Factors influencing the outcome of cochlear implantation: what role is played by secondary and post-secondary education?

Abstract

Background: Individual cognitive abilities are increasingly discussed as a potential factor influencing the outcomes of cochlear implant (CI) treatment. In this context, the present study investigated a possible correlation between the secondary and post-secondary education of a large cohort of CI recipients and their speech comprehension. Other variables with a potential influence on the treatment outcome included age at implantation, the duration of hearing loss, and the treatment mode.

Methods: The study included data of n = 326 patients from the audiology database of the Frankfurt University ENT Clinic. Secondary and post-secondary education histories were collected as part of the anamnesis using a questionnaire. Speech comprehension was assessed using the Freiburg monosyllabic test (FBE) and the Oldenburg sentence test in noise (OLSA) at 6 and 12 months after implantation and correlated with various biographical and audiological factors.

Results: Patients with higher educational qualifications showed better outcomes in the FBE at 6 months (ANOVA_Welch; F (2, 104) = 5.60; p = 0.05) and at 12 months (F (2, 223) = 3.07; p = 0.05; η² = 0.03) compared to those with vocational qualifications. In the speech comprehension in noise (OLSA), a significant group difference was observed 12 months postoperatively. Patients without qualifications or with other qualifications scored lower than those with vocational or higher qualifications (F (2, 74) = 4.41; p = 0.02; η² = 0.11). Other significant factors influencing speech comprehension included the age at implantation and mode of care.

Conclusion: The correlation between secondary and post-secondary education and speech comprehension after CI treatment was not unequivocal. Only the choice of post-secondary education showed a significant correlation with speech comprehension. Further research is required to confirm a potential relationship.