Audiovisual Processing Skills Before Cochlear Implantation Predict Postoperative Speech Recognition in Adults

Area of Science:

• Audiology
• Neuroscience
• Speech-Language Pathology

Background:

• Adults with hearing loss (HL) benefit more from visual cues combined with auditory cues (visual enhancement, VE) than normal-hearing individuals.
• The impact of cochlear implants (CIs) on VE in patients with moderate-to-profound sensorineural HL is not well understood.
• The role of pre-CI VE in post-CI speech recognition variability requires investigation.

Purpose of the Study:

• To determine if adult CI recipients experience a decrease in VE after implantation.
• To investigate if the magnitude of pre-CI VE predicts post-CI auditory-only speech recognition.
• To ascertain whether pre-CI VE has a beneficial, redundant, or maladaptive effect on post-CI outcomes.

Main Methods:

• A longitudinal study involving 30 adults tested before CI surgery and 6 months post-activation.
• Speech recognition was assessed using auditory-only, visual-only, and audiovisual (AV) conditions with CUNY sentences.
• VE scores were calculated, and correlation analyses examined the relationship between pre-CI VE and post-CI auditory performance.

Main Results:

• Contrary to hypothesis 1, participants did not show a significant decrease in VE scores after CI implantation.
• Consistent with hypothesis 2, preoperative VE scores positively predicted postoperative auditory-only sentence recognition in quiet and babble (rho = 0.40 to 0.45, p < 0.05).
• Pre-CI VE did not significantly predict post-CI isolated word recognition; raw AV scores also predicted outcomes.

Conclusions:

• Cochlear implant users maintain their level of visual enhancement (VE) after surgery.
• The degree of VE before CI surgery is a positive predictor of auditory-only sentence recognition outcomes 6 months after implantation.
• Preoperative AV testing, including VE assessment, may help predict and manage patient expectations for CI outcomes.