A comparison of postcochlear implantation speech scores in an adult population

OBJECTIVES: The vast majority of cochlear implant recipients realize significant improvement in speech perception. However, there continue to be a small group that does not realize such a benefit. In an effort to identify possible predictors for this, we have compared pre- and postimplant audiologic data using Hearing In Noise Test (HINT), City University of New York (CUNY), or Central Institute for the Deaf (CID) scores for 445 consecutive English-speaking adult patients followed for a minimum of 1 year postimplantation in two distinct groups, poor versus excellent performers. STUDY DESIGN: Retrospective. METHODS: Poor performers were those who realized a worsening, no improvement, or an improvement of less than 10%. This group numbered 58 (13%). High performers consisted of a cadre of 194 (44%) patients who scored between 91 and 100% postimplantation. Demographic data relating to onset of deafness, education exposure, etiology, etc., were evaluated. RESULTS: Of the poor performers, 33 (57%) were pre-/perilingually deafened. Of these, 79% had not received any auditory/oral training in childhood. On the other hand, a total of 109 implant recipients were individuals who were pre-/perilingually deafened. Of these, 24 were in the excellent performer category. All were identified early and were recipients of a strong auditory/oral education. Of the high performers, 170 (88%) were deafened late. Other findings such as preoperative electronystagmography with caloric testing, hearing aid use, device type, and high-resolution computed tomography scan of the temporal bone will be discussed for both groups. CONCLUSIONS: A high preimplant speech score, auditory verbal therapy, and postlingual deafness statistically correlate with higher postimplant speech scores 1 year after cochlear implantation. Device type, caloric response and hearing aid use preimplantation, age at surgery, and sex do not statistically correlate with either poor or excellent speech discrimination s