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Self-rated quality of life after unilateral cochlear implantation and its correlation with audiological
Parietti-Winkler C. , Rumeau C. , Montaut-Verient B. , Lion A. , Gauchard G. , Frere J.
ENT Department, University Hospital of Nancy, Nancy Cedex, France, 2Université de Lorraine, EA3450 DevHA, Nancy, France
Introduction: Despite wide variation in post-CI speech recognition methods, all published studies agree to show
an improvement in hearing performances. Numerous studies using assessment of quality of life (QoL) through
self-rated questionnaires showed also an improvement thanks to CI, even though QoL is still not routinely
evaluated after CI, because questionnaires are time-consuming. Tinnitus and phone use are two additional
important factors, not routinely assessed, that also may impact QoL. This study aimed to evaluate the impact of
cochlear implantation (CI) on quality of life (QoL) with general and CI-specific questionnaires, and to determine
its relationship with speech recognition performances, phoning abilities and tinnitus.
Methods: Twenty-six volunteer adults had monaural CI for post-lingually profound deafness and used implant
for at least one year. The Glasgow benefit inventory (GBI) and Nijmegen cochlear implant questionnaire (NCIQ)
assessed QoL. Speech recognition was tested with phonemic Lafon´s lists and Subjective tinnitus severity scale
questionnaire was used. Patients were split into four groups according to their phone ability.
Results: Both QoL questionnaires detected an improvement following CI but moderately correlated between
them (r=0.47). A significant relationship between phone ability, QoL and speech recognition was found.
Improving phone ability led to higher QoL (p< 0.05) and speech recognition (p< 0.01) scores. Post-CI occurrence
of tinnitus significantly decreased, but its severity was not correlated with QoL.
Discussion: QoL questionnaires and speech recognition assessment both provide information of great interest
in evaluating patient's rehabilitation in daily life, but the one cannot replace the other. Specific and general
HRQoL questionnaires are both moderately correlated to speech recognition but when related to phone ability,
the NCIQ seems to be more fine-tuned than the GBI to assess the QoL of CI patients. Tinnitus severity does not
impact on the use of phone and on QoL of post-CI patients, probably through a reprioritization of symptoms due
to hearing rehabilitation, the benefit in hearing performances lessening the impact of any tinnitus on QoL. The
questioning about phoning ability might provide a valuable approach to assess hearing abilities and QoL after CI,
QoL and speech recognition performances being all the more high than abilities to phone in post-CI patients
reached normal-hearing subjects one's.
Conclusion: Post-CI assessment should be realized through speech recognition and QoL evaluation. NCIQ
appeared more efficient than GBI to detect an improvement in QoL when related to phone ability. The
assessment of post CI patient´s phoning ability represents an easy and fast approach to evaluate hearing
performances and QoL and consequently reflect the global outcomes of the cochlear implantation.
Learning outcome: It could be a very helpful tool for clinicians in their daily clinical practice.