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Background This study aimed to evaluate the quality of life (QOL) of older adults using cochlear implants (CIs) by focusing on how individual characteristics and speech perception are related to generic QOL ratings and utilizing the Health Utilities Index Mark III (HUI3) for assessment. Methodology A cross-sectional study was conducted with 19 participants aged ≥60 years, who were within one to five years post-implant activation. Data were obtained through self-administered questionnaires, including the HUI3 for generic QOL assessment and disease-specific indexes. Speech perception tests and chart reviews provided personal characteristic data. Statistical analysis was performed using the Mann-Whitney U-test, one-way analysis of variance, and Pearson's correlation coefficient. Results In total, 18 patients responded to the study. This study revealed that the generic QOL in older adult CI users was lower than that in the general older adult population. There was no significant association between QOL and variables such as sex, duration of implant usage, or age. However, a longer duration of hearing loss before receiving an implant was associated with higher generic QOL scores. Additionally, a strong correlation was observed between the hearing-related QOL score and utility scores. Conclusions Longer pre-implantation hearing loss correlated with better post-implantation QOL. Additionally, a reduced QOL, specifically within the hearing attribute, a subdomain of the HUI3, was associated with a lower overall generic QOL. The results suggest that generic QOL cannot be evaluated based on hearing ability alone and that cochlear implantation does not completely improve generic QOL. This study represents an important first step in understanding the QOL of older adult CI users from a variety of backgrounds.
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OBJECTIVES: Resonance properties of the nasal and sinus cavities are involved in the individuality of speech. However, detailed information on how alterations in the nasal cavity morphology affect voice quality is lacking. The aim of the present study was to investigate the effects of structural changes in the nasal cavity on voice production by spraying a topical adrenaline solution with a vasoconstrictive effect into the nasal cavity, causing nasal mucosal contraction. STUDY DESIGN: Prospective. METHODS: Overall, 51 adult volunteers were recruited from the Otorhinolaryngology Outpatient Department of the Jikei University Hospital from June to September 2022. Among them, 20 completed acoustic rhinometry and voice recordings before and after adrenaline spraying. The nasal consonant [N] uttered with the mouth completely closed was recorded for 5 seconds. The remaining 31 volunteers completed all auditory experiments. This was conducted to determine whether the changes in voice before and after adrenaline spraying could be discriminated against by the participants. RESULTS: The nasal volume had increased 5 and 10 minutes after spraying compared to that before spraying, reaching a significance at 10 minutes (P = 0.06). It had increased at 2 and 5 cm from the external nostrils compared to that within 3 cm of the external nostrils (P = 0.04). Among the 31 volunteers in the auditory experiments, 30 had a discrimination rate >90%, with a mean of 96.3% (standard error, 3.2). The spectral envelope of the 16 frequency bands varied significantly at 500-Hz increments (P = 0.0006). In particular, changes in the high-frequency bands were larger between 4500 and 6000 Hz. CONCLUSIONS: Nasal enlargement with 0.02% topical adrenaline affects the spectral envelope, particularly in the high-frequency bands between 4500 and 6000 Hz, and perceptibly alters the voice.
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OBJECTIVE: This study investigated factors related to the satisfaction level of cochlear implants for the elderly. METHODS: A survey was conducted by sending an anonymous self-reported questionnaire to medical facilities specializing in cochlear implantation throughout Japan and members of cochlear implant self-help groups aged 65 years and older. The subjects were divided into two age-based groups (under 75 and 75 years and older) to analyze the usage of cochlear implants. Binary logistic regression was performed to analyze factors related to the satisfaction level of the recipients with hearing improvements provided by cochlear implants (p<0.05). RESULTS: Responses were received from 60 cochlear implant users. The mean age of the respondents was 74.9±6.87 (mean ± 1SD) years. The mean cochlear implant use was 12.4 ± 4.0 (mean ± 1SD) hours per day. Regarding satisfaction with the cochlear implants, 93.3% responded "somewhat satisfactory" or better, indicating at least moderate satisfaction. However, fewer respondents in the 75-years and older group reported feeling "satisfactory" or better (chi-square test, p<0.05). Concerning device operation and management, difficulties including volume adjustment, switching between program, and exchanging cables, were reported. Among the patient-reported indices of postoperative hearing improvements studied, their ability to hear and comprehend conversations with family members and information provided at reception desks were most associated with user satisfaction with cochlear implants. CONCLUSION: Many elderly patients were satisfied with their cochlear implants; however, respondents in the 75-years and older group had lower levels of satisfaction compared to those in respondents in the under-75-years group. Elderly patients had problems with more complex operations and management of their cochlear implants. Moreover, they were satisfied with their ability to comprehend familiar, everyday conversations. These factors related to satisfaction level may be useful in providing valuable rehabilitation for elderly patients with cochlear implants.