Patil, Reena Dhanda

Objective: To evaluate for equivalence in postoperative changes of speech recognition scores in a veteran patient population undergoing cochlear implantation (CI) compared to matched nonveteran patients. Study Design: Retrospective chart review. Setting: Tertiary referral center. Patients: A total of 83 veteran patients who underwent CI at a single Veterans Affairs Medical Center (VA cohort) were matched to 83 nonveteran patients from the Health Insurance Portability and Accountability Act-secure, Encrypted, Research, Management and Evaluation Solution database (HERMES cohort) based on age, sex, and baseline Consonant–Nucleus–Consonant (CNC) scores. Intervention: Patients underwent CI. Main Outcome Measures: Comparison of postoperative CNC and Arizona Biomedical Institute recognition scores. Results: The mean difference and lower confidence interval of CNC scores between matched Veterans Affairs and HERMES cohorts were within a −ΔNI boundary of −15% at the 3-month (mean = 6.15, lower confidence interval = −2.38), 6-month (mean = 7.36, lower confidence interval = −2.21), and 12-month (mean = 4.03, lower confidence interval = −4.88) postoperative time points. The mean difference and lower confidence interval of Arizona Biomedical Institute scores between cohorts were within the −ΔNI boundary of −30% at 3 months (mean = 1, lower confidence interval = −8.71), 6 months (mean = 0.31, lower confidence interval = −12.30), and 12 months (mean = 0.72, lower confidence interval = −10.48). Conclusion: Our veteran population demonstrated improvements in speech recognition scores after CI comparable to a matched nonveteran population. Although veterans face unique factors that affect their hearing, access to medical care, and baseline general health, these findings affirm appropriate veteran candidates should be offered CI.