title: Factors Predicting Postoperative Unilateral and Bilateral Speech Recognition in Adult Cochlear Implant Recipients with Acoustic Hearing.
abstract: OBJECTIVE
  The first objective was to examine factors that could be predictive of postoperative unilateral (cochlear implant alone) speech recognition ability in a group of subjects with greater degrees of preoperative acoustic hearing than has been previously examined. Second, the study aimed to identify factors predictive of speech recognition in the best-aided, bilateral listening condition.
  
  
  METHODS
  Participants were 65 postlinguistically hearing-impaired adults with preoperative phoneme in quiet scores of greater than or equal to 46% in one or both ears. Preoperative demographic and audiometric factors were assessed as predictors of 12-month postoperative unilateral and bilateral monosyllabic word scores in quiet and of bilateral speech reception threshold (SRT) in babble.
  
  
  RESULTS
  The predictive regression model accounted for 34.1% of the variance in unilateral word recognition scores in quiet. Factors that predicted better scores included: a shorter duration of severe to profound hearing loss in the implanted ear; and poorer pure-tone-averaged thresholds in the contralateral ear. Predictive regression models of postimplantation bilateral function accounted for 36.0% of the variance for word scores in quiet, and 30.9% of the variance for SRT in noise. A shorter duration of severe to profound hearing loss in the implanted ear, a lower age at the time of implantation, and better contralateral hearing thresholds were associated with higher bilateral word recognition in quiet and SRT in noise.
  
  
  CONCLUSIONS
  In this group of cochlear implant recipients with preoperative acoustic hearing, a shorter duration of severe to profound hearing loss in the implanted ear was shown to be predictive of better unilateral and bilateral outcomes. However, further research is warranted to better understand the impact of that factor in a larger number of subjects with long-term hearing impairment of greater than 30 years. Better contralateral hearing was associated with poorer unilateral word scores with the implanted ear alone, but better absolute bilateral speech recognition. As a result, it is clear that different models would need to be developed to predict unilateral and bilateral postimplantation scores.
authors.affiliation: 1The HEARing CRC, Carlton, Victoria, Australia; 2Cochlear Limited, East Melbourne, Victoria, Australia; 3The University of Melbourne, Parkville, Victoria, Australia; 4Bionics Institute, East Melbourne, Victoria, Australia; and 5Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Kerrie
authors.initials: K
authors.lastname: Plant
authors.forename: Hugh
authors.initials: H
authors.lastname: McDermott
authors.forename: Richard
authors.initials: R
authors.lastname: van Hoesel
authors.forename: Pamela
authors.initials: P
authors.lastname: Dawson
authors.forename: Robert
authors.initials: R
authors.lastname: Cowan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019929:Cochlear Implantation; D003054:Cochlear Implants; D005260:Female; D006310:Hearing Aids; D006312:Hearing Loss, Bilateral / Q000534:rehabilitation*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D013067:Speech Perception