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Bevan Yueh - One of the best experts on this subject based on the ideXlab platform.
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improving measurement efficiency of the inner ear scale with item response theory
Otolaryngology-Head and Neck Surgery, 2018Co-Authors: Annika Jessen, Bevan Yueh, Andrew D Ho, Eduardo C Corrales, Jennifer J ShinAbstract:Objectives(1) To assess the 11-item Inner Effectiveness of Auditory Rehabilitation (Inner EAR) instrument with item response theory (IRT). (2) To determine whether the underlying latent ability cou...
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transcultural adaptation to spanish of the instrument effectiveness of Auditory Rehabilitation for the assessment of quality of life in patients using hearing aids
Acta Otorrinolaringologica, 2013Co-Authors: Felipe Cardemil, Lorena Aguayo, Adrian Fuente, Patricia Esquivel, Tamara Barria, Rocio Carvajal, Rose Fromin, Ivan Villalobos, Bevan YuehAbstract:Abstract Introduction and objectives It is becoming increasingly important to have reliable and valid questionnaires. This becomes especially important when evaluating hearing loss. The aim of this work was to validate the « Effectiveness of Auditory Rehabilitation » (EAR) questionnaire for the Spanish-speaking population. This instrument assesses quality of life and hearing aspects in patients using hearing aids. Material and method Cross-sectional validation study. A cultural adaptation through the use of English to Spanish translations and re-translations was carried out. The validity and reliability of the newly adapted instrument were evaluated. Results A total of 69 individuals (44 older adults and 25 younger adults) were examined. The pure-tone averages were 47.3 dB and 47.1 dB for the left and right ears, respectively. The mean maximum speech discrimination in silence for monosyllables were 83.3% and 82.9% for the left and right ears, respectively. Internal consistency presented Cronbach alpha values of 0.85 and 0.77 for the internal and external dimensions, respectively. The intraclass correlation coefficients were 0.80 for the internal module and 0.85 for the external module. Construct validity reported a correlation coefficient of 0.71 at baseline and 0.76 at 3 months after the initial assessment for the internal module, and 0.62 at baseline and 0.74 at 3 months after the initial assessment for the external module. The size effects were 1.3 and 1.1 for the internal and external modules, respectively. Conclusions The Spanish version of the EAR questionnaire seems to be a reliable and valid instrument. The evaluation of audiological aspects, as well as aspects relating to aesthetics and comfort are the main strengths of this instrument. Finally, the EAR scale is more sensitive to change than other scales.
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adaptacion transcultural al espanol del instrumento de evaluacion de calidad de vida en pacientes usuarios de audifonos effectiveness of Auditory Rehabilitation
Acta otorrinolaringológica española, 2013Co-Authors: Felipe Cardemil, Lorena Aguayo, Adrian Fuente, Patricia Esquivel, Tamara Barria, Rocio Carvajal, Rose Fromin, Ivan Villalobos, Bevan YuehAbstract:Introduccion y objetivos Cada vez adquiere mayor importancia el contar con cuestionarios validos y confiables. Esto cobra mayor relevancia al evaluar la hipoacusia. El objetivo del trabajo es validar en poblacion hispanohablante el cuestionario Effectiveness of Auditory Rehabilitation (EAR), que evalua la calidad de vida y los aspectos auditivos en pacientes usuarios de audifonos. Material y metodo Estudio de validacion de instrumento. Se realizo adaptacion transcultural por medio de traduccion y retraduccion, luego comparacion con la version original, y evaluacion de confiabilidad y validez. Resultados Se evaluaron 69 individuos, de los cuales 44 fueron adultos mayores y 25 fueron adultos jovenes. El umbral de audicion promedio (PTP) fue 47,3 dB en oido izquierdo y 47,1 en derecho. La discriminacion de monosilabos promedio fue 83,3% en oido izquierdo y 82,9% en derecho. La consistencia interna presento un alfa de Cronbach de 0,85 y 0,77 para las dimensiones interna y externa. El coeficiente de correlacion intraclase fue de 0,80 para el modulo interno y 0,85 para el externo. La validez de constructo informo de una correlacion de 0,71 basal y 0,76 a los 3 meses para el modulo interno, y de 0,62 inicial y 0,74 a los 3 meses en el modulo externo. La magnitud de efecto fue de 1,3 y 1,1 para el modulo interno y externo. Discusion La version al espanol del cuestionario EAR parece ser un instrumento confiable y valido. Sus fortalezas son que evalua aspectos audiologicos, pero ademas aspectos esteticos y comodidad. Por ultimo, es mas sensible al cambio que otras escalas.
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Transcultural Adaptation to Spanish of the Instrument “ Effectiveness of Auditory Rehabilitation” for the Assessment of Quality of Life in Patients Using Hearing Aids
Acta Otorrinolaringologica, 2013Co-Authors: Felipe Cardemil, Lorena Aguayo, Adrian Fuente, Patricia Esquivel, Tamara Barria, Rocio Carvajal, Rose Fromin, Ivan Villalobos, Bevan YuehAbstract:Abstract Introduction and objectives It is becoming increasingly important to have reliable and valid questionnaires. This becomes especially important when evaluating hearing loss. The aim of this work was to validate the « Effectiveness of Auditory Rehabilitation » (EAR) questionnaire for the Spanish-speaking population. This instrument assesses quality of life and hearing aspects in patients using hearing aids. Material and method Cross-sectional validation study. A cultural adaptation through the use of English to Spanish translations and re-translations was carried out. The validity and reliability of the newly adapted instrument were evaluated. Results A total of 69 individuals (44 older adults and 25 younger adults) were examined. The pure-tone averages were 47.3 dB and 47.1 dB for the left and right ears, respectively. The mean maximum speech discrimination in silence for monosyllables were 83.3% and 82.9% for the left and right ears, respectively. Internal consistency presented Cronbach alpha values of 0.85 and 0.77 for the internal and external dimensions, respectively. The intraclass correlation coefficients were 0.80 for the internal module and 0.85 for the external module. Construct validity reported a correlation coefficient of 0.71 at baseline and 0.76 at 3 months after the initial assessment for the internal module, and 0.62 at baseline and 0.74 at 3 months after the initial assessment for the external module. The size effects were 1.3 and 1.1 for the internal and external modules, respectively. Conclusions The Spanish version of the EAR questionnaire seems to be a reliable and valid instrument. The evaluation of audiological aspects, as well as aspects relating to aesthetics and comfort are the main strengths of this instrument. Finally, the EAR scale is more sensitive to change than other scales.
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development and validation of the effectiveness of the Auditory Rehabilitation scale
Archives of Otolaryngology-head & Neck Surgery, 2005Co-Authors: Bevan Yueh, Jennifer A Mcdowell, Margaret P Collins, Pamela E Souza, Carl F Loovis, Richard A DeyoAbstract:Objective To develop a new scale of hearing-related function and quality of life in patients with hearing aids that addresses overlooked concerns, such as hearing-aid comfort, convenience, and cosmetic appearance, that may influence hearing-aid adherence while maintaining brevity and sensitivity to clinical change. Design Prospective, multicenter instrument validation. Setting Four diverse sites in Washington State, including 2 private practices, 1 university setting, and 1 Veterans Affairs hospital. Patients Seventy-eight patients with hearing aids. Interventions We created 2 modules in the Effectiveness of Auditory Rehabilitation (EAR) scale. The first module (Inner EAR) covers intrinsic hearing issues such as hearing in quiet and hearing in noise and is administered both before and after treatment. The second module (Outer EAR) covers extrinsic (hearing-aid related) issues such as comfort, appearance, and convenience and is administered after hearing-aid fitting. Main Outcome Measures Both scales were developed and validated in 3 stages. Stage 1 used a qualitative approach from multiple data sources to develop preliminary instruments. Stage 2 used approaches from classic test theory to reduce the number of items and psychometrically validate the instruments. Stage 3 examined the responsiveness or sensitivity to clinical change. Results A 10-item Inner EAR module and a 10-item Outer EAR module were created and validated. Internal consistency of individual domains (Cronbach α = 0.85 and 0.72, respectively) and test-retest reliability (intraclass correlation coefficients = 0.76 and 0.81, respectively) were excellent. Evidence of construct validity included concurrent validity with other hearing scales and global visual analog scales, discriminant validity with dizziness handicap, correlation with hearing-aid adherence, and confirmatory factor analyses. Both scales had strong evidence of responsiveness (sensitivity to change), with higher effect sizes and Guyatt responsiveness statistics than the 2 widely used hearing scales in this study. The scales took an average of 5 minutes to complete. Conclusions The EAR scale is a valid and reliable measure of the effectiveness of amplification in the treatment of sensorineural hearing loss. It addresses the range of issues that are of importance to hearing-aid patients. The scales have excellent psychometric properties, are more responsive than several widely used hearing scales, and are minimally burdensome for patients to complete. The EAR may be a valuable outcome measure in future studies of both existing hearing aids and newer hearing-aid technologies, such as bone-anchored aids or middle ear implants.
John J. Galvin - One of the best experts on this subject based on the ideXlab platform.
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Maximizing cochlear implant patients' performance with advanced speech training procedures.
Hearing research, 2007Co-Authors: Qian-jie Fu, John J. GalvinAbstract:Advances in implant technology and speech processing have provided great benefit to many cochlear implant patients. However, some patients receive little benefit from the latest technology, even after many years' experience with the device. Moreover, even the best cochlear implant performers have great difficulty understanding speech in background noise, and music perception and appreciation remain major challenges. Recent studies have shown that targeted Auditory training can significantly improve cochlear implant patients' speech recognition performance. Such benefits are not only observed in poorly performing patients, but also in good performers under difficult listening conditions (e.g., speech noise, telephone speech, music, etc.). Targeted Auditory training has also been shown to enhance performance gains provided by new implant devices and/or speech processing strategies. These studies suggest that cochlear implantation alone may not fully meet the needs of many patients, and that additional Auditory Rehabilitation may be needed to maximize the benefits of the implant device. Continuing research will aid in the development of efficient and effective training protocols and materials, thereby minimizing the costs (in terms of time, effort and resources) associated with Auditory Rehabilitation while maximizing the benefits of cochlear implantation for all recipients.
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Perceptual Learning and Auditory Training in Cochlear Implant Recipients
Trends in Amplification, 2007Co-Authors: Qian-jie Fu, John J. GalvinAbstract:Learning electrically stimulated speech patterns can be a new and difficult experience for cochlear implant (CI) recipients. Recent studies have shown that most implant recipients at least partially adapt to these new patterns via passive, daily-listening experiences. Gradually introducing a speech processor parameter (eg, the degree of spectral mismatch) may provide for more complete and less stressful adaptation. Although the implant device restores hearing sensation and the continued use of the implant provides some degree of adaptation, active Auditory Rehabilitation may be necessary to maximize the benefit of implantation for CI recipients. Currently, there are scant resources for Auditory Rehabilitation for adult, postlingually deafened CI recipients. We recently developed a computer-assisted speech-training program to provide the means to conduct Auditory Rehabilitation at home. The training software targets important acoustic contrasts among speech stimuli, provides Auditory and visual feedback, a...
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Computer-Assisted Speech Training for Cochlear Implant Patients: Feasibility, Outcomes, and Future Directions
Seminars in Hearing, 2007Co-Authors: Qian-jie Fu, John J. GalvinAbstract:Learning electrically stimulated speech patterns can be a new and difficult experience for cochlear implant patients. Cochlear implantation alone may not fully meet the needs of many patients, and additional Auditory Rehabilitation may be necessary to maximize the benefits of the implant device. A recently developed computer-assisted speech-training program provides cochlear implant patients with the means to conduct Auditory Rehabilitation at home. The training software targets important acoustic contrasts between speech stimuli and provides Auditory and visual feedback as well as progressive training, thereby maintaining patients’ interest in the Auditory training exercises. Recent scientific studies have demonstrated the effectiveness of such specialized Auditory training programs in improving cochlear implant patients’ speech recognition performance. Provided with an inexpensive and accessible Auditory training program, cochlear implant patients may find the motivation and momentum to get the most from the implant device.
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Auditory Training with Spectrally Shifted Speech: Implications for Cochlear Implant Patient Auditory Rehabilitation
Journal of the Association for Research in Otolaryngology, 2005Co-Authors: Qian-jie Fu, Geraldine Nogaki, John J. GalvinAbstract:After implantation, postlingually deafened cochlear implant (CI) patients must adapt to both spectrally reduced and spectrally shifted speech, due to the limited number of electrodes and the limited length of the electrode array. This adaptation generally occurs during the first three to six months of implant use and may continue for many years. To see whether moderate speech training can accelerate this learning process, 16 naïve, normal-hearing listeners were trained with spectrally shifted speech via an eight-channel acoustic simulation of CI speech processing. Baseline vowel and consonant recognition was measured for both spectrally shifted and unshifted speech. Short daily training sessions were conducted over five consecutive days, using four different protocols. For the test-only protocol, no improvement was seen over the five-day period. Similarly, sentence training provided little benefit for vowel recognition. However, after five days of targeted phoneme training, subjects’ recognition of spectrally shifted vowels significantly improved in most subjects. This improvement did not generalize to the spectrally unshifted vowel and consonant tokens, suggesting that subjects adapted to the specific spectral shift, rather than to the eight-channel processing in general. Interestingly, significant improvement was also observed for the recognition of spectrally shifted consonants. The largest improvement was observed with targeted vowel contrast training, which did not include any explicit consonant training. These results suggest that targeted phoneme training can accelerate adaptation to spectrally shifted speech. Given these results with normal-hearing listeners, Auditory Rehabilitation tools that provide targeted phoneme training may be effective in improving the speech recognition performance of adult CI users.
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Effects of Auditory training on adult cochlear implant patients: a preliminary report
Cochlear Implants International, 2004Co-Authors: Qian-jie Fu, John J. Galvin, Xiaosong Wang, Geri NogakiAbstract:AbstractThe process of learning new electrically stimulated speech patterns can be difficult for many cochlear implant users, especially congenitally deafened patients. Some implant users receive little benefit from the device, even after long-term experience. While many factors may influence individual patient outcomes, the paucity of Auditory Rehabilitation resources, especially for adult users, may contribute to some implant patients' poorer performance. The present study examined whether moderate Auditory training, using speech stimuli, can improve the speech-recognition performance of adult cochlear implant patients. Ten cochlear implant patients with limited speech-recognition capabilities used a recently developed computerbased Auditory Rehabilitation tool to train at home for a period of one month or longer. Before training began, baseline speech-recognition performance was measured for each patient; baseline performance was measured for at least two weeks, until performance asymptoted. After base...
Qian-jie Fu - One of the best experts on this subject based on the ideXlab platform.
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Maximizing cochlear implant patients' performance with advanced speech training procedures.
Hearing research, 2007Co-Authors: Qian-jie Fu, John J. GalvinAbstract:Advances in implant technology and speech processing have provided great benefit to many cochlear implant patients. However, some patients receive little benefit from the latest technology, even after many years' experience with the device. Moreover, even the best cochlear implant performers have great difficulty understanding speech in background noise, and music perception and appreciation remain major challenges. Recent studies have shown that targeted Auditory training can significantly improve cochlear implant patients' speech recognition performance. Such benefits are not only observed in poorly performing patients, but also in good performers under difficult listening conditions (e.g., speech noise, telephone speech, music, etc.). Targeted Auditory training has also been shown to enhance performance gains provided by new implant devices and/or speech processing strategies. These studies suggest that cochlear implantation alone may not fully meet the needs of many patients, and that additional Auditory Rehabilitation may be needed to maximize the benefits of the implant device. Continuing research will aid in the development of efficient and effective training protocols and materials, thereby minimizing the costs (in terms of time, effort and resources) associated with Auditory Rehabilitation while maximizing the benefits of cochlear implantation for all recipients.
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Perceptual Learning and Auditory Training in Cochlear Implant Recipients
Trends in Amplification, 2007Co-Authors: Qian-jie Fu, John J. GalvinAbstract:Learning electrically stimulated speech patterns can be a new and difficult experience for cochlear implant (CI) recipients. Recent studies have shown that most implant recipients at least partially adapt to these new patterns via passive, daily-listening experiences. Gradually introducing a speech processor parameter (eg, the degree of spectral mismatch) may provide for more complete and less stressful adaptation. Although the implant device restores hearing sensation and the continued use of the implant provides some degree of adaptation, active Auditory Rehabilitation may be necessary to maximize the benefit of implantation for CI recipients. Currently, there are scant resources for Auditory Rehabilitation for adult, postlingually deafened CI recipients. We recently developed a computer-assisted speech-training program to provide the means to conduct Auditory Rehabilitation at home. The training software targets important acoustic contrasts among speech stimuli, provides Auditory and visual feedback, a...
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Computer-Assisted Speech Training for Cochlear Implant Patients: Feasibility, Outcomes, and Future Directions
Seminars in Hearing, 2007Co-Authors: Qian-jie Fu, John J. GalvinAbstract:Learning electrically stimulated speech patterns can be a new and difficult experience for cochlear implant patients. Cochlear implantation alone may not fully meet the needs of many patients, and additional Auditory Rehabilitation may be necessary to maximize the benefits of the implant device. A recently developed computer-assisted speech-training program provides cochlear implant patients with the means to conduct Auditory Rehabilitation at home. The training software targets important acoustic contrasts between speech stimuli and provides Auditory and visual feedback as well as progressive training, thereby maintaining patients’ interest in the Auditory training exercises. Recent scientific studies have demonstrated the effectiveness of such specialized Auditory training programs in improving cochlear implant patients’ speech recognition performance. Provided with an inexpensive and accessible Auditory training program, cochlear implant patients may find the motivation and momentum to get the most from the implant device.
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Auditory Training with Spectrally Shifted Speech: Implications for Cochlear Implant Patient Auditory Rehabilitation
Journal of the Association for Research in Otolaryngology, 2005Co-Authors: Qian-jie Fu, Geraldine Nogaki, John J. GalvinAbstract:After implantation, postlingually deafened cochlear implant (CI) patients must adapt to both spectrally reduced and spectrally shifted speech, due to the limited number of electrodes and the limited length of the electrode array. This adaptation generally occurs during the first three to six months of implant use and may continue for many years. To see whether moderate speech training can accelerate this learning process, 16 naïve, normal-hearing listeners were trained with spectrally shifted speech via an eight-channel acoustic simulation of CI speech processing. Baseline vowel and consonant recognition was measured for both spectrally shifted and unshifted speech. Short daily training sessions were conducted over five consecutive days, using four different protocols. For the test-only protocol, no improvement was seen over the five-day period. Similarly, sentence training provided little benefit for vowel recognition. However, after five days of targeted phoneme training, subjects’ recognition of spectrally shifted vowels significantly improved in most subjects. This improvement did not generalize to the spectrally unshifted vowel and consonant tokens, suggesting that subjects adapted to the specific spectral shift, rather than to the eight-channel processing in general. Interestingly, significant improvement was also observed for the recognition of spectrally shifted consonants. The largest improvement was observed with targeted vowel contrast training, which did not include any explicit consonant training. These results suggest that targeted phoneme training can accelerate adaptation to spectrally shifted speech. Given these results with normal-hearing listeners, Auditory Rehabilitation tools that provide targeted phoneme training may be effective in improving the speech recognition performance of adult CI users.
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Effects of Auditory training on adult cochlear implant patients: a preliminary report
Cochlear Implants International, 2004Co-Authors: Qian-jie Fu, John J. Galvin, Xiaosong Wang, Geri NogakiAbstract:AbstractThe process of learning new electrically stimulated speech patterns can be difficult for many cochlear implant users, especially congenitally deafened patients. Some implant users receive little benefit from the device, even after long-term experience. While many factors may influence individual patient outcomes, the paucity of Auditory Rehabilitation resources, especially for adult users, may contribute to some implant patients' poorer performance. The present study examined whether moderate Auditory training, using speech stimuli, can improve the speech-recognition performance of adult cochlear implant patients. Ten cochlear implant patients with limited speech-recognition capabilities used a recently developed computerbased Auditory Rehabilitation tool to train at home for a period of one month or longer. Before training began, baseline speech-recognition performance was measured for each patient; baseline performance was measured for at least two weeks, until performance asymptoted. After base...
H Olze - One of the best experts on this subject based on the ideXlab platform.
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in patients undergoing cochlear implantation psychological burden affects tinnitus and the overall outcome of Auditory Rehabilitation
Frontiers in Human Neuroscience, 2017Co-Authors: Petra Bruggemann, Agnieszka J Szczepek, Katharina Klee, S Grabel, Birgit Mazurek, H OlzeAbstract:Cochlear implantation (CI) is increasingly being used in the Auditory Rehabilitation of deaf patients. Here, we investigated whether the Auditory Rehabilitation can be influenced by the psychological burden caused by mental conditions. Our sample included 47 patients who underwent implantation. All patients were monitored before and 6 months after CI. Auditory performance was assessed using the Oldenburg Inventory (OI) and Freiburg monosyllable (FB MS) speech discrimination test. The health-related quality of life was measured with Nijmegen Cochlear implantation Questionnaire (NCIQ) whereas tinnitus-related distress was measured with the German version of Tinnitus Questionnaire (TQ). We additionally assessed the general perceived quality of life, the perceived stress, coping abilities, anxiety levels and the depressive symptoms. Finally, a structured interview to detect mental conditions (CIDI) was performed before and after surgery. We found that CI led to an overall improvement in Auditory performance as well as the anxiety and depression, quality of life, tinnitus distress and coping strategies. CIDI revealed that 81% of patients in our sample had affective, anxiety, and/or somatoform disorders before or after CI. The affective disorders included dysthymia and depression, while anxiety disorders included agoraphobias and unspecified phobias. We also diagnosed cases of somatoform pain disorders and unrecognizable figure somatoform disorders. We found a positive correlation between the Auditory performance and the decrease of anxiety and depression, tinnitus-related distress and perceived stress. There was no association between the presence of a mental condition itself and the outcome of Auditory Rehabilitation. We conclude that the CI candidates exhibit high rates of psychological disorders, and there is a particularly strong association between somatoform disorders and tinnitus. The presence of mental disorders remained unaffected by CI but the degree of psychological burden decreased significantly post-CI. The implants benefitted patients in a number psychosocial areas, improving the symptoms of depression and anxiety, tinnitus, and their quality of life and coping strategies. The prevalence of mental disorders in patients who are candidates for CI suggests the need for a comprehensive psychological and psychosomatic management of their treatment.
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elderly patients benefit from cochlear implantation regarding Auditory Rehabilitation quality of life tinnitus and stress
Laryngoscope, 2012Co-Authors: H Olze, S Grabel, Ulrike Forster, Nina Zirke, Laura E Huhnd, Heidemarie Haupt, Birgit MazurekAbstract:Objectives/Hypothesis: To determine the effect of cochlear implantation on quality of life, speech performance, tinnitus, perceived stress, and coping strategy in patients aged ≥70 years in comparison with younger patients. Study Design: Retrospective study. Methods: A total of 55 postlingually deafened adults who were unilaterally implanted with a multichannel cochlear implant for at least 6 months were included in the study. Twenty patients were aged ≥70 years (70–84 years), and 35 patients were <70 years (19–67 years). Speech perception was measured using the Freiburg monosyllable test in quiet and the Hochmair-Schulz-Moser sentence test. In addition, the patients filled in six validated questionnaires. Results: Speech perception and subjectively assessed Auditory ability were similar in the two age groups after implantation. Disease-specific quality of life was improved in patients aged ≥70 years and even to a higher extent as compared to younger patients. Tinnitus annoyance and perceived stress were reduced in elderly patients to the same extent as in younger patients in the case of high initial severity level. The scores for the coping subdomain “seeking support” were reduced in elderly patients. Conclusions: The present study provides evidence that cochlear implantation constitutes a very successful procedure of Auditory Rehabilitation, even for patients aged ≥70 years. In addition, elderly patients benefit from implantation, with increased quality of life and reduced tinnitus and stress.
Birgit Mazurek - One of the best experts on this subject based on the ideXlab platform.
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in patients undergoing cochlear implantation psychological burden affects tinnitus and the overall outcome of Auditory Rehabilitation
Frontiers in Human Neuroscience, 2017Co-Authors: Petra Bruggemann, Agnieszka J Szczepek, Katharina Klee, S Grabel, Birgit Mazurek, H OlzeAbstract:Cochlear implantation (CI) is increasingly being used in the Auditory Rehabilitation of deaf patients. Here, we investigated whether the Auditory Rehabilitation can be influenced by the psychological burden caused by mental conditions. Our sample included 47 patients who underwent implantation. All patients were monitored before and 6 months after CI. Auditory performance was assessed using the Oldenburg Inventory (OI) and Freiburg monosyllable (FB MS) speech discrimination test. The health-related quality of life was measured with Nijmegen Cochlear implantation Questionnaire (NCIQ) whereas tinnitus-related distress was measured with the German version of Tinnitus Questionnaire (TQ). We additionally assessed the general perceived quality of life, the perceived stress, coping abilities, anxiety levels and the depressive symptoms. Finally, a structured interview to detect mental conditions (CIDI) was performed before and after surgery. We found that CI led to an overall improvement in Auditory performance as well as the anxiety and depression, quality of life, tinnitus distress and coping strategies. CIDI revealed that 81% of patients in our sample had affective, anxiety, and/or somatoform disorders before or after CI. The affective disorders included dysthymia and depression, while anxiety disorders included agoraphobias and unspecified phobias. We also diagnosed cases of somatoform pain disorders and unrecognizable figure somatoform disorders. We found a positive correlation between the Auditory performance and the decrease of anxiety and depression, tinnitus-related distress and perceived stress. There was no association between the presence of a mental condition itself and the outcome of Auditory Rehabilitation. We conclude that the CI candidates exhibit high rates of psychological disorders, and there is a particularly strong association between somatoform disorders and tinnitus. The presence of mental disorders remained unaffected by CI but the degree of psychological burden decreased significantly post-CI. The implants benefitted patients in a number psychosocial areas, improving the symptoms of depression and anxiety, tinnitus, and their quality of life and coping strategies. The prevalence of mental disorders in patients who are candidates for CI suggests the need for a comprehensive psychological and psychosomatic management of their treatment.
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elderly patients benefit from cochlear implantation regarding Auditory Rehabilitation quality of life tinnitus and stress
Laryngoscope, 2012Co-Authors: H Olze, S Grabel, Ulrike Forster, Nina Zirke, Laura E Huhnd, Heidemarie Haupt, Birgit MazurekAbstract:Objectives/Hypothesis: To determine the effect of cochlear implantation on quality of life, speech performance, tinnitus, perceived stress, and coping strategy in patients aged ≥70 years in comparison with younger patients. Study Design: Retrospective study. Methods: A total of 55 postlingually deafened adults who were unilaterally implanted with a multichannel cochlear implant for at least 6 months were included in the study. Twenty patients were aged ≥70 years (70–84 years), and 35 patients were <70 years (19–67 years). Speech perception was measured using the Freiburg monosyllable test in quiet and the Hochmair-Schulz-Moser sentence test. In addition, the patients filled in six validated questionnaires. Results: Speech perception and subjectively assessed Auditory ability were similar in the two age groups after implantation. Disease-specific quality of life was improved in patients aged ≥70 years and even to a higher extent as compared to younger patients. Tinnitus annoyance and perceived stress were reduced in elderly patients to the same extent as in younger patients in the case of high initial severity level. The scores for the coping subdomain “seeking support” were reduced in elderly patients. Conclusions: The present study provides evidence that cochlear implantation constitutes a very successful procedure of Auditory Rehabilitation, even for patients aged ≥70 years. In addition, elderly patients benefit from implantation, with increased quality of life and reduced tinnitus and stress.