Self-Reported Voice-Related Quality of Life in Cochlear Implant Users
Calidad de vida relacionada con la voz autoinformada en usuarios de implantes cocleares
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Show authors biography
Objective. The aim of this study was to identify if cochlear implant (CI) users are perceiving a decrease in life quality due to voice problems. This study evaluated 43 CI user’s perception of their voice and how it affects their quality of life through a survey.
Approach. Forty-three CI users responded to a survey regarding their demographics, details about their CI, the Hearing Health Quick Test (HHQT), the Voice Related Quality of Life (V-RQOL), and the Voice Handicap Index-10 (VHI-10). The survey responses were analyzed using univariate linear regression analysis.
Results. Few of the CI users scored below the cut off for normal voice related quality of life. CI users averaged 93.4 out of 100 on the V-RQOL and only four scored abnormally for the VHI-10. Lower scores on the V-RQOL were correlated with the participants having an associate degree and with participants visiting friends, family, and neighbors less often due to hearing loss. The VHI-10 scores were correlated with gender, education levels, difficulty in social situations due to hearing loss, noise exposure, and tinnitus.
Limitations of the study. The small n was the primary limitation of this study.
Originality. This study was one of the first to examine the voice-related quality of life in CI users.
Conclusions. Overall, respondents did not perceive much voice-related difficulty. However, they were more likely to perceive voice-related difficulty if they experienced difficulty hearing in noise and avoided social situations due to hearing loss.
Article visits 343 | PDF visits 121
- National Institute on Deafness and Other Communication Disorders (NIDCD). Quick Statistics About Hearing [Internet]. 2021 Mar 25.. Available from: https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing
- Mildner V, Liker M. Fricatives, affricates, and vowels in Croatian children with cochlear implants. Clin Linguist Phon [Internet]. 2008 Jan;22(10–11):845–56. doi: http://dx.doi.org/10.1080/02699200802130557
- American Speech-Language-Hearing Association. Cochlear Implants. [Internet]. 2004. doi: http://doi.org/10.1044/policy.TR2004-00041
- Oticon Medical. Cochlear implants - a modern miracle | Oticon Medical. [Internet]. 2022. Available from: https://www.oticonmedical.com/us/cochlear-implants
- Cochlear™ Nucleus® Hearing Implants. Cochlear. [Internet]. 2022. [cited 2023 Aug 18]. Available from: https://www.cochlear.com/us/en/home/products-and-accessories/cochlear-nucleus-system/nucleus-implants
- van der Jagt MA, Briaire JJ, Verbist BM, Frijns JHM. Comparison of the HiFocus Mid-Scala and HiFocus 1J Electrode Array: Angular Insertion Depths and Speech Perception Outcomes. Audiol Neurootol. 2016;21(5):316-25. doi: http://dx.doi.org/10.1159/000448581
- MED-EL Pro. MED-EL Cochlear Implant Electrode Arrays. [Internet]. 2022 [cited 2023 Aug 18]. Available from: https://www.medel.pro/products/electrode-arrays
- Aronoff JM, Stelmach J, Padilla M, Landsberger DM. Interleaved processors improve cochlear implant patients' spectral resolution. Ear Hear. 2016;37(2):e85-e90. doi: http://dx.doi.org/10.1097/aud.0000000000000249
- Staisloff HE, Aronoff JM. Comparing methods for pairing electrodes across ears with cochlear implants. Ear Hear. 2021;42(5):1218-27. doi: https://doi.org/10.1097/AUD.0000000000001006
- MED-EL Pro. Why MED-EL: Cochlear Implants. [Internet] [cited 2023 Aug 18]. Available from: https://www.medel.pro/systems/cochlear-implant-system
- Iddings T. Cochlear Implants for Adults: Evaluation, Implantation and Outcomes. 2022 Oct 17.
- Eshraghi AA, Ahmed J, Krysiak E, Ila K, Ashman P, Telischi FF, et al. Clinical, surgical, and electrical factors impacting residual hearing in cochlear implant surgery. Acta Otolaryngol. 2017;137(4):384-8. doi: https://doi.org/10.1080/00016489.2016.1256499
- Zanetti D, Nassif N, Redaelli De Zinis LO. Factors affecting residual hearing preservation in cochlear implantation. Acta Otorhinolaryngol Ital. 2015;35(6):433-41. doi: https://doi.org/10.14639/0392-100X-619
- Schafer EC, Miller S, Manning J, Zhang Q, Lavi A, Bodish E, et al. Meta-Analysis of Speech Recognition Outcomes in Younger and Older Adults With Cochlear Implants. Am J Audiol. 2021;30(3):241-54. doi: https://doi.org/10.1044/2021_AJA-20-00141
- Forli F, Lazzerini F, Fortunato S, Bruschini L, Berrettini S. Cochlear Implant in the Elderly: Results in Terms of Speech Perception and Quality of Life. Audiol Neurootol. 2019;24(2):77-83. doi: https://doi.org/10.1159/000499176
- Bourn SS, Goldstein MR, Morris SA, Jacob A. Cochlear implant outcomes in the very elderly. Am J Otolaryngol. 2022;43(1):103200. doi: https://doi.org/10.1016/j.amjoto.2021.103200
- McRackan TR, Fabie JE, Bhenswala PN, Nguyen SA, Dubno JR. General Health Quality of Life Instruments Underestimate the Impact of Bilateral Cochlear Implantation. Otol Neurotol. 2019;40(6):745-53. doi: https://doi.org/10.1097/MAO.0000000000002225
- McRackan TR, Bauschard M, Hatch JL, Franko-Tobin E, Droghini R, Nguyen SA, et al. Meta-analysis of quality-of-life improvement after cochlear implantation and associations with speech recognition abilities. Laryngoscope. 2018;128(4):982-90. doi: https://doi.org/10.1002/lary.26738
- Luo X, Kern A, Pulling KR. Vocal emotion recognition performance predicts the quality of life in adult cochlear implant users. J Acoust Soc Am. 2018;144(5):EL429-35.. doi: https://doi.org/10.1121/1.5079575
- Moberly AC, Harris MS, Boyce L, Vasil K, Wuchini T, Pisoni DB, et al. Relating quality of life to outcomes and predictors in adult cochlear implant users: Are we measuring the right things? Laryngoscope. 2018;128(4):959-66. doi: https://doi.org/10.1002/lary.26791
- Abbs E, Aronoff JM, Kirchner A, O’Brien E, Harmon B. Cochlear Implant Users’ Vocal Control Correlates Across Tasks. J Voice. 2020;34(3): 490e.7-490e.10. doi: https://doi.org/10.1016/j.jvoice.2018.10.008
- Liu H, Behroozmand R, Larson CR. Chapter 9.3 - Audio-vocal interactions in the mammalian brain. In: Brudzynski SM, editor. Handbook of Behavioral Neuroscience. Vol 19. Elsevier; 2010. p. 393-402. doi: https://doi.org/10.1016/B978-0-12-374593-4.00036-X
- Zamani P, Bayat A, Saki N, Ataee E, Bagheripour H. Post-lingual deaf adult cochlear implant users’ speech and voice characteristics: Cochlear implant turned-on versus turned-off. Acta Otolaryngol. 2021;141(4): 367-73. doi: https://doi.org/10.1080/00016489.2020.1866778
- Frankford SA, Marks KL, Feaster TF, Doyle PC, Stepp CE. Symptom Expression Across Voiced Speech Sounds in Adductor Laryngeal Dystonia. J Voice. Forthcoming 2022. doi: https://doi.org/10.1016/j.jvoice.2022.10.002
- Medved DMS, Cavalheri LMR, Coelho AC, Fernandes ACN, da Silva EM, Sampaio AL.et al. Systematic Review of Auditory Perceptual and Acoustic Characteristics of the Voice of Cochlear Implant Adult Users. J Voice. 2021;35(6):934.e7-934.e16. doi: https://doi.org/10.1016/j.jvoice.2020.02.023
- Teixeira JP, Oliveira C, Lopes C. Vocal Acoustic Analysis – Jitter, Shimmer and HNR Parameters. Procedia Technol. 2013;9:1112-22. doi: https://doi.org/10.1016/j.protcy.2013.12.124
- Li G, Hou Q, Zhang C, Jiang Z, Gong S. Acoustic parameters for the evaluation of voice quality in patients with voice disorders. Ann Palliat Med. 2021;10(1):118-24. doi: https://doi.org/10.21037/apm-20-2102
- Ruff S, Bocklet T, Nöth E, Müller J, Hoster E, Schuster M. Speech Production Quality of Cochlear Implant Users with Respect to Duration and Onset of Hearing Loss. ORL. 2017;79(5): 282-294. doi: https://doi.org/10.1159/000479819
- An YS, Kim ST, Chung JW. Preoperative Voice Parameters Affect the Postoperative Speech Intelligibility in Patients with Cochlear Implantation. Clin Exp Otorhinolaryngol. 2012;5(suppl 1):S69-S72. Available from: https://www.e-ceo.org/journal/view.php?doi=10.3342/ceo.2012.5.S1.S69
- Aronoff JM, Kirchner A, Abbs E, Harmon B. When singing with cochlear implants, are two ears worse than one for perilingually/postlingually deaf individuals? J Acoust Soc Am. 2018;143(6):EL503-EL508. doi: https://doi.org/10.1121/1.5043093
- Kirchner A, Loucks TM, Abbs E, Shi K, Yu KS, Aronoff JM. Influence of bilateral cochlear implants on vocal control. J Acoust Soc Am. 2020;147(4):2423-31. doi: https://doi.org/10.1121/10.0001099
- Timmons Sund L, Collum JA, Bhatt NK, Hapner ER. VHI-10 Scores in a Treatment-Seeking Population With Dysphonia. J Voice [Internet]. 2023 Mar;37(2):290.e1-290.e6. doi: http://dx.doi.org/10.1016/j.jvoice.2020.12.017
- Rosen CA, Lee AS, Osborne J, Zullo T, Murry T. Development and validation of the voice handicap index-10. Laryngoscope. 2004;114(9):1549-56. doi: https://doi.org/10.1097/00005537-200409000-00009
- Hogikyan ND, Sethuraman G. Validation of an instrument to measure voice-related quality of life (V-RQOL). J Voice. 1999;13(4):557-69. doi: https://doi.org/10.1016/S0892-1997(99)80010-1
- Kupfer RA, Hogikyan EM, Hogikyan ND. Establishment of a Normative Database for the Voice-Related Quality of Life (V-RQOL) Measure. J Voice. 2014;28(4):449-51. doi: https://doi.org/10.1016/j.jvoice.2013.11.003
- Hsu H-W, Fang T-J, Lee L-A, Tsou Y-T, Chen SH, Wu C-M. Multidimensional evaluation of vocal quality in children with cochlear implants: a cross-sectional, case-controlled study. Clin Otolaryngol [Internet]. 2014 Feb;39(1):32–8. doi: http://dx.doi.org/10.1111/coa.12213
- Cappellaro J, Beber BC. Vocal Tract Discomfort and Voice-Related Quality of Life in Wind Instrumentalists. J Voice. 2018;32(3):314-18. doi: https://doi.org/10.1016/j.jvoice.2017.05.011
- Spina AL, Maunsell R, Sandalo K, Gusmão R, Crespo A. Correlation between voice and life quality and occupation. Braz J Otorhinolaryngol. 2009;75(2):275-9. doi: https://doi.org/10.1016/S1808-8694(15)30790-4
- Cantor Cutiva LC, Burdorf A. Factors Associated with Voice-Related Quality of Life among Teachers with Voice Complaints. J Commun Disord. 2014;52:134-42. doi: https://doi.org/10.1016/j.jcomdis.2014.05.003
- Lu D, Wen B, Yang H, Chen F, Liu J, Xu Y., et al. A Comparative Study of the VHI-10 and the V-RQOL for Quality of Life Among Chinese Teachers With and Without Voice Disorders. J Voice. 2017;31(4):509.e1-509.e6. doi: https://doi.org/10.1016/j.jvoice.2016.10.025
- Alarouj H, Althekerallah JM, AlAli H, Ebrahim MA, Ebrahim MAK. A Comparative Study Utilizing the Voice Handicap Index-10 (VHI-10) in Teachers and the General Population of Kuwait. J Voice. 2022;36(2):289.e1-289.e10. doi: https://doi.org/10.1016/j.jvoice.2020.05.006
- Moy FM, Hoe VCW, Hairi NN, Chu AHY, Bulgiba A, Koh D. Determinants and Effects of Voice Disorders among Secondary School Teachers in Peninsular Malaysia Using a Validated Malay Version of VHI-10. PLoS One. 2015;10(11):e0141963. doi: https://doi.org/10.1371/journal.pone.0141963
- Cohen SM, Turley R. Coprevalence and impact of dysphonia and hearing loss in the elderly. Laryngoscope. 2009;119(9):1870-3. doi: https://doi.org/10.1002/lary.20590
- Colby S, Orena AJ. Recognizing Voices Through a Cochlear Implant: A Systematic Review of Voice Perception, Talker Discrimination, and Talker Identification. J Speech Lang Hear Res. 2022;65(8):3165-94. doi: https://doi.org/10.1044/2022_JSLHR-21-00209
- Tourville JA, Guenther FH. The DIVA model: A neural theory of speech acquisition and production. Lang Cogn Process [Internet]. 2011 Aug;26(7):952–81. doi: http://dx.doi.org/10.1080/01690960903498424
- Guo M, Li S, Liu J, Sun F. Family Relations, Social Connections, and Mental Health Among Latino and Asian Older Adults. Research on Aging [Internet]. 2014 Feb 23;37(2):123–47. doi: http://dx.doi.org/10.1177/0164027514523298