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Myhrum M, Heldahl MG, Rødvik AK, Tvete OE, Jablonski GE. Validation of the Norwegian Version of the Speech, Spatial and Qualities of Hearing Scale (SSQ). Audiol Neurootol 2023; 29:124-135. [PMID: 37918367 PMCID: PMC10994583 DOI: 10.1159/000534197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 09/06/2023] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION The main objective of the study was to validate the Norwegian translation of the Speech, Spatial and Qualities of Hearing Scale (SSQ) and investigate the SSQ disability profiles in a cochlear implant (CI) user population. METHODS The study involved 152 adult CI users. The mean age at implantation was 55 (standard deviation [SD] = 16), and the mean CI experience was 5 years (SD = 4.8). The cohort was split into three groups depending on the hearing modality: bilateral CIs (BCIs), a unilateral CI (UCI), and bimodal (CI plus contralateral hearing aid; HCI). The SSQ disability profiles of each group were compared with those observed in similar studies using the English version and other translations of the SSQ. Standard values, internal consistency, sensitivity, and floor and ceiling effects were investigated, and the missing-response rates to specific questions were calculated. Relationships to speech perception were measured using monosyllabic word scores and the Norwegian Hearing in Noise Test scores. RESULTS In the BCI group, the average scores were around 5.0 for the speech and spatial sections and 7.0 for the qualities section (SD ∼2). The average scores of the UCI and HCI groups were about one point lower than those of the BCI group. The SSQ disability profiles were comparable to the profiles in similar studies. The slopes of the linear regression lines measuring the relationships between the SSQ speech and monosyllabic word scores were 0.8 per 10% increase in the monosyllabic word score for the BCI group (explaining 35% of the variation) and 0.4 for the UCI and HCI groups (explaining 22-23% of the variation). CONCLUSION The Norwegian version of the SSQ measures hearing disability similar to the original English version, and the internal consistency is good. Differences in the recipients' pre-implantation variables could explain some variations we observed in the SSQ responses, and such predictors should be investigated. Data aggregation will be possible using the SSQ as a routine clinical assessment in global CI populations. Moreover, pre-implantation variables should be systematically registered so that they can be used in mixed-effects models.
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Affiliation(s)
- Marte Myhrum
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mariann Gjervik Heldahl
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Arne Kirkhorn Rødvik
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Ole Edvard Tvete
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Greg Eigner Jablonski
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Lindquist NR, Holder JT, Patro A, Cass ND, Tawfik KO, O'Malley MR, Bennett ML, Haynes DS, Gifford RH, Perkins EL. Cochlear Implants for Single-Sided Deafness: Quality of Life, Daily Usage, and Duration of Deafness. Laryngoscope 2023; 133:2362-2370. [PMID: 36254870 DOI: 10.1002/lary.30452] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/22/2022] [Accepted: 09/15/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To report our experience for adults undergoing cochlear implantation (CI) for single-sided deafness (SSD). METHODS This is a retrospective case series for adults with SSD who underwent CI between January 2013 and May 2021 at our institution. CNC and AzBio speech recognition scores, Tinnitus Handicap Inventory (THI), Speech, Spatial, and Qualities of Hearing Scale (SSQ12), datalogging, and the Cochlear Implant Quality of Life (CIQOL)-10 Global measure were utilized. RESULTS Sixty-six adults underwent CI for SSD (median 51.3 years, range 20.0-74.3 years), and 57 (86.4%) remained device users at last follow-up. Compared to pre-operative performance, device users demonstrated significant improvement in speech recognition scores and achieved peak performance at six months post-activation for CNC (8.0% increased to 45.6%, p < 0.0001) and AzBio in quiet (12.2% increased to 59.5%, p < 0.0001). THI was decreased at 6 months post-implantation (58.1-14.6, p < 0.0001), with 77% of patients reporting improved or resolved tinnitus. Patients demonstrated improved SSQ12 scores as well as the disease-specific CIQOL-10 Global questionnaire. Duration of deafness was not associated with significant differences in speech recognition performance. Average daily wear time was positively associated with CNC and AzBio scores as well as post-operative CIQOL-10 scores. CONCLUSIONS Herein we present the largest cohort of adult CI recipients with SSD with data on speech recognition scores, tinnitus measures, and SSQ12. Novel insights regarding the correlation of datalogging, duration of deafness, and CI-specific quality of life (CIQOL-10) metrics are discussed. Data continue to support CI as an efficacious treatment option for SSD. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2362-2370, 2023.
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Affiliation(s)
- Nathan R Lindquist
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jourdan T Holder
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ankita Patro
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Nathan D Cass
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kareem O Tawfik
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Matthew R O'Malley
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Marc L Bennett
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David S Haynes
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - René H Gifford
- Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Elizabeth L Perkins
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Daher GS, Kocharyan A, Dillon MT, Carlson ML. Cochlear Implantation Outcomes in Adults With Single-Sided Deafness: A Systematic Review and Meta-analysis. Otol Neurotol 2023; 44:297-309. [PMID: 36791341 DOI: 10.1097/mao.0000000000003833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To assess spatial hearing, tinnitus, and quality-of-life outcomes in adults with single-sided deafness (SSD) who underwent cochlear implantation. DATABASES REVIEWED PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus databases were searched from January 2008 to September 2021 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS Studies reporting spatial hearing, tinnitus, and quality-of-life outcomes in adult cochlear implant (CI) recipients (≥18 yr old) with SSD were evaluated. Study characteristics, demographic data, spatial hearing (speech recognition in noise, sound source localization), tinnitus (severity, loudness), and quality-of-life outcomes were collected. RESULTS From an initial search of 1,147 articles, 36 studies that evaluated CI use in 796 unique adults with SSD (51.3 ± 12.4 yr of age at time of implantation) were included. The mean duration of deafness was 6.2 ± 9.6 years. There was evidence of improvement for speech recognition in noise using different target-to-masker spatial configurations, with the largest benefit observed for target-to-masker configurations assessing head shadow (mean, 1.87-6.2 dB signal-to-noise ratio). Sound source localization, quantified as root-mean-squared error, improved with CI use (mean difference [MD], -25.3 degrees; 95% confidence interval [95% CI], -35.9 to -14.6 degrees; p < 0.001). Also, CI users reported a significant reduction in tinnitus severity as measured with the Tinnitus Handicap Inventory (MD, -29.97; 95% CI, -43.9 to -16.1; p < 0.001) and an improvement in spatial hearing abilities as measured with the Spatial, Speech, and Qualities of Hearing questionnaire (MD, 2.3; 95% CI, 1.7 to 2.8; p < 0.001). CONCLUSIONS Cochlear implantation and CI use consistently offer improvements in speech recognition in noise, sound source localization, tinnitus, and perceived quality of life in adults with SSD.
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Affiliation(s)
- Ghazal S Daher
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Armine Kocharyan
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Margaret T Dillon
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
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Alam N, Munjal SK, Panda NK, Kaur R. Translation and Adaptation of the Nijmegen Cochlear Implant Questionnaire in Hindi: A Health-Related Quality of Life Questionnaire for Adults with Cochlear Implants. Indian J Otolaryngol Head Neck Surg 2023; 75:121-126. [PMID: 37206733 PMCID: PMC10188667 DOI: 10.1007/s12070-022-03306-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
Nijmegen Cochlear Implant Questionnaire is an HRQoL tool that was developed by Dutch researchers to assess the QoL in adult CI users in the English language. It is used to measure the impact of the use of CI on the daily life situations of its users, on the perception of speech sounds, and on the cost-benefit assessment CI in adult CI users. There is no specific instrument available to assess the QoL in adult CI users in India, hence there was a need to take up this study. The primary aim of the study was to adapt and translate NCIQ into Hindi with a secondary aim to describe the effect of CI on quality of life in adult CI users. For translation, permission was taken from the authors of the original tool. The Forward-backward translation method was utilized for translation. The final version of the NCIQ-H was administered to the study participants (25 no.) 25, aged 18-60 years; High School as the minimum level of education; post-lingual hearing impairment, and CI use ≥ 12 months. The Cronbach's α coefficient was calculated for all domains and subdomains in the NCIQ-H showed the overall reliability of the questionnaire (0.82), showing good internal consistency. The CI users reported high scores across all the domains indicating improved quality of life. No significant correlation was found between the CI usage time and NCIQ scores on Spearman's correlation test. Also, there was no significant difference in NCIQ-H scores between genders on the Kruskal-Wallis test. The NCIQ (H) can be used to assess QoL in adults with cochlear implants. The scores suggest improvement in physical, social and psychological domains of life. No correlation was observed between the NCIQ-H scores and duration of CI usage as well as with gender differences.
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Affiliation(s)
| | | | | | - Ramandeep Kaur
- Dr. B.R. Ambedkar State Institute of Medical Sciences, Sahibzada, Mohali India
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Mitton TJ, Yancey KL, Isaacson B, Kutz W, Whitson J, Hunter JB. Audiometric and Patient-Reported Outcomes in Single-Sided Deafness Cochlear Implant Recipients Using the CIQOL-35. Otolaryngol Head Neck Surg 2023; 168:1156-1163. [PMID: 36871181 DOI: 10.1002/ohn.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/28/2022] [Accepted: 09/04/2022] [Indexed: 03/06/2023]
Abstract
OBJECTIVE Describe the effect that cochlear implantation (CI) has on audiometric outcomes and quality of life (QOL) in patients with single-sided deafness (SSD). STUDY DESIGN Retrospective case review. SETTING Tertiary university hospital system. METHODS Preoperative and postoperative AzBio performance and Cochlear Implant Quality of Life-35 (CIQOL-35) Profile scores in CI patients with SSD were compared, and postoperative measures were compared to those from CI patients without SSD. RESULTS Seventeen patients with unilateral CI and contralateral unaided pure-tone averages ≤30 dB were included. The median age was 60.2 (interquartile range [IQR], 50.9-64.9 years), and 7/17 (41%) were women. Median daily use was 8.2 hour (IQR, 5.4-11.9 h). The median preoperative AzBio quiet score in the ear to be implanted was 3% (IQR, 0%-6%). After a median follow-up of 12.0 months, the median postoperative AzBio quiet score was 76% (IQR, 47%-86%) (p < .01). SSD subjects demonstrated statistically significant improvements in median scores on the following CIQOL-35 subdomains following implantation: Entertainment (17 preoperatively vs 21 postoperatively), Listening Effort (12 vs 14), Social (17 vs 22), and Global (28 vs 35; p < .05). SSD patients achieved equal or higher postoperative CIQOL-35 scores in most subdomains (6/7) compared to an age-matched group of non-SSD CI recipients who underwent unilaterally (N = 19) or sequential (N = 6) implantation. CONCLUSION SSD CI patients not only demonstrate significant improvements in speech perception testing in the implanted ear but also exhibit improvement in multiple QOL subdomains on the CIQOL-35, the only validated cochlear implant QOL instrument.
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Affiliation(s)
- Tanner J Mitton
- University of Texas Southwestern Medical School, Dallas, Texas, USA
| | - Kristen L Yancey
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Brandon Isaacson
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Walter Kutz
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Johanna Whitson
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jacob B Hunter
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Oh SJ, Mavrommatis MA, Fan CJ, DiRisio AC, Villavisanis DF, Berson ER, Schwam ZG, Wanna GB, Cosetti MK. Cochlear Implantation in Adults With Single-Sided Deafness: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2023; 168:131-142. [PMID: 35230924 DOI: 10.1177/01945998221083283] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 02/09/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine the clinical outcomes of adult patients with single-sided deafness (SSD) undergoing ipsilateral cochlear implantation. DATA SOURCE An electronic search of Medline and Embase articles. REVIEW METHODS A systematic review was performed with a search strategy developed by a licensed librarian to identify studies of adult patients with SSD who underwent ipsilateral cochlear implantation. Articles were managed in Covidence and evaluated by 2 independent reviewers. Risk of bias was assessed and data were extracted, including patient demographics, etiology of deafness, duration of deafness, and postoperative change in speech recognition, tinnitus, sound localization, and quality of life (QoL). A meta-analysis was performed, and pooled mean differences were calculated for each outcome of interest via random effects models by each outcome, as well as subgroup analyses by the individual clinical score used. RESULTS Of 2309 studies identified, 185 full texts were evaluated, and 50 were ultimately included involving 674 patients. Speech perception scores in quiet and noise, tinnitus control, sound localization, and QoL all significantly improved after implantation. Pooled outcomes demonstrated score improvements in speech perception (standardized mean difference [SMD], 2.8 [95% CI, 2.16-3.43]), QoL (SMD, 0.68 [95% CI, 0.45-0.91]), sound localization (SMD, -1.13 [95% CI, -1.68 to -0.57]), and tinnitus score reduction (SMD, -1.32 [95% CI, -1.85 to -0.80]). CONCLUSIONS Cochlear implantation in adults with SSD results in significant improvements in speech perception, tinnitus control, sound localization, and QoL. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Samuel J Oh
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Maria A Mavrommatis
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Caleb J Fan
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Aislyn C DiRisio
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Dillan F Villavisanis
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Elisa R Berson
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Zachary G Schwam
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - George B Wanna
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Maura K Cosetti
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
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American Cochlear Implant Alliance Task Force Guidelines for Clinical Assessment and Management of Adult Cochlear Implantation for Single-Sided Deafness. Ear Hear 2022; 43:1605-1619. [PMID: 35994570 PMCID: PMC9592177 DOI: 10.1097/aud.0000000000001260] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The indications for cochlear implantation have expanded to include individuals with profound sensorineural hearing loss in the impaired ear and normal hearing (NH) in the contralateral ear, known as single-sided deafness (SSD). There are additional considerations for the clinical assessment and management of adult cochlear implant candidates and recipients with SSD as compared to conventional cochlear implant candidates with bilateral moderate to profound sensorineural hearing loss. The present report reviews the current evidence relevant to the assessment and management of adults with SSD. A systematic review was also conducted on published studies that investigated outcomes of cochlear implant use on measures of speech recognition in quiet and noise, sound source localization, tinnitus perception, and quality of life for this patient population. Expert consensus and systematic review of the current literature were combined to provide guidance for the clinical assessment and management of adults with SSD.
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Dahlin Redfors Y, Jönsson R, Finizia C. A validation study of the Swedish version of the Glasgow hearing aid benefit profile evaluated in otosclerosis subjects. Laryngoscope Investig Otolaryngol 2022; 7:807-815. [PMID: 35734042 PMCID: PMC9195022 DOI: 10.1002/lio2.787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/03/2022] [Accepted: 03/15/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives The aim of this study was to translate the Glasgow Benefit Hearing Aid Profile (GHABP) to Swedish, and to analyze its validity and reliability in patients undergoing rehabilitation with surgery or hearing aids. Methods The GHABP was translated to Swedish following published guidelines. One version of the questionnaire was adapted to fit the surgical intervention. A modification was made to the questionnaire by removing the answer option “not applicable” (N/A) since it was found confusing by the subjects. A prospective multicenter cohort study was performed to validate the questionnaire. One hundred and twenty‐three individuals diagnosed with otosclerosis were included in the study prior to the intervention. The individuals were divided into three groups based on the intervention and previous hearing aid experience. Pure tone audiometry was performed 1 month prior and 1 year after the intervention. The Swedish version of the GHABP was completed by the individuals prior to the intervention, as well as 6 and 12 months after the intervention. Validity and reliability were assessed. Results The Swedish versions of the GHABP were well accepted by the included individuals. The questionnaires showed good psychometric properties, with comparable results for the two different interventions and three separate intervention groups. Initial disability was more pronounced in more challenging listening situations. Disability was reduced after the intervention. The “Use,” “Benefit,” and “Satisfaction” domains demonstrated beneficial results; however, a ceiling effect was noted in the same domains. The reliability was overall very high. Conclusion The Swedish version of the GHABP had good psychometric properties, with high validity and reliability. The same outcomes were found for the hearing aid and surgery groups. A ceiling effect was observed that can affect the questionnaire's ability to distinguish between subjects and measures over time. Level of evidence 2c
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Affiliation(s)
- Ylva Dahlin Redfors
- Department of Otorhinolaryngology, Head, and Neck Surgery Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Department of Otorhinolaryngology, Head, and Neck Surgery Region Västra Götaland, Sahlgrenska University Hospital Gothenburg Sweden
| | - Radoslava Jönsson
- Department of Otorhinolaryngology, Head, and Neck Surgery Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Department of Otorhinolaryngology, Head, and Neck Surgery Region Västra Götaland, Sahlgrenska University Hospital Gothenburg Sweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head, and Neck Surgery Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Department of Otorhinolaryngology, Head, and Neck Surgery Region Västra Götaland, Sahlgrenska University Hospital Gothenburg Sweden
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YJ Tan V, Zhang EZY, Leem PS, D'Souza D, Li H, Teng SW, Krishna S G, Ong B, Tan BYB. Audiologic and patient perceived benefit in cochlear implantation for single-sided deafness. PROCEEDINGS OF SINGAPORE HEALTHCARE 2022. [DOI: 10.1177/20101058221083393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background CI in SSD strives to restore binaural hearing. With normal acoustic hearing on one ear, the benefits of rehabilitating the deaf ear with an implant are not well established. Objectives We investigate audiologic and quality-of-life measures, and long-term usage patterns of cochlear implantation (CI) in patients with single-sided deafness (SSD) Methods Eight patients with idiopathic sudden sensorineural hearing loss of less than 5-year duration were recruited. Pure tone average (PTA), speech discrimination score (SDS), hearing-in-noise test (HINT), tinnitus handicap inventory (THI), quality-of-life speech spatial qualities (SSQ) scale tests were performed before, and one-year after CI. Long-term usage of CI four-years post-operatively was determined. Results The median PTA of the deaf ear was 96 dBHL (IQR = 90–120) before, and 30 dBHL (IQR = 27–33) after CI ( p = 0.0156). SDS improved from median of 0% (IQR = 0–3) to 33% (IQR = 24–58) ( p = 0.0360). Median signal-to-noise ratio (SNR), particularly of the S0Nbetter setting of HINT showed improvement from 6.4 dB (IQR = 5.7–7) to 0.9 dB (IQR = −2.25–6.2) ( p = 0.1094). Despite median THI improving from 24 (IQR = 6–47) to 4 (IQR = 2–7) ( p = 0.1563), two patients experienced worsening of tinnitus. SSQ scores in all subscales showed modest improvement not approaching significance. 5 of 8 (62%) patients stopped using their implant four years after surgery. Conclusion Despite improved audiologic and tinnitus outcome measures, our patients’ SDS remained in non-serviceable range, while quality-of-life measures showed only modest improvement. Majority of our patients stopped using their implant four years post-surgery. Our study suggests that objective measurable benefits of CI in SSD may not translate to actual patient perceived benefits.
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Affiliation(s)
- Vanessa YJ Tan
- Department of Otorhinolaryngology – Head and Neck Surgery, Singapore General Hospital, Singapore
| | - Edward ZY Zhang
- Department of Otorhinolaryngology – Head and Neck Surgery, Singapore General Hospital, Singapore
| | - PS Leem
- Centre for Hearing and Ear Implants, Singapore General Hospital, Singapore
| | - Deepak D'Souza
- Centre for Hearing and Ear Implants, Singapore General Hospital, Singapore
| | - Huihua Li
- Health Services Research Unit, Singapore General Hospital, Singapore
| | - SW Teng
- Centre for Hearing and Ear Implants, Singapore General Hospital, Singapore
| | - Gopal Krishna S
- Centre for Hearing and Ear Implants, Singapore General Hospital, Singapore
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Ha J, Kim H, Lee JH, Park HY. Sound localization in patients with a unilateral hearing aid: Discordance between the right and left ears. Laryngoscope Investig Otolaryngol 2022; 7:599-603. [PMID: 35434348 PMCID: PMC9008160 DOI: 10.1002/lio2.769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/15/2022] [Accepted: 02/16/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives Patients with unilateral hearing loss (UHL) have difficulty in recognizing the direction of a sound. Previous studies have shown that hearing aids (HAs) could improve the directional perception of sound. In this study, we analyzed the results of sound localization tests in patients using a unilateral HA. Methods All patients with UHL who had performed sound localization tests since 2018 were included in this study. Sound localization tests, functional gain tests, and the speech discrimination scores (SDSs) were analyzed. The tests were obtained at 1‐, 3‐, and 6‐month after fitting the HA. Results Of the 32 patients with UHL, 13 were right‐sided and 19 were left‐sided. After 6 months of using a HA, the results of the sound localization test were significantly better in patients with right than left UHL (percent correct [PCT], 61.9 ± 24.0% vs. 37.9 ± 24.6%, p = .011; mean absolute error (MAE), 41.4 ± 23.9° vs. 65.5 ± 28.6°, p = .018; root‐mean‐square error (RMS), 25.8 ± 17.6° vs. 48.8 ± 24.5°, p = .007]. The aided SDSs were not different between the two groups (78.7 ± 16.5% vs. 77.2 ± 18.5%, p = .825). Conclusion The side of the hearing loss could have a substantial effect on sound localization in UHL patients using a HA. Sound localization test results should be interpreted with the consideration of this discordance. Level of Evidence 4
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Affiliation(s)
- Jungho Ha
- Department of Otolaryngology Ajou University School of Medicine Suwon South Korea
| | - Hantai Kim
- Department of Otorhinolaryngology–Head and Neck Surgery Konyang University College of Medicine Daejeon South Korea
| | - Ju Ho Lee
- Department of Otolaryngology Ajou University School of Medicine Suwon South Korea
| | - Hun Yi Park
- Department of Otolaryngology Ajou University School of Medicine Suwon South Korea
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Grimm DR, Fakurnejad S, Alyono JC. Cochlear Implantation and Risk of Falls in Older Adults. Otolaryngol Head Neck Surg 2021; 167:531-536. [PMID: 34905438 DOI: 10.1177/01945998211064981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine whether cochlear implantation (CI) increases the risk of clinically significant falls in older adults. STUDY DESIGN Retrospective analysis of deidentified administrative claims from a US commercial insurance database. SETTING Nationwide deidentified private insurance claims database (Clinformatics Data Mart; Optum). METHODS Patients undergoing CI were identified through Current Procedural Terminology codes. Number of days with falls resulting in health care expenditure were counted 1 year pre- and post-CI. Generalized estimating equation Poisson regression was used to determine medical and sociodemographic predictors for fall days, including age, sex, race, and income, with pre- vs post-CI status. RESULTS Between 2003 and 2019, 3773 patients aged >50 years underwent CI. An overall 139 (3.68%) patients recorded at least 1 fall diagnosis a year pre-CI, and 142 (3.76%) recorded at least 1 fall diagnosis post-CI. The average number of days with fall diagnoses per patient with a recorded fall was 3.12 pre-CI and 2.04 post-CI. In bivariate analysis, age (P < .0001) and Charlson Comorbidity Index (P < .0001) were predictive of falls, but sex (P < .10), race (P < .72), and income (P < .51) were not. Poisson regression demonstrated a statistically significant association between Charlson Comorbidity Index and days with fall diagnoses (risk ratio, 1.39 [95% CI, 1.30-1.49]; P < .0001]). No statistically significant difference in falls was seen pre- vs post-CI (risk ratio, 0.67 [95% CI, 0.34-1.33]; P < .25]). Age also was not predictive of falls in multivariate analysis. CONCLUSIONS CI does not appear to increase the risk of falls in older adults. Patient comorbidities correlate most strongly with fall risk and should be considered in patient selection for CI.
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Affiliation(s)
- David R Grimm
- Department of Otolaryngology, School of Medicine, Stanford University, Stanford, California, USA
| | - Shayan Fakurnejad
- Department of Otolaryngology, School of Medicine, Stanford University, Stanford, California, USA
| | - Jennifer C Alyono
- Department of Otolaryngology, School of Medicine, Stanford University, Stanford, California, USA
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Alnıaçık A, Çakmak E, Öz O. Cross-cultural adaptation of the Nijmegen cochlear implant questionnaire into Turkish language: validity, reliability and effects of demographic variables. Eur Arch Otorhinolaryngol 2021; 279:2175-2182. [PMID: 34837517 PMCID: PMC8627160 DOI: 10.1007/s00405-021-07191-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/15/2021] [Indexed: 11/12/2022]
Abstract
Purpose The purpose of this study was to evaluate the validity and reliability of the Turkish version of the Nijmegen Cochlear Implant Questionnaire (Tr-NCIQ) and reveal the demographic factors contributing to the outcomes. Methods A group of 118 cochlear implant users aged between 18 and 70 years filled the Tr-NCIQ and the Turkish Hearing Handicapped Inventory for Adults (the Tr-HHI-Adult) via electronic survey. Cross-cultural adaptation of the Tr-NCIQ was performed. The reliability and validity of the questionnaire were evaluated utilizing internal consistency coefficient, split-half method, and predictive validity. Results The overall Cronbach’s alpha coefficient of the scale was 0.91, and the Spearman-Brown coefficient was 0.91. A moderately significant and negative correlation was present between the basic sound perception, speech production, self-esteem, activity, and social interactions subdomain scores and the HHI-Adult scores. Patients with post-lingual onset of hearing loss had significantly better results than those with pre-lingual onset, in the advanced sound perception subdomain. In addition, bilateral cochlear implant users had better results than the unilateral and bimodal users in the speech production subdomain and then the bimodal users in the self-esteem subdomain. There was no effect of age, duration of implant use, age at implantation, and the daily usage of cochlear implant (CI) on the quality-of-life outcomes. Conclusion The Tr-NCIQ is a reliable and valid tool to evaluate the subjective quality of life in CI users. In addition, as a standardized instrument, it can be easily self-administered both in clinical practice and for research purposes.
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Affiliation(s)
- Asuman Alnıaçık
- Department of Audiology, Faculty of Health Sciences, Başkent University, Bağlıca Campus, Eskişehir Road, 18. km, 06790, Ankara, Turkey.
| | - Eda Çakmak
- Department of Audiology, Faculty of Health Sciences, Başkent University, Bağlıca Campus, Eskişehir Road, 18. km, 06790, Ankara, Turkey
| | - Okan Öz
- The Eargroup, Antwerp, Belgium
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Dreyfuss M, Giat Y, Veraguth D, Röösli C, Huber AM, Laske RD. Cost Effectiveness of Cochlear Implantation in Single-Sided Deafness. Otol Neurotol 2021; 42:1129-1135. [PMID: 34191788 DOI: 10.1097/mao.0000000000003135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To analyze the cost effectiveness of cochlear implantation (CI) for the treatment of single-sided deafness (SSD). STUDY DESIGN Cost-utility analysis in an adapted Markov model. SETTING Adults with single-sided deafness in a high-income country. INTERVENTION Unilateral CI was compared with no intervention. MAIN OUTCOME MEASURE Incremental cost-effectiveness ratios were compared with different cost-effectiveness thresholds ($10,000 to $150,000) for different age, sex, and cost combinations. The calculations were based on the quality-adjusted life year (QALY), national life expectancy tables, and different cost settings. The health utility values for the QALY were either directly collected from published data, or, derived from published data using a regression model of multiple utility indices (regression estimate). RESULTS The regression estimate showed an increase of the health utility value from 0.62 to 0.74 for SSD patients who underwent CI. CI for SSD was cost effective for women up to 64 years ($50,000 per-QALY threshold), 80 years ($100,000 per-QALY threshold), and 86 years ($150,000 per-QALY threshold). For men, these values were 58, 77, and 84, respectively. Changing the discount rate by up to 5% further increased the cutoff ages up to 5 years. A detailed cost and age sensitivity analysis is presented and allows testing for cost effectiveness in local settings worldwide. CONCLUSIONS CI is a cost-effective option to treat patients with SSD.
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Affiliation(s)
- Michael Dreyfuss
- Department of Industrial Engineering and Management, Jerusalem College of Technology, Jerusalem, Israel
| | - Yahel Giat
- Department of Industrial Engineering and Management, Jerusalem College of Technology, Jerusalem, Israel
| | - Dorothe Veraguth
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
| | - Christof Röösli
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
| | - Alexander M Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
| | - Roman D Laske
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
- HNO Wiedikon, Zurich, Switzerland
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Heggdal POL, Næss MH, Hess-Erga J, Larsen KS, Aarstad HJ. Psychometric properties for the Norwegian translations of two revised APHAB-subscales and an adapted IOI-HA (IOI-CI) in patients with cochlear implants. Int J Audiol 2021; 61:607-614. [PMID: 34126843 DOI: 10.1080/14992027.2021.1937719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The objective was to examine the psychometric properties of two questionnaires in Norwegian for the self-assessment of satisfaction following cochlear implantation. DESIGN The International Outcome Inventory for Hearing Aids adapted for cochlear implants (IOI-CI) and two revised subscales from the Norwegian translation of the Abbreviated Profile of Hearing Aid Benefit (APHAB) were applied. Internal consistency was tested using Cronbach's α. Testing of psychometric properties included the calculation of inter-item correlations and corrected item-total correlations. Spearman's rho was used to investigate associations. Exploratory principal component analyses with Kaiser normalisation were performed. STUDY SAMPLE One hundred and twenty-one patients (51 males) with cochlear implants (27-88 years, M = 59). RESULTS For IOI-CI, Cronbach's α was 0.79. Corrected item-total correlations ranged from 0.29 to 0.69. The factor analysis revealed two components. For APHAB, Cronbach's α was 0.91. Two components were revealed by the factor analysis. Corrected item-total correlations for the two subscales "communication in quiet situations" and "communication in adverse situations" were 0.47-0.81 and 0.58-0.80, respectively. The convergent validity of the questionnaires was adequate as reflected by a Spearman's coefficient of 0.67. CONCLUSION Both questionnaires show good psychometric properties.
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Affiliation(s)
- Peder O Laugen Heggdal
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
| | - Mathias H Næss
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
| | - Jeanette Hess-Erga
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
| | - Kristina S Larsen
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
| | - Hans Jørgen Aarstad
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Katiri R, Hall DA, Killan CF, Smith S, Prayuenyong P, Kitterick PT. Systematic review of outcome domains and instruments used in designs of clinical trials for interventions that seek to restore bilateral and binaural hearing in adults with unilateral severe to profound sensorineural hearing loss ('single-sided deafness'). Trials 2021; 22:220. [PMID: 33743802 PMCID: PMC7981927 DOI: 10.1186/s13063-021-05160-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/27/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND This systematic review aimed to identify, compare and contrast outcome domains and outcome instruments reported in studies investigating interventions that seek to restore bilateral (two-sided) and/or binaural (both ears) hearing in adults with single-sided deafness (SSD). Findings can inform the development of evidence-based guidance to facilitate design decisions for confirmatory trials. METHODS Records were identified by searching MEDLINE, EMBASE, PubMed, CINAHL, ClinicalTrials.gov, ISRCTN, CENTRAL, WHO ICTRP and the NIHR UK clinical trials gateway. The search included records published from 1946 to March 2020. Included studies were those as follows: (a) recruiting adults aged 18 years or older diagnosed with SSD of average threshold severity worse than 70 dB HL in the worse-hearing ear and normal (or near-normal) hearing in the better-hearing ear, (b) evaluating interventions to restore bilateral and/or binaural hearing and (c) enrolling those adults in a controlled trial, before-and-after study or cross-over study. Studies that fell just short of the participant eligibility criteria were included in a separate sensitivity analysis. RESULTS Ninety-six studies were included (72 full inclusion, 24 sensitivity analysis). For fully included studies, 37 exclusively evaluated interventions to re-establish bilateral hearing and 29 exclusively evaluated interventions to restore binaural hearing. Overall, 520 outcome domains were identified (350 primary and 170 secondary). Speech-related outcome domains were the most common (74% of studies), followed by spatial-related domains (60% of studies). A total of 344 unique outcome instruments were reported. Speech-related outcome domains were measured by 73 different instruments and spatial-related domains by 43 different instruments. There was considerable variability in duration of follow-up, ranging from acute (baseline) testing to 10 years after the intervention. The sensitivity analysis identified no additional outcome domains. CONCLUSIONS This review identified large variability in the reporting of outcome domains and instruments in studies evaluating the therapeutic benefits and harms of SSD interventions. Reports frequently omitted information on what domains the study intended to assess, and on what instruments were used to measure which domains. TRIAL REGISTRATION The systematic review protocol is registered on PROSPERO (International Prospective Register of Systematic Reviews): Registration Number CRD42018084274 . Registered on 13 March 2018, last revised on 7th of May 2019.
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Affiliation(s)
- Roulla Katiri
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Department of Audiology, Mater Misericordiae University Hospital, Dublin, D07 R2WY Ireland
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
| | - Deborah A. Hall
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
- University of Nottingham Malaysia, Jalan Broga, 43500 Semenyih, Selangor Darul Ehsan Malaysia
| | - Catherine F. Killan
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
- Yorkshire Auditory Implant Service, Bradford Teaching Hospitals Foundation NHS Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
| | - Sandra Smith
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
| | - Pattarawadee Prayuenyong
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Pádraig T. Kitterick
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
- Nottingham University Hospitals NHS Trust, Queen’s Medical Centre, Derby Road, Nottingham, NG7 2UH UK
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Moses LE, Friedmann DR. Cochlear implant indications: a review of third-party payers' policies for standard and expanded indications. Cochlear Implants Int 2021; 22:237-244. [PMID: 33509047 DOI: 10.1080/14670100.2021.1877865] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
As cochlear implant (CI) candidacy has expanded, commercial payers in the United States have varied in their adoption of new indications, potentially confusing providers' knowledge about appropriate patients for referral. We reviewed how third-party payers classify the medical necessity of cochlear implants for a variety of indications across the lifespan.We compared policies of the six largest commercial payers in our region, focusing on clinical scenarios for which many centers experience difficulty obtaining pre-authorization. These include: (1) CI in children under 12 months, (2) audiometric and speech perception criteria in children, (3) sequential bilateral CI, (4) electro-acoustic stimulation, (5) impending cochlear ossification, and (6) single-sided deafness (SSD).Of the more notable findings for the clinical scenarios half of commercial payers have a pediatric age requirement of greater than 12 months. Generally, audiologic and speech perception criteria are more stringent for children than adults across all policies. SSD is considered investigational by most policies.Third-party payers employ variable criteria regarding the medical necessity of CI, many of which are not contemporaneous with clinical knowledge and best practices. This may impact referral patterns among audiologists. More methodologically rigorous clinical trials may help shift such restrictive policies to benefit a greater number of patients.
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Affiliation(s)
- Lindsey E Moses
- Department of Otolaryngology - Head & Neck Surgery, New York University Langone Health, 550 First Avenue, Skirball Suite 7Q, New York, NY 10016, USA
| | - David R Friedmann
- Department of Otolaryngology - Head & Neck Surgery, New York University Langone Health, 550 First Avenue, Skirball Suite 7Q, New York, NY 10016, USA
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Bojrab D, Hong RS. The case for cochlear implantation in unilateral and asymmetric sensorineural hearing loss. Curr Opin Otolaryngol Head Neck Surg 2020; 28:329-334. [PMID: 32841959 DOI: 10.1097/moo.0000000000000656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Cochlear implants have been used to treat bilateral deafness for over 40 years. A more recent development has been the application of this technology toward single-sided deafness (SSD) and asymmetric hearing loss (AHL), culminating in the Food and Drug Administration (FDA) approval in the United States for this indication in July of 2019. This review examines the recent literature on cochlear implants for SSD and AHL, focusing on speech perception, sound localization, tinnitus, and quality of life. RECENT FINDINGS There is an expanding body of literature supporting the use of cochlear implant in SSD/AHL patients. The cochlear implant offers a unique rehabilitation option for this subset of patients as it potentially restores binaural hearing (direct stimulation of both ears). A review of the literature reveals significant improvements with the cochlear implant in speech perception in quiet and noise, sound localization, tinnitus, and quality of life. In addition, these improvements appear to be greater than what conventional options such as a contralateral routing of signal (CROS) hearing aid and bone conduction device (BCD) are able to achieve. SUMMARY Cochlear implants offer additional benefits over previously available options of CROS and BCDs and have recently been approved by the FDA for use in patient with SSD/AHL. Given the growing body of literature demonstrating the benefit of cochlear implant over other devices, it is important to offer cochlear implant as an option to these patients.
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Affiliation(s)
| | - Robert S Hong
- Michigan Ear Institute, Farmington Hills.,Department of Otolaryngology-Head & Neck Surgery, Wayne State University, Detroit, Michigan, USA
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Long-term Benefit of Unilateral Cochlear Implantation on Quality of Life and Speech Perception in Bilaterally Deafened Patients. Otol Neurotol 2020; 40:e430-e440. [PMID: 30870378 DOI: 10.1097/mao.0000000000002008] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Cochlear implantation (CI) is a common treatment modality for unilaterally and bilaterally deafened patients as well as patients with severe to profound hearing loss. The aim of our study is the complex evaluation of the improvement and influence of health related quality of life (HRQoL) and auditory performance in cochlear implant patients during a long-term follow-up. METHODS Sixty-one bilaterally, postlingually deafened patients with unilateral CI were included in this prospective study. Assessment tools for auditory performance and HRQoL included the Freiburg Monosyllabic Speech test, Oldenburg Inventory (OI) questionnaire, Nijmegen Cochlear Implant Questionnaire (NCIQ) and 36-item Short Form Survey (SF-36). Data were collected before CI, at 6, 12, and 24 months postoperatively. RESULTS The assessment tools for speech perception yielded a statistically significant improvement in the Freiburg Monosyllabic Speech test scores and of all subdomain scores of the OI during the 6-month follow-up period. The subdomain scores of the NCIQ and the psychological score of the SF-36 also improved significantly during this follow-up period. All results remained stable thereafter during the 12- and 24-month follow-up. There was a statistically significant correlation between subjective speech perception and HRQoL after CI. CONCLUSION This is the first prospective study to show results in regard to speech perception and HRQoL and their correlation during a 2-year follow-up after unilateral CI in bilaterally deafened patients. Our results for speech perception and HRQoL showed a significant improvement during the 6-month follow-up that remained stable thereafter during a 24-month follow-up, even after finishing the hearing rehabilitation program.
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Távora-Vieira D, Acharya A, Rajan GP. What can we learn from adult cochlear implant recipients with single-sided deafness who became elective non-users? Cochlear Implants Int 2020; 21:220-227. [PMID: 32122282 DOI: 10.1080/14670100.2020.1733746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: This retrospective study investigates the incidence of elective cochlear implant (CI) non-use amongst a cohort of adult CI recipients with single-sided deafness (SSD), identifies the causes that led to non-use, and assesses how non-use could be prevented. Methods: All adults with SSD who received a CI between 2008 and 2018 and who became elective CI non-users were included. Elective non-users were defined as CI recipients who decided to stop using their CI or, if explantation was necessary, refused reimplantation. Results: 5/114 (4.4%) adults with SSD who received a CI became elective non-users. The 5 non-users were a mean 44.2 years old (range 33-70 years) at implantation, had a mean duration of deafness of 7.1 years (range 0.5-20 years) at implantation, and used their CI for a mean 11.5 months (range 1.5-60 months) before (fully) discontinuing use. The primary cause of elective non-use was postoperative discouragement due to unrealistic expectations (4 participants) regarding sound perception with the CI or about the greater than expected level of commitment necessary for rehabilitation. Conclusions: Elective non-use among adult CI recipients with single-sided deafness was very rare and could be further prevented by comprehensive counselling to ensure that candidates have realistic expectations about the rehabilitation requirements and the outcomes with the CI.
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Affiliation(s)
- Dayse Távora-Vieira
- Fiona Stanley Hospital, Perth, Australia.,Otolaryngology, Head & Neck Surgery, Medical School, University of Western Australia, Perth, Australia
| | - Aanand Acharya
- Fiona Stanley Hospital, Perth, Australia.,Otolaryngology, Head & Neck Surgery, Medical School, University of Western Australia, Perth, Australia
| | - Gunesh P Rajan
- Otolaryngology, Head & Neck Surgery, Medical School, University of Western Australia, Perth, Australia.,Otolaryngology, Head & Neck Surgery Department, Luzerner Kantonsspital, Lucerne, Switzerland
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20
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Cochlear implantation in adults with single-sided deafness: generic and disease-specific long-term quality of life. Eur Arch Otorhinolaryngol 2019; 277:695-704. [DOI: 10.1007/s00405-019-05737-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 11/16/2019] [Indexed: 12/17/2022]
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21
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Távora-Vieira D, Rajan GP, Van de Heyning P, Mertens G. Evaluating the Long-Term Hearing Outcomes of Cochlear Implant Users With Single-Sided Deafness. Otol Neurotol 2019; 40:e575-e580. [PMID: 31135665 DOI: 10.1097/mao.0000000000002235] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To investigate the long-term outcomes of cochlear implantation in individuals with single-sided deafness (SSD) in terms of speech perception, subjective hearing performance, and sound localization. METHODS Thirty-four subjects with SSD were recruited across two large cochlear implant (CI) centers (Antwerp, Belgium and Perth, Australia). The long-term hearing outcomes (between 4 and 10 years of CI use) were evaluated using speech in noise tests, a subjective hearing performance questionnaire (Speech, Spatial and Qualities Questionnaire [SSQ12]), and sound localization tests. RESULTS Statistically significant improvements were observed in speech perception in noise and sound localization results postoperatively with the use of a CI in comparison to preoperative measurements. Subjective hearing abilities also significantly improved after long-term CI use. CONCLUSION Access to binaural hearing is important for subjects with SSD. CI users with SSD experience long-term benefits in speech understanding, sound localization, and quality of life.
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Affiliation(s)
- Dayse Távora-Vieira
- Otolaryngology, Head & Neck Surgery, Medical School, University of Western Australia
- Fiona Stanley Hospital, Perth, Australia
| | - Gunesh P Rajan
- Otolaryngology, Head & Neck Surgery, Medical School, University of Western Australia
- Otolaryngology, Head & Neck Surgery Department, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Paul Van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Griet Mertens
- Otolaryngology, Head & Neck Surgery Department, Luzerner Kantonsspital, Lucerne, Switzerland
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp
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Benefits of Cochlear Implantation for Single-Sided Deafness: Data From the House Clinic-University of Southern California-University of California, Los Angeles Clinical Trial. Ear Hear 2019; 40:766-781. [DOI: 10.1097/aud.0000000000000671] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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23
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Häußler SM, Köpke V, Knopke S, Gräbel S, Olze H. Multifactorial positive influence of cochlear implantation on patients with single‐sided deafness. Laryngoscope 2019; 130:500-506. [DOI: 10.1002/lary.28007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/02/2019] [Accepted: 03/28/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Sophia M. Häußler
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
| | - Vanessa Köpke
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
| | - Steffen Knopke
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
| | - Stefan Gräbel
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
| | - Heidi Olze
- Department of Otorhinolaryngology, Head and Neck SurgeryCharité–University Medical Center Berlin Berlin Germany
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Caldeira JMA, Goffi-Gomez MVS, Imamura R, Bento RF. Speech Recognition of Cochlear Implant Users Inside a Noisy Helicopter Environment. Audiol Neurootol 2019; 24:32-37. [PMID: 30955013 DOI: 10.1159/000497031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 01/16/2019] [Indexed: 11/19/2022] Open
Abstract
In this study, we tested whether the speech recognition, through radio communications, of cochlear implant (CI) users inside a noisy helicopter cockpit is adequate for safe flight. METHOD Speech recognition tests (sentences, numbers and disyllables) through a very-high-frequency radio were administered to 12 CI users in a soundproof booth, inside a helicopter with the engine turned off and turned on. RESULTS In quiet environments, radio communications were impacted only for disyllable intelligibility, but in noisy situations, all tests were affected. CONCLUSIONS CI subjects did not achieve the auditory levels recommended by the International Civil Aviation Organization.
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Affiliation(s)
| | - Maria Valéria Schmidt Goffi-Gomez
- Cochlear Implant Group, Department of Otorhinolaryngology, Clinical Hospital, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Rui Imamura
- Department of Otorhinolaryngology, Clinical Hospital, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Ricardo Ferreira Bento
- Department of Otorhinolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil
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Marx M, Costa N, Lepage B, Taoui S, Molinier L, Deguine O, Fraysse B. Cochlear implantation as a treatment for single-sided deafness and asymmetric hearing loss: a randomized controlled evaluation of cost-utility. BMC EAR, NOSE, AND THROAT DISORDERS 2019; 19:1. [PMID: 30766449 PMCID: PMC6362575 DOI: 10.1186/s12901-019-0066-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/09/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Single-sided deafness (SSD) and asymmetric hearing loss (AHL) have recently been proposed as a new indication for cochlear implantation. There is still no recommended treatment for these hearing deficits, and most options considered rely on the transfer of sound from the poor ear to the better ear, using Contralateral Routing of the Signal (CROS) hearing aids or bone conduction (BC) devices. In contrast, cochlear implantation allows the poor ear to be stimulated and binaural hearing abilities to be partially restored. Indeed, most recently published studies have reported an improvement in the spatial localisation of an incoming sound and better speech recognition in noisy environments after cochlear implantation in SSD/AHL subjects. It also provides consistent relief of tinnitus when associated. These encouraging hearing outcomes raise the question of the cost-utility of this expensive treatment in an extended indication. METHODS The final endpoint of this national multicentre study is to determine the incremental cost-utility ratio (ICUR) of cochlear implantation in comparison to the current standard of care in France through simple observation, using a randomised controlled trial. Firstly, the study comprises a prospective and descriptive part, where 150 SSD/AHL subjects try CROS hearing aids and a BC device for three weeks each. Secondly, the choice is made between CROS hearing aids, BC implanted device and cochlear implantation. Hearing outcomes and quality of life measurements are described after 6 months for the subjects who chose CROS, BC or declined any option. The subjects who opt for cochlear implantation are randomised between one group where the cochlear implant is inserted without delay and one group of simple initial observation. Hearing outcomes and quality of life measurements are compared after 6 months. DISCUSSION The present study was designed to assess the efficiency of cochlear implantation in SSD/AHL. A favourable cost-utility ratio in this extended indication would strengthen the promising clinical results and justify a reimbursement by the health insurance. The efficiency of other options (CROS, BC) will also be described. TRIAL REGISTRATION This research has been registered in ClinicalTrials.gov (http://www.clinicaltrials.gov/), the 29th July 2014 under the n°NCT02204618.
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Affiliation(s)
- Mathieu Marx
- Service d’Oto–Rhino–Laryngologie, d’Oto-Neurologie et d’ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
- Université de Toulouse, CerCo UMR 5549 CNRS, Université Paul Sabatier, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
| | - Nadège Costa
- Health Economic Unit, Centre Hospitalier Universitaire de Toulouse, Hôtel-Dieu Saint-Jacques, 2, rue viguerie, 31059 Toulouse Cedex 9, France
- Unité Inserm UMR 1027, Faculté de Médecine, National Institute for Health and Medical Research (Inserm), 37 allées Jules Guesde, 31073 Toulouse, France
| | - Benoit Lepage
- Department of Epidemiology, USMR, 37 allées Jules Guesde, 31073 Toulouse, France
| | - Soumia Taoui
- Service d’Oto–Rhino–Laryngologie, d’Oto-Neurologie et d’ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
| | - Laurent Molinier
- Health Economic Unit, Centre Hospitalier Universitaire de Toulouse, Hôtel-Dieu Saint-Jacques, 2, rue viguerie, 31059 Toulouse Cedex 9, France
- Unité Inserm UMR 1027, Faculté de Médecine, National Institute for Health and Medical Research (Inserm), 37 allées Jules Guesde, 31073 Toulouse, France
| | - Olivier Deguine
- Service d’Oto–Rhino–Laryngologie, d’Oto-Neurologie et d’ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
- Université de Toulouse, CerCo UMR 5549 CNRS, Université Paul Sabatier, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
| | - Bernard Fraysse
- Service d’Oto–Rhino–Laryngologie, d’Oto-Neurologie et d’ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Place du Dr Baylac, 31059 Toulouse Cedex 9, France
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van Wieringen A, Boudewyns A, Sangen A, Wouters J, Desloovere C. Unilateral congenital hearing loss in children: Challenges and potentials. Hear Res 2019; 372:29-41. [PMID: 29395617 DOI: 10.1016/j.heares.2018.01.010] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/17/2017] [Accepted: 01/21/2018] [Indexed: 11/16/2022]
Abstract
The estimated incidence of sensorineural hearing impairment (>40 dB HL) at birth is 1.86 per 1000 newborns in developed countries and 30-40% of these are unilateral. Profound sensorineural unilateral hearing impairment or single sided deafness (SSD) can be treated with a cochlear implant. However, this treatment is costly and invasive and unnecessary in the eyes of many. Very young children with SSD often do not exhibit language and cognitive delays and it is hard to imagine that neurocognitive skills will present difficulties with one good ear. In the current paper we review the most recent evidence on the consequences of unilateral hearing impairment for auditory and neurocognitive factors. While data of both adults and children are discussed, we focus on developmental factors, congenital deafness and a window of opportunity for intervention. We discuss which etiologies qualify for a cochlear implant and present our multi-center prospective study on cochlear implants in infants with one deaf ear. The large, state-of-the art body of research allows for evidence-based decisions regarding management of unilateral hearing loss in children.
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Affiliation(s)
- Astrid van Wieringen
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium.
| | - An Boudewyns
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, 2650 Edegem, Belgium
| | - Anouk Sangen
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium
| | - Jan Wouters
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium
| | - Christian Desloovere
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium; University Hospital Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium
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Asymmetric hearing loss and the benefit of cochlear implantation regarding speech perception, tinnitus burden and psychological comorbidities: a prospective follow-up study. Eur Arch Otorhinolaryngol 2018; 275:2683-2693. [DOI: 10.1007/s00405-018-5135-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/15/2018] [Indexed: 11/27/2022]
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Santos NPD, Couto MIV, Martinho-Carvalho AC. Nijmegen Cochlear Implant Questionnaire (NCIQ): translation, cultural adaptation, and application in adults with cochlear implants. Codas 2017; 29:e20170007. [PMID: 29236905 DOI: 10.1590/2317-1782/20172017007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 07/08/2017] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Cross-cultural adaptation and translation of the Nijmegen Cochlear Implant Questionnaire (NCIQ) into Brazilian Portuguese and analysis of quality of life (QoL) results in adults with cochlear implant (CI). METHODS The NCIQ instrument was translated into Brazilian Portuguese and culturally adapted. After that, a cross-sectional and clinical QoL evaluation was conducted with a group of 24 adults with CI. RESULTS The questionnaire title in Brazilian Portuguese is 'Questionário Nijmegen de Implantes Cocleares' (NCIQ-P). The version of the NCIQ questionnaire translated into Brazilian Portuguese presented good internal consistency (0.78). The social and physical domains presented the highest scores, with the basic and advanced sound perception subdomains achieving the highest scores. No correlation between gender and time of device use was found for the questionnaire domains and subdomains. CONCLUSION The cross-cultural adaptation and translation of the NCIQ into Brazilian Portuguese suggests that this instrument is reliable and useful for clinical and research purposes in Brazilian adults with CI.
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Affiliation(s)
- Nathália Porfírio Dos Santos
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - FM, Universidade de São Paulo - USP - São Paulo (SP), Brasil
| | - Maria Inês Vieira Couto
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - FM, Universidade de São Paulo - USP - São Paulo (SP), Brasil
| | - Ana Claudia Martinho-Carvalho
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - FM, Universidade de São Paulo - USP - São Paulo (SP), Brasil
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