement sound processing algorithm. J Am Acad Audiol 2015; 26 (05) 502-508
104 Noble W, Tyler R, Dunn C, Bhullar N. Unilateral and bilateral cochlear implants and the implant-plus-hearing-aid profile: comparing self-assessed and measured abilities. Int J Audiol 2008; 47 (08) 505-514
105 Schafer EC, Thibodeau LM. Speech-recognition performance of children using cochlear implants and FM systems. J Educational Audiol 2003; 11: 15-26
106 Schafer EC, Thibodeau LM. Speech recognition abilities of adults using cochlear implants with FM systems. J Am Acad Audiol 2004; 15 (10) 678-691
107 Spahr AJ, Dorman MF, Loiselle LH. Performance of patients using different cochlear implant systems: effects of input dynamic range. Ear Hear 2007; 28 (02) 260-275
108 Wolfe J, Schafer EC, Heldner B, Mülder H, Ward E, Vincent B. Evaluation of speech recognition in noise with cochlear implants and dynamic FM. J Am Acad Audiol 2009; 20 (07) 409-421
109 Knecht HA, Nelson PB, Whitelaw GM. , et al. Bilateral cochlear implants in adults and children. Am J Audiol 2002; 11: 65-71
110 American Speech-Language Hearing Association. Position statement and guidelines for acoustics in educational settings. Available at: https://www.asha.org/uploadedFiles/elearning/jss/6173/6173Article3.pdf . Accessed March 13, 2018
111 Anderson KL, Goldstein H, Colodzin L. , et al. Benefit of S/N enhancing devices to speech perception of children listening in a typical classroom with hearing aids or a cochlear implant. J Educational Audiol 2005; 12: 14-28
112 Davies MG, Yellon L, Purdy SC. Speech-in-noise perception of children using cochlear implants and FM systems. Aust N Z J Audiol 2001; 23 (01) 52-62
113 Fitzpatrick EM, Séguin C, Schramm DR, Armstrong S, Chénier J. The benefits of remote microphone technology for adults with cochlear implants. Ear Hear 2009; 30 (05) 590-599
114 Schafer EC, Kleineck M. Improvements in speech recognition using cochlear implants and three types of FM systems: a meta-analytic approach. J Educational Audiol 2009; 15: 4-14
115 Schafer EC, Thibodeau LM. Speech Recognition in noise in children with cochlear implants while listening in bilateral, bimodal, and FM-system arrangements. Am J Audiol 2006; 15 (02) 114-126
116 Wolfe J, Neumann S, Marsh M. , et al. Benefits of adaptive signal processing in a commercially available cochlear implant sound processor. Otol Neurotol 2015; 36 (07) 1181-1190
117 Wolfe J, Schafer EC. Optimizing the benefit of sound processors coupled to personal FM systems. J Am Acad Audiol 2008; 19 (08) 585-594
118 Wolfe J, Morais M, Schafer E. , et al. Evaluation of speech recognition of cochlear implant recipients using a personal digital adaptive radio frequency system. J Am Acad Audiol 2013; 24 (08) 714-724
119 Fitzpatrick EM, Fournier P, Séguin C, Armstrong S, Chénier J, Schramm D. Users' perspectives on the benefits of FM systems with cochlear implants. Int J Audiol 2010; 49 (01) 44-53
120 Wolfe J, Schafer E, Parkinson A. , et al. Effects of input processing and type of personal frequency modulation system on speech-recognition performance of adults with cochlear implants. Ear Hear 2013; 34 (01) 52-62
121 Crandell CC, Holmes AE, Flexer C. , et al. Effects of soundfield FM amplification on the speech recognition of listeners with cochlear implants. J Educational Audiol 1998; 6: 21-27
122 Ganek H, McConkey Robbins A, Niparko JK. Language outcomes after cochlear implantation. Otolaryngol Clin North Am 2012; 45 (01) 173-185