Binaural Hearing Rehabilitation Improves Speech Perception, Quality of Life, Tinnitus Distress, and Psychological Comorbidities.

OBJECTIVES: To determine and compare the benefit of binaural hearing rehabilitation via cochlear implantation (CI) on speech perception, assessment of auditory abilities, tinnitus distress, health-related quality of life (HRQoL) and psychological comorbidities in patients suffering from asymmetric hearing loss (AHL) as well as bilaterally-deafened and sequentially bilaterally-implanted patients. METHODS: 53 patients were implanted between 2011 and 2016. 24 AHL patients were implanted unilaterally, using a hearing aid on the other side. 29 bilaterally-deafened patients were sequentially implanted bilaterally. Speech perception, subjective hearing quality, HRQoL, tinnitus distress, anxiety, depressiveness, perceived stress level and coping abilities were evaluated before implantation, as well as 6 and 24 months postoperatively. RESULTS: Before CI, AHL and bilaterally-deaf patients showed significant differences regarding assessment of auditory abilities, speech discrimination, tinnitus distress and HRQoL. 24 months after CI both groups significantly improved in those scales. We could not find a significant difference between the groups after 2 years. Tinnitus distress significantly decreased 6 and 24 months postoperatively in both groups. CONCLUSIONS: This study demonstrates the long-term benefit of binaural hearing rehabilitation in AHL and bilaterally-deaf patients not only regarding speech perception but also HRQoL, tinnitus distress and subjective hearing quality. Bilaterally-deafened patients present lower scores preoperatively, but they did not differ from AHL patients 2 years after CI. Up to now, this is the first study evaluating the outcome of CI in AHL patients compared to bilaterally-implanted patients and demonstrating the benefit of binaural hearing rehabilitation in these specific groups.

The impact of cochlear implantation on tinnitus, stress and quality of life in postlingually deafened patients.

Tinnitus is a common complaint in the candidates for cochlear implantation (CI). Tinnitus-related distress has often been measured in these patients using categorical ratings, which lack information about tinnitus severity, stress and health-related quality of life or their correlation. Here, using 4 validated questionnaires, we evaluated psychometric parameters and the quality of life of 32 postlingually deafened patients before and after CI. The data regarding pre-CI were collected retrospectively. Of all patients included in this study, 28 (87.5%) suffered from tinnitus before implantation. Following a mean of 24 months after surgery, these patients reported a significant decrease (39.2%) of tinnitus impairment, as measured by the Tinnitus Questionnaire. In none of the 28 patients has tinnitus worsened. Moreover, the 4 tinnitus-free patients remained so after the CI surgery. In addition, the implant supply resulted in 36.7% reduction in perceived stress and in 15.4% reduction in evasive coping. In addition, the focus on positive coping has improved by 12.3%, whereas the health-related quality of life improved by 53.4% in all patients. Tinnitus impairment and stress were reduced more strongly in patients who had initially higher scores. Interestingly, a significant correlation between the psychometric scores was found mainly after CI. Our results indicate that patients with higher tinnitus-related distress have a lower quality of life, lesser coping abilities and perceive more stress, but before implantation it is masked by deafness. We conclude that tinnitus-related screening of patients before and after CI is an important step in the identification of individuals who would benefit from specific fitting and/or tinnitus therapy after implantation.