Author(s)
Natalie Schauwecker, MD
Barak Spector, BS
Ankita Patro, MD, MS
Terrin N. Tamati, PhD
David S. Haynes, MD
Theodore R. McRackan, MD
Aaron C. Moberly, MD
Affiliation(s)
Vanderbilt University Medical Center;
Abstract:
Objective: 1) To assess clinically significant improvements in speech perception and patient-reported outcome measures (PROMs) in cochlear implant (CI) users and 2) to identify factors that influence both outcomes.
Study Design: Retrospective cohort.
Setting: Tertiary referral center.
Patients: Adult CI users with pre- and 6-12 month-post-operative CI-specific PROMs and speech perception testing.
Main Outcome Measures: Pre- and post-operative CI-only AzBio Quiet and CIQOL scores; datalogging, hearing history, demographic variables.
Results: For 86 patients, average age at implantation was 65 years (SD=15.7), and average device use was 11.3 hours/day (SD=3.8). Mean CI-only AzBio score increased from 21% (SD=23.9, median 10%, IQR=38) preoperatively to 65% (SD=29.1, median 76%, IQR=37) 6-12 months post-operatively. Mean CIQOL outcome scores were 38.5 (SD=7.3, median 37.5, IQR=11) preoperatively and 51.1 (SD=6.8, median 51, IQR=14) post-operatively. 85% showed significant improvement in CI-only speech perception testing, and 62% showed significant improvement in CIQOL. Only 2 (2%) patients demonstrated no improvement in AzBio nor CIQOL. CIQOL and AzBio improvements were significantly associated with lower pre-CI AzBio scores (below cohort’s median, 9.5, p=0.014 and p=0.032). Younger age (p=0.039) was only associated with CIQOL improvement. Datalogging and duration of hearing loss were not associated with significant CIQOL or AzBio improvement.
Conclusions: Speech perception and PROMs should be viewed as complementary assessments of CI outcomes. Individual patient factors may contribute differently to these outcomes and can inform counseling regarding expected outcomes.