Limitations
This was an observational study and enrolment bias may be present in the
sample. Investigators were instructed to offer participation to all
consecutively implanted adult and adolescent Nucleus® implant
recipients. However, recipients who were more motivated which may
influence outcomes may have been more likely to agree to participate. As
self-assessment was required, those with severe comorbidities and those
who are unable to read were less likely to be included. Baseline
evaluations were made between the day of the surgery and the first
fitting, which may result in a recall bias.