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Cochlear Implant Outcomes: A Comparison between Irradiated and Non-irradiated Ears.

Soh JM, D'Souza VD, Sarepaka GK, Ng WN, Ong CS, Low WK - Clin Exp Otorhinolaryngol (2012)

Bottom Line: Global and category scores in both groups were averaged and statistically compared via non-inferiority (NI) testing.From the results, lower 95% confidence interval limits of global APHAB, SDS, ease of communication, and background noise scores of the irradiated group were within the defined -ΔNI boundary and hence are not inferior to the control.The overall hearing outcomes after cochlear implantation for post-irradiated patients were not worse than patients who have had no prior irradiation to ear structures.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Singapore General Hospital, Singapore.

ABSTRACT

Objectives: Radiotherapy for head and neck tumors is known to potentially induce sensorineural hearing loss, which is possibly due to damage to the cochlear and/or auditory pathways. Since the success of cochlear implantation depends on a functional auditory nerve, this paper aims to study the hearing outcomes of cochlear implantation in irradiated ears.

Methods: A retrospective study of cochlear implant recipients from our institution who had previously received radiotherapy for head and neck cancers was performed. A control group with cochlear implants who did not receive radiotherapy was recruited. A review of case records, speech discrimination scores (SDS), and a validated subjective questionnaire in the form of the Abbreviated Profile of Hearing Aid Benefit (APHAB) was administered to the study group who fulfilled the inclusion criteria. Global and category scores in both groups were averaged and statistically compared via non-inferiority (NI) testing.

Results: With the control group (n=8) as the reference, the -ΔNI was defined, and a one-tailed lower 95% confidence interval was used for the irradiated group (n=8). The APHAB degree of improvement (%) results were as follows: global, 28.9% (19.32%, -ΔNI=16.3%); ease of communication, 67.0% (58.36%, -ΔNI=37.5%); background noise, 53.2% (44.14%, -ΔNI=26.8%); reverberation, 41.7% (28.85%, -ΔNI=32.7%); and aversiveness, -46.2% (-67.80%, -ΔNI=-56.9%). The SDS was 66.9% (56.02%, -ΔNI=51.0%). From the results, lower 95% confidence interval limits of global APHAB, SDS, ease of communication, and background noise scores of the irradiated group were within the defined -ΔNI boundary and hence are not inferior to the control. The categories of reverberation and aversiveness could not be proven, however.

Conclusion: This study demonstrated marked improvements in hearing measured both objectively and subjectively. The overall hearing outcomes after cochlear implantation for post-irradiated patients were not worse than patients who have had no prior irradiation to ear structures.

No MeSH data available.


Related in: MedlinePlus

Mean responses for Abbreviated Profile of Hearing Aid Benefit (APHAB) & speech discrimination scores (SDS) for both the irradiated and control groups in the unaided listening condition prior to their cochlear implantation. EC, ease of communication; BN, background noise; RV, reverberation; AV, aversiveness. Error bars, +/- 1 SD.
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Figure 1: Mean responses for Abbreviated Profile of Hearing Aid Benefit (APHAB) & speech discrimination scores (SDS) for both the irradiated and control groups in the unaided listening condition prior to their cochlear implantation. EC, ease of communication; BN, background noise; RV, reverberation; AV, aversiveness. Error bars, +/- 1 SD.

Mentions: Fig. 1 depicts the mean responses for APHAB and SDS for both the irradiated and control groups in the unaided listening condition prior to their cochlear implantation. The average frequency of problems (represented as percentages) without the use of amplification was similar in both groups, and no significant differences (P>0.05) were observed between the means of the subcategories of BN, RV, AV, global scores and SDS when subjected to an independent samples T-test. There was statistical significance found in the EC scores with T-testing, indicating that there were more problems in the EC domain reported in the irradiated group (X, 97.9%; standard deviation [SD], 5.89) as compared to the control (X, 83.0%; SD, 16.4; t=2.428; P=0.029) with 95% confidence intervals 1.74 and 28.12, respectively. Given the small sample of patients, it would be reasonable to conclude that patients in the irradiated group were largely similar to the control group in most domains except for EC. For the purposes of this study, more emphasis would be placed on the degree of hearing benefit and whether this benefit is similar in both groups.


Cochlear Implant Outcomes: A Comparison between Irradiated and Non-irradiated Ears.

Soh JM, D'Souza VD, Sarepaka GK, Ng WN, Ong CS, Low WK - Clin Exp Otorhinolaryngol (2012)

Mean responses for Abbreviated Profile of Hearing Aid Benefit (APHAB) & speech discrimination scores (SDS) for both the irradiated and control groups in the unaided listening condition prior to their cochlear implantation. EC, ease of communication; BN, background noise; RV, reverberation; AV, aversiveness. Error bars, +/- 1 SD.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369992&req=5

Figure 1: Mean responses for Abbreviated Profile of Hearing Aid Benefit (APHAB) & speech discrimination scores (SDS) for both the irradiated and control groups in the unaided listening condition prior to their cochlear implantation. EC, ease of communication; BN, background noise; RV, reverberation; AV, aversiveness. Error bars, +/- 1 SD.
Mentions: Fig. 1 depicts the mean responses for APHAB and SDS for both the irradiated and control groups in the unaided listening condition prior to their cochlear implantation. The average frequency of problems (represented as percentages) without the use of amplification was similar in both groups, and no significant differences (P>0.05) were observed between the means of the subcategories of BN, RV, AV, global scores and SDS when subjected to an independent samples T-test. There was statistical significance found in the EC scores with T-testing, indicating that there were more problems in the EC domain reported in the irradiated group (X, 97.9%; standard deviation [SD], 5.89) as compared to the control (X, 83.0%; SD, 16.4; t=2.428; P=0.029) with 95% confidence intervals 1.74 and 28.12, respectively. Given the small sample of patients, it would be reasonable to conclude that patients in the irradiated group were largely similar to the control group in most domains except for EC. For the purposes of this study, more emphasis would be placed on the degree of hearing benefit and whether this benefit is similar in both groups.

Bottom Line: Global and category scores in both groups were averaged and statistically compared via non-inferiority (NI) testing.From the results, lower 95% confidence interval limits of global APHAB, SDS, ease of communication, and background noise scores of the irradiated group were within the defined -ΔNI boundary and hence are not inferior to the control.The overall hearing outcomes after cochlear implantation for post-irradiated patients were not worse than patients who have had no prior irradiation to ear structures.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Singapore General Hospital, Singapore.

ABSTRACT

Objectives: Radiotherapy for head and neck tumors is known to potentially induce sensorineural hearing loss, which is possibly due to damage to the cochlear and/or auditory pathways. Since the success of cochlear implantation depends on a functional auditory nerve, this paper aims to study the hearing outcomes of cochlear implantation in irradiated ears.

Methods: A retrospective study of cochlear implant recipients from our institution who had previously received radiotherapy for head and neck cancers was performed. A control group with cochlear implants who did not receive radiotherapy was recruited. A review of case records, speech discrimination scores (SDS), and a validated subjective questionnaire in the form of the Abbreviated Profile of Hearing Aid Benefit (APHAB) was administered to the study group who fulfilled the inclusion criteria. Global and category scores in both groups were averaged and statistically compared via non-inferiority (NI) testing.

Results: With the control group (n=8) as the reference, the -ΔNI was defined, and a one-tailed lower 95% confidence interval was used for the irradiated group (n=8). The APHAB degree of improvement (%) results were as follows: global, 28.9% (19.32%, -ΔNI=16.3%); ease of communication, 67.0% (58.36%, -ΔNI=37.5%); background noise, 53.2% (44.14%, -ΔNI=26.8%); reverberation, 41.7% (28.85%, -ΔNI=32.7%); and aversiveness, -46.2% (-67.80%, -ΔNI=-56.9%). The SDS was 66.9% (56.02%, -ΔNI=51.0%). From the results, lower 95% confidence interval limits of global APHAB, SDS, ease of communication, and background noise scores of the irradiated group were within the defined -ΔNI boundary and hence are not inferior to the control. The categories of reverberation and aversiveness could not be proven, however.

Conclusion: This study demonstrated marked improvements in hearing measured both objectively and subjectively. The overall hearing outcomes after cochlear implantation for post-irradiated patients were not worse than patients who have had no prior irradiation to ear structures.

No MeSH data available.


Related in: MedlinePlus