Related Experiment Video
Updated: Jun 7, 2025
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Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
339
Clinical Outcomes for Adult Single-Sided Deafness Cochlear Implantees Exceeding the 5% Candidacy Criterion
Joshua G W Bernstein1,2, Elicia M Pillion1,2, Anthony M Tolisano2,3
1National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Ear and Hearing
|November 21, 2024
Summary
Patients with single-sided deafness (SSD) who exceeded the 5% word-recognition score criterion still benefited significantly from cochlear implants (CIs). These benefits in speech perception and spatial hearing were comparable to those who met the stricter criterion.
Area of Science:
- Audiology and Hearing Science
- Neurosurgery and Otolaryngology
- Biomedical Engineering
Background:
- Regulatory approval for single-sided deafness cochlear implants (SSD-CIs) in the US has strict candidacy criteria (≤5% word recognition).
- This study used a less stringent criterion (≤50% CNC score) based on traditional CI candidacy, implanted SSD patients before regulatory approval.
- Investigated benefits of SSD-CI in patients exceeding the 5% CNC criterion using spatial hearing and quality-of-life measures.
Purpose of the Study:
- To determine if single-sided deafness patients exceeding the 5% Consonant-Nucleus-Consonant (CNC) word-recognition score criterion benefit from cochlear implantation (CI).
- To compare outcomes between patients meeting and exceeding the 5% CNC criterion.
- To assess improvements in speech understanding in noise (SIN), sound localization, and quality of life (CIQOL).
Main Methods:
- Retrospective chart review of 27 adult SSD-CI recipients (21 SSD, 6 AHL) with ≥3 months follow-up.
- Patients divided into 'MEETS' (≤5% CNC) and 'EXCEEDS' (>5% CNC) groups based on preoperative scores.
- Evaluated CI-alone speech perception (CNC, AzBio), binaural spatial hearing (localization, SIN), and CIQOL, comparing pre- and post-operative performance.
Main Results:
- 11 of 27 patients exceeded the 5% CNC criterion.
- Both groups showed significant improvements in all primary outcome measures (speech perception, spatial hearing, CIQOL).
- No significant differences in postoperative scores or improvement magnitude between the MEETS and EXCEEDS groups.
Conclusions:
- SSD-CI and Asymmetric Hearing Loss CI (AHL-CI) recipients exceeding the 5% CNC criterion experience significant, indistinguishable benefits compared to those meeting the criterion.
- A less restrictive candidacy criterion for SSD-CI and AHL-CI should be considered.
- Further large-scale clinical trials are warranted to evaluate CI efficacy with less stringent criteria.
