Acta Scientific Otolaryngology (ASOL) (ISSN: 2582-5550)

Research Article Volume 3 Issue 7

The Use of COSI Questionnaire to Evaluate the Effect of Input Dynamic Range Variables on Cochlear Implant Performance in Postlingual CI Adults

Tarek Abd El-Aziz Ghannoum, Mona Hassan Selim, Amira Maged El-Shennawy and Zahraa Mohamed Yousry Elbohy*

Audio-Vestibular Medicine Unit, Otorhinolaryngology Department, Cairo University, Egypt

*Corresponding Author: Zahraa Mohamed Yousry Elbohy, Lecturer of Audio-vestibular Medicine, Cairo University, Kasr Al-Ainy Hospital, Cairo, Egypt.

Received: May 26, 2021; Published: June 10, 2021


Background: If our goal is to obtain optimal patient performance in everyday life; clinical fitting should improve the cochlear implant (CI) users’ ability to understand soft speech as well as speech in noise. It is of great value to change the input dynamic range (IDR) characteristics for CI performance optimization in daily life. Aim of work is to use the Client Oriented Scale Improvement (COSI) questionnaire for evaluation of the effect of different IDR characteristics on CI performance.

Methods: The study group comprised of fourteen postlingual CI adults who were implanted and used their devices for at least 6 months were studied. Programs were adjusted for four input sensitivity settings differing in threshold (T) and comfortable (C) levels, microphone sensitivity (MS) and volume sensitivity. Subjects were assessed subjectively by using COSI questionnaire 2 weeks after each program setting.

Results: The commonest specific needs in the patient population were firstly to hear conversation with group in noise. Both 3rd and 4th programs revealed the highest percentage of hearing final ability at both 2nd and 3rd important listening situations. This means that patients preferred the programs with the maximum microphone sensitivity, and C level set below MCL.

Conclusion: COSI questionnaire highlights the specific needs of the CI user referring to the advantages of the CI in those situations. High microphone sensitivity settings might make low-level sounds more audible. C level might need to be reduced to an acceptable level. Based on our results, high microphone sensitivity and setting of C level below MCL should be taken into consideration.

Keywords: Cochlear Implant; Input Dynamic Range; COSI; Sound


  1. Soken H., et al. “Cochlear implant surgery”. In C. Umat (ed.). (2012).
  2. James Chris J., et al. “An investigation of input level range for the nucleus 24 cochlear implant system: speech perception performance, program preference, and loudness comfort ratings”. Ear and Hearing 24.2 (2003): 157-174.
  3. Flexer CA. “The importance of hearing and the impact of hearing problems”. Facilitating Hearing and Listening in Young Children. 2nd San Diego: Singular Publishing Group (1999): 1-22.
  4. Davidson Lisa S., et al. “The effect of instantaneous input dynamic range setting on the speech perception of children with the nucleus 24 implant”. Ear and Hearing3 (2009): 340-349.
  5. Dillon H., et al. “Client Oriented Scale of Improvement (COSI) and its relationship to several other measures of benefit and satisfaction provided by hearing aids”. Journal of the American Academy of Audiology1 (1997): 27-43.
  6. Dillon H., et al. “Measuring the Outcomes of a National Rehabilitation Program: Normative Data for the Client Oriented Scale of Improvement (COSI) and the Hearing Aid User's Questionnaire (HAUQ)”. Journal of the American Academy of Audiology2 (1999): 67-79.
  7. Emerson LP and Job A. “Use of the client oriented scale of improvement (COSI) and international outcome inventory of hearing aids (IOI-HA) as a clinical outcome measure in a rural community”. Egyptian Journal of Ear, Nose, Throat and Allied Sciences 15 (2014): 225-230.
  8. Dillon H., et al. “Rehabilitation effectiveness II: assessing the needs of clients entering a national hearing rehabilitation program”. Australian Journal of Audiology2 (1991): 55-65.
  9. Holden Laura K., et al. “Optimizing the perception of soft speech and speech in noise with the Advanced Bionics cochlear implant system”. International Journal of Audiology4 (2011): 255-269.
  10. Donaldson Gail S., et al. “BKB-SIN and ANL predict perceived communication ability in cochlear implant users”. Ear and Hearing4 (2009): 401-410.


Citation: Zahraa Mohamed Yousry Elbohy., et al. “The Use of COSI Questionnaire to Evaluate the Effect of Input Dynamic Range Variables on Cochlear Implant Performance in Postlingual CI Adults".Acta Scientific Otolaryngology 3.7 (2021): 32-37.


Copyright: © 2021 Zahraa Mohamed Yousry Elbohy., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate34%
Acceptance to publication20-30 days
Impact Factor0.871

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is May 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US