Supplementary Material for: Late Cochlear Implantation in Early-Deafened Adults: A Detailed Analysis of Auditory and Self-Perceived Benefits

Objectives: It is known that early-deafened cochlear implant (CI) users are a very heterogeneously performing group. To gain more insight into this population, this study investigated (1) postoperative changes in auditory performance over time based on various outcome measures, focusing on poor performers, (2) self-perceived outcomes, (3) relations between auditory and self-perceived outcomes, and (4) preimplantation factors predicting postoperative outcomes. Methods: Outcomes were assessed prospectively in a group of 27 early-deafened, late-implanted CI users, up to 3 years after implantation. Outcome measures included open-set word and sentence recognition, closed-set word recognition, speech tracking and a questionnaire on self-perceived outcomes. Additionally, the relative influence of 8 preimplantation factors on CI outcome was assessed with linear regression analyses. Results: Significant improvements were found for auditory performance measures and most of the questionnaire domains. Significant changes of the closed-set word test, speech tracking and questionnaire were also found for a subgroup of poor performers. Correlations between auditory and self-perceived outcomes were weak and nonsignificant. Preoperative word recognition and preoperative hearing thresholds, both for the implanted ear, were significant predictors of postoperative outcome in the multivariable regression model, explaining 63.5% of the variation. Conclusions: Outcome measurement in this population should be adjusted to the patients’ individual performance level and include self-perceived benefit. There is still a need for more knowledge regarding predictors of CI outcomes in this group, but the current study suggests the importance of the preoperative performance of the ear to be implanted.

研究目的：现有研究证实，早期耳聋人工耳蜗（cochlear implant, CI）使用者的术后表现具有高度异质性。为深入了解该人群，本研究展开了四项调研：（1）基于多种结局指标追踪听觉表现随术后时间的变化趋势，重点关注表现较差的亚组；（2）评估患者自我感知的术后结局；（3）探究听觉结局与自我感知结局之间的关联；（4）筛选可预测术后结局的术前植入相关因素。
方法：本研究前瞻性纳入27名早期耳聋、延迟植入人工耳蜗的使用者，对其术后最长3年的结局指标进行评估。采用的结局评估工具包括开放式词语与句子识别测试、闭合式词语识别测试、言语追踪测试，以及针对自我感知结局的问卷调查量表。此外，本研究通过线性回归分析，评估了8项术前植入相关因素对人工耳蜗结局的相对影响程度。
结果：研究显示，听觉表现相关指标与大部分问卷维度均出现显著改善。针对表现较差的亚组，闭合式词语识别测试、言语追踪测试以及问卷得分同样出现显著变化。听觉结局与自我感知结局之间的相关性较弱且无统计学意义。多变量回归模型分析结果表明，植入耳的术前词语识别能力与术前听阈均为术后结局的显著预测因素，可解释63.5%的结局变异度。
结论：针对该人群的术后结局评估，应结合患者个体表现水平进行调整，且需纳入自我感知获益维度。目前仍需更多研究以明确该人群人工耳蜗结局的预测因素，但本研究提示了待植入耳术前表现的重要性。