Change of phonation control after cochlear implantation.
OBJECTIVE
To assess the influence of acquired auditory control on some voice parameters in deaf children and adults after cochlear implantation.


METHODS
Prospective clinical study.


METHODS
Tertiary referral center.


METHODS
Twenty-nine prelingually deafened children and 11 postlingually deafened adults.


METHODS
The samples of a vowel /a/ were analyzed with an Multi-Dimensional Voice Program (Kay Elemetrics Corporation, Lincoln Park, NJ) before and 6 to 12 months after the cochlear implantation.


METHODS
The average fundamental frequency (F0), the short-term variation of F0 (JIT) and the amplitude (SH), the very long-term variation of F0 (vF0) and the amplitude (vAm), and the noise-to-harmonic ratio (NHR) were determined and compared for both age groups. The results of the acoustic analysis performed before the implantation were compared with the results after the implantation for children and adults.


RESULTS
Significantly greater JIT, SH, vF0, and vAm were detected in the children than in the adults before and after the implantation. The prelingually deafened children significantly improved the control of their phonation after 6 to 12 months' use of the cochlear implant (JIT: p=0.014, SH: p=0.011, vF0: p=0.014, vAm: p=0.031). In the postlingually deafened adults, no significant improvement was found in any of the studied voice parameters after the implantation. F0 showed little or no change after the implantation in children and adults.


CONCLUSIONS
As expected, the voice quality of the prelingually deafened children was significantly worse than that of the postlingually deafened adults. After cochlear implantation, the children significantly improved their short-term and long-term F0 and amplitude variability. In adults, no significant improvement was detected. We suppose that the improvement is a consequence not only of the acquired hearing control but also of the adaptation ability of neuromuscular phonation control and the maturing of these control mechanisms in children. In adults, better phonation quality in general and lesser improvement after the implantation can be the results of well-developed and stable phonation patterns.
Hocevar-Boltezar
Irena
I
Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center, Ljubljana, Slovenia. irena.hocevar@kclj.si
Radsel
Zora
Z
Vatovec
Jagoda
J
Geczy
Branka
B
Cernelc
Smilja
S
Gros
Anton
A
Zupancic
Janez
J
Battelino
Saba
S
Lavrencak
Bostjan
B
Zargi
Miha
M
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003054:Cochlear Implants; D005260:Female; D034381:Hearing Loss / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010699:Phonation / Q000502:physiology*; D011446:Prospective Studies; D013061:Speech Acoustics; D016896:Treatment Outcome; D014833:Voice Quality