Abstract
PurposeBilateral cochlear implant (CI) implantation is increasingly used in the auditory rehabilitation of bilaterally deafened adults. However, after successful unilateral implantation, objective patient counselling is essential.MethodsWe investigated the extra benefit of a second CI in adults in terms of health-related quality of life, tinnitus, stress, anxiety, depression, quality of hearing, and speech recognition. Hearing ability was assessed by using the Freiburg monosyllable speech discrimination test (FB MS) and the Oldenburg sentence test with azimuth variations. In a prospective patient cohort, we administered validated questionnaires before a CI, after a first CI and after a second CI implantation.ResultsThe study included 29 patients, made up of nine women and 20 men. The median time between the first and the second implantation was 23 months. The mean total NCIQ score and TQ before a CI improved significantly after both implantations. Stress, anxiety, and depression were stable over time and were not significantly affected by CI implantations. Speech recognition with noise significantly improved after the first and again after the second CI. Correlation analysis showed a strong connection between auditory performance and HRQoL.ConclusionWe demonstrated that a unilateral CI benefitted many fields and that the second sequential CI leads again to additional improvement. Bilateral CI implantation should, therefore, be the standard form of auditory rehabilitation in deafened adults.
Highlights
The number of bilaterally deafened adults is increasing, mainly due to a constantly ageing society
Most research investigating bilateral cochlear implant (CI) supply has focused on auditory improvement, including sound localisation and enhanced speech perception, but little is known about the subjectively experienced changes created by a CI, and very few studies have analysed the health-specific quality of life changes due to a second CI [12, 13]
The present study demonstrates that in bilaterally deafened adult patients, a second CI implantation improves HRQoL, tinnitus annoyance, speech comprehension under noisy conditions, and subjective quality of hearing compared to a one-sided CI condition
Summary
The number of bilaterally deafened adults is increasing, mainly due to a constantly ageing society. In post-lingual bilaterally deafened adults, there is ongoing discussion regarding outcomes as well as medical and surgical safety concerns [2]. CI are improved sound localisation, enhanced speech perception, and a reduced risk of being "off-air" [3,4,5]. The debate about cost-effectiveness is controversial [9,10,11] Up to this point, most research investigating bilateral CI supply has focused on auditory improvement, including sound localisation and enhanced speech perception, but little is known about the subjectively experienced changes created by a CI, and very few studies have analysed the health-specific quality of life changes due to a second CI [12, 13]
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