RP308 - Speech Recognition and Quality of Life Outcomes for Cochlear Implant Users Meeting Expanded Indications

Abstract:
Conventional candidacy criteria for cochlear implantation have been limited to patients with poor hearing and speech recognition abilities in both ears. Adults with preoperative unaided hearing detection and/or aided speech recognition scores that exceed these criteria may also experience significant improvements on measures of speech recognition and quality of life with cochlear implant (CI) use. The present study evaluated the speech recognition in quiet and noise as well as quality of life measures over time for adult CI users whose preoperative unaided hearing detection and aided speech recognition in the ear-to-be implanted and/or the contralateral ear exceeded conventional candidacy criteria.

Summary:
Objective
The present study evaluated the speech recognition in quiet and noise as well as quality of life measures over time for adult cochlear implant (CI) users whose preoperative unaided hearing detection and aided speech recognition in the ear-to-be implanted and/or the contralateral ear exceeded conventional candidacy criteria.

Rational
Conventional candidacy criteria for cochlear implantation have been limited to patients with poor hearing and speech recognition abilities in both ears, however adults with preoperative unaided hearing detection and/or aided speech recognition scores that exceed these criteria may also experience significant improvements on measures of speech recognition and quality of life with CI use. As candidacy criteria continues to expand, it is critical to examine patient outcomes.

Design
Forty-four adult participants presented with moderate-to-profound sensorineural hearing loss and aided word recognition between 10-60% in the ear-to-be implanted and ≤70% in the contralateral ear at the preoperative interval. Participants ranged in age from 23 to 91 years at time of surgery. Aided speech recognition was assessed in monaural and binaural listening conditions. Recorded speech recognition materials included CNC words in quiet and AzBio sentences in a 10-talker masker. Quality of life measures included the Speech Spatial and Qualities of Hearing Scale (SSQ) and the Abbreviated Profile of Hearing Aid Benefit (APHAB). Speech recognition and quality of life measures were evaluated preoperatively with an appropriately fit hearing aid, and at 1-, 3-, 6-, and 12-months post-activation with their CI.

Results
Participants experienced significant improvements in speech recognition and quality of life with a CI compared to preoperative abilities with a hearing aid. Improved speech recognition was observed in the monaural and binaural conditions in quiet and noise.

Conclusions
Patients who exceed conventional candidacy criteria for cochlear implantation experience a significant benefit from CI use on measures of speech recognition and quality of life as compared to preoperative abilities. These data demonstrate the need for expanded candidacy criteria for cochlear implantation to include all individuals who may benefit from CI use.

Brief Summary of Clinical Takeaways:
Patients who exceed conventional candidacy criteria for cochlear implantation experience a significant benefit from CI use on measures of speech recognition and quality of life as compared to preoperative abilities.