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

Yvette E. Smulders, Thomas Hendriks, Inge Stegeman, Robert H. Eikelboom, Cathy Sucher, Gemma Upson, Ronel Chester Browne, Dona Jayakody, Peter L. Santa Maria, Marcus D. Atlas, Peter L. Friedland

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)1500-1507
Number of pages8
JournalClinical Otolaryngology
Volume43
Issue number6
DOIs
Publication statusPublished - 1 Dec 2018

Fingerprint

Cochlear Implantation
Hearing Aids
Cohort Studies
Hearing Loss
Retrospective Studies
Ear
Cochlear Implants
Statistical Models
Teaching Hospitals
Outcome Assessment (Health Care)

Cite this

@article{7d6623ab8bee49b5a4100ce56cfae3df,
title = "Predicting sequential bilateral cochlear implantation performance in postlingually deafened adults; A retrospective cohort study",
abstract = "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.",
keywords = "adult, bilateral, cochlear implantation, hearing loss, predict, sequential",
author = "Smulders, {Yvette E.} and Thomas Hendriks and Inge Stegeman and Eikelboom, {Robert H.} and Cathy Sucher and Gemma Upson and {Chester Browne}, Ronel and Dona Jayakody and {Santa Maria}, {Peter L.} and Atlas, {Marcus D.} and Friedland, {Peter L.}",
year = "2018",
month = "12",
day = "1",
doi = "10.1111/coa.13193",
language = "English",
volume = "43",
pages = "1500--1507",
journal = "Clinical Otolaryngology",
issn = "0307-7772",
publisher = "Wiley-Blackwell",
number = "6",

}

Predicting sequential bilateral cochlear implantation performance in postlingually deafened adults; A retrospective cohort study. / Smulders, Yvette E.; Hendriks, Thomas; Stegeman, Inge; Eikelboom, Robert H.; Sucher, Cathy; Upson, Gemma; Chester Browne, Ronel; Jayakody, Dona; Santa Maria, Peter L.; Atlas, Marcus D.; Friedland, Peter L.

In: Clinical Otolaryngology, Vol. 43, No. 6, 01.12.2018, p. 1500-1507.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predicting sequential bilateral cochlear implantation performance in postlingually deafened adults; A retrospective cohort study

AU - Smulders, Yvette E.

AU - Hendriks, Thomas

AU - Stegeman, Inge

AU - Eikelboom, Robert H.

AU - Sucher, Cathy

AU - Upson, Gemma

AU - Chester Browne, Ronel

AU - Jayakody, Dona

AU - Santa Maria, Peter L.

AU - Atlas, Marcus D.

AU - Friedland, Peter L.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - 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.

AB - 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.

KW - adult

KW - bilateral

KW - cochlear implantation

KW - hearing loss

KW - predict

KW - sequential

UR - http://www.scopus.com/inward/record.url?scp=85052840491&partnerID=8YFLogxK

U2 - 10.1111/coa.13193

DO - 10.1111/coa.13193

M3 - Article

VL - 43

SP - 1500

EP - 1507

JO - Clinical Otolaryngology

JF - Clinical Otolaryngology

SN - 0307-7772

IS - 6

ER -