Sources of variability of speech,spatial, and qualities of hearing scale (SSQ) scores in normal-hearing and hearing-impaired populations

Objective: To identify and quantify sources of variability in scores on the speech, spatial, and qualities of hearing scale (SSQ) and its short forms among normal-hearing and hearing-impaired subjects using a French-language version of the SSQ. Design: Multi-regression analyses of SSQ scores were performed using age, gender, years of education, hearing loss, and hearing-loss asymmetry as predictors. Similar analyses were performed for each subscale (Speech, Spatial, and Qualities), for several SSQ short forms, and for differences in subscale scores. Study sample: One hundred normal-hearing subjects (NHS) and 230 hearing-impaired subjects (HIS). Results: Hearing loss in the better ear and hearing-loss asymmetry were the two main predictors of scores on the overall SSQ, the three main subscales, and the SSQ short forms. The greatest difference between the NHS and HIS was observed for the Speech subscale, and the NHS showed scores well below the maximum of 10. An age effect was observed mostly on the Speech subscale items, and the number of years of education had a significant influence on several Spatial and Qualities subscale items. Conclusion: Strong similarities between SSQ scores obtained across different populations and languages, and between SSQ and short forms, underline their potential international use.     

Hearing-related,health-related quality of life in patients who have undergone otosclerosis surgery: A long-term follow-up study

Objectives: The aims of the study were to assess health-related quality of life and hearing-related disability in subjects with otosclerosis 30 years after surgery. Design: An observational study was performed. Medical records were reviewed, a clinical examination as well as audiometric assessments were performed. Generic health-related quality of life was assessed by the SF-36v2 and hearing disability by a shortened version of SSQ (speech spatial and qualities of hearing scale). Study sample: Sixty-five individuals, who had undergone stapedectomy in 1977-79 at a tertiary referral center. Results: Generic health-related quality of life according to SF-36 subscale scores was comparable to that of an age- and sex-matched reference population. The SF-36 mental component summary score (MCS) was, however, significantly better than that of the reference population. The mental and physical summary component scores correlated significantly to hearing disability measured by the SSQ but not to hearing impairment. Hearing disability was displayed in all SSQ sub-scores, especially in more complex listening situations and in the localization of sounds. Conclusions: This study shows that individuals with otosclerosis, 30 years after surgery, have a good generic health-related quality of life, despite moderate to severe hearing loss and significant hearing disabilities.     

Validation of a French translation of the speech,spatial, and qualities of hearing scale (SSQ) and comparison with other language versions

Objective: To validate a French version of the speech, spatial, and qualities of hearing scale (SSQ), a subjective evaluation of patients’ hearing disability, and to assess SSQ reproducibility across different language versions. Design: The SSQ was translated in accordance with the principles of the ‘Universalist approach’ of cross-cultural adaptation of patient-reported outcome instruments. Scores from a normal-hearing and a hearing-impaired population were compiled and compared, whenever possible, with data from the literature, collected using other language versions. Study sample: One hundred normal-hearing subjects and 230 hearing-impaired subjects. Results: Good reproducibility of scores and inter-subject variability were obtained between several language versions, even if scores found using the French version were slightly lower than those obtained using Dutch or English versions. A comparison of factor analysis outcomes between the English and French versions confirmed good conceptual equivalence across languages and robustness of the SSQ for use in international settings. The three main subscales (speech, spatial, and qualities) confirmed their usefulness in assessing different aspects of hearing disability. Conclusion: This study validated a French-language version of the SSQ, and assessed the reproducibility of the SSQ across subject groups, administration modes, and different countries/languages, confirming its potential as an international standard for hearing disability evaluation.     

Outcomes in implanted teenagers who do not meet the adult candidacy criteria

Severe to profoundly deaf adults who score 50% or over on the Bamford-Kowal-Bench (BKB) sentence test currently cannot obtain NHS funding for a cochlear implant according to the NICE guidelines (NICE Technical Appraisal Guidance (TAG166), 2009. Cochlear implants for children and adults with severe to profound deafness. NICE technology appraisal guidance [TAG166]. http://www.nice.org.uk/ta166 accessed 08/02/2016). There is no cut-off restriction from the BKB score for children. This study challenges this restrictive criteria for adults, by presenting the outcomes of cochlear implantation in older children who scored over 50% on BKB sentence testing pre-implantation and therefore would not have been implanted under the adult NICE guidelines. Outcomes are presented using the Speech, Spatial and Qualities of Hearing Scale Version C (SSQ-C) (Gatehouse, S., Noble, W. 2004. The Speech, Spatial and Qualities of Hearing Scale (SSQ). International Journal of Audiology, 43: 85–99.). This study suggests a greater proportion of adults who are currently being restricted from having a cochlear implant would benefit from implantation.     

Psychometric properties of the hearing handicap questionnaire: a Kannada (South-Indian) translation

Objective: To assess the psychometric properties of the Hearing Handicap Questionnaire (HHQ) in Kannada (a South-Indian language) among adults with hearing loss. Design: The study involved a cross-sectional survey design. Participants provided demographic details and completed the Kannada and English (original) version of the HHQ questionnaire. To evaluate test-retest reliability, ～50% of the participants completed the Kannada version for the second time after 15 days. Study sample: The sample comprised 103 adults with hearing loss recruited from local audiology clinics. Results: Exploratory factor analysis indicated a one-factor structure, which explained 71% of the variance in Kannada-HHQ scores. The internal consistency measured with Cronbach’s alpha was 0.96. The test-retest reliability correlations of the Kannada version with the English and with the same Kannada version re-administered after 15 days were 0.96 and 0.91, respectively. Convergent validity of the scale was confirmed by significant correlations with the Participation Scale and the Assessment of Quality of Life scales. Discriminant validity was found to be low as all the Kannada-HHQ questions were highly correlated with each other (r>?0.60). No floor and ceiling effects were identified. Conclusions: The psychometric properties of the Kannada-HHQ scale are considered to be adequate for clinical or research use.     

言语空间听觉质量量表-父母版的信效度分析

目的 言语空间听觉质量量表-父母版(Speech,Spatial,and Other Qualities of Hearing Scale for parents,SSQ-P)是在Speech,Spatial and Qualities of Hearing Scale(SSQ)的基础上为儿童人群修改的版本,通过对患儿...     

Adaptation of the Tinnitus Handicap Inventory into Polish and its testing on a clinical population of tinnitus sufferers

Objective: To describe how the Tinnitus Handicap Inventory (THI) was translated into Polish (THI-POL) and to present psychometric data on how well it performed in a clinical population of tinnitus sufferers. Design: The original version of THI was adapted into Polish. The reliability of THI-POL was investigated using test–retest, Cronbach’s alpha, endorsement rate and item–total correlation. Construct validity and convergent validity were also assessed based on confirmatory factor analysis, inter-item correlation and Pearson product-moment correlations using subscale A (Tinnitus) of the Tinnitus and Hearing Survey (THS-POL); divergent validity was checked using subscale B (Hearing) of THS-POL. Study sample: A group of 167 adults filled in THI-POL twice over their three-day hospitalisation period. Results: Test–retest reliability for the total THI-POL scores was strong (r?=?0.91). Cronbach’s alpha coefficient for the total score was high (r?=?0.95), confirming the questionnaire’s stability. Confirmatory factor analysis (CFA) and inter-item correlation did not confirm the three-factor model. Convergent validity from the Tinnitus subscale of THS showed a positive strong (r?=?0.75) correlation. Divergent validity showed only a moderate correlation. All analyses were statistically significant (p?< 0.01). Conclusions: THI-POL is a valid and reliable self-administered tool, which allows the overall tinnitus handicap of Polish-speaking patients to be effectively assessed.     

Prognostic value of psychological state in cochlear implantation

Conclusion: Perioperative Minnesota Multiphasic Personality Inventory (MMPI) scores may be beneficial for predicting prognosis of cochlear implantation (CI). A positive attitude for social interaction in particular correlates with a better speech outcome. Proper perioperative psychological management may, therefore, assist in the auditory rehabilitation of CI patients. Objective: To determine the perioperative psychological state of CI patients and its relationship with patient prognosis after CI. Methods: This study prospectively enrolled 29 patients who underwent CI from 2005–2013. The MMPI was administered to assess psychosocial and emotional issues surrounding CI and the Korean version of the Central Institute of Deafness (K-CID) score was used to measure speech perception. Results: CI resulted in a significant improvement on the MMPI Paranoia scale (p?= 0.02). Patients with abnormal pre-operative and post-operative MMPI scores also had an earlier onset of deafness, longer duration of deafness, and lower K-CID scores than patients with normal MMPI scores (all p?p?p?=?0.02), Psychasthenia (p?=?0.02), Schizophrenia (p?=?0.04), Hypomania (p?=?0.02) and Social Introversion (p?=?0.03) scores.     

Development and psychometric evaluation of a health-related quality of life instrument for individuals with adult-onset hearing loss

Objective: Self-reports of ‘hearing handicap’ are available, but a comprehensive measure of health-related quality of life (HRQOL) for individuals with adult-onset hearing loss (AOHL) does not exist. Our objective was to develop and evaluate a multidimensional HRQOL instrument for individuals with AOHL. Design: The Impact of Hearing Loss Inventory Tool (IHEAR-IT) was developed using results of focus groups, a literature review, advisory expert panel input, and cognitive interviews. Study sample: The 73-item field-test instrument was completed by 409 adults (22–91 years old) with varying degrees of AOHL and from different areas of the USA. Results: Multitrait scaling analysis supported four multi-item scales and five individual items. Internal consistency reliabilities ranged from 0.93 to 0.96 for the scales. Construct validity was supported by correlations between the IHEAR-IT scales and scores on the 36-item Short Form Health Survey, version 2.0 (SF-36v2) mental composite summary (r?=?0.32–0.64) and the Hearing Handicap Inventory for the Elderly/Adults (HHIE/HHIA) (r?≥??0.70). Conclusions: The field test provides initial support for the reliability and construct validity of the IHEAR-IT for evaluating HRQOL of individuals with AOHL. Further research is needed to evaluate the responsiveness to change of the IHEAR-IT scales and identify items for a short-form.     

ORIGINAL ARTICLE: The relationship between patients’ perception of the effects of neurofibromatosis type 2 and the domains of the Short Form-36

Clin. Otolaryngol. 2010, 35 , 291–299 Objectives: To investigate the relationship between those issues concerning quality of life in patients with neurofibromatosis type 2 (NF2) as identified by the closed set NF2 questionnaire and the eight norm-based measures and the physical component summary (PCS) and mental component summary (MCS) scores of the Short Form-36 (SF-36) Questionnaire. Design: Postal questionnaire study. Setting: Questionnaires sent to subjects’ home addresses. Participants: Eighty-seven adult subjects under the care of the Manchester Multidisciplinary NF2 Clinic were invited to participate. Main outcome measures: Sixty-two (71%) completed sets of closed set NF2 questionnaires and SF-36 questionnaires were returned. Results: Subjects with NF2 scored less than the norm of 50 on both the physical component summary and mental component summary scores and the eight individual norm-based measures of the Short Form-36 questionnaire. Correlations (using Kendall’s tau) were examined between patients’ perceptions of their severity of difficulty with the following activities and the eight norm-based measures and the physical component summary and mental component summary scores of the Short Form-36 questionnaire: Communicating with spouse/significant other (N = 61). The correlation coefficients were significant at the 0.01 level for the mental component summary score, together with three of the norm-based scores [vitality (VT), social functioning and role emotional]. Social communication (N = 62). All 10 correlations were significant at the 0.01 or 0.001 level. Balance (N = 59). All 10 correlations were highly significant at the P < 0.001 level. Hearing difficulties (N = 61). All correlations were significant at either the 0.01 level or less apart from the mental component summary score and three of the norm-based scores (role physical, VT and mental health). Mood change (N = 61). All correlations were significant at the 0.01 level or less, apart from one norm-based score (role physical). Conclusions: The Short Form-36 questionnaire has allowed us to relate patients’ perceptions of their difficulties, as identified by the closed set NF2 questionnaire, to the physical and mental domains measured by this validated and widely used scale, and has provided further insight into areas of functioning affected by NF2.     

Quality of life,effort and disturbance perceived in noise: A comparison between employees with aided hearing impairment and normal hearing

Abstract

Objectives: The aims were to compare health-related quality of life (HRQOL) and hearing handicap between two groups of employees with normal hearing and aided hearing impairment (HI). HRQOL was also compared to a normative population. The second aim was to compare perceived effort (PE) and disturbance after completing a task in office noise between the two study groups. Design: A Swedish version of the short form-36 (SF-36) and the hearing handicap inventory for adults (HHIA) was used to determine HRQOL and hearing handicap. The Borg-CR 10 scale was used to measure PE and disturbance. Study sample: Hearing impaired (n = 20) and normally hearing (n = 20) participants. The normative sample comprised of 597 matched respondents. Results: Hearing-impaired employees report relatively good HRQOL in relation to the normative population, but significantly lower physical functioning and higher PE than their normally-hearing peers in noise. Results from the HHIA showed mild self-perceived hearing handicap. Conclusions: The current results demonstrate that physical health status can be negatively affected even at a mild-moderate severity of HI, and that a higher PE is reported from this group when performing a task in noise, despite the regular use of hearing aids.     

言语、空间与听觉质量量表在老年听力损失者助听器验配中的应用

目的探讨言语、空间与听觉质量量表(speech,spatial and qualities of hearing scale,SSQ)用于老年听力损失患者佩戴助听器的效果评估作用。方法以100例老年感音神经性听力损失者(60~90岁)为研究对象,采用横断面研究和前瞻性研究,其中,无助听器使用经验者44例(75.8±8.1岁,气导纯音平均听阈59.8±13.3 dB HL)、有助听器使用经验者34例(77.5±6.3岁,气导纯音平均听阈64.5±17.8 dB HL,助听器佩戴时间大于三个月)进行横断面研究;22例(74.3±8.6岁,气导纯音平均听阈58.1±12.6 dB HL)首次配戴助听器者进行前瞻性研究;二组参与横断面研究者进行一次SSQ评估,前瞻性研究组分别在助听前和佩戴助听器1个月后进行二次SSQ评估,均采用面对面问答方式用SSQ量表评估三组受试者在言语理解能力、空间定位能力和声音聆听质量方面的变化。结果横断面研究结果显示,有助听经验组SSQ问卷言语理解(97.29±23.43分)、空间听觉(131.94±19.27分)、声音质量(143.53±20.31分)和总分(372.76±51.92分)均显著高于无助听经验组(分别为58.66±30.13、99.41±37.09、108.09±43.28、266.16±78.18分)。前瞻性研究结果显示,受试者初次佩戴助听器一个月后的SSQ问卷言语理解(106.27±13.86分)、空间听觉(136.00±14.09分)、声音质量(151.73±13.91分)和总分(394.00±34.70分)均显著高于佩戴助听器前(分别为65.64±21.89、115.09±17.17、111.91±25.41、292.64±45.58分),横断面研究和前瞻性研究结果均显示,老年听力损失患者佩戴助听器后在言语理解能力、空间声源定位能力和声音聆听质量方面均有显著改善(P<0.05)。结论SSQ量表可以有效评估老年听力损失患者助听器使用效果;老年听力损失患者佩戴助听器后在言语理解能力、空间定位能力和声音聆听质量方面均有显著提高。     

Validation of the Hearing Implant Sound Quality Index (HISQUI19) to assess Spanish-speaking cochlear implant users’ auditory abilities in everyday communication situations

Conclusion: The Spanish-language HISQUI₁₉ is a reliable and easy-to-use tool for quantifying the self-perceived level of auditory benefit that cochlear implant (CI) users experience in everyday listening situations. Objectives: To validate the Spanish-language version of The Hearing Implant Sound Quality Index (HISQUI₁₉), a questionnaire for quantifying the self-perceived level of auditory benefit that CI users experience in everyday listening situations. Methods: Adult Spanish-speaking subjects with a CI were asked to complete a Spanish-language version of the HISQUI₁₉. Reliability of the questionnaire was determined using Cronbach’s α coefficient; exploratory factor analyses with a rotated (varimax) factor solution was applied to check construct validity; external validity was confirmed using Pearson’s correlation. Test–re-test analysis was also performed. The MED-EL Assessment Database was used to assist in the administration, reporting, and data collection. Results: Sixty-six of 77 subjects completed and returned the HISQUI₁₉. The mean score auditory ability score (mean?±?standard deviation) of the HISQUI₁₉ was 79.9?±?24.0, a ‘moderate’ auditory benefit. An inverse relationship was found between the HISQUI₁₉ score and age at implantation. Gender and side of implantation did not influence self-perceived functioning. The objective measures (disyllables tested without lip-reading and in quiet) were correlated with the Total Score.     

ORIGINAL ARTICLE: The bone-anchored hearing aid in the rehabilitation of single-sided deafness: experience with 58 patients

Clin. Otolaryngol. 2010, 35 , 284–290 Objectives: To assess the efficacy of the bone-anchored hearing aid (BAHA) in the rehabilitation of single-sided deafness (SSD). Study design: Retrospective case–control series review. Setting: Tertiary referral unit. Patients: Fifty-eight consecutive patients that had a bone-anchored hearing aid for single-sided deafness completed outcome questionnaires, building upon earlier audiological assessment of 19 patients. Single-sided deafness controls (n = 49) were mainly acoustic neuroma patients. Main outcome measurements: speech discrimination testing in directional noise, speech and spatial qualities of hearing questionnaire and the Glasgow Benefit Inventory (GBI). Results: The mean follow-up time was 28.4 months. Five (13%) of the bone-anchored hearing aid patients were non-users because of lack of benefit. The audiometric testing confirmed that when noise was on the bone-anchored hearing aid side speech perception was reduced but benefited when noise was on the side of the hearing ear. There was no difference between the Speech and Spatial Qualities of Hearing Scores in bone-anchored hearing aid users and controls. In particular there was no difference in the spatial subscores. In the bone-anchored hearing aid users the median Glasgow Benefit Inventory score was 11. If the non-users are included then 13 (22%) patients had no or detrimental (negative) Benefit scores. No or negative benefit scores were more frequent in those deaf for <10 years. In open-field questions, patients felt the bone-anchored hearing aid was most useful in small groups or in ‘one-to-one’ conversation. Conclusions: Bone-anchored hearing aid rehabilitation for single-sided deafness is less successful than for other indications, reflected here by relatively low median Glasgow Benefit Inventory scores. There was also no significant difference between controls and bone-anchored hearing aid users in the Speech and Spatial Qualities of Hearing Questionnaire. Patients with a longer duration of deafness report greater subjective benefit than those more recently deafened, perhaps due to differing expectations.     

Sound localization ability of young children with bilateral cochlear implants.

OBJECTIVE: To evaluate the benefit of bilateral cochlear implantation in young children. STUDY DESIGN: Clinical trial comparing a group of bilaterally implanted children with a group of unilaterally implanted children. SETTING: Tertiary referral center. PATIENTS: Five bilaterally implanted children (mean age at testing, 3 yr 7 mo) were compared with 5 unilaterally implanted children (mean age at testing, 5 yr 3 mo). Meningitis was the cause of deafness in all of the children. METHODS: Children were asked to localize a prerecorded melody band limited from 500 to 4,000 Hz presented from loudspeakers placed at either -90 or 90 degrees or -30 or 30 degrees azimuth. Their parents filled in the Speech, Spatial and Qualities of Hearing Scale (SSQ) and PedsQL questionnaires on hearing and health-related quality of life of their children. RESULTS: The bilaterally implanted children had significantly better scores on the localization test than the children with unilateral cochlear implants. The scores of the children with bilateral cochlear implants were also significantly higher on the spatial domain of the SSQ, which concerns localization. No significant differences were found in the speech and quality of hearing domains and the total scores on the SSQ or the PedsQL between the two groups. CONCLUSION: Children with bilateral cochlear implantation already demonstrate an advantage over unilaterally implanted children at a young age.     

Objective,audiological and quality of life measures with the CI532 slim modiolar electrode

Objectives: To report on electrode array measurements for the Nucleus^® CI532 Slim Modiolar Electrode device including: ECAP thresholds, electrode impedances, and psychophysical comfort levels, as well as speech perception results pre- and post-operatively and standardized evaluations of quality of life.

Methods: Forty-four subjects were implanted with the CI532. Electrically evoked compound action potential (ECAP) thresholds and impedances were measured using automatic Neural Response Telemetry intra-operatively, at activation and at six months post implant. Pre- and post-operative measures of words in quiet and sentences in noise were made in multiple languages. Quality of life was assessed using The Speech Spatial Qualities questionnaire (SSQ) and Glasgow Benefit Inventory (GBI).

Results: Intra-operative ECAP thresholds were recorded successfully from 90% of electrodes tested. ECAP thresholds varied across the array and a post-hoc Dunn’s test showed that median thresholds for electrodes E1–E13 were significantly greater than those for E17–E22 (all P?<?0.001). Impedances increased significantly between surgery and activation. Speech recognition scores for words in quiet and sentences in noise showed a significant improvement for the group at six months, when using the cochlear implant, compared with pre-operative performance (P?<?0.001). There was a significant increase compared to pre-operative ratings for all sections of the SSQ at six months post activation (P?<?0.001). The GBI gave scores significantly above zero for the ‘general’ subscale and total score.

Conclusion: Objective ECAP and impedance measures for this new electrode array were as expected and similar to results reported for other array types. Speech perception and quality of life improved significantly following implantation.

Trial registration: ClinicalTrials.gov identifier: NCT02392403.     

Which ear should we choose for cochlear implantation in the elderly: The poorer or the better? Audiometric outcomes,quality of sound,and quality-of-life results

Conclusions: Cochlear implantation in the poorer ear of an elderly patient does not predict poorer post-operative audiological, quality-of-life (QoL), and quality of sound results. Objectives: To determine whether choosing the ‘better’ or the ‘poorer’ ear for cochlear implantation impacts performance outcome in an elderly population. Methods: Forty-two out of 73 elderly (≥ 60 years) cochlear implant users with some residual hearing in at least one ear were selected. Three criteria were used to group the patients as ‘better’ or ‘poorer’ ear implanted; (C1) based on previous use of hearing aid, (C2) pre-operative PTA, and (C3) pre-operative speech discrimination. The Glasgow Benefit Inventory (GBI) and the Hearing Implant Sound Quality Index (HISQUI) were used to measure QoL and quality of sound, respectively. Results: The mean post-operative PTA was 38.7 ± 7.2 dBHL. In quiet, the mean disyllabic SDS at 65dBSPL was 75.4 ± 18.5, whereas the discrimination of sentences was 95.0% ± 6.9. The mean total GBI score was 30.9 ± 21.8, 92.9% of patients reporting a positive score. The mean HISQUI score was 111.3 ± 36.0, which corresponds to ‘moderate’ sound quality. No significant differences were found between both groups in terms of audiological outcomes, HISQUI scores or GBI scores when considering each of the three criteria.     

Assessment of the American Medical Association guide to the evaluation of binaural hearing impairment

Abstract

Objective: To assess the American Medical Association (AMA) guide to the evaluation of binaural hearing impairment (BHI) as a procedure for estimating severity of hearing loss from audiograms. Design: The BHIs of Australian war veterans were calculated from their hearing threshold levels (HTLs) and compared with their scores on a hearing questionnaire, the hearing measurement scale (HMS). Study sample: The HTLs of 282 Australian war veterans were measured at frequencies from 0.25 to 8 kHz and scores on the HMS were obtained from 154 of those veterans. Results: No grounds could be found for altering the frequencies included in the average HTL or the high fence of 92 dB HL used in calculating the monaural hearing impairments (MHIs) of the veterans, and no grounds could be found for altering the ratio of 5:1 used in determining the BHI from the MHIs of the better and worse ears. However, agreement between HMS score and BHI was improved by reducing the low fence used in calculating MHI from 25 to 15 dB HL. Conclusion: A modified version of BHI provided an improved procedure for estimating severity of hearing loss from audiograms but would not be suitable for compensation purposes.     

Health-related quality of life in hearing-impaired adolescents and children

Objective: To evaluate health-related quality of life (HRQoL) in hearing-impaired adolescents and children and to compare it with that of hearing individuals.

Study design and setting: Hearing-impaired adolescents and children were recruited to the study during their annual control visit to the Hearing Clinic of Helsinki University Hospital. They filled in a HRQoL questionnaire, either the 16-dimensional 16D (adolescents aged 12–17 years) or the 17-dimensional 17D (children aged 7–11 years). The total HRQoL scores were compared with previously collected data, matched for age and gender, from adolescents and children without any known handicaps or illnesses.

Results: In total 50 adolescents and 50 children completed the questionnaire. Of the 16/17 dimensions of the HRQoL instrument, hearing and communication were affected the most. The total HRQoL scores were somewhat lower in adolescents and children with hearing impairment than in the general populations of age-matched peers (p?Conclusions: HRQoL in hearing-impaired adolescents and children is only slightly worse than in hearing adolescents and children.

Significance: This study evaluates the impact of hearing loss on HRQoL to enhance the care of these children.     

Can adolescents and young adults with prelingual hearing loss benefit from a second,sequential cochlear implant?

Abstract

This study aimed to determine if adolescents/young adults gained additional perceptual benefit from sequential bilateral cochlear implants within 12 months, and to document adaptation to the second implant. Assessments comprised a pediatric version of The Speech, Spatial and Qualities of Hearing Scale (SSQ), anecdotal reports of device use and daily listening, and the Adaptive Spondee Discrimination Test (AdSpon). All nine participants achieved full-time use of, a preference for, and superior daily listening with, bilateral implants. Eight participants were comfortable using the second implant alone, and two achieved similar daily listening with either implant alone. SSQ ratings were higher post-operatively for the majority of participants. AdSpon performance was superior bilaterally for five participants with noise ipsilateral to the first implant, but not contralateral. Unilateral performance with either implant was similar for one participant. A second implant may provide additional benefit up to 19 years of age, even with congenital hearing loss and >16 years between implants. Families and clinicians should understand the aspects of second-implant candidacy and post-operative use that are unique to adolescents/young adults.

Sumario

El objetivo del estudio fue determinar si los adolescentes y adultos jóvenes obtenían un beneficio adicional con implantes cocleares bilaterales secuenciales en un periodo de 12 meses, y documentar la adaptación al segundo implante. La evaluación comprendió una versión pediátrica de la Escala para el Lenguaje, la Audición Espacial y las Cualidades Auditivas (SSQ), reportes anecdóticos de uso de dispositivos y escucha cotidiana; y la Prueba Adaptativa de Discriminación de Espondaicas (AdSpon). Los nueve participantes lograron el uso por tiempo completo, la preferencia por, y la escucha superior cotidiana con los implantes bilaterales. Ocho participantes se sintieron a gusto con el segundo implante solamente y dos lograron condiciones de escucha similares con cualquiera de los implantes individualmente. Las puntuaciones de SSQ fueron más altas en el postoperatorio para la mayoría de los participantes. Para seis participantes, el desempeño en la AdSpon fue superior en la condición bilateral con ruido ipsilateral en el primer implante, pero no en el contralateral. El desempeño unilateral con cualquiera de los implantes fue similar para un participante. Un segundo implante puede proporcionar beneficio adicional hasta los 19 años de edad, aun en el caso de hipoacusia congénita y más de 16 años entre implantes. Las familias y los clínicos deben entender los aspectos para la candidatura de un segundo implante y su uso postoperatorio que son singulares para los adolescentes y los adultos jóvenes.