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Zeitler DM, Prentiss SM, Sydlowski SA, Dunn CC. American Cochlear Implant Alliance Task Force: Recommendations for Determining Cochlear Implant Candidacy in Adults. Laryngoscope 2024; 134 Suppl 3:S1-S14. [PMID: 37435829 PMCID: PMC10914083 DOI: 10.1002/lary.30879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023]
Abstract
The indications for cochlear implantation have expanded over time due to evidence demonstrating identification and implantation of appropriate cochlear implant (CI) candidates lead to significant improvements in speech recognition and quality of life (QoL). However, clinical practice is variable, with some providers using outdated criteria and others exceeding current labeled indications. As a results, only a fraction of those persons who could benefit from CI technology receive it. This document summarizes the current evidence for determining appropriate referrals for adults with bilateral hearing loss into CI centers for formal evaluation by stressing the importance of treating each ear individually and a "revised 60/60 rule". By mirroring contemporary clinical practice and available evidence, these recommendations will also provide a standardized testing protocol for CI candidates using a team-based approach that prioritizes individualized patient care. This manuscript was developed by the Adult Cochlear Implantation Candidacy Task Force of the American Cochlear Implant Alliance using review of the existing literature and clinical consensus. LEVEL OF EVIDENCE: N/A Laryngoscope, 134:S1-S14, 2024.
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Affiliation(s)
- Daniel M. Zeitler
- Listen for Life Center, Department of Otolaryngology-Head and Neck Surgery, Virginia Mason Medical Center, Seattle, WA
| | - Sandra M. Prentiss
- Department of Otolaryngology-Head and Neck Surgery, University of Miami, Miami, FL
| | | | - Camille C. Dunn
- The University of Iowa Cochlear Implant Clinical Research Center, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, IA
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Rizkou FE, Benhoummad O, Rochd S, Lakhdar Y, Rochdi Y, Raji A. Cochlear Implant Outcomes: Quality of Life in Prelingually Deafened, Late-Implanted Patients. Otol Neurotol 2024; 45:e24-e27. [PMID: 38085762 DOI: 10.1097/mao.0000000000004052] [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: 12/18/2023]
Abstract
AIMS Reevaluating and expanding cochlear implantation's (CI) indication while measuring the quality of life (QoL) outcomes regarding the parent's point of view of prelingually deafened, late-implanted patients, which are widely known to showcases a limited improvement in speech recognition. MATERIALS AND METHODS A retrospective descriptive and analytic study to assess QoL outcomes from CI in 64 early deafened, late-implanted patients, according to their parent's perspective, between January 2009 and December 2019, using the Nottingham Pediatric Cochlear Implant Program (Nottingham University Hospital, Nottingham, United Kingdom) "Children with cochlear implantation: parents perspective." RESULTS The most represented age interval is the 5 and 7 interval and the mean age is 10.09 years. There was no sex predominance, with rural origin and high school academicals level preponderance. Fourteen children had experienced neonatal icterus, eight had meningitis, and seven were the result of related marriage. The age of the first consultation was typically over 2 years old, with only 45 schooled children. Age had a significantly statistic correlation between Self-reliance and Well-being and happiness subscales. History of receiving aid and speech therapy has a clear correlation with Self-reliance, Well-being and happiness, and Communication and Education. Schooling statuses, sex, age of appearance, and communication mode were not correlated to any subscale score, and with the exception of Effect of implantation, all the other "Children with cochlear implantation: parent's perspective" subscales were intercorrelated. CONCLUSION Properly validated QoL assessments for CI are a must, as outcomes of CI expand beyond audiometric performances to include the improvement of QoL.
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Affiliation(s)
- Fatima Ezzahra Rizkou
- ENT and Neck and Head Surgery Department, Mohammed VI University Hospital Center, Marrakech
| | - Othmane Benhoummad
- ENT and Neck and Head Surgery Department, Faculty of Medicine and Pharmacy of Agadir, University Hospital of Agadir, Agadir, Morocco
| | - Sara Rochd
- ENT and Neck and Head Surgery Department, Mohammed VI University Hospital Center, Marrakech
| | - Youssef Lakhdar
- ENT and Neck and Head Surgery Department, Mohammed VI University Hospital Center, Marrakech
| | - Youssef Rochdi
- ENT and Neck and Head Surgery Department, Mohammed VI University Hospital Center, Marrakech
| | - Abdelaziz Raji
- ENT and Neck and Head Surgery Department, Mohammed VI University Hospital Center, Marrakech
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Kobosko J, Jedrzejczak WW, Rostkowska J, Porembska DB, Fludra M, Skarżyński H. Satisfaction with life in a sample of prelingually deaf cochlear implant users with a good command of spoken Polish as the primary language. JOURNAL OF COMMUNICATION DISORDERS 2023; 105:106370. [PMID: 37683553 DOI: 10.1016/j.jcomdis.2023.106370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 08/18/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023]
Abstract
INTRODUCTION This study investigated the level of satisfaction with life (SWL) in a group of cochlear implant (CI) users who had been prelingually deaf but were orally educated. They had received one or two CIs (as a child, adolescent, or adult) and were highly competent Polish speakers. This study looked at three factors that may affect SWL - psychosocial, deafness/hearing and communication related, and sociodemographic. METHODS The participants were prelingually deaf CI users who had learned highly competent spoken Polish as their primary language. They had been educated in mainstream or integrated schools (not schools for the deaf), and had no other disability or severe illness. Measurements were done with 5 questionnaires: the Satisfaction With Life Scale (SWLS), the I-Others Questionnaire, the Patient Health Questionnaire (PHQ-9), the Deaf Identity Development Scale (DIDS), and the Nijmegen Cochlear Implant Questionnaire (NCIQ). RESULTS The SWL level of the group was similar to that of the standard Polish population. SWL was positively related to positive self-perception, acceptance of oneself as a deaf person, and to perceiving the benefits of having a CI (as measured by three NCIQ domains: self-esteem, activity limitations, and social interactions). On the other hand, negative self-perception, marginal deaf identity, and depressive symptoms were negatively related to SWL. There was no relationship between SWL and knowledge of sign language. Lower depressive symptoms and greater hearing loss were both significant predictors of SWL, although those who used two CIs generally had a lower SWL. CONCLUSIONS Prelingually deaf CI users with low SWL require psychological support in many spheres, including working through problems of deaf identity, self-acceptance, and depression. Additional research should involve diverse DHH CI users, including those with limited spoken Polish competency or sign language skills, as well as members of the Polish Deaf community.
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Affiliation(s)
- Joanna Kobosko
- Institute of Physiology and Pathology of Hearing, ul. M. Mochnackiego 10, 02-042 Warsaw, Poland; World Hearing Center, ul. Mokra 17, Kajetany 05-830 Nadarzyn, Poland; Maria Grzegorzewska University, ul. Szczęśliwicka 40, 02-353 Warsaw, Poland
| | - W Wiktor Jedrzejczak
- Institute of Physiology and Pathology of Hearing, ul. M. Mochnackiego 10, 02-042 Warsaw, Poland; World Hearing Center, ul. Mokra 17, Kajetany 05-830 Nadarzyn, Poland.
| | - Joanna Rostkowska
- Institute of Physiology and Pathology of Hearing, ul. M. Mochnackiego 10, 02-042 Warsaw, Poland; World Hearing Center, ul. Mokra 17, Kajetany 05-830 Nadarzyn, Poland
| | - D Beata Porembska
- Institute of Physiology and Pathology of Hearing, ul. M. Mochnackiego 10, 02-042 Warsaw, Poland; World Hearing Center, ul. Mokra 17, Kajetany 05-830 Nadarzyn, Poland; Maria Grzegorzewska University, ul. Szczęśliwicka 40, 02-353 Warsaw, Poland
| | - Małgorzata Fludra
- Institute of Physiology and Pathology of Hearing, ul. M. Mochnackiego 10, 02-042 Warsaw, Poland; World Hearing Center, ul. Mokra 17, Kajetany 05-830 Nadarzyn, Poland
| | - Henryk Skarżyński
- Institute of Physiology and Pathology of Hearing, ul. M. Mochnackiego 10, 02-042 Warsaw, Poland; World Hearing Center, ul. Mokra 17, Kajetany 05-830 Nadarzyn, Poland
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Spitzer ER, Waltzman SB. Cochlear implants: the effects of age on outcomes. Expert Rev Med Devices 2023; 20:1131-1141. [PMID: 37969071 DOI: 10.1080/17434440.2023.2283619] [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: 07/13/2023] [Accepted: 11/10/2023] [Indexed: 11/17/2023]
Abstract
INTRODUCTION Cochlear implants (CIs) provide access to sound for children and adults who do not receive adequate benefit from hearing aids. Age at implantation is known to affect outcomes across the lifespan. AREAS COVERED The effects of age on CI outcomes are examined for infants, children, adolescents, and older adults. A variety of outcome measures are considered, including speech perception, language, cognition, and quality of life measures. EXPERT OPINION/COMMENTARY For those meeting candidacy criteria, CIs are beneficial at any age. In general, younger age is related to greater benefit when considering pre-lingual deafness. Other factors such as additional disabilities, may mitigate this effect. Post-lingually deafened adults demonstrate similar benefit regardless of age, though the oldest individuals (80+) may see smaller degrees of improvement from preoperative scores. Benefit can be measured in many ways, and the areas of greatest benefit may vary based on age: young children appear to see the greatest effects of age at implantation on language measures, whereas scores on cognitive measures appear to be most impacted for the oldest population. Future research should consider implantation at extreme ages (5-9 months or > 90 years), unconventional measures of CI benefit including qualitative assessments, and longitudinal designs.
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Affiliation(s)
- Emily R Spitzer
- Department of Otolaryngology-Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Susan B Waltzman
- Department of Otolaryngology-Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
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Candidacy for Cochlear Implantation in Prelingual Profoundly Deaf Adult Patients. J Clin Med 2022; 11:jcm11071874. [PMID: 35407482 PMCID: PMC8999851 DOI: 10.3390/jcm11071874] [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: 02/09/2022] [Revised: 03/14/2022] [Accepted: 03/21/2022] [Indexed: 12/04/2022] Open
Abstract
Cochlear implantation is usually not recommended for prelingual profoundly deaf adults, although some of these patients might benefit from it. This study aims to define the candidates for cochlear implantation in this population. This retrospective study reviewed 34 prelingual profoundly deaf patients who had received a cochlear implant at 32 ± 1.7 years old (16−55), with at least 1 year of follow-up. Speech perception and quality of life were assessed before and 3, 6, and 12 months after cochlear implantation, then every year thereafter. According to the word speech intelligibility in quiet (WSI) 1 year after implantation, two groups were identified: good performer (GP) with WSI ≥ 50% (n = 15), and poor performer (PP) with WSI ≤ 40% (n = 19). At the 1 year mark, mean WSI improved by 28 ± 4.6% (−20−100) (p < 0.0001). In GP, the intelligibility for words and sentences, communication and quality of life scales improved. In PP, the communication scale improved, but not auditory performance or quality of life. GP and PP differed pre-operatively in speech production, communication abilities, and WSI in best-aided conditions. In prelingual profoundly deaf adults, a dramatic auditory performance benefit could be expected after cochlear implantation if the patients have some degree of speech intelligibility in aided conditions and have developed oral communication and speech production.
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Shafiro V, Luzum N, Moberly AC, Harris MS. Perception of Environmental Sounds in Cochlear Implant Users: A Systematic Review. Front Neurosci 2022; 15:788899. [PMID: 35082595 PMCID: PMC8785216 DOI: 10.3389/fnins.2021.788899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 12/07/2021] [Indexed: 11/27/2022] Open
Abstract
Objectives: Improved perception of environmental sounds (PES) is one of the primary benefits of cochlear implantation (CI). However, past research contains mixed findings on PES ability in contemporary CI users, which at times contrast with anecdotal clinical reports. The present review examined extant PES research to provide an evidence basis for clinical counseling, identify knowledge gaps, and suggest directions for future work in this area of CI outcome assessment. Methods: Six electronic databases were searched using medical subject headings (MeSH) and keywords broadly identified to reference CI and environmental sounds. Records published between 2000 and 2021 were screened by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement to identify studies that met the inclusion criteria. Data were subsequently extracted and evaluated according to synthesis without-meta-analysis (SWiM) guidelines. Results: Nineteen studies met the inclusion criteria. Most examined PES in post-lingually implanted adults, with one study focused on pre/perilingual adults. Environmental sound identification (ESI) in quiet using open- or closed-set response format was most commonly used in PES assessment, included in all selected studies. ESI accuracy in CI children (3 studies) and adults (16 studies), was highly variable but generally mediocre (means range: 31–87%). Only two studies evaluated ESI performance prospectively before and after CI, while most studies were cross-sectional. Overall, CI performance was consistently lower than that of normal-hearing peers. No significant differences in identification accuracy were reported between CI candidates and CI users. Environmental sound identification correlated in CI users with measures of speech perception, music and spectro-temporal processing. Conclusion: The findings of this systematic review indicate considerable limitations in the current knowledge of PES in contemporary CI users, especially in pre/perilingual late-implanted adults and children. Although no overall improvement in PES following implantation was found, large individual variability and existing methodological limitations in PES assessment may potentially obscure potential CI benefits for PES. Further research in this ecologically relevant area of assessment is needed to establish a stronger evidence basis, identify CI users with significant deficits, and improve CI users' safety and satisfaction through targeted PES rehabilitation.
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Affiliation(s)
- Valeriy Shafiro
- Department of Communication Disorders and Sciences, Rush University Medical Center, Chicago, IL, United States
- *Correspondence: Valeriy Shafiro
| | - Nathan Luzum
- Medical College of Wisconsin, Milwaukee, WI, United States
| | - Aaron C. Moberly
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Michael S. Harris
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, United States
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Butera IM, Larson ED, DeFreese AJ, Lee AKC, Gifford RH, Wallace MT. Functional localization of audiovisual speech using near infrared spectroscopy. Brain Topogr 2022; 35:416-430. [PMID: 35821542 PMCID: PMC9334437 DOI: 10.1007/s10548-022-00904-1] [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: 10/27/2021] [Accepted: 05/19/2022] [Indexed: 11/21/2022]
Abstract
Visual cues are especially vital for hearing impaired individuals such as cochlear implant (CI) users to understand speech in noise. Functional Near Infrared Spectroscopy (fNIRS) is a light-based imaging technology that is ideally suited for measuring the brain activity of CI users due to its compatibility with both the ferromagnetic and electrical components of these implants. In a preliminary step toward better elucidating the behavioral and neural correlates of audiovisual (AV) speech integration in CI users, we designed a speech-in-noise task and measured the extent to which 24 normal hearing individuals could integrate the audio of spoken monosyllabic words with the corresponding visual signals of a female speaker. In our behavioral task, we found that audiovisual pairings provided average improvements of 103% and 197% over auditory-alone listening conditions in -6 and -9 dB signal-to-noise ratios consisting of multi-talker background noise. In an fNIRS task using similar stimuli, we measured activity during auditory-only listening, visual-only lipreading, and AV listening conditions. We identified cortical activity in all three conditions over regions of middle and superior temporal cortex typically associated with speech processing and audiovisual integration. In addition, three channels active during the lipreading condition showed uncorrected correlations associated with behavioral measures of audiovisual gain as well as with the McGurk effect. Further work focusing primarily on the regions of interest identified in this study could test how AV speech integration may differ for CI users who rely on this mechanism for daily communication.
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Affiliation(s)
- Iliza M. Butera
- grid.152326.10000 0001 2264 7217Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN USA
| | - Eric D. Larson
- grid.34477.330000000122986657Institute for Learning & Brain Sciences, University of Washington, Seattle Washington, USA
| | - Andrea J. DeFreese
- grid.152326.10000 0001 2264 7217Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN USA
| | - Adrian KC Lee
- grid.34477.330000000122986657Institute for Learning & Brain Sciences, University of Washington, Seattle Washington, USA ,grid.34477.330000000122986657Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington USA
| | - René H. Gifford
- grid.152326.10000 0001 2264 7217Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN USA
| | - Mark T. Wallace
- grid.152326.10000 0001 2264 7217Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN USA ,grid.152326.10000 0001 2264 7217Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN USA ,grid.412807.80000 0004 1936 9916Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN USA
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Forli F, Lazzerini F, Montecchiari V, Morganti R, Bruschini L, Berrettini S. Cochlear implant in prelingually hearing-impaired adults: prognostic factors and results. ACTA ACUST UNITED AC 2021; 41:173-179. [PMID: 34028463 PMCID: PMC8142735 DOI: 10.14639/0392-100x-n1146] [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: 09/29/2020] [Accepted: 11/27/2020] [Indexed: 11/23/2022]
Abstract
Objectives The aim of present study is to evaluate the impact of prognostic factors on the outcome in a group of prelingually hearing-impaired patients submitted to cochlear implantation (CI) at an adult age. Methods This is a retrospective study on a cohort of prelingually severe-to-profound hearing-impaired patients cochlear implanted in adulthood and followed by a single audiology centre. We correlated post-CI results in term of speech perception with patients’ speech perception with hearing aids before implantation, history of progression of hearing loss (HL), and levels of education and cognition. The study group was composed of 49 patients. Results Post-CI open-set recognition score in silence and noise was significantly correlated with pre-CI open-set recognition score in silence and with background noise. Patients with a history of progression of HL gained significantly better results. Furthermore, we found higher improvements in patients with a higher level of education. Conclusions Prelingually deafened patients implanted in adulthood achieved satisfactory results. Significantly better results were achieved by patients with better pre-operative speech perception scores, progressive HL and higher level of education.
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Affiliation(s)
- Francesca Forli
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy
| | - Francesco Lazzerini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy
| | | | | | - Luca Bruschini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy
| | - Stefano Berrettini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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Debruyne JA, Janssen AM, Brokx JPL. Systematic Review on Late Cochlear Implantation in Early-Deafened Adults and Adolescents: Predictors of Performance. Ear Hear 2021; 41:1431-1441. [PMID: 33136620 DOI: 10.1097/aud.0000000000000889] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Early-deafened, late-implanted adolescents and adults constitute a unique group of cochlear implant (CI) users, showing a large variability in outcomes. The current systematic review aimed to determine which preimplantation factors are relevant in predicting postoperative outcomes in this patient group. DESIGN A systematic search for studies published between 2000 and September 2017 was performed in five electronic databases (PubMed, Embase, the Cochrane library, CINAHL, and PsycInfo). Prognostic studies that assessed the relation between patient-related factors and CI outcomes in early-deafened but late-implanted adolescent and adult CI users were included. Study quality was assessed with the Quality In Prognosis Studies (QUIPS) tool. RESULTS The systematic search and subsequent full-text evaluation identified 13 studies that had a clear prognostic study goal. Eight out of these 13 studies had a high risk of bias for at least one of the five QUIPS domains. Analysis of the outcomes identified that communication mode (in childhood), preoperative speech intelligibility, and preoperative speech recognition scores were significantly related to speech perception outcomes for this group of CI users. A number of additional factors considered worth for further investigation were also identified. CONCLUSIONS The analysis of the studies assessing the effect of a number of patient-related factors on outcome with CI in early-deafened adolescents and adults identified three potential prognostic factors and a number of additional factors to be incorporated in future research. More high-quality prognosis studies in the investigated patient population are still needed.
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Affiliation(s)
- Joke A Debruyne
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - A Miranda Janssen
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jan P L Brokx
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
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Debruyne JA, Janssen AM, Brokx JPL. Systematic Review on Late Cochlear Implantation in Early-Deafened Adults and Adolescents: Clinical Effectiveness. Ear Hear 2021; 41:1417-1430. [PMID: 33136619 DOI: 10.1097/aud.0000000000000884] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Cochlear implantation in early-deafened patients, implanted as adolescents or adults, is not always advised due to poor expected outcomes. In order to judge whether such reluctance is justified, the current systematic review aimed to gather all available evidence on postoperative outcomes obtained by early-deafened patients using a state-of-the art cochlear implant (CI). DESIGN Five electronic databases (PubMed, Embase, the Cochrane library, CINAHL, and PsycInfo) were systematically searched for studies in English, French, German, or Dutch, published between 2000 and September 2017. Studies that reported pre- and postoperative outcomes on any measure of speech or sound perception, audiovisual or subjective benefit (quality of life) were included. Study quality was assessed with the Institute of Health Economics quality appraisal tool for case series studies. RESULTS The systematic search and subsequent full-text evaluation identified 38 studies meeting the inclusion criteria. Only a limited number of studies were judged to be of high quality according to the Institute of Health Economics tool, with lack of (clear) presentation of relevant study information being a recurring problem. Twenty-five studies presented viable outcomes on open-set speech understanding in quiet: mean postoperative scores obtained with CI remained below 50% for the vast majority of studies; significant postoperative improvements were found in 16 studies, although this number might have been higher if appropriate statistical testing had been performed in all studies. Eight studies observed increased audiovisual performance after implantation, which was statistically significant in six studies. A validated measure of hearing-related quality of life was used in only 5 of the 16 studies assessing subjective outcomes, showing significant postoperative improvements for most questionnaire domains. The relation between auditory and subjective outcomes was assessed in two studies, with contradictory results. CONCLUSIONS The current review showed that late cochlear implantation in early-deafened subjects resulted in significantly improved open-set speech perception, audiovisual speech perception, and (hearing-related) quality of life in the majority of the studies involved. Nonetheless, more and especially higher-quality research is needed in order to gain a more detailed understanding of the outcomes of cochlear implantation in this population.
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Affiliation(s)
- Joke A Debruyne
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - A Miranda Janssen
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jan P L Brokx
- Department of ENT/Audiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, The Netherlands
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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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Dixon PR, Feeny D, Tomlinson G, Cushing S, Chen JM, Krahn MD. Health-Related Quality of Life Changes Associated With Hearing Loss. JAMA Otolaryngol Head Neck Surg 2021; 146:630-638. [PMID: 32407468 DOI: 10.1001/jamaoto.2020.0674] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Importance Utility is a single-value, preference-based measure of health-related quality of life that represents the desirability of a health state relative to being dead or in perfect health. Clinical, funding, and policy decisions rely on measured changes in utility. The benefit of hearing loss treatments may be underestimated because existing utility measures fail to capture important changes in quality of life associated with hearing loss. Objective To develop a comprehensive profile of items that describe how quality of life is associated with hearing loss and its treatments that can be used to generate hearing-related quality of life measures, including a novel utility measure. Design, Setting, and Participants This qualitative study, performed from August 1, 2018, to August 1, 2019, in tertiary referral centers, comprised a systematic literature review, focus groups, and semistructured interviews. The systematic review evaluated studies published from 1982 to August 1, 2018. Focus groups included 8 clinical experts experienced in the measurement, diagnosis, treatment, and rehabilitation of hearing loss. Semistructured interviews included 26 adults with hearing loss recruited from an institutional data set and outpatient hearing aid and otology clinics using stratified convenience sampling to include individuals of diverse ages, urban and rural residency, causes of hearing loss, severity of hearing loss, and treatment experience. Main Outcomes and Measures A set of items and subdomains that collectively describe the association of hearing loss with health-related quality of life. Results The literature search yielded 2779 articles from the MEDLINE, Embase, Cochrane, PsycINFO, and CINAHL databases. Forty-five studies including 1036 individuals (age range, 18-84 years) were included. The focus group included 4 audiologists and 4 otologists. Hour-long semistructured interviews were conducted with 26 individuals (13 women; median age, 54 years; range, 25-83 years) with a broad range of hearing loss causes, configurations, and severities. From all 3 sources, a total of 125 items were generated and organized into 29 subdomains derived from the World Health Organization's International Classification of Functioning, Disability and Health. Conclusions and Relevance The association of hearing loss with quality of life is multidimensional and includes subdomains that are not considered in the estimation of health utility by existing utility measures. The presented comprehensive profile of items can be used to generate or evaluate measures of hearing-related quality of life, including utility measures.
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Affiliation(s)
- Peter R Dixon
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, Canada
| | - David Feeny
- Department of Economics, McMaster University, Hamilton, Ontario, Canada.,Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.,Health Utilities Incorporated, Hamilton, Ontario, Canada
| | - George Tomlinson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, Canada
| | - Sharon Cushing
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Joseph M Chen
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Murray D Krahn
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, Canada.,University Health Network, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Herrmann B, Johnsrude IS. A model of listening engagement (MoLE). Hear Res 2020; 397:108016. [DOI: 10.1016/j.heares.2020.108016] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 04/28/2020] [Accepted: 06/02/2020] [Indexed: 12/30/2022]
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A Systematic Review of Cochlear Implant Outcomes in Prelingually-deafened, Late-implanted Patients. Otol Neurotol 2020; 41:444-451. [DOI: 10.1097/mao.0000000000002555] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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