The outcomes of cochlear implantation in Thailand: Audiologic performance and quality of life

Abstract

© 2018, Medical Association of Thailand. All rights reserved. Background: Cochlear implantation is the one of modalities for restoring hearing function. Recently, trends in cochlear implants are increase but few studies have reported on quality of life and hearing outcomes after cochlear implant placement in Thailand. Objective: To assess the auditory performance and quality of life of patients after receiving cochlear implants. Materials and Methods: An observational study was conducted in 11 cochlear implant centers in Thailand. The study was implemented through a secure web-based platform. Retrieved data concerning cochlear implants were classified into two periods. Prior to October 1, 2016, retrospective chart reviews were performed, whereas the prospective element of the study investigated patients who underwent cochlear implantation after October 1, 2016. Data were collected until August 31, 2017. Results: Two hundred and twenty-six patients were registered. Unfortunately, 10 medical chart records contained insufficient data; thus, data from 216 patients were analyzed. Postoperative hearing outcomes, specifically aided thresholds, PB scores and SRT/ STD scores were superior to pre-implant performance and improved at each successive post-implant assessment point (p = 0.001, p<0.001, and p<0.001, respectively). It took a median of 36 months to aurally rehabilitate patients: the criterion used was achieving a CAP score of more than 5, indicating good communication performance. Use of sign language alone as a means of preoperative communication was a predictor of poor rehabilitation success (p = 0.013). The QOL of patients with cochlear implants was assessed with questionnaires including EQ5D5L, Pedsql, and HUI3. The outcomes were not clearly significantly better than pre-implantation; however, in the early post-operative period the trend was superior to pre-implantation performance. Complications of cochlear implantation were rare in our series. Conclusion: Cochlear implantation in Thailand seems to be providing good audiologic parameters, communication performances and QOL. A limitation of the study is the small amount of data due to difficulty in retrieving retrospective data. Therefore, a standard system for managing case data should be instituted now to improve the evidence base concerning outcomes of cochlear implant surgery.