The relation between cochlear implant programming levels and speech perception performance in post-lingually deafened adults: a data-driven approach (original) (raw)
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2012
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 implanted since 2003 in 15 international centres were collected. Speech scores in quiet and in noise were converted into percentile ranks to remove differences between centres. The influence of 15 pre-, perand postoperative factors, such as the duration of moderate hearing loss (mHL), the surgical approach (cochleostomy or round window approach), the angle of insertion, the percentage of active electrodes, and the brand of device were tested. The usual factors, duration of profound HL (pHL), age, etiology, duration of CI experience, that are already known to have an influence, were included in the statistical analyses. Results: The significant f...
Clinical Otolaryngology
To identify which preoperative patient characteristics influence sequential bilateral cochlear implantation performance and to create a statistical model that predicts benefit. Design: Multicentre retrospective cohort study. Setting: All patients were operated in four academic teaching hospitals in Perth, Australia, and followed up by audiologists of the Ear Science Institute Australia. Participants: A total of 92 postlingually deafened adult patients who had undergone sequential cochlear implantations between 19 June 1990 and 14 March 2016 were included. Patients were excluded if the 12-month follow-up consonant-nucleus-consonant (CNC) phoneme score was missing. Main outcome measure: The effect of 18 preoperative factors on the CNC phoneme score in quiet (at 65 dB SPL) with the second cochlear implant (CI2) one year after implantation. Results: Two factors were positively correlated to speech understanding with CI2: Wearing a hearing aid (HA) before receiving CI2 (r = 0.46, P = 0.00) and the maximum CNC phoneme score with the first CI (CI1) (r = 0.21, P = 0.05). Two factors were negatively correlated: the length of hearing loss before CI2 in the second implanted ear (r = −0.25, P = 0.02) and preoperative pure tone average (PTA) (0.5, 1, 2 kHz) before CI2 in the second implanted ear (r = −0.27, P = 0.01). The following model could be created: predicted CNC phoneme score with CI2 (%) = 16 + (44 * HA use before CI2 (yes)) − (0.22 * length of hearing loss before CI2 (years)) + (0.23 * CNC phoneme score with CI1 (%)). Because the effect of HA use before implantation played such a major role, we also created a model after exclusion of the HA factor: Predicted CNC phoneme score with CI2 (%) = 82 − (0.17 * length of hearing loss before CI2 (years)) − (0.27 * PTA in second implanted ear before CI2 (0.5, 1, 2 kHz)) + (0.20 * CNC phoneme score with CI1 (%)).
THE EFFECT OF COCHLEAR IMPLANT USE IN POSTLINGUALLY DEAF ADULTS
International Journal of Technology Assessment in Health Care, 2000
To assess the effect of the use of cochlear implants (CI) on the health status of postlingually deaf adults. Methods: Participants comprised 45 postlingually deaf adult multichannel CI users and 46 deaf candidates on the waiting list for a CI. The latter group acted as control subjects to corroborate the validity of retrospective completion of the questionnaires by the CI recipients. Three HRQOL instruments were used: a) a specially developed CI questionnaire (NCIQ); b) a generic HRQOL questionnaire (SF-36); and c) a health-state classification system (HUI-2) suited to estimate single preference scores. Results: Retrospectively estimated pre-implant scores in the CI user group corresponded very well with the scores in the control group. Postimplant scores in the CI users were substantially higher in all six domains ( p < .001) of the NCIQ than the scores in the control group. Effects due to a CI were also observed with the SF-36 in five of the seven domains ( p < .01). Statistically significant differences between the two groups ( p = .001) were observed in two of the six domains of the HUI-2. Conclusions: All three questionnaires detected improvements in HRQOL due to CI use. To make a detailed assessment of the effect of a CI on functional outcomes and well-being, a special purpose HRQOL instrument is far more adequate than a general HRQOL instrument. This study also showed that a CI affects several other health domains besides auditory performance. The effect of CI use on general functioning and well-being proved to be considerable.
Cochlear Implant Outcomes and Quality of Life in Adults with Prelingual Deafness
The Laryngoscope, 2007
Objectives: To evaluate sound and speech perception and quality of life in prelingually deafened adults implanted with state of the art devices. To investigate which patient factors influence postoperative performance. Study Design: Prospective intervention study. Methods: Eight prelingually deafened subjects (with onset of severe hearing impairment before the age of 4 years and functioning in an oral-aural setting) participated in this study. Subjects were implanted at a mean age of 36 (range, 21-55) years with a CII or 90 K cochlear implant (Advanced Bionics Corp.). All subjects completed standard speech perception tests as well as quality of life measures (Health Utility Index Mark-II, Nijmegen Cochlear Implant Questionnaire, visual analogue scale for subject's hearing and health) at different points in time. Postoperative scores were compared with each other and with the baseline preoperative scores. The relationship between nine patient variables and the postoperative consonant-vowel-consonant (CVC) phoneme score was also investigated. Results: Significant improvement was measured for CVC word and phoneme scores and several quality of life measures. Postoperative speech perception correlated with a new and promising factor named quality of a patient's own speech production (QoSP). Conclusion: With state of the art implants, speech perception and quality of life do improve in prelingually deafened adults. More importantly, the prognostic value of QoSP should be investigated further.
2014
A number of factors influence the quality of life of deaf individuals following cochlear implantation. In this study, we adapted the ICF model to create a survey to specifically fit Cochlear Implant (CI) users. This enabled us to make a novel comparison and correlation among multiple factors and categories between two groups: a high and low score group in response to survey questions. The objective of this study was to determine the broader effects that cochlear implantation has on adults with prelingual deafness. Using the WHO-ICF model, in addition to previous quality of life studies as a framework, a 65-item survey (modified ICF Checklist) was created and sent out to 71 participants. From there, outcome measures were categorized as follows: 1) Activities, Participation and Personal Factors, 2) Hearing Activities, and 3) Environmental Factors. The results of this study clearly show that the quality of life of adults with prelingual deafness improved after cochlear implantation. More specifically, this study showed overall improvements in one-on-one conversations, family relationships, enjoyment in music, safety, self-esteem/confidence, overall happiness, quality of life, and level of independence. Second, this study highlighted the impact of support from family, health professionals and friends on the overall benefits received from CIs. Finally, this study showed that based on comparing two groups with high and low survey scores there is an evident trend seen between the outcome categories wherein an improvement in one outcome category showed improvements in the other two outcome categories.
Quality of life and speech perception in two late deafened adults with cochlear implants
Audiology Research, 2018
The aim was to demonstrate the need for a quality of life assessment in biopsychosocial aural rehabilitation (AR) practices with late deafened adults (LDAs) with cochlear implants (CIs). We present a case report of a medical records review of two LDAs enrolled in a biopsychosocial group AR program. A speech perception test Contrasts for Auditory and Speech Training (CAST) and a quality of life (QoL) assessment the Nijmegen Cochlear Implant Questionnaire (NCIQ) were given prior to AR therapy. CAST scores indicated both patients had excellent basic speech perception. However, NCIQ results revealed patients' difficulties in basic and advanced listening settings. NCIQ highlighted patients' self-perceived poor self-esteem and ongoing challenges to their QoL. Speech perception testing results alone are not enough to document the daily challenges of QoL needs of LDAs with CIs. The inclusion of a QoL measure such as the NCIQ is vital in evaluating outcomes of cochlear implantation in LDAs.
Trends in Hearing
While the majority of cochlear implant recipients benefit from the device, it remains difficult to estimate the degree of benefit for a specific patient prior to implantation. Using data from 2,735 cochlear-implant recipients from across three clinics, the largest retrospective study of cochlear-implant outcomes to date, we investigate the association between 21 preoperative factors and speech recognition approximately one year after implantation and explore the consistency of their effects across the three constituent datasets. We provide evidence of 17 statistically significant associations, in either univariate or multivariate analysis, including confirmation of associations for several predictive factors, which have only been examined in prior smaller studies. Despite the large sample size, a multivariate analysis shows that the variance explained by our models remains modest across the datasets ([Formula: see text]–0.21). Finally, we report a novel statistical interaction indic...