Decisional Regret in Adult Cochlear Implant Recipients With Single-Sided Deafness

Area of Science:

• Otolaryngology
• Audiology
• Neuroscience

Background:

• Single-sided deafness (SSD) presents unique challenges for hearing rehabilitation.
• Cochlear implantation (CI) is an option for adults with SSD, but outcomes and patient satisfaction require further investigation.
• Decisional regret (DR) is a crucial metric for assessing patient satisfaction after medical interventions.

Purpose of the Study:

• To examine the association between cochlear implant (CI) outcomes and decisional regret (DR) in adult CI users with single-sided deafness (SSD).
• To evaluate the impact of speech perception, quality of life, and device usage on DR.
• To compare DR levels in SSD CI users with those of bilateral hearing loss CI recipients.

Main Methods:

• A cross-sectional cohort study was conducted at a tertiary medical center.
• Fourteen adult CI recipients with SSD (defined by four-frequency pure-tone average ≤30 dB in the non-implanted ear) were included.
• Validated surveys (CIQOL-10, DR) and objective measures (CNCq speech score, device usage) were analyzed.

Main Results:

• Twenty-one percent of participants reported moderate post-CI decisional regret.
• While no significant differences were found in pure-tone average or duration of deafness, CIQOL-10 scores and device usage showed large effect sizes, indicating potential meaningful differences in perceived benefit.
• Greater speech perception improvement in the moderate regret group suggested a disconnect between objective outcomes and subjective satisfaction.

Conclusions:

• Adults with SSD who undergo CI and use their device report low levels of DR, similar to bilateral CI users.
• Speech performance improvement and duration of deafness may not be significant predictors of DR in this population.
• Further research is needed on factors influencing patient satisfaction, including preoperative counseling and expectation assessment.