Rationale: Using a cochlear implant (CI) in both ears can yield substantial improvements over unilateral implantation for those with bilateral severe to profound hearing loss in terms of speech recognition in noise and sound source localization. However, recent evidence suggests that there can also be detrimental effects, particularly for vocal control. This decreased vocal control may impair regular vibration of the vocal folds, leading to disordered voice quality. Objectives. This work investigates the relationship between the condition of wearing CIs, the production of voice through the monitoring of objective parameters and the perceived quality of voice defined through a subjective questionnaire. Methods. Twenty-one subjects (13 male, 8 female) with mean age equal to 68.7 years (± 9.0 years) have been voluntarily involved in the study. Subjects were recruited having a bilateral hearing loss and wearing at least one CI on the most disadvantaged ear. In particular, four subjects wore bilateral CI, six subjects wore one CI and one hearing-aid (HA), and 11 subjects wore only one CI. The experimental protocol regarded the acquisition of voice recordings and the administration of subjective questionnaires to assess the perception of voice quality and its consequences on the performance of daily activities. Tests were carried out in an acoustically treated room of the clinics, with low noise and short reverberation time. Experiments regarded the monitoring of voice production under several implant activation conditions, that are, (i) with CI/HA switched off, (ii) with only one CI/HA switched on and (iii) with both CI/CI or CI/HA switched on. The speech material acquired in the voice monitoring, repeated under each implant activation condition, concerned the sustained vocalization of letter /a/ and the reading of a phonetically balanced passage. With respect to the objective parameters analyzed from the speech material acquired, they included the Cepstral Peak Prominence Smoothed (CPPS), the Acoustic Voice Quality Index (AVQI), Shimmer (Shim), Harmonics-to-Noise Ratio (HNR), and Spectrum Slope. Results: Linear mixed effect models fit by maximum likelihood were used for the aforementioned parameters. In all the models, the following two factors were considered: (1) sex and (2) implant activation conditions (Off, Unilateral, and Bilateral). Participant id was included as a random factor. No significant differences associated to sex were found. CPPS, HNR and Slope showed significantly higher values in the condition Off, while AVQI and Shim showed significantly lower values in the condition Off. Wen considering the pairwise comparisons between Unilateral and Bilateral conditions, no statistically significant differences were detected. Conclusions: The results showed a decrease in voice quality in CI users while using CI, suggesting the need of implementing voice therapy for this clinical population.

Impact of cochlear implants use on voice production and on its perceived quality in older adults / Albera, Andrea; Guastamacchia, Angela; Puglisi, GIUSEPPINA EMMA; Astolfi, Arianna; Bottalico, Pasquale. - ELETTRONICO. - (2022). ((Intervento presentato al convegno Congresso Nazionale Società Italiana di Otorinolaringoiatria e Chirurgia Cervico Facciale tenutosi a Roma (IT) nel 25-28 Maggio 2022.

Impact of cochlear implants use on voice production and on its perceived quality in older adults

Andrea Albera;Angela Guastamacchia;Giuseppina Emma Puglisi;Arianna Astolfi;
2022

Abstract

Rationale: Using a cochlear implant (CI) in both ears can yield substantial improvements over unilateral implantation for those with bilateral severe to profound hearing loss in terms of speech recognition in noise and sound source localization. However, recent evidence suggests that there can also be detrimental effects, particularly for vocal control. This decreased vocal control may impair regular vibration of the vocal folds, leading to disordered voice quality. Objectives. This work investigates the relationship between the condition of wearing CIs, the production of voice through the monitoring of objective parameters and the perceived quality of voice defined through a subjective questionnaire. Methods. Twenty-one subjects (13 male, 8 female) with mean age equal to 68.7 years (± 9.0 years) have been voluntarily involved in the study. Subjects were recruited having a bilateral hearing loss and wearing at least one CI on the most disadvantaged ear. In particular, four subjects wore bilateral CI, six subjects wore one CI and one hearing-aid (HA), and 11 subjects wore only one CI. The experimental protocol regarded the acquisition of voice recordings and the administration of subjective questionnaires to assess the perception of voice quality and its consequences on the performance of daily activities. Tests were carried out in an acoustically treated room of the clinics, with low noise and short reverberation time. Experiments regarded the monitoring of voice production under several implant activation conditions, that are, (i) with CI/HA switched off, (ii) with only one CI/HA switched on and (iii) with both CI/CI or CI/HA switched on. The speech material acquired in the voice monitoring, repeated under each implant activation condition, concerned the sustained vocalization of letter /a/ and the reading of a phonetically balanced passage. With respect to the objective parameters analyzed from the speech material acquired, they included the Cepstral Peak Prominence Smoothed (CPPS), the Acoustic Voice Quality Index (AVQI), Shimmer (Shim), Harmonics-to-Noise Ratio (HNR), and Spectrum Slope. Results: Linear mixed effect models fit by maximum likelihood were used for the aforementioned parameters. In all the models, the following two factors were considered: (1) sex and (2) implant activation conditions (Off, Unilateral, and Bilateral). Participant id was included as a random factor. No significant differences associated to sex were found. CPPS, HNR and Slope showed significantly higher values in the condition Off, while AVQI and Shim showed significantly lower values in the condition Off. Wen considering the pairwise comparisons between Unilateral and Bilateral conditions, no statistically significant differences were detected. Conclusions: The results showed a decrease in voice quality in CI users while using CI, suggesting the need of implementing voice therapy for this clinical population.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11583/2971712