Expanding unilateral cochlear implantation criteria for adults with bilateral acquired severe sensorineural hearing loss

Eur Arch Otorhinolaryngol. 2019 May;276(5):1313-1320. doi: 10.1007/s00405-019-05358-z. Epub 2019 Feb 27.

Abstract

Objectives: To report on a retrospective cohort study on the effects of expanding inclusion criteria for application of cochlear implants (CIs) on the performance 1-year post-implantation.

Methods: Based on pre-implantation audiometric thresholds and aided speech recognition scores, the data of 164 CI recipients were divided into a group of patients that fulfilled conservative criteria (mean hearing loss at 0.5, 1 and 2 kHz > 85 dB HL and phoneme scores with hearing aids < 30%), and the remaining group of patients that felt outside this conservative criterion. Speech recognition scores (in quiet) and quality of life (using the NCIQ) of both groups, measured at 1-year post-implantation, were compared.

Results: The group that felt outside the conservative criterion showed a higher phoneme score at 1-year post-implantation compared to the conservative group, suggesting that relaxed criteria have a positive influence on the speech recognition results with CI. With respect to quality of life, both groups significantly improved 1-year post-implantation. The conservative group showed a higher benefit on the advanced perception domain of the NCIQ. Based on their worse pre-implantation hearing, this was expected.

Conclusions: The data suggest that relaxation of CI indication positively affects the speech recognition performance of patients with severe hearing loss. Both groups of patients showed a positive effect of CI on the quality of life. This benefit relates to communication skills and the subjective day-to-day functioning in society.

Keywords: CI indication criteria; Cochlear implantation; Hearing loss; Performance; Quality of life; Speech recognition.

MeSH terms

  • Aged
  • Audiometry
  • Auditory Threshold
  • Cochlear Implantation / standards*
  • Cochlear Implants*
  • Female
  • Hearing Aids
  • Hearing Loss, Bilateral / surgery*
  • Hearing Loss, Sensorineural / surgery*
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Retrospective Studies
  • Speech Perception