QoL, CIs, QALYs, and Individualized Rehabilitation: The Clinical and Practical Benefits of Regularly Assessing the Quality of Life of Adult Cochlear Implant Recipients

This study aimed to report quality of life (QoL) scores in unilateral cochlear implant (CI) users and to generate guidance for clinicians on using QoL measures to individualize CI counselling and rehabilitation and to increase access to CIs as a mode of rehabilitation. Participants (n = 101) were unilateral CI users with single-sided deafness (SSD; n = 17), asymmetrical hearing loss (AHL; n = 26), or bilateral hearing loss (Uni; n = 58). Generic QoL was assessed via the Health Utilities Index (HUI-3), and disease-specific QoL was assessed via the Speech, Spatial, and Qualities of Hearing scale (SSQ12) and Nijmegen CI Questionnaire (NCIQ) at preimplantation and at 6 and 12 months of CI use. All groups had significantly increased HUI-3 scores at both intervals. The SSD group showed significant benefit on the SSQ12 at visit 3, the AHL group showed significant benefit on the SSQ12 and most NCIQ subdomains at both intervals, and the Uni group showed significant benefit with both tests at both intervals. Unilateral CI recipients demonstrate improved QoL within the first 12 months of device use. Regular assessment with generic and disease-specific questionnaires has the potential to play an important role in personalizing treatment and possibly in increasing access to CI provision.

Evolution of speech perception in patients with ossified cochlea and short array cochlear implant

Background: Short array cochlear implant is indicated as rehabilitation in patients with severe to profound deafness, especially when there is cochlear ossification. In these cases, with reduced intracochlear patency, total insertion becomes more difficult, requiring the use of this type of electrode (15 mm). Few studies have been published to evaluate auditory performance, presenting controversial audiological results.Aims/Objectives: To report the speech perception of users of cochlear implants (CI) with short array. Material and Methods: A retrospective analysis of medical records of patients who underwent surgery for cochlear implantation with a short array, between 2009 and 2020, at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP) was carried out. Results: There was performance evolution in the speech perception tests in the data analysis. Meningitis and congenital hearing loss were the main indications for CI in the sample. Conclusion. CI with a short array is an alternative in the management of patients with a history of cochlear ossification and severe or profound sensorineural hearing loss. Significance: To demonstrate the evolution of speech perception tests with short array cochlear implant in patients with or without ossified cochlea and its characteristics for application in clinical practice.

List of words to evaluate speech perception: recording and verification of applicability

ABSTRACT Purpose: to record the “List of Words to Evaluate the Speech Perception of Children with Hearing Loss” which is standardized for live speech presentation and verify its clinical applicability. Methods: recording: acoustic standards were used, three recordings of each word and analysis by judges. The list was recorded in silence at 60 decibels (dB) and signal noise relation of +10 dB. Participants: 30 children in the age range from five years to 10 years and 11 months, with no auditory and language disorders. The procedure was performed in live and recorded speech. Wilcoxon’s, paired t and Spearman’s correlation coefficient tests (p-value significantly less or equal to 0.05), were applied. Results: the comparison of performance for recognition of words and phonemes between live and recorded speech resulted in a statistically significant difference (p ≤ 0.05), in all conditions analyzed. The results were higher in the silence condition. There was no statistically significant difference between the time of application in the recorded speech when compared in silence and noise (p=0.064). Conclusion: the recording and application of the procedure that analyzes recognition of phonemes and words proved to be viable in recorded speech in silence and noise.

Parental perspectives of children using cochlear implant

PURPOSE: To evaluate the parents' perspective with regard to evolution of their child with cochlear implant (CI). METHODS: This was a cross-sectional prospective study conducted at the Centro de Pesquisas Audiológicas of Hospital de Reabilitação de Anomalias Craniofaciais of Universidade de São Paulo. The selection of the sample was performed from the spontaneous demand, among the months from July to December 2011. The final sample comprised 50 parents or guardians of children using CI, with minimum 1 year and maximum of 3 years of device use. The translated and adapted to Brazilian Portuguese version of the questionnaire "Perspectives of parents of children with cochlear implants" was applied. This instrument consists of 74 questions and allows quantification of the parents' perspective on subscales that illustrate the situation of the child and family. Each question has five options scored from one to five responses. The Spearman test for comparison of results between the subscales was applied. RESULTS: The social relationships, self-sufficiency, and communication subscales showed the highest mean score, whereas the worst score was for child support subscale, reflecting the independence and autonomy of the patients. The correlation between the child subscales was realized, and the results showed themselves significant and positive for communication subscale of communication with all others subscales. The family subscales also had a positive correlation with the communication, education, and self-sufficiency. CONCLUSION: These results demonstrate that parents have good expectations regarding communication, independence, and social participation of children after CI surgery, and this questionnaire is a useful tool for use in clinical practice.

Fonoaudiologia como opção de carreira universitária: estudo exploratórioSpeech Language Pathology and Audiology as a higher education option: exploratory study

Objetivo identificar junto aos alunos dos Cursos de Fonoaudiologia: fatores que levaram a esta escolha de carreira e informações que gostariam de ter recebido sobre esta profissão antes do exame vestibular. Métodos estudo exploratório, descritivo, transversal. Discentes dos cursos de graduação em Fonoaudiologia oferecidos pela Universidade de São Paulo nos campi de Bauru, São Paulo e Ribeirão Preto e egressos do campus de Bauru foram convidados a preencher anonimamente, um questionário online composto por 10 questões a respeito de suas opções de carreira universitária e sobre as fontes e suficiência de informação a respeito da profissão Fonoaudiologia quando da inscrição no exame vestibular. Resultados responderam ao questionário 201 sujeitos (144 graduandos e 57 egressos). A Fonoaudiologia foi a primeira opção de carreira para 119 (59,2%) dos participantes. O interesse pela profissão foi o motivador de escolha para 42% dos participantes e o status da universidade, a relação candidato/vaga e a influencia de familiares, dentre outros, para 58% dos respondentes. Os guias de profissões foram as principais fontes de informação sobre a carreira. Cerca de 80% dos sujeitos não estavam satisfeitos com as informações que receberam antes do vestibular, a maioria indicando que gostariam de saber mais sobre o campo de atuação do fonoaudiólogo. Conclusão fatores não relacionados à afinidade ou pendor pela profissão levam à opção pela carreira Fonoaudiologia para a maioria dos participantes. Há necessidade de intensificar a veiculação de informações sobre a profissão, sobretudo o seu campo de atuação para candidatos ao exame vestibular.

O uso da Classificação Internacional de Funcionalidade, Incapacidade e Saúde para acompanhamento de pacientes usuários de Implante Coclear

OBJETIVO: Caracterizar o perfil dos pacientes usuários de Implante Coclear a partir do proposto pela Classificação Internacional de Funcionalidade, Incapacidade e Saúde para Crianças e Jovens (CIF-CJ). MÉTODOS: Tratou-se de um estudo descritivo, retrospectivo transversal, em que foram analisados 30 prontuários de pacientes usuários de Implante Coclear do Centro de Pesquisas Audiológicas. Para caracterização do perfil dos pacientes, foi utilizada a CIF-CJ. Para avaliação, os pesquisadores basearam-se em procedimentos realizados na rotina clínica, além de informações registradas no prontuário. Após a revisão dessas informações, estas foram relacionadas com o código da CIF-CJ, sendo acrescido posteriormente um qualificador. RESULTADOS: No total, 55 códigos da CIF foram relacionados com os instrumentos para caracterização desta população. Com relação ao domínio Funções do Corpo, a maioria dos participantes não apresentava deficiência quanto aos aspectos relacionados à recepção e expressão da linguagem oral e funções auditivas, sendo apenas encontrada deficiência na linguagem escrita. Esse mesmo achado foi observado no domínio Atividade e Participação. Quanto aos Fatores Ambientais, o ruído e a não disponibilidade de recursos tecnológicos para auxiliar na compreensão auditiva no ruído foram caracterizados como barreira, além da não realização da terapia fonoaudiológica. CONCLUSÃO: Este trabalho permitiu-nos concluir que a maioria das crianças participantes não apresentou deficiência nas Funções do Corpo, sendo observadas apenas dificuldades no desempenho escolar. Os fatores ambientais (ruído, não disponibilidade de recursos tecnológicos, não realização da terapia fonoaudiológica) foram caracterizados como barreira. Notou-se também a necessidade de ampliar as avaliações na rotina clínica.