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Cochlear implants for adults obtaining marginal benefit from acoustic amplification: a European study
B Fraysse1, N Dillier, T Klenzner
1CHU Purpan, Toulouse, France.
The American Journal of Otology
|September 30, 1998
Summary
Cochlear implantation (CI) significantly benefits non-English speaking adults with hearing loss, with a 30% speech recognition score being an effective candidacy criterion. Post-implantation, residual hearing is often preserved, and contralateral hearing aids offer limited additional benefit.
Area of Science:
- Otolaryngology
- Audiology
- Biomedical Engineering
Background:
- Post-linguistically deafened adults often have limited benefit from hearing aids.
- Cochlear implants (CI) offer a potential solution for severe to profound hearing loss.
Purpose of the Study:
- To evaluate the efficacy of a 30% open-set speech recognition score as a preoperative benchmark for cochlear implant candidacy in European non-English speakers.
- To assess the impact of cochlear implantation on residual hearing thresholds.
- To determine the use and benefit of contralateral hearing aids after cochlear implantation.
Main Methods:
- A single-subject design study involving 20 post-linguistically deafened adults across 8 clinics in France, Germany, and Spain.
- Preoperative hearing aid performance was compared to 6-month postoperative cochlear implant performance using Nucleus Mini 22 or Nucleus 24 systems.
- Speech recognition, pure-tone hearing thresholds, and contralateral hearing aid use were assessed.
Main Results:
- Nineteen of 20 subjects showed significant improvement in open-set speech recognition 6 months post-CI.
- Cochlear implantation led to a significant downward shift in hearing thresholds in the implanted ear for most subjects, with 50% retaining some residual hearing.
- Most subjects discontinued contralateral hearing aid use due to lack of perceived benefit.
Conclusions:
- The Nucleus Multichannel CI is highly beneficial for post-linguistically deafened adults with limited hearing aid benefit.
- A 30% open-set speech recognition score is a suitable upper limit for CI candidacy in these populations.
- Implanting the ear with poorer pure-tone thresholds is recommended for asymmetric hearing loss; contralateral hearing aids provide minimal additional benefit post-CI.