Preliminary assessment of the feasibility of using AB words to assess candidacy in adults

Background: Adult cochlear implant (CI) candidacy is assessed in part by the use of speech perception measures. In the United Kingdom the current cut-off point to fall within the CI candidacy range is a score of less than 50% on the BKB sentences presented in quiet (presented at 70 dBSPL). Goal: The specific goal of this article was to review the benefit of adding the AB word test to the assessment test battery for candidacy. Results: The AB word test scores showed good sensitivity and specificity when calculated based on both word and phoneme scores. The word score equivalent for 50% correct on the BKB sentences was 18.5% and it was 34.5% when the phoneme score was calculated; these scores are in line with those used in centres in Wales (15% AB word score). Conclusion: The goal of the British Cochlear Implant Group (BCIG) service evaluation was to determine if the pre-implant assessment measures are appropriate and set at the correct level for determining candidacy, the future analyses will determine whether the speech perception cut-off point for candidacy should be adjusted and whether other more challenging measures should be used in the candidacy evaluation

Cognitive Improvement After Cochlear Implantation in Older Adults With Severe or Profound Hearing Impairment: A Prospective, Longitudinal, Controlled, Multicenter Study

Objective: To compare the cognitive evolution of older adults with severe or profound hearing impairment after cochlear implantation with that of a matched group of older adults with severe hearing impairment who do not receive a cochlear implant (CI).Design: In this prospective, longitudinal, controlled, and multicenter study, 24 older CI users were included in the intervention group and 24 adults without a CI in the control group. The control group matched the intervention group in terms of gender, age, formal education, cognitive functioning, and residual hearing. Assessments were made at baseline and 14 months later. Primary outcome measurements included the change in the total score on the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing impaired individuals score and on its subdomain score to assess cognitive evolution in both groups. Secondary outcome measurements included self-reported changes in sound quality (Hearing Implant Sound Quality Index), self-perceived hearing disability (Speech, Spatial, and Qualities of Hearing Scale), states of anxiety and depression (Hospital Anxiety and Depression Scale), and level of negative affectivity and social inhibition (Type D questionnaire).Results: Improvements of the overall cognitive functioning (p = 0.05) and the subdomain “Attention” (p = 0.02) were observed after cochlear implantation in the intervention group; their scores were compared to the corresponding scores in the control group. Significant positive effects of cochlear implantation on sound quality and self-perceived hearing outcomes were found in the intervention group. Notably, 20% fewer traits of Type D personalities were measured in the intervention group after cochlear implantation. In the control group, traits of Type D personalities increased by 13%.Conclusion: Intervention with a CI improved cognitive functioning (domain Attention in particular) in older adults with severe hearing impairment compared to that of the matched controls with hearing impairment without a CI. However, older CI users did not, in terms of cognition, bridge the performance gap with adults with normal hearing after 1 year of CI use. The fact that experienced, older CI users still present subnormal cognitive functioning may highlight the need for additional cognitive rehabilitation in the long term after implantation

Telehealth rehabilitation for adults with cochlear implants in response to the Covid-19 pandemic: platform selection and case studies

BackgroundEffective information giving and goal setting before cochlear implantation and individualised rehabilitation following implantation are both crucial for shaping patients’ expectations and optimising outcomes. The Covid-19 pandemic led to temporary cessation of face to face clinic appointments. This created a need for telehealth rehabilitation for adults whose hearing loss presents unique communication challenges.AimsWe describe the piloting and implementation of telehealth rehabilitation within an adult cochlear implant service.MethodVideo conferencing and telehealth tools were assessed in terms of security, accessibility and functionality. Written support materials were developed. Telehealth sessions were piloted with lay volunteers. During service implementation, feedback was collected from patients and staff.Outcomes & resultsA video call platform was identified that was supported by the host Trust and also met the rehabilitation service’s needs. A telehealth service was successfully implemented, ensuring continuity of care during lockdown. We share the platform selection framework used, practical lessons learned and patient support materials.Conclusion.Telehealth rehabilitation facilitated a well-received, effective service for adult cochlear implant patients. It is predicted that the benefits of telehealth rehabilitation will last beyond the lockdown restrictions posed by Covid-19

Evolution of type D personality traits after cochlear implantation in severely hearing impaired adults 55 years and older : an exploratory prospective, longitudinal, controlled, multicenter study

Purpose To study the evolution of type D personality traits in older adults after cochlear implantation compared with a control group of severely hearing impaired older adults who did not receive a cochlear implant (CI). The influence of COVID-19 on this evolution was also explored. Type D personality combines a high degree of negative affectivity (NA) and social inhibition (SI). Methods In this prospective, longitudinal, controlled multicenter exploratory study, 76 older CI users and 21 severely hearing impaired controls without CI were included. The CI group and the control group did not differ significantly regarding age, formal education, residual hearing, Type D Scale-14 (DS14) total score, NA, and SI at baseline. Type D personality traits were assessed with the DS14 at baseline (T0) and 14 months later (T14). Results Type D personality traits differed significantly over time between the CI group and the control group (p < 0.001). In the CI group, the DS14 total score (mean delta T =-6.63; p < 0.001), NA (mean delta T =-3.26; p < 0.001), and SI (mean delta T =-3.37; p < 0.001) improved significantly over time (delta T = T14-T0), whereas no significant difference was found in the control group. Significantly fewer subjects were categorized as type D personalities in the CI group (delta T =-12; p = 0.023) at T14, whereas no significant change was found in the control group (delta T = 3; p = 0.250). COVID-19 did not influence the evolution of type D personality traits significantly in the CI group. Conclusion Cochlear implantation has a positive effect on type D personality traits in older adults with a severe-to-profound hearing impairment