Speech Quality Perception in Unilateral Cochlear Implant Users With Single‐Sided Deafness

• Published in: Otolaryngology-head and neck surgery 2025-01, Vol.172 (1), p.224-232
• Main Authors: Kelly, Scott, Kuhlmey, Megan E., Despotidis, Meghan A., Alter, Isaac L., Hwa, Tiffany P., Chern, Alexander, Lalwani, Anil K.
• Format: Article
• Language: English
• Subjects: Adult; Aged; cochlear implant; Cochlear Implantation; Cochlear Implants; Cross-Sectional Studies; CSQI; Deafness - physiopathology; Deafness - rehabilitation; Deafness - surgery; Female; hearing loss; Hearing Loss, Unilateral - physiopathology; Hearing Loss, Unilateral - rehabilitation; Hearing Loss, Unilateral - surgery; Humans; Male; Middle Aged; single‐sided deafness; Speech Perception - physiology; speech quality perception
• ISSN: 0194-5998; 1097-6817; 1097-6817
• DOI: 10.1002/ohn.941

Objective Cochlear implant (CI) users frequently complain about speech quality perception (SQP). In patients undergoing cochlear implantation for single‐sided deafness, there is concern that poor SQP from the implanted ear will negatively impact binaural (CI + normal hearing [NH]) SQP. In this study, we investigate if binaural SQP is measurably different than unimplanted NH alone. Study Design Cross‐sectional study. Setting Tertiary care center. Methods Fifteen unilateral CI users with NH in the contralateral ear completed the validated Columbia Speech Quality Instrument. This instrument consists of 9 audio clips rated across 14 specific speech qualities using a 10‐point visual analog scale. SQP was assessed in 3 conditions: CI only, NH only, and CI + NH. Results Median speech quality scores were worse in the CI only condition compared to the NH only (50.0 vs 72.6, P = .0003) and binaural (50.0 vs 71.0, P = .007) conditions. Median speech quality scores were not significantly different between the NH only and binaural conditions (72.6 vs 71, P = .8). Compared to NH, CI speech quality sounded less clear, less natural, and more mechanical. Conclusion Compared to NH, SQP is poorer with a CI alone. However, in contrast to expectation, there is no significant difference between NH and binaural SQP. This suggests poorer CI speech perception does not negatively impact binaural SQP in patients undergoing cochlear implantation for single‐sided deafness.