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：已知早年失聪的人工耳蜗（Cochlear Implant, CI）使用者的术后表现群体异质性极强。为深入阐明该人群的特征，本研究开展了四项核心分析：（1）以多种结局评估指标为基础，聚焦表现不佳亚组，探究随时间推移的听觉功能术后变化；（2）受试者的自我感知结局情况；（3）听觉结局与自我感知结局之间的关联；（4）可预测术后结局的术前影响因素。
研究方法：本研究前瞻性评估了27名早年失聪且延迟植入人工耳蜗的使用者，随访时长至术后3年。所用结局评估指标包括开放集词语与语句识别测试、闭合集词语识别测试、言语追踪测试，以及用于评估自我感知结局的问卷。此外，本研究通过线性回归分析，量化了8项术前影响因素对人工耳蜗结局的相对影响程度。
研究结果：听觉功能相关指标以及多数问卷维度均出现显著改善。在表现不佳的受试者亚组中，闭合集词语识别测试、言语追踪测试得分及问卷得分同样存在显著变化。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。多变量回归模型显示，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子，可解释63.5%的结局变异量。
研究结论：针对该人群的人工耳蜗结局评估应结合患者个体表现水平进行个性化调整，并纳入自我感知获益维度。目前仍需更多针对该人群人工耳蜗结局预测因子的研究，但本研究结果提示，待植入耳的术前表现具有重要临床参考价值。