Reduced Cochlear Implant Performance in Listeners with Single-Sided Deafness: Comparison with Bilateral Listeners

The efficacy of the Cochlear Implant (CI) in listeners with single-sided deafness (SSD) was evaluated by comparing single-ear speech perception in SSD listeners and bilateral cochlear implant listeners (BCI).

Consonant-nucleus-consonant (CNC) speech perception scores for the CI-only ear in SSD listeners (N = 55; 36 female, 19 male) were compared to single-ear performance in age and device experience-matched BCI listeners (N = 55; 29 female, 26 male). Separate analyses examined: (1) a matched ear from the BCI listeners (for sequentially implanted BCI listeners, the first-implanted ear in sequential BCI listeners, or, for simultaneously implanted BCI listeners, the ear on the same side as the CI in the matching SSD listener), and (2) the lower-performing ear across BCI listeners. Additional models included moderators such as age, time since activation, CI usage, and etiology. A final analysis compared first and second implants for sequential BCI listeners.

SSD listeners showed significantly lower CNC performance after controlling for age, time since activation, CI usage, and etiology. Sequential BCI listeners exhibited significantly lower CNC performance on their second ear, compared to their first ear.

Speech perception with CIs is reduced in SSD listeners compared to BCI users, likely due to blocking, where the normal-hearing ear diminishes reliance on the CI. Lower performance in the second implanted ear of sequential BCI listeners also suggests greater reliance on the more experienced ear. These findings highlight the need for additional training, resources, and support to optimize CI performance in SSD listeners, despite prior evidence of positive CNC outcomes.