Further Evidence for Individual Ear Consideration in Cochlear Implant Candidacy Evaluation.
Otol Neurotol
; 43(9): 1033-1040, 2022 10 01.
Article
em En
| MEDLINE
| ID: mdl-36075098
ABSTRACT
OBJECTIVE:
To report speech outcomes after cochlear implantation (CI) for asymmetric hearing loss (AHL) and assess the influence of contralateral hearing. STUDYDESIGN:
Retrospective review.SETTING:
Tertiary referral center. PATIENTS One hundred eighty-eight adults (mean age, 70 yr) undergoing CI for AHL from 2015 to 2020. Candidacy included pure-tone average (PTA) at least 70 dB hearing level and AzBio in quiet 60% or less in the implanted ear and AzBio in quiet greater than 40% in the contralateral ear. MAIN OUTCOMEMEASURES:
PTA; Consonant-Nucleus-Consonant (CNC) word, AzBio sentences scores; Speech, Spatial, and Qualities of Hearing Scale (SSQ).RESULTS:
Mean preoperative PTA and AzBio in the implanted and contralateral ears were 85.2 and 68.1 dB hearing level and 24.7% and 69.2%, respectively. Mean CNC in the implanted ear increased from 18.3% preoperatively to 44.4% ( p < 0.0001) at 6 months and 49.3% ( p < 0.0001) at 12 months. Mean AzBio in the implanted ear improved from 24.7% preoperatively to 60.3% ( p < 0.0001) at 6 months and 64.3% ( p < 0.0001) at 12 months. Patients demonstrated significant improvement in all SSQ domains at 6 and 12 months. When comparing patients with preoperative contralateral AzBio greater than 60% versus 41% to 60%, no significant differences existed in postoperative CNC scores (6-mo 47% versus 41%, p = 0.276; 12-mo 51% versus 47%, p = 0.543). There were no significant differences in 6-month ( p = 0.936) or 12-month ( p = 0.792) CNC scores between patients with AHL (contralateral ear AzBio >40%) and 169 unilateral CI patients meeting the traditional Medicare criteria (contralateral ear AzBio ≤40%).CONCLUSION:
CI recipients with AHL derive significant speech improvements, supporting individual ear consideration for CI candidacy and patient benefit outside of current Medicare criteria.
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Base de dados:
MEDLINE
Assunto principal:
Percepção da Fala
/
Implantes Cocleares
/
Implante Coclear
/
Perda Auditiva
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article