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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

Comparison of the mean degree of hearing benefit for the irradiated and control groups. EC, ease of communication; BN, background noise; RV, reverberation; AV, aversiveness; SDS, speech discrimination scores. Error bars, +/- 1 SD.
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Figure 3: Comparison of the mean degree of hearing benefit for the irradiated and control groups. EC, ease of communication; BN, background noise; RV, reverberation; AV, aversiveness; SDS, speech discrimination scores. Error bars, +/- 1 SD.

Mentions: Fig. 3 and Table 1 present the comparison of the average benefit for the irradiated and control groups. The average benefit score is given for both groups for each subcategory. As suggested by the aided scores, the data revealed similar mean responses between the two groups in terms of the degree of hearing benefit improvement in all subcategories. T-testing supported this finding, and the comparison of mean hearing benefit scores showed non-significant differences between the two groups (P>0.05).


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)

Comparison of the mean degree of hearing benefit for the irradiated and control groups. EC, ease of communication; BN, background noise; RV, reverberation; AV, aversiveness; SDS, speech discrimination scores. Error bars, +/- 1 SD.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Comparison of the mean degree of hearing benefit for the irradiated and control groups. EC, ease of communication; BN, background noise; RV, reverberation; AV, aversiveness; SDS, speech discrimination scores. Error bars, +/- 1 SD.
Mentions: Fig. 3 and Table 1 present the comparison of the average benefit for the irradiated and control groups. The average benefit score is given for both groups for each subcategory. As suggested by the aided scores, the data revealed similar mean responses between the two groups in terms of the degree of hearing benefit improvement in all subcategories. T-testing supported this finding, and the comparison of mean hearing benefit scores showed non-significant differences between the two groups (P>0.05).

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