Benefits of Cochlear Implantation for Single-Sided Deafness: Data From the House Clinic-University of Southern California-University of California, Los Angeles Clinical Trial
| Autor: | Qian-Jie Fu, Robert V. Shannon, Suzannah C. Hagan, John J. Galvin, Eric P. Wilkinson, J. Eric Lupo, Monica Padilla, Dawna Mills |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Sound localization medicine.medical_specialty Hearing loss Visual analogue scale Audiology Hearing Loss Unilateral Severity of Illness Index 01 natural sciences Tinnitus 03 medical and health sciences Speech and Hearing 0302 clinical medicine Quality of life 0103 physical sciences Severity of illness otorhinolaryngologic diseases Humans Medicine Longitudinal Studies Sound Localization 030223 otorhinolaryngology 010301 acoustics Aged business.industry Middle Aged medicine.disease Cochlear Implantation Otorhinolaryngology Quality of Life Speech Perception Female medicine.symptom Unilateral hearing loss Noise business Binaural recording |
| Zdroj: | Ear & Hearing. 40:766-781 |
| ISSN: | 0196-0202 |
| Popis: | Objectives Cochlear implants (CIs) have been shown to benefit patients with single-sided deafness (SSD) in terms of tinnitus reduction, localization, speech understanding, and quality of life (QoL). While previous studies have shown cochlear implantation may benefit SSD patients, it is unclear which point of comparison is most relevant: baseline performance before implantation versus performance with normal-hearing (NH) ear after implantation. In this study, CI outcomes were assessed in SSD patients before and up to 6 mo postactivation. Benefits of cochlear implantation were assessed relative to binaural performance before implantation or relative to performance with the NH ear alone after implantation. Design Here, we report data for 10 patients who completed a longitudinal, prospective, Food and Drug Administration-approved study of cochlear implantation for SSD patients. All subjects had severe to profound unilateral hearing loss in one ear and normal hearing in the other ear. All patients were implanted with the MED-EL CONCERTO Flex 28 device. Speech understanding in quiet and in noise, localization, and tinnitus severity (with the CI on or off) were measured before implantation (baseline) and at 1, 3, 6 mo postactivation of the CI processor. Performance was measured with both ears (binaural), the CI ear alone, and the NH ear alone (the CI ear was plugged and muffed). Tinnitus severity, dizziness severity, and QoL were measured using questionnaires administered before implantation and 6 mo postactivation. Results Significant CI benefits were observed for tinnitus severity, localization, speech understanding, and QoL. The degree and time course of CI benefit depended on the outcome measure and the reference point. Relative to binaural baseline performance, significant and immediate (1 mo postactivation) CI benefits were observed for tinnitus severity and speech performance in noise, but localization did not significantly improve until 6 mo postactivation; questionnaire data showed significant improvement in QoL 6 mo postactivation. Relative to NH-only performance after implantation, significant and immediate benefits were observed for tinnitus severity and localization; binaural speech understanding in noise did not significantly improve during the 6-mo study period, due to variability in NH-only performance. There were no correlations between behavioral and questionnaire data, except between tinnitus visual analog scale scores at 6 mo postactivation and Tinnitus Functional Index scores at 6 mo postactivation. Conclusions The present behavioral and subjective data suggest that SSD patients greatly benefit from cochlear implantation. However, to fully understand the degree and time course of CI benefit, the outcome measure and point of comparison should be considered. From a clinical perspective, binaural baseline performance is a relevant point of comparison. The lack of correlation between behavioral and questionnaire data suggest that represent independent measures of CI benefit for SSD patients. |
| Databáze: | OpenAIRE |
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