Intelligibility of the Patient's Speech Predicts the Likelihood of Cochlear Implant Success in Prelingually Deaf Adults.

Objectives: The objective of this study was to determine the validity and clinical applicability of intelligibility of the patient's own speech, measured via a Vowel Identification Test (VOW), as a predictor of speech perception for prelingually deafened adults after 1 year of cochlear implant use. Specifically, the objective was to investigate the probability that a prelingually deaf patient, given a VOW score above (or below) a chosen cutoff point, reaches a postimplant speech perception score above (or below) a critical value. High predictive values for VOW could support preimplant counseling and implant candidacy decisions in individual patients. Design: One hundred and fifty-two adult cochlear implant candidates with prelingual hearing impairment or deafness took part as speakers in a VOW; 149 speakers completed the test successfully. Recordings of the speech stimuli, consisting of nonsense words of the form [h]-V-[t], where V represents one of 15 vowels/diphthongs ([[Latin small letter alpha], a:, [Latin Small Letter Open E], e:, [Latin letter small capital I], i[middle dot], [Latin small letter open o], o:, Y, y:, u[middle dot], o:, [Latin Small Letter Open E]i, oey, [Latin small letter alpha]u]), were presented to two normal-hearing listeners. VOW score was expressed as the percentage of vowels identified correctly (averaged over the 2 -listeners). Subsequently, the 149 participants enrolled in the cochlear implant selection procedure. Extremely poor speakers were excluded from implantation, as well as patients who did not meet regular selection criteria as developed for postlingually deafened patients. From the 149 -participants, 92 were selected for implantation. For the implanted group, speech perception data were collected at 1-year postimplantation. Results: Speech perception score at 1-year postimplantation (available for 77 of the 92 implanted participants) correlated positively with preimplant intelligibility of the patient's speech, as represented by VOW (r = 0.79, p = 60% achieves "above-chance" speech perception after implantation is 0.91. Conversely, the probability that a patient with VOW

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