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Holistic assessment of cochlear implant outcomes using the international classification of functioning disability and health model: data analysis of a longitudinal prospective multicenter study

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To study outcome after cochlear implantation using the Cochlear Implant (CI) outcome assessment protocol based on the International Classification of Functioning, Disability and Health (ICF) model (CI-ICF).

Methods

Raw data of a prospective, longitudinal, multicenter study was analyzed. Seventy-two CI candidates were assessed preoperatively and six months postoperatively using the CI-ICF protocol. Following tools were used: (1) Work Rehabilitation Questionnaire (WORQ), (2) Abbreviated Profile of Hearing Aid Benefit (APHAB), (3) Audio Processor Satisfaction Questionnaire (APSQ), (4) Speech, Spatial, and Qualities of Hearing Scale (SSQ12), (5) Hearing Implant Sound Quality Index (HISQUI19), (6) Nijmegen CI Questionnaire (NCIQ) (7) pure tone audiometry, (8) speech audiometry, (9) sound localization.

Results

There was a significant improvement of speech discrimination in quiet (p = 0.015; p < 0.001) and in noise (p = 0.041; p < 0.001), sound detection (p < 0.001), tinnitus (p = 0.026), listening (p < 0.001), communicating with—receiving—spoken messages (p < 0.001), conversation (p < 0.001), family relationships (p < 0.001), community life (p = 0.019), NCIQ total score and all subdomain scores (p < 0.001). Subjective sound localization significantly improved (p < 0.001), while psychometric sound localization did not. There was no significant subjective deterioration of vestibular functioning and no substantial change in sound aversiveness. CI users reported a high level of implant satisfaction postoperatively.

Conclusion

This study highlights the positive impact of cochlear implantation on auditory performance, communication, and subjective well-being. The CI-ICF protocol provides a holistic and comprehensive view of the evolution of CI outcomes.

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Data availability

To protect study participant privacy, data cannot be shared openly. The public availability of data was not included in the ethics approval of this study. The datamanagement part of the study protocol states that raw participant data can only be accessed by the principal investigators and cannot be shared or given to anyone outside the study team.

References

  1. National institute on deafness and other communication disorders. Cochlear Implants. 2021. https://www.nidcd.nih.gov/health/cochlear-implants. Accessed 21 Aug 2023

  2. Goman AM, Lin FR (2016) Prevalence of hearing loss by severity in the United States. Am J Public Health 106(10):1820–1822

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sorkin DL, Buchman CA (2016) Cochlear implant access in six developed countries. Otol Neurotol 37(2):e161–e164

    Article  PubMed  Google Scholar 

  4. D’haese PSC et al (2018) Awareness of hearing loss in older adults: results of a survey conducted in 500 subjects across 5 European countries as a basis for an online awareness campaign. Inquiry. 55:0046958018759421

    PubMed  PubMed Central  Google Scholar 

  5. Mertens G et al (2020) Cognitive improvement after cochlear implantation in older adults with severe or profound hearing impairment: a prospective, longitudinal, controlled, multicenter study. Ear Hear 42(3):606–614

    Article  PubMed Central  Google Scholar 

  6. Andries E et al (2023) Evaluation of cognitive functioning before and after cochlear implantation in adults aged 55 years and older at risk for mild cognitive impairment. JAMA Otolaryngol Head Neck Surg 149(4):310–316

    Article  PubMed  PubMed Central  Google Scholar 

  7. Weichbold V et al (2023) 5-year observation period of quality of life after cochlear implantation. Otol Neurotol 44(3):e155–e159

    Article  PubMed  Google Scholar 

  8. Boisvert I et al (2020) Cochlear implantation outcomes in adults: a scoping review. PLoS ONE 15(5):e0232421

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Kay-Rivest E, Schlacter J, Waltzman SB (2022) Cochlear implantation outcomes in the older adult: a scoping review. Cochlear Implant Int. https://doi.org/10.1080/14670100.2022.2091723

    Article  Google Scholar 

  10. Ma C et al (2023) Longitudinal speech recognition changes after cochlear implant: systematic review and meta-analysis. Laryngoscope 133(5):1014–1024

    Article  PubMed  Google Scholar 

  11. Walia A et al (2023) Predictors of short-term changes in quality of life after cochlear implantation. Otol Neurotol 44(3):e146–e154

    Article  PubMed  PubMed Central  Google Scholar 

  12. Andries E et al (2022) The impact of cochlear implantation on health-related quality of life in older adults, measured with the health utilities index mark 2 and mark 3. Eur Arch Otorhinolaryngol 279(2):739–750

    Article  PubMed  Google Scholar 

  13. Illg A et al (2023) A holistic perspective on hearing loss: first quality-of-life questionnaire (HL-QOL) for people with hearing loss based on the international classification of functioning, disability, and health. Front Audiol Otol 1:1207220

    Article  Google Scholar 

  14. Andries E et al (2020) Systematic review of quality of life assessments after cochlear implantation in older adults. Audiol Neurotol 26:61

    Article  Google Scholar 

  15. Danermark B et al (2013) The creation of a comprehensive and a brief core set for hearing loss using the international classification of functioning, disability and health. Am J Audiol 22(2):323–328

    Article  PubMed  Google Scholar 

  16. World Health Organization (2001) International classification of functioning, disability and health. World Health Organization, Geneva

    Google Scholar 

  17. Meyer C et al (2016) What is the international classification of functioning, disability and health and why is it relevant to audiology? Semin Hear 37(3):163–186

    Article  PubMed  PubMed Central  Google Scholar 

  18. Andries E et al (2023) Implementation of the international classification of functioning, disability and health model in cochlear implant recipients: a multi-center prospective follow-up cohort study. Front Audiol Otol 1:1257504

    Article  Google Scholar 

  19. Andries E et al (2022) Evaluating the revised work rehabilitation questionnaire in cochlear implant users cochlear implant outcome assessment based on the international classification of functioning, disability, and health (ICF). Otol Neurotol 43(5):e571–e577

    Article  PubMed  Google Scholar 

  20. Mertens G et al (2022) Towards a consensus on an icf-based classification system for horizontal sound-source localization. J Personal Med 12(12):1971

    Article  Google Scholar 

  21. Lorens A et al (2023) Holistic rehabilitation of cochlear implant users: using the international classification of functioning, disability and health. J Hear Sci 13(1):19–25

    Article  Google Scholar 

  22. Finger M et al (2014) Work rehabilitation questionnaire (WORQ): development and preliminary psychometric evidence of an ICF-based questionnaire for vocational rehabilitation. J Occup Rehabil 24(3):498–510

    PubMed  Google Scholar 

  23. Cox MR, Alexander CG (1995) The abbreviated profile of hearing aid benefit. Ear Hear 16(2):176–186

    Article  CAS  PubMed  Google Scholar 

  24. Billinger-Finke M et al (2020) Development and validation of the audio processor satisfaction questionnaire (APSQ) for hearing implant users. Int J Audiol. https://doi.org/10.1080/14992027.2019.1697830

    Article  PubMed  Google Scholar 

  25. Noble W et al (2013) A short form of the speech, spatial and qualities of hearing scale suitable for clinical use: the SSQ12. Int J Audiol 52(6):409–412

    Article  PubMed  PubMed Central  Google Scholar 

  26. Amann E, Anderson I (2014) Development and validation of a questionnaire for hearing implant users to self-assess their auditory abilities in everyday communication situations: the hearing implant sound quality index (HISQUI19). Acta Otolaryngol 134(9):915–923

    Article  PubMed  Google Scholar 

  27. Hinderink JB, Krabbe PF, Van Den Broek P (2000) Development and application of a health-related quality-of-life instrument for adults with cochlear implants: the Nijmegen cochlear implant questionnaire. Otolaryngol Head Neck Surg 123(6):756–765

    Article  CAS  PubMed  Google Scholar 

  28. Van de Heyning P et al (2017) Towards a unified testing framework for single-sided deafness studies: a consensus paper. Audiol Neurotol 21(6):391–398

    Article  Google Scholar 

  29. Rasmussen KD et al (2023) Tinnitus suppression in a prospective cohort of 45 cochlear implant recipients: occurrence, degree and correlates. Eur Arch Otorhinolaryngol 280(9):4073–4082

    Article  PubMed  Google Scholar 

  30. James CJ et al (2021) The listening network and cochlear implant benefits in hearing-impaired adults. Front Aging Neurosci 13:589296

    Article  PubMed  PubMed Central  Google Scholar 

  31. Mertens G, De Bodt M, Van de Heyning P (2016) Cochlear implantation as a long-term treatment for ipsilateral incapacitating tinnitus in subjects with unilateral hearing loss up to 10 years. Hear Res 331:1–6

    Article  PubMed  Google Scholar 

  32. Andries E et al (2022) Evolution of type D personality traits after cochlear implantation in severely hearing impaired adults 55 years and older: an exploratory prospective, longitudinal, controlled, multicenter study. Otol Neurotol 43(8):e865–e871

    Article  PubMed  Google Scholar 

  33. Bekele Okuba T et al (2023) Cochlear implantation impact on health service utilisation and social outcomes: a systematic review. BMC Health Serv Res 23(1):929

    Article  PubMed  PubMed Central  Google Scholar 

  34. Stuermer KJ et al (2019) Preservation of vestibular function and residual hearing after round window cochlear implantation. Otol Neurotol 40(7):878–882

    Article  PubMed  Google Scholar 

  35. Pieper SH et al (2022) Considerations for fitting cochlear implants bimodally and to the single-sided deaf. Trends Hear 26:23312165221108260

    PubMed  PubMed Central  Google Scholar 

  36. Morelli L et al (2023) Cochlear implantation in single-sided deafness: a single-center experience of 138 cases. Eur Arch Otorhinolaryngol 280(10):4427–4432

    Article  CAS  PubMed  Google Scholar 

  37. Kraaijenga VJC et al (2019) No difference in behavioral and self-reported outcomes for simultaneous and sequential bilateral cochlear implantation: evidence from a multicenter randomized controlled trial. Front Neurosci 13:54

    Article  PubMed  PubMed Central  Google Scholar 

  38. Plant K, Babic L (2016) Utility of bilateral acoustic hearing in combination with electrical stimulation provided by the cochlear implant. Int J Audiol 55(Suppl 2):S31–S38

    Article  PubMed  Google Scholar 

  39. van Loon MC et al (2017) Cochlear implantation in adults with asymmetric hearing loss: benefits of bimodal stimulation. Otol Neurotol 38(6):e100–e106

    Article  PubMed  Google Scholar 

  40. Anderson I et al (2006) Telephone use: what benefit do cochlear implant users receive? Int J Audiol 45(8):446–453

    Article  PubMed  Google Scholar 

  41. Zhou J, Rau P-LP, Salvendy G (2014) Age-related difference in the use of mobile phones. Univ Access Inf Soc 13(4):4001–4413

    Article  Google Scholar 

  42. McRackan TR et al (2019) Cochlear implant quality of life (CIQOL): development of a profile instrument (CIQOL-35 Profile) and a global measure (CIQOL-10 Global). J Speech Lang Hear Res. 62(9):3554–3563

    Article  PubMed  PubMed Central  Google Scholar 

  43. Ovari A et al (2022) Functional outcomes and quality of life after cochlear implantation in patients with long-term deafness. J Clin Med 11(17):5156

    Article  PubMed  PubMed Central  Google Scholar 

  44. Häußler SM et al (2019) Long-term benefit of unilateral cochlear implantation on quality of life and speech perception in bilaterally deafened patients. Otol Neurotol 40(4):e430–e440

    Article  PubMed  Google Scholar 

  45. Claes AJ et al (2016) The repeatable battery for the assessment of neuropsychological status for hearing impaired patients (RBANS-H) before and after cochlear implantation: a protocol for a prospective, longitudinal cohort study. Front Neurosci 10:222139

    Article  Google Scholar 

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Funding

The Antwerp University Hospital currently receives a research grant from the company MED-EL.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium

    Ellen Andries, Paul Van de Heyning, Vincent Van Rompaey & Griet Mertens

  2. Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium

    Ellen Andries, Paul Van de Heyning, Vincent Van Rompaey & Griet Mertens

  3. World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Warsaw, Poland

    Artur Lorens, Piotr Henryk Skarżyński & Henryk Skarżyński

  4. Center of Hearing and Speech ‘Medincus’, Kajetany, Poland

    Piotr Henryk Skarżyński

  5. Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Warsaw, Poland

    Piotr Henryk Skarżyński

  6. Institute of Sensory Organs, Kajetany, Poland

    Piotr Henryk Skarżyński

  7. Department of Otolaryngology, La Paz University Hospital, IdiPAZ Institute for Health Research, Madrid, Spain

    Miryam Calvino, Javier Gavilán & Luis Lassaletta

  8. Biomedical Research Networking Centre On Rare Diseases (CIBERER-U761), Institute of Health Carlos III, Madrid, Spain

    Miryam Calvino & Luis Lassaletta

  9. Department of Otolaryngology, Head & Neck Surgery, Fiona Stanley Fremantle Hospital Group, Perth, Australia

    Dayse Tavora-Vieira & Aanand Acharya

  10. Medical School, Division of Surgery, The University of Western Australia, Perth, Australia

    Dayse Tavora-Vieira

  11. Faculty of Health Sciences, School of Allied Health, Curtin University, Perth, Australia

    Dayse Tavora-Vieira

  12. Comprehensive Hearing Center, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany

    Anja Kurz & Rudolf Hagen

  13. Clinical Research Department, MED-EL GmbH, Innsbruck, Austria

    Ilona Anderson, Karin Koinig & Yassin Abdelsamad

Authors
  1. Ellen Andries
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  2. Artur Lorens
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  17. Griet Mertens
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Contributions

All authors contributed to the study conception and design. Data collection was performed by EA, AL, MC, DTV, AK, and GM. Data analysis was performed by EA. The first draft of the manuscript was written by EA and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ellen Andries.

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Conflicts of interest

The Antwerp University Hospital receives a research grant from the company MED-EL GmbH, Innsbruck (Austria). Ilona Anderson, Karin Koinig and Yassin Abdelsamad are employees of MED-EL GmbH. All participating centers are members of the HEARRING network, which is supported by MED-EL GmbH.

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Andries, E., Lorens, A., Skarżyński, P.H. et al. Holistic assessment of cochlear implant outcomes using the international classification of functioning disability and health model: data analysis of a longitudinal prospective multicenter study. Eur Arch Otorhinolaryngol (2024). https://doi.org/10.1007/s00405-024-08600-5

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