Last Updated: 2008-06-13 9:43:00 -0400 (Reuters Health)

NEW YORK (Reuters Health) – Patients with profound hearing loss experience substantial improvements in quality of life after placement of a second cochlear implant, results of a prospective study indicate. Bilateral implants are also cost-effective, the study authors report.

Dr. Richard T. Miyamoto and Dr. Bradford G. Bichey identified 23 postlingually deafened patients with bilateral cochlear implants treated at the Indiana University Medical Center in Indianapolis. Median age at first implantation was 20 years (range 5 to 76 years), and median length of time to the second implantation was 6.3 years (range 0.9 to 13.6 years).

Patients were contacted within 3.2 years of the second surgery and asked to complete a health utility index survey, which measures change in eight domains of quality of life. A score of 1.0 represents "perfect health-related quality of life." Patients rated each domain for the time period just before receiving the first implant, just before receiving the second implant, and at the current time.

Each patient had a clinically significant improvement in quality of life after each procedure, Drs. Miyamoto and Bichey report in the May issue of Otolaryngology–Head and Neck Surgery. The health utility scores averaged 0.33, 0.69, and 0.81 at each succeeding time period (p = 0.0001).

Eleven patients specifically noted greater ability to hear in noisy environments after the second procedure. Improvements were also noted in the domains of speech production, emotional well-being, cognition, and pain.

"The cost-utility of bilateral cochlear implantation in this cohort of patients realistically lies somewhere in the range of $23,000 to $24,000 per quality-adjusted life year," the authors note. "Thus, the data from this study lend support to earlier studies that support cochlear implantation as a compelling candidate for the allocation of limited health care resources."

Otolaryngol Head Neck Surg 2008;138:655-661.

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