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International audience; The objectives of the study were to demonstrate the audiological and subjective benefits of the adaptive UltraZoom beamforming technology available in the Naída CI Q70 sound processor, in cochlear-implanted adults upgraded from a previous generation sound processor. Thirty-four adults aged between 21 and 89 years (mean 53 ± 19) were prospectively included. Nine subjects were unilaterally implanted, 11 bilaterally and 14 were bimodal users. The mean duration of cochlear implant use was 7 years (range 5–15 years). Subjects were tested in quiet with monosyllabic words and in noise with the adaptive French Matrix test in the best-aided conditions. The test setup contained a signal source in front of the subject and three noise sources at +/−90° and 180°. The noise was presented at a fixed level of 65 dB SPL and the level of speech signal was varied to obtain the speech reception threshold (SRT). During the upgrade visit, subjects were tested with the Harmony and with the Naída CI sound processors in omnidirectional microphone configuration. After a take-home phase of 2 months, tests were repeated with the Naída CI processor with and without UltraZoom. Subjective assessment of the sound quality in daily environments was recorded using the APHAB questionnaire. No difference in performance was observed in quiet between the two processors. The Matrix test in noise was possible in the 21 subjects with the better performance. No difference was observed between the two processors for performance in noise when using the omnidirectional microphone. At the follow-up session, the median SRT with the Naída CI processor with UltraZoom was −4 dB compared to −0.45 dB without UltraZoom. The use of UltraZoom improved the median SRT by 3.6 dB (p < 0.0001, Wilcoxon paired test). When looking at the APHAB outcome, improvement was observed for speech understanding in noisy environments (p < 0.01) and in aversive situations (p < 0.05) in the group of 21 subjects who were able to perform the Matrix test in noise and for speech understanding in noise (p < 0.05) in the group of 13 subjects with the poorest performance, who were not able to perform the Matrix test in noise. The use of UltraZoom beamforming technology, available on the new sound processor Naída CI, improves speech performance in difficult and realistic noisy conditions when the cochlear implant user needs to focus on the person speaking at the front. Using the APHAB questionnaire, a subjective benefit for listening in background noise was also observed in subjects with good performance as well as in those with poor performance. This study highlighted the importance of upgrading CI recipients to new technology and to include assessment in noise and subjective feedback evaluation as part of the process.

Objectif : L’objectif de cette étude était de rechercher les causes de variabilité dans les performances en lecture labiale chez les adultes atteints de surdité évolutive, afin d’en dégager des facteurs prédictifs. Méthodes : Les données de 232 patients présentant une surdité sévère à profonde ont été recueillies à partir des bilans orthophoniques effectués dans le cadre de leurs bilans pré-implants. Les performances en lecture labiale ont été analysées en fonction du sexe, de l’âge, du niveau d’études et de la durée de la surdité profonde. Résultats : Les résultats montrent que les sujets plus âgés ont de moins bonnes performances en lecture labiale pour l’intégration globale des informations verbales (mots dissyllabiques et phrases) mais pas pour la perception analytique. De plus, les femmes obtiennent de meilleurs résultats aux tests de reconnaissance de phrases. Au total, l’analyse multivariée des facteurs prédictifs indique un effet de l’âge sur l’acquisition d’une lecture labiale fonctionnelle, expliquant ainsi 6,7 % de la variance observée. Conclusion : Cette étude confirme l’importante hétérogénéité des performances observée pour l’intégration visuelle de la parole avec la lecture labiale chez les sujets adultes candidats à l’implantation cochléaire. L’ensemble de ces données confirme l’intérêt de futures études portant sur l’évaluation des fonctions cognitives et exécutives telles que la mémoire, la flexibilité et l’attention impliquées dans le développement de la lecture labiale.

OBJECTIVE The relationship between hearing loss and cognitive function has already been established. The objective of our study was to determine whether the two short cognitive tests, COgnitive Disorders EXamination (CODEX) and Montreal Cognitive Assessment (MoCA), could be used in daily clinical practice to detect cognitive impairment, and its changes after cochlear implantation. PATIENTS Eighteen patients with severe to profound postlingual progressive hearing loss (mean age ± SEM: 64 ± 3.5 yr; range, 23-83 yr) were tested before, and 12 months after cochlear implantation, with adapted visual presentation of CODEX and MoCA tests. Auditory performance was tested under best-aided conditions in quiet and noise. RESULTS Twelve months after cochlear implantation, hearing performance had clearly improved (paired t tests, p

International audience; Visual processing has been extensively explored in deaf subjects in the context of verbal communication, through the assessment of speech reading and sign language abilities. However, little is known about visual emotional processing in adult progressive deafness, and after cochlear implantation. The goal of our study was thus to assess the influence of acquired post-lingual progressive deafness on the recognition of dynamic facial emotions that were selected to express canonical fear, happiness, sadness, and anger. A total of 23 adults with post-lingual deafness separated into two groups; those assessed either before (n = 10) and those assessed after (n = 13) cochlear implantation (CI); and 13 normal hearing (NH) individuals participated in the current study. Participants were asked to rate the expression of the four cardinal emotions, and to evaluate both their emotional valence (unpleasant-pleasant) and arousal potential (relaxing-stimulating). We found that patients with deafness were impaired in the recognition of sad faces, and that patients equipped with a CI were additionally impaired in the recognition of happiness and fear (but not anger). Relative to controls, all patients with deafness showed a deficit in perceiving arousal expressed in faces, while valence ratings remained unaffected. The current results show for the first time that acquired and progressive deafness is associated with a reduction of emotional sensitivity to visual stimuli. This negative impact of progressive deafness on the perception of dynamic facial cues for emotion recognition contrasts with the proficiency of deaf subjects with and without CIs in processing visual speech cues (Rouger et al., 2007; Strelnikov et al., 2009; Lazard and Giraud, 2017). Altogether these results suggest there to be a trade-off between the processing of linguistic and non-linguistic visual stimuli.

International audience; Most cochlear implantations are unilateral. To explore the benefits of a binaural cochlear implant, we used water-labelled oxygen-15 positron emission tomography. Relative cerebral blood flow was measured in a binaural implant group (n = 11), while the subjects were passively listening to human voice sounds, environmental sounds non-voice or silence. Binaural auditory stimulation in the cochlear implant group bilaterally activated the temporal voice areas, whereas monaural cochlear implant stimulation only activated the left temporal voice area. Direct comparison of the binaural and the monaural cochlear implant stimulation condition revealed an additional right temporal activation during voice processing in the binaural condition and the activation of a right fronto-parietal cortical network during sound processing that has been implicated in attention. These findings provide evidence that a bilateral cochlear implant stimulation enhanced the spectral cues associated with sound perception and improved brain processing of voice stimuli in the right temporal region when compared to a monaural cochlear implant stimulation. Moreover, the recruitment of sensory attention resources in a right fronto-parietal network allowed patients with bilateral cochlear implant stimulation to enhance their sound discrimination, whereas the same patients with only one cochlear implant stimulation had more auditory perception difficulties.

OBJECTIVE To evaluate the auditory brainstem implant (ABI) performances in neurofibromatosis type 2 (NF2) and non-NF2 patients. STUDY DESIGN Retrospective cohort study. SETTING Tertiary referral center. PATIENTS Between 1996 and 2006, 31 adult patients (mean age, 41 yr; range, 17-65 yr) were implanted with a 21-electrode Nucleus device (Cochlear Inc., Lane Cove, Australia). The population comprised 23 NF2, 3 postmeningitis bilateral ossified cochleas, 3 solitary vestibular schwannomas on the only hearing ear, 1 inner ear malformation, and 1 bilateral cochlear destruction by otosclerosis. INTERVENTION Auditory brainstem implant was placed through a translabyrinthine or a retrosigmoid approach. MAIN OUTCOME MEASURES Auditory brainstem implant was evaluated by open-set words and sentences in sound, vision, and sound-plus-vision modes. RESULTS In NF2 patients, 16 (70%) were daily users of their implants. In these patients, the open-set dissyllabic word recognition was 36 +/- 6.0 % for vision-only mode, 33 +/- 6.5 % for sound-only mode, and 65 +/- 8.0 % in vision-plus-sound mode with a high interindividual variation. Negative prognostic factors were long duration of total hearing loss (>10 yr), low number of active electrodes (

CEA-Inserm U1000 Neuroimaging and Psychiatry, Service Hospitalier Frederic Joliot, Orsay, France, CEA, DRM, DSV, Service Hospitalier Frederic-Joliot, Orsay, France, Laboratoire de Correction Auditive, Eric Bizaguet, Paris, France, Inserm, UMR-S 867, Paris, France, AP-HP, Hopital Beaujon, Service d’ORL et de Chirurgie cervico-faciale, Clichy, France, Universite Paris 7 Denis Diderot, Paris, France, AP-HP, Hopital Louis Mourier, Service d’ORL et de Chirurgie cervico-faciale, Colombes, France, AP-HP, Hopital Pitie-Salpetriere, Service Urgences cerebro-vasculaires, Paris, France, Universite Paris 6 Pierre et Marie Curie, Paris, France

The objective of the study was to compare the performance of cochlear implantation between post-meningitic and non-meningitic patients, and to evaluate the impact on hearing outcome of technical advances in cochlear implant technology. Retrospective chart review was used as the study design. Twenty adults with post-meningitic profound hearing loss receiving unilateral or bilateral cochlear implants between 1990 and 2008 were tested. Results were compared to a control group of 46 adults implanted for a non-meningitic hearing loss, with the same pre-operative speech scores. Speech scores were poorer in post-meningitic patients compared to those of control group, whatever the duration after implantation (p < 0.0001). Speech scores of subjects implanted and fitted before 2001 were compared to those of subjects implanted after 2001, with the same duration of hearing loss. Performance improved with implants and processors available after 2001, with a magnitude of improvement higher in post-meningitic patients (p < 0.0001 and p < 0.05 in post-meningitic and control groups, respectively, two-way ANOVA). Consequently, speech scores of post-meningitic patients implanted after 2001 achieved those of control subjects (two-way ANOVA). Advances in cochlear implant technology and coding strategy improve hearing outcome in post-meningitic adult patients, who now achieve similar performance as those of non-meningitic patients.

International audience; The superior temporal sulcus (STS) is specifically involved in processing the human voice. Profound acquired deafness by post-meningitis ossified cochlea and by bilateral vestibular schwannoma in neurofibromatosis type 2 patients are two indications for auditory brainstem implantation (ABI). In order to objectively measure the cortical voice processing of a group of ABI patients, we studied the activation of the human temporal voice areas (TVA) by PET H(2)(15)O, performed in a group of implanted deaf adults (n=7) with more than two years of auditory brainstem implant experience, with an intelligibility score average of 17%+/-17 [mean+/-SD]. Relative cerebral blood flow (rCBF) was measured in the three following conditions: during silence, while passive listening to human voice, and to non-voice stimuli. Compared to silence, the activations induced by voice and non-voice stimuli were bilaterally located in the superior temporal regions. However, compared to non-voice stimuli, the voice stimuli did not induce specific supplementary activation of the TVA along the STS. The comparison of ABI group with a normal-hearing controls group (n=7) showed that TVA activations were significantly enhanced among controls group. ABI allowed the transmission of sound stimuli to temporal brain regions but lacked transmitting the specific cues of the human voice to the TVA. Moreover, among groups, during silent condition, brain visual regions showed higher rCBF in ABI group, although temporal brain regions had higher rCBF in the controls group. ABI patients had consequently developed enhanced visual strategies to keep interacting with their environment.

International audience; UNLABELLED: Cochlear implants may improve the medical and social prognosis of profound deafness. Nevertheless, some patients have experienced poor results without any clear explanations. One correlate may be an alteration in cortical voice processing. To test this hypothesis, we studied the activation of human temporal voice areas (TVA) using a well-standardized PET paradigm adapted from previous functional MRI (fMRI) studies. METHODS: A PET H(2)(15)O activation study was performed on 3 groups of adult volunteers: normal-hearing control subjects (n = 6) and cochlear-implanted postlingually deaf patients with >2 y of cochlear implant experience, with intelligibility scores in the "Lafon monosyllabic task" >80% (GOOD group; n = 6) or

Objective: To evaluate speech performance, in quiet and noise, and localization ability in adult patients who had undergone bilateral and simultaneous implantation. Study Design: Prospective multi-center study. Methods: Twenty-seven adult patients with profound or total hearing loss were bilaterally implanted in a single-stage procedure, and simultaneously activated (Med-El, Combi 40/40+). Subjects were assessed before implantation and at 3, 6 and 12 months after switch-on. Speech perception tests in monaural and binaural conditions were performed in quiet and in noise using disyllabic words, with speech coming from the front and a cocktail party background noise coming from 5 loudspeakers. Sound localization measurements were also performed in background noise coming from 5 loudspeakers positioned from –90° to +90° azimuth in the horizontal plane, and using a speech stimulus. Results: There was a bilateral advantage at 12 months in quiet (77 ± 5.0% in bilateral condition, 67 ± 5.3% for the better ear, p < 0.005) and in noise (signal-to-noise ratio +15 dB: 63 ± 5.9% in bilateral condition, 55 ± 6.9% for the better ear, p < 0.05). Considering unilateral speech scores recorded in quiet at 12 months, subjects were categorized as ‘good performers’ (speech comprehension score ≥60% for the better ear, n = 19) and ‘poor performers’ (n = 8). Subjects were also categorized as ‘asymmetrical’ (difference between their 2 unilateral speech scores ≥20%, n = 11) or ‘symmetrical’ (n = 16). The largest advantage (bilateral compared to the better ear) was obtained in poor performers: +19% compared to +7% in good performers (p < 0.05). In the group of good performers, there was a bilateral advantage only in cases of symmetrical results between the 2 ears (n = 10). In the group of poor performers, the bilateral advantage was shown in both patients with symmetrical (n = 6) and asymmetrical results (n = 2). In bilateral conditions, the sound localization ability in noise was improved compared to monaural conditions in patients with symmetrical and asymmetrical performance between the 2 ears. No preoperative factor (age, duration of deafness, use of hearing aids, etiology, etc.) could predict the asymmetrical performance, nor which ear would be the best. Conclusion: This study demonstrates a bilateral advantage (at 12 months after the implantation) in speech intelligibility and sound localization in a complex noisy environment. In quiet, this bilateral advantage is shown in cases of poor performance of both ears, and in cases of good performance with symmetrical results between the 2 ears. No preoperative factor can predict the best candidates for a simultaneous bilateral implantation.

* orthophonistes, centre referent implant cochleaire adulte d'Ile de France et surdite genetique de l'adulte du Pr O.Sterkers, groupe hospitalier Pitie-Salpetriere bâtiment Paul Castaigne 50-52 bd Vincent Auriol 75013 Paris ** orthophoniste, Dr en neurosciences, service ORL du Pr G. Lamas, groupe hospitalier PitieSalpetriere 50-52 bd Vincent Auriol 75013 Paris ***Docteur, Unite d’Otologie, Implants Auditifs et Chirurgie de la Base du Crâne, Hopital PitieSalpetriere, AP-HP, Paris. **** Professeur, Unite d’Otologie, Implants Auditifs et Chirurgie de la Base du Crâne, Hopital PitieSalpetriere, AP-HP, Paris.

Aim : While many researches have recently focused on immediate activation after cochlear implantation, a few studies only have explored the issue of CI adults users’ preliminary assessment of speech recognition. The very first post-surgery CI users’ appointments are meant to activate the electrodes and adjust stimulation threshold fittings. The onset of speech recognition evaluation only starts from 3-month post-implantation, though short perceptive tests are already run from 1-month post-activation. The aim of our study is to explore a possible predictive aspect of the «early» scores when compared to long-term performances.Materials/Methods : Data of twenty first-time CI adult patients with post-lingual deafness assessed with closed-set word test (days of the week randomly listed) at 7-day and 1- month post-CI activation and with monosyllabic word tests (Lafon lists) at 7-day, 1-month, 3-month and 6-month after implantation were analyzed.Results: A predictive value in monosyllabic word recognition has been found between 1-month and 6-month, with a plateau effect at 3-month. The results of closed-set word test 7-day post-activation were also linked to monosyllabic word test outcomes at 6-month. However, performances in pre and post-implantation were not correlated as predictive of post-implantation outcomes.Conclusion : Early speech recognition results at 1-month after implantation could be a relevant prognosis of long-term performances’ evolution profiles in order to adapt and maximize post-implantation rehabilitation. These predictive indicators could even be ascertained as early as days after activation, should immediate stimulation expand as a standardized procedure.; Objectif : Si l’activation immédiate de l’implant cochléaire à J1 post-opératoire soulève actuellement un intérêt scientifique, la littérature présente peu d’études relatives à l’évaluation précoce des performances liées à la perception de la parole des patients adultes implantés cochléaires. Les premiers rendez-vous en post-implant immédiat sont consacrés à l’activation des électrodes et aux réglages des seuils de stimulation. Or, les tests perceptifs interviennent seulement à partir de 3 mois post-activation lors des bilans orthophoniques, même si des évaluations sont déjà réalisées en pratique clinique courante dès le premier mois. Cette étude vise à savoir si ces premiers résultats sont prédictifs des performances ultérieures.Matériels/Méthodes : Les données de vingt adultes primo-implantés présentant une surdité acquise ont été analysées en compréhension de mots (liste fermée de jours de la semaine) à J7 et à M1 post-activation, ainsi qu’à partir de listes de mots monosyllabiques à J7, M1, M3 à M6.Résultats : Il existe une valeur prédictive pour la reconnaissance de mots monosyllabiques entre M1 et M6, avec un relais à M3. Une corrélation apparaît dès J7 entre la liste fermée et la liste de Lafon à M6. Cependant, aucune corrélation ne peut être établie entre les performances pré et post-implantation qui serait prédictive des résultats en post-IC.Conclusion : L’analyse des performances précoces permettrait de constituer des profils de progression et d’optimiser la rééducation post-implant. Ces indices pourraient être repérés dès l’activation de l’implant si la pratique d’une stimulation post-opératoire immédiate venait à se généraliser.

Social interactions in noisy environments lead to an increased mobilization of cognitive abilities and attention resources. Speechreading enables a better understanding in noise, especially for people with hearing loss. We tried to learn if noise has an impact on speechreading performance and therefore on the attention resources used when integrating speech in noise.; Les interactions sociales en milieu bruyant entraînent une mobilisation accrue des capacités cognitives et des ressources attentionnelles. La lecture labiale permet une meilleure compréhension dans le bruit, notamment chez les personnes malentendantes. Nous avons cherché à savoir si le bruit a un impact sur les performances en lecture labiale et donc sur les ressources attentionnelles sollicitées lors de l’intégration audiovisuelle de la parole dans le bruit.

Acquired deafness and its effects in verbal processing have been largely explored, especially specific abilities in speech reading. In contrast, very little has been written so far about emotional processing of visual stimuli; the only research reported is (Ambert-Dahan 2014) that surprisingly revealed impaired emotional perception. The aim of the present study was to assess this type of social skill. Seventeen candidates for cochlear implants were individually tested. Two types of tasks were used: firstly control tasks intended to eliminate those who were likely to have some difficulties either to make a forced choice among six answers, or to perceive faces (prosopagnosia); secondly a protocol composed of three timed tasks belonging to a social cognition battery of tests (BCS Ehrlé et al 2011), a task of emotion recognition based on the six primary facial emotions identified by Paul Ekmann (anger, surprise, fear, happiness, disgust and sadness), a discrimination task (without any resort to verbal labeling), and last an intensity rating task. Patients’ performances have been expressed in terms of standard deviation, with reference to BCS’s normative data. Two of them were excluded due to weak scores in control tasks. The results bring to light deficiency in all tasks and for all dependent variables (answers and times), which were not emotion-specific and varied from one patient to another., La surdité acquise et ses effets sur le traitement verbal ont été largement explorés, tout particulièrement les aptitudes manifestées dans le domaine de la lecture labiale. En revanche, le traitement émotionnel des stimuli visuels a été peu étudié. Les seuls travaux recensés (Ambert-Dahan 2014) ont révélé de façon inattendue un trouble de la perception émotionnelle des expressions faciales. L’objectif de la présente étude était d’évaluer cette dimension des habiletés sociales. Dix-sept patients candidats à l’implant cochléaire ont été testés individuellement. Deux types de tâches ont été utilisées : tout d’abord des tâches contrôle destinées à écarter les personnes qui auraient pu avoir des difficultés à effectuer un choix forcé parmi six réponses possibles ou encore à percevoir les visages (prosopagnosie) ; en second lieu un protocole issu de la batterie de cognition sociale (BCS Ehrlé et coll. 2011) et consistant en trois épreuves chronométrées: une tâche d’identification d’émotions basée sur les six émotions primaires identifiées par Paul Ekman (colère, surprise, peur, joie, dégoût et tristesse), une tâche de discrimination d’émotions limitant le facteur verbal, et enfin une tâche de jugement émotionnel. Les résultats font apparaître des déficits dans chacune des tâches et pour chaque variable dépendante (réponses et temps), qui ne sont pas sélectifs à certains patients mais s’expriment de façon variable de l’un à l’autre.

Several studies have shown that hearing impairment had an impact on cognitive functioning. In this study, 24 adults with severe post lingual hearing loss completed Codex (Cognitive disorders examination, Belmin, 2004) and MoCA (Montreal cognitive assessment, Nasreddine, 2005) tests, both prior to and after cochlear implantation. Results show a significant improvement in cognitive abilities in the group that had pathological scores at the MoCA test prior to cochlear implantation. No correlations were found between cognitive scores and subject’s age, or duration of deafness. We argue that the MoCA test could be an interesting tool in observing the evolution of cognitive abilities in subjects with abnormal scores prior to implantation as well as assessing cognitive frailties in hearing impaired elderly subjects. This multidimensional approach could lead to a interdisciplinary intervention in the sensory-cognitive deprived subjects., Il a été démontré dans plusieurs études que la surdité avait un impact sur les habilités cognitives des sujets. Les tests cognitifs CODEX (Belmin, 2004) et MoCA (Nasreddine, 2006) ont été proposés à 24 adultes atteints de surdité neurosensorielle évolutive avant et après leur implantation cochléaire. Les scores obtenus au MoCA après l’implantation se sont révélés meilleurs que ceux obtenus avant l’implantation chez les sujets ayant obtenus des scores pathologiques avant leur implantation cochléaire. Aucune relation entre les résultats aux tests cognitifs et les performances auditives du sujet, son âge ou la durée de surdité profonde avant l’implantation n’a pu être retrouvée. Ces données indiquent que le MoCA pourrait être considéré comme un test de repérage de l’évolution des habiletés cognitives pertinent, chez les sujets ayant obtenu des scores pathologiques avant l’implantation cochléaire. Cette approche permettrait de prendre en compte la dimension de repérage des «fragilités» chez le sujet âgé et d’optimiser la prise en charge multidimensionnelle des patients atteints de déficits sensori-cognitifs.

BACKGROUND: A link was shown between age-related hearing loss and age-related cognition.AIM: The purpose of this paper is to determine whether the cognitive abilities of patients with presbycusis, evaluated by CODEX and MoCA cognitive tests, differed from those of healthy age-matched controls. METHOD: 40 adult patients with deep and progressive hearing loss were tested prior to implantation on lists of syllables, words and sentences presented in the auditory mode and with 2 cognitive tests CODEX and MoCA presented in the visual mode. RESULTS: The cognitive profile of deaf adults is different from that of hearing subjects since the items testing executive functions and episodic memory seem to discriminate deaf adults. CONCLUSIONS: The easy and rapid to use cognitive screening tests CODEX and MoCA can be used for longitudinal follow-up of cochlear implanted subjects so as to confirm the improvement of cognitive functions after hearing rehabilitation., CONTEXTE : Un lien a été montré entre le vieillissement auditif et le vieillissement cognitif. OBJECTIF : L’objectif de cette étude est de déterminer si les capacités cognitives des patients presbyacousiques, évaluées avec les tests CODEX et MoCA, sont différentes de celles des sujets normo-entendants de même âge. MÉTHODE : Les performances auditives de 40 patients adultes présentant une surdité profonde évolutive ont été testées lors d’un bilan pré-implantation avec des listes de syllabes, de mots et de phrases proposées en modalité auditive et avec les tests cognitifs de dépistage CODEX et MoCA proposés en modalité visuelle. RÉSULTATS : Le profil cognitif des sujets presbyacousiques est différent des normo-entendants, les épreuves testant les fonctions exécutives et la mémoire épisodique apparaissant discriminantes chez ces patients. CONCLUSION : Les tests cognitifs de dépistage MoCA et Codex, simples et rapides, pourront être utilisés dans le suivi longitudinal des sujets implantés cochléaires afin de confirmer l’amélioration des fonctions cognitives grâce à la réhabilitation auditive.

The purpose of this study is to identify predictive functions for lipreading. Lipreading skills, in particular in homophene discrimination, and visual attention and memory were assessed on 22 people with profound hearing loss, and a control group as well. As a result, despite bigger lipreading abilities, deaf patients do not discriminate homophene more than controls. Furthermore, there are correlations between lipreading skills and visual memory and attention skills., Le but de cette étude est de mettre en évidence les facteurs prédictifs d'une lecture labiale fonctionnelle. Les capacités en lecture labiale, et notamment en discrimination des sosies labiaux, ainsi que les capacités d'attention et de mémoire visuelles ont été évaluées auprès de 22 personnes atteintes de surdité profonde, et d'une population contrôle. Il en résulte que malgré un traitement visuel de la parole plus performant, les patients sourds ne discriminent pas plus les sosies labiaux que les témoins. De plus, il existe des corrélations entre les capacités en lecture labiale et les capacités en mémoire et attention visuelles.

The purpose of this study was to evaluate the benefits from vocal processor upgrading in deaf adults with cochlear implants. Fourteen participants were evaluated with acoustic, speech discrimination and ecological tests. The findings suggest that vocal processor upgrading leads to finer speech perception which could be enhanced by rehabilitation so as to improve speech discrimination., Notre étude porte sur les bénéfices potentiels chez des adultes sourds implantés cochléaires après le renouvellement de leur processeur vocal. Quatorze sujets ont été évalués par des tests à la fois acoustiques, perceptifs et écologiques. Les résultats montrent que le renouvellement apporte une perception plus fine des sons. Celle-ci peut être entraînée par une prise en charge orthophonique de manière spécifique afin de pouvoir être exploitée au niveau de la compréhension.