Nijmegen Cochlear Implant Questionnaire Research Articles

Long-term outcome of patients with Ménière's disease following cochlear implantation: a comprehensive outcome study with validated assessment tools.

Patients suffering from Ménière's disease (MD) experience vertigo, and impairments in hearing and quality of life (QoL). This study aims to investigate the impact of cochlear implantation (CI) on various aspects affecting patients with MD. A single tertiary centre's CI database for CI recipients with MD between 2014 and 2022 was screened retrospectively. Hearing, vertigo, tinnitus symptoms, and hearing-related QoL were assessed. Pre- and postoperative hearing tests in conjunction with subjective outcome measures by visual analogue scale (VAS) and validated tools such as the Dizziness Handicap Inventory (DHI), Tinnitus Handicap Inventory (THI) and Nijmegen Cochlear Implant Questionnaire (NCIQ), as well as the assessment of the pre- and postoperative Functional Level Scale (FLS) were examined. Eleven ears were included (median age: 59 years at implantation). Following implantation, there was a significant enhancement in Word Recognition Scores at sound levels of 65 dB and 80 dB compared to before treatment (preop vs. 12 months postop: p = 0.012). However, no significant enhancement was observed for 50 dB. MD-related impairments improved significantly postoperatively, as measured by the VAS (vertigo: p = 0.017; tinnitus: p = 0.042), DHI (p = 0.043), THI (p = 0.043) and NCIQ (p < 0.001). The FLS improved significantly (p = 0.020). CI has positive effects on all areas examined in our cohort. However, discrimination of speech at low sound pressure levels remained problematic postoperatively. In patients suffering from MD, the prioritized treatment goals include not only improved hearing but also the rehabilitation of vertigo and tinnitus, as well as the enhancement of QoL. Validated instruments are useful screening tools.

Perceived social support improves health-related quality of life in cochlear implant patients.

Perceived social support has been shown to positively correlate with health-related quality of life (HR-QoL) in a variety of conditions. This study investigated whether perceived social support is affecting HR-QoL of patients who receive a cochlear implant (CI) for deafness. Eighty eight adults (56 males, 32 females; mean age: 60years) with a uni- or bilateral CI for bilateral high-grade hearing loss were administered two questionnaires: a questionnaire for perceived social support (FSU-14) and the Nijmegen Cochlear Implant Questionnaire (NCIQ) for hearing-specific HR-QoL. Administration of the questionnaires occurred at four points in time: before implantation and three, 12 and 24months after implant activation. The CI patients had quite high levels of perceived social support (mean percentile rank: 71), which remained stable at all four measurement points. Multivariate Analysis showed a significant interaction between perceived social support and HR-QoL indicating that higher perceived social support lead to higher improvement of HR-QoL after cochlear implantation. The CI patients in this study had higher than average levels of perceived social support, which did not change before and after cochlear implantation. Perceived social support and HR-QoL were related such that patients with high levels of perceived social support experienced greater improvement of their HR-QoL after cochlear implantation than patients with low levels of perceived social support. Based on this finding, perceived social support must be considered as an important factor for HR-QoL after cochlear implantation.

Influence of cochlear implantation on the working ability of hearing-impaired patients: A prospective study on potential influencing factors

Purpose This study evaluates the effect of cochlear implantation (CI) on work ability. The influences of quality of life (QOL), age, mental health, and hearing were analyzed. Methods Seventy-nine patients undergoing CI surgery were evaluated preoperatively and 12 months postoperatively. Work ability was evaluated using the Work Ability Index (WAI). QOL was assessed with the Nijmegen Cochlear Implant Questionnaire (NCIQ) and the WHOQOL-BREF. Mental health was assessed with the Patient Health Questionnaire. Results The WAI was unaffected by CI (Δ 0.8 ± 6.8, p = 0.42). No significant changes in WAI were observed for employees (Δ – 1.1 ± 5.7, p = 0.25) and pensioners (Δ −0.4 ± 7.8, p = 0.73). Patients without elevated depressiveness, stress, or somatoform symptoms had significantly better WAI. The multiple regression analyses show that WHOQOL-BREF (ß = 0.49, p ≤ 0.001), age (ß = −0.34, p ≤ 0.001), and depressiveness (ß = 0.33, p = 0.04) were significantly associated with WAI. In the employee group, the NCIQ (ß = 0.58, p = 0.008) had the strongest association with the WAI. Conclusion Age, mental health, and QOL are predictive factors for work ability. This should be considered in the consultation and the rehabilitation process.

Development of aGerman short version of the Nijmegen Cochlear Implant Questionnaire

The Nijmegen Cochlear Implant Questionnaire (NCIQ) is aquestionnaire for assessing hearing-specific quality of life in the context of cochlear implantation. Its length (60items) makes it difficult to use in clinical practice, so ashort version is desirable. The question arises as to which items should be selected for the short version. The items were selected statistically using uncorrected item-total score correlation. Item selection was made based on datasets from three measurement points: before implantation and 3and 12months after processor activation. The items were selected according to the criterion that they were among the 40items with the highest item-total score correlation at each of the three measurement points. Of the 60items in the NCIQ, 25met the criterion and were hence included in the short version. The short version yields similar scores as the long version at the postoperative timepoints; however, at the preoperative timepoint, the agreement of the scores is suboptimal. Split-half reliability and internal homogeneity of the short version are very good. The present study constitutes an initial positive evaluation of ashort form of the NCIQ in terms of standard psychometric criteria. Application of the short form is associated with significantly reduced resources in terms of processing and evaluating.

Is Age a Limiting Factor for Audiological Results in Active Middle Ear Implants?

Active middle ear implants (AMEI) are implantable options for patients with sensorineural, conductive, or mixed hearing loss who are not good candidates for hearing aids. The aim of this study was to compare audiological, surgical, quality of life, and sound quality outcomes in adults <60 and ≥60 years receiving an AMEI. Twenty adult patients who underwent AMEI implantation were divided into two groups, <60 and ≥60 y. Preoperative tests included pure-tone average and speech discrimination score (SDS) at 65 dB for disyllabic words in quiet. Postoperative measures included AMEI-aided bone conduction threshold, free-field warble-tone threshold, and SDS at 65 dB for disyllabic words in quiet 12 months after the AMEI fitting. Subjective benefit was evaluated using the Nijmegen Cochlear Implant Questionnaire (NCIQ), Glasgow Benefit Inventory (GBI), and Hearing Implant Sound Quality Index (HISQUI19). Mean functional gain was 32 and 30 dB, and SDS at 65 dB improved from 19 to 95% and from 31 to 84% in the <60 and ≥60 y groups, respectively. All NCIQ domains improved following surgery, and all patients had a positive overall GBI score. The mean HISQUI19 score was 97 in both age groups. AMEIs are an effective hearing restoration method for older adults suffering from conductive or mixed hearing loss.

Influence of depressive disorders, stress, and personality traits on quality of life after cochlear implantation

PurposeThis study aimed to determine whether preoperative depressiveness, stress, and personality influence quality of life (QOL) after cochlear implant (CI) surgery.MethodsIn this prospective study, 79 patients undergoing CI surgery were evaluated preoperatively and 12 months postoperatively. Disease-specific QOL was assessed with the Nijmegen Cochlear Implant Questionnaire (NCIQ) and general QOL with the WHOQOL-BREF. Depressiveness and stress were assessed with the Patient Health Questionnaire (PHQ-D). The Charlson Comorbidity Index (CCI) was used to classify comorbidities. The Big Five Personality Test (B5T) was used to assess the basic personality dimensions. Speech comprehension was evaluated in quiet with the Freiburg monosyllable test and in noise with the Oldenburg sentence test.ResultsAfter CI surgery, the total NCIQ score improved significantly (Δ 17.1 ± 14.7, p < 0.001). General QOL (WHOQOL-BREF, Δ 0.4 ± 9.9, p = 0.357), stress (Δ 0.25 ± 3.21, p = 0.486), and depressiveness (Δ 0.52 ± 3.21, p = 0.121) were unaffected by CI surgery. Patients without elevated depressiveness (p < 0.01) or stress (p < 0.001) had significantly better total NCIQ scores. The results of the multiple regression analyses show that, after adjusting for the CCI, personality, age, and mental health stress (ß = − 0.495, p < 0.001) was significantly associated with postoperative NCIQ outcome scores. Depressiveness and neuroticism had the strongest influence on the generic QOL (ß = − 0.286 and ß = − 0.277, p < 0.05).ConclusionStress symptoms and personality traits are significant predictive factors for disease-specific QOL, as well as hearing status. This should be considered in the preoperative consultation and in optimizing the rehabilitation process.

QoL, CIs, QALYs, and Individualized Rehabilitation: The Clinical and Practical Benefits of Regularly Assessing the Quality of Life of Adult Cochlear Implant Recipients.

This study aimed to report quality of life (QoL) scores in unilateral cochlear implant (CI) users and to generate guidance for clinicians on using QoL measures to individualize CI counselling and rehabilitation and to increase access to CIs as a mode of rehabilitation. Participants (n = 101) were unilateral CI users with single-sided deafness (SSD; n = 17), asymmetrical hearing loss (AHL; n = 26), or bilateral hearing loss (Uni; n = 58). Generic QoL was assessed via the Health Utilities Index (HUI-3), and disease-specific QoL was assessed via the Speech, Spatial, and Qualities of Hearing scale (SSQ12) and Nijmegen CI Questionnaire (NCIQ) at preimplantation and at 6 and 12 months of CI use. All groups had significantly increased HUI-3 scores at both intervals. The SSD group showed significant benefit on the SSQ12 at visit 3, the AHL group showed significant benefit on the SSQ12 and most NCIQ subdomains at both intervals, and the Uni group showed significant benefit with both tests at both intervals. Unilateral CI recipients demonstrate improved QoL within the first 12 months of device use. Regular assessment with generic and disease-specific questionnaires has the potential to play an important role in personalizing treatment and possibly in increasing access to CI provision.

An Exploration of Quality of Life Perceptions of Cochlear Implant Recipients and Their Frequent Communication Partners

Purpose: Quality of life (QoL) after cochlear implantation has been investigated using a variety of QoL questionnaires. However, few studies have examined the perceived QoL of cochlear implant (CI) recipients compared between the recipient and a frequent communication partner (FCP) using both hearing-related (hearing-specific) and health-general (health-general) measures. Method: For this multiple case study, five participant pairs were recruited, consisting of five adult recipients who were implanted at least 6 months prior to the time of evaluation and five adult FCPs who lived with the recipient at the time of evaluation. All 10 participants (five pairs) completed a health-general questionnaire (Medical Outcome Study Short-Form Survey 12-Item [SF-12]), and eight participants (four pairs) completed a disease specific questionnaire (Nijmegen Cochlear Implant Questionnaire [NCIQ]). Results: Both recipients and partners tended to score similarly to each other on both measures. However, both groups scored higher on the SF-12 than the NCIQ. Results also revealed a better interrater agreement between pairs on the SF-12 compared to the NCIQ. Conclusions: Overall, scores for recipients and partners were higher for the health-general SF-12 compared to the hearing-related NCIQ. Additionally, rater agreement was better for the SF-12 compared to the NCIQ, suggesting that differences in QoL perceptions exist for more hearing-specific challenges. These results highlight potential differences in perception of recipient QoL postimplantation as illustrated through the use of multiple QoL measures. Results speak to the importance of open communication between recipients and partners.

Satisfaction with life in a sample of prelingually deaf cochlear implant users with a good command of spoken Polish as the primary language

IntroductionThis study investigated the level of satisfaction with life (SWL) in a group of cochlear implant (CI) users who had been prelingually deaf but were orally educated. They had received one or two CIs (as a child, adolescent, or adult) and were highly competent Polish speakers. This study looked at three factors that may affect SWL – psychosocial, deafness/hearing and communication related, and sociodemographic. MethodsThe participants were prelingually deaf CI users who had learned highly competent spoken Polish as their primary language. They had been educated in mainstream or integrated schools (not schools for the deaf), and had no other disability or severe illness. Measurements were done with 5 questionnaires: the Satisfaction With Life Scale (SWLS), the I–Others Questionnaire, the Patient Health Questionnaire (PHQ-9), the Deaf Identity Development Scale (DIDS), and the Nijmegen Cochlear Implant Questionnaire (NCIQ). ResultsThe SWL level of the group was similar to that of the standard Polish population. SWL was positively related to positive self-perception, acceptance of oneself as a deaf person, and to perceiving the benefits of having a CI (as measured by three NCIQ domains: self-esteem, activity limitations, and social interactions). On the other hand, negative self-perception, marginal deaf identity, and depressive symptoms were negatively related to SWL. There was no relationship between SWL and knowledge of sign language. Lower depressive symptoms and greater hearing loss were both significant predictors of SWL, although those who used two CIs generally had a lower SWL. ConclusionsPrelingually deaf CI users with low SWL require psychological support in many spheres, including working through problems of deaf identity, self-acceptance, and depression. Additional research should involve diverse DHH CI users, including those with limited spoken Polish competency or sign language skills, as well as members of the Polish Deaf community.

Prospective comparative analysis of cochlear implant patients with single-sided deafness and asymmetric hearing loss with regard to health-related quality of life, tinnitus distress and psychological comorbidities

Patients with single-sided deafness (SSD) and asymmetric hearing loss (AHL) are increasingly being treated with cochlear implants (CI) due to the demonstrated improvements in auditory abilities and quality of life. To date, there are few published studies in which these two groups are comparatively studied. The aim of the current study was to examine which factors differ between those two patient groups, especially preoperatively. Asecondary analysis of the previously published raw data of 66prospectively recruited CI patients (21SSD/45AHL) was performed. In addition to the hearing outcome, tinnitus distress (tinnitus questionnaire), health-related quality of life (Nijmegen Cochlear Implant Questionnaire, NCIQ), stress (Perceived Stress Questionnaire, PSQ), and psychological comorbidities (General Depression Scale, ADS‑L and Generalized Anxiety Disorder scale, GAD-7) were assessed in SSD and AHL patients pre- and postoperatively. Preoperatively, SSD patients showed significantly higher scores in the NCIQ subdomains "elementary" and "advanced sound perception" than the AHL group. Stress (PSQ) and anxiety symptoms (GAD-7) were significantly higher preoperatively in SSD patients than in AHL patients. After CI, these differences were strongly reduced, with minimal differences being detectable between the groups in the investigated domains postoperatively. SSD and AHL patients differ significantly preoperatively in terms of their subjective hearing assessment and psychosocial parameters. In SSD patients, psychological stress factors may have astronger impact on the quality of life than in AHL patients. These aspects should be taken into account in the preoperative counseling and postoperative rehabilitation.

Health-related quality of life and knowledge of sign language as a second language in adults with prelingual deafness using cochlear implant

The article aims to find an answer to the question whether the knowledge of sign language in the subjective assessment of study participants is connected to health-related quality of life (HRQOL) specific in terms of deafness/hearing and life satisfaction. The study involved 107 people with prelingual deafness using cochlear implants since childhood, adolescence, or adulthood. The results show significant relationship between the quality of life related to deafness/hearing assessed using the Nijmegen Cochlear Implant Questionnaire and the level of knowledge of sign language the following areas: advanced auditory perception and speech perception. Participants fluent in sign language obtained significantly lower results in these areas. Moreover, it was fund that the proportion of people who do not use telephones was larger in the group with a high level of knowledge of sign language than in the groups with medium or no knowledge of sign language. However, there were no significant difference, due to knowledge of sign language, in relation to life satisfaction measured using the Satisfaction with Life Scale. The discussed issue of the role of sign language in relation to the HRQOL in people with prelingual deafness requires further research, including, among others, objective assessment of linguistic competence in Polish Sign Language and the age and method of their acquisition, as well as qualitative research.

Malay Version of Nijmegen Cochlear Implant Questionnaire and Quality of Life of Patients with Post-lingual Deafness.

The Nijmegen Cochlear Implant questionnaire (NCIQ) was used to gauge the quality of life (QOL) improvement among cochlear implant (CI) users who suffered from post-lingual deafness. This study aimed to determine the consistency and reliability of the Malay version of the Nijmegen Cochlear Implant questionnaire (NCIQ-M) and to report the QOL of patients using NCIQ-M. This study has two phases: Phase I involves the translation of the NCIQ from English to Malay, followed by internal consistency and test-retest reliability assessment of the final version of NCIQ-M. Phase II involves QOL assessment of post-lingual deafness using NCIQ-M. Twenty CI users and 20 non-CI users answered the NCIQ-M. Test-retest reliability analysis of the NCIQ-M was performed using an intraclass correlation coefficient, achieving scores of more than 0.85. Internal consistency was analysed with Cronbach α of more than 0.70 in all subdomains. Scores between the two groups of subjects were analyzed using an independent sample t-test. Good internal consistency, intraclass correlation, and test-retest reliability were obtained. Scores in all six subdomains of the NCIQ-M are significantly higher in the CI user group than in the non-CI user group. The NCIQ-M is a consistent and reliable subjective questionnaire to determine the QOL of CI users concerning physical, psychological, and social functioning.

Response shift in hearing related quality of life after cochlear implantation – effect size and clinical significance: a then-test study

BackgroundQuality of life questionnaires are often used in the assessment of rehabilitation of hearing-impaired patients with a cochlear implant. However, a prospective study with a systematic retrospective evaluation of the preoperative quality of life after surgery has not yet been conducted and may reveal a change in internal standards, such as a response shift, due to the implantation and hearing rehabilitation.MethodsThe Nijmegen Cochlear Implant Questionnaire (NCIQ) was used for assessing hearing related quality of life. It has three general domains (physical, psychological and social) and six subdomains. Seventeen patients were tested before (t0) and retrospectively (then-test; pre-t1) and acutely postoperative (post-t1) after cochlear implantation. Observed changes, then-test changes, response shifts and effect sizes were calculated. Non-parametric statistical methods were used.ResultsThe NCIQ total score was 52.32 ± 18.69 (mean, standard deviation) for t0, 59.29 ± 14.06 for pre-t1 and 67.65 ± 26.02 for post-t1 questioning. The observed change was statistically significant in all domains but in speech production. Response shift was statistically significant in the total score and in part of the domains. The effect sizes for the response shift were moderate (> 0.5) in the total score, psychological, social general scores and subdomains.ConclusionsIn this study we found that response shift does exist in adults with severe to profound hearing loss undergoing cochlear implantation. By advising the participants to deactivate the implant for the then-test, recall bias and noise were minimized. The clinical significance of the response shift was present in the total score and in the social and psychological domains.Trial RegistrationThis study was retrospectively registered with the German Clinical Trial Register, TRN DRKS00029467, on 07/08/2022.

Long-term outcome of cochlear implantation on speech perception and quality of life

BackgroundCochlear implantation (CI) is currently a well-established method for restoring hearing to people with profound hearing loss (Blamey and Artieres, Audiol Neurotol 18:36-47, 2013; Holden and Finley, Ear Hear 34:342-360, 2013).Cochlear implantation not only affects hearing abilities, speech perception, and production, but also has an outstanding impact on the social life, activities, and self-esteem of each patient. The Nijmegen Cochlear Implant Questionnaire (NCIQ) and Parents’ Views and Experiences with pediatric Cochlear Implant Questionnaire (PVECIQ) have been developed to assess the quality of life in such patients (Damen and Beynon, Otolaryngol Head Neck Surg 136:597-604, 2007; Hirschfelder and Gräbel, Otolaryngol Head Neck Surg 138:357-362, 2008).The long-term outcome of cochlear implantation (CI) in Egypt and its influence on patients’ lives have not been investigated. This study was designed to evaluate the long-term effect of CI on speech perception and to assess the quality of life (QoL) and get insight about major problems encountered by these patients over years.MethodsForty adults and children CI users of least 5 years of CI experience were subjected to full history taking and CI outcome measures: CI questionnaires, aided sound field pure tone audiometry, and speech perception tests.ResultsThrough QoL questionnaires, the highest scores were obtained in the physical functioning domain than in the psychological and social domains in adults, while for children, the highest scores were obtained in the general domain than in the communication and self-reliance domains. No statistically significant correlation was found between QOL questionnaires and speech tests.ConclusionAudiological evaluation including speech perception tests is not enough to reflect the true performance of CI subjects in everyday listening situations. The Arabic versions of QoL questionnaires were complementary to other outcome CI measures. Long-term evaluation for CI users is crucial.

Translation and Adaptation of the Nijmegen Cochlear Implant Questionnaire in Hindi: A Health-Related Quality of Life Questionnaire for Adults with Cochlear Implants.

Nijmegen Cochlear Implant Questionnaire is an HRQoL tool that was developed by Dutch researchers to assess the QoL in adult CI users in the English language. It is used to measure the impact of the use of CI on the daily life situations of its users, on the perception of speech sounds, and on the cost-benefit assessment CI in adult CI users. There is no specific instrument available to assess the QoL in adult CI users in India, hence there was a need to take up this study. The primary aim of the study was to adapt and translate NCIQ into Hindi with a secondary aim to describe the effect of CI on quality of life in adult CI users. For translation, permission was taken from the authors of the original tool. The Forward-backward translation method was utilized for translation. The final version of the NCIQ-H was administered to the study participants (25 no.) 25, aged 18-60 years; High School as the minimum level of education; post-lingual hearing impairment, and CI use ≥12 months. The Cronbach's α coefficient was calculated for all domains and subdomains in the NCIQ-H showed the overall reliability of the questionnaire (0.82), showing good internal consistency. The CI users reported high scores across all the domains indicating improved quality of life. No significant correlation was found between the CI usage time and NCIQ scores on Spearman's correlation test. Also, there was no significant difference in NCIQ-H scores between genders on the Kruskal-Wallis test. The NCIQ (H) can be used to assess QoL in adults with cochlear implants. The scores suggest improvement in physical, social and psychological domains of life. No correlation was observed between the NCIQ-H scores and duration of CI usage as well as with gender differences.

Development of the hearing-related quality of life questionnaire for auditory-visual, cognitive and psychosocial functioning (hAVICOP)

IntroductionThere is a need for a validated and standardized self-assessment instrument to assess the subjective effect of hearing aid (HA) use and/or cochlear implantation (CI) on different aspects of functioning in daily life. The aim of this study was to develop a new holistic Patient Reported Outcome Measure (PROM) to assess hearing-related quality of life. The new PROM is titled the hearing-related quality of life questionnaire for Auditory-VIsual, COgnitive and Psychosocial functioning (hAVICOP). MethodsA conceptual framework was set up and test items were prepared per domain. Preliminary testing involved a semi-structured interview-based assessment in normal-hearing and hearing-impaired adults and an expert panel. For the further psychometric evaluation, a new sample of 15 adult HA users, 20 adult CI users and 20 normal-hearing adults filled in the refined version of the hAVICOP, the Speech, Spatial and Qualities of Hearing Scale, the Nijmegen Cochlear Implant Questionnaire and the TNO-AZL Questionnaire for Adult's Health-Related Quality of Life. Based on these results, a factor analysis was conducted and internal consistency, discriminant validity and concurrent construct validity were determined. ResultsThe final version of the hAVICOP consists of three domains for hearing-related quality of life: (1) auditory-visual functioning, (2) cognitive functioning, and (3) psychosocial functioning. A sufficient internal consistency was found, and discriminant validity and concurrent construct validity were good. ConclusionsA new PROM to assess hearing-related quality of life was developed, named the hAVICOP. In the future the validity and reliability should be examined further.

Study protocol for a randomised controlled trial evaluating the benefits from bimodal solution with cochlear implant and hearing aid versus bilateral hearing aids in patients with asymmetric speech identification scores

IntroductionCochlear implant (CI) and hearing aid (HA) in a bimodal solution (CI+HA) is compared with bilateral HAs (HA+HA) to test if the bimodal solution results in better speech intelligibility and...

Long Term Impact of Age at Implantation on Quality-of-Life Outcomes in Cochlear Implant Recipient Children.

Cochlear implantation (CI) is used in management of children with bilateral severe to profound sensorineural hearing loss (SNHL). Recently, due to technological advancements, more and more infants and toddlers are undertaking the CI. The age at implantation may have an impact on CI outcomes. The primary aim of this study was to determine the long-term impact of 'age at implantation' on Health Related Quality of Life (HRQoL) outcome post-CI. In this prospective study at a tertiary care centre, we evaluated 50 CI recipient children from 2011 to 2018. Group A consisted of 35 (70%) children who received CI at less than or equal to 5years of age and Group B with 15 (30%) children who underwent CI at more than 5years of age. Following CI, all children received auditory-verbal therapy and thereafter we evaluated their long-term HRQoL outcomes at 5years post-CI. Children were assessed by Nijmegen Cochlear Implant Questionnaire (NCIQ) and Children with cochlear implants: parental perspectives-questionnaire (CCIPPQ). There were significantly improved HRQoL outcomes (with an increase of 11.7% in mean NCIQ and 11.4% in mean CCIPPQ scores) at 5years post-CI in CI recipients of age group '5years or less' as compared to those who underwent CI at 'more than 5years' age [P value < 0.05 for both the mean NCIQ scores and mean CCIPPQ scores respectively]. However, for children with 'more than 5years' age at implantation, mean NCIQ and CCIPPQ scores were still more than 80% of maximum achievable NCIQ and CCIPPQ scores. In this study, CI recipient children who were implanted at less than or equal to 5years of age were found to have significantly improved HRQoL outcomes at 5years post-CI. Hence, it seems desirable to provide CI at an early age. However, even in children who received CI at more than 5years of age, there was a substantial enhancement in HRQoL outcomes and CI was still effective in these children. Hence, knowledge of 'age at implantation' may provide reasonable assistance in predicting the HRQoL outcomes and optimal counseling of parents and families of CI candidates.

Third-party disability in cochlear implant users

Objective To date, auditory rehabilitation mainly focuses on the person with hearing impairment (PHI). This study aimed to analyse the burden of hearing loss on significant others (SOs), and to explore the impact of contextual and mediating psychosocial co-factors and auditory rehabilitation by cochlear implantation (CI). Design and study sample Third-party disability (SOS-HEAR) and quality of life (Nijmegen Cochlear Implant Questionnaire) were evaluated in 41 PHI scheduled for CI surgery and their close partners pre- and 6-month post-implantation. Further, age, hearing status, educational level, depressive symptoms (GDS-15), coping strategies (Brief-COPE), resilience (RS-13), stress (PSQ) of SOs and PHI were studied. Results Hearing loss imposes a burden on SOs, particularly in relation to changes in communication and socialisation. Third-party disability was higher in SOs of PHI with lower educational background (p = 0.04) and of advanced age (p = 0.008). Hearing status of SOs negatively correlated with SOS-HEAR (p = 0.04). After CI, quality of life of PHI and third-party disability of SOs improved (p < 0.001), except in relationship changes. SOs with higher pre-operative burden also experienced more third-party disability afterwards (p ≤ 0.003). Conclusion Audiological rehabilitation should expand to include SOs in the rehabilitation process, as the burden experienced by SOs might persist even after CI.

Application of Patient Reported Outcome Measures in Cochlear Implant Patients: Implications for the Design of Specific Rehabilitation Programs.

Cochlear implants (CI) have been developed to enable satisfying verbal communication, while music perception has remained in the background in both the research and technological development, thus making CI users dissatisfied by the experience of listening to music. Indications for clinicians to test and train music abilities are at a preliminary stage compared to the existing and well-established hearing and speech rehabilitation programs. The main aim of the present study was to test the utility of the application of two different patient reporting outcome (PRO) measures in a group of CI users. A secondary objective was to identify items capable of driving the indication and design specific music rehabilitation programs for CI patients. A consecutive series of 73 CI patients referred to the Audiology Unit, University of Padova, was enrolled from November 2021 to May 2022 and evaluated with the audiological battery test and PRO measures: Musica e Qualità della Vita (MUSQUAV) and Nijmegen Cochlear Implant Questionnaire (NCIQ) Italian version. The reliability analysis showed good consistency between the different PRO measures (Cronbach's alpha = 0.873). After accounting for the epidemiological and clinical variables, the PRO measures showed a correlation with audiological outcomes in only one case (rho = -0.304; adj. p = 0.039) for NCIQ-T with the CI-pure tone average. A willingness for musical rehabilitation was present in 63% of patients (Rehab Factor, mean value of 0.791 ± 0.675). We support the role of the application of MUSQUAV and NCIQ to improve the clinical and audiological evaluation of CI patients. Moreover, we proposed a derivative item, called the rehab factor, which could be used in clinical practice and future studies to clarify the indication and priority of specific music rehabilitation programs.