Do Patients Benefit From a Cochlear Implant When They Qualify Only in the Presence of Background Noise?

Abstract

Objective: To compare the difference in pre- to postoperative speech performance of patients qualifying for a cochlear implant (CI) in quiet, +10 dB signal-to-noise ratio (SNR), and +5 dB SNR. Study Design: Retrospective. Setting: Tertiary referral center. Patients: Fifty-eight post-lingually deafened, unilateral CI recipients from three Groups were included: 1) those who met CI candidacy criteria with AzBio sentences in quiet, 2) in noise at +10 dB SNR but not in quiet, 3) and in noise at +5 dB SNR but not in quiet or +10 dB SNR. Intervention: Unilateral CI. Main Outcome Measures: Pre- and 1 year postoperative speech recognition scores. Results: Best-aided AzBio speech recognition of individuals in Group 1 improved significantly for all test conditions and improved significantly for Groups 2 and 3 in the +10 and +5 dB SNR test conditions postoperatively. When tested with their CI alone however, while AzBio speech recognition of individuals in Group 1 and Group 2 improved significantly in the quiet and +10 dB SNR conditions, speech recognition was not significantly changed postoperatively under any testing condition for individuals in Group 3. Conclusions: While individuals qualifying for a CI only in the +5 dB SNR condition may derive significant benefit from implantation in best aided conditions, speech understanding outcomes can be more variable thus warranting additional counseling before implantation and case-by-case consideration of listening needs and goals.

The Impact of Age on Noise Sensitivity in Cochlear Implant Recipients

“…Most elderly adults are enrolled in CMS, who have the strictest CI candidacy criteria ( 40% in best aided condition), and one of the challenges is the ambiguity over testing materials and the use of background noise. Varying levels of background noise are often used to qualify older adults that otherwise would be missed (24,25). It is critical to understand the impact of adding noise on testing and how it is measured in relation to performance in the elderly compared with younger adults.…”

Relationships Between the Auditory Nerve Sensitivity to Amplitude Modulation, Perceptual Amplitude Modulation Rate Discrimination Sensitivity, and Speech Perception Performance in Postlingually Deafened Adult Cochlear Implant Users

“…Therefore, CNC word lists (Peterson & Lehiste 1962) were presented not only in quiet but also in speech-shaped noise at a signal to noise ratio (SNR) of +10 dB in this study. These two testing conditions are routinely used in clinical practice and have been used in many research studies (e.g., Dorman et al 2008; Lundberg et al 2021). The noise condition with a SNR of 5 dB was not tested to avoid the potential floor effect on study results.…”

Home-Based Speech Perception Monitoring for Clinical Use With Cochlear Implant Users

“…These scores reflect large variability in performance for persons with hearing aids (HA) and cochlear implants (CI), especially in noise (e.g., Gifford et al, 2008 , 2015 ; Zeitler et al, 2008 ; Meister et al, 2015 ; Ricketts et al, 2019 ), due to differences in patient demographics, as well as technical, linguistic, and cognitive factors ( Rählmann et al, 2018 ; James et al, 2019 ; de Graaff et al, 2020 ; Zhao et al, 2020 ). The multidisciplinary nature of audiological rehabilitation requires a wide range of performance measures to capture bottom-up and top-down neurocognitive skills ( Moberly et al, 2016 ; Rählmann et al, 2018 ; Skidmore et al, 2020 ; Tamati et al, 2020 ; Völter et al, 2020 ; Zhan et al, 2020 ; Biever et al, 2021 ; Lundberg et al, 2021 ). However, clinical time is scarce.…”