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Goudey B, Plant K, Kiral I, Jimeno-Yepes A, Swan A, Gambhir M, Büchner A, Kludt E, Eikelboom RH, Sucher C, Gifford RH, Rottier R, Anjomshoa H. A MultiCenter Analysis of Factors Associated with Hearing Outcome for 2,735 Adults with Cochlear Implants. Trends Hear 2021; 25:23312165211037525. [PMID: 34524944 PMCID: PMC8450683 DOI: 10.1177/23312165211037525] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
While the majority of cochlear implant recipients benefit from the device, it
remains difficult to estimate the degree of benefit for a specific patient prior
to implantation. Using data from 2,735 cochlear-implant recipients from across
three clinics, the largest retrospective study of cochlear-implant outcomes to
date, we investigate the association between 21 preoperative factors and speech
recognition approximately one year after implantation and explore the
consistency of their effects across the three constituent datasets. We provide
evidence of 17 statistically significant associations, in either univariate or
multivariate analysis, including confirmation of associations for several
predictive factors, which have only been examined in prior smaller studies.
Despite the large sample size, a multivariate analysis shows that the variance
explained by our models remains modest across the datasets (R2=0.12–0.21). Finally, we report a novel statistical interaction
indicating that the duration of deafness in the implanted ear has a stronger
impact on hearing outcome when considered relative to a candidate’s age. Our
multicenter study highlights several real-world complexities that impact the
clinical translation of predictive factors for cochlear implantation outcome. We
suggest several directions to overcome these challenges and further improve our
ability to model patient outcomes with increased accuracy.
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Affiliation(s)
- Benjamin Goudey
- 127113IBM Research Australia, Southbank, Victoria, Australia.,School of Computing and Information Systems, University of Melbourne, Parkville, Victoria, Australia
| | - Kerrie Plant
- 104148Cochlear Limited, Sydney, New South Wales, Australia
| | - Isabell Kiral
- 127113IBM Research Australia, Southbank, Victoria, Australia
| | | | - Annalisa Swan
- 127113IBM Research Australia, Southbank, Victoria, Australia
| | - Manoj Gambhir
- 127113IBM Research Australia, Southbank, Victoria, Australia
| | - Andreas Büchner
- 9177Medizinische Hochschule Hannover, Hannover, Niedersachsen, Germany
| | - Eugen Kludt
- 9177Medizinische Hochschule Hannover, Hannover, Niedersachsen, Germany
| | - Robert H Eikelboom
- 104182Ear Science Institute Australia, Subiaco, Western Australia, Australia.,Ear Sciences Centre, The University of Western Australia, Nedlands, Western Australia, Australia.,Department of Speech Language Pathology and Audiology, University of Pretoria, South Africa
| | - Cathy Sucher
- 104182Ear Science Institute Australia, Subiaco, Western Australia, Australia.,Ear Sciences Centre, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Rene H Gifford
- Department of Hearing and Speech Sciences, 12328Vanderbilt University Medical Center, Nashville, TN, USA
| | - Riaan Rottier
- 104148Cochlear Limited, Sydney, New South Wales, Australia
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Kraaijenga VJC, Derksen TC, Stegeman I, Smit AL. The effect of side of implantation on unilateral cochlear implant performance in patients with prelingual and postlingual sensorineural hearing loss: A systematic review. Clin Otolaryngol 2017; 43:440-449. [PMID: 28944603 DOI: 10.1111/coa.12988] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Cerebral lateralisation of language processing leads to a right ear advantage in normal hearing subjects. The aim of this study was to present a systematic overview of the effect of implantation side on postoperative cochlear implant performance in patients with symmetrical severe to profound sensorineural hearing loss. DATA SOURCES PubMed, Embase and The Cochrane Library databases. RESEARCH METHODS Databases were searched from database inception up to 9 January 2017 for cochlear implant and side and all synonyms. Title, abstract and full-text of retrieved articles were screened for eligibility. Then, directness of evidence and risk of bias were assessed. For the included articles, study characteristics and outcome data (hearing and language development) were extracted. RESULTS 2541 unique articles were screened, of which twenty were eligible for critical appraisal. No randomised controlled trials were identified. Twelve studies with a high directness of evidence remained for data extraction. Four of six studies including children with pre-lingual sensorineural hearing loss and four of seven studies investigating adults with postlingual sensorineural hearing loss found a right ear advantage in at least one outcome measurement related to cochlear implant performance. CONCLUSION The available evidence on the effect of side of implantation is of low quality, as study populations and outcome measures are heterogeneous. The majority of studies reveals evidence for a right ear advantage in prelingually deafened children as well as postlingually deafened adults. In view of the present evidence and as no left ear advantage was identified, we cautiously advise implanting the cochlear implant in the right ear when other prognostic factors do not favour the left ear and sensorineural hearing loss is symmetrical.
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Affiliation(s)
- V J C Kraaijenga
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, The Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - T C Derksen
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - I Stegeman
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, The Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.,Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
| | - A L Smit
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, The Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
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