Individual Patient Comorbidities and Effect on Cochlear Implant Performance

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.