Hearing handicap ratings among different profiles of adult cochlear implant users

OBJECTIVE: The aim was to compare outcomes in the domain of self-reported hearing handicap across groups of patients fit with one versus two cochlear implants (CI, CI + CI), or with an implant and a hearing aid (HA) in the nonimplanted ear (CI + HA). DESIGN: The design was retrospective, and a preliminary step was to factor analyze the two measures used, namely, the Hearing Handicap Inventory for the Elderly (HHIE) and the Hearing Handicap Questionnaire (HHQ). Longer versus shorter-term experience with a single implant profile was compared, and further analysis confined to patients fit for less than 100 mo across the three profiles. Pre- versus postimplant self-report and performance (speech test, localization) data were also compared. RESULTS: Three factors were identified in the HHIE, labeled Emotional Distress (HHIE), Difficulty in Hearing, and Social Restriction (HHIE). Highest handicap score for Emotional Distress (HHIE) was observed in the CI + HA group. There were significantly lower scores for Difficulty in Hearing in the CI + CI group than in the CI (p = 0.02) or CI + HA (p = 0.001) groups. On the Social Restriction (HHIE) subscale, the CI + CI group reported significantly lower rating than the CI (p = 0.009) or CI + HA (p = 0.006) groups. Two factors were identified in the HHQ, labeled Emotional Distress (HHQ) and Social Restriction (HHQ). Significantly higher Emotional Distress (HHQ) score was observed in the CI + HA group than in the CI + CI group (p = 0.002); significantly lower Social Restriction (HHQ) score was found in the CI + CI group than in the CI (p = 0.02) or CI + HA (p < 0.001) groups. Pre-post speech test performance showed least contrast in the CI + HA group. CONCLUSIONS: Outcomes demonstrate an evident reduction from single or bilateral implantation in the area of emotional distress and a further advantage from bilateral implantation in the areas of hearing difficulty and social restriction.