Cochlear Implantation in the Active Duty Military Population: A Survey Assessing Military Readiness and Satisfaction

Sommerfeldt, John M; Fischer, Jakob L; Morrison, Danielle; Pillion, Elicia M.; Bernstein, Jeffrey; Tolisano, Anthony M.

doi:10.1097/mao.0000000000003000

Cited by 4 publications

(1 citation statement)

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“…Cochlear implants (CIs) restore hearing in patients who suffer from bilateral severe to profound sensorineural hearing loss. In addition to clear benefits for speech understanding (1), CIs reduce age-related dementia and isolation (2), restore music appreciation (3), and facilitate military readiness (4). In July 2019, the Food & Drug Administration (FDA) approved the first CI for use in patients who suffer from single-sided deafness (SSD) based on its ability to “improve performance regarding speech perception in quiet and in noise, sound localization (SL) and subjective measures regarding quality of life, music enjoyment and tinnitus” (5).…”

Section: Introductionmentioning

confidence: 99%

Quality of Life Impact of Cochlear Implantation for Single-Sided Deafness: Assessing the Interrelationship of Objective and Subjective Measures

et al. 2022

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Objective: To determine the effect on quality of life (QOL) of cochlear implantation (CI) for single-sided deafness (SSD) and asymmetric hearing loss (AHL) using the first psychometrically developed CI-specific QOL tool for English-speaking patients and to assess its relationship to objective perceptual measures. Study Design: Retrospective cohort study. Setting: Tertiary-care medical center. Patients: English-speaking adults with SSD or AHL. Interventions: Unilateral CI. Main Outcome Measures: Cochlear Implant Quality of Life (CIQOL) score, CI-alone speech-in-quiet (SIQ) score (CNC and AzBio), binaural speech-in-noise (SIN) threshold, binaural azimuthal sound localization (SL) error. Results: At the most recent postoperative evaluation (median, 9.3 months postimplantation), 25 of 28 subjects (89%) had a CIQOL improvement, with the improvement considered clinically beneficial (>3 points) for 18 of 28 subjects (64%). Group-mean CIQOL improvement was observed at the first postoperative visit and did not change significantly thereafter. Objective percep-tual measures (SL, SIQ, SIN) continued to improve over 12 months after implantation. Linear mixed-model regression analyses showed a moderate positive correlation between SIN and SIQ improvements (r = 0.50 to 0.59, p < 0.0001) and a strong positive correlation between the improvement in the two SIQ measures (r = 0.89, p < 0.0001). No significant relationships were observed ( p > 0.05) among QOL or the objective perceptual measures. Conclusions: QOL improved for the majority of subjects implanted for SSD and AHL. Different time courses for improvement in QOL and audiologic tests, combined with the lack of significant relationships among them, suggest that QOL outcomes reflect different aspects of the CI experience than those captured by speech-understanding and localization measures. SIQ may substitute for SIN when clinical constraints exist.

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Section: Introductionmentioning

confidence: 99%

Quality of Life Impact of Cochlear Implantation for Single-Sided Deafness: Assessing the Interrelationship of Objective and Subjective Measures

et al. 2022

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Sudden and Asymmetric Hearing Loss Among Active Duty Service Members: Underscoring the Importance of Active Screening

2021

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Military personnel are at increased risk of asymmetric hearing loss secondary to noise exposure. This report illustrates the importance of expeditiously evaluating for retrocochlear pathology even in young active duty service members with asymmetric or sudden hearing loss. A 36-year-old male presented with right-sided sudden hearing loss and dizziness. Audiometry revealed profound mid-to-high-frequency sensorineural hearing loss in the right ear. A 10-day course of oral steroid therapy and two intratympanic steroid injections were unsuccessful in restoring hearing. MRI revealed a 4.2 cm contrast-enhancing cerebellopontine angle tumor, consistent with a vestibular schwannoma (VS). Microsurgical resection utilizing a retrosigmoid craniotomy approach was performed with near-total resection of the tumor and preservation of the facial nerve but not the cochlear nerve. Despite preservation of the facial nerve, progression of post-operative facial weakness required gold weight placement to prevent exposure keratopathy. The patient had recovered partial function in all facial nerve branches at last follow-up. In light of the rising global incidence of VS, any asymmetric or sudden hearing loss in military service members should be evaluated with audiometry and referral to otolaryngology for workup of retrocochlear pathology.

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Hypoglossal Nerve Stimulator in the Active Duty Population: Military Readiness and Satisfaction

et al. 2023

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Introduction Because inadequate sleep impairs mission performance, the U.S. Army regards sleep as a core pillar of soldier readiness. There is an increasing incidence of obstructive sleep apnea (OSA) among active duty (AD) service members, which is a disqualifying condition for initial enlistment. Moreover, a new diagnosis of OSA in the AD population often prompts a medical evaluation board, and if symptomatic OSA proves refractory to treatment, this may result in medical retirement. Hypoglossal nerve stimulator implantation (HNSI) is a newer implantable treatment option, which requires minimal ancillary equipment to function and may provide a useful treatment modality to support AD service members while maintaining readiness in appropriate candidates. Because of a perception among AD service members that HNSI results in mandatory medical discharge, we aimed to evaluate the impact of HNSI on military career progression, maintenance of deployment readiness, and patient satisfaction. Methods The Department of Research Programs at the Walter Reed National Military Medical Center provided institutional review board approval for this project. This is a retrospective, observational study and telephonic survey of AD HNSI recipients. Military service information, demographics, surgical data, and postoperative sleep study results were collected from each patient.Additional survey questions assessed each service member’s experience with the device. Results Fifteen AD service members who underwent HNSI between 2016 and 2021 were identified. Thirteen subjects completed the survey. The mean age was 44.8 years (range 33-61), and all were men. Six subjects (46%) were officers. All subjects maintained AD status following HNSI yielding 14.5 person-years of continued AD service with the implant. One subject underwent formal assessment for medical retention. One subject transferred from a combat role to a support role. Six subjects have since voluntarily separated from AD service following HNSI. These subjects spent an average of 360 (37-1,039) days on AD service. Seven subjects currently remain on AD and have served for an average of 441 (243-882) days. Two subjects deployed following HNSI. Two subjects felt that HSNI negatively affected their career. Ten subjects would recommend HSNI to other AD personnel. Following HNSI, of the eight subjects with postoperative sleep study data, five achieved surgical success defined as >50% reduction of apnea–hypopnea index and absolute apnea–hypopnea index value of <20. Conclusions Hypoglossal nerve stimulator implantation for AD service members offers an effective treatment modality for OSA, which generally allows for the ability to maintain AD status, however: The impact on deployment readiness should be seriously considered and tailored to each service member based on their unique duties before implantation. Seventy-seven percent of HNSI patients would recommend it to other AD service members suffering from OSA.

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Cochlear Implantation in the Active Duty Military Population: A Survey Assessing Military Readiness and Satisfaction

Cited by 4 publications

References 23 publications

Quality of Life Impact of Cochlear Implantation for Single-Sided Deafness: Assessing the Interrelationship of Objective and Subjective Measures

Quality of Life Impact of Cochlear Implantation for Single-Sided Deafness: Assessing the Interrelationship of Objective and Subjective Measures

Sudden and Asymmetric Hearing Loss Among Active Duty Service Members: Underscoring the Importance of Active Screening

Hypoglossal Nerve Stimulator in the Active Duty Population: Military Readiness and Satisfaction

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