Paul Govaerts

Paul Govaerts
The Eargroup

MD, MSc, PhD

About

172
Publications
31,712
Reads
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5,609
Citations
Additional affiliations
February 2015 - present
Vrije Universiteit Amsterdam
Position
  • Professor
March 2003 - present
The Eargroup
Position
  • Managing Director
July 1991 - March 2003
Sint-Augustinus Hospital
Position
  • ENT consultant

Publications

Publications (172)
Article
Full-text available
Hearing outcomes of two cases of growing sporadic vestibular schwannoma, resected via a translabyrinthine approach with simultaneous cochlear implantation are reported. After gross total resection and anatomical preservation of the facial and cochlear nerve, the integrity of the cochlear nerve—on an electrophysiological level—was evaluated using th...
Article
Full-text available
Purpose The purpose of this study was to (a) investigate which speech material is most appropriate as stimulus in head shadow effect (HSE) and binaural squelch (SQ) tests, (b) obtain normative values of both tests using the material decided to be optimal, and (c) explore the results in bilateral cochlear implant (CI) users. Method Study participan...
Article
Objective: Cochlear implants (CIs) are the treatment of choice for patients with severe to profound hearing loss. The hearing results, however, considerably vary across patients. This may partly be due to variability in the CI fitting. We investigated the effect of FOX, a software tool to program CIs using artificial intelligence (AI), on hearing...
Article
Objective: A prospective, longitudinal, randomized controlled trial with an original crossover design for 1 year was conducted to compare manual fitting to artificial intelligence-based fitting in newly implanted patients. Design: Twenty-four patients who received their first cochlear implant (CI) were randomly assigned to the manual or Fitting...
Article
Full-text available
Objective As a follow-up to the studies by Vaerenberg et al. (Sci World J 501738:1–12, 2014) and Browning et al. (Cochlear Implant Int 21(3):1–13, 2020), who used questionnaires, we determined whether there are between-centre variations in the fitting of cochlear implants by analysing the methodology, fitting parameters and hearing results of patie...
Article
Objectives: This study aimed to compare the audiological outcomes of cochlear reimplantation with those of the first cochlear implant (CI). Design: A retrospective analysis was performed on the data of all CI recipients who received the first CI at the age of 8 years or earlier and who were subsequently reimplanted on the same side. All particip...
Article
Full-text available
The global digital transformation enables computational audiology for advanced clinical applications that can reduce the global burden of hearing loss. In this article, we describe emerging hearing-related artificial intelligence applications and argue for their potential to improve access, precision, and efficiency of hearing health care services....
Chapter
In the chapter, the authors address the prescient need to update accepted care models of cochlear implant (CI) fitting and long-term maintenance to better utilize self-care and tele-medicine possibilities, thus shifting the focus of CI maintenance to the recipient. There is a strong evidence base that such a move will better meet the needs of CI us...
Article
Full-text available
Background and objectives: A rare type of nonsyndromic autosomal recessive hereditary hearing loss is caused by pathogenic mutations in the TRIOBP gene mostly involving exons 6 and 7. These mutations cause hearing loss originating from dysfunction of sensory inner ear hair cells. Of all the affected siblings, 2 brothers and 1 sister, part of an Af...
Preprint
Full-text available
The global digital transformation enables computational audiology for advanced clinical applications that have the potential to impact the global burden of hearing loss. In this paper we describe emerging hearing-related artificial intelligence applications and argue for their potential to improve access, precision and efficiency of hearing health...
Article
Full-text available
In recent years there has been an increasing percentage of cochlear implant (CI) users who have usable residual hearing in the contralateral, nonimplanted ear, typically aided by acoustic amplification. This raises the issue of the extent to which the signal presented through the cochlear implant may influence how listeners process information in t...
Article
Objective: This study aims to assess the feasibility of autonomous cochlear implant (CI) fitting by adult CI recipients based on psychoacoustic self-testing and artificial intelligence (AI). Design: A feasibility study was performed on six adult CI recipients implanted with a Nucleus device. Two weeks after processor activation in the clinic, a ‘se...
Article
Objectives: Previous research has shown that children with cochlear implants (CIs) encounter more communication difficulties than their normal-hearing (NH) peers in kindergarten and elementary schools. Yet, little is known about the potential listening difficulties that children with CIs may experience during secondary education. The aim of this s...
Article
Objective: To assess whether CI programming by means of a software application using artificial intelligence (AI), FOX®, may improve cochlear implant (CI) performance. Patients: Two adult CI recipients who had mixed auditory results with their manual fitting were selected for an AI-assisted fitting. Even after 17 months CI experience and 19 manual...
Article
Objectives: The newest CI processor from MED-EL company, the SONNET, has two new directional microphone settings. Besides the Omnidirectional microphone mode, it has the possibility to switch to Natural or Adaptive directionality. Both new modes favour perception of sound coming from a front-facing direction compared to sounds from sources at alter...
Chapter
In the chapter, the authors address the prescient need to update accepted care models of cochlear implant (CI) fitting and long-term maintenance to better utilize self-care and tele-medicine possibilities, thus shifting the focus of CI maintenance to the recipient. There is a strong evidence base that such a move will better meet the needs of CI us...
Article
Full-text available
Purpose The introduction of connectivity technologies in hearing implants allows new ways to support cochlear implant (CI) users remotely. Some functionalities and services that are traditionally only available in an in-clinic care model can now also be accessed at home. This study explores the feasibility of a prototype of a tablet computer applic...
Article
Full-text available
Purpose: To overcome the potential tension between clinical and ecological validity in speech audiometric assessment by creating a new set of sentence materials with high linguistic validity for the Dutch-speaking area. Methods: A linguistic "fingerprint" of modern spoken Dutch and Flemish served to generate a set of sentences recorded from 1 ma...
Conference Paper
Objectives: To explore the feasibility of autonomous CI fitting by CI recipients 66 Material and Methods: in the context of our target-driven computer-assisted CI fitting, we have developed (1) self- tests for the audiological assessment of a CI recipient, (2) a wired/wireless connection between the computer and the CP900/CP1000 processor (Cochlear...
Conference Paper
Objectives: We’ve conducted a proof of concept trial to re- place the second CI fitting session with a remote session. Following our standard procedures, this second session en- compasses audiological tests and computer-assisted MAP optimization. This was done remotely thanks to the use of (1) FOX, the fitting assistant using artificial intelligenc...
Article
Background: Previous research has suggested that speech perception in elderly adults is influenced not only by age-related hearing loss or presbycusis but also by declines in cognitive abilities, by background noise and by the syntactic complexity of the message. Aims: To gain further insight into the influence of these cognitive as well as acou...
Article
Full-text available
Objectives: The newest Nucleus CI processor, the CP900, has two new options to improve speech-in-noise perception: (1) use of an adaptive directional microphone (SCAN mode) and (2) wireless connection to MiniMic1 and MiniMic2 wireless remote microphones. Design: An analysis was made of the absolute and relative benefits of these technologies in...
Article
Full-text available
Objective: The software application FOX ('Fitting to Outcome eXpert') is an intelligent agent to assist in the programing of cochlear implant (CI) processors. The current version utilizes a mixture of deterministic and probabilistic logic which is able to improve over time through a learning effect. This study aimed at assessing whether this learn...
Conference Paper
Full-text available
An extended retrospective analyses of CT and MRI imaging in patients with the same P51S mutation in the COCH gene, confirmed the recently discovered characteristic radiologic feature
Article
Valider une nouvelle méthode d’audiométrie vocale utilisant des listes personnalisées, enregistrées par le sujet à tester, et bénéficiant d’une notation automatique.
Article
This contribution addresses cochlear implantation (CI) selection criteria as a discussion topic. It expresses a personal viewpoint that challenges the usefulness and necessity of formal selection criteria. Scientifically, it is argued that CI selection must be highly individual, whereas the current criteria are general, not valid, not based on a wi...
Article
Objectives: To validate a novel speech audiometry method using customized self-voice recorded word lists with automated scoring. Patients and methods: The self-voice effect was investigated by comparing results with prerecorded or self-recorded CVC (consonant-vowel-consonant) word lists. Then customized lists of 3-phoneme words were drawn up usi...
Article
Full-text available
In speech audiometric testing, hearing performance is typically measured by calculating the number of correct repetitions of a speech stimulus. We investigate to what extent the repetition accuracy of Dutch speech stimuli presented against a background noise is influenced by nonauditory processes. We show that variation in verbal repetition accurac...
Article
Full-text available
This report provides a detailed analysis of incorrect responses from an open-set spoken word-repetition task which is part of a Dutch speech audiometric test battery. Single-consonant confusions were analyzed from 230 normal hearing participants in terms of the probability of choice of a particular response on the basis of acoustic-phonetic, lexica...
Article
Full-text available
Roger is a digital adaptive multi-channel remote microphone technology that wirelessly transmits a speaker's voice directly to a hearing instrument or cochlear implant sound processor. Frequency hopping between channels, in combination with repeated broadcast, avoids interference issues that have limited earlier generation FM systems. This study ev...
Conference Paper
Full-text available
Introduction and aim Recently a new phenotypic and characteristic radiologic feature of DNA9 has been discovered in a series of 9 patients, all with the same PSIS COCH gene mutation. This study adds more patients to the series. Material and methods CT en MRI imaging of 14 patients who presented between 2007 and 2014 with otovestibular deterioration...
Article
Full-text available
To compare speech perception outcomes between bilateral implantation (cochlear implants [CIs]) and bimodal rehabilitation (one CI on one side plus one hearing aid [HA] on the other side) and to explore the clinical factors that may cause asymmetric performances in speech intelligibility between the two ears in case of bilateral implantation. Retros...
Article
Full-text available
One of the major complaints of people with a single-sided deafness is the inability to localize sound sources. Evidence suggests that subjects with a hearing loss can benefit from the use of a cochlear implant (CI) in sound localization. This study aimed to determine the effect of CI use on localization ability in unilaterally deafened subjects. Si...
Article
Objectives Cochlear's new sound processor system (Nucleus(®) 6) features a new noise reduction algorithm called SNR-NR (signal-to-noise ratio), and an environmental classifier called SCAN, which activates the appropriate sound coding algorithms for a given listening environment. In addition, the sound processors (CP910 and CP920) have a data loggin...
Article
Objective: To compare the fitting time requirements and the efficiency in achieving improvements in speech perception during the first 6 months after initial stimulation of computer-assisted fitting with the Fitting to Outcome eXpert' (FOX) and a standard clinical fitting procedure. Method: Twenty-seven post-lingually deafened adults, newly impl...
Article
Full-text available
Objectives: To evaluate the possible impact of 'Fitting to Outcomes eXpert (FOX(®))' on cochlear implant (CI) fitting in a clinic with extensive experience of fitting a range of CI systems, as a way to assess whether a software tool such as FOX is able to complement standard clinical procedures. Methods: Ten adult post-lingually deafened and uni...
Article
Understanding and predicting the impact of MAP changes on the electrical current delivered at the level of cochlear implant (CI) electrodes is challenging. However, it is an important prerequisite for effectively programming these devices in clinical practice. This article describes a graphical representation to illustrate the intensity-coding beha...
Article
Full-text available
Focal sclerosis of one or more semicircular canals on computed tomographic (CT) scans and a corresponding signal loss on magnetic resonance (MR) imaging are radiologic lesions that are linked to patients who are suffering from advanced otovestibular impairment caused by hereditary DFNA9 hearing loss. DFNA9 is a hereditary hearing loss that is chara...
Article
Full-text available
Objective. The paper aims to demonstrate the feasibility of defining a substantial set of psychoacoustic outcome measures with preset targets and to adopt a systematic methodology for reaching these targets in a large group of subjects, by more than one clinical centre. Design. Retrospective data analysis. Setting. Multicentre with 14 participating...
Article
Full-text available
The programming of CIs is essential for good performance. However, no Good Clinical Practice guidelines exist. This paper reports on the results of an inventory of the current practice worldwide. A questionnaire was distributed to 47 CI centers. They follow 47600 recipients in 17 countries and 5 continents. The results were discussed during a debat...
Article
Background This study compares 4- to 7-year-old cochlear implanted (CI) and specific language impaired (SLI) children in the production of finite verb morphology and mean length of utterance (MLU). It has been hypothesized that, due to reduced exposure to grammatical elements in the ambient language, both groups are delayed in their acquisition of...
Article
Full-text available
Objective The estimation of perceptive thresholds is a basic element of psychoacoustics. One of the drawbacks of commonly used adaptive algorithms is the lack of reliability when the behavioral response is not robust. To address this issue an adaptive algorithm, TEMA (Threshold Estimation by Managed Algorithm), has been developed. Design TEMA seek...
Conference Paper
Severe and profound hearing losses can be treated with cochlear implants (CI). Given that a CI may have up to 150 tunable parameters, adjusting them is a highly complex task. For this reason, we decided to build a decision support system based on a new type of probabilistic graphical model (PGM) that we call tuning networks. Given the results of a...
Article
In the literature, languages have been identified as having more or less transparent orthographies, depending on the degree of predictability of their spelling-to-sound correspondences. Quantitative measures based on large-scaled language corpora which are capable to objectively assess such cross-linguistic variation are rather scarce. The quantita...
Article
The clinical assessment of speech discrimination by professional audiologists is resource intensive. Yet discrepancies in language or dialect between the test subject and the audiologist may cause a significant bias in the test result. To address these issues, a speech audiometric test (SAT) has been designed to be language/dialect independent and...
Article
This study discusses the speech stimuli that are used in the 10 most frequently used tests for speech audiometry in The Netherlands and in Flanders. This discussion elaborates on why different types of speech stimuli (e.g. sentences, words) are chosen andwhat kind of information distinct types of stimuli give on the speech perception abilities of t...
Article
Full-text available
Objective: To assess the auditory performance of Digisonic(®) cochlear implant users with electric stimulation (ES) and electro-acoustic stimulation (EAS) with special attention to the processing of low-frequency temporal fine structure. Method: Six patients implanted with a Digisonic(®) SP implant and showing low-frequency residual hearing were...
Article
Full-text available
OBJECTIVE: To test the influence of multiple factors on cochlear implant (CI) speech performance in quiet and in noise for postlinguistically deaf adults, and to design a model of predicted auditory performance with a CI as a function of the significant factors. STUDY DESIGN: Retrospective multi-centre study. METHODS: Data from 2251 patients impl...
Article
Full-text available
Objective: To update a 15-year-old study of 800 postlinguistically deaf adult patients showing how duration of severe to profound hearing loss, age at cochlear implantation (CI), age at onset of severe to profound hearing loss, etiology and CI experience affected CI outcome. Study design: Retrospective multicenter study. Methods: Data from 225...
Article
Full-text available
Background Pitch relates to the low frequency temporal content of sound, which mainly depends on phase coding at the level of the auditory nerve. In this study, we aim to assess the detectibility of pitch changes in different populations of hearingimpaired subjects suffering from sensorineural hearing loss in order to identify possible poor tempora...
Article
Full-text available
There are numerous cochlear implant fixation techniques to prevent soft tissue complications related to device migration. The literature does not provide sufficient evidence to determine the most suitable fixation method. Cochlear implants (CI) are becoming a routine treatment for patients with severe to profound deafness. Steadily growing numbers...
Article
Full-text available
Objectives: The auditory speech sounds evaluation 2009 test battery for assessment of speech pitch perception is presented. It was designed to (a) assess perception of pitch in linguistic contexts without the confounds of secondary acoustic cues, (b) be usable with listeners from different language backgrounds, and (c) be suitable for use in a cli...
Article
Full-text available
Recent neurobiological studies have advanced the hypothesis that language development is not continuously plastic but is governed by biological constraints that may be modified by experience within a particular time window. This hypothesis is tested based on spontaneous speech data from deaf cochlear-implanted (CI) children with access to linguisti...
Article
The perception of pitch has recently gained attention. At present, clinical audiologic tests to assess this are hardly available. This article reports on the development of a clinical test using harmonic intonation (HI) and disharmonic intonation (DI). Prospective collection of normative data and pilot study in hearing-impaired subjects. Tertiary r...
Article
Full-text available
This report describes the application of the software tool "Fitting to Outcomes eXpert" (FOX) in programming the cochlear implant (CI) processor in new users. FOX is an intelligent agent to assist in the programming of CI processors. The concept of FOX is to modify maps on the basis of specific outcome measures, achieved using heuristic logic and b...
Article
An intelligent agent, Fitting to Outcomes eXpert, was developed to optimize and automate Cochlear implant (CI) programming. The current article describes the rationale, development, and features of this tool. Cochlear implant fitting is a time-consuming procedure to define the value of a subset of the available electric parameters based primarily o...
Article
Full-text available
Otosclerosis is a common form of hearing loss, characterized by disordered bone remodeling in the otic capsule. Within the otosclerotic foci, several immunocompetent cells and immune-modulating factors can be found. Different etiological theories involving the immune system have been suggested. However, a genetic component is clearly present. In la...