Resident Physician Washington University in St. Louis
Objective: To prospectively measure the impact of cochlear implantation on quality of life using the novel Cochlear Implant Quality of Life (CIQOL-35) questionnaire. To determine audiologic and demographic factors influencing the CIQOL-35.
Study Design: Prospective observational study.
Setting: Tertiary referral center.
Patients: Thirty patients aged 31 to 96 years with sensorineural hearing loss
Interventions: Unilateral cochlear implantation
Main Outcome Measures: CIQOL-35 global score pre- and 6-months post implantation. Physical function measured by the short form survey (SF-36), audiologic, and demographic variables.
Results: Speech-perception performance improved significantly across all patients with a mean CNC improvement of 45.1% (95% CI, 34.1 to 56.1). Likewise, the CIQOL-35 showed significant improvement from pre-implantation to 6-months post-activation with a mean difference of 14.9 points (95% CI, 11.3 to 18.5; p < 0.0001). Improvement in CIQOL-35 correlated linearly with age (r = -0.63; p = 0.0004) and improvement in CNC score (r = 0.64; p = 0.0003). Physical functional status, device usage, and performance in noise did not significantly correlate with CIQOL-35 global score outcomes (p > 0.05). Multivariate modeling using age and change in CNC score explained 64% of the variability measured by the CIQOL- 35 global score.
Conclusions: This study is novel for pre- and post-implantation usage of the CIQOL-35. Cochlear implantation can be strongly recommended, not only for hearing rehabilitation, but also to improve quality of life. However, younger patients and those with a greater improvement in speech-perception performance are more likely to achieve a greater quality of life benefit.
*Professional Practice Gap & Educational Need: Quality of life with cochlear implantation is perhaps the most important clinical outcome measure. Prior to the psychometrically validated CIQOL-35, there was poor correlation between patient reported outcomes and commonly obtained demographic variables or speech-perception outcomes. This study prospectively utilizes the CIQOL-35 to measure the quality-of-life effect size after implantation as well as determine which factors may influence CIQOL-35 outcomes.
*Learning Objective:To understand quality of life improvement in patients after receiving cochlear implants. To assess the audiologic and demographic variables that contribute to the improvement in quality of life after cochlear implantation (CI).
*Desired Result: Despite at times limited improvement in speech perception performance, practitioners and researchers will realize that the majority of patients receive significant improvement in quality-of-life metrics as measured by the CIQOL-35 global score after CI. Younger patients and those with a greater improvement in speech-performance metrics are more likely to experience a greater cochlear implant-specific quality of life improvement after CI.
*Level of Evidence: IV
*Indicate IRB or IACUC: Washington University in St. Louis IRB #201911035; 11/11/19