Single-centre experience and practical considerations of the benefit of a second cochlear implant in bilaterally deaf ad
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OTOLOGY
Single‑centre experience and practical considerations of the benefit of a second cochlear implant in bilaterally deaf adults Dominik Péus1,2 · Andreas Pfluger1 · Sophia Marie Häussler1 · Steffen Knopke1 · Manuel Christoph Ketterer1 · Agnieszka J. Szczepek1 · Stefan Gräbel1 · Heidi Olze1 Received: 31 March 2020 / Accepted: 20 August 2020 © The Author(s) 2020
Abstract Purpose Bilateral cochlear implant (CI) implantation is increasingly used in the auditory rehabilitation of bilaterally deafened adults. However, after successful unilateral implantation, objective patient counselling is essential. Methods We investigated the extra benefit of a second CI in adults in terms of health-related quality of life, tinnitus, stress, anxiety, depression, quality of hearing, and speech recognition. Hearing ability was assessed by using the Freiburg monosyllable speech discrimination test (FB MS) and the Oldenburg sentence test with azimuth variations. In a prospective patient cohort, we administered validated questionnaires before a CI, after a first CI and after a second CI implantation. Results The study included 29 patients, made up of nine women and 20 men. The median time between the first and the second implantation was 23 months. The mean total NCIQ score and TQ before a CI improved significantly after both implantations. Stress, anxiety, and depression were stable over time and were not significantly affected by CI implantations. Speech recognition with noise significantly improved after the first and again after the second CI. Correlation analysis showed a strong connection between auditory performance and HRQoL. Conclusion We demonstrated that a unilateral CI benefitted many fields and that the second sequential CI leads again to additional improvement. Bilateral CI implantation should, therefore, be the standard form of auditory rehabilitation in deafened adults. Keywords Cochlear implant · CI · Bilaterally deafened · Hearing loss · Quality of life · Speech recognition
Introduction The number of bilaterally deafened adults is increasing, mainly due to a constantly ageing society. A bilateral CI is a widely accepted medical practice in infants and children h [1]. However, in post-lingual bilaterally deafened adults, there is ongoing discussion regarding outcomes as well as medical and surgical safety concerns [2]. It is known that CIs allow people with hearing disorders to regain auditory perception and an acoustic understanding of speech. Among the positive consequences of a bilateral CI versus a unilateral * Heidi Olze [email protected] 1
Department of Otorhinolaryngology, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
Department of Otorhinolaryngology, Kantonsspital Baselland, Liestal, Switzerland
2
CI are improved sound localisation, enhanced speech perception, and a reduced risk of being "off-air" [3–5]. The theoretically potential disadvantages include bilateral vestibular alterations, surgical complications, and cost [6
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