Cochlear Implants for Single‐Sided Deafness: Quality of Life, Daily Usage, and Duration of Deafness

Abstract

ObjectiveTo report our experience for adults undergoing cochlear implantation (CI) for single‐sided deafness (SSD).MethodsThis is a retrospective case series for adults with SSD who underwent CI between January 2013 and May 2021 at our institution. CNC and AzBio speech recognition scores, Tinnitus Handicap Inventory (THI), Speech, Spatial, and Qualities of Hearing Scale (SSQ12), datalogging, and the Cochlear Implant Quality of Life (CIQOL)‐10 Global measure were utilized.ResultsSixty‐six adults underwent CI for SSD (median 51.3 years, range 20.0–74.3 years), and 57 (86.4%) remained device users at last follow‐up. Compared to pre‐operative performance, device users demonstrated significant improvement in speech recognition scores and achieved peak performance at six months post‐activation for CNC (8.0% increased to 45.6%, p < 0.0001) and AzBio in quiet (12.2% increased to 59.5%, p < 0.0001). THI was decreased at 6 months post‐implantation (58.1–14.6, p < 0.0001), with 77% of patients reporting improved or resolved tinnitus. Patients demonstrated improved SSQ12 scores as well as the disease‐specific CIQOL‐10 Global questionnaire. Duration of deafness was not associated with significant differences in speech recognition performance. Average daily wear time was positively associated with CNC and AzBio scores as well as post‐operative CIQOL‐10 scores.ConclusionsHerein we present the largest cohort of adult CI recipients with SSD with data on speech recognition scores, tinnitus measures, and SSQ12. Novel insights regarding the correlation of datalogging, duration of deafness, and CI‐specific quality of life (CIQOL‐10) metrics are discussed. Data continue to support CI as an efficacious treatment option for SSD.Level of Evidence4 Laryngoscope, 133:2362–2370, 2023

Cochlear Implant Qualification in Noise Versus Quiet: Do Patients Demonstrate Similar Postoperative Benefits?

“…Recent research highlighted the importance of device use on CI performance. Holder et al demonstrated that even with short‐term increased device use (4 weeks), CI users improved speech recognition scores while Linquist et al demonstrated that device use is associated with both speech recognition performance and quality of life (QOL) outcomes in CI users 36,37 …”

“…Holder et al demonstrated that even with short-term increased device use (4 weeks), CI users improved speech recognition scores while Linquist et al demonstrated that device use is associated with both speech recognition performance and quality of life (QOL) outcomes in CI users. 36,37 Our study is limited by selection criteria. There inevitably are patients not tested with AzBio Quiet sentences (those only tested with CNC words, or unable to perform open-set testing), who were not included in our study.…”

Discrepancies Between Expected and Actual Cochlear Implant–Related Functional Outcomes

“…It may not be necessary for expectations to exactly match normative data, but patients should have a clear understanding of which outcomes are most likely based on available evidence. Moreover, these data may help motivate patients to work toward maximizing functional abilities with their implant through increased device use, challenging themselves to engage in conversation in adverse listening conditions, and placing higher stake in auditory training resources to potentially reach these goals (24)(25)(26). For patients with low expectations, evidence-based pre-CI counseling may assure them that they are likely to meet their expected outcomes, while also illustrating that even more improvement is possible.…”

Cochlear Implant Electrode Array Design and Speech Understanding

“…Although the date of surgery stratification offers some measure of control of evolving CI technology and practices, there is likely to be unmeasured confounding in these factors as well as the changing CI patient population. Although LW versus PM groups had similar preoperative CNC-w scores, preoperative low-frequency hearing and postoperative hearing preservation were not specifically assessed, which represents an area where array design may be especially impactful for CI performance (26)(27)(28). Despite these limitations, our study encompassed a wide time period of surgical implantations as well as significant longitudinal follow-up in a large sample across all three major CI manufacturers, and we believe that these results add to the converging evidence that suggest overall improved speech understanding in patients implanted with PM arrays.…”