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Updated: Nov 11, 2025

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Comparison of test methods to assess the implanted ear alone for pediatric cochlear implant recipients with
Lisa R Park1, Elizabeth Preston1, Amy S Noxon2
1Department of Otolaryngology / Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Objectives:
The purpose of this investigation was to compare three test methods for isolating the test ear for children with single-sided deafness (SSD) who use a cochlear implant (CI).
Methods:
Word recognition was assessed for five CI recipients with SSD and six bilateral CI recipients with no acoustic hearing. For the SSD subjects, performance was compared: 1) in the sound field with masking in the normal-hearing ear, 2) in the sound field with an earplug and earmuff ("plug-and-muff"), and 3) via direct connect (DC). For the bilateral CI subjects, performance was compared: 1) in the sound field and 2) via DC.
Results:
For the bilateral CI subjects, word recognition was similar when assessed in the sound field versus via DC. For the SSD subjects, performance was similar when assessed with the plug-and-muff and DC methods but was significantly poorer with masking presented to the normal-hearing ear.
Discussion:
Masking the normal-hearing ear to isolate the CI for word recognition is problematic in this population. The plug-and-muff and DC test methods may provide a more accurate assessment.
Conclusion:
DC or plug-and-muff methods are recommended to isolate the CI-ear for word recognition testing in children with SSD. Patient specific variables should be considered.
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