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Hearing Disorders: HELP
Articles by Melissa Jane Polonenko
Based on 12 articles published since 2010
(Why 12 articles?)
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Between 2010 and 2020, M. Polonenko wrote the following 12 articles about Hearing Disorders.
 
+ Citations + Abstracts
1 Review Binaural integration: a challenge to overcome for children with hearing loss. 2017

Gordon, Karen A / Cushing, Sharon L / Easwar, Vijayalakshmi / Polonenko, Melissa J / Papsin, Blake C. ·Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada. ·Curr Opin Otolaryngol Head Neck Surg · Pubmed #29049038.

ABSTRACT: PURPOSE OF REVIEW: Access to bilateral hearing can be provided to children with hearing loss by fitting appropriate hearing devices to each affected ear. It is not clear, however, that bilateral input is properly integrated through hearing devices to promote binaural hearing. In the present review, we examine evidence indicating that abnormal binaural hearing continues to be a challenge for children with hearing loss despite early access to bilateral input. RECENT FINDINGS: Behavioral responses and electrophysiological data in children, combined with data from developing animal models, reveal that deafness in early life disrupts binaural hearing and that present hearing devices are unable to reverse these changes and/or promote expected development. Possible limitations of hearing devices include mismatches in binaural place, level, and timing of stimulation. Such mismatches could be common in children with hearing loss. One potential solution is to modify present device fitting beyond providing audibility to each ear by implementing binaural fitting targets. SUMMARY: Efforts to better integrate bilateral input could improve spatial hearing in children with hearing loss.

2 Article The Parallel Auditory Brainstem Response. 2019

Polonenko, Melissa J / Maddox, Ross K. ·Department of Biomedical Engineering, University of Rochester, NY, USA. · Department of Neuroscience, Del Monte Institute for Neuroscience, University of Rochester, NY, USA. ·Trends Hear · Pubmed #31516096.

ABSTRACT: The frequency-specific tone-evoked auditory brainstem response (ABR) is an indispensable tool in both the audiology clinic and research laboratory. Most frequently, the toneburst ABR is used to estimate hearing thresholds in infants, toddlers, and other patients for whom behavioral testing is not feasible. Therefore, results of the ABR exam form the basis for decisions regarding interventions and hearing habilitation with implications extending far into the child's future. Currently, responses are elicited by periodic sequences of toneburst stimuli presented serially to one ear at a time, which take a long time to measure multiple frequencies and intensities, and provide incomplete information if the infant wakes up early. Here, we describe a new method, the parallel ABR (pABR), which uses randomly timed toneburst stimuli to simultaneously acquire ABR waveforms to five frequencies in both ears. Here, we describe the pABR and quantify its effectiveness in addressing the greatest drawback of current methods: test duration. We show that in adults with normal hearing the pABR yields high-quality waveforms over a range of intensities, with similar morphology to the standard ABR in a fraction of the recording time. Furthermore, longer latencies and smaller amplitudes for low frequencies at a high intensity evoked by the pABR versus serial ABR suggest that responses may have better place specificity due to the masking provided by the other simultaneous toneburst sequences. Thus, the pABR has substantial potential for facilitating faster accumulation of more diagnostic information that is important for timely identification and treatment of hearing loss.

3 Article Etiology and therapy indication for cochlear implantation in children with single-sided deafness : Retrospective analysis. 2019

Cushing, S L / Gordon, K A / Sokolov, M / Papaioannou, V / Polonenko, M / Papsin, B C. ·Department of Otolaryngology, Head and Neck Surgery, Hospital for Sick Children, Room 6103C Burton Wing, 555 University Avenue, M5G 1X8, Toronto, ON, Canada. sharon.cushing@sickkids.ca. · Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Toronto, ON, Canada. sharon.cushing@sickkids.ca. · Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Toronto, ON, Canada. sharon.cushing@sickkids.ca. · Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Toronto, ON, Canada. · Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Toronto, ON, Canada. · Department of Communication Disorders, Hospital for Sick Children, Toronto, ON, Canada. · Department of Otolaryngology, Head and Neck Surgery, Hospital for Sick Children, Room 6103C Burton Wing, 555 University Avenue, M5G 1X8, Toronto, ON, Canada. · Department of Neurosciences & Mental Health, Hospital for Sick Children, Toronto, ON, Canada. · Institute of Medical Science, University of Toronto, Toronto, ON, Canada. ·HNO · Pubmed #31478064.

ABSTRACT: OBJECTIVE: The characteristics of children with single-sided deafness (SSD) who become candidates for unilateral cochlear implantation (uCI) were identified. STUDY DESIGN: In all, 118 children with SSD presenting from 2013-2019 to a tertiary pediatric children's hospital were retrospectively assessed regarding candidacy for uCI. RESULTS: Of the 118 children, 103 had completed uCI candidacy assessment, while 15 were undergoing this assessment at the time of review. More than half of children did not go on to implantation (63/103, 61%), with the 2 main reasons being (1) half (31/63) did not meet candidacy criteria for implantation, most commonly due to cochlear nerve aplasia/hypoplasia (31/82 who were assessed with MRI, 38%) and (2) families (30/103; 29%) declined participation in the surgical arm of the trial. The most common etiologies of SSD in the 37/103 (36%) children who both met candidacy and consented to implantation were congenital cytomegalovirus (cCMV; 16/37, 43%), unknown (6/37, 16%), cochleovestibular anomaly and trauma (each 5/37, 14%). CONCLUSIONS: Many children with SSD who present for implant candidacy assessment do not ultimately receive uCI. Major factors contributing to noncandidacy are cochlear nerve aplasia and parental acceptance of the intervention. While approximately half of children with SSD in our cohort were candidates for implantation, only 1/3 of the total cohort proceeded with implantation with the main predictors of acceptability of this intervention being an etiology (i.e., cCMV) that carries risk of progressive deterioration in the better hearing ear or SSD that was sudden in onset. These findings provide important insight into this new population of cochlear implant users and the emerging acceptance of intervention in children with SSD.

4 Article Limiting asymmetric hearing improves benefits of bilateral hearing in children using cochlear implants. 2018

Polonenko, Melissa Jane / Papsin, Blake Croll / Gordon, Karen Ann. ·Institute of Medical Science, The University of Toronto, Toronto, ON, M5S 1A8, Canada. melissa.polonenko@mail.utoronto.ca. · Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada. melissa.polonenko@mail.utoronto.ca. · Institute of Medical Science, The University of Toronto, Toronto, ON, M5S 1A8, Canada. · Department of Otolaryngology - Head & Neck Surgery, The University of Toronto, Toronto, ON, M5G 2N2, Canada. · Otolaryngology - Head & Neck Surgery, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada. · Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada. ·Sci Rep · Pubmed #30181590.

ABSTRACT: Neurodevelopmental changes occur with asymmetric hearing loss, limiting binaural/spatial hearing and putting children at risk for social and educational challenges. These deficits may be mitigated by providing bilateral hearing in children through auditory prostheses. Effects on speech perception and spatial hearing were measured in a large cohort of >450 children who were deaf and used bilateral cochlear implants or bimodal devices (one cochlear implant and a contralateral hearing aid). Results revealed an advantage of bilateral over unilateral device use but this advantage decreased as hearing in the two ears became increasingly asymmetric. Delayed implantation of an ear with severe to profound deafness allowed asymmetric hearing, creating aural preference for the better hearing ear. These findings indicate that bilateral input with the most appropriate device for each ear should be provided early and without delay during development.

5 Article Delayed access to bilateral input alters cortical organization in children with asymmetric hearing. 2018

Polonenko, Melissa Jane / Papsin, Blake Croll / Gordon, Karen Ann. ·Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada. · Neurosciences & Mental Health, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada. · Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON M5G 2N2, Canada. · Otolaryngology - Head & Neck Surgery, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada. ·Neuroimage Clin · Pubmed #29159054.

ABSTRACT: Bilateral hearing in early development protects auditory cortices from reorganizing to prefer the better ear. Yet, such protection could be disrupted by mismatched bilateral input in children with asymmetric hearing who require electric stimulation of the auditory nerve from a cochlear implant in their deaf ear and amplified acoustic sound from a hearing aid in their better ear (bimodal hearing). Cortical responses to bimodal stimulation were measured by electroencephalography in 34 bimodal users and 16 age-matched peers with normal hearing, and compared with the same measures previously reported for 28 age-matched bilateral implant users. Both auditory cortices increasingly favoured the better ear with delay to implanting the deaf ear; the time course mirrored that occurring with delay to bilateral implantation in unilateral implant users. Preference for the implanted ear tended to occur with ongoing implant use when hearing was poor in the non-implanted ear. Speech perception deteriorated with longer deprivation and poorer access to high-frequencies. Thus, cortical preference develops in children with asymmetric hearing but can be avoided by early provision of balanced bimodal stimulation. Although electric and acoustic stimulation differ, these inputs can work sympathetically when used bilaterally given sufficient hearing in the non-implanted ear.

6 Article Cortical organization restored by cochlear implantation in young children with single sided deafness. 2017

Polonenko, Melissa Jane / Gordon, Karen Ann / Cushing, Sharon Lynn / Papsin, Blake Croll. ·Institute of Medical Sciences, The University of Toronto, Toronto, ON, M5S 1A8, Canada. melissa.polonenko@mail.utoronto.ca. · Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada. melissa.polonenko@mail.utoronto.ca. · Institute of Medical Sciences, The University of Toronto, Toronto, ON, M5S 1A8, Canada. · Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada. · Department of Otolaryngology - Head & Neck Surgery, The University of Toronto, Toronto, ON, M5G 2N2, Canada. · Otolaryngology - Head & Neck Surgery, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada. ·Sci Rep · Pubmed #29203800.

ABSTRACT: Early treatment of single sided deafness in children has been recommended to protect from neurodevelopmental preference for the better hearing ear and from social and educational deficits. A fairly homogeneous group of five young children (≤3.6 years of age) with normal right sided hearing who received a cochlear implant to treat deafness in their left ears were studied. Etiology of deafness was largely cytomegalovirus (n = 4); one child had an enlarged vestibular aqueduct. Multi-channel electroencephalography of cortical evoked activity was measured repeatedly over time at: 1) acute (0.5 ± 0.7 weeks); 2) early chronic (1.1 ± 0.2 months); and 3) chronic (5.8 ± 3.4 months) cochlear implant stimulation. Results indicated consistent responses from the normal right ear with marked changes in activity from the implanted left ear. Atypical distribution of peak amplitude activity from the implanted ear at acute stimulation marked abnormal lateralization of activity to the ipsilateral left auditory cortex and recruitment of extra-temporal areas including left frontal cortex. These abnormalities resolved with chronic implant use and contralateral aural preference emerged in both auditory cortices. These findings indicate that early implantation in young children with single sided deafness can rapidly restore bilateral auditory input to the cortex needed to improve binaural hearing.

7 Article Music perception improves in children with bilateral cochlear implants or bimodal devices. 2017

Polonenko, Melissa J / Giannantonio, Sara / Papsin, Blake C / Marsella, Pasquale / Gordon, Karen A. ·Archie's Cochlear Implant Laboratory, Department of Otolaryngology, The Hospital for Sick Children, Room 6D08, Toronto M5G 1X8, Canada. · Audiology and Otosurgery Unit, Bambino Gesù Pediatric Hospital, Piazza di Sant'Onofrio 4, 00165, Rome, Italy. ·J Acoust Soc Am · Pubmed #28679263.

ABSTRACT: The objectives of this study were to determine if music perception by pediatric cochlear implant users can be improved by (1) providing access to bilateral hearing through two cochlear implants or a cochlear implant and a contralateral hearing aid (bimodal users) and (2) any history of music training. The Montreal Battery of Evaluation of Musical Ability test was presented via soundfield to 26 bilateral cochlear implant users, 8 bimodal users and 16 children with normal hearing. Response accuracy and reaction time were recorded via an iPad application. Bilateral cochlear implant and bimodal users perceived musical characteristics less accurately and more slowly than children with normal hearing. Children who had music training were faster and more accurate, regardless of their hearing status. Reaction time on specific subtests decreased with age, years of musical training and, for implant users, better residual hearing. Despite effects of these factors on reaction time, bimodal and bilateral cochlear implant users' responses were less accurate than those of their normal hearing peers. This means children using bilateral cochlear implants and bimodal devices continue to experience challenges perceiving music that are related to hearing impairment and/or device limitations during development.

8 Article Children With Single-Sided Deafness Use Their Cochlear Implant. 2017

Polonenko, Melissa Jane / Papsin, Blake Croll / Gordon, Karen Ann. ·1Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada; 2Neurosciences & Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada; 3Institute of Medical Sciences, The University of Toronto, Toronto, Ontario, Canada; 4Collaborative Program in Neuroscience, The University of Toronto, Toronto, Ontario, Canada; 5Department of Otolaryngology - Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada; and 6Department of Otolaryngology - Head & Neck Surgery, The University of Toronto, Toronto, Ontario, Canada. ·Ear Hear · Pubmed #28542017.

ABSTRACT: OBJECTIVES: To assess acceptance of a cochlear implant (CI) by children with single-sided deafness (SSD) as measured by duration of CI use across daily listening environments. DESIGN: Datalogs for 7 children aged 1.1 to 14.5 years (mean ± SD: 5.9 ± 5.9 years old), who had SSD and were implanted in their deaf ear, were anonymized and extracted from their CI processors. Data for all available follow-up clinical appointments were included, ranging from two to six visits. Measures calculated from each datalog included frequency and duration of time the coil disconnected from the internal device, average daily CI use, and both duration (hr/day) and percentage of CI use (% daily use) in different intensity ranges and environment types. Linear mixed effects regression analyses were used to evaluate the relationships between CI experience, daily CI use, frequency of coil-offs, and duration of coil-off time. Nonlinear regression analyses were used to evaluate CI use with age in different acoustic environments. RESULTS: Children with SSD used their CI on average 7.4 hr/day. Older children used their CI for longer periods of the day than younger children. Longitudinal data indicated consistent CI use from the date of CI activation. Frequency of coil-offs reduced with CI experience, but did not significantly contribute to hours of coil-off time. Children used their CI longest in environments that were moderately loud (50 to 70 dB A) and classified as containing speech-in-noise. Preschoolers tended to spend less time in quiet but more time in music than infants/toddlers and adolescents. CONCLUSIONS: Children with SSD consistently use their CI upon activation in a variety of environments commonly experienced by children. CI use in children with SSD resembles reported bilateral hearing aid use in children but is longer than reported hearing aid use in children with less severe unilateral hearing loss, suggesting that (1) the normal-hearing ear did not detract from consistent CI use; and (2) a greater asymmetry between ears presents a significant impairment that may facilitate device use to access bilateral sound.

9 Article Hearing Benefit and Rated Satisfaction in Children with Unilateral Conductive Hearing Loss Using a Transcutaneous Magnetic-Coupled Bone-Conduction Hearing Aid. 2016

Polonenko, Melissa J / Carinci, Lora / Gordon, Karen A / Papsin, Blake C / Cushing, Sharon L. ·Archie's Cochlear Implant Laboratory, Department of Otolaryngology, The Hospital for Sick Children, Toronto, ON, Canada. · Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. · Department of Communication Disorders, The Hospital for Sick Children, Toronto, ON, Canada. · Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. ·J Am Acad Audiol · Pubmed #27885975.

ABSTRACT: BACKGROUND: Bilateral hearing is important for learning, development, and function in complex everyday environments. Children with conductive and mixed hearing loss (HL) have been treated for years with percutaneous coupling through an abutment, which achieves powerful output, but the implant site is susceptible to skin reactions and trauma. To overcome these complications, transcutaneous magnetic coupling systems were recently introduced. PURPOSE: The purpose of the study was to evaluate whether the new transcutaneous magnetic coupling is an effective coupling paradigm for bone-conduction hearing aids (BCHAs). We hypothesized that magnetic coupling will (1) have limited adverse events, (2) provide adequate functional gain, (3) improve spatial hearing and aid listening in everyday situations, and (4) provide satisfactory outcomes to children and their families given one normal hearing ear. RESEARCH DESIGN: Retrospective analysis of audiological outcomes in a tertiary academic pediatric hospital. STUDY SAMPLE: Nine children aged 5-17 yr with permanent unilateral conductive HL (UCHL) or mixed HL were implanted with a transcutaneous magnet-retained BCHA. Average hearing thresholds of the better and implanted ears were 12.3 ± 11.5 dB HL and 69.1 ± 11.6 dB HL, respectively, with a 59.4 ± 4.8 dB (mean ± standard deviation) conductive component. DATA COLLECTION AND ANALYSIS: Data were extracted from audiology charts of the children with permanent UCHL or mixed HL who qualified for a surgically retained BCHA and agreed to the magnetic coupling. Outcomes were collected from the 3- to 9-mo follow-up appointments, and included surgical complications, aided audiometric thresholds with varying magnet strength, speech performance in quiet and noise, and patient-rated benefit and satisfaction using questionnaires. Repeated measures analysis of variance was used to analyze audiometric outcomes, and nonparametric tests were used to evaluate rated benefit and satisfaction. RESULTS: All nine children tolerated the device and only one child had discomfort at the wound site. Similar access to sound was achieved regardless of magnet strength. Speech performance did not significantly improve in quiet or noise conditions with +10 and +5 dB signal-to-noise ratio. Children benefited from spatially separating the noise from the speech signal, regardless of whether the noise was directed to the implanted or better ear. When wearing the BCHA, the children reported satisfaction and significant implant benefit, particularly in background noise, but at the expense of increased aversiveness to sound. CONCLUSIONS: Our findings, therefore, indicate that providing a transcutaneous magnetic-coupled BCHA to children who have UCHL or mixed HL provides benefit on some objective measures of bilateral hearing, as well as some subjective benefit in noise and everyday situations.

10 Article Stimulation parameters differ between current anti-modiolar and peri-modiolar electrode arrays implanted within the same child. 2016

Polonenko, M J / Cushing, S L / Gordon, K A / Allemang, B / Jewell, S / Papsin, B C. ·Archie's Cochlear Implant Laboratory,Department of Otolaryngology,Hospital for Sick Children,Toronto,Canada. ·J Laryngol Otol · Pubmed #27739380.

ABSTRACT: OBJECTIVE: To compare stimulation parameters of peri-modiolar and anti-modiolar electrode arrays using two surgical approaches. METHODS: Impedance, stimulation thresholds, comfortably loud current levels, electrically evoked compound action potential thresholds and electrically evoked stapedial reflex thresholds were compared between 2 arrays implanted in the same child at 5 time points: surgery, activation/day 1, week 1, and months 1 and 3. The peri-modiolar array was implanted via cochleostomy in all children (n = 64), while the anti-modiolar array was inserted via a cochleostomy in 43 children and via the round window in 21 children. RESULTS: The anti-modiolar array had significantly lower impedance, but required higher current levels to elicit thresholds, comfort, electrically evoked compound action potential thresholds and electrically evoked stapedial reflex thresholds than the peri-modiolar array across all time points, particularly in basal electrodes (p < 0.05). The prevalence of open electrodes was similar in anti-modiolar (n = 5) and peri-modiolar (n = 3) arrays. CONCLUSION: Significant but clinically acceptable differences in stimulation parameters between peri-modiolar and anti-modiolar arrays persisted four months after surgery in children using bilateral cochlear implants. The surgical approach used to insert the anti-modiolar array had no overall effect on outcomes.

11 Article The effects of asymmetric hearing on bilateral brainstem function: findings in children with bimodal (electric and acoustic) hearing. 2015

Polonenko, Melissa J / Papsin, Blake C / Gordon, Karen A. ·Archie's Cochlear Implant Laboratory, Department of Otolaryngology, The Hospital for Sick Children, Toronto, Ont., Canada. ·Audiol Neurootol · Pubmed #25998954.

ABSTRACT: As implantation criteria are broadening to include children with asymmetric hearing loss, it is important to determine the degree of residual hearing needed to protect the bilateral auditory pathways for binaural hearing and whether there is a sensitive period in development for implantation in these children. We have been studying these questions in a growing cohort of children. In the present study, auditory brainstem responses were recorded in 21 children who had 2.2 ± 2.2 years of bimodal hearing. Responses were evoked by 11-Hz acoustic clicks presented to the non-implanted ear and with biphasic electric pulses presented to the implanted ear. Twelve of these children also completed a behavioural task in which they were asked to which side of their heads bilaterally presented clicks/pulses that varied in interaural level or timing lateralized. All children experienced a delay in the non-implanted ear that resulted in 2.0 ± 0.35 ms longer peak latencies. These were further prolonged in 7 children as measured by longer interwave latencies from this ear than from the implanted ear. Despite large asymmetries in timing of brainstem activity between the two ears, all children perceived changes in interaural level differences. They were unable to detect differences in interaural timing cues. Symmetric brainstem function suggests bilateral development was preserved in some children. Future work will explore whether these children have better potential for developing binaural hearing using bimodal input.

12 Article Fit to targets, preferred listening levels, and self-reported outcomes for the DSL v5.0 a hearing aid prescription for adults. 2010

Polonenko, Melissa J / Scollie, Susan D / Moodie, Sheila / Seewald, Richard C / Laurnagaray, Diana / Shantz, Juliane / Richards, Andrea. ·National Centre for Audiology, University of Western Ontario, Canada. ·Int J Audiol · Pubmed #20438300.

ABSTRACT: STUDY OBJECTIVE: This study evaluated how closely the DSL v5.0 a prescription could be approximated with hearing aids, its relationship to preferred listening levels (PLLs) of adults with acquired hearing loss, and the self-reported outcomes of the resulting fittings. PARTICIPANTS: Thirty adults with varying degrees and configurations of hearing loss ranging from mild to severe. METHODS: Hearing aid output was measured after the initial fitting to DSL v5.0 a targets and after determination of the PLL after approximately 90 days. The Client Oriented Scale of Improvement (COSI) was used to evaluate outcome. RESULTS: The 95% confidence interval of fits to target ranged from 5.8 to 8.4 dB across frequency. The DSL v5.0 a adult algorithm approximated the PLLs of the participants within 2.6 dB on average. Hearing aid fittings provided positive subjective outcome improvements on the COSI. CONCLUSIONS: Findings suggest that the use of DSL v5.0 a for the fitting of hearing aids on adults with acquired hearing loss was feasible and provided an appropriate initial fitting.