Cochlear implants and quality of life: a prospective study.

OBJECTIVE: To evaluate changes in quality of life, anxiety, and depression after cochlear implantation in adults. DESIGN: Twenty-seven postlingually deafened adults who had received a MED-EL Combi 40+ implant were investigated. One generic Health-Related Quality of Life measure, the SF-36, two disease-specific measures, the Patient Quality of Life Form (PQLF) and the Index Relative Questionnaire Form (IRQF) completed by a near relative to the patient, in addition to a domain specific measure, the Hopkins Symptom Check List 25 items (HSCL-25), were used in a prospective study. The subjects were investigated before surgery and 12 to 15 months after surgery. RESULTS: The scores were significantly better after surgery in four of six categories of the PQLF. In the IRQF, where a family member of the cochlear implant recipient was studied, the scores were significantly better in four of five categories. There was a significant improvement in the HSCL-25 scores after surgery. In the SF-36, only one of eight scales showed significant improvement. CONCLUSIONS: Cochlear implants were associated with statistically significant improvement in quality of life in postlingually deafened adults. The improvements were largest in the categories concerning communication, feelings of being a burden, isolation, and relations to friends and family. The implants also improved the relatives' daily lives. There was a statistically significant reduction in degree of depression and anxiety. Reduction in anxiety and depression was associated with gain in quality of life.

Cochlear implants and health status: a comparison with other hearing-impaired patients.

Eighty-four adult cochlear implant (CI) users were compared with 3 other groups of severely to profoundly hearing impaired adults concerning quality of life (QOL): 1) 19 CI candidates who were accepted as candidates for implantation, but who were not operated on; 2) 16 CI candidates whose impairment was not severe enough for implantation; and 3) 60 users of acoustic hearing aids. Generic and disease-specific QOL questionnaires were used. The CI group scored significantly better than the CI candidates who met the criteria for implantation, but who were not operated on, on 2 of 6 categories of a disease-specific QOL measure. The CI patients had significantly less anxiety and depression than the unoperated CI candidates who met the criteria for implantation. Validation and reliability testing of 2 disease-specific QOL measures were performed by factor analyses.

Social hearing measured with the Performance Inventory for Profound and Severe Loss: a comparison between adult multichannel cochlear implant patients and users of acoustical hearing aids.

The objective of this study was to investigate social hearing in successful users of multichannel cochlear implants (CIs) and to compare the scores with those of a group of hearing-impaired adults using acoustical hearing aids (HAs). Out of 88 patients who had undergone surgery, 75 CI users with a mean age of 55 years and a mean pre-operative hearing level of 113dB in the better ear were compared with 59 users of acoustical HAs with a mean age of 56 years and a mean hearing level of 82dB in the better ear. Seven CI patients were non-users and were excluded from the study. The Performance Inventory for Profound and Severe Loss, a questionnaire that measures different aspects of hearing handicap, was used. The CI group scored significantly better than the HA group in three of six evaluated categories, measuring subjective intensity of sounds, speech with visual cues, and response to auditory failure. Awareness of environmental sounds, speech with no visual cues and personal reactions did not differ significantly. The group of successful CI users scored higher on a self-report measure than did a group of users of acoustical HAs with moderate- severe-profound deafness. The best CI users scored better than the best HA users, and the worst CI users scored worse than the worst HA users.

Tinnitus in cochlear implant patients--a comparison with other hearing-impaired patients.

As part of a quality of life study, 84 patients who received multichannel intra-cochlear cochlear implants (CIs) were evaluated regarding tinnitus problems by a questionnaire. As controls, 60 hearing aid (HA) users and 35 non-operated CI candidates were used. The prevalence of tinnitus in the CI group was 70%, and that of troublesome tinnitus was 35%. In the two other groups, the prevalences of tinnitus were 40% (HA) and 74% (non-CI). Twenty-three per cent of HA users and 51% of non-operated CI candidates had troublesome tinnitus. CIs were found to be superior to HAs in reducing tinnitus, 54% of the CI patients with tinnitus experiencing a reduction in tinnitus when using a CI. In the other two groups, 4% of HA users and 23% of non-operated CI candidates experienced a reduction in tinnitus when using an HA. Eight per cent of the CI patients with tinnitus experienced an increase in tinnitus when using their implant. Not having paid employment was independently associated with troublesome tinnitus in all three groups.