Voice of the hearing impaired of cochlear implant users: integrative review

Abstract

Introduction: The cochlear implant (CI) provides better conditions for the development and maintenance of hearing, providing auditory feedback during phonation and speech. Objectives: To analyze recent publications on vocal production of the hearing impaired user of CI. Methods: Integrative literature review, by searching the SciELO and PubMed databases. Articles published in English or Portuguese, from 2016 to 2020, whose titles included the words “voice” and “cochlear implant” and mentioned the relationship between CI and vocal production were included. Editorials, systematic reviews of the literature, those that related the CI with vocal perception or speech production in isolation were excluded. Results: 10 studies were selected that evaluated the voices of children, adults and alderly users of CI through: 1) Objective evaluation - acoustic analysis; 2) Subjective evaluations - from the patient himself (vocal self-assessment questionnaires), from speech therapist judges (Auditory Perceptual Assessment) and from other individuals (identification of vocal emotions); 3) Evaluation of physiological data - aerodynamic vocal analysis. Studies report progressive improvement in fundamental frequency, jitter, subglottic pressure and maximum phonation time after surgery and use of CI and speech therapy. There was a decrease in the general degree of vocal deviation, instability, degree of alteration in resonance, improvement in speech intelligibility and prosodic cues. Self-assessment revealed deviated symptoms and vocal handicap and improved quality of life 6 months after surgery. Conclusion: The auditory feedback provided by CI and rehabilitation therapies improves communication and reflects positive effects on the quality of life and voice of users.