Nordic results of cochlear implantation in adults: speech perception and patient reported outcomes.

BACKGROUND: Although cochlear implantation (CI) is widely performed in postlingually hearing-impaired adults in the Nordic countries, the literature on hearing outcomes remains scarce. Aims/objectives: To evaluate and correlate hearing outcomes after implantation. METHODS: Prospective evaluation of 40 adult first-implantation recipients pre- and post-implantation with Dantale, the Danish Hearing in Noise Test (HINT), the Nijmegen Cochlear Implant Questionnaire (NCIQ) and the Speech, Spatial and Qualities of Hearing Scale (SSQ12). RESULTS: Dantalemean increased from 50% (95% CI [41.7,58.4])) to 73% (95% CI [66.6,80.1]) and 19% (95% CI [13.3,25.1]) to 40%(95% CI [32.1,46.7]) (quiet/noise). HINTwords increased from 71% (95% CI [58.8,83.8]) to 83% (95% CI [69.8,95.4]) and 59% (95% CI [46.2,70.6]) to 73% (95% CI [63.3,82.8]) (quiet/noise). NCIQmean changed from 277 (95% CI [252.4,301.6]) to 396 (95% CI [366.7,424.7]) and SSQ12mean from 27 (95% CI [21.3,31.8]) to 48 (95% CI [39.4,55.6]). Correlations coefficients were r s = 0.39-0.74 (p < .01) between Dantale/HINT, rs = 0.78 (p < .0001) between NCIQ/SSQ12, r s = 0.41-0.59 (p < .01) between NCIQ/SSQ12 and Dantale and r s = 0.24-0.41 (ns) between NCIQ/SSQ12 and HINT. CONCLUSION: The study documents a high auditory performance and patient-perceived improvement after implantation and advocate broader awareness of implantation as treatment option in the growing population of severe-to-profound hearing-impaired adults. Correlations between hearing measures may influence future evaluation practices.

Auditory verbal skills training is a new approach in adult cochlear implant rehabilitation.

INTRODUCTION: Outcome after cochlear implantation in adults varies and is affected by many factors. One factor is auditory training after implantation. No national guidelines for adult auditory training currently exist in Denmark. An auditory verbal skills training (AVST) rehabilitation programme was developed and applied at the East Danish Cochlear Implant (CI) Centre (Rigshospitalet, Gentofte Unit). The AVST intervention was inspired by the auditory verbal therapy practice and targeted the paediatric population and their families. The objectives were to document the outcome for first-time adult CI users, to apply and explore the effects of the AVST and to examine CI users' possibly extended need for technical follow-up. METHODS: A prospective comparative study design was used. Ten CI users participated in AVST with a relative. Seven CI users were included in a control group. The outcome measures of speech understanding and quality of life (QoL) were recorded pre-implant and post-implant. RESULTS: All participants showed improved speech understanding and a higher QoL post-implant. The within-group analyses showed significant improvements in outcome over time. However, no differences were seen in the between-group analyses post-implant. The CI users in the intervention group received more CI fine-tuning. CONCLUSIONS: The AVST was successfully implemented at the CI Centre. Improvements in speech understanding and QoL were seen in both groups over time, but no differences were seen between the groups. The CI users in the intervention group received more fine-tuning of their processor. FUNDING: Oticon Medical A/S supported the study financially. TRIAL REGISTRATION: Not relevant as the study applied a prospective method study design.