Longitudinal Speech Recognition Changes After Cochlear Implant: Systematic Review and Meta‐analysis

Abstract

Objectives To examine patterns of change and plateau in speech recognition scores in postlingually hearing impaired adult cochlear implant recipients. The study also examines variations in change patterns for different speech materials and testing conditions. Study Design Used systematic review with meta‐analysis. Methods Articles in English reporting speech recognition scores of adults with postlingual hearing loss at pre‐implantation and at least two post‐implantation time points were included. Statistically significant changes were determined by meta‐analysis and the 95% confidence interval. Results A total of 22 articles representing 1954 patients were included. Meta‐analysis of mean difference demonstrated significant improvements in speech recognition score for words in quiet (37.4%; 95% confidence interval [34.7%, 40.7%]), sentences in quiet (49.4%; 95% confidence interval [44.9%, 53.9%]), and sentences in noise (30.8%; 95% confidence interval [25.2%, 36.4%]) from pre‐op to 3 months. Scores continued to increase from 3 to 12 months but did not reach significance. Similarly, significant improvements from pre‐op to 3 months were observed for consonant nucleus consonant (CNC) words in quiet (37.1%; 95% confidence interval [33.8%, 40.4%]), hearing in noise test (HINT) sentences in quiet (46.5%; 95% confidence interval [37.0%, 56.0%]), AzBio sentences in quiet (45.9%; 95% confidence interval [44.2%, 47.5%]), and AzBio sentences in noise (26.4%; 95% confidence interval [18.6%, 34.2%]). HINT sentences in noise demonstrated improvement from pre‐op to 3 months (35.1%; 95% confidence interval [30.0%, 40.3%]) and from 3 to 12 months (15.5%; 95% confidence interval [7.2%, 23.8%]). Conclusions Mean speech recognition scores demonstrate significant improvement within the first 3 months, with no further statistically significant improvement after 3 months. However, large individual variation should be expected and future research is needed to explain the sources of these individual differences. Laryngoscope, 133:1014–1024, 2023

Hearing health care access for adult cochlear implant candidates and recipients: Travel time and socioeconomic status

“…A review by Ma et al suggests that multiple follow‐up visits may not be necessary for every CI recipient considering when plateaus in speech recognition are observed. 22 Additionally, some CI centers have investigated the use of remote programming, 23 which could reduce the strain on the patient's time and financial resources. Future studies will aim to assess long‐term outcomes and patients' attitudes toward alternative service delivery models.…”

“…A patient's decision to pursue cochlear implantation may be influenced by the recommended follow‐up visits to the CI center within the first year, which also place strain on time and financial resources for the patient. A review by Ma et al suggests that multiple follow‐up visits may not be necessary for every CI recipient considering when plateaus in speech recognition are observed 22 . Additionally, some CI centers have investigated the use of remote programming, 23 which could reduce the strain on the patient's time and financial resources.…”

Determinants of Cochlear Implant Satisfaction and Decisional Regret in Adult Cochlear Implant Users

“…This trend demonstrates the importance of measuring functional abilities, beyond speech recognition, through validated PROMs as a key component of monitoring post-CI outcomes and providing pre-CI counseling. Prior evidence has demonstrated that most CI users experience improvement in speech recognition after implantation (6,7); however, evidence describing the association between pre-/post-CI improvement in speech recognition scores and patient satisfaction is limited. In the current study, there was a minimal effect from either word or sentence recognition improvement on CI satisfaction.…”

“…For adults with postlingual hearing loss, the vast majority experience improvements in speech recognition scores compared with their pre-CI scores, with improvements of 35% or more common for both words in quiet and sentences in quiet testing (6,7). Similarly, functional abilities assessed with patient-reported outcome measures (PROMs) have consistently shown significant improvement for patients across multiple domains compared with pre-CI abilities (8)(9)(10).…”

Cochlear Implant Outcomes in the Chinese-Speaking Adult Population: A Systematic Review

“…Cochlear implants (CI) are surgically placed devices that can improve speech perception in people with severe sensorineural hearing loss (1). Speech perception remains the primary outcome of interest for most CI patients, a measure that is inseparable from the patient's preferred spoken language.…”