Department of Otolaryngology—Head and Neck Surgery
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Item AUDIOVISUAL INTEGRATION OF SPEECH BY CHILDREN AND ADULTS WITH COCHEAR IMPLANTS(Institute of Electrical and Electronics Engineers, 2002) Kirk, Karen Iler; Pisoni, David B.; Lachs, Lorin; Department of Otolaryngology--Head & Neck Surgery, School of MedicineThe present study examined how prelingually deafened children and postlingually deafened adults with cochlear implants (CIs) combine visual speech information with auditory cues. Performance was assessed under auditory-alone (A), visual- alone (V), and combined audiovisual (AV) presentation formats. A measure of visual enhancement, RA, was used to assess the gain in performance provided in the AV condition relative to the maximum possible performance in the auditory-alone format. Word recogniton was highest for AV presentation followed by A and V, respectively. Children who received more visual enhancement also produced more intelligible speech. Adults with CIs made better use of visual information in more difficult listening conditions (e.g., when mutiple talkers or phonemically similar words were used). The findings are discussed in terms of the complementary nature of auditory and visual sources of information that specify the same underlying gestures and articulatory events in speech.Item General intelligence and modality-specific differences in performance: a response to Schellenberg (2008)(Empirical Musicology Review, 2009-01) Tierney, Adam T.; Bergeson, Tonya R.; Pisoni, David B.; Otolaryngology -- Head and Neck Surgery, School of MedicineTierney et al. (2008) reported that musicians performed better on an auditory sequence memory task when compared to non-musicians, but the two groups did not differ in performance on a sequential visuo-spatial memory task. Schellenberg (2008) claims that these results can be attributed entirely to differences in IQ. This explanation, however, cannot account for the fact that the musicians' advantage was modality-specific.Item Effects of congenital hearing loss and cochlear implantation on audiovisual speech perception in infants and children(IOS Press, 2010) Bergeson, Tonya R.; Houston, Derek M.; Miyamoto, Richard T.; Otolaryngology -- Head and Neck Surgery, School of MedicinePurpose Cochlear implantation has recently become available as an intervention strategy for young children with profound hearing impairment. In fact, infants as young as 6 months are now receiving cochlear implants (CIs), and even younger infants are being fitted with hearing aids (HAs). Because early audiovisual experience may be important for normal development of speech perception, it is important to investigate the effects of a period of auditory deprivation and amplification type on multimodal perceptual processes of infants and children. The purpose of this study was to investigate audiovisual perception skills in normal-hearing (NH) infants and children and deaf infants and children with CIs and HAs of similar chronological ages. Methods We used an Intermodal Preferential Looking Paradigm to present the same woman’s face articulating two words (“judge” and “back”) in temporal synchrony on two sides of a TV monitor, along with an auditory presentation of one of the words. Results The results showed that NH infants and children spontaneously matched auditory and visual information in spoken words; deaf infants and children with HAs did not integrate the audiovisual information; and deaf infants and children with CIs initially did not initially integrate the audiovisual information but gradually matched the auditory and visual information in spoken words. Conclusions These results suggest that a period of auditory deprivation affects multimodal perceptual processes that may begin to develop normally after several months of auditory experience.Item An analysis of hearing aid fittings in adults using cochlear implants and contralateral hearing aids(Wiley, 2010-12) Harris, Michael S.; Hay-McCutcheon, Marcia; Otolaryngology -- Head and Neck Surgery, School of MedicineOBJECTIVES/HYPOTHESIS: The objective of this study was to assess the appropriateness of hearing aid fittings within a sample of adult cochlear implant recipients who use a hearing aid in the contralateral ear (i.e., bimodal stimulation). METHODS: The hearing aid gain was measured using real ear testing for 14 postlingually deaf English-speaking adults who use a cochlear implant in the contralateral ear. Unaided and aided audiometric testing assessed the degree of functional gain derived from hearing aid use. RESULTS: On average, the target to actual output level difference was within 10 dB only at frequencies of 750 Hz and 1,000 Hz. Only 1 of the 14 study participants had a hearing aid for which the majority of the tested frequencies were within 10 dB of the target gain. In addition, a greater amount of functional gain (i.e., the increase in unaided behavioral thresholds after amplification) was provided for lower frequencies than higher frequencies. CONCLUSIONS: Hearing aid settings in our sample were suboptimal and may be regarded as a contributing factor to the variability in bimodal benefit. Refining hearing aid fitting strategies tailored to the needs of the concurrent cochlear implant and hearing aid user is recommended.Item Long-Term Speech and Language Outcomes in Prelingually Deaf Children, Adolescents and Young Adults Who Received Cochlear Implants in Childhood(Karger, 2013) Ruffin, Chad V.; Kronenberger, William G.; Colson, Bethany G.; Henning, Shirley C.; Pisoni, David B.; Otolaryngology -- Head and Neck Surgery, School of MedicineThis study investigated long-term speech and language outcomes in 51 prelingually deaf children, adolescents and young adults who received cochlear implants (CIs) prior to 7 years of age and had used their implants for at least 7 years. Average speech perception scores were similar to those found in prior research with other samples of experienced CI users. Mean language test scores were lower than norm-referenced scores from nationally representative normal-hearing, typically developing samples, although a majority of the CI users scored within 1 standard deviation of the normative mean or higher on the Peabody Picture Vocabulary Test, Fourth Edition (63%), and the Clinical Evaluation of Language Fundamentals, Fourth Edition (69%). Speech perception scores were negatively associated with a meningitic etiology of hearing loss, older age at implantation, poorer preimplant unaided pure-tone average thresholds, lower family income and the use of 'total communication'. Subjects who had used CIs for 15 years or more were more likely to have these characteristics and were more likely to score lower on measures of speech perception compared to those who had used CIs for 14 years or less. The aggregation of these risk factors in the >15 years of CI use subgroup accounts for their lower speech perception scores and may stem from more conservative CI candidacy criteria in use at the beginning of pediatric cochlear implantation.Item Retinoic acid deficiency impairs the vestibular function(Society for Neuroscience, 2013-03-27) Romand, Raymond; Krezel, Wojciech; Beraneck, Mathieu; Cammas, Laura; Fraulob, Valérie; Messaddeq, Nadia; Kessler, Pascal; Hashino, Eri; Dollé, Pascal; Otolaryngology -- Head and Neck Surgery, School of MedicineThe retinaldehyde dehydrogenase 3 (Raldh3) gene encodes a major retinoic acid synthesizing enzyme and is highly expressed in the inner ear during embryogenesis. We found that mice deficient in Raldh3 bear severe impairment in vestibular functions. These mutant mice exhibited spontaneous circling/tilted behaviors and performed poorly in several vestibular-motor function tests. In addition, video-oculography revealed a complete loss of the maculo-ocular reflex and a significant reduction in the horizontal angular vestibulo-ocular reflex, indicating that detection of both linear acceleration and angular rotation were compromised in the mutants. Consistent with these behavioral and functional deficiencies, morphological anomalies, characterized by a smaller vestibular organ with thinner semicircular canals and a significant reduction in the number of otoconia in the saccule and the utricle, were consistently observed in the Raldh3 mutants. The loss of otoconia in the mutants may be attributed, at least in part, to significantly reduced expression of Otop1, which encodes a protein known to be involved in calcium regulation in the otolithic organs. Our data thus reveal a previously unrecognized role of Raldh3 in structural and functional development of the vestibular end organs.Item 3D mouse embryonic stem cell culture for generating inner ear organoids(Springer Nature, 2014) Koehler, Karl R.; Hashino, Eri; Otolaryngology -- Head and Neck Surgery, School of MedicineThis protocol describes a culture system in which inner-ear sensory tissue is produced from mouse embryonic stem (ES) cells under chemically defined conditions. This model is amenable to basic and translational investigations into inner ear biology and regeneration. In this protocol, mouse ES cells are aggregated in 96-well plates in medium containing extracellular matrix proteins to promote epithelialization. During the first 14 d, a series of precisely timed protein and small-molecule treatments sequentially induce epithelia that represent the mouse embryonic non-neural ectoderm, preplacodal ectoderm and otic vesicle epithelia. Ultimately, these tissues develop into cysts with a pseudostratified epithelium containing inner ear hair cells and supporting cells after 16-20 d. Concurrently, sensory-like neurons generate synapse-like structures with the derived hair cells. We have designated the stem cell-derived epithelia harboring hair cells, supporting cells and sensory-like neurons as inner ear organoids. This method provides a reproducible and scalable means to generate inner ear sensory tissue in vitro.Item Hearing versus Listening: Attention to Speech and Its Role in Language Acquisition in Deaf Infants with Cochlear Implants(Elsevier, 2014-01-01) Houston, Derek M.; Bergeson, Tonya R.; Department of Otolaryngology--Head & Neck Surgery, IU School of MedicineThe advent of cochlear implantation has provided thousands of deaf infants and children access to speech and the opportunity to learn spoken language. Whether or not deaf infants successfully learn spoken language after implantation may depend in part on the extent to which they listen to speech rather than just hear it. We explore this question by examining the role that attention to speech plays in early language development according to a prominent model of infant speech perception – Jusczyk’s WRAPSA model – and by reviewing the kinds of speech input that maintains normal-hearing infants’ attention. We then review recent findings suggesting that cochlear-implanted infants’ attention to speech is reduced compared to normal-hearing infants and that speech input to these infants differs from input to infants with normal hearing. Finally, we discuss possible roles attention to speech may play on deaf children’s language acquisition after cochlear implantation in light of these findings and predictions from Jusczyk’s WRAPSA model.Item Stem cell-derived tissue-engineered constructs for hemilaryngeal reconstruction(Sage Publications, 2014-02) Halum, Stacey L.; Bijangi-Vishehsaraei, Khadijeh; Zhang, Hongji; Sowinski, John; Bottino, Marco C.; Department of Otolaryngology--Head and Neck Surgery, IU School of MedicineOBJECTIVES: As an initial step toward our goal of developing a completely tissue-engineered larynx, the aim of this study was to describe and compare three strategies of creating tissue-engineered muscle-polymer constructs for hemilaryngeal reconstruction. METHODS: Cartilage-mimicking polymer was developed from electrospun poly(D,L-lactide-co-ε-caprolactone) (PCL). Primary muscle progenitor cell cultures were derived from syngeneic F344 rat skeletal muscle biopsies. Twenty F344 rats underwent resection of the outer hemilaryngeal cartilage with the underlying laryngeal adductor muscle. The defects were repaired with muscle stem cell-derived muscle-PCL constructs (5 animals), myotube-derived muscle-PCL constructs (5 animals), motor end plate-expressing muscle-PCL constructs (5 animals), or PCL alone (controls; 5 animals). The outcome measures at 1 month included animal survival, muscle thickness, and innervation status as determined by electromyography and immunohistochemistry. RESULTS: All of the animals survived the 1-month implant period and had appropriate weight gain. The group that received motor end plate-expressing muscle-PCL constructs demonstrated the greatest muscle thickness and the strongest innervation, according to electromyographic activity and the percentage of motor end plates that had nerve contact. CONCLUSIONS: Although all of the tissue-engineered constructs provided effective reconstruction, those that expressed motor end plates before implantation yielded muscle that was more strongly innervated and viable. This finding suggests that this novel approach may be useful in the development of a tissue-engineered laryngeal replacement.Item Influence of early linguistic experience on regional dialect categorization by an adult cochlear implant user: a case study(Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins, 2014-05) Tamati, Terrin N.; Gilbert, Jaimie L.; Pisoni, David B.; Department of Otolaryngology--Head & Neck Surgery, IU School of MedicineTo investigate the ability of a cochlear implant user to categorize talkers by region of origin and examine the influence of prior linguistic experience on the perception of regional dialect variation. A postlingually deafened adult cochlear implant user from the Southern region of the United States completed a six-alternative forced-choice dialect categorization task. The cochlear implant user was most accurate at categorizing unfamiliar talkers from his own region and another familiar dialect region, and least accurate at categorizing talkers from less familiar regions. Although the dialect-specific information made available by a cochlear implant may be degraded compared with information available to normal-hearing listeners, this experienced cochlear implant user was able to reliably categorize unfamiliar talkers by region of origin. The participant made use of dialect-specific acoustic-phonetic information in the speech signal and previously stored knowledge of regional dialect differences from early exposure before implantation despite an early hearing loss.