Predicting sequential bilateral cochlear implantation performance in postlingually deafened adults; A retrospective cohort study

Autor:	Dona M. P. Jayakody, Inge Stegeman, Marcus D. Atlas, Yvette E. Smulders, Peter L. Santa Maria, Cathy Sucher, Gemma S. Upson, Thomas Hendriks, Ronel Chester Browne, Peter L. Friedland, Robert H. Eikelboom
Rok vydání:	2018
Předmět:	Adult Male Hearing aid medicine.medical_specialty Hearing loss medicine.medical_treatment Patient characteristics Deafness Audiology 03 medical and health sciences 0302 clinical medicine Hearing Cochlear implant otorhinolaryngologic diseases medicine Humans 030223 otorhinolaryngology Cochlear implantation Retrospective Studies Adult patients business.industry Outcome measures Retrospective cohort study Middle Aged Cochlear Implantation Treatment Outcome Otorhinolaryngology Speech Perception Female medicine.symptom business 030217 neurology & neurosurgery Follow-Up Studies
Zdroj:	Clinical Otolaryngology. 43:1500-1507
ISSN:	1749-4478
DOI:	10.1111/coa.13193
Popis:	Objective To identify which preoperative patient characteristics influence sequential bilateral cochlear implantation performance and to create a statistical model that predicts benefit. Design Multicentre retrospective cohort study. Setting All patients were operated in four academic teaching hospitals in Perth, Australia, and followed up by audiologists of the Ear Science Institute Australia. Participants A total of 92 postlingually deafened adult patients who had undergone sequential cochlear implantations between 19 June 1990 and 14 March 2016 were included. Patients were excluded if the 12-month follow-up consonant-nucleus-consonant (CNC) phoneme score was missing. Main outcome measure The effect of 18 preoperative factors on the CNC phoneme score in quiet (at 65 dB SPL) with the second cochlear implant (CI2) one year after implantation. Results Two factors were positively correlated to speech understanding with CI2: Wearing a hearing aid (HA) before receiving CI2 (r = 0.46, P = 0.00) and the maximum CNC phoneme score with the first CI (CI1) (r = 0.21, P = 0.05). Two factors were negatively correlated: the length of hearing loss before CI2 in the second implanted ear (r = -0.25, P = 0.02) and preoperative pure tone average (PTA) (0.5, 1, 2 kHz) before CI2 in the second implanted ear (r = -0.27, P = 0.01). The following model could be created: predicted CNC phoneme score with CI2 (%) = 16 + (44 * HA use before CI2 (yes)) - (0.22 * length of hearing loss before CI2 (years)) + (0.23 * CNC phoneme score with CI1 (%)). Because the effect of HA use before implantation played such a major role, we also created a model after exclusion of the HA factor: Predicted CNC phoneme score with CI2 (%) = 82 - (0.17 * length of hearing loss before CI2 (years)) - (0.27 * PTA in second implanted ear before CI2 (0.5, 1, 2 kHz)) + (0.20 * CNC phoneme score with CI1 (%)). Conclusion Advanced age or a long interval between implantations does not necessarily lead to poor CI2 results. Patients who are successful HA users before CI2, who have a low PTA before CI2, a high CNC phoneme score with CI1 and a limited length of hearing loss before CI2, are likely to be successful CI2 recipients.
Databáze:	OpenAIRE
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