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Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
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Individual Patient Comorbidities and Effect on Cochlear Implant Performance.

Sabina Dang1, Dorina Kallogjeri, Karmela Dizdar1

  • 1Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|March 4, 2024
PubMed
Summary
This summary is machine-generated.

Preoperative comorbidities impact cochlear implant (CI) speech outcomes. While all patients show improvement, those with severe comorbidities achieve less benefit compared to those without. This highlights the importance of assessing comorbidities for CI success.

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Area of Science:

  • Audiology
  • Otolaryngology
  • Neurosurgery

Background:

  • Cochlear implantation (CI) is a common treatment for severe to profound hearing loss.
  • Preoperative patient health status, including comorbidities, may influence CI outcomes.
  • Understanding this association can help manage patient expectations and surgical planning.

Purpose of the Study:

  • To investigate the relationship between preoperative comorbidities and speech understanding after cochlear implantation.
  • To determine if the severity of comorbidities affects speech outcomes in adult CI recipients.

Main Methods:

  • Retrospective cohort study of 976 adult patients undergoing cochlear implantation (CI) between 2015 and 2022.
  • Comorbidities were assessed using the Adult Comorbidity Evaluation 27 (ACE-27) scale based on preoperative anesthesia notes.
  • Speech outcomes, including Consonant-Nucleus-Consonant (CNC) and AzBio Sentence scores (quiet and +10 dB SNR), were evaluated at 3, 6, and 12 months post-implantation.

Main Results:

  • Of 560 eligible patients, 20% had no comorbidities, 36.4% mild, 28.8% moderate, and 14.8% severe.
  • All comorbidity groups demonstrated clinically meaningful speech improvement over 12 months.
  • Patients with severe comorbidities showed significantly poorer speech outcomes compared to those with no comorbidities (e.g., AzBio Quiet: 52.3 vs 32.5 difference).

Conclusions:

  • Preoperative comorbidities, as measured by ACE-27, are significantly associated with cochlear implant speech performance.
  • While patients with severe comorbidities still benefit from CI, their overall speech outcomes are less favorable than those without comorbidities.
  • Comorbidity assessment is crucial for predicting and managing expectations regarding CI outcomes.