Relationships Between Speech, Spatial and Qualities of Hearing Short Form SSQ12 Item Scores and their Use in Guiding Rehabilitation for Cochlear Implant Recipients.

Cochlear implantation successfully improves hearing in most adult recipients. However, in rare cases, post-implant rehabilitation is required to maximize benefit. The primary aim of this investigation was to test if self-reports by cochlear implant users indicate the need for post-implant rehabilitation. Listening performance was assessed with the Speech, Spatial and Qualities short-form SSQ12, which was self-administered via a web-based survey. Subjects included over 2000 adult bilateral or unilateral cochlear implant users with at least one year of experience. A novel application of regression tree analysis identified core SSQ12 items that serve as first steps in establishing a plan for further rehabilitation: items 1, 8, and 11 dealing with single-talker situations, loudness perception, and clarity, respectively. Further regression and classification tree analyses revealed that SSQ12 item scores were weakly related to age, degree of tinnitus, and use of bilateral versus unilateral implants. Conversely, SSQ12 scores were strongly associated with self-rated satisfaction and confidence in using their cochlear implant. The SSQ12 total scores did not vary significantly over 1-9 or more years' experience. These findings suggest that the SSQ12 may be a useful tool to guide rehabilitation at any time after cochlear implantation. Identification of poor performance may have implications for timely management to improve the outcomes, through various techniques such as device fitting adjustments, counseling, active sound exposure, and training spatial hearing.

The Listening Network and Cochlear Implant Benefits in Hearing-Impaired Adults.

Older adults with mild or no hearing loss make more errors and expend more effort listening to speech. Cochlear implants (CI) restore hearing to deaf patients but with limited fidelity. We hypothesized that patient-reported hearing and health-related quality of life in CI patients may similarly vary according to age. Speech Spatial Qualities (SSQ) of hearing scale and Health Utilities Index Mark III (HUI) questionnaires were administered to 543 unilaterally implanted adults across Europe, South Africa, and South America. Data were acquired before surgery and at 1, 2, and 3 years post-surgery. Data were analyzed using linear mixed models with visit, age group (18-34, 35-44, 45-54, 55-64, and 65+), and side of implant as main factors and adjusted for other covariates. Tinnitus and dizziness prevalence did not vary with age, but older groups had more preoperative hearing. Preoperatively and postoperatively, SSQ scores were significantly higher (Δ0.75-0.82) for those aged <45 compared with those 55+. However, gains in SSQ scores were equivalent across age groups, although postoperative SSQ scores were higher in right-ear implanted subjects. All age groups benefited equally in terms of HUI gain (0.18), with no decrease in scores with age. Overall, younger adults appeared to cope better with a degraded hearing before and after CI, leading to better subjective hearing performance.

Self-assessment of daily hearing function for implant recipients: A comparison of mean total scores for the Speech Spatial Qualities of Hearing Scale (SSQ49) with the SSQ12.

OBJECTIVE: To assess the relationship and agreement between mean total scores for the Speech Spatial Qualities of Hearing Scale (SSQ49) and the shorter SSQ12 to measure daily hearing function for a large group of auditory implant recipients. METHODS: Prospective, longitudinal self-assessment by 1013 implant recipients using the SSQ49 at preimplant and at annual post-implant intervals (one, two and three-years) via an international registry. Mean total scores were calculated for the SSQ49 and the extracted SSQ12 responses. Pearson correlation and Bland-Altman agreement were examined between the SSQ49, SSQ12 and transformed SSQ12 versions. Longitudinal mixed-effects models were used to compare changes over time. RESULTS: Very high correlation was shown between mean total scores for all versions while perfect agreement was not reached. Clinically acceptable agreement (<1.0 unit) between all versions was obtained with the transformed SSQ12 being least biased. All versions showed statistically significant improvement at one-year post-implant (>2.2 units; p < 0.001). CONCLUSIONS: All scale-versions showed comparable sensitivity to changes in self-reported hearing function over time. TheSSQ12 may be considered as a potential time-efficient self-assessment of hearing function for implant recipients in routine practice. Further research may involve independent repeated administration of each scale version.