Anirudh Gautam1, James G Naples2, Steven J Eliades2,3. 1. Royal College of Surgeons in Ireland School of Medicine, Dublin, Ireland. 2. Department of Otorhinolaryngology: Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A. 3. Auditory and Communication Systems Laboratory, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A.
Abstract
OBJECTIVE: Hearing plays an important role in the learning and production of speech, but the benefits of cochlear implantation for such vocal control are unclear. Here, we present a perspective and review of recent work on the control of speech and voice following cochlear implantation. We further discuss insights provided on the mechanisms of normal vocal control and implications for future rehabilitative approaches. DATA SOURCES: Peer-reviewed articles on speech and voice production in cochlear implant patients were identified from PUBMED. Relevant articles were supplemented with selected publications describing normal vocal control mechanisms and behaviors. REVIEW METHODS: Publications that discussed speech and voice outcomes following cochlear implantation were chosen, with a focus on those presenting measurements of specific speech or voice parameters. RESULTS: Recent studies demonstrate that hearing restoration by cochlear implantation has significant effects on many aspects of voice and speech production. These include changes in vocal pitch and loudness, as well as improved control of both vowels and consonants. Despite these improvements, however, the speech of many implant recipients remains abnormal as compared to normal hearing individuals. Such differences likely result from the impoverished auditory feedback provided by the implant. CONCLUSIONS: Cochlear implants provide valuable insights into the role of hearing in vocal production. Although implants improve vocal production for most patients, there remains considerable room for future study and therapeutic improvement. Laryngoscope, 129:2158-2163, 2019.
OBJECTIVE: Hearing plays an important role in the learning and production of speech, but the benefits of cochlear implantation for such vocal control are unclear. Here, we present a perspective and review of recent work on the control of speech and voice following cochlear implantation. We further discuss insights provided on the mechanisms of normal vocal control and implications for future rehabilitative approaches. DATA SOURCES: Peer-reviewed articles on speech and voice production in cochlear implant patients were identified from PUBMED. Relevant articles were supplemented with selected publications describing normal vocal control mechanisms and behaviors. REVIEW METHODS: Publications that discussed speech and voice outcomes following cochlear implantation were chosen, with a focus on those presenting measurements of specific speech or voice parameters. RESULTS: Recent studies demonstrate that hearing restoration by cochlear implantation has significant effects on many aspects of voice and speech production. These include changes in vocal pitch and loudness, as well as improved control of both vowels and consonants. Despite these improvements, however, the speech of many implant recipients remains abnormal as compared to normal hearing individuals. Such differences likely result from the impoverished auditory feedback provided by the implant. CONCLUSIONS: Cochlear implants provide valuable insights into the role of hearing in vocal production. Although implants improve vocal production for most patients, there remains considerable room for future study and therapeutic improvement. Laryngoscope, 129:2158-2163, 2019.