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. 2025 Apr 22;10(2):e70090.
doi: 10.1002/lio2.70090. eCollection 2025 Apr.

Speech, Spatial, and Qualities of Hearing Scale and Tinnitus Functional Index Improvements After Cochlear Implant Surgery for Single-Sided Deafness

Scott B Shapiro  1 , Todd M Mowery  1 , P Ashley Wackym  1
Affiliations

Speech, Spatial, and Qualities of Hearing Scale and Tinnitus Functional Index Improvements After Cochlear Implant Surgery for Single-Sided Deafness

Scott B Shapiro et al. Laryngoscope Investig Otolaryngol. .

Abstract

Objective: Examine improvements in hearing and tinnitus-related quality-of-life metrics that occur after cochlear implant surgery in patients with single-sided deafness (SSD) and asymmetric hearing loss (AHL).

Methods: Adult patients undergoing cochlear implant surgery for SSD or AHL during a 2-year period at a quaternary academic medical center completed the validated survey instruments tinnitus functional index (TFI) and Speech, Spatial, and Qualities of Hearing Scale (SSQ) before surgery, and at least 3 months after cochlear implant activation. Standardized protocols for audiometric assessment were completed pre- and postoperatively.

Results: Twenty-four patients met inclusion criteria and had complete audiometric and survey data. Overall, composite TFI score improved significantly from a mean severity of 48.2 ± 9.2-18.6 ± 6.53; after cochlear implantation (q = 2.01, p < 0.001) and there was statistically significant improvement in all eight subdomains of the TFI after surgery. The SSQ composite scores significantly improved from a mean of 2.5 ± 0.30-5.07 ± 0.44 after CI (q = 2.01, p < 0.001). All three subdomains of the SSQ improved significantly after cochlear implantation though the magnitude of the changes were higher for Speech Hearing and Spatial Hearing compared with the Qualities of Hearing domain.

Conclusions: Cochlear implantation surgery in patients with SSD or AHL leads to significant overall improvements in hearing related quality of life, but particularly in the areas of speech understanding, spatial aspects of hearing, and tinnitus severity.

Level of evidence: 3.

Keywords: cochlear implant; quality of life; single‐sided deafness; spatial awareness; tinnitus.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Tinnitus Functional Index (TFI) scores after cochlear implantation (CI) in single‐sided deafness patients. (A) Strip chart showing mean, standard error of the mean (SEM), and individual data points with Tukey honest significant difference (HSD) analysis for measures of TFI Intrusiveness before (red) and after (green) CI. Right, Tukey HSD analysis. (B) Strip chart showing mean, SEM, and individual data points with Tukey HSD analysis for measures of TFI Reduced Sense of Control before (red) and after (green) CI. Right, Tukey HSD analysis. (C) Strip chart showing mean, SEM, and individual data points with Tukey HSD analysis for measures of TFI Cognitive Interference before (red) and after (green) CI. Right, Tukey HSD analysis. (D) Strip chart showing mean, SEM, and individual data points with Tukey HSD analysis for measures of TFI Sleep Disturbance before (red) and after (green) CI. Right, Tukey HSD analysis. (E) Strip chart showing mean, SEM, and individual data points with Tukey HSD analysis for measures of TFI Auditory Difficulties before (red) and after (green) CI. Right, Tukey HSD analysis. (F) Strip chart showing mean, SEM, and individual data points with Tukey HSD analysis for measures of TFI Interference with Relaxation before (red) and after (green) CI. Right, Tukey HSD analysis. (G) Strip chart showing mean, SEM, and individual data points with Tukey HSD analysis for measures of TFI Reduced Quality of Life before (red) and after (green) CI. Right, Tukey HSD analysis. (H) Strip chart showing mean, SEM, and individual data points with Tukey HSD analysis for measures of TFI Emotional Distress before (red) and after (green) CI. Right, Tukey HSD analysis. * p < 0.05, **p < 0.01, ***p < 0.001. Post‐SSD CI = postoperative single‐sided deafness CI; Pre‐SSD CI = preoperative single‐sided deafness CI. Copyright P.A. Wackym, MD, published with permission.
FIGURE 2
FIGURE 2
Tinnitus Functional Index (TFI) general severity scores for tinnitus after cochlear implantation (CI) in single‐sided deafness (SSD) patients. Strip chart showing mean, SEM, and individual data points with Tukey honest significant difference (HSD) analysis for measures of TFI general severity before (red) and after (green) CI. Right, Tukey HSD analysis. ***p < 0.001. Post‐SSD CI = postoperative single‐sided deafness CI; Pre‐SSD CI = preoperative single‐sided deafness CI. Copyright P.A. Wackym, MD, published with permission.
FIGURE 3
FIGURE 3
Measures of speech spatial qualities (SSQ) after cochlear implantation (CI) in single‐sided deafness (SSD) patients. (A) Strip chart showing mean, SEM, and individual data points with Tukey honest significant difference (HSD) analysis for measures of SSQ Speech Hearing before (red) and after (green) CI. Right, Tukey HSD analysis. (B) Strip chart showing mean, SEM, and individual data points with Tukey HSD analysis for measures of SSQ Spatial Hearing before (red) and after (green) CI. Right, Tukey HSD analysis. (C) Strip chart showing mean, SEM, and individual data points with Tukey HSD analysis for qualitative measures of SSQ Quality of Hearing before (red) and after (green) CI. Right, Tukey HSD analysis. * p < 0.05, ***p < 0.001. Post‐SSD CI = postoperative single‐sided deafness CI; Pre‐SSD CI = preoperative single‐sided deafness CI. Copyright P.A. Wackym, MD, published with permission.
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