PLoS By Category | Recent PLoS Articles

Biotechnology - Neuroscience - Otolaryngology - Physiology - Surgery

Pre-, Per- and Postoperative Factors Affecting Performance of Postlinguistically Deaf Adults Using Cochlear Implants: A New Conceptual Model over Time
Published: Friday, November 09, 2012
Author: Diane S. Lazard et al.

by Diane S. Lazard, Christophe Vincent, Frédéric Venail, Paul Van de Heyning, Eric Truy, Olivier Sterkers, Piotr H. Skarzynski, Henryk Skarzynski, Karen Schauwers, Stephen O'Leary, Deborah Mawman, Bert Maat, Andrea Kleine-Punte, Alexander M. Huber, Kevin Green, Paul J. Govaerts, Bernard Fraysse, Richard Dowell, Norbert Dillier, Elaine Burke, Andy Beynon, François Bergeron, Deniz Baskent, Françoise Artières, Peter J. Blamey


To test the influence of multiple factors on cochlear implant (CI) speech performance in quiet and in noise for postlinguistically deaf adults, and to design a model of predicted auditory performance with a CI as a function of the significant factors.

Study Design

Retrospective multi-centre study.


Data from 2251 patients implanted since 2003 in 15 international centres were collected. Speech scores in quiet and in noise were converted into percentile ranks to remove differences between centres. The influence of 15 pre-, per- and postoperative factors, such as the duration of moderate hearing loss (mHL), the surgical approach (cochleostomy or round window approach), the angle of insertion, the percentage of active electrodes, and the brand of device were tested. The usual factors, duration of profound HL (pHL), age, etiology, duration of CI experience, that are already known to have an influence, were included in the statistical analyses.


The significant factors were: the pure tone average threshold of the better ear, the brand of device, the percentage of active electrodes, the use of hearing aids (HAs) during the period of pHL, and the duration of mHL.


A new model was designed showing a decrease of performance that started during the period of mHL, and became faster during the period of pHL. The use of bilateral HAs slowed down the related central reorganization that is the likely cause of the decreased performance.