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Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
Baseline Differences in Cochlear Implant Candidates: Bilateral Traditional vs. Expanded Indications
Jack Y Lin1, Andrew L S Thornton2, Margaret L Wilson2
1Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Journal of Clinical Medicine
|July 15, 2026
Summary
Single-sided deafness (SSD) and asymmetric hearing loss (AHL) cochlear implant (CI) candidates have different patient-reported outcomes than bilateral hearing loss (HL) candidates, despite similar speech recognition in the implanted ear. Contralateral ear scores better predict functional hearing.
Area of Science:
- Audiology
- Otolaryngology
- Neurosurgery
Background:
- Cochlear implant (CI) candidacy now includes single-sided deafness (SSD) and asymmetric hearing loss (AHL) beyond traditional bilateral hearing loss (HL).
- Baseline differences in speech recognition and patient-reported outcome measures (PROMs) between these groups are not well understood.
- This study aims to characterize and compare preoperative speech recognition and PROMs in bilateral HL versus SSD/AHL CI candidates.
Purpose of the Study:
- To compare preoperative speech recognition and PROMs between bilateral HL and SSD/AHL CI candidates.
- To examine associations between preoperative word recognition scores and PROMs in CI candidates.
- To inform population-specific counseling and the use of PROMs in CI evaluations.
Main Methods:
- Sixty-eight adult CI candidates (31 bilateral HL, 12 SSD, 25 AHL) were evaluated.
- Speech recognition (Consonant-Nucleus-Consonant [CNC] and AzBio) was assessed for the CI ear and contralateral ear.
- PROMs included the Speech, Spatial and Qualities of Hearing Scale (SSQ-12), Cochlear Implant Quality of Life-35 (CIQOL-35), PHQ-2, Tinnitus Handicap Inventory (THI), and Instrumental Activities of Daily Living (IADL).
Main Results:
- No significant difference in preoperative CI-ear speech recognition between bilateral HL and SSD/AHL groups.
- SSD/AHL candidates showed better contralateral-ear speech recognition and higher SSQ-12 and CIQOL-35 scores.
- Contralateral-ear CNC scores, not CI-ear scores, were significantly associated with SSQ-Mean and CIQOL-Global scores.
Conclusions:
- Bilateral HL and SSD/AHL CI candidates have distinct preoperative PROMs (SSQ-12, CIQOL-35) despite similar CI-ear speech recognition.
- Contralateral-ear speech recognition is a significant predictor of perceived functional hearing (SSQ-Mean, CIQOL-Global).
- PROMs and audiometric data, particularly contralateral ear performance, are crucial for comprehensive CI candidacy evaluation.