Is Speech Perception a Good Surrogate for Cochlear Implant Outcomes?

Introduction: Success after cochlear implantation (CI) is traditionally measured by quantifiable audiometric testing, but how this translates into quality of life is unclear. The Cochlear Implant Quality of Life-35 (CIQOL-35) questionnaire, validated for CI patients, is now commonly used. We sought to define the relationship between speech discrimination (SDS) and CIQOL-35 scores, as this has been under investigated.

Methods: Our single-institution retrospective cohort included adult patients who underwent unilateral cochlear implantation with documented post-activation CIQOL-35 survey and SDS. Audiometric outcomes included monaural AzBio sentences in quiet and in noise and CNC wordlist in quiet. QOL outcomes included the seven domains in the CIQOL-35 questionnaire: global, communication, emotional, entertainment, environment, listening effort, and social. The CORR procedure measured correlation between audiometric testing and QOL scores. A multivariate logistic regression was performed to analyze if audiometric testing can predict QOL scores. Significance was set at p=0.05 and r≥0.25.

Results: Fifty-three patients (26 F, 27 M) with mean age 64 years (20 to 90 years) completed 76 post-activation CIQOL-35 surveys for unilateral CI. AzBio sentences in quiet had a positive correlation with global (r=0.25, p=0.046), communication (r=0.32, p< 0.01), and social scores (r=0.29, p=0.02). AzBio sentences in noise and CNC wordlist scores did not correlate with QOL scores. SDS did not affect QOL outcomes when multivariate logistic regression was performed. Mean follow-up time was 15.5 months (3 – 41 months).

Conclusions: Quantifiable speech perception testing does not fully characterize post-CI benefit for unilateral adult CI patients. AzBio sentences in quiet are correlated with QOL scores in multiple domains; other speech perception tests did not correlate. Speech perception testing results did not predict QOL scores.