The Role of Hearing Aids and Cochlear Implants in Post-Viral Hearing Loss: A Speech Perception Analysis

Abstract

Objective: To compare short- and long-term speech perception outcomes with hearing aids (HAs) versus cochlear implants (CIs) in adults with postviral sensorineural hearing loss (SNHL).

Methods: Sixty participants (18–55 years) with confirmed post-viral SNHL were allocated by severity to HA (moderate–to–severe; n=30) or CI (severe to profound; n=30) groups. Speech perception was evaluated at baseline (unaided) and at 1- and 6-months post-intervention using CNC word recognition (quiet) and Quick Speech-in-Noise (QuickSIN). Analyses used baseline-adjusted linear mixed models and ANCOVA for between-group contrasts; multiplicity was controlled with Holm Bonferroni adjustments.

Results: At 1 month, HA users improved +30 percentage points (pp) on CNC and +25 pp on speech-in-noise; CI users improved +45 pp and +40 pp, respectively (all p<.001). At 6 months, HA users reached 90% (CNC) and 70% (noise); CI users reached 80% (CNC) and 70% (noise). Models confirmed significant Time and Group×Time effects for CNC and Time effects for noise (all p<.05). Between-group contrasts (baseline-adjusted) at 6 months showed a 10-pp adva tage for HA in quiet (p=.03) and no difference in noise (p=.99).

Conclusion: Both HAs and CIs significantly enhance speech perception in post-viral SNHL, with CIs offering superior long-term benefits. Early intervention and tailored rehabilitation strategies are crucial for optimizing outcomes. Future research should explore neuroplasticity and speech perception recovery to refine device programming. Reporting Quick SIN SNR-Loss (dB) as a primary metric is recommended