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Updated: Jan 9, 2026
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Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
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From Clinic to Reality: Integrating Sound Field Testing and Hearing Quality Measures in Cochlear Implant Users
Marta Álvarez-Cendrero1, Manuel Lazo-Maestre2, Serafín Sánchez-Gómez2
1Department of Otolaryngology, Head and Neck Surgery, De La Merced University Hospital, 41640 Osuna, Spain.
Journal of Clinical Medicine
|December 11, 2025
Summary
Cochlear implant (CI) users struggle with speech understanding and sound localization in noisy environments, unlike normal-hearing individuals. Standard hearing tests don't capture these real-world listening challenges for CI users.
Area of Science:
- Audiology
- Neuroscience
- Speech and Hearing Sciences
Background:
- Traditional audiological assessments inadequately represent cochlear implant (CI) users' difficulties in complex acoustic settings.
- CI users often show persistent deficits in speech recognition and sound localization, even with good audiometric results.
Purpose of the Study:
- To assess how acoustic environment complexity affects speech recognition and sound localization in CI users compared to normal-hearing (NH) individuals.
- To evaluate subjective auditory performance using validated questionnaires in CI users and NH individuals.
Main Methods:
- Thirty-four unilateral CI users and fifty NH participants were tested using an eight-speaker 360° array.
- Evaluated pure-tone average (PTA), word recognition scores (WRS) in quiet and noise, sound localization, and the SSQ-12 questionnaire.
- Utilized correlation, regression, and MANOVA analyses to examine objective and subjective outcomes.
Main Results:
- CI users demonstrated significantly lower WRS, poorer sound localization, and lower SSQ-12 scores than NH participants, with performance worsening in complex noise.
- Pre-implant PTA was the strongest predictor of post-implant speech recognition.
- The SSQ-12 questionnaire showed correlation with objective measures, indicating clinical relevance.
Conclusions:
- CI users experience persistent deficits in realistic listening conditions that standard audiometry overlooks.
- Integrating sound field testing and hearing quality questionnaires offers a more holistic assessment for personalized CI rehabilitation and programming.
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