Evidence-based guidelines for recommending cochlear implantation for postlingually deafened adults

Leigh, Jaime; Moran, Michelle; Hollow, Rod; Dowell, Richard C.

doi:10.3109/14992027.2016.1146415

Cited by 68 publications

(56 citation statements)

References 27 publications

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“…Speech perception results showed a significant improvement for the group at six months, when using the cochlear implant compared with pre-operative performance. Individual scores indicated that at least 75% of subjects improved their word and sentence scores postoperatively for both the implanted ear, and the best-aided performance, meeting the success criteria for implantation suggested by Leigh et al (2016). A significant proportion of subjects also improved their speech perception scores by at least 20% (the threshold for a clinically significant improvement suggested by the UK CI study group, 2004) in the implanted ear in quiet (75%), and in noise (50%).…”

Section: Discussionmentioning

confidence: 76%

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

Hey

Wesarg

Mewes

et al. 2018

Cochlear Implants International

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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 intraoperatively, 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. (Registered as NCT02392403 on ClinicalTrials.gov PRS)

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Section: Discussionmentioning

confidence: 76%

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

Hey

Wesarg

Mewes

et al. 2018

Cochlear Implants International

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“…This results in significant variability in outcomes across the population of cochlear implant recipients. For the individual candidate, the variability of outcomes with cochlear implants limits the degree of prognostic certainty that clinicians can provide when making recommendations on the potential for benefit [6]. The greater the degree of preoperative residual hearing, the greater the perceived potential for loss in the unlikely event of an unsuccessful intervention.…”

Section: Introductionmentioning

confidence: 99%

Cochlear implantation outcomes in adults: A scoping review

et al. 2020

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Cochlear implantation has become known as "the treatment of choice" for adults with severe to profound hearing loss. Wide variability exists, however, in the way hearing loss severity is measured and in the candidacy criteria used to recommend cochlear implantation. ObjectivesThis study aimed to provide a descriptive analysis of recent evidence available in the literature in relation to the efficacy of unilateral cochlear implantation in adults, the general findings of these studies, and the populations to which these findings apply. It also aimed to appraise the individual success rate and the magnitude of benefit following implantation. DesignA scoping review was conducted to identify English-language, peer-reviewed journal articles published between 2000 and 2018 assessing the outcomes of cochlear implantation in adults who received their first cochlear implant from 2000 onwards. To be included, studies had to report speech perception or self-reported measures of listening or quality of life at least three months after implantation. Systematic searches were conducted in Medline, Embase, Web of Science and Google Scholar. A two-stage screening approach was used, with seven reviewers independently screening titles and abstracts against inclusion criteria and three from this group further reviewing full-texts. A data charting form was developed and trialled, with 10% of the study data extracted in duplicate to compare results and further refine the form. Data relevant for efficacy analyses were extracted from studies with sample sizes of at least 10 participants. ResultsA total of 4182 abstracts were screened against inclusion criteria, and of these, 603 fulltexts were further screened. After exclusion of non-eligible articles, 201 articles were included in the first part of this scoping review. The majority of these articles were case series or comparative studies without a concurrent group, and had small sample sizes. Data PLOS ONECompeting interests: The authors have declared that no competing interests exist. synthesis conducted with the 102 articles with more than 10 participants highlighted that the average word perception ability improved from 8.2% to 53.9% after implantation. Selfreported benefit improved by 21.5 percentage points. At the individual level, 82.0% of adults with postlingual hearing loss and 53.4% of adults with prelingual hearing loss improved their speech perception ability by 15 percentage points or more. A small proportion had poorer ability after implantation or had stopped using the cochlear implant. ConclusionsDespite broad inconsistencies in measurement, research design, and reporting across articles, it is evident that cochlear implantation is beneficial to the majority of adults of any age who have limited aided speech perception abilities. While many adults with severe-to-profound hearing loss may also have poor speech perception abilities with hearing aids, the validity of using hearing loss severity as a criterion for cochlear implantation has not been demonstrated. Clinical and...

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“…In turn, this has lead to relaxation of the audiological implantation criteria. Whereas CI initially was meant to be a solution for patients with total deafness, it gradually evolved in a solution for patients with severe to profound hearing loss as well as for patients with a partial (high frequency) deafness [ 6 , 7 ]. Luntz et al [ 8 ] describes the initially stiff process of accepting cochlear implantation as a safe hearing solution in the early days.…”

Section: Introductionmentioning

confidence: 99%

Expanding unilateral cochlear implantation criteria for adults with bilateral acquired severe sensorineural hearing loss

Huinck

Mylanus

Snik

2019

Eur Arch Otorhinolaryngol

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Objectives To report on a retrospective cohort study on the effects of expanding inclusion criteria for application of cochlear implants (CIs) on the performance 1-year post-implantation. Methods Based on pre-implantation audiometric thresholds and aided speech recognition scores, the data of 164 CI recipients were divided into a group of patients that fulfilled conservative criteria (mean hearing loss at 0.5, 1 and 2 kHz > 85 dB HL and phoneme scores with hearing aids < 30%), and the remaining group of patients that felt outside this conservative criterion. Speech recognition scores (in quiet) and quality of life (using the NCIQ) of both groups, measured at 1-year post-implantation, were compared. Results The group that felt outside the conservative criterion showed a higher phoneme score at 1-year post-implantation compared to the conservative group, suggesting that relaxed criteria have a positive influence on the speech recognition results with CI. With respect to quality of life, both groups significantly improved 1-year post-implantation. The conservative group showed a higher benefit on the advanced perception domain of the NCIQ. Based on their worse pre-implantation hearing, this was expected. Conclusions The data suggest that relaxation of CI indication positively affects the speech recognition performance of patients with severe hearing loss. Both groups of patients showed a positive effect of CI on the quality of life. This benefit relates to communication skills and the subjective day-to-day functioning in society.

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Evidence-based guidelines for recommending cochlear implantation for postlingually deafened adults

Cited by 68 publications

References 27 publications

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

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

Cochlear implantation outcomes in adults: A scoping review

Expanding unilateral cochlear implantation criteria for adults with bilateral acquired severe sensorineural hearing loss

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