Nijmegen Cochlear Implant Questionnaire Research Articles

Differences in perception of hearing handicap between cochlear implant users and their spouses

To examine the relationship between patient and proxy ratings of health-related quality of life (HRQL) in patients with cochlear implants. Prospective survey. Eighty-two adult cochlear implant recipients and their spouses/partners were asked to complete the Nijmegen Cochlear Implant Questionnaire (NCIQ) and the Hearing Participation Scale (HPS) that were mailed to them. For the NCIQ, there were 38 useable responses from recipients and 31 useable responses from the partners. There were 27 paired and useable questionnaires (i.e., from both the recipient and his/her partner). For the HPS, there were 42 useable responses from recipients and 36 useable responses from the partners. Of these, there were 35 paired questionnaires. There was good agreement between partners and patients with both the HPS (r = 0.62) and the NCIQ (r = 0.80). There was a significant statistical difference in the scoring of the Basic Sound Perception subscale between the two groups (P = .039), with spouses under-rating performance in this subscale. For patients with cochlear implants, patients' partners corroborate patients' self-reported HRQL. In cases in which patients have sensory impairment, there may be an additional role for proxy ratings of HRQL to give a more complete assessment of functional limitations.

Music and Quality of Life in Early-Deafened Late-Implanted Adult Cochlear Implant Users

The early-deafened, late-implanted (EDLI) CI users constitute a relatively new and understudied clinical population. To contribute to a better understanding of the implantation outcome, this study evaluated this population for self-reported enjoyment and perception of music. Additionally, correlations of these measures with the self-reported quality of life and everyday hearing ability and a behaviorally measured word recognition test were explored. EDLI CI users from the Northern Netherlands were sent 4 questionnaires: 1) Dutch Musical Background Questionnaire (enjoyment and perception of music), 2) Nijmegen Cochlear Implant Questionnaire (quality of life), 3) Cochlear Implant Functioning Index (auditory-related functioning), and 4) Speech, Spatial and Qualities of Hearing Scale (hearing ability). Complementary, behavioral word recognition in quiet tests (phoneme score) were completed. Twelve (60%) of 20 participants reported music to sound pleasant. In general, the self-perceived quality of music was scored positively. No correlations were observed between enjoyment and perception of music, quality of life, hearing ability, and word recognition. The results indicate that, differently than postlingually deafened, EDLI CI users enjoy music and rate the quality of music positively. Potential explanations for the absence of correlations between the music measures and the other outcomes could be that other factors, such as speech perception, contribute more to quality of life of EDLI CI users or that this group simply lacks previous exposure to music with acoustic hearing. Overall, these positive findings may give extra support for implant candidacy of early-deafened individuals, but further studies should be conducted.

Active Middle Ear Implantation for Patients With Sensorineural Hearing Loss and External Otitis

To study long-term subjective benefit of patients with sensorineural hearing loss and chronic external otitis who use active middle ear implants. Single-subject repeated measures in a preintervention and postintervention design with multiple postintervention measurements (questionnaires). Tertiary academic center. Moderate-to-severe sensorineural hearing loss (n = 56) with severe chronic external otitis who use the Vibrant Soundbridge (VSB) or Otologics MET middle ear implant systems. Changes in hearing disability and handicap as evaluated using the Abbreviated Profile of Hearing Aid Benefit (APHAB), the Nijmegen Cochlear Implant Questionnaire (NCIQ), and the Glasgow Benefit Inventory (GBI). Data of 33 patients (mean postoperative duration of 7.5 yr) were available. No difference in subjective results was found between the VSB and Otologics MET patient groups. Total percentage of nonuse was 13%. Long-term APHAB results show a significant decrease in disability for 43% of the patients compared with 54% at 1-year postoperative. NCIQ results show a significant benefit for all subdomains with a negative trend over time. The GBI results show a significant long-term increase in quality of life with positive scores for 82% of the assessed patients. Long-term postoperative patient satisfaction and quality of life results show a significant difference compared with preoperative measurements, with conventional hearing aids. A negative trend over time is found on all questionnaires, which might reflect patient aging (increase of hearing loss) or habituation to a situation with fewer concerns regarding a patient's external otitis.

Extra Benefit of a Second Cochlear Implant With Respect to Health-Related Quality of Life and Tinnitus

To evaluate whether the second cochlear implant (CI) provides any extra benefit with respect to health-related quality of life, tinnitus, and auditory abilities. The data were evaluated using validated questionnaires before and after the first and second CI supply. Preimplantation data were collected retrospectively. Forty postlingually deafened adults, 11 male and 29 female subjects were included in this study. All patients were sequentially bilaterally implanted with a multi-channel CI for at least 6 months. The health-related quality of life assessed with the Nijmegen Cochlear Implant Questionnaire further increased after the second CI. In patients with initially higher level of tinnitus annoyance measured with the Tinnitus Questionnaire, the scores decreased after the first CI and remained steady after the second CI. Patients with initially lower level of tinnitus annoyance had a further decrease of the Tinnitus Questionnaire score after the second CI. Additionally, the second CI induced further improvement of auditory abilities, as assessed by the Oldenburg Inventory and the Freiburg monosyllable test in quiet and the HSM and Oldenburg sentence tests in noise. The quality of life scores correlated with the auditory abilities, especially after the second CI. The present study provides evidence that the second CI leads to further increase in quality of life and reduction of tinnitus annoyance in addition to improvement of auditory abilities as compared with the first CI. Patients with bilateral CIs benefit from additional positive effects in all these fields.

Musical background not associated with self-perceived hearing performance or speech perception in postlingual cochlear-implant users

In normal-hearing listeners, musical background has been observed to change the sound representation in the auditory system and produce enhanced performance in some speech perception tests. Based on these observations, it has been hypothesized that musical background can influence sound and speech perception, and as an extension also the quality of life, by cochlear-implant users. To test this hypothesis, this study explored musical background [using the Dutch Musical Background Questionnaire (DMBQ)], and self-perceived sound and speech perception and quality of life [using the Nijmegen Cochlear Implant Questionnaire (NCIQ) and the Speech Spatial and Qualities of Hearing Scale (SSQ)] in 98 postlingually deafened adult cochlear-implant recipients. In addition to self-perceived measures, speech perception scores (percentage of phonemes recognized in words presented in quiet) were obtained from patient records. The self-perceived hearing performance was associated with the objective speech perception. Forty-one respondents (44% of 94 respondents) indicated some form of formal musical training. Fifteen respondents (18% of 83 respondents) judged themselves as having musical training, experience, and knowledge. No association was observed between musical background (quantified by DMBQ), and self-perceived hearing-related performance or quality of life (quantified by NCIQ and SSQ), or speech perception in quiet.

Sequential Bilateral Cochlear Implantation in Children<subtitle>Quality of Life</subtitle>

To assess the effect of sequential bilateral cochlear implantation in children on their quality of life (QoL). Prospective cohort-control study. Tertiary academic referral center. Thirty children with prelingual deafness underwent sequential bilateral cochlear implantation (mean age at first implant, 1.8 years; mean age at second implant, 5.3 years). Nine children with a unilateral cochlear implant were also included in the study. All children had prelingual deafness, had good implant performance, and had no benefit from a contralateral conventional hearing aid. The groups were matched on duration of unilateral implant use, chronological age, and degree of bilateral hearing loss. Sequential bilateral cochlear implantation. Quality of life was assessed before surgery of the second implant and after 12 and 24 months of bilateral implant use. In the children with a unilateral cochlear implant, QoL was assessed over time and was compared with the study group after 12 and 24 months. Six questionnaires were used to measure QoL: overall health status using a visual analog scale; the Health Utilities Index Mark 3 (HUI3); the Pediatric Quality of Life Inventory (PedsQL); the Glasgow Children's Benefit Inventory (GCBI); the Speech, Spatial, and Qualities of Hearing Scale (SSQ); and the Nijmegen Cochlear Implant Questionnaire (NCIQ). Results showed no significant gain in generic QoL measures associated with sequential bilateral cochlear implantation (P>.05). The nonsignificant effect yielded on the HUI3 could be attributed to the ceiling effect and the lack of resolution in the hearing domain obtained in cochlear implant recipients. The gain in QoL of +0.04 may, therefore, be underestimated. In contrast, the 3 disease-specific questionnaires showed a significant improvement in QoL (P<.05). Results also showed that, unlike the children with a unilateral implant, QoL measures continued to improve with longer durations of bilateral implant use. Within the study group, the age at second implantation had no influence on the gain in QoL (P>.05). Sequential bilateral cochlear implantation in children is associated with an improvement in QoL, although this is predominantly reflected in the disease-related aspects of QoL and not necessarily in generic QoL.

Benefit and Quality of Life in Older Bone-Anchored Hearing Aid Users

Benefit and quality-of-life analysis in the older adult bone-anchored hearing aid (BAHA) users. Retrospective evaluation. Four questionnaires (Glasgow Benefit Inventory, Abbreviated Profile of Hearing Aid Benefit [APHAB], Nijmegen Cochlear Implant Questionnaire [NCIQ], and the Hearing Handicap Inventory for the Elderly screening version [HHIE-S]) were used. The response rate was 80%, mean age was 75 years (range, 62-93 yr), and mean pure-tone average at frequencies of 500, 1,000, 2,000, and 4,000 Hz for bone conduction was 42 +/- 13 dBHL. More than 80% of the patients were using their BAHA for more than 8 hours a day. To obtain a "snapshot" of current BAHA use, the NCIQ, HHIE-S, and the APHAB were used. The NCIQ showed good disability and handicap results (score range, 49-64). The HHIE-S showed that 60% of the patients had a mild to moderate handicap. The APHAB aided scores ranged from 39 to 58%. Mean benefit scores of the Glasgow Benefit Inventory were positive in 112 of the 134 patients (84%). The APHAB showed clinically significantly more benefit with the BAHA than with the previous aided or unaided situation. A trend could be seen-the higher the pure-tone average at frequencies of 500, 1,000, 2,000, and 4,000 Hz for bone conduction, the smaller the mean benefit scores on the questionnaires. Bone-anchored hearing aid users aged 60 years or older were able to place and handle the device very adequately and clean the skin around the implant. Most patients reported comparable or increased general benefit and good quality of life with the BAHA.

Clinical Relevance of Quality of Life Outcome in Cochlear Implantation in Postlingually Deafened Adults

To evaluate the benefits of cochlear implantation in postlingually deafened adults and estimate the clinical relevance of these benefits. Prospective intervention study. Tertiary referral hospital. Forty-four postlingually deafened adults. Cochlear implantation with a Clarion CII HiFocus 1 or HiRes 90K. The Health Utility Index Mark II (HUI2) and Nijmegen Cochlear Implant Questionnaire were administered to quantify health-related QoL (HRQoL); utilities were obtained from the HUI2 and time trade-off instrument. Speech perception scores were analyzed. Patient factors were correlated with postimplant HRQoL and speech perception scores. Clinical significant benefit was estimated using the minimal clinically significant difference (MID) and effect size (ES). The results show a significant improvement in HRQoL and speech perception (p < 0.001). The improvement in HRQoL is mainly obtained in the first months after implantation and is largest in the categories concerning physical functioning (hearing). A shorter duration of deafness (p = 0.003) and higher educational level (p = 0.015) were significant predictors of better speech perception. Cochlear implantation proved to be a cost-effective procedure. By using the MID and ES, we found important clinical improvements on 6 health domains of the Nijmegen Cochlear Implant Questionnaire and on the sensation domain of the HUI2 in most patients; all but 1 of the ESs were large. Cochlear implants have a large and significant positive impact on HRQoL and speech perception and are cost-effective. These improvements are clinically relevant as measured by the MID.

Quality of life after cochlear implantation in postlingually deaf adults

To evaluate the quality of life after cochlear implantation in adult cochlear implant recipients and to assess the applicability of Nijmegen Cochlear implant Questionnaire (NCIQ). Thirty-two postlingually deaf patients, 19 males and 13 females, underwent cochlear implantation with the age at operation of 35.27 (18-66) during the period from 1996 to the end of 2006. NCIQ was used to investigate the application of the equipment, hearing ability, and emotional exchange ability. All of the patients used their cochlear implants for 16 h every day on average with an experience in using such implant of more than 6 months. Improvement was seen in sound recognition, speech recognition, confidence, daily life, social exchange, and emotional behavior ability at different degrees. The improvement of confidence was very obvious. The speech communication ability of those with a hearing deprivation time longer than 5 years was lower than that of those with a shorter hearing deprivation time. Age and educational level did not influence the efficiency. Cochlear implantation is a cost effective intervention in the postlingually deaf adults. NCIQ test can be used to evaluate the quality of life among postlingually deaf adult cochlear implant recipients in China.

The impact of cochlear implantation on quality of life: The role of audiologic performance and variables

The purpose of this study was to assess the impact of cochlear implantation (CI) on health-related quality of life (HRQOL), to correlate the results with audiologic performance, and to analyze the influence of variables that possibly affect the CI outcome. A retrospective study. Fifty-six adult CI users were evaluated by two HRQOL-questionnaires (the Nijmegen Cochlear Implant Questionnaire [NCIQ] and the Medical Outcome Study Short-Form 36 [SF-36]) and speech-perception tests (Freiburger monosyllable and Hochmair, Schulz, Moser (HSM) sentence test). The NCIQ showed significant improvements in the total score and in all subdomains after CI. The NCIQ total score and the advanced sound-perception and speech-production score correlated significantly with speech test results. Significant inverse relationships were noted between speech test results and duration of deafness. Significant associations were found between time since CI, NCIQ total score, and speech test results. The NCIQ was able to detect significant effects of CI on HRQOL and correlated with audiologic measures, supporting its use as a measurement tool in CI.

Cochlear Implant Outcomes and Quality of Life in Adults with Prelingual Deafness

To evaluate sound and speech perception and quality of life in prelingually deafened adults implanted with state of the art devices. To investigate which patient factors influence postoperative performance. Prospective intervention study. Eight prelingually deafened subjects (with onset of severe hearing impairment before the age of 4 years and functioning in an oral-aural setting) participated in this study. Subjects were implanted at a mean age of 36 (range, 21-55) years with a CII or 90 K cochlear implant (Advanced Bionics Corp.). All subjects completed standard speech perception tests as well as quality of life measures (Health Utility Index Mark-II, Nijmegen Cochlear Implant Questionnaire, visual analogue scale for subject's hearing and health) at different points in time. Postoperative scores were compared with each other and with the baseline preoperative scores. The relationship between nine patient variables and the postoperative consonant-vowel-consonant (CVC) phoneme score was also investigated. Significant improvement was measured for CVC word and phoneme scores and several quality of life measures. Postoperative speech perception correlated with a new and promising factor named quality of a patient's own speech production (QoSP). With state of the art implants, speech perception and quality of life do improve in prelingually deafened adults. More importantly, the prognostic value of QoSP should be investigated further.

Outcomes in adults implanted with the FLEXsoft electrode

Conclusion. Achieving deep insertions, as well as good speech perception results, the FLEXsoft electrode array allows for some preservation in subjects with measurable low frequency hearing, even after a period of time. This opens the door for future research in electrode design, hearing preservation research and drug delivery systems. Objectives. The FLEXsoft electrode is designed to be atraumatic to the structures of the cochlea during deep insertion of a cochlear implant electrode. This paper reports on the surgical and functional outcomes in implantations with the FLEXsoft electrode array. Patients and methods. Twenty-three adult subjects received a FLEXsoft electrode array and were assessed on speech perception tests (monosyllables, sentences in quiet and in noise), a subjective questionnaire (Nijmegen Cochlear Implant Questionnaire) and a pure-tone audiogram. Results at 1, 3, 6 and 12 months post first fitting were compared to scores from the preoperative interval. Results. Surgery was uneventful in all cases, the surgical handling was satisfactory and correct position of the electrode was achieved in all cases. Hearing could be preserved (as determined by the audiogram) in half of the subjects who had measurable audiograms preoperatively at the 1 month test interval, and in a quarter of subjects after 12 months of device use, despite deep insertion of the electrode. Speech perception scores showed significant improvement over time, as did quality of life scores, and were comparable to results with the standard electrode array as used in the COMBI 40+ and PULSARCI100.

Development and application of a health-related quality-of-life instrument for adults with cochlear implants: The Nijmegen Cochlear Implant Questionnaire

Objective: The goal was to develop a quantifiable, self-assessment health-related quality of life (QoL) instrument for use in cochlear implant (CI) users. Design: Three principal domains were distinguished: physical, psychological, and social. Forty-five postlingually deaf adult multichannel CI users and 46 deaf candidates on the waiting list for CIs (control group) participated in the study. Results: Retrospective scores for the CI group corresponded very well with the scores for the control group. Current QoL scores were substantially higher for all 6 subdomains. Internal consistency and testretest reliability coefficients proved to be satisfactory, and the ability to detect clinical changes with the Nijmegen Cochlear Implantation Questionnaire (NCIQ) proved to be good. Conclusions: The psychometric characteristics of the NCIQ proved to be reliable and probably valid and sensitive to clinical changes. The data obtained with the NCIQ reflected that the instrument was able to detect that a CI had significant effects on several health-related QoL aspects, including the social and psychological domains. (Otolaryngol Head Neck Surg 2000;123:756-65.)