Mentoring in Patient-Oriented Research to Optimize Cochlear Implant Outcomes

About This Grant

PROJECT SUMMARY Cochlear implants (CIs) are the standard of care for adults with severe-to-profound sensorineural hearing loss. Unfortunately, a sizeable portion of adults receiving CIs experience relatively poor CI benefit: up to 50% of CI users are unable to use the telephone without captions, and 13% of patients are unable to repeat 10% of the words presented auditorily. I have spent the last 12 years of my career working to identify “top-down” cognitive- linguistic abilities that explain and predict CI outcomes, in addition to “bottom-up” auditory abilities. Extensive evidence suggests that a poor speech recognition outcome may be attributable to deficits in bottom-up processing, top-down processing, or both. However, prior work has not yet led to interventions to improve CI outcomes, especially for poor performers, which the proposed project aims to address. I am also devoted to mentoring the next generation of surgeon-scientists in the field of Otology/Neurotology and specifically patient- oriented research. The number of physicians pursuing patient-oriented research is declining. Maintaining a strong pipeline of surgeon-scientist trainees devoted to patient-oriented research is crucial for continued development of our specialty and scientific advancement. The proposed project will be a clinical trial feasibility study to characterize the top-down and bottom-up profiles of a group of adult CI recipients who demonstrate relatively poor speech recognition outcomes, and to determine the feasibility of two different interventions for these individuals including an “auditory” intervention approach and a “cognitive” intervention approach. Results of this project will advance our basic knowledge of factors contributing to poor outcomes in adult CI users and will form the foundation for a larger randomized controlled trial of auditory and cognitive interventions to optimize outcomes for poor-performing adult CI users, while providing opportunities for surgeon-scientist mentees to develop their skills in patient-oriented research.