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Myhrum M, Heldahl MG, Rødvik AK, Tvete OE, Jablonski GE. Validation of the Norwegian Version of the Speech, Spatial and Qualities of Hearing Scale (SSQ). Audiol Neurootol 2023; 29:124-135. [PMID: 37918367 PMCID: PMC10994583 DOI: 10.1159/000534197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 09/06/2023] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION The main objective of the study was to validate the Norwegian translation of the Speech, Spatial and Qualities of Hearing Scale (SSQ) and investigate the SSQ disability profiles in a cochlear implant (CI) user population. METHODS The study involved 152 adult CI users. The mean age at implantation was 55 (standard deviation [SD] = 16), and the mean CI experience was 5 years (SD = 4.8). The cohort was split into three groups depending on the hearing modality: bilateral CIs (BCIs), a unilateral CI (UCI), and bimodal (CI plus contralateral hearing aid; HCI). The SSQ disability profiles of each group were compared with those observed in similar studies using the English version and other translations of the SSQ. Standard values, internal consistency, sensitivity, and floor and ceiling effects were investigated, and the missing-response rates to specific questions were calculated. Relationships to speech perception were measured using monosyllabic word scores and the Norwegian Hearing in Noise Test scores. RESULTS In the BCI group, the average scores were around 5.0 for the speech and spatial sections and 7.0 for the qualities section (SD ∼2). The average scores of the UCI and HCI groups were about one point lower than those of the BCI group. The SSQ disability profiles were comparable to the profiles in similar studies. The slopes of the linear regression lines measuring the relationships between the SSQ speech and monosyllabic word scores were 0.8 per 10% increase in the monosyllabic word score for the BCI group (explaining 35% of the variation) and 0.4 for the UCI and HCI groups (explaining 22-23% of the variation). CONCLUSION The Norwegian version of the SSQ measures hearing disability similar to the original English version, and the internal consistency is good. Differences in the recipients' pre-implantation variables could explain some variations we observed in the SSQ responses, and such predictors should be investigated. Data aggregation will be possible using the SSQ as a routine clinical assessment in global CI populations. Moreover, pre-implantation variables should be systematically registered so that they can be used in mixed-effects models.
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Affiliation(s)
- Marte Myhrum
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mariann Gjervik Heldahl
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Arne Kirkhorn Rødvik
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Ole Edvard Tvete
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Greg Eigner Jablonski
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Dourado RPB, Caldas FF, Cardoso CC, Santos DCD, Bahmad F. Benefits of Bimodal Stimulation to Speech Perception in Noise and Silence. Int Arch Otorhinolaryngol 2023; 27:e645-e653. [PMID: 37876694 PMCID: PMC10593532 DOI: 10.1055/s-0043-1761169] [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: 07/25/2022] [Accepted: 09/26/2022] [Indexed: 10/26/2023] Open
Abstract
Introduction Understanding all the benefits of bimodality with self-assessment questionnaires on the effect of hearing on quality of life is still necessary. Objective To present whether bimodality still offers hearing benefits to the population who uses acoustic stimulation associated with electrical stimulation. Methods The present study included 13 participants aged between 16 and 80 years old who were users of cochlear implants from Cochlear Corporation and hearing aids. All patients underwent the Hearing in Noise Test, and their visual analog scale score was obtained. Four-tone means were collected, and the participants answered the Speech, Spatial and Hearing Qualities questionnaire. Results Bimodal users had an average sentence recognition rate of 76.0% in silence and 67.6% in fixed noise, and the signal-to-noise ratio in adaptive noise was +2.89dB. In addition, a lower level of difficulty was observed in the test using the visual analog scale. The domain with the highest average was auditory qualities (6.50), followed by spatial hearing (6.26) and hearing for speech (5.81). Individuals with an average between 50 and 70 dB of hearing level showed better sentence recognition in silence and noise. Conclusion Bimodal stimulation showed benefits for users with different degrees of hearing loss; however, individuals who presented greater hearing residue had better performance in speech recognition with noise and in silence in addition to a good perception of hearing quality.
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Affiliation(s)
- Rayssa Pacheco Brito Dourado
- Health Sciences Postgraduate Program in Ciências da Saúde, Campus Universitário Darcy Ribeiro, Universidade de Brasília, Brasília, DF, Brazil
| | | | | | - Danielle Cristovão dos Santos
- Faculdade de Ciências da Saúde, Universidade de Brasília, Brasilia, DF, Brazil
- Centro de Reabilitação da Audição e Fala, Instituto Brasiliense de Otorrino, Asa Norte, Brasília, DF, Brazil
| | - Fayez Bahmad
- Health Science School, Universidade de Brasilia, Brasilia, DF, Brazil
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Houmøller SS, Wolff A, Tsai LT, Narayanan SK, Hougaard DD, Gaihede ML, Neher T, Godballe C, Schmidt JH. Impact of hearing aid technology level at first-fit on self-reported outcomes in patients with presbycusis: a randomized controlled trial. FRONTIERS IN AGING 2023; 4:1158272. [PMID: 37342862 PMCID: PMC10277865 DOI: 10.3389/fragi.2023.1158272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/22/2023] [Indexed: 06/23/2023]
Abstract
To provide clinical guidance in hearing aid prescription for older adults with presbycusis, we investigated differences in self-reported hearing abilities and hearing aid effectiveness for premium or basic hearing aid users. Secondly, as an explorative analysis, we investigated if differences in gain prescription verified with real-ear measurements explain differences in self-reported outcomes. The study was designed as a randomized controlled trial in which the patients were blinded towards the purpose of the study. In total, 190 first-time hearing aid users (>60 years of age) with symmetric bilateral presbycusis were fitted with either a premium or basic hearing aid. The randomization was stratified on age, sex, and word recognition score. Two outcome questionnaires were distributed: the International Outcome Inventory for Hearing Aids (IOI-HA) and the short form of the Speech, Spatial, and Qualities of Hearing Scale (SSQ-12). In addition, insertion gains were calculated from real-ear measurements at first-fit for all fitted hearing aids. Premium hearing aid users reported 0.7 (95%CI: 0.2; 1.1) scale points higher total SSQ-12 score per item and 0.8 (95%CI: 0.2; 1.4) scale points higher speech score per item, as well as 0.6 (95%CI: 0.2; 1.1) scale points higher qualities score compared to basic-feature hearing aid users. No significant differences in reported hearing aid effectiveness were found using the IOI-HA. Differences in the prescribed gain at 1 and 2 kHz were observed between premium and basic hearing aids within each company. Premium-feature devices yielded slightly better self-reported hearing abilities than basic-feature devices, but a statistically significant difference was only found in three out of seven outcome variables, and the effect was small. The generalizability of the study is limited to community-dwelling older adults with presbycusis. Thus, further research is needed for understanding the potential effects of hearing aid technology for other populations. Hearing care providers should continue to insist on research to support the choice of more costly premium technologies when prescribing hearing aids for older adults with presbycusis. Clinical Trial Registration: https://register.clinicaltrials.gov/, identifier NCT04539847.
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Affiliation(s)
- Sabina Storbjerg Houmøller
- Research Unit for ORL—Head and Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Anne Wolff
- Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
| | - Li-Tang Tsai
- Research Unit for ORL—Head and Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | | | - Dan Dupont Hougaard
- Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Michael Lyhne Gaihede
- Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Tobias Neher
- Research Unit for ORL—Head and Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Christian Godballe
- Research Unit for ORL—Head and Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Jesper Hvass Schmidt
- Research Unit for ORL—Head and Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
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Nijmeijer HGB, Groenewoud HMM, Mylanus EAM, Goedegebure A, Huinck WJ, van der Wilt GJ. Impact of Expanding Eligibility Criteria for Cochlear Implantation - Dynamic Modeling Study. Laryngoscope 2023; 133:924-932. [PMID: 35792007 DOI: 10.1002/lary.30270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Eligibility criteria for cochlear implantation (CI) are shifting due to technological and surgical improvements. The aim of this study was to explore the impact of further expanding unilateral CI criteria in those with severe hearing loss (HL) (61-80 dBHL) in terms of number of CI recipients, costs, quality of life, and cost-effectiveness. METHODS A dynamic population-based Markov model was constructed mimicking the Dutch population in three age categories over a period of 20 years. Health states included severe HL (61-80 dBHL), profound HL (>81 dBHL), CI recipients, and no-CI recipients. Model parameters were based on published literature, (national) databases, expert opinion, and model calibration. RESULTS If persons with severe HL would qualify and opt for CI similar to those with profound HL now, this would lead to a 6-7 times increase of new CI recipients and an associated increase in costs (€550 million) and QALYs (54.000) over a 20-year period (incremental cost utility ratio: 10.771 euros/QALY [2.5-97.5 percentiles: 1.252-23.171]). One-way-sensitivity analysis indicated that model outcomes were most sensitive to regaining employment, utility associated with having a CI, and costs of surgery and testing. CONCLUSION Our findings suggest that expanding eligibility for CI to persons with severe HL could be a cost-effective use of resources. Clearly, however, it would require a significant increase in diagnostic, operative, and rehabilitative capacity. Our quantitative estimates can serve as a basis for a wider societal deliberation on the question whether such an increase can and should be pursued. LEVEL OF EVIDENCE NA Laryngoscope, 133:924-932, 2023.
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Affiliation(s)
- Hugo G B Nijmeijer
- Department of Otorhinolaryngology, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Hans M M Groenewoud
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Emmanuel A M Mylanus
- Department of Otorhinolaryngology, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Wendy J Huinck
- Department of Otorhinolaryngology, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Gert Jan van der Wilt
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
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Dixon PR, Shapiro J, Tomlinson G, Cottrell J, Lui JT, Falk L, Chen JM. Health State Utility Values Associated with Cochlear Implants in Adults: A Systematic Review and Network Meta-Analysis. Ear Hear 2023; 44:244-253. [PMID: 36303282 DOI: 10.1097/aud.0000000000001287] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The cost-effectiveness of bilateral cochlear implants in adults remains uncertain despite established clinical benefits. In cost-effectiveness studies, benefit is often measured by change in health state utility value (HSUV), a single number summary of health-related quality of life anchored at 0 (state of being dead) and 1 (perfect health). Small differences in bilateral cochlear implant HSUV change conclusions of published models, and invalid estimates can therefore mislead policy and funding decisions. As such, we aimed to review and synthesize published HSUV estimates associated with cochlear implants. DESIGN We included observational or experimental studies reporting HSUV for adult patients (age ≥18 years) with at least moderate-profound sensorineural hearing loss in both ears who received unilateral or bilateral cochlear implants. We searched MEDLINE, EMBASE, PsycINFO, and Cochrane Library databases up to May 1, 2021. Study and participant characteristics and HSUV outcomes were extracted. Narrative synthesis is reported for all studies. A Bayesian network meta-analysis was conducted to generate pooled estimates for the mean difference in HSUV for three comparisons: (1) unilateral cochlear implant versus preimplant, (2) bilateral cochlear implants versus preimplant, (3) bilateral versus unilateral cochlear implants. Our principal measure was pooled mean difference in HSUV. RESULTS Thirty-six studies reporting unique patient cohorts were identified. Health Utilities Index, 3 (HUI-3) was the most common HSUV elicitation method. HSUV from 19 preimplant mean estimates (1402 patients), 19 unilateral cochlear implant mean estimates (1701 patients), and 5 bilateral cochlear implants mean estimates (83 patients) were pooled to estimate mean differences in HUI-3 HSUV by network meta-analysis. Compared with preimplant, a unilateral cochlear implant was associated with a mean change in HSUV of +0.17 (95% credible interval [CrI] +0.12 to +0.23) and bilateral cochlear implants were associated with a mean change of +0.25 (95% CrI +0.12 to +0.37). No significant difference in HSUV was detected for bilateral compared with unilateral cochlear implants (+0.08 [95% CrI -0.06 to +0.21]). Overall study quality was moderate. CONCLUSIONS The findings of this review and network meta-analysis comprise the best-available resource for parameterization of cost-utility models of cochlear implantation in adults and highlight the need to critically evaluate the validity of available HSUV instruments for bilateral cochlear implant populations.Protocol registration: PROSPERO (CRD42018091838).
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Affiliation(s)
- Peter R Dixon
- Department of Otolaryngology-Head & Neck Surgery, University of California San Diego, San Diego, California
| | - Justin Shapiro
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Canada
- Temerty Faculty of Medicine, University of Toronto
| | - George Tomlinson
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Canada
- Toronto Health Economics and Technology Assessment Collaborative, Toronto, Canada
| | - Justin Cottrell
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, Canada
| | - Justin T Lui
- Section of Otolaryngology-Head & Neck Surgery, Department of Surgery, University of Calgary, Calgary, Canada
| | - Lindsey Falk
- Evidence, Development and Standards, Health Quality Ontario
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada
| | - Joseph M Chen
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, Canada
- Department of Otolaryngology-Head & Neck Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada
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Borre ED, Kaalund K, Frisco N, Zhang G, Ayer A, Kelly-Hedrick M, Reed SD, Emmett SD, Francis H, Tucci DL, Wilson BS, Kosinski AS, Ogbuoji O, Sanders Schmidler GD. The Impact of Hearing Loss and Its Treatment on Health-Related Quality of Life Utility: a Systematic Review with Meta-analysis. J Gen Intern Med 2023; 38:456-479. [PMID: 36385406 PMCID: PMC9905346 DOI: 10.1007/s11606-022-07795-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Hearing loss significantly impacts health-related quality of life (QoL), yet the effects of current treatments on QoL utility remain uncertain. Our objective was to describe the impact of untreated and treated hearing loss on QoL utility to inform hearing healthcare policy. METHODS We searched databases for articles published through 02/01/2021. Two independent reviewers screened for articles that reported elicitation of general QoL utility values for untreated and treated hearing loss health states. We extracted data and quality indicators from 62 studies that met the inclusion criteria. RESULTS Included studies predominately used observational pre/post designs (61%), evaluated unilateral cochlear implantation (65%), administered the Health Utilities Index 3 (HUI3; 71%), and were conducted in Europe and North America (84%). In general, treatment of hearing loss improved post-treatment QoL utility when measured by most methods except the Euro-QoL 5 dimension (EQ-5D). In meta-analysis, hearing aids for adult mild-to-moderate hearing loss compared to no treatment significantly improved HUI3-estimated QoL utility (3 studies; mean change=0.11; 95% confidence interval (CI): 0.07 to 0.14) but did not impact EQ-5D-estimated QoL (3 studies; mean change=0.0; 95% CI: -0.03 to 0.04). Cochlear implants improved adult QoL utility 1-year post-implantation when measured by the HUI3 (7 studies; mean change=0.17; 95% CI: 0.11 to 0.23); however, pediatric VAS-estimated QoL utility was non-significant (4 studies; mean change=0.12; 95% CI: -0.02 to 0.25). The quality of included studies was limited by failure to report missingness of data and low survey response rates. Our study was limited by heterogeneous study populations and designs. FINDINGS Treatment of hearing loss significantly improves QoL utility, and the HUI3 and VAS were most sensitive to improvements in hearing. Improved access to hearing healthcare should be prioritized. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: CRD42021253314.
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Affiliation(s)
- Ethan D Borre
- Department of Medicine, Duke University School of Medicine, 100 Fuqua Drive, Box 90120, Durham, NC, 27708, USA
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Kamaria Kaalund
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA
| | - Nicholas Frisco
- Department of Medicine, Duke University School of Medicine, 100 Fuqua Drive, Box 90120, Durham, NC, 27708, USA
| | - Gloria Zhang
- Department of Medicine, Duke University School of Medicine, 100 Fuqua Drive, Box 90120, Durham, NC, 27708, USA
| | - Austin Ayer
- Department of Medicine, Duke University School of Medicine, 100 Fuqua Drive, Box 90120, Durham, NC, 27708, USA
| | - Margot Kelly-Hedrick
- Department of Medicine, Duke University School of Medicine, 100 Fuqua Drive, Box 90120, Durham, NC, 27708, USA
| | - Shelby D Reed
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke University Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - Susan D Emmett
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Howard Francis
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Debara L Tucci
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Blake S Wilson
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA
- Department of Electrical & Computer Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA
| | - Andrzej S Kosinski
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Osondu Ogbuoji
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, USA
| | - Gillian D Sanders Schmidler
- Department of Medicine, Duke University School of Medicine, 100 Fuqua Drive, Box 90120, Durham, NC, 27708, USA.
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA.
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
- Duke University Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
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Távora-Vieira D, Wedekind A. Single-Sided Deafness: Emotional and Social Handicap, Impact on Health Status and Quality of Life, Functional Hearing, and the Effects of Cochlear Implantation. Otol Neurotol 2022; 43:1116-1124. [PMID: 36351222 DOI: 10.1097/mao.0000000000003725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To evaluate the functional and subjective outcomes in individuals with single-sided deafness (SSD) treated with a cochlear implant (CI). METHODS Eighty-one adult CI users with SSD participated in this study. Functional assessments consisted of speech in noise testing and localization. Subjective assessments consisted of the Speech Spatial Quality of Hearing Scale, the Tinnitus Reaction Questionnaire, the Abbreviated Profile of Hearing Aid Benefit questionnaire, the Hearing Handicap Inventory for Adults questionnaire, and the Glasgow Health Status Inventory and the Glasgow Benefit Inventory questionnaires. RESULTS SSD has remarkable consequences on quality of life (QoL) and imposes a substantial emotional and social handicap on the individuals. Self-reported QoL improved after CI with tinnitus intrusion significantly reduced as early as 3 months post-CI. A significant improvement was seen in all speech understanding in noise configurations. Localization ability significantly improved with CI on. CONCLUSION Our findings demonstrate that SSD reduces social and psychological QoL and imposes a remarkable level of handicap as per general and specific self-assessments tool. CI provided a significant improvement in function including speech understanding in noise and localization ability, as well as improved QoL and reduced tinnitus significantly in both the early and long terms.
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Craddock LC, Hodson J, Gosling A, Cooper S, Morse RP, Begg P, Prokopiou A, Irving RM. Comparison of an Implantable Middle Ear Microphone and Conventional External Microphone for Cochlear Implants: A Clinical Feasibility Study. Otol Neurotol 2022; 43:1162-1169. [PMID: 36240742 PMCID: PMC7613807 DOI: 10.1097/mao.0000000000003713] [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
OBJECTIVES All commercially available cochlear implant (CI) systems use an external microphone and sound processor; however, external equipment carries lifestyle limitations. Although totally implantable devices using subcutaneous microphones have been developed, these are compromised by problems with soft tissue sound attenuation, feedback, and intrusive body noise. This in vivo pilot study evaluates a middle ear microphone (MEM) that aims to overcome these issues and compares hearing performance with that of an external CI microphone. DESIGN Six adult participants with an existing CI were implanted with a temporary MEM in the contralateral ear. Signals from the MEM were routed via a percutaneous plug and cable to the CI sound processor. Testing was performed in the CI microphone and MEM conditions using a range of audiometric assessments, which were repeated across four visits. RESULTS Performance of the MEM did not differ significantly from that of the CI on the assessments of Auditory Speech Sounds Evaluation loudness scaling at either 250 or 1000 Hz, or in the accuracy of repeating keywords presented at 70 dB. However, the MEM had significantly poorer aided sound-field thresholds, particularly at higher frequencies (≥4000 Hz), and significantly poorer performance on Arthur Boothroyd words presented at 55 dB, compared with the CI. CONCLUSION In this pilot study, the MEM showed comparable performance to that of an external CI microphone across some audiometric assessments. However, performance with the MEM was poorer than the CI in soft-level speech (55 dB) and at higher frequencies. As such, the benefits of MEM need to be considered against the compromises in hearing performance. However, with future development, MEM is a potentially promising technology.
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Affiliation(s)
| | - James Hodson
- University Hospitals Birmingham NHS Foundation Trust, UK
- Health Data Science Team, Research Development and Innovation, Institute for Translational Medicine, University Hospitals Birmingham NHS Foundation Trust
| | - Amy Gosling
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - Stacey Cooper
- University Hospitals Birmingham NHS Foundation Trust, UK
| | | | - Philip Begg
- University Hospitals Birmingham NHS Foundation Trust, UK
- University of Kentucky, USA
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9
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Assouly KKS, Arts RAGJ, Graham PL, van Dijk B, James CJ. Influence of tinnitus annoyance on hearing-related quality of life in cochlear implant recipients. Sci Rep 2022; 12:14423. [PMID: 36002556 PMCID: PMC9402917 DOI: 10.1038/s41598-022-18823-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/19/2022] [Indexed: 01/10/2023] Open
Abstract
Tinnitus is a common symptom in cochlear implant (CI) recipients. There is no clear evidence of the influence of tinnitus on hearing-related quality of life (QoL) in this population. The aim of this study was to assess the relationship between hearing-related QoL measured by the Speech, Spatial and Qualities of Hearing scale (SSQ12) and tinnitus annoyance or perceived change in tinnitus annoyance after cochlear implantation. The study sample consisted of 2322 implanted adults across France, Germany, Ireland, Italy, the Netherlands, Sweden and the United Kingdom. Information relating to QoL measured using the SSQ12 and tinnitus annoyance and change in tinnitus annoyance, assessed using single-item questions, were collected one or more years post-implantation. The relationship between SSQ12 score and tinnitus annoyance or change in tinnitus annoyance was analysed using linear models adjusted for age and unilateral versus bilateral implants. Tukey pairwise tests were used to compare mean SSQ12 scores across levels of tinnitus annoyance and changes. Tinnitus prevalence was 33.9% post-implantation. Recipients with tinnitus had a significantly lower SSQ12 score than recipients without tinnitus. SSQ scores varied significantly with tinnitus annoyance, age and unilateral versus bilateral implants. Overall, CI recipients who experienced less bothersome tinnitus reported better hearing-related QoL. Healthcare professionals should be aware of the influence of tinnitus on CI recipients’ hearing to manage patient expectations.
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Affiliation(s)
- Kelly K S Assouly
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. .,University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands. .,Cochlear Technology Centre Belgium, Mechelen, Belgium.
| | | | - Petra L Graham
- School of Mathematical and Physical Sciences, Macquarie University, North Ryde, NSW, Australia
| | - Bas van Dijk
- Cochlear Technology Centre Belgium, Mechelen, Belgium
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Cutler H, Gumbie M, Olin E, Parkinson B, Bowman R, Quadri H, Mann T. The cost-effectiveness of unilateral cochlear implants in UK adults. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:763-779. [PMID: 34727294 PMCID: PMC9170662 DOI: 10.1007/s10198-021-01393-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 10/21/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The National Institute for Health and Care Excellence (NICE) updated its eligibility criteria for unilateral cochlear implants (UCIs) in 2019. NICE claimed this would not impact the cost-effectiveness results used within its 2009 technology appraisal guidance. This claim is uncertain given changed clinical practice and increased healthcare unit costs. Our objective was to estimate the cost-effectiveness estimates of UCIs in UK adults with severe to profound hearing loss within the contemporary NHS environment. METHODS A cost-utility analysis employing a Markov model was undertaken to compare UCIs with hearing aids or no hearing aids for people with severe to profound hearing loss. A clinical pathway was developed to estimate resource use. Health-related quality of life, potential adverse events, device upgrades and device failure were captured. Unit costs were derived mostly from the NHS data. Probabilistic sensitivity analysis further assessed the effect of uncertain model inputs. RESULTS A UCI is likely to be deemed cost-effective when compared to a hearing aid (£11,946/QALY) or no hearing aid (£10,499/QALY). A UCI has an 93.0% and 98.7% likelihood of being cost-effective within the UK adult population when compared to a hearing aid or no hearing aid, respectively. ICERs were mostly sensitive to the proportion of people eligible for cochlear implant, discount rate, surgery and device costs and processor upgrade cost. CONCLUSION UCIs remain cost-effective despite changes to clinical practice and increased healthcare unit costs. Updating the NICE criteria to provide better access UCIs is projected to increase annual implants in adults and children by 70% and expenditure by £28.6 million within three years. This increased access to UCIs will further improve quality of life of recipients and overall social welfare.
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Affiliation(s)
- Henry Cutler
- Macquarie University Centre for the Health Economy, Sydney, Australia.
| | - Mutsa Gumbie
- Macquarie University Centre for the Health Economy, Sydney, Australia
| | - Emma Olin
- Macquarie University Centre for the Health Economy, Sydney, Australia
| | - Bonny Parkinson
- Macquarie University Centre for the Health Economy, Sydney, Australia
| | - Ross Bowman
- Health Technology Analysts, Sydney, Australia
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Cochlear Implantation Improves Both Speech Perception and Patient-Reported Outcomes: A Prospective Follow-Up Study of Treatment Benefits among Adult Cochlear Implant Recipients. J Clin Med 2022; 11:jcm11082257. [PMID: 35456353 PMCID: PMC9032498 DOI: 10.3390/jcm11082257] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/14/2022] [Indexed: 01/27/2023] Open
Abstract
Cochlear implantation is considered the best treatment option for patients with severe-to-profound sensorineural hearing loss for whom conventional hearing aids are insufficient. We used a repeated measures longitudinal approach to evaluate speech recognition and patient-reported outcomes after cochlear implantation in an unbiased cohort of Danish adult patients in a prospective cohort study. We assessed 39 recipients before and two times after implantation using a battery of tests that included Dantale I, the Danish Hearing in Noise Test, the Nijmegen Cochlear Implant Questionnaire, and the Speech, Spatial, and Qualities of Hearing Scale. The study group improved significantly on all outcome measures following implantation. On average, Dantale I scores improved by 29 percentage points and Hearing in Noise Test scores improved by 22 percentage points. Most notably, the average Dantale score improved from 26 to 70% in the CI in quiet condition and from 12 to 42% in the cochlear implantation in noise condition when tested monaurally. Dantale demonstrated a significant positive correlation with Nijmegen Cochlear Implant Questionnaire and Speech, Spatial, and Qualities of Hearing Scale scores, while Hearing in Noise Test had no significant correlation with the patient-reported outcome measures. Patients improved significantly at 4 months and marginally improved further at 14 months, indicating that they were approaching a plateau. Our study’s use of audiometric and patient-reported outcome measures provides evidence of the treatment benefits of cochlear implantation in adults, which may help physicians advise patients on treatment decisions and align treatment benefit expectations, as well as serve as a foundation for the development of new cochlear implantation selection criteria.
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12
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Mauch H, Kaur J, Irwin C, Wyss J. Design, implementation, and management of an international medical device registry. Trials 2021; 22:845. [PMID: 34823566 PMCID: PMC8613936 DOI: 10.1186/s13063-021-05821-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Registries are powerful clinical investigational tools. Although in hospitals registries may be mandated, industry-sponsored, international registries are voluntary and therefore can require clearer objectives and more planning. The registry also needs sufficient resources and appropriate measurement tools to motivate long-term participation and ensure success. METHODS We summarize our learnings from 10 years of running a medical device registry that surveys patient-reported benefits of hearing implants. RESULTS We enlisted 77 participating clinics globally, who actively recruited a total of more than 1500 hearing implant users. We identified the stages in developing a registry specific to hearing loss. Furthermore, we report the challenges and successes in design and implementation and make recommendations for future registries. CONCLUSIONS Data collection infrastructure needs to be kept up to date throughout the defined registry lifetime, and it is essential to oversee data quality and completeness. Compliance at registry sites is important for data quality and needs to be weighed against the cost of site monitoring. To motivate sites to enter data accurately and expeditiously, we facilitated easy access to their own data which helped to support their clinical routine. TRIAL REGISTRATION ClinicalTrials.gov NCT02004353. 9th December 2013.
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13
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Dreyfuss M, Giat Y, Veraguth D, Röösli C, Huber AM, Laske RD. Cost Effectiveness of Cochlear Implantation in Single-Sided Deafness. Otol Neurotol 2021; 42:1129-1135. [PMID: 34191788 DOI: 10.1097/mao.0000000000003135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To analyze the cost effectiveness of cochlear implantation (CI) for the treatment of single-sided deafness (SSD). STUDY DESIGN Cost-utility analysis in an adapted Markov model. SETTING Adults with single-sided deafness in a high-income country. INTERVENTION Unilateral CI was compared with no intervention. MAIN OUTCOME MEASURE Incremental cost-effectiveness ratios were compared with different cost-effectiveness thresholds ($10,000 to $150,000) for different age, sex, and cost combinations. The calculations were based on the quality-adjusted life year (QALY), national life expectancy tables, and different cost settings. The health utility values for the QALY were either directly collected from published data, or, derived from published data using a regression model of multiple utility indices (regression estimate). RESULTS The regression estimate showed an increase of the health utility value from 0.62 to 0.74 for SSD patients who underwent CI. CI for SSD was cost effective for women up to 64 years ($50,000 per-QALY threshold), 80 years ($100,000 per-QALY threshold), and 86 years ($150,000 per-QALY threshold). For men, these values were 58, 77, and 84, respectively. Changing the discount rate by up to 5% further increased the cutoff ages up to 5 years. A detailed cost and age sensitivity analysis is presented and allows testing for cost effectiveness in local settings worldwide. CONCLUSIONS CI is a cost-effective option to treat patients with SSD.
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Affiliation(s)
- Michael Dreyfuss
- Department of Industrial Engineering and Management, Jerusalem College of Technology, Jerusalem, Israel
| | - Yahel Giat
- Department of Industrial Engineering and Management, Jerusalem College of Technology, Jerusalem, Israel
| | - Dorothe Veraguth
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
| | - Christof Röösli
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
| | - Alexander M Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
| | - Roman D Laske
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
- HNO Wiedikon, Zurich, Switzerland
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14
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The impact of cochlear implantation on health-related quality of life in older adults, measured with the Health Utilities Index Mark 2 and Mark 3. Eur Arch Otorhinolaryngol 2021; 279:739-750. [PMID: 33683447 DOI: 10.1007/s00405-021-06727-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/25/2021] [Indexed: 01/09/2023]
Abstract
PURPOSE To determine the usefulness of the Health Utilities Index (HUI) in older cochlear implant (CI) recipients, the primary aims were: (1) to assess health-related quality of life (HRQoL), measured with HUI, in older CI candidates while comparing with age- and gender-matched normal-hearing controls; (2) to compare HRQoL after CI with the pre-operative situation, using HUI and the Nijmegen cochlear implant questionnaire (NCIQ). The difference between pre- and postoperative speech intelligibility in noise (SPIN) and in quiet (SPIQ) and the influence of pre-operative vestibular function on HRQoL in CI users were also studied. METHODS Twenty CI users aged 55 years and older with bilateral severe-to-profound postlingual sensorineural hearing loss and an age- and gender-matched normal-hearing control group were included. HRQoL was assessed with HUI Mark 2 (HUI2), HUI Mark 3 (HUI3) and NCIQ. The CI recipients were evaluated pre-operatively and 12 months postoperatively. RESULTS HUI3 Hearing (p = 0.02), SPIQ (p < 0.001), SPIN (p < 0.001) and NCIQ (p = 0.001) scores improved significantly comparing pre- and postoperative measurements in the CI group. No significant improvement was found comparing pre- and postoperative HUI3 Multi-Attribute scores (p = 0.07). The HUI3 Multi-Attribute score after CI remained significantly worse (p < 0.001) than those of the control group. Vestibular loss was significantly related to a decrease in HUI3 Multi-Attribute (p = 0.037) and HUI3 Emotion (p = 0.021) scores. CONCLUSION The HUI is suitable to detect differences between normal-hearing controls and CI users, but might underestimate HRQoL changes after CI in CI users over 55.
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James CJ, Graham PL, Betances Reinoso FA, Breuning SN, Durko M, Huarte Irujo A, Royo López J, Müller L, Perenyi A, Jaramillo Saffon R, Salinas Garcia S, Schüssler M, Schwarz Langer MJ, Skarzynski PH, Mecklenburg DJ. The Listening Network and Cochlear Implant Benefits in Hearing-Impaired Adults. Front Aging Neurosci 2021; 13:589296. [PMID: 33716706 PMCID: PMC7947658 DOI: 10.3389/fnagi.2021.589296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/28/2021] [Indexed: 01/10/2023] Open
Abstract
Older adults with mild or no hearing loss make more errors and expend more effort listening to speech. Cochlear implants (CI) restore hearing to deaf patients but with limited fidelity. We hypothesized that patient-reported hearing and health-related quality of life in CI patients may similarly vary according to age. Speech Spatial Qualities (SSQ) of hearing scale and Health Utilities Index Mark III (HUI) questionnaires were administered to 543 unilaterally implanted adults across Europe, South Africa, and South America. Data were acquired before surgery and at 1, 2, and 3 years post-surgery. Data were analyzed using linear mixed models with visit, age group (18–34, 35–44, 45–54, 55–64, and 65+), and side of implant as main factors and adjusted for other covariates. Tinnitus and dizziness prevalence did not vary with age, but older groups had more preoperative hearing. Preoperatively and postoperatively, SSQ scores were significantly higher (Δ0.75–0.82) for those aged <45 compared with those 55+. However, gains in SSQ scores were equivalent across age groups, although postoperative SSQ scores were higher in right-ear implanted subjects. All age groups benefited equally in terms of HUI gain (0.18), with no decrease in scores with age. Overall, younger adults appeared to cope better with a degraded hearing before and after CI, leading to better subjective hearing performance.
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Affiliation(s)
| | - Petra L Graham
- Department of Mathematics and Statistics, Macquarie University, North Ryde, NSW, Australia
| | | | | | - Marcin Durko
- Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, Lodz, Poland
| | - Alicia Huarte Irujo
- Department of Otorhinolaryngology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Juan Royo López
- Servicio de Otorrinolaringología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Lida Müller
- Tygerberg Hospital-Stellenbosch University Cochlear Implant Unit, Tygerberg, South Africa
| | - Adam Perenyi
- Department of Otolaryngology and Head Neck Surgery, Albert Szent Györgyi Medical Center, University of Szeged, Szeged, Hungary
| | | | - Sandra Salinas Garcia
- Servicio de Otorrinolaringología y Patología Cérvico-Facial, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Mark Schüssler
- Deutsches HörZentrum Hannover der HNO-Klinik, Medizische Hochschule Hannover, Hannover, Germany
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16
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Müller L, Graham P, Kaur J, Wyss J, Greenham P, James CJ. Factors contributing to clinically important health utility gains in cochlear implant recipients. Eur Arch Otorhinolaryngol 2021; 278:4723-4731. [PMID: 33452623 PMCID: PMC8553698 DOI: 10.1007/s00405-020-06589-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/24/2020] [Indexed: 11/26/2022]
Abstract
Purpose Cochlear implantation can restore access to sound and speech understanding in subjects with substantial hearing loss. The Health Utilities Index Mark III (HUI3) measures the impact of an intervention on the patient’s quality of life and is sensitive to changes in hearing. In the current study we used factor analysis to predict a clinically important gain in HUI3 scores in adult cochlear implant recipients. Methods Data were collected in an observational study for 137 adult recipients from a single center who had at least 1-year HUI3 follow-up. Demographic and other baseline parameters were retrospectively analyzed for their association with a clinically important HUI3 scale gain, defined as at least 0.1 points. Data were also collected for the speech spatial qualities (SSQ) scale. Results Baseline telephone use and HUI3 hearing, speech and emotion attribute levels were significantly associated with clinically important gains in HUI3 scores. However, SSQ scores increased significantly with or without clinically important HUI3 gains. Conclusion Those subjects who were unhappy or experienced difficulties communicating with strangers or in a group were twice as likely to obtain a clinically important gain in health utility compared to those who were happy or had less difficulty communicating. Subjects who were unable to use the telephone prior to cochlear implantation were one and a half times more likely to obtain a clinically important gain. The SSQ scale was more sensitive to hearing improvements due to cochlear implantation. An inability to use the telephone is an easy to assess biomarker for candidacy for cochlear implantation.
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Affiliation(s)
- Lida Müller
- Cochlear Implant Unit, Tygerberg Hospital, 5th Floor Gold Ave, Francie van Zijl Drive, Tygerberg, 7505, South Africa
| | - Petra Graham
- Department of Mathematics and Statistics, Macquarie University, North Ryde, NSW, 2109, Australia
| | - Jasmin Kaur
- Cochlear AG, Peter Merian-Weg 4, 4052, Basel, Switzerland
| | - Josie Wyss
- Cochlear AG, Peter Merian-Weg 4, 4052, Basel, Switzerland
| | - Paula Greenham
- Greenham Research Consulting Ltd, Downland House, Ashbury, SN6 8LP, UK.
| | - Chris J James
- Cochlear France SAS, 135 Route de Saint Simon, 31100, Toulouse, France
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Kharytaniuk N, Cowley P, Werring DJ, Bamiou DE. Case Report: Auditory Neuropathy and Central Auditory Processing Deficits in a Neuro-Otological Case-Study of Infratentorial Superficial Siderosis. Front Neurol 2021; 11:610819. [PMID: 33519690 PMCID: PMC7840843 DOI: 10.3389/fneur.2020.610819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/15/2020] [Indexed: 11/13/2022] Open
Abstract
Hearing and balance impairment are the most frequently reported features of infratentorial (classical) superficial siderosis (iSS). There are few comprehensive descriptions of audiovestibular function in iSS and therefore limited understanding of the affected segment(s) of the audiovestibular pathway. In addition, monitoring disease progression and response to treatment is challenging and currently mainly guided by subjective patient reports and magnetic resonance imaging. To the best of our knowledge, there have been no previous reports assessing central auditory function in iSS. We describe such findings in a patient with iSS in an attempt to precisely localize the site of the audiovestibular dysfunction, determine its severity and functional impact. We confirm the presence of (asymmetrical) auditory neuropathy and identify central auditory processing deficits, suggesting involvement of the central auditory pathway beyond the brainstem. We correlate the audiological and vestibular findings with self-report measures and the siderosis appearances on brain magnetic resonance images.
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Affiliation(s)
- Natallia Kharytaniuk
- Ear Institute, University College London, London, United Kingdom
- National Institute for Health Research, University College London Hospitals Biomedical Research Centre (Deafness and Hearing Problems Theme), London, United Kingdom
- Department of Neuro-Otology, Royal National Throat, Nose and Ear Hospital, London, United Kingdom
| | - Peter Cowley
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - David J. Werring
- Department of Brain Repair and Rehabilitation, Stroke Research Centre, Institute of Neurology, University College London, London, United Kingdom
- Department of Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Doris-Eva Bamiou
- Ear Institute, University College London, London, United Kingdom
- National Institute for Health Research, University College London Hospitals Biomedical Research Centre (Deafness and Hearing Problems Theme), London, United Kingdom
- Department of Neuro-Otology, Royal National Throat, Nose and Ear Hospital, London, United Kingdom
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18
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Self-assessment of unilateral and bimodal cochlear implant experiences in daily life. PLoS One 2020; 15:e0242871. [PMID: 33270689 PMCID: PMC7714204 DOI: 10.1371/journal.pone.0242871] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 11/09/2020] [Indexed: 11/19/2022] Open
Abstract
Objective The subjective experiences were assessed of cochlear implant (CI) users either wearing or not wearing a hearing aid (HA) at the contralateral ear. Design Unilateral CI-recipients were asked to fill out a set of daily-life questionnaires on bimodal HA use, hearing disability, hearing handicap and general quality of life. Study sample Twenty-six CI-recipients who regularly use a contralateral HA (bimodal group) and twenty-two CI-recipients who do not use a HA in the contralateral ear (unilateral group). Results Comparisons between both groups (bimodal versus unilateral) showed no difference in self-rated disability, hearing handicap or general quality of life. However within the group of bimodal listeners, participants did report a benefit of bimodal hearing ability in various daily life listening situations. Conclusions Bimodal benefit in daily life can consistently be experienced and reported within the group of bimodal users.
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19
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Noroozi M, Nikakhlagh S, Angali KA, Bagheripour H, Saki N. Relationship between age at cochlear implantation and auditory speech perception development skills in children. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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20
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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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21
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Völter C, Götze L, Haubitz I, Dazert S, Thomas JP. Benefits of Cochlear Implantation in Middle-Aged and Older Adults. Clin Interv Aging 2020; 15:1555-1568. [PMID: 32982193 PMCID: PMC7500174 DOI: 10.2147/cia.s255363] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/08/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction Nowadays cochlear implantation (CI) is the treatment of choice in adults in case conventional hearing devices fail. Besides speech perception, an improvement in quality of life and in cognitive performance has been reported. Thereby, the study focused on the impact of age. Participants and Methods Thirty middle-aged (MA) between 50 and 64 years and 41 older subjects (OA) aged 65 and older with bilateral severe hearing loss performed a comprehensive computer-based neurocognitive test battery (ALAcog) pre- and 12 months post-implantation. Besides, monosyllabic speech perception in quiet (Freiburg monosyllabic speech test), health-related quality of life (HR-QoL, Nijmegen Cochlear Implant Questionnaire) and depressive symptoms (GDS-15) have been assessed. Results Both age groups significantly improved in all three categories after 12 months. No differences were evaluated between MA and OA regarding speech perception and HR-QoL pre- and post-operatively. In contrast, cognitive performance differed between the age groups: pre-operatively OA performed worse in most neurocognitive subdomains like working memory (p=0.04), inhibition (p=0.004), processing speed (p=0.003) and mental flexibility (p=0.01), post-operatively MA outperformed OA only in inhibition (p=0.01). Age only slightly influenced cognitive performance in MA, whereas in OA age per se tremendously impacted on working memory (p=0.04), inhibition (p=0.02), memory (p=0.04) and mental flexibility (p=0.01). Educational level also affected processing speed, mental flexibility (p=0.01) and working memory (p=0.01). This was more pronounced in OA. In both age groups, hearing status had a strong effect on attentional tasks (p=0.01). In MA, depressive symptoms were more influential on cognitive functioning and on HR-QoL than in OA. Improvement in quality of life (p=0.0002) and working memory (p=0.001) was greater for those with a higher pre-operative depression score. Conclusion Speech perception and HR-QoL improved in hearing impaired, independently of age. Pre-operative differences in cognitive performance between OA and MA clearly attenuated 12 months after CI. Impact of comorbidities differed between age groups.
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Affiliation(s)
- Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr-University of Bochum, Bochum, Germany
| | - Lisa Götze
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr-University of Bochum, Bochum, Germany
| | - Imme Haubitz
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr-University of Bochum, Bochum, Germany
| | - Stefan Dazert
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr-University of Bochum, Bochum, Germany
| | - Jan Peter Thomas
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr-University of Bochum, Bochum, Germany
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Marx M, Mosnier I, Belmin J, Wyss J, Coudert-Koall C, Ramos A, Manrique Huarte R, Khnifes R, Hilly O, Martini A, Cuda D. Healthy aging in elderly cochlear implant recipients: a multinational observational study. BMC Geriatr 2020; 20:252. [PMID: 32703167 PMCID: PMC7376635 DOI: 10.1186/s12877-020-01628-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/24/2020] [Indexed: 11/24/2022] Open
Abstract
Background Given an increase in the aging population and its impact on healthcare systems, policy makers for provision of health and social services are aiming to keep older adults in good health for longer, in other words towards ‘healthy aging’. Our study objective is to show that rehabilitation with cochlear implant treatment in the elderly with hearing impairment improves the overall health-related quality of life and general well-being that translate into healthy aging. Methods The multicentre, prospective, repeated measures, single-subject, clinical observational study will accrue 100 elderly, first-time, unilateral CI recipients (≥ 60 years) and analyze changes on specific measurement tools over ca. 20 months from preimplant to postimplant. Evaluations will consist of details collected through case history and interview questionnaires by clinicians, data logging, self-report questionnaires completed by the recipients and a series of commonly used audiometric measures and geriatric assessment tools. The primary indicator of changes in overall quality of life will be the HUI-3. Discussion The protocol is designed to make use of measurement tools that have already been applied to the hearing-impaired population in order to compare effects of CI rehabilitation in adults immediately before their implantation, (pre-implant) and after gaining 1–1.5 years of experience (post-implant). The broad approach will lead to a greater understanding of how useful hearing impacts the quality of life in elderly individuals, and thus improves potentials for healthy aging. Outcomes will be described and analyzed in detail. Trial registration This research has been registered in ClinicalTrials.gov (http://www.clinicaltrials.gov/), 7 March 2017 under the n° NCT03072862.
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Affiliation(s)
- M Marx
- Otology and Neurotology Department, ENT Department, Bâtiment Pierre Paul Riquet - Hôpital Purpan, Place du Dr Baylac, 31059, Toulouse Cedex 9, France.
| | - I Mosnier
- Groupe Hospitalier de la Pitié-Salpétrière, Paris, France
| | - J Belmin
- Université Pierre and Marie Curie and Hôpital Charles Foix, Paris, France
| | - J Wyss
- Cochlear Ltd., Sydney, Australia
| | | | - A Ramos
- Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | | | - R Khnifes
- Bnai Zion Medical Center, Haifa, Israel
| | - O Hilly
- ENT Department at Rabin Medical Center (Beilinson), Petah Tikva, Israel
| | - A Martini
- ENT Otosurgery Department at Azienda Ospedaliera di Padova, Padova, Italy
| | - D Cuda
- ENT Department of Ospedale Guglielmo da Saliceto, Piacenza, Italy
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Wyss J, Mecklenburg DJ, Graham PL. Self-assessment of daily hearing function for implant recipients: A comparison of mean total scores for the Speech Spatial Qualities of Hearing Scale (SSQ49) with the SSQ12. Cochlear Implants Int 2019; 21:167-178. [PMID: 31887255 DOI: 10.1080/14670100.2019.1707993] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess the relationship and agreement between mean total scores for the Speech Spatial Qualities of Hearing Scale (SSQ49) and the shorter SSQ12 to measure daily hearing function for a large group of auditory implant recipients. METHODS Prospective, longitudinal self-assessment by 1013 implant recipients using the SSQ49 at preimplant and at annual post-implant intervals (one, two and three-years) via an international registry. Mean total scores were calculated for the SSQ49 and the extracted SSQ12 responses. Pearson correlation and Bland-Altman agreement were examined between the SSQ49, SSQ12 and transformed SSQ12 versions. Longitudinal mixed-effects models were used to compare changes over time. RESULTS Very high correlation was shown between mean total scores for all versions while perfect agreement was not reached. Clinically acceptable agreement (<1.0 unit) between all versions was obtained with the transformed SSQ12 being least biased. All versions showed statistically significant improvement at one-year post-implant (>2.2 units; p < 0.001). CONCLUSIONS All scale-versions showed comparable sensitivity to changes in self-reported hearing function over time. TheSSQ12 may be considered as a potential time-efficient self-assessment of hearing function for implant recipients in routine practice. Further research may involve independent repeated administration of each scale version.
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Affiliation(s)
| | | | - Petra L Graham
- Department of Economics, GenIMPACT, Macquarie University, North Ryde, Australia
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24
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Erdem BK, Çiprut A. Evaluation of Speech, Spatial Perception and Hearing Quality in Unilateral, Bimodal and Bilateral Cochlear Implant Users. Turk Arch Otorhinolaryngol 2019; 57:149-153. [PMID: 31620697 DOI: 10.5152/tao.2019.4105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 04/02/2019] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of the study was to conduct a scale-based evaluation of the hearing skills of unilateral, bimodal and bilateral cochlear implant (CI) users, including distinguishing, orientating and locating speech and environmental sounds in their surrounding environment that they are exposed to in different contexts of everyday life. The scale results were compared between groups. Methods A total of 74 cochlear implant users, 30 unilateral, 30 bimodal and 14 bilateral, were included in the study. Their ages ranged from 11 to 64 years. Participants were assessed using the Speech, Spatial and Qualities of Hearing Scale (SSQ). Results Bilateral CI users' subjective ratings of their own hearing skills were found to be significantly better than those of bimodal and unilateral CI users; bimodal users' subjective ratings were also found to be significantly better than those of unilateral CI users. Paired comparisons showed statistically significant differences between the groups in terms of total scores of Speech, Spatial, Qualities of Hearing and General SSQ (p<0.05). Conclusion Our findings show that bilateral use of cochlear implants should be recommended for those presently using bimodal and unilateral devices. Moreover, subjective tests should be used regularly along with objective tests for evaluating CI patients.
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Affiliation(s)
- Büşra Koçak Erdem
- Department of Audiology, Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey
| | - Ayça Çiprut
- Department of Audiology, Marmara University School of Medicine, İstanbul, Turkey
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25
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Hagen R, Radeloff A, Stark T, Anderson I, Nopp P, Aschbacher E, Möltner A, Khajehnouri Y, Rak K. Microphone directionality and wind noise reduction enhance speech perception in users of the MED-EL SONNET audio processor. Cochlear Implants Int 2019; 21:53-65. [DOI: 10.1080/14670100.2019.1664529] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital of Würzburg, Würzburg, Germany
| | - Andreas Radeloff
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University of Oldenburg, Oldenburg, Germany
| | - Thomas Stark
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, HELIOS Klinikum München West, Munich, Germany
| | | | - Peter Nopp
- MED-EL Medical Electronics, Innsbruck, Austria
| | | | | | | | - Kristen Rak
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital of Würzburg, Würzburg, Germany
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26
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Hey M, Wesarg T, Mewes A, Helbig S, Hornung J, Lenarz T, Briggs R, Marx M, Ramos A, Stöver T, Escudé B, James CJ, Aschendorff A. Objective, audiological and quality of life measures with the CI532 slim modiolar electrode. Cochlear Implants Int 2018; 20:80-90. [DOI: 10.1080/14670100.2018.1544684] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Matthias Hey
- Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | | | | | - Silke Helbig
- Klinikum der J. W. Goethe-Universität, Frankfurt, Germany
| | | | | | | | - Mathieu Marx
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Angel Ramos
- Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas, Spain
| | - Timo Stöver
- Klinikum der J. W. Goethe-Universität, Frankfurt, Germany
| | | | - Chris J. James
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
- Cochlear France SAS, Toulouse, France
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27
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Anderson M, Rallapalli V, Schoof T, Souza P, Arehart K. The use of self-report measures to examine changes in perception in response to fittings using different signal processing parameters. Int J Audiol 2018; 57:809-815. [PMID: 30052097 PMCID: PMC6364848 DOI: 10.1080/14992027.2018.1490035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/07/2018] [Accepted: 06/07/2018] [Indexed: 10/28/2022]
Abstract
Clinicians have long used self-report methods to assess hearing aid benefit. However, there are fewer data as to whether self-report instruments can be used to compare differences between signal processing settings. This study examined how self-perceived performance varied as a function of modifications in signal processing using two self-report measures. Data were collected as part of a double-blind randomised crossover clinical trial. Participants were fit with two fittings: mild processing (slow time constants, disabled frequency lowering) and strong processing (fast time constants, frequency lowering enabled). The speech, spatial, and qualities of hearing (SSQ) questionnaire and the Effectiveness of Auditory Rehabilitation (EAR) questionnaire were collected at multiple time points. Older adults with sensorineural hearing loss who had not used hearing aids within the previous year participated (49 older adults were consented; 40 were included in the final data analyses). Findings show that listeners report a difference in perceived performance when hearing aid features are modified. Both self-report measures were able to capture this change in perceived performance. Self-report measures provide a tool for capturing changes in perceived performance when hearing aid processing features are modified and may enhance provision of an evidence-based hearing aid fitting.
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Affiliation(s)
- Melinda Anderson
- Department of Otolaryngology, University of Colorado Anschutz Medical Campus, 12631 E. 17 Avenue, Room 3001, Mail Stop B205, Aurora, CO 80045
| | - Varsha Rallapalli
- Department of Communication Sciences & Disorders, Northwestern University
| | - Tim Schoof
- Department of Speech, Hearing and Phonetic Sciences, Division of Psychology and Language Sciences, University College London
| | - Pamela Souza
- Department of Communication Sciences and Disorders and Knowles Hearing Center, Northwestern University
| | - Kathryn Arehart
- Speech-Language-Hearing Sciences, University of Colorado at Boulder
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28
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Wallhäusser-Franke E, Balkenhol T, Hetjens S, Rotter N, Servais JJ. Patient Benefit Following Bimodal CI-provision: Self-reported Abilities vs. Hearing Status. Front Neurol 2018; 9:753. [PMID: 30250450 PMCID: PMC6139334 DOI: 10.3389/fneur.2018.00753] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 08/20/2018] [Indexed: 01/09/2023] Open
Abstract
Objectives: Patient-reported outcomes gain importance for the assessment of auditory abilities in cochlear implant users and for the evaluation of auditory rehabilitation. Aims of the study were to explore the interrelation of self-reported improvements in auditory ability with improvements in speech comprehension and to identify factors other than audiological improvement that affect self-reported auditory ability. Study Design: Explorative prospective analysis using a within-subjects repeated measures design. Setting: Academic tertiary care center. Participants: Twenty-seven adult participants with bilateral sensorineural hearing loss who received a HiRes 90K CI and continued use of a HA at the non-implanted ear (bimodal hearing). Intervention: Cochlear implantation. Main Outcome Measures: Self-reported auditory ability/disability assessed by the comparative version of the Speech, Spatial and Qualities of Hearing Scale (SSQ-B), and monosyllable as well as sentence comprehension in quiet and within speech modulated noise from different directions assessed pre- as well as 3 and 6 months post-implantation. Results: Data of 17 individuals were analyzed. At the endpoint of the study, improvement of self-reported auditory ability was significant. Regarding audiometric measures, significant improvement was seen for CI-aided pure tone thresholds, for monaural CI-assisted and bimodal sentence comprehension in quiet and in speech-modulated noise that was presented from the same source or at the side of the HA-ear. Correlations between self-reported and audiometric improvements remained weak, with the exception of the improvement seen for monaural CI-aided sentence comprehension in quiet and self-perceived improvement of sound quality. Considerable correlations existed between self-reported improvements and current level of depression and anxiety, and with general self-efficaciousness. Regression analyses substantiated a positive influence of self-efficaciousness on self-reported improvement in speech comprehension and between the improvement of monaural CI-aided sentence comprehension in quiet and perceived sound quality as well as a negative influence of anxiety on self-reported improvement in spatial hearing. Self-reported improvements were significantly better in the subgroup with intensive as compared to regular rehabilitation. Conclusions: Self-reported auditory ability/disability represents an important measure for the success of bimodal CI-provision. It is influenced by personal and mental health factors that may improve CI-rehabilitation results if addressed during rehabilitation.
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Affiliation(s)
- Elisabeth Wallhäusser-Franke
- Department of Otorhinolaryngology Head and Neck Surgery, Medical Faculty Mannheim, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Tobias Balkenhol
- Department of Otorhinolaryngology Head and Neck Surgery, Medical Faculty Mannheim, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Svetlana Hetjens
- Institute of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nicole Rotter
- Department of Otorhinolaryngology Head and Neck Surgery, Medical Faculty Mannheim, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Jerome J Servais
- Department of Otorhinolaryngology Head and Neck Surgery, Medical Faculty Mannheim, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
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Ramos Macías A, Falcón-González JC, Manrique Rodríguez M, Morera Pérez C, García-Ibáñez L, Cenjor Español C, Coudert-Koall C, Killian M. One-Year Results for Patients with Unilateral Hearing Loss and Accompanying Severe Tinnitus and Hyperacusis Treated with a Cochlear Implant. Audiol Neurootol 2018; 23:8-19. [PMID: 29929187 DOI: 10.1159/000488755] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 03/23/2018] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To show that patients with unilateral hearing loss (UHL), with one ear fulfilling cochlear implant (CI) indication criteria, and an additional severe tinnitus handicap can be treated effectively with a CI. METHOD A prospective multi-centre study was conducted in five Spanish centres. Sixteen adult patients with UHL and a mean Tinnitus Handicap Inventory (THI) score of at least 58 were implanted. The study design included repeated within-subject measures of quality of life (Health Utility Index Mark 3 [HUI3]), tinnitus (THI, Visual Analogue Scale [VAS] on tinnitus loudness), hearing (Speech, Spatial, and Qualities of Hearing Scale- [SSQ]), and hyperacusis (Test de Hipersensibilidad al Sonido [THS]) up to 12 months after the initial CI fitting. RESULTS Group data showed significant subjective benefit from CI treatment: the preoperative HUI3 total utility score of 0.45 went up to 0.57 at 6 months and 0.63 at 12 months; the preoperative THI total score of 75 decreased to 40 at 6 months and 35 at 12 months. The preoperative tinnitus loudness VAS score of 8.2 decreased to 2.4 at 6 months and 2.2 at 12 months with the implant "On" and to 6.7 at 6 months and 6.5 at 12 months with the implant "Off." The preoperative THS total score of 26 decreased to 17 at 12 months. The preoperative SSQ total score of 4.2 increased to 5.1 at 6 months and 6.3 at 12 months. No unanticipated adverse events were reported during the study period. At 12 months after CI activation all subjects (except 1 subject who used the device 6 days a week) wore their devices all day and every day. The primary reason for CI use was split evenly between tinnitus suppression (n = 6) and both hearing and tinnitus (n = 6). CONCLUSION A CI should be considered as a treatment option in patients with UHL and a concomitant severe tinnitus handicap. However, appropriate counselling of candidates on the anticipated risks, benefits, and limitations that are inherent to cochlear implantation is imperative.
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Affiliation(s)
- Angel Ramos Macías
- Unidad de Hipoacusia, Servicio de Otorrinolaringología, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas, Spain
| | - Juan Carlos Falcón-González
- Unidad de Hipoacusia, Servicio de Otorrinolaringología, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas, Spain
| | | | | | - Luis García-Ibáñez
- Servicio de Otorrinolaringología, Instituto de Otologia Garcia Ibanez, Barcelona, Spain
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30
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Turunen-Taheri S, Carlsson PI, Johnson AC, Hellström S. Severe-to-profound hearing impairment: demographic data, gender differences and benefits of audiological rehabilitation. Disabil Rehabil 2018; 41:2766-2774. [PMID: 29893149 DOI: 10.1080/09638288.2018.1477208] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Purpose: The purpose of this study was to identify and report demographic data of patients with severe-to-profound hearing loss, assess participation in audiological rehabilitation and analyze the benefits of various rehabilitation methods.Materials and methods: Data on 4286 patients with severe-to-profound hearing impairments registered in the Swedish Quality Register of Otorhinolaryngology over a period from 2006-2015 were studied. Demographic data, gender differences, audiological rehabilitation and benefits of the rehabilitation were analyzed.Results: Group rehabilitation and visits to a hearing rehabilitation educator provided the most benefits in audiological rehabilitation. Only 40.5% of the patients received extended audiological rehabilitation, of which 54.5% were women. A total of 9.5% of patients participated in group rehabilitation, with 59.5% being women. Women also visited technicians, welfare officers, hearing rehabilitation educators, psychologists and physicians and received communication rehabilitation in a group and fit with cochlea implants significantly more often than did men.Conclusions: The study emphasizes the importance of being given the opportunity to participate in group rehabilitation and meet a hearing rehabilitation educator to experience the benefits of hearing rehabilitation. There is a need to offer extended audiological rehabilitation, especially in terms of gender differences, to provide the same impact for women and men.Implications for RehabilitationSignificantly more women than men with severe-to-profound hearing impairment receive audiological rehabilitation.Hearing impairment appears to have a significantly more negative impact on women's quality of life than men's.It is important to offer extended audiological rehabilitation to all patients with severe-to-profound hearing loss to obtain an equal hearing health care regardless of gender.
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Affiliation(s)
- Satu Turunen-Taheri
- Department of CLINTEC, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Stockholm, Sweden.,Department of Audiology and Neurotology, Karolinska University Hospital, Stockholm, Sweden
| | - Per-Inge Carlsson
- Department of Otorhinolaryngology, Central Hospital, Karlstad, Sweden.,Audiological Research Center, Örebro University Hospital, Sweden
| | - Ann-Christin Johnson
- Department of CLINTEC, Division of Audiology, Karolinska Institutet, Huddinge, Sweden
| | - Sten Hellström
- Department of CLINTEC, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Stockholm, Sweden.,Department of Audiology and Neurotology, Karolinska University Hospital, Stockholm, Sweden
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31
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Völter C, Götze L, Dazert S, Falkenstein M, Thomas JP. Can cochlear implantation improve neurocognition in the aging population? Clin Interv Aging 2018; 13:701-712. [PMID: 29719382 PMCID: PMC5916259 DOI: 10.2147/cia.s160517] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Introduction The relationship between cognition and the ability to hear is well known. Due to changes in demographics, the number of people with sensorineural hearing loss and cognitive impairment is increasing. The aim of this study was to identify the impact of hearing rehabilitation via cochlear implantation on cognitive decline among the aging population. Patients and methods This prospective study included 60 subjects aged between 50 and 84 years (mean 65.8 years, SD=8.9) with a severe to profound bilateral hearing impairment. A computer-based evaluation of short- and long-term memory, processing speed, attention, working memory and inhibition was performed prior to surgery as well as 6 and 12 months after cochlear implantation. Additionally, speech perception at 65 and 80 dB (Freiburger monosyllabic speech test) as well as disease-related (Nijmegen Cochlear Implant Questionnaire) and general (WHOQOL-OLD) quality of life were assessed. Results Six months postimplantation, speech perception, quality of life and also neurocognitive abilities significantly increased. The most remarkable improvement after 6 months was detected in executive functions such as attention (p<0.001), inhibition (p=0.025) and working memory (n-back: p=0.002; operation span task: p=0.008), followed by delayed recall (p=0.03). In contrast, long-term memory showed a significant change of performance only after 12 months (p=0.021). After 6 months, most cognitive domains remained stable, except working memory assessed by the operation span task, which significantly improved between 6 and 12 months (p<0.001). No correlation was found between cognitive results and duration of deafness, speech perception or quality of life. Conclusion Cochlear implantation does not only lead to better speech perception and quality of life, but has also been shown to improve cognitive skills in hearing impaired adults aged 50 years or more. These effects seem to be independent of each other.
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Affiliation(s)
- Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr University Bochum, St. Elisabeth-Hospital, Bochum, Germany
| | - Lisa Götze
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr University Bochum, St. Elisabeth-Hospital, Bochum, Germany
| | - Stefan Dazert
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr University Bochum, St. Elisabeth-Hospital, Bochum, Germany
| | - Michael Falkenstein
- Institute for Work, Learning and Ageing (ALA), Bochum, Germany.,Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Jan Peter Thomas
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr University Bochum, St. Elisabeth-Hospital, Bochum, Germany
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