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Lebensqualität und Schwindel bei bilateraler Cochleaimplantation

Fragebogeninstrumente zur Qualitätssicherung

Quality of life and vertigo after bilateral cochlear implantation

Questionnaires as tools for quality assurance

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Zusammenfassung

Hintergrund

Persistierende Schwindelbeschwerden nach Cochleaimplantation sind bekannte Einflussfaktoren auf die Lebensqualität. Mit in diesen Patientenkollektiven bisher nur teilweise eingesetzten Fragebogeninstrumenten werden die Effekte einer bilateralen Versorgung mit einem Cochleaimplantat (CI) auf die Lebensqualität sowie subjektive Schwindelbeschwerden analysiert.

Ziel der Arbeit

Es sollte untersucht werden, ob Fragebogeninstrumente eine erfolgreiche Methode zur Dokumentation von Schwindelbeschwerden und der Lebensqualität im Rahmen der Qualitätssicherung darstellen.

Material und Methoden

Es wurden 32 bilateral versorgte CI-Patienten bezüglich ihrer Schwindelsymptomatik und Lebensqualität befragt. Dabei kam der Nijmegen-Cochlear-Implant-Fragebogen (NCIQ) zum Einsatz. Bei berichteten, regelmäßigen Schwindelbeschwerden wurden zusätzlich der Schwindel-Handicap-Fragebogen (VHQ) und der Vertigo-Symptom-Scale(VSS)-Fragebogen erhoben.

Ergebnisse

Acht von 32 Patienten zeigten persistierende Schwindelbeschwerden. Die Lebensqualität, gemessen mit dem NCIQ, verbesserte sich signifikant (p < 0,001) um 23,7 % durch eine Versorgung mit dem zweiten CI. Die Schwindelbeschwerden veränderten sich geringfügig (VHQ –11,2 %; VSS +16,4%) nach der zweiten Implantation.

Schlussfolgerung

Die Ergebnisse zeigen, dass mit den Fragebögen praktikable Instrumente vorliegen, mit denen sich Lebensqualität und Schwindelbeschwerden zur Qualitätssicherung dokumentieren lassen und die möglicherweise ergänzend oder alternativ zur apparativen Schwindeldiagnostik sinnvoll angewendet werden können.

Abstract

Background

Persistent dizziness symptoms after cochlear implantation have an impact on quality of life. In this study, the effects of bilateral cochlear implants (CI) on quality of life as well as on subjective dizziness complaints are analyzed using questionnaires, some of which have never been applied before in these patient collectives.

Objective

In this article, questionnaires for the assessment of dizziness symptoms and quality of life are introduced in order to realize quality assurance.

Materials and methods

A total of 32 patients with bilateral CI were questioned regarding dizziness symptoms and quality of life. The Nijmegen Cochlear Implant Questionnaire (NCIQ) was used. In the case of reported regular dizziness, the Vertigo Handicap Questionnaire (VHQ) and the Vertigo Symptom Scale (VSS) were also assessed.

Results

Persistent dizziness symptoms were shown in 8 of 32 patients. Quality of life was measured with the NCIQ and was improved significantly (p < 0.001) by 23.7% after the second CI. The dizziness symptoms changed slightly (VHQ –11.2%; VSS +16.4%) after the second implantation.

Conclusion

The results show that the questionnaires are valid instruments for documenting quality of life and dizziness symptoms for quality assurance. These questionnaires may be applied as a complement or an alternative to device-based measurements of peripheral vestibular dysfunction.

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Danksagung

Die Autoren danken Frau Prof. Dr. med. Heidi Olze, Direktorin der Hals‑, Nasen‑, Ohrenklinik Campus Virchow-Klinikum und Charité Campus Mitte der Charité – Universitätsmedizin Berlin für die Bereitstellung der deutschen Version des Fragebogens Nijmegen Cochlear Implant Questionnaire (NCIQ). S. Strieth wird von der Deutschen Forschungsgemeinschaft (DFG STR 1014/4-1) gefördert.

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Authors and Affiliations

  1. Klinik für Hals-Nasen-Ohren-Heilkunde, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland

    T. Rader, B. P. Ernst &  S. Strieth

  2. Klinik für Hals-Nasen-Ohren-Heilkunde, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Deutschland

    M. Haerterich & T. Stöver

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  1. T. Rader
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Correspondence to S. Strieth.

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Interessenkonflikt

T. Rader, M. Haerterich, B. P. Ernst, T. Stöver und S. Strieth geben an, dass kein Interessenkonflikt besteht.

Alle beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission Kommission des Fachbereichs Medizin der Goethe-Universität Frankfurt am Main genehmigt (Geschäftszeichen 334/12), im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt.

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Rader, T., Haerterich, M., Ernst, B.P. et al. Lebensqualität und Schwindel bei bilateraler Cochleaimplantation. HNO 66, 219–228 (2018). https://doi.org/10.1007/s00106-017-0456-3

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