Considerations for a Revised Adult Cochlear Implant Candidacy Evaluation Protocol

Area of Science:

• Audiology
• Otorhinolaryngology
• Biomedical Engineering

Background:

• Current adult cochlear implant candidacy evaluations use varied metrics.
• A need exists to standardize and update assessment protocols for better patient selection.

Purpose of the Study:

• To compare the consistency and applicability of current adult cochlear implant candidacy evaluation metrics.
• To recommend an updated assessment battery for cochlear implant candidacy.

Main Methods:

• A prospective, multicenter, within-subject clinical trial involving 100 adult hearing aid users.
• Speech perception was assessed using Consonant-Nucleus-Consonant (CNC) words in quiet and AzBio sentences in noise.
• Patient-reported hearing disability was measured using the Speech, Spatial, and Qualities of Hearing Scale (SSQ) preoperatively and postoperatively.

Main Results:

• Significant improvements were observed in speech perception and SSQ subscales after cochlear implantation.
• Potential floor effects were noted in preoperative objective background noise testing.
• A wide range of postoperative outcomes indicated individual variability.

Conclusions:

• Consonant-Nucleus-Consonant (CNC) word testing is a reliable tool for assessing hearing ability changes post-cochlear implantation.
• Adjusting screening protocols to prioritize CNC words over sentences in noise for candidacy appears justified.
• Supplementing CNC testing with the SSQ provides a comprehensive assessment for cochlear implant candidacy.