• Journal of Audiology & Otology
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• 제25권2호
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• pp.110-114
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• 2021

We report a case of hearing rehabilitation following combined cochlear implantation and ossiculoplasty. A 71-year-old patient visited the clinic for right-sided mixed hearing loss. We targeted neural and conductive components, performing two different operations simultaneously. At two months post-operative, the patient showed satisfactory results with respect to hearing threshold and speech comprehension. Our experience suggests that careful evaluation of patients and consideration of the diverse array of available treatment strategies can be used to provide personalized rehabilitation with maximal effectiveness. To the best of our knowledge, this is the first report to take such an integrated approach to treat hearing impairment and is thus likely to have clinical importance for otologists.

• 인간행동과 음악연구
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• 제14권1호
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• pp.1-16
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• 2017

본 연구는 음정 모방 중심 노래부르기 프로그램이 인공와우이식아동의 음고 산출 정확도 및 음고 범위에 어떠한 영향을 미치는지 확인하고자 시행한 사례연구이다. 본 연구에서는 만 5세의 인공와우이식아동 3명을 대상으로 음정 모방 중심 노래부르기 프로그램이 실시되었고 회기 당 35분, 주 2-3회씩 총 12회기의 개별 세션이 진행되었다. 음정 모방 중심 노래부르기 프로그램 동안 3도, 5도, 8도의 목표 음정을 중심으로 음고 변별 - 음고 모방 - 목표 음고를 포함한 노래부르기 활동이 단계적으로 시행되었고, 프로그램 전후에는 음고 모방 및 노래 내 음고 산출의 정확도 변화가 측정되었다. 연구 결과, 3명의 아동 모두 프로그램 참여 후 제시된 음고를 산출하는 정확도가 증가하고 노래부르기 시 산출된 음고가 기대 음고에 유사해지는 것으로 나타났다. 또한 산출 가능한 음고의 범위가 확장됨을 알 수 있었다. 이러한 결과는 인공와우이식아동의 음정 지각 특성을 반영한 단계적 접근과 다감각적 환경에서의 체계적 음악 정보 처리가 학령 전기 인공와우이식아동의 음고 산출을 효과적으로 이끌어낼 수 있음을 보여준다. 더 나아가 본 연구는 음악 지각이나 인공와우이식성인 대상군에 초점이 맞추어졌던 연구 영역을 확장시키고, 학령 전기 인공와우이식아동의 음고 산출 능력 향상을 위해 적용할 수 있는 프로그램을 제안했다는 점에 의의가 있다.

• 인간행동과 음악연구
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• 제15권2호
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• pp.69-92
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• 2018

본 연구는 노래만들기 중재가 인공와우이식청소년의 자기표현 능력 향상을 가져오는지 알아보기 위한 사례연구이다. 본 연구의 노래만들기 중재는 인공와우이식자의 음악지각에 관한 선행연구 결과를 반영하여 CI이식청소년의 성공적인 자기표현 경험을 위해 구성되었다. 단계적으로 구성된 노래만들기와 음악테크놀로지(예, iPad의 GarageBand)가 활용되었다. 두 명의 CI이식청소년이 연구에 참여하였고, 중재는 주 1회씩 총 8주간 제공되었다. 결과분석을 위해 중재 과정 중 변화 양상이 중요함에 따라 자기표현과 관련한 언어적 비언어적 행동과 음악적 반응의 변화를 서술하였다. 연구 결과 노래만들기 중재에 참여한 대상자들은 공통적으로 음악을 통한 자기표현의 자신감 향상과 단순한 자기표현에서 자신의 정서 및 의견을 표현으로의 변화가 관찰되어, 자기표현 능력의 향상에 긍정적인 변화를 확인할 수 있었다. 결과적으로 인공와우이식에 따른 청지각적 특징을 반영한 음악 중재가 성취감 및 긍정적인 자기표현 경험을 도울 수 있음을 확인하였으며, 이는 추후 인공와우이식자를 대상으로 노래만들기 연구가 지속적으로 수행될 필요가 있음을 시사한다.

• 말소리와 음성과학
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• 제14권2호
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• pp.77-86
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• 2022

본 연구는 조기 양측 인공와우이식 아동과 건청 아동 간 파열음의 조음위치와 발성유형에 대한 성대진동 시작시간(voice onset time, VOT)의 차이를 살펴봄으로써, 조기 양측 인공와우이식을 통한 청각적 보상과 피드백이 청각장애 아동의 말 운동통제 능력에 미치는 영향을 살펴보고자 하였다. 대상자는 만 5세부터 10세 사이의 양측 인공와우이식 아동 15명과 건청 아동 15명을 선정하였다. 검사 과제는 조음위치 및 발성 유형을 고려한 9개 파열음의 VCV음절을 사용하였다. VOT 측정을 위해 Praat 프로그램을 사용하였으며, 정확한 측정을 위해 녹음된 음성, 스펙트로그램, 포먼트 정보를 함께 사용하였다. 삼원혼합분산분석 결과, 집단에 대한 주 효과는 유의하지 않았다. 조음위치에 대한 주 효과는 유의하였으며, 연구개음의 VOT값이 양순음과 치조음보다 유의하게 길었다. 발성유형에 대한 주 효과도 유의하였으며, VOT값은 격음, 평음, 경음 순으로 유의하게 길었다. 이러한 결과는 조기 양측 인공와우이식을 통한 양이 청취가 고도 이상의 난청 아동의 말 운동 통제 능력에 긍정적인 영향을 준다는 것을 시사한다.

• 대한청각학회지
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• 제24권2호
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• pp.71-78
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• 2020

Background and Objectives: Currently limited information is available on speech stimuli processing at the subcortical level in the recipients of cochlear implant (CI). Speech processing in the brainstem level is measured using speech-auditory brainstem response (S-ABR). The purpose of the present study was to measure the S-ABR components in the sound-field presentation in CI recipients, and compare with normal hearing (NH) children. Subjects and Methods: In this descriptive-analytical study, participants were divided in two groups: patients with CIs; and NH group. The CI group consisted of 20 prelingual hearing impairment children (mean age=8.90±0.79 years), with ipsilateral CIs (right side). The control group consisted of 20 healthy NH children, with comparable age and sex distribution. The S-ABR was evoked by the 40-ms synthesized /da/ syllable stimulus that was indicated in the sound-field presentation. Results: Sound-field S-ABR measured in the CI recipients indicated statistically significant delayed latencies, than in the NH group. In addition, these results demonstrated that the frequency following response peak amplitude was significantly higher in CI recipients, than in the NH counterparts (p<0.05). Finally, the neural phase locking were significantly lower in CI recipients (p<0.05). Conclusions: The findings of sound-field S-ABR demonstrated that CI recipients have neural encoding deficits in temporal and spectral domains at the brainstem level; therefore, the sound-field S-ABR can be considered an efficient clinical procedure to assess the speech process in CI recipients.

• Journal of Audiology & Otology
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• 제24권2호
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• pp.71-78
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• 2020

Background and Objectives: Currently limited information is available on speech stimuli processing at the subcortical level in the recipients of cochlear implant (CI). Speech processing in the brainstem level is measured using speech-auditory brainstem response (S-ABR). The purpose of the present study was to measure the S-ABR components in the sound-field presentation in CI recipients, and compare with normal hearing (NH) children. Subjects and Methods: In this descriptive-analytical study, participants were divided in two groups: patients with CIs; and NH group. The CI group consisted of 20 prelingual hearing impairment children (mean age=8.90±0.79 years), with ipsilateral CIs (right side). The control group consisted of 20 healthy NH children, with comparable age and sex distribution. The S-ABR was evoked by the 40-ms synthesized /da/ syllable stimulus that was indicated in the sound-field presentation. Results: Sound-field S-ABR measured in the CI recipients indicated statistically significant delayed latencies, than in the NH group. In addition, these results demonstrated that the frequency following response peak amplitude was significantly higher in CI recipients, than in the NH counterparts (p<0.05). Finally, the neural phase locking were significantly lower in CI recipients (p<0.05). Conclusions: The findings of sound-field S-ABR demonstrated that CI recipients have neural encoding deficits in temporal and spectral domains at the brainstem level; therefore, the sound-field S-ABR can be considered an efficient clinical procedure to assess the speech process in CI recipients.

• Clinical and Experimental Pediatrics
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• 제50권1호
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• pp.7-13
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• 2007

Hearing loss in newborns is the most frequently occurring birth defect. If hearing impaired children are not identified and managed early, it is difficult for many of them to acquire the fundamental language, social and cognitive skills that provide the foundation for later schooling and success in society. All newborns, both high and low risk, should be screened for hearing loss in the birth hospital prior discharge (Universal Newborn Heaing Screening, UNHS). Objective physiologic measures must be used to detect newborns and very young infants with hearing loss. Recent technological developments have produced screening methods and both evoked otoacoustic emission (EOAE) and auditory brainstem response (ABR) have been successfully implemented for UNHS. Audiologic evaluation should be carried out before 3 months of age and infants with confirmed hearing loss should receive intervention before 6 months of age. All infants who pass newborn hearing screening but who have risk indicators for other auditory disorders and/or speech and language delay receive ongoing audiologic surveillance and monitoring for communication development. Infants with sensorineural hearing loss are managed with hearing aids and receive auditory and speech-language rehabilitation therapies. Cochlear implants can be an outstanding option for certain children aged 12 months and older with severe to profound hearing loss who show limited benefit from conventional amplifications.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제61권12호
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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.

• 말소리와 음성과학
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• 제13권2호
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• pp.103-109
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• 2021

In this study, we investigated longitudinal music perception of adult cochlear implant (CI) users and how acoustic stimulation with CI affects their music performance. A total of 163 participants' data were analyzed retrospectively. 96 participants were using acoustic stimulation with CI and 67 participants were using electrical stimulation only via CI. The music performance (melody identification, appreciation, and satisfaction) data were collected pre-implantation, 1-year, and 2-year post-implantation. Mixed repeated measures of ANOVA and pairwise analysis adjusted by Tukey were used for the statistics. As result, in both groups, there were significant improvements in melody identification, music appreciation, and music satisfaction at 1-year, and 2-year post-implantation than a pre-implantation, but there was no significant difference between 1 and 2 years in any of the variables. Also, the group of acoustic stimulation with CI showed better perception skill of melody identification than the CI-only group. However, no differences found in music appreciation and satisfaction between the two groups, and possible explanations were discussed. In conclusion, acoustic and/or electrical hearing devices benefit the recipients in music performance over time. Although acoustic stimulation accompanied with electrical stimulation could benefit the recipients in terms of listening skills, those benefits may not extend to the subjective acceptance of music. These results suggest the need for improved sound processing mechanisms and music rehabilitation.

• Journal of Audiology & Otology
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• 제23권4호
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• pp.193-196
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• 2019

Background and Objectives: Facial nerve stimulation (FNS) is a complication of cochlear implantation (CI). This study compared the thickness and density of the bone separating the upper basal turn of the cochlea (UBTC) and the labyrinthine segment of the facial nerve (LSFN) on preoperative computed tomography (CT) in patients with and without FNS after CI. Subjects and Methods: Adult patients who underwent CI from January 2011 to February 2017 with preoperative CT at a tertiary referral hospital were considered for this retrospective case-control study. Patients were divided into two groups: with FNS (n=4) and without FNS (n=53). The density and thickness of the bone between the LSFN and UBTC were measured on preoperative CT. Charts were reviewed for other parameters. Results: A statistically significant difference was seen in the thickness (p=0.007) but not in the density (p=0.125) of the bone between the UBTC and LSFN. Four patients had FNS at the mid-range electrode arrays, and one of them additionally had FNS at the basal arrays. Conclusions: Decreased thickness of the bone between the UBTC and LSFN can explain postoperative FNS, confirming the histologic and radiologic findings in previous studies, which indicated that the thickness of the temporal bone between the LSFN and UBTC is less in patients who experience FNS. While the density in this region was also less, it was not statistically significant.