{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T07:13:07Z","timestamp":1793517187572,"version":"4.5.0"},"reference-count":33,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MED-EL"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This study aimed to report quality of life (QoL) scores in unilateral cochlear implant (CI) users and to generate guidance for clinicians on using QoL measures to individualize CI counselling and rehabilitation and to increase access to CIs as a mode of rehabilitation. Participants (n = 101) were unilateral CI users with single-sided deafness (SSD; n = 17), asymmetrical hearing loss (AHL; n = 26), or bilateral hearing loss (Uni; n = 58). Generic QoL was assessed via the Health Utilities Index (HUI-3), and disease-specific QoL was assessed via the Speech, Spatial, and Qualities of Hearing scale (SSQ12) and Nijmegen CI Questionnaire (NCIQ) at preimplantation and at 6 and 12 months of CI use. All groups had significantly increased HUI-3 scores at both intervals. The SSD group showed significant benefit on the SSQ12 at visit 3, the AHL group showed significant benefit on the SSQ12 and most NCIQ subdomains at both intervals, and the Uni group showed significant benefit with both tests at both intervals. Unilateral CI recipients demonstrate improved QoL within the first 12 months of device use. Regular assessment with generic and disease-specific questionnaires has the potential to play an important role in personalizing treatment and possibly in increasing access to CI provision.<\/jats:p>","DOI":"10.3390\/ijerph20206906","type":"journal-article","created":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T06:14:04Z","timestamp":1696918444000},"page":"6906","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["QoL, CIs, QALYs, and Individualized Rehabilitation: The Clinical and Practical Benefits of Regularly Assessing the Quality of Life of Adult Cochlear Implant Recipients"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8260-4523","authenticated-orcid":false,"given":"Luis","family":"Lassaletta","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Hospital La Paz. IdiPAZ Research Institute, 28046 Madrid, Spain"},{"name":"Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, (CIBERER-U761), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3301-2185","authenticated-orcid":false,"given":"Miryam","family":"Calvino","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Hospital La Paz. IdiPAZ Research Institute, 28046 Madrid, Spain"},{"name":"Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, (CIBERER-U761), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6687-4913","authenticated-orcid":false,"given":"Isabel","family":"Sanchez-Cuadrado","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Hospital La Paz. IdiPAZ Research Institute, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4978-1915","authenticated-orcid":false,"given":"Piotr Henryk","family":"Skarzynski","sequence":"additional","affiliation":[{"name":"Institute of Physiology and Pathology of Hearing, World Hearing Center, 05-830 Kajetany, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1224-1074","authenticated-orcid":false,"given":"Katarzyna B.","family":"Cywka","sequence":"additional","affiliation":[{"name":"Institute of Physiology and Pathology of Hearing, World Hearing Center, 05-830 Kajetany, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1203-6679","authenticated-orcid":false,"given":"Natalia","family":"Czajka","sequence":"additional","affiliation":[{"name":"Institute of Physiology and Pathology of Hearing, World Hearing Center, 05-830 Kajetany, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7828-3712","authenticated-orcid":false,"given":"Justyna","family":"Kutyba","sequence":"additional","affiliation":[{"name":"Institute of Physiology and Pathology of Hearing, World Hearing Center, 05-830 Kajetany, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6249-7268","authenticated-orcid":false,"given":"Dayse","family":"Tavora-Vieira","sequence":"additional","affiliation":[{"name":"Fiona Stanley Fremantle Hospitals Group, Perth 6150, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8424-3717","authenticated-orcid":false,"given":"Paul","family":"Van de Heyning","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Antwerp University Hospital, 2650 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8621-0292","authenticated-orcid":false,"given":"Griet","family":"Mertens","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Antwerp University Hospital, 2650 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0348-3015","authenticated-orcid":false,"given":"Hinrich","family":"Staecker","sequence":"additional","affiliation":[{"name":"ENT Department, University of Kansas Medical Centre, Kansas City, KS 66160, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Humphrey","sequence":"additional","affiliation":[{"name":"ENT Department, University of Kansas Medical Centre, Kansas City, KS 66160, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4288-2809","authenticated-orcid":false,"given":"Mario","family":"Zernotti","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Sanatorio Allende de C\u00f3rdoba, C\u00f3rdoba 5000, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3616-0324","authenticated-orcid":false,"given":"Maximo","family":"Zernotti","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Sanatorio Allende de C\u00f3rdoba, C\u00f3rdoba 5000, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Magele","sequence":"additional","affiliation":[{"name":"ENT Department, Universit\u00e4tsklinikum St. P\u00f6lten, 3100 St. P\u00f6lten, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Ploder","sequence":"additional","affiliation":[{"name":"ENT Department, Universit\u00e4tsklinikum St. P\u00f6lten, 3100 St. P\u00f6lten, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Speranza","family":"Zabeu","sequence":"additional","affiliation":[{"name":"Hospital de Reabilitac\u00e3o de Anomalias Craniofaciais da Universidade de Sao Paulo, Campus Bauru, Bauru 17012-230, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2110","DOI":"10.1002\/lary.25848","article-title":"Quality of life after intervention with a cochlear implant or hearing aid","volume":"126","author":"Contrera","year":"2016","journal-title":"Laryngoscope"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/MOO.0000000000000838","article-title":"Cochlear implantation for paediatric and adult cases of unilateral and asymmetric hearing loss","volume":"30","author":"Thompson","year":"2022","journal-title":"Curr. Opin. Otolaryngol. Head Neck Surg."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Lassaletta, L., Calvino, M., Sanchez-Cuadrado, I., Skarzynski, P.H., Cywka, K.B., Czajka, N., Kutyba, J., Tavora-Vieira, D., van de Heyning, P., and Mertens, G. (2022). Using Generic and Disease-Specific Measures to Assess Quality of Life before and after 12 Months of Hearing Implant Use: A Prospective, Longitudinal, Multicenter, Observational Clinical Study. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19052503"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e155","DOI":"10.1097\/MAO.0000000000003809","article-title":"5-Year Observation Period of Quality of Life After Cochlear Implantation","volume":"44","author":"Weichbold","year":"2023","journal-title":"Otol. Neurotol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/1477-7525-1-54","article-title":"The Health Utilities Index (HUI): Concepts, measurement properties and applications","volume":"1","author":"Horsman","year":"2003","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s40271-013-0036-x","article-title":"Validity and reliability of the Assessment of Quality of Life (AQoL)-8D multi-attribute utility instrument","volume":"7","author":"Richardson","year":"2014","journal-title":"Patient"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1097\/AUD.0000000000001287","article-title":"Health State Utility Values Associated with Cochlear Implants in Adults: A Systematic Review and Network Meta-Analysis","volume":"44","author":"Dixon","year":"2023","journal-title":"Ear Hear."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1097\/AUD.0000000000001022","article-title":"Validity and reliability of the Cochlear Implant Quality of Life (CIQOL)-35 Profile and CIQOL-10 Global instruments in comparison to legacy instruments","volume":"42","author":"McRackan","year":"2021","journal-title":"Ear Hear."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1159\/000508433","article-title":"Systematic Review of Quality of Life Assessments after Cochlear Implantation in Older Adults","volume":"26","author":"Andries","year":"2021","journal-title":"Audiol. Neurootol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"409","DOI":"10.3109\/14992027.2013.781278","article-title":"A short form of the Speech, Spatial and Qualities of Hearing scale suitable for clinical use: The SSQ12","volume":"52","author":"Noble","year":"2013","journal-title":"Int. J. Audiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1067\/mhn.2000.108203","article-title":"Development and application of a health-related quality-of-life instrument for adults with cochlear implants: The Nijmegen cochlear implant questionnaire","volume":"123","author":"Hinderink","year":"2000","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1097\/00003446-199504000-00005","article-title":"The abbreviated profile of hearing aid benefit","volume":"16","author":"Cox","year":"1995","journal-title":"Ear Hear."},{"key":"ref_13","first-page":"103","article-title":"Factors influencing the decision for Baha in unilateral deafness: The Bern benefit in single-sided deafness questionnaire","volume":"71","author":"Kompis","year":"2011","journal-title":"Adv. Otorhinolaryngol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1097\/AUD.0000000000001101","article-title":"Development and Critical Evaluation of a Condition-Specific Preference-Based Measure Sensitive to Binaural Hearing in Adults: The York Binaural Hearing-Related Quality-of-Life System","volume":"43","author":"Summerfield","year":"2022","journal-title":"Ear Hear."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"(2017). Corrigendum. Otolaryngol. Head Neck Surg., 156, 391.","DOI":"10.1177\/0194599816679126"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Peters, J.P.M., van Heteren, J.A.A., Wendrich, A.W., van Zanten, G.A., Grolman, W., Stokroos, R.J., and Smit, A.L. (2021). Short-term outcomes of cochlear implantation for single-sided deafness compared to bone conduction devices and contralateral routing of sound hearing aids-Results of a Randomised controlled trial (CINGLE-trial). PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0257447"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1007\/s11606-022-07795-9","article-title":"The Impact of Hearing Loss and Its Treatment on Health-Related Quality of Life Utility: A Systematic Review with Meta-analysis","volume":"38","author":"Borre","year":"2023","journal-title":"J. Gen. Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1097\/AUD.0000000000001260","article-title":"American Cochlear Implant Alliance Task Force Guidelines for Clinical Assessment and Management of Adult Cochlear Implantation for Single-Sided Deafness","volume":"43","author":"Dillon","year":"2022","journal-title":"Ear Hear."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1002\/lary.25525","article-title":"Does quality of life depend on speech recognition performance for adult cochlear implant users?","volume":"126","author":"Capretta","year":"2016","journal-title":"Laryngoscope"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1001\/jamaoto.2019.0055","article-title":"Association of Demographic and Hearing-Related Factors with Cochlear Implant-Related Quality of Life","volume":"145","author":"McRackan","year":"2019","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1097\/AUD.0000000000000671","article-title":"Benefits of Cochlear Implantation for Single-Sided Deafness: Data from the House Clinic-University of Southern California-University of California, Los Angeles Clinical Trial","volume":"40","author":"Galvin","year":"2019","journal-title":"Ear Hear."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e795","DOI":"10.1097\/MAO.0000000000002682","article-title":"Explaining Speech Recognition and Quality of Life Outcomes in Adult Cochlear Implant Users: Complementary Contributions of Demographic, Sensory, and Cognitive Factors","volume":"41","author":"Skidmore","year":"2020","journal-title":"Otol. Neurotol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1001\/jamaoto.2022.2292","article-title":"Understanding Patient Expectations Before Implantation Using the Cochlear Implant Quality of Life-Expectations Instrument","volume":"148","author":"McRackan","year":"2022","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1080\/14670100.2021.2019522","article-title":"CI decision making and expectations by older adults","volume":"23","author":"Illg","year":"2022","journal-title":"Cochlear Implant. Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1001\/jamaoto.2019.3760","article-title":"Audiology Practices in the Preoperative Evaluation and Management of Adult Cochlear Implant Candidates","volume":"146","author":"Prentiss","year":"2020","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1002\/lio2.20","article-title":"Postoperative Rehabilitation Strategies Used by Adults with Cochlear Implants: A Pilot Study","volume":"1","author":"Harris","year":"2016","journal-title":"Laryngoscope Investig. Otolaryngol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1002\/lary.30270","article-title":"Impact of Expanding Eligibility Criteria for Cochlear Implantation Dynamic Modeling Study","volume":"133","author":"Nijmeijer","year":"2023","journal-title":"Laryngoscope"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1097\/MAO.0000000000003040","article-title":"Cost-Utility Analysis of Bilateral Cochlear Implantation in Adults with Severe to Profound Sensorineural Hearing Loss in Poland","volume":"42","author":"Skarzynski","year":"2021","journal-title":"Otol. Neurotol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1007\/s10198-021-01393-y","article-title":"The cost-effectiveness of unilateral cochlear implants in UK adults","volume":"23","author":"Cutler","year":"2022","journal-title":"Eur. J. Health Econ."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2362","DOI":"10.1002\/lary.30452","article-title":"Cochlear Implants for Single-Sided Deafness: Quality of Life, Daily Usage, and Duration of Deafness","volume":"133","author":"Lindquist","year":"2023","journal-title":"Laryngoscope"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e571","DOI":"10.1097\/MAO.0000000000003524","article-title":"Evaluating the Revised Work Rehabilitation Questionnaire in Cochlear Implant Users Cochlear Implant Outcome Assessment Based on the International Classification of Functioning, Disability, and Health (ICF)","volume":"43","author":"Andries","year":"2022","journal-title":"Otol. Neurotol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1044\/0161-1461(2012\/12-0005)","article-title":"Predictors of hearing aid use time in children with mild-to-severe hearing loss","volume":"44","author":"Walker","year":"2013","journal-title":"Lang. Speech Hear. Serv. Sch."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"38s","DOI":"10.1097\/AUD.0000000000000208","article-title":"Trends and Predictors of Longitudinal Hearing Aid Use for Children Who Are Hard of Hearing","volume":"36","author":"Walker","year":"2015","journal-title":"Ear Hear."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/20\/6906\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:04:09Z","timestamp":1760130249000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/20\/6906"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,10]]},"references-count":33,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["ijerph20206906"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20206906","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,10]]}}}