The Sound of Feeling Better

Cochlear implants improve speech perception and quality of life

Cochlear implants are an appealing option to many adults with hearing loss. New research suggests that the implants might provide patients with more than just improved hearing.

A recent study looked at how well adults with cochlear implants could do on certain hearing tests and how they described life changes since getting the implants.

Researchers reviewed 42 previous studies that asked adults with hearing loss to complete various tests measuring their abilities to understand speech and rate their quality of life.

The data suggested that adults with at least one cochlear implant experienced improved understanding of speech and increased hearing-related quality of life. Two implants improved speech perception even further, the research showed.

"Consult your physician if you have trouble hearing."

James M. Gaylor, BA, of the Tufts Evidence-Based Practice Center at the Tufts Medical Center, and colleagues led the study to find out what adults with hearing loss experienced after getting a cochlear implant.

The cochlear implant is a small electronic device that gets surgically inserted in the ear. The implant helps people with severe hearing loss and deafness detect sound.

To carry out their research, the researchers reviewed 42 already-published studies on adults with hearing loss who had surgery to insert either one or two cochlear implants.   

The previous studies included sentence comprehension tests, word tests with multiple syllables or quality of life measures. Participants in these studies could also use hearing aids.

A total of 16 studies measured how well the participants could communicate in various ways after getting one cochlear implant.

In 11 of those 16 studies, the participants’ average speech scores significantly improved after getting a cochlear implant. The five remaining studies reported a smaller benefit.

A total of 15 studies looked at how participants with two cochlear implants were able to communicate on certain tests.

In 13 of those studies, the participants’ communication scores significantly improved when both of the implants were turned on compared to the scores when only one implant was turned on.

In 14 of the studies, participants with two cochlear implants did significantly better at locating the source of a sound in a quiet room compared to those with only one implant.

The researchers also looked at differences in how the participants rated their quality of life after getting cochlear implants.

General quality of life scores improved by an average of 1.05 points in the nine studies that tested this measure.

Patients’ quality of life related to their cochlear implants improved by an average of 1.71 points after the surgery, according to the five studies that included this measure.

Participants also had an average 1.24-point improvement in their hearing-specific quality of life scores.

“In summary, unilateral cochlear implantation with or without the additional use of hearing aids was an effective method for improving speech perception and health-related quality of life in adults with severe to profound sensorineural hearing loss in the studies assessed within this review,” the authors wrote.

“Compared with unilateral implantation, bilateral cochlear implantation provided added improvements in speech perception,” the authors concluded.

The study was published on February 21 in the journal JAMA Otolaryngology–Head & Neck Surgery.

The research was funded by the Agency for Healthcare Research and Quality, part of the United States Department of Health and Human Services. The authors reported no potential conflicts of interest.

Reviewed by: 

Chris Galloway, M.D.

Review Date: 

February 25, 2013

 Citation: 

JAMA Otolaryngology–Head & Neck Surgery, “Cochlear Implantation in AdultsA Systematic Review and Meta-analysis”

Violence In & Out of Relationships

Intimate partner and sexual violence and stalking rates high in the US

Loving and being loved has nothing to do with violence. But physical and sexual violence in intimate relationships is still very common. 

A recent report by the Centers for Disease Control and Prevention (CDC) released statistics on intimate partner violence, sexual violence and stalking rates in the United States.

A portion of the report showed that rates of stalking and violence were higher in lesbian, gay and bisexual groups than among the heterosexual population.

Researchers made recommendations for promoting healthy family environments to reduce future violence and for improving training for healthcare workers to support patient recovery from violence.

"Call the National Domestic Violence Hotline: 1-800-799-SAFE if you are experiencing partner violence. "

Emergency number for those in Lagos, Nigeria: 767 or 112 you can comment by leaving emergency numbers for your country, region or area.

The CDC has released its data from The National Intimate Partner and Sexual Violence Survey (NISVS).

For the NISVS, 16,507 adult men and women in the US, aged 18 and older, were randomly selected by a telephone dialing system in 2010 and interviewed about sexual violence, stalking and intimate partner violence.

Incidence of rape was reported by 18 percent of women, with 51 percent of those women being raped by an intimate partner and 41 percent by a known acquaintance. A total of 42 percent of women said they were raped before turning 18 years of age.

Incidence of rape was reported by 1 percent of men, with 52 percent of those men being raped by a known acquaintance and 15 percent by a stranger. A total of 28 percent of men said they were raped before turning 11 years of age.

Sexual coercion, or being pressured to have unwanted sex in a nonphysical way, was reported by 13 percent of women and 6 percent of men.

A total of 16 percent of women and 5 percent of men reported having been the target of a stalker who made them fearful of harm.

A total of 24 percent of women and 14 percent of men reported they had experienced severe physical violence by an intimate partner.

Based on sexual orientation, intimate partner violence, sexual violence and stalking was reported by:

• 61 percent of bisexual women
• 44 percent of lesbian women
• 35 percent of heterosexual women
• 37 percent of bisexual men
• 26 percent of gay men
• 29 percent of heterosexual men

Overall, the CDC estimates 24 people per minute, which totals 12 million people per year, experience physical violence, stalking or sexual violence by an intimate partner.

Major public health concerns associated with intimate partner and sexual violence included, but were not limited to: physical injury, headaches, trouble sleeping, depression, anxiety, suicide attempts, post-traumatic stress disorder (PTSD), stomach trouble, substance abuse, sexually transmitted infections and gynecological and pregnancy complications.

“We know that violence affects everyone, regardless of sexual orientation. This report suggests that lesbians, gay men and bisexuals in this country suffer a heavy toll of sexual violence and stalking committed by an intimate partner. While intervening and providing services are important, prevention is equally critical,” said CDC Director Dr. Tom Frieden.

The CDC recommended prevention efforts start early and promote healthy, respectful and emotionally supportive relationships in family environments.

Early childhood interactions based on trust and respect would promote effective and non-violent communication in later romantic relationships.

In addition, the CDC recommended increased training for healthcare professionals to help people physically and psychologically recover from sexual violence.

This report was released in January on the Centers for Disease Control and Prevention website.

Conditions: 

Violence Prevention Mental Health

Author Info

Reviewed by: 

Robert Carlson, M.D

By:Sarah Wickline