Audiometric and Patient‐Reported Outcomes in Single‐Sided Deafness Cochlear Implant Recipients Using the CIQOL‐35

Abstract

Objective. Describe the effect that cochlear implantation (CI) has on audiometric outcomes and quality of life (QOL) in patients with single-sided deafness (SSD).Study Design. Retrospective case review.Setting. Tertiary university hospital system.Methods. Preoperative and postoperative AzBio performance and Cochlear Implant Quality of Life-35 (CIQOL-35) Profile scores in CI patients with SSD were compared, and postoperative measures were compared to those from CI patients without SSD.Results. Seventeen patients with unilateral CI and contralateral unaided pure-tone averages ≤30 dB were included. The median age was 60.2 (interquartile range [IQR], 50.9-64.9 years), and 7/17 (41%) were women. Median daily use was 8.2 hour (IQR, 5.4-11.9 h). The median preoperative AzBio quiet score in the ear to be implanted was 3% (IQR, 0%-6%). After a median follow-up of 12.0 months, the median postoperative AzBio quiet score was 76% (IQR, 47%-86%) (p < .01). SSD subjects demonstrated statistically significant improvements in median scores on the following CIQOL-35 subdomains following implantation: Entertainment (17 preoperatively vs 21 postoperatively), Listening Effort (12 vs 14), Social (17 vs 22), and Global (28 vs 35; p < .05). SSD patients achieved equal or higher postoperative CIQOL-35 scores in most subdomains (6/7) compared to an age-matched group of non-SSD CI recipients who underwent unilaterally (N = 19) or sequential (N = 6) implantation.Conclusion. SSD CI patients not only demonstrate significant improvements in speech perception testing in the implanted ear but also exhibit improvement in multiple QOL subdomains on the CIQOL-35, the only validated cochlear implant QOL instrument.

Correlation Between Quality of Life and Speech Recognition Outcomes Following Cochlear Implantation

“…One study by McRackan et al (17) showed very weak positive correlations between the CIQOL-35 domain scores and AzBio in quiet scores even when controlling for various demographic and audiometric factors. Recent studies by Mitton et al and Tolisano et al (11,18) on patients with single-sided deafness also did not find significant relationships between the global subdomain of CIQOL-35 (equivalent to the CIQOL-10) and speech recognition outcomes and between the change in CIQOL-35 subdomains scores and change in speech recognition scores.…”

“…These questionnaires differed from other commonly used PROMs as they were developed using focus groups of CI patients and with thorough psychometric analysis. A few studies have investigated the association between speech recognition outcomes and quality of life as assessed by the CIQOL-35 or CIQOL-10 but have shown conflicting results (17)(18)(19).…”

Quality of Life With Cochlear Implantation Using the CIQOL-35 at a Tertiary Urban Medical Center: Our Experience

“…Our results demonstrate clear benefit of CI in terms of QOL among all CI patients. CI centers around the US are reporting promising findings in regard to PROMs using the CIQOL-35 (7,12,14,15). Walia et al (7) and McRackan et al ( 14) demonstrated significant benefit among all CIQOL-35 domains, whereas Mitton et al (12) revealed significant QOL improvement among entertainment, listening effort, social, and global domains for single-sided deafness patients.…”

“…CI centers around the US are reporting promising findings in regard to PROMs using the CIQOL-35 (7,12,14,15). Walia et al (7) and McRackan et al ( 14) demonstrated significant benefit among all CIQOL-35 domains, whereas Mitton et al (12) revealed significant QOL improvement among entertainment, listening effort, social, and global domains for single-sided deafness patients. Our study shows a marked improvement in all QOL domains among a heterogenous CI population, which solidifies that all CI patients can reasonably expect positive change in QOL and increases the generalizability of PROMs using the CIQOL-35.…”

“…The new Cochlear Implant Quality of Life-35 (CIQOL-35) Profile Instrument was specifically created and validated for CI-related QOL and to quantify patient-reported outcome measures (PROMs) (7,(12)(13)(14)(15), as many available healthrelated QOL surveys do not assess communication and interpersonal interaction in the same fashion (16). The Speech, Spatial, and Qualities of Hearing Scale has been previously used to assess CI-related QOL (17), but it is not validated for this purpose (18).…”