Decisional Regret in Adult Cochlear Implant Recipients With Single-Sided Deafness

Examine the association between cochlear implant (CI) outcomes such as speech perception, quality of life, and device usage and decisional regret in adult CI users with single-sided deafness (SSD).

Cross-sectional cohort study.

Tertiary medical center.

Fourteen adult CI recipients (mean age, 55.6 yr; range, 24-73 yr) with SSD as defined by a four-frequency pure-tone average (PTA) ≤30 dB of the non-implanted ear.

Participants completed the validated CI Quality of Life (CIQOL)-10 Global and Decisional Regret (DR) survey after CI surgery. Demographics, including etiology of hearing loss and length of deafness, pre- and post-CI speech outcomes (Consonant Nucleus Consonant (CNCq) word score in quiet), and device usage were collected and analyzed.

Twenty-one percent of patients (3 of 14) reported moderate post-CI decisional regret. Although no significant differences were observed in 4fPTA or duration of deafness, large effect sizes in CIQOL-10 scores and device usage suggest potential meaningful differences in perceived benefit. Notably, greater CNCq improvement at 6 months in the moderate regret group highlights a potential disconnect between objective outcomes and subjective satisfaction in this population.

Adults with SSD who proceed with CI and use their device report low levels of DR, comparable to adult CI recipients with bilateral hearing loss. Improvement in speech performance and the duration of deafness may not significantly impact DR after CI for SSD. Additional investigation into variables affecting patient satisfaction in this population, including preoperative counseling and expectation assessment, is warranted.