European Archives of Oto-Rhino-Laryngology

, Volume 269, Issue 3, pp 739–745 | Cite as

The influence of various factors on the performance of repetition tests in adults with cochlear implants

  • Il Joon Moon
  • Eun Yeon Kim
  • Jin Ok Jeong
  • Won-Ho Chung
  • Yang-Sun Cho
  • Sung Hwa Hong


A variety of internal and external factors influence speech perception performance following cochlear implantation (CI) in adult deaf patients. The aim of this study was to evaluate the speech perception performance during repetition testing according to various factors and to identify the predictive factors associated with postoperative speech perception. The performances on speech perception under audio-only conditions were examined over time in 61 adult patients with CI. Mono- and bi-syllable and sentence repetition testing, using both the Korean version of the Central Institute for the Deaf (K-CID) and the K-Western Aphasia Battery test (K-WAB), were performed preoperatively and at 3, 6 and 12 months postoperatively. To elucidate the effect that the etiology of deafness has on postoperative outcome, patients were divided into the following four groups: Prelingual hearing loss (HL) (n = 9), Meningitis (n = 6), Progressive HL (n = 31) and Sudden HL groups (n = 15). Moreover, the duration of HL and deafness was defined as follows: (1) “age of deafness onset: AoD”, (2) “number of years between the onset of profound deafness and CI: DoD” and (3) “percentage of the patient’s life with moderate-to-profound hearing loss before CI: PoL”. DoD and PoL were significantly different between the four groups. Although AoD appeared to be associated with performance on the sentence repetition test before standardizing for education level and age (P = 0.015), there was no association after adjusting for these factors (P = 0.719). Only PoL showed a good correlation with performance on repetition testing after CI after adjusting for AoD and DoD. However, DoD was associated with speech perception performance on the sentence repetition test only. In addition, speech perception performance results in the Progressive and Sudden HL groups were improved over the Prelingual HL and Meningitis groups. The Meningitis group showed the poorest speech perception performance among postlingually deaf adults. Consideration of age, education level, etiology and overall time with hearing loss may be necessary for predicting speech perception outcomes in CI recipients.


Cochlear implants Adult Prognosis Speech perception Hearing loss Deafness 



The authors gratefully acknowledge the statistical assistance from Dr. Eun-Hee Choi of the Department of Biostatistics, Yonsei University College of Medicine. This work was supported by grant from the Strategic Technology Development Program of Ministry of Knowledge Economy (Grant No. 10031764) and Korea Healthcare technology R&D Project, Ministry of Health and Welfare (Grant No. A100211), Republic of Korea.

Conflict of interest



  1. 1.
    Battmer RD, Gupta SP, Allum-Mecklenburg DJ, Lenarz T (1995) Factors influencing cochlear implant perceptual performance in 132 adults. Ann Otol Rhinol Laryngol Suppl 166:185–187PubMedGoogle Scholar
  2. 2.
    Blamey PJ, Pyman BC, Gordon M, Clark GM, Brown AM, Dowell RC, Hollow RD (1992) Factors predicting postoperative sentence scores in postlinguistically deaf adult cochlear implant patients. Ann Otol Rhinol Laryngol 101:342–348PubMedGoogle Scholar
  3. 3.
    Gomaa NA, Rubinstein JT, Lowder MW, Tyler RS, Gantz BJ (2003) Residual speech perception and cochlear implant performance in postlingually deafened adults. Ear Hear 24:539–544PubMedCrossRefGoogle Scholar
  4. 4.
    Green KM, Bhatt YM, Mawman DJ, O’Driscoll MP, Saeed SR, Ramsden RT, Green MW (2007) Predictors of audiological outcome following cochlear implantation in adults. Cochlear Implants Int 8:1–11PubMedCrossRefGoogle Scholar
  5. 5.
    Leung J, Wang NY, Yeagle JD, Chinnici J, Bowditch S, Francis HW, Niparko JK (2005) Predictive models for cochlear implantation in elderly candidates. Arch Otolaryngol Head Neck Surg 131:1049–1054PubMedCrossRefGoogle Scholar
  6. 6.
    Proops DW, Donaldson I, Cooper HR, Thomas J, Burrell SP, Stoddart RL, Moore A, Cheshire IM (1999) Outcomes from adult implantation, the first 100 patients. J Laryngol Otol Suppl 24:5–13PubMedGoogle Scholar
  7. 7.
    Waltzman SB, Fisher SG, Niparko JK, Cohen NL (1995) Predictors of postoperative performance with cochlear implants. Ann Otol Rhinol Laryngol Suppl 165:15–18PubMedGoogle Scholar
  8. 8.
    Moore BC, Tyler LK, Marslen-Wilson W (2008) Introduction. The perception of speech: from sound to meaning. Philos Trans R Soc Lond B Biol Sci 363:917–921PubMedCrossRefGoogle Scholar
  9. 9.
    Bromley DB (1991) Aspects of written language production over adult life. Psychol Aging 6:296–308PubMedCrossRefGoogle Scholar
  10. 10.
    Shewan CM, Kertesz A (1980) Reliability and validity characteristics of the Western Aphasia Battery (WAB). J Speech Hear Disord 45:308–324PubMedGoogle Scholar
  11. 11.
    Kertesz A, Poole E (2004) The aphasia quotient: the taxonomic approach to measurement of aphasic disability. 1974. Can J Neurol Sci 31:175–184PubMedGoogle Scholar
  12. 12.
    Kim H, Na DL (2004) Normative data on the Korean version of the Western Aphasia Battery. J Clin Exp Neuropsychol 26:1011–1020PubMedCrossRefGoogle Scholar
  13. 13.
    Santarelli R, Magnavita V, De Filippi R, Ventura L, Genovese E, Arslan E (2009) Comparison of speech perception performance between Sprint/Esprit 3G and Freedom processors in children implanted with nucleus cochlear implants. Otol Neurotol 30:304–312PubMedCrossRefGoogle Scholar
  14. 14.
    Bacciu A, Pasanisi E, Vincenti V, Ormitti F, Di Lella F, Guida M, Berghenti M, Bacciu S (2009) Cochlear implantation in children with cerebral palsy. A preliminary report. Int J Pediatr Otorhinolaryngol 73:717–721PubMedCrossRefGoogle Scholar
  15. 15.
    Liu XZ, Angeli SI, Rajput K, Yan D, Hodges AV, Eshraghi A, Telischi FF, Balkany TJ (2008) Cochlear implantation in individuals with Usher type 1 syndrome. Int J Pediatr Otorhinolaryngol 72:841–847PubMedCrossRefGoogle Scholar
  16. 16.
    Dowell RC, Hollow R, Winton E (2004) Outcomes for cochlear implant users with significant residual hearing: implications for selection criteria in children. Arch Otolaryngol Head Neck Surg 130:575–581PubMedCrossRefGoogle Scholar
  17. 17.
    Buchner A, Schussler M, Battmer RD, Stover T, Lesinski-Schiedat A, Lenarz T (2009) Impact of low-frequency hearing. Audiol Neurootol 14(Suppl 1):8–13PubMedGoogle Scholar
  18. 18.
    Eisenberg LS, Martinez AS, Holowecky SR, Pogorelsky S (2002) Recognition of lexically controlled words and sentences by children with normal hearing and children with cochlear implants. Ear Hear 23:450–462PubMedCrossRefGoogle Scholar
  19. 19.
    Philippon D, Bergeron F, Ferron P, Bussieres R (2010) Cochlear implantation in postmeningitic deafness. Otol Neurotol 31:83–87PubMedCrossRefGoogle Scholar
  20. 20.
    Niparko JK, Tobey EA, Thal DJ, Eisenberg LS, Wang NY, Quittner AL, Fink NE (2010) Spoken language development in children following cochlear implantation. JAMA 303:1498–1506PubMedCrossRefGoogle Scholar
  21. 21.
    Gantz BJ, Woodworth GG, Knutson JF, Abbas PJ, Tyler RS (1993) Multivariate predictors of audiological success with multichannel cochlear implants. Ann Otol Rhinol Laryngol 102:909–916PubMedGoogle Scholar
  22. 22.
    Roditi RE, Poissant SF, Bero EM, Lee DJ (2009) A predictive model of cochlear implant performance in postlingually deafened adults. Otol Neurotol 30:449–454PubMedCrossRefGoogle Scholar
  23. 23.
    Rubinstein JT, Parkinson WS, Tyler RS, Gantz BJ (1999) Residual speech recognition and cochlear implant performance: effects of implantation criteria. Am J Otol 20:445–452PubMedGoogle Scholar
  24. 24.
    Helvik AS, Jacobsen GW, Hallberg LR (2006) Life consequences of hearing loss in terms of activity limitation and participation restriction. Scand J Disabil Res 8:53–66CrossRefGoogle Scholar
  25. 25.
    Hiraumi H, Tsuji J, Kanemaru S, Fujino K, Ito J (2007) Cochlear implants in post-lingually deafened patients. Acta Otolaryngol Suppl 127:17–21Google Scholar
  26. 26.
    Padilla Romero MJ, Sainz Quevedo M, Roldan Segura C (2004) Cochlear implant in postlingual adults with progressive hearing loss. Acta Otorrinolaringol Esp 55:457–462PubMedGoogle Scholar
  27. 27.
    Dell GS (1986) A spreading-activation theory of retrieval in sentence production. Psychol Rev 93:283–321PubMedCrossRefGoogle Scholar
  28. 28.
    Dell GS, O’Seaghdha PG (1991) Mediated and convergent lexical priming in language production: a comment on Levelt et al. (1991). Psychol Rev 98:604–614; discussion 615–608Google Scholar
  29. 29.
    Rumelhart DE, McClelland JL (1982) An interactive activation model of context effects in letter perception: part 2. The contextual enhancement effect and some tests and extensions of the model. Psychol Rev 89:60–94PubMedCrossRefGoogle Scholar
  30. 30.
    McClelland JL, Mirman D, Holt LL (2006) Are there interactive processes in speech perception? Trends Cogn Sci 10:363–369PubMedCrossRefGoogle Scholar
  31. 31.
    Lin YS (2009) Clinical outcomes of scala vestibuli cochlear implantation in children with partial labyrinthine ossification. Acta Otolaryngol 129:273–280PubMedCrossRefGoogle Scholar
  32. 32.
    Steenerson RL, Gary LB, Wynens MS (1990) Scala vestibuli cochlear implantation for labyrinthine ossification. Am J Otol 11:360–363PubMedGoogle Scholar
  33. 33.
    Young NM, Hughes CA, Byrd SE, Darling C (2000) Postmeningitic ossification in pediatric cochlear implantation. Otolaryngol Head Neck Surg 122:183–188PubMedCrossRefGoogle Scholar
  34. 34.
    Incesulu A, Nadol JB Jr (1998) Correlation of acoustic threshold measures and spiral ganglion cell survival in severe to profound sensorineural hearing loss: implications for cochlear implantation. Ann Otol Rhinol Laryngol 107:906–911PubMedGoogle Scholar
  35. 35.
    Demel C, Hoegen T, Giese A, Angele B, Pfister HW, Koedel U, Klein M (2011) Reduced spiral ganglion neuronal loss by adjunctive neurotrophin-3 in experimental pneumococcal meningitis. J Neuroinflammation 8:7PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Il Joon Moon
    • 1
  • Eun Yeon Kim
    • 1
  • Jin Ok Jeong
    • 1
  • Won-Ho Chung
    • 1
  • Yang-Sun Cho
    • 1
  • Sung Hwa Hong
    • 1
  1. 1.Department of Otorhinolaryngology-Head and Neck SurgerySungkyunkwan University School of Medicine, Samsung Medical CenterSeoulKorea

Personalised recommendations