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Walia A, Bao J, Dwyer N, Rathgeb S, Chen S, Shew MA, Durakovic N, Herzog JA, Buchman CA, Wick CC. Predictors of Short-Term Changes in Quality of Life after Cochlear Implantation. Otol Neurotol 2023; 44:e146-e154. [PMID: 36728163 PMCID: PMC9928883 DOI: 10.1097/mao.0000000000003805] [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] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study aimed 1) to measure the effect of cochlear implantation on health-related quality of life (HR-QOL) using the Cochlear Implant Quality of Life (CIQOL) questionnaire and 2) to determine audiologic, demographic, and non-CI/hearing-related QOL factors influencing the CIQOL. STUDY DESIGN Prospective observational study. SETTING Tertiary referral center. PATIENTS AND INTERVENTIONS Thirty-seven adult patients with sensorineural hearing loss undergoing cochlear implantation. MAIN OUTCOME MEASURES CIQOL-global score preimplantation and 6 months postimplantation. Physical function score as measured by the short-form survey, audiologic, and demographic variables. RESULTS CIQOL showed significant improvement from preimplantation to 6 months postactivation with a mean difference of 14.9 points (95% confidence interval, 11.3 to 18.5, p < 0.0001). Improvement in CIQOL (ΔCIQOL) correlated linearly with age ( r = -0.49, p = 0.001) and improvement in speech perception testing ( r = 0.63, p < 0.0001). Multivariate modeling using age and change in consonant-vowel nucleus-consonant (CNC) score explained 46% of the variability measured by the ΔCIQOL-global score. CONCLUSIONS Nearly all CI recipients achieve significant gains for all domains as measured by the CIQOL. However, younger patients and those with a greater improvement in speech perception performance (CNC) are more likely to achieve a greater CIQOL benefit. Results here suggest the importance of considering preoperative CIQOL and speech perception measures when evaluating predictors of HR-QOL.
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Affiliation(s)
- Amit Walia
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
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Babajanian EE, Carmichael EC, Gordon SA, Patel NS, Gurgel RK. Cochlear Implantation in Patients With Known Cognitive Impairment: What Are the Benefits? Otol Neurotol 2022; 43:1144-1148. [PMID: 36201563 PMCID: PMC9649849 DOI: 10.1097/mao.0000000000003701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the outcomes of cochlear implantation (CI) in adults with preoperatively diagnosed cognitive impairment. STUDY DESIGN Retrospective cohort study. SETTING Tertiary-care academic center. PATIENTS Adults undergoing CI with preexisting cognitive impairment. INTERVENTIONS Cochlear implantation. MAIN OUTCOME MEASURES 1) Hearing improvement after CI; 2) morbidity and mortality associated with surgery. RESULTS Eight patients met inclusion criteria with mean age 77.8 years (SD, 9.6 y) at time of implantation; 7 were included in subsequent analysis as one did not have speech recognition scores. Average preoperative MoCA cognitive score of 22.6 (SD, 3.9, ≤25 demonstrates cognitive impairment). Average follow-up was 29.0 months (SD, 33.3 mo). Two patients passed away at an average 58.0 months (SD, 31.1 mo) after surgery. Median preoperative pure tone average was 86.3 dB HL ( interquartile range 31.3 dB HL) compared with 33.8 dB HL (IQR 5.0 dB HL) postoperatively ( p = <0.001). Median preoperative speech testing score (AzBio/HINT) was 21% (IQR, 24%) compared with 44% (IQR, 21%) postoperatively ( p = <0.001). There were no observed surgical complications during the follow-up period. CONCLUSIONS This study demonstrates that patients with cognitive impairment before CI can experience improved hearing, no increased risk of complications, and good longevity after CI. Further prospective studies are needed to further define the utility of CI in patients with impaired cognition.
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Affiliation(s)
- Eric E Babajanian
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah
| | - Erin C Carmichael
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah
| | - Steven A Gordon
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah
| | - Neil S Patel
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah
| | - Richard K Gurgel
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah
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Babajanian EE, Patel NS, Gurgel RK. The Impact of Cochlear Implantation: Cognitive Function, Quality of Life, and Frailty in Older Adults. Semin Hear 2021; 42:342-351. [PMID: 34912162 PMCID: PMC8660171 DOI: 10.1055/s-0041-1739367] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
This review examines the relationship between cochlear implantation and cognition and quality of life in older adults, as well as how frailty affects outcomes for older patients with cochlear implants. A growing body of evidence suggests that there is a strong association between hearing loss and cognitive impairment. Preliminary studies suggest that cochlear implantation in older adults may be protective against cognitive decline. While studies have observed a positive impact of cochlear implantation on quality of life, currently it is unclear what factors contribute the most to improved quality of life. Frailty, as a measurement of general health, likely plays a role in complication rates and quality-of-life outcomes after cochlear implantation, though larger prospective studies are required to further elucidate this relationship.
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Affiliation(s)
- Eric E Babajanian
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah
| | - Neil S Patel
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah
| | - Richard K Gurgel
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah
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O'Neill ER, Basile JD, Nelson P. Individual Hearing Outcomes in Cochlear Implant Users Influence Social Engagement and Listening Behavior in Everyday Life. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4982-4999. [PMID: 34705529 DOI: 10.1044/2021_jslhr-21-00249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The goal of this study was to assess the listening behavior and social engagement of cochlear implant (CI) users and normal-hearing (NH) adults in daily life and relate these actions to objective hearing outcomes. METHOD Ecological momentary assessments (EMAs) collected using a smartphone app were used to probe patterns of listening behavior in CI users and age-matched NH adults to detect differences in social engagement and listening behavior in daily life. Participants completed very short surveys every 2 hr to provide snapshots of typical, everyday listening and socializing, as well as longer, reflective surveys at the end of the day to assess listening strategies and coping behavior. Speech perception testing, with accompanying ratings of task difficulty, was also performed in a lab setting to uncover possible correlations between objective and subjective listening behavior. RESULTS Comparisons between speech intelligibility testing and EMA responses showed poorer performing CI users spending more time at home and less time conversing with others than higher performing CI users and their NH peers. Perception of listening difficulty was also very different for CI users and NH listeners, with CI users reporting little difficulty despite poor speech perception performance. However, both CI users and NH listeners spent most of their time in listening environments they considered "not difficult." CI users also reported using several compensatory listening strategies, such as visual cues, whereas NH listeners did not. CONCLUSION Overall, the data indicate systematic differences between how individual CI users and NH adults navigate and manipulate listening and social environments in everyday life.
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Affiliation(s)
- Erin R O'Neill
- Department of Psychology, University of Minnesota, Twin Cities, Minneapolis
| | - John D Basile
- Department of Biomedical Engineering, University of Minnesota, Twin Cities, Minneapolis
| | - Peggy Nelson
- Department of Speech-Language-Hearing Sciences, Center for Applied and Translational Sensory Science (CATSS), University of Minnesota, Twin Cities, Minneapolis
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Holman JA, Drummond A, Naylor G. Hearing Aids Reduce Daily-Life Fatigue and Increase Social Activity: A Longitudinal Study. Trends Hear 2021; 25:23312165211052786. [PMID: 34747674 PMCID: PMC8579337 DOI: 10.1177/23312165211052786] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
People with hearing loss experience fatigue, and it is unknown whether this is alleviated by treatment with hearing aids. The objective of this study was to address this issue and to investigate the possible concomitant effect of hearing-aid fitting on activity levels. An intervention group (n = 53) who were due to be fitted with their first-ever hearing aid(s) and a control group (n = 53) who had hearing loss but no change in hearing aid status-completed a battery of self-report outcome measures four times: once before fitting, and at 2 weeks, 3 months, and 6 months post fitting. Self-report outcome measures at each assessment captured fatigue, listening effort, hearing handicap, auditory lifestyle, social participation restrictions, and work, social and physical activity levels. Hearing-aid fitting led to a significant reduction in listening-related fatigue, but not general fatigue, in the intervention group compared to the control group. Additionally, social activity level increased and social participation restriction decreased significantly after hearing aid fitting in the intervention group compared to the control group. No significant interaction was found between working status and change in listening-related fatigue score. This study is the first to make a longitudinal measurement of fatigue before and after first-ever hearing aid fitting and to identify an increase in social activity level after hearing aid fitting. These findings have important implications for future research and the clinical practice of hearing aid fitting.
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Affiliation(s)
- Jack A Holman
- Hearing Sciences (Scottish Section), Mental Health and Clinical Neurosciences, School of Medicine, 6123University of Nottingham, Glasgow, UK
| | - Avril Drummond
- School of Health Sciences, 6123University of Nottingham, Nottingham, UK
| | - Graham Naylor
- Hearing Sciences (Scottish Section), Mental Health and Clinical Neurosciences, School of Medicine, 6123University of Nottingham, Glasgow, UK
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Abstract
INTRODUCTION Older adults with late-onset hearing loss are at risk for cognitive decline. Our study addresses the question of whether cochlear implantation (CI) can counteract this potential influence. We investigated whether cognitive performance in older adults with severe and profound hearing loss improves 12 months after CI to a level comparable to controls with normal hearing, matched for age, sex, and education level. DESIGN This cohort study was performed at two tertiary referral centers. The study included 29 patients, of age between 60 and 80 years, with adult-onset, severe to profound bilateral sensorineural hearing loss and indication for CI (study group), as well as 29 volunteers with age-adjusted hearing abilities, according to the norm curves of ISO-702 9:2000-01, (control group). Before CI and 12 months after CI, participants completed a neurocognitive test battery including tests of global cognition, verbal and figural episodic memory, and executive functions (attentional control, inhibition, and cognitive flexibility). RESULTS Twelve months after CI, the performance of the study group improved significantly in global cognition, compared to the situation before CI. Differences in verbal episodic memory, figural episodic memory, and executive function were not significant. Moreover, the improvement of the study group was significantly larger only in global cognition compared to the control group. Noninferiority tests on the cognitive performances of the study group after CI revealed that comparable levels to normal hearing controls were reached only in global cognition, figural episodic memory (immediate recall), and attentional control. The improvement in global cognition was significantly associated with speech recognition 3 months after CI, but not with speech recognition 12 months after CI. CONCLUSION One year after CI, cognitive deficits in older individuals with adult-onset hearing loss, compared to normal-hearing peers, could only improve some cognitive skills.
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Holman JA, Drummond A, Naylor G. The Effect of Hearing Loss and Hearing Device Fitting on Fatigue in Adults: A Systematic Review. Ear Hear 2021; 42:1-11. [PMID: 32639255 PMCID: PMC7757744 DOI: 10.1097/aud.0000000000000909] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 05/20/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To conduct a systematic review to address two research questions: (Q1) Does hearing loss have an effect on fatigue? (Q2) Does hearing device fitting have an effect on fatigue? It was hypothesized that hearing loss would increase fatigue (H1), and hearing device fitting would reduce fatigue (H2). DESIGN Systematic searches were undertaken of five bibliographic databases: Embase, MedLine, Web of Science, Psychinfo, and the Cochrane Library. English language peer-reviewed research articles were included from inception until present. Inclusion and exclusion criteria were formulated using the Population, Intervention, Comparison, Outcomes and Study design strategy. RESULTS Initial searches for both research questions produced 1,227 unique articles, after removal of duplicates. After screening, the full text of 61 studies was checked, resulting in 12 articles with content relevant to the research questions. The reference lists of these studies were examined, and a final updated search was conducted on October 16, 2019. This resulted in a final total of 20 studies being selected for the review. For each study, the information relating to the Population, Intervention, Comparison, Outcomes and Study design criteria and the statistical outcomes relating to both questions (Q1 and Q2) were extracted. Evidence relating to Q1 was provided by 15 studies, reporting 24 findings. Evidence relating to Q2 was provided by six studies, reporting eight findings. One study provided evidence for both. Using the Grading of Recommendations Assessment, Development and Evaluation guidelines, the quality of evidence on both research questions was deemed to be "very low." It was impossible to perform a meta-analysis of the results due to a lack of homogeneity. CONCLUSIONS As the studies were too heterogeneous to support a meta-analysis, it was not possible to provide statistically significant evidence to support the hypotheses that hearing loss results in increased fatigue (H1) or that hearing device fitting results in decreased fatigue (H2). Despite this, the comparative volume of positive results and the lack of any negative findings are promising for future research (particularly in respect of Q1). There was a very small number of studies deemed eligible for the review, and there was large variability between studies in terms of population, and quantification of hearing loss and fatigue. The review highlights the need for consistency when measuring fatigue, particularly when using self-report questionnaires, where the majority of the current evidence was generated.
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Affiliation(s)
- Jack A. Holman
- Hearing Sciences (Scottish Section), Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Glasgow, United Kingdom
| | - Avril Drummond
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Graham Naylor
- Hearing Sciences (Scottish Section), Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Glasgow, United Kingdom
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Holman JA, Hornsby BWY, Bess FH, Naylor G. Can listening-related fatigue influence well-being? Examining associations between hearing loss, fatigue, activity levels and well-being. Int J Audiol 2021; 60:47-59. [PMID: 33390065 PMCID: PMC8315207 DOI: 10.1080/14992027.2020.1853261] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective Well-being is influenced by the activities we undertake. Hearing loss may reduce well-being directly through increased listening-related fatigue due to cognitive and emotional strain in challenging situations. Hearing loss and hearing device use may also indirectly impact fatigue and well-being by altering the frequency and type of daily-life activities. This review examines the available literature to help understand the relationships. Design We provide (i) a summary of the extant literature regarding hearing loss, hearing device use and fatigue in adults, as well as regarding fatigue and daily-life activity (work, social and physical) and (ii) a systematic search and narrative review of the relationships between hearing loss, hearing device use and activity. Study sample The systematic search resulted in 66 eligible texts. Results Data examining well-being in persons with hearing loss are limited. Our literature review suggests that well-being can be related directly and indirectly to hearing loss, hearing device use, activity level and listening-related fatigue. Conclusions Variations and interactions between hearing loss, hearing device use, fatigue and activity levels can be expected to impact well-being in persons with hearing loss in direct and indirect ways. Future research linking hearing and daily-life fatigue should take account of activity levels.
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Affiliation(s)
- Jack A Holman
- Hearing Sciences (Scottish Section), Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Glasgow, UK
| | - Benjamin W Y Hornsby
- Department of Hearing and Speech Sciences, Vanderbilt Bill Wilkerson Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Fred H Bess
- Department of Hearing and Speech Sciences, Vanderbilt Bill Wilkerson Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Graham Naylor
- Hearing Sciences (Scottish Section), Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Glasgow, UK
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Goh BS, Marimuthu D, Wan Hashim WF, Abdullah A. Surgical management of cochlear implant in chronic otitis media patients: safe and sound. Acta Otolaryngol 2020; 140:914-918. [PMID: 32692598 DOI: 10.1080/00016489.2020.1784463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Cochlear implantation (CI) in cases with chronic otitis media (COM) was previously contraindicated but recent advances have made it possible. OBJECTIVE To review surgical and audiological outcomes of COM patients that underwent CI. MATERIAL AND METHODS Retrospective review of patients above 18 years old. RESULTS Ten patients with complete data were included. Patients were aged 24-69 years old. Tympanoplasty and mastoidectomy were performed before CI. Imaging was performed to rule out ossifications. Eight patients underwent a standard canal wall up with either cochleostomy or round window approach. One patient had additional canalplasty and tympanoplasty and another one had blind sac procedure respectively. Analysis of the hearing aided level with CI and hearing aid showed significant benefit provided by the CI (Z = 2.803, p = .005). DISCUSSION Creating a dry and safe ear is important prior to CI. Definite hearing improvement is seen in all our cases that helped them to become independent again in their daily life. Hearing aid usage pre-CI might not be important as the hearing aids may continue to cause discharging ears and the benefits of hearing aids in severe to profound hearing loss are very minimal. CONCLUSIONS Cochlear implant is safe and effective in COM patients.
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Affiliation(s)
- Bee See Goh
- Department of Otorhinolaryngology-Head & Neck Surgery, Faculty of Medicine, University Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur, Malaysia
| | - Dayaabaran Marimuthu
- Department of Otorhinolaryngology-Head & Neck Surgery, Faculty of Medicine, University Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur, Malaysia
| | - Wan Fazlina Wan Hashim
- Department of Medical Rehabilitation Sciences, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Asma Abdullah
- Department of Otorhinolaryngology-Head & Neck Surgery, Faculty of Medicine, University Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur, Malaysia
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Opperman E, le Roux T, Masenge A, Eikelboom RH. The effect of tinnitus on hearing-related quality of life outcomes in adult cochlear implant recipients. Int J Audiol 2020; 60:246-254. [PMID: 33100038 DOI: 10.1080/14992027.2020.1828633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To describe the effect of tinnitus distress on the hearing-related quality of life (QoL) outcomes over time in adult cochlear implant (CI) recipients. DESIGN A retrospective, longitudinal study of adult CI recipients was conducted. Hearing-related QoL and tinnitus distress were assessed using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Tinnitus Reaction Questionnaire (TRQ) preoperatively and at 6-months, 12-months and >24-month postoperatively. The association between tinnitus distress and hearing-related QoL outcomes over time was investigated. Furthermore, 13 potential predictive factors were identified from the retrospective dataset. Multiple regression analyses were performed to identify variables that influence hearing-related QoL outcomes over time. STUDY SAMPLE The study sample included 210 adult (≥18 years) CI recipients implanted between 2001 and 2017. RESULTS Lower tinnitus distress and younger age at implantation were significant predictors of better hearing-related QoL in adult CI recipients. A significant reduction in tinnitus distress up to two years post-implantation was found, as well as greater tinnitus distress correlating with poorer hearing-related QoL outcomes. CONCLUSION Tinnitus distress negatively affects the hearing-related QoL outcomes of adult CI recipients. Tinnitus distress and age at implantation were found to be significant predictors of hearing-related QoL when controlling for other predictive factors.
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Affiliation(s)
- Elmien Opperman
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Hatfield, South Africa
| | - Talita le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Hatfield, South Africa
| | - Andries Masenge
- Department of Statistics, University of Pretoria, Hatfield, South Africa
| | - Robert H Eikelboom
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Hatfield, South Africa.,Ear Science Institute Australia, Subiaco, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, Australia
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Andries E, Gilles A, Topsakal V, Vanderveken OM, Van de Heyning P, Van Rompaey V, Mertens G. Systematic Review of Quality of Life Assessments after Cochlear Implantation in Older Adults. Audiol Neurootol 2020; 26:61-75. [PMID: 32653882 DOI: 10.1159/000508433] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/05/2020] [Indexed: 11/19/2022] Open
Abstract
Cochlear implants (CI) have increasingly been adopted in older adults with severe to profound sensorineural hearing loss as a result of the growing and aging world population. Consequently, researchers have recently shown great interest in the cost-effectiveness of cochlear implantation and its effect on quality of life (QoL) in older CI users. Therefore, a systematic review and critical evaluation of the available literature on QoL in older adult CI users was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were selected by searching MEDLINE (PubMed) and the Cochrane Library and by checking the reference lists of relevant articles. Inclusion criteria were as follows: (1) the study sample were adults aged 50 years and older with postlingual onset of bilateral severe to profound hearing loss, (2) all subjects received a multi-electrode CI, and (3) QoL was assessed before and after implantation. Out of 1,093 records, 18 articles were accepted for review. Several studies demonstrated significant positive effects of cochlear implantation on QoL in older adults, but high-level evidence-based medicine is lacking. An improvement of QoL was generally reported when using disease-specific instruments, which are designed to detect treatment-specific changes, whereas the outcomes of generic QoL questionnaires, assessing general health states, were rather ambiguous. However, only generic questionnaires would be able to provide calculations of the cost-effectiveness of CI and comparisons across patient populations, diseases, or interventions. Hence, generic and disease-specific QoL instruments are complementary rather than contradictory. In general, older CI users' QoL was assessed using a variety of methods and instruments, which complicated comparisons between studies. There is a need for a standardized, multidimensional, and comprehensive QoL study protocol including all relevant generic and disease-specific instruments to measure and compare QoL, utility, and/or daily life performance in CI users.
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Affiliation(s)
- Ellen Andries
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium, .,Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium,
| | - Annick Gilles
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium.,Department of Education, Health and Social Work, University College Ghent (HoGent), Ghent, Belgium
| | - Vedat Topsakal
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Olivier M Vanderveken
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Paul Van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Griet Mertens
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
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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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Abstract
OBJECTIVES Functional outcomes following cochlear implantation have traditionally been focused on word and sentence recognition, which, although important, do not capture the varied communication and other experiences of adult cochlear implant (CI) users. Although the inadequacies of speech recognition to quantify CI user benefits are widely acknowledged, rarely have adult CI user outcomes been comprehensively assessed beyond these conventional measures. An important limitation in addressing this knowledge gap is that patient-reported outcome measures have not been developed and validated in adult CI patients using rigorous scientific methods. The purpose of the present study is to build on our previous work and create an item bank that can be used to develop new patient-reported outcome measures that assess CI quality of life (QOL) in the adult CI population. DESIGN An online questionnaire was made available to 500 adult CI users who represented the adult CI population and were recruited through a consortium of 20 CI centers in the United States. The questionnaire included the 101 question CIQOL item pool and additional questions related to demographics, hearing and CI history, and speech recognition scores. In accordance with the Patient-Reported Outcomes Measurement Information System, responses were psychometrically analyzed using confirmatory factor analysis and item response theory. RESULTS Of the 500 questionnaires sent, 371 (74.2%) subjects completed the questionnaire. Subjects represented the full range of age, durations of CI use, speech recognition abilities, and listening modalities of the adult CI population; subjects were implanted with each of the three CI manufacturers' devices. The initial item pool consisted of the following domain constructs: communication, emotional, entertainment, environment, independence, listening effort, and social. Through psychometric analysis, after removing locally dependent and misfitting items, all of the domains were found to have sound psychometric properties, with the exception of the independence domain. This resulted in a final CIQOL item bank of 81 items in 6 domains with good psychometric properties. CONCLUSIONS Our findings reveal that hypothesis-driven quantitative analyses result in a psychometrically sound CIQOL item bank, organized into unique domains comprised of independent items which measure the full ability range of the adult CI population. The final item bank will now be used to develop new instruments that evaluate and differentiate adult CIQOL across the patient ability spectrum.
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Bergman P, Lyxell B, Harder H, Mäki-Torkko E. The Outcome of Unilateral Cochlear Implantation in Adults: Speech Recognition, Health-Related Quality of Life and Level of Anxiety and Depression: a One- and Three-Year Follow-Up Study. Int Arch Otorhinolaryngol 2019; 24:e338-346. [PMID: 32754246 PMCID: PMC7394645 DOI: 10.1055/s-0039-3399540] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 09/24/2019] [Indexed: 12/20/2022] Open
Abstract
Introduction
Hearing impairment is a common disease worldwide, with a comprehensive impact, and cochlear implantation (CI) is an intervention for profound hearing impairment.
Objective
To study the outcome one and three years after unilateral CI on hearing, health-related quality of life and level of depression and anxiety, and the correlation between the outcomes. Second, to study whether age, gender, etiology, operated side, residual hearing or cognitive performance can predict the outcome.
Methods
A prospective longitudinal study including adults with profound postlingual hearing impairment, with respect to hearing (speech recognition), health-related quality of life (Health Utilities Index 3) and level of depression and anxiety (Hospital Anxiety and Depression scale), pre-CI, and one and three years post-CI. The total sample was composed of 40 participants (40% of men), with a mean age of 71 years.
Results
Speech recognition and the overall health-related quality of life improved one year post-CI (
p
= 0.000), without correlation (ρ= 0.27), and with no difference three years post-CI. The hearing attribute (in the health-related quality of life instrument) improved one and three years post-CI (
p
= 0.000). The level of anxiety did not change one and three years post-CI. The level of depression improved one year post-CI (
p
= 0.036), and deteriorated three years post-CI (
p
= 0.031). Age, etiology, operated side, residual hearing and cognitive performance did not predict the outcome, but the female gender did significantly improve speech recognition compared with men (
p
= 0.009).
Conclusion
The CI significantly improved speech recognition, health-related quality of life and level of depression one year post-CI without mutual correlation, and women performed significantly better than men. There were no further improvements three years post-CI, apart from the hearing attribute.
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Affiliation(s)
- Pia Bergman
- Department of Otorhinolaryngology, Jönköping County hospital, Jönköping, Sweden.,Division of Neuro and Inflammation Science, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,Department of Otorhinolaryngology in Linköping, Anaesthetics, Operations and Specialty Surgery Center, Region Östergötland, Linköping, Sweden
| | - Björn Lyxell
- Department of Special Needs Education, Oslo University, Oslo, Norway.,Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden
| | - Henrik Harder
- Department of Otorhinolaryngology in Linköping, Anaesthetics, Operations and Specialty Surgery Center, Region Östergötland, Linköping, Sweden
| | - Elina Mäki-Torkko
- Division of Neuro and Inflammation Science, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,Department of Otorhinolaryngology in Linköping, Anaesthetics, Operations and Specialty Surgery Center, Region Östergötland, Linköping, Sweden.,Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.,Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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15
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Kobosko J, Jedrzejczak WW, Gos E, Geremek-Samsonowicz A, Ludwikowski M, Skarzynski H. Self-esteem in the deaf who have become cochlear implant users as adults. PLoS One 2018; 13:e0203680. [PMID: 30204775 PMCID: PMC6133281 DOI: 10.1371/journal.pone.0203680] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 08/26/2018] [Indexed: 11/25/2022] Open
Abstract
Objective Self-esteem is a good predictor of mental health and is crucial for well-being and psychological functioning. It is especially important in situations where there are potential mental health problems, such as in people suffering from hearing loss or total deafness. This study aims to gauge the level of self-esteem in adults with hearing problems, in particular those who, in adulthood, had received a cochlear implant (CI). The subjects had different onset (pre-lingual/post-lingual) and amount (deafness/partial deafness) of hearing loss, and their current level of self-esteem was compared to that of the general population. The association of self-esteem with other deafness-related variables (e.g. satisfaction with their CI or whether they also used a hearing aid) and sociodemographic factors was also investigated. Methods Data were obtained from questionnaires mailed to patients who, when adult, had received a CI. The subjects were divided into four subgroups: subjects with pre-lingual deafness, post-lingual deafness, pre-lingual partial deafness, and post-lingual partial deafness. To evaluate their self-esteem, the Rosenberg Self-Esteem Scale (RSES) was used. For data on sociodemographic status and information related to deafness and CI, we used our own Information Inquiry form. For statistical analysis of the results, we compared means (t-test, ANOVA), investigated correlations, and applied linear regression. Results The self-esteem of deaf and partially deaf CI users was significantly lower than in the general population, especially for post-lingually deafened subjects. The only factor related to deafness and CIs that explained self-esteem was self-rated satisfaction with the CI–meaning that higher satisfaction was associated with higher self-esteem. The major sociodemographic factor that explained self-esteem was marital/partnership status (being in a relationship was helpful). Also men had higher self-esteem than women. Those with higher levels of education, and those working or studying, had higher self-esteem than those who did not. RSES was found to have a single-factor structure. Conclusion Deafness and partial deafness appear to be risk factors for lower self-esteem, a finding that rehabilitation, medical, educational, and employment communities should be made aware of. Medical intervention in the form of a CI supplies the person with improved hearing, but it is not a panacea: their self-esteem is still vulnerable, and reinforcement of self-esteem is an aspect that professionals should focus on. Psychological, psycho-educational, and psychotherapeutic interventions have important roles to play for CI recipients.
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Affiliation(s)
- Joanna Kobosko
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland
- World Hearing Center, Kajetany Nadarzyn, Poland
| | - W. Wiktor Jedrzejczak
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland
- World Hearing Center, Kajetany Nadarzyn, Poland
- * E-mail:
| | - Elżbieta Gos
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland
- World Hearing Center, Kajetany Nadarzyn, Poland
| | - Anna Geremek-Samsonowicz
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland
- World Hearing Center, Kajetany Nadarzyn, Poland
| | - Maciej Ludwikowski
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland
- World Hearing Center, Kajetany Nadarzyn, Poland
| | - Henryk Skarzynski
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland
- World Hearing Center, Kajetany Nadarzyn, Poland
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16
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Crowson MG, Semenov YR, Tucci DL, Niparko JK. Quality of Life and Cost-Effectiveness of Cochlear Implants: A Narrative Review. Audiol Neurootol 2017; 22:236-258. [PMID: 29262414 DOI: 10.1159/000481767] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 09/21/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To review evidence regarding the health-related quality of life (HRQoL) and cost-effectiveness of unilateral and bilateral cochlear implantation (CI) among children and adults with severe-to-profound hearing loss. STUDY DESIGN Narrative review. METHODS Publications related to quality of life (QoL) and costs of care in CI were acquired through searches in English-language databases. Studies were included if they had identified the HRQoL attainment, cost of care, cost-utility, or cost-effectiveness associated with CI. RESULTS 57 studies were critically reviewed. The QoL outcome metrics used in these articles were divided into 2 categories - generic and condition specific. In studies investigating children, many reported no significant difference in QoL attainment between CI recipients and normal-hearing peers. In adults, significant improvements in QoL after implantation and higher QoL than in their nonimplanted (hearing-aided) peers were frequently reported. Studies involving an older adult cohort reported significant improvement in QoL after implantation, which was often independent of audiological performance. Overall, the calculated cost-utility ratios consistently met the threshold of cost acceptance, indicating acceptable values for expenditures on CI. CONCLUSIONS Considerable work has been done on the QoL attainment and health economic implications of CI. Unilateral CI across all age groups leads to reported sustained benefits in the recipients' overall and disease-specific QoL. With increased cost associated with bilateral CI, further study is needed to characterize its costs and benefits with respect to the recipients' health, well-being, and contributions to society.
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Affiliation(s)
- Matthew G Crowson
- Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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17
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Brandão M, Rebelo C. Uma Revisão Sistemática de Instrumentos sobre Qualidade de Vida em Pessoas Idosas após Implante Coclear. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2017. [DOI: 10.1159/000477645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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18
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Sladen DP, Peterson A, Schmitt M, Olund A, Teece K, Dowling B, DeJong M, Breneman A, Beatty CW, Carlson ML, Neff BA, Hughes-Borst B, Driscoll CL. Health-related quality of life outcomes following adult cochlear implantation: A prospective cohort study. Cochlear Implants Int 2017; 18:130-135. [DOI: 10.1080/14670100.2017.1293203] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Ann Peterson
- Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA
| | - Matt Schmitt
- Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA
| | - Amy Olund
- Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA
| | - Katherine Teece
- Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA
| | | | - Melissa DeJong
- Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA
| | - Alyce Breneman
- Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Brian A. Neff
- Department of Otolaryngology, Mayo Clinic, Rochester, MN, USA
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19
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Contrera KJ, Sung YK, Betz J, Li L, Lin FR. Change in loneliness after intervention with cochlear implants or hearing aids. Laryngoscope 2017; 127:1885-1889. [PMID: 28059448 DOI: 10.1002/lary.26424] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 10/17/2016] [Accepted: 10/19/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate the impact of hearing aid (HA) and cochlear implant (CI) use on loneliness in adults. STUDY DESIGN Prospective observational cohort study. METHODS One hundred and thirteen adults, aged ≥ 50 years, with postlingual hearing loss and receiving routine clinical care at a tertiary academic medical center, were evaluated with the University of California at Los Angeles Loneliness Scale before and 6 and 12 months after intervention with HAs or CIs. Change in score was assessed using linear mixed effect models adjusted for age; gender; education; and history of hypertension, diabetes, and smoking. RESULTS Significant improvements in loneliness scores were observed in CI users from baseline to 6 months (-3.79 [95% confidence interval): -5.73, -1.85], P <.001) and baseline to 12 months (-3.26 [95% confidence interval: -5.66, -0.87], P =.007). We did not observe a significant improvement in loneliness scores in HA users from baseline to 6 months (-0.83 [95% confidence interval: -2.68, 1.02], P =.381) or baseline to 12 months (-0.34 [95% confidence interval: -2.77, -2.10], P = .007). The most substantial increases were observed in individuals with the lowest baseline scores. CONCLUSION Treatment of hearing loss with CIs results in a significant reduction in loneliness symptoms. This improvement was not observed with HAs. We observed differential effects of treatment depending on the baseline loneliness score, with the greatest improvements observed in individuals with the most loneliness symptoms at baseline. LEVEL OF EVIDENCE 2b. Laryngoscope, 127:1885-1889, 2017.
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Affiliation(s)
- Kevin J Contrera
- Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Yoon K Sung
- Drexel University College of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - Joshua Betz
- Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A
| | - Lingsheng Li
- University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, U.S.A
| | - Frank R Lin
- Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland, U.S.A.,Departments of Otolaryngology-Head & Neck Surgery, Geriatric Medicine, Mental Health and Epidemiology, Johns Hopkins University, Baltimore, Maryland, U.S.A
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20
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Angelo TCSD, Moret ALM, Costa OAD, Nascimento LT, Alvarenga KDF. Quality of life in adult cochlear implant users. Codas 2016; 28:106-12. [PMID: 27191872 DOI: 10.1590/2317-1782/20162015097] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 07/16/2015] [Indexed: 11/21/2022] Open
Abstract
Objective To evaluate the quality of life (QOL) of adult cochlear implant users (CI) and compare it with the QOL of adults with normal hearing; and study the influence of the variables socioeconomic status, education, age at assessment, auditory sensory deprivation time, device usage time and performance in auditory speech perception tests in the QOL of adult cochlear implant users. Design The QOL was assessed using the World Health Organization Quality of Life (WHOQOL-BREF) generic assessment questionnaire. Study sample Seventy adult CI users formed the experimental group (EG) and 50 adults with normal hearing formed the control group (CG). Results The EG scores were close to the maximum score in satisfactory quality of life for all domains of the WHOQOL-BREF and there were similar results between the EG and CG. The variables age at assessment, duration of auditory sensory deprivation, duration of CI use and performance in auditory speech perception did not influence the results of the QOL of adult cochlear implant users. Conclusion Evaluating the QOL should be a concern of interdisciplinary teams in CI for an intervention with humanized care.
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21
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le Roux T, Vinck B, Butler I, Louw L, Nauta L, Schlesinger D, Swanepoel DW. Predictors of health-related quality of life in adult cochlear implant recipients in South Africa. Int J Audiol 2016; 56:16-23. [DOI: 10.1080/14992027.2016.1227482] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Talita le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa,
| | - Bart Vinck
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa,
- Speech-Language Audiology Department, Ghent University, Gent, Belgium,
| | - Iain Butler
- Department of Otorhinolaryngology, University of the Free State, Bloemfontein, South Africa,
| | - Liebie Louw
- Department of Statistics, University of Pretoria, Pretoria, South Africa,
| | - Leone Nauta
- Johannesburg Cochlear Implant Program, Johannesburg, South Africa,
| | - Dani Schlesinger
- Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Soweto, South Africa,
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa,
- Ear Sciences Centre, School of Surgery, University of Western Australia, Nedlands, Australia, and
- Ear Science Institute Australia, Subiaco, Australia
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22
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Contrera KJ, Betz J, Li L, Blake CR, Sung YK, Choi JS, Lin FR. Quality of life after intervention with a cochlear implant or hearing aid. Laryngoscope 2016; 126:2110-5. [PMID: 26775283 DOI: 10.1002/lary.25848] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 11/23/2015] [Accepted: 12/01/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS To investigate the impact of hearing aid and cochlear implant use on quality of life in adults. STUDY DESIGN Prospective observational cohort study. METHODS One hundred thirteen adults aged ≥50 years with postlingual hearing loss receiving routine clinical care at a tertiary academic medical center were evaluated with the Medical Outcome Study Short Form-36 before and 6 and 12 months after intervention with hearing aids or cochlear implants. Change in score was assessed using linear mixed effect models adjusted for age, gender, education, and history of hypertension, diabetes, and smoking. RESULTS A significant increase in Mental Component Summary score was observed in both hearing aid and cochlear implant users from baseline to 12 months, with cochlear implant users increasing nearly twice that of hearing aid users (hearing aid: 2.49 [95% confidence interval: 0.11, 4.88], P = .041; cochlear implant: 4.20 [95% confidence interval: 1.85, 6.55], P < .001). The most substantial increases were observed in individuals with the lowest baseline scores. There was no significant difference in physical component summary score from baseline to 12 months. CONCLUSIONS Treatment of hearing loss with hearing aids and cochlear implants results in significant increases in mental health quality of life. The majority of the increase is observed by 6 months post-treatment, and we observed differential effects of treatment depending on the level of baseline quality of life score with the greatest gains observed in those with the lowest scores. LEVEL OF EVIDENCE 2b. Laryngoscope, 126:2110-2115, 2016.
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Affiliation(s)
- Kevin J Contrera
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Joshua Betz
- Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Lingsheng Li
- University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - Caitlin R Blake
- Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Yoon K Sung
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Janet S Choi
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Frank R Lin
- Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.,Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A.,Department of Geriatric Medicine, Johns Hopkins University, Baltimore, Maryland, U.S.A.,Department of Mental Health, Johns Hopkins University, Baltimore, Maryland, U.S.A.,Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, U.S.A
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23
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Abstract
BACKGROUND/OBJECTIVES Ménière's disease (MD) that results in bilateral severe to profound sensorineural hearing loss is a rare indication for cochlear implantation; only a few studies exist documenting performance in these patients. The primary objective was to compare the difference in preoperative to 12-month postoperative speech perception scores among subjects with MD and controls. Groupwise comparisons of secondary postoperative outcomes (Tinnitus Handicap Inventory [THI] scores, 36-Item Short Form [SF-36] scores, and postoperative dizziness) were also performed. METHODS A retrospective cohort study was conducted. Subjects with MD and controls matched by age, device manufacturer and model, preoperative sentence score, and sentence test used for preimplantation and postimplantation performance assessments were identified from 1,130 patients in the prospectively maintained cochlear implant database at our center. Speech perception, THI, and SF-36 scores and demographic variables were obtained from the database. Vestibular outcomes were obtained by retrospective chart review. Statistical comparisons were performed to compare preoperative to postoperative change between groups. RESULTS Twenty patients with MD were identified. At 1 year after CI, improvements in sentence and word understanding did not differ in magnitude from the controls. Tinnitus was reduced significantly in patients with MD, whereas there was a trend for improvement in the controls. Quality of life as measured by the SF-36 improved in both groups. Patients with MD had significant improvements in 1 domain compared with 5 domains for the controls. Subjects with MD had significantly more chronic dizziness in the postoperative period than did controls. CONCLUSIONS Patients with MD who have bilateral severe to profound sensorineural hearing loss benefit significantly from CI. Ongoing dizziness in some patients with MD may result in quality of life improvements that are slightly less than seen for the average adult patient with CI. Larger studies are needed to corroborate the results.
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24
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Capretta NR, Moberly AC. Does quality of life depend on speech recognition performance for adult cochlear implant users? Laryngoscope 2015; 126:699-706. [DOI: 10.1002/lary.25525] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 06/15/2015] [Accepted: 06/30/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Natalie R. Capretta
- Department of Otolaryngology-Head and Neck Surgery; The Ohio State University Wexner Medical Center; Columbus Ohio U.S.A
| | - Aaron C. Moberly
- Department of Otolaryngology-Head and Neck Surgery; The Ohio State University Wexner Medical Center; Columbus Ohio U.S.A
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25
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Abstract
OBJECTIVE To determine the safety, efficacy, and outcomes of cochlear implantation in patients with chronic suppurative otitis media (CSOM). STUDY DESIGN Retrospective case review. SETTING Tertiary referral center with large cochlear implant program. PATIENTS Nineteen patients with CSOM who underwent cochlear implantation were identified. Case history, timing of surgical procedures, complications, infections, and postimplant audiometric scores (Hearing in Noise Test [HINT], City University of New York Sentences [CUNY], and Central Institute for the Deaf Sentences [CID]) were evaluated. MAIN OUTCOME MEASURES Rates of postoperative infections and complications as well as postimplant auditory performance. RESULTS Twelve patients underwent a staged procedure involving canal wall down mastoidectomy or radical revision mastoidectomy with middle ear and mastoid obliteration and closure of the external auditory canal followed by cochlear implantation approximately 5 months later. Seven patients were implanted in a single procedure. There were no infections or medical complications after implantation. On average, patients had excellent audiometric scores at 1 year postimplantation (mean sentence test, 79%; SD, 14), and these scores were comparable to our general population (mean sentence test, 71%; SD, 32). CONCLUSION Cochlear implant patients with CSOM have no increased risk of postoperative infections or complications. These patients have excellent outcomes with audiometric scores comparable to the general cochlear implant population. Cochlear implantation is a safe and effective treatment for patients with profound hearing loss secondary to CSOM.
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26
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Merdad M, Wolter NE, Cushing SL, Gordon KA, Papsin BC. Surgical efficiency in bilateral cochlear implantation: A cost analysis. Cochlear Implants Int 2013; 15:43-7. [DOI: 10.1179/1754762813y.0000000042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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27
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Mistry D, Ryan J, Maessen H, Bance M. Differences in perception of hearing handicap between cochlear implant users and their spouses. Laryngoscope 2013; 124:1199-203. [PMID: 24114999 DOI: 10.1002/lary.24404] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 07/19/2013] [Accepted: 08/26/2013] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS To examine the relationship between patient and proxy ratings of health-related quality of life (HRQL) in patients with cochlear implants. STUDY DESIGN Prospective survey. METHODS Eighty-two adult cochlear implant recipients and their spouses/partners were asked to complete the Nijmegen Cochlear Implant Questionnaire (NCIQ) and the Hearing Participation Scale (HPS) that were mailed to them. RESULTS For the NCIQ, there were 38 useable responses from recipients and 31 useable responses from the partners. There were 27 paired and useable questionnaires (i.e., from both the recipient and his/her partner). For the HPS, there were 42 useable responses from recipients and 36 useable responses from the partners. Of these, there were 35 paired questionnaires. There was good agreement between partners and patients with both the HPS (r = 0.62) and the NCIQ (r = 0.80). There was a significant statistical difference in the scoring of the Basic Sound Perception subscale between the two groups (P = .039), with spouses under-rating performance in this subscale. CONCLUSIONS For patients with cochlear implants, patients' partners corroborate patients' self-reported HRQL. In cases in which patients have sensory impairment, there may be an additional role for proxy ratings of HRQL to give a more complete assessment of functional limitations.
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Affiliation(s)
- Dipan Mistry
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia
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28
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Arnoldner C, Lin VY, Honeder C, Shipp D, Nedzelski J, Chen J. Ten‐year health‐related quality of life in cochlear implant recipients. Laryngoscope 2013; 124:278-82. [DOI: 10.1002/lary.24387] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 06/19/2013] [Accepted: 08/09/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Christoph Arnoldner
- Department of Otolaryngology–Head & Neck Surgery, Sunnybrook Health Sciences CentreUniversity of TorontoToronto Ontario Canada
| | - Vincent Y. Lin
- Department of Otolaryngology–Head & Neck Surgery, Sunnybrook Health Sciences CentreUniversity of TorontoToronto Ontario Canada
| | - Clemens Honeder
- Department of Otolaryngology–Head & Neck SurgeryMedical University of ViennaVienna Austria
| | - David Shipp
- Department of Otolaryngology–Head & Neck Surgery, Sunnybrook Health Sciences CentreUniversity of TorontoToronto Ontario Canada
| | - Julian Nedzelski
- Department of Otolaryngology–Head & Neck Surgery, Sunnybrook Health Sciences CentreUniversity of TorontoToronto Ontario Canada
| | - Joseph Chen
- Department of Otolaryngology–Head & Neck Surgery, Sunnybrook Health Sciences CentreUniversity of TorontoToronto Ontario Canada
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29
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de Carvalho GM, Guimarães AC, Danieli F, Onuki LCB, Paschoal JR, Bianchini WA, Castilho AM. Evaluation of the Digisonic® SP cochlear implant: patient outcomes and fixation system with titanium screws. Braz J Otorhinolaryngol 2012; 78:56-62. [PMID: 23306569 PMCID: PMC9446367 DOI: 10.5935/1808-8694.20120034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 10/02/2012] [Indexed: 11/20/2022] Open
Abstract
Cochlear implants have revolutionized the way patients affected by severe hearing loss experience the world. Neurelec developed a fixation system with two titanium screws that requires no skull bone drilling. Objective To describe the outcomes and procedure-related details of a series of patients implanted with the Digisonic® SP cochlear implant. Method This retrospective study analyzed patients submitted to cochlear implant placement within a period of 18 months. All patients had postlingual hearing impairment. Data was collected from patient charts and standard questionnaires answered by the surgeons in charge of carrying out the procedures. Results The six patients offered the Digisonic® SP cochlear implants were operated by experienced surgeons. The procedures took 95 to 203 minutes (mean = 135') to be completed, which is less time than what has been described for other fixation approaches. No complications were recorded and hearing improvement was satisfactory. Conclusion The Digisonic® SP cochlear implant developed by Neurelec offered good audiological results for adult patients, shorter surgery time, and no surgical or postoperative complications.
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Affiliation(s)
- Guilherme Machado de Carvalho
- MSc in Medicine, MD, ENT (Fellow in Otology. UNICAMP)
- Send correspondence to: Dr. Guilherme Machado de Carvalho. Disciplina de Otorrinolaringologia - UNICAMP. Faculdade de Ciências Médicas. Universidade de Campinas - UNICAMP. Campinas - SP. Brasil. CEP: 13083-970. Caixa Postal: 6111. Tel: +55 (19) 3521-7523. Fax: +55 (19) 3521-7563
| | | | | | | | | | - Walter Adriano Bianchini
- MSc in Medicine. MD, ENT. (Head and Coordinator of the Otology, Audiology, Cochlear Implant, and Implantable Hearing Aid Service. UNICAMP)
| | - Arthur Menino Castilho
- MD, PhD, ENT. (Head and Coordinator of the Otology, Audiology, Cochlear Implant, and Implantable Hearing Aid Service. UNICAMP)
- Otology, Audiology and Implantable Ear Prostheses Ear, Nose, Throat and Head & Neck Surgery Department
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