Perceived sound quality and speech recognition are not interchangeable outcome measures in adult cochlear implant users

Introduction This study examined whether descriptor-based reports of perceived sound quality in adult cochlear implant users are associated with speech-recognition outcomes, preoperative maximum monosyllabic word recognition, and patient- or device-related factors. Methods In this retrospective single-center analysis, 249 adult cochlear implant users completed a 25-item descriptor-based sound-quality assessment covering retrospectively recalled early (T1) and current (T2) listening experience. Descriptor profiles and superordinate descriptor groups were linked to preoperative maximum monosyllabic word recognition and postoperative speech-recognition outcomes in quiet and noise using group comparisons, univariate logistic regression, and multiple linear regression of rank-transformed objective outcomes, with false-discovery-rate correction. Results Individual sound-quality descriptors were not robustly associated with concurrent or later speech-recognition performance. Preoperative maximum monosyllabic word recognition was not robustly associated with later descriptor profiles. Patient- and device-related factors showed selective associations with descriptor endorsement. Among nominally significant associations in adjusted models, descriptors and supergroups explained 1.5–3.2 percentage points of additional variance in speech-recognition outcomes and 1.8–3.3 percentage points in preoperative maximum monosyllabic word recognition beyond patient- and device-related factors. Conclusion Speech-recognition measures do not reliably capture perceived cochlear implant sound quality. Structured sound-quality assessment may add clinically relevant information beyond standard speech testing, particularly when subjective listening experience and conventional outcome measures do not align.