Faculty Bibliography

OBJECTIVE:To develop a comprehensive cochlear implant questionnaire (CCIQ) as a tool for assessing changes in quality of life (QoL) after receiving a second cochlear implant (CI2) and to correlate the QoL with speech perception changes after CI2. STUDY DESIGN/METHODS:Retrospective case series with planned data collection. SETTING/METHODS:Academic cochlear implant center. PATIENTS/METHODS:Ninety-eight English-speaking adults who received CI2 between 2000 and 2011. INTERVENTION/METHODS:CCIQ is a 28-item, 5-point Likert-scale questionnaire that assesses the physical and psychosocial benefits of CI2. MAIN OUTCOME MEASURES/METHODS:Test-retest reliability and Cronbach's alpha internal consistency were used to assess the reliability of the CCIQ. Speech perception was tested using CNC and HINT. RESULTS:Fifty-four patients completed the CCIQ, and 26 were retested. Respondents reported a subjective improvement in all domains. Test-retest reliability was satisfactory, with 64% of items achieving an intraclass correlation coefficient of greater than 0.6. Internal consistency reliability was excellent for the overall measure and was satisfactory for 6 of 9 subdomains. Speech perception data were available for 22 patients. Average CNC scores improved 13 ± 16%, and HINT scores improved 42 ± 16%. No statistically significant correlation was found between QoL scores and audiometric data or duration of CI2 use. CONCLUSION/CONCLUSIONS:Our preliminary data indicate that this CCIQ is a promising tool in assessing QoL specific to CI2 patients. Overall, patients reported improved QoL, independent of speech perception scores. Further refinements of the questionnaire with larger patient numbers are needed to strengthen the CCIQ.

This case study presents a report of inflammatory pseudotumor of the inner ear in a child, discusses radiographic findings and clinical management, and reviews the current literature on this rare disease. A 2.5-year-old presented with otalgia, transient vertigo, and fluctuating facial palsy partially responsive to myringotomy with tube. Work-up for infectious and neoplastic processes was negative. Computed tomography (CT) of the temporal bone showed a very unusual, expansile, erosive appearance to the otic capsule, and magnetic resonance imaging of the temporal bone revealed soft tissue enhancement of the middle ear, mastoid, and inner ear. The patient's symptoms were transiently responsive to tympanomastoidectomy. Inner ear histopathology after labyrinthectomy revealed changes consistent with pseudotumor. Inflammatory pseudotumor of the inner ear is extremely rare but needs to be considered in cases of refractory otitis media with facial palsy, particularly when certain changes appear on CT of the temporal bone.