The Listening Network and Cochlear Implant Benefits in Hearing-Impaired Adults

Abstract

Older adults with mild or no hearing loss make more errors and expend more effort listening to speech. Cochlear implants (CI) restore hearing to deaf patients but with limited fidelity. We hypothesized that patient-reported hearing and health-related quality of life in CI patients may similarly vary according to age. Speech Spatial Qualities (SSQ) of hearing scale and Health Utilities Index Mark III (HUI) questionnaires were administered to 543 unilaterally implanted adults across Europe, South Africa, and South America. Data were acquired before surgery and at 1, 2, and 3 years post-surgery. Data were analyzed using linear mixed models with visit, age group (18–34, 35–44, 45–54, 55–64, and 65+), and side of implant as main factors and adjusted for other covariates. Tinnitus and dizziness prevalence did not vary with age, but older groups had more preoperative hearing. Preoperatively and postoperatively, SSQ scores were significantly higher (Δ0.75–0.82) for those aged <45 compared with those 55+. However, gains in SSQ scores were equivalent across age groups, although postoperative SSQ scores were higher in right-ear implanted subjects. All age groups benefited equally in terms of HUI gain (0.18), with no decrease in scores with age. Overall, younger adults appeared to cope better with a degraded hearing before and after CI, leading to better subjective hearing performance.

Design, implementation, and management of an international medical device registry

“…This can be factored in when considering the endpoints of the registry. There should be rigorous statistical analysis of data sets of enrolled individuals that are followed up versus those that are lost to follow-up [ 21 , 22 ]. It is also prudent to consider accounting for aspects that may influence or skew the interpretation of the data in a voluntary registry.…”

“…However, of course, the main aim of the treatment is restoring functional hearing, i.e. speech understanding [ 21 ]. Probing speech understanding capacity has been incorporated into generic health utility measures such as the Health Utility Index (HUI) [ 13 ].…”

Design, Implementation and Management of an International Medical Device Registry

“…These data were utilized at various intervals to generate a wide range of local and international conference posters or presentations as well as articles and publications in peer-reviewed journals. Scienti c ndings for CIs from the IROS registry have been published in several papers [Czerniejewska-Wolska 2015, Lenarz 2017, Wyss 2019, Müller 2021, James 2021. Pooled data could identify outcome trends as well as provide input for the design for more robust comparative studies.…”

“…This can be factored in when considering the end points of the registry. Rigorous statistical treatment of data sets including enrolled individuals that are followed-up versus those that are lost to follow-up should be performed (Lenarz 2017, James 2021). It also is prudent to consider accounting for aspects that may in uence or skew interpretation of the data in a voluntary registry such as how a registrant was recruited; the guidance provided to subjects on the completion methods of forms and questionnaires; and by whom and timing of evaluations.…”

“…These devices serve to overcome various dysfunctions in the auditory system from the outer ear to the inner ear and further up the auditory pathway. As such, although sensitivity to sound may be restored in all cases, functional hearing such as speech understanding is the main aim of such devices [James 2021]. Probing speech understanding capacity has been incorporated into generic health utility measures such as the Health Utility Index (HUI) [Feeny 2002] so that the bene t of a hearing implant may be calibrated against interventions for other health attributes.…”