Postoperative optimization of cochlear implantation for single sided deafness and asymmetric hearing loss: a systematic review

Abstract

Objective

Identify and evaluate the effectiveness of methods for improving postoperative cochlear implant (CI) hearing performance in subjects with single-sided deafness (SSD) and asymmetric hearing loss (AHL).

Data Sources

Embase, PubMed, Scopus.

Review Methods

Systematic review and narrative synthesis. English language studies of adult CI recipients with SSD and AHL reporting a postoperative intervention and comparative audiometric data pertaining to speech in noise, speech in quiet and sound localization were included.

Results

32 studies met criteria for full text review and 6 (n = 81) met final inclusion criteria. Interventions were categorized as: formal auditory training, programming techniques, or hardware optimization. Formal auditory training (n = 10) found no objective improvement in hearing outcomes. Experimental CI maps did not improve audiologic outcomes (n = 9). Programed CI signal delays to improve synchronization demonstrated improved sound localization (n = 12). Hardware optimization, including multidirectional (n = 29) and remote (n = 11) microphones, improved sound localization and speech in noise, respectively.

Conclusion

Few studies meeting inclusion criteria and small sample sizes highlight the need for further study. Formal auditory training did not appear to improve hearing outcomes. Programming techniques, such as CI signal delay, and hardware optimization, such as multidirectional and remote microphones, show promise to improve outcomes for SSD and AHL CI users.

Keywords:

• Single sided deafness
• Asymmetric hearing loss
• Cochlear implant
• Rehabilitation
• Unilateral hearing loss

Geographical information

This work is a review of international publications. There is no single geographic location for the data and works described within this manuscript.

Disclaimer

The opinions or assertions contained herein are the private ones of the author/speaker and are not to be construed as official or reflecting the views of the Department of Defense, the Uniformed Services University of the Health Sciences or any other agency of the U.S. Government.

Disclaimer statements

Contributors: None.

Funding: None.

Conflict of interests: No potential conflict of interest was reported by the author(s).

Ethics approval: None.

Additional information

Notes on contributors

Kristofer G. Andren

Dr. Kristofer G. Andren, DO is an Otolaryngology – Head & Neck Surgery resident at San Antonio Military Medical Center in San Antonio, TX. He is interested in utilizing large databases for quality improvement in Otolaryngology. Native to Massachusetts, he discovered his passion for outcomes-focused research at Boston Children’s Hospital. He attended medical school at the University of New England College of Osteopathic Medicine in Maine.

Kevin Duffin

Dr. Kevin Duffin, MD completed his medical degree at the Uniformed Services University of the Health Sciences in 2022 and is currently completing his internship at Balboa Naval Medical Center in San Diego, CA. He is planning to do an operational medical tour with the Navy before applying for an Otolaryngology residency position.

Matthew T. Ryan

Dr. Matthew T. Ryan, MD earned his medical degree from the Uniformed Services University School of Medicine in 2019. He is currently working as an Otolaryngology - Head & Neck Surgery resident at Walter Reed National Military Medical Center in Bethesda, MD.

Charles A. Riley

Dr. Charles A. Riley, MD is the Chief of the Division of Rhinology and Anterior Skull Base Surgery in the Department of Otolaryngology – Head and Neck Surgery at Walter Reed National Military Medical Center, and Assistant Professor at the Uniformed Services University of the Health Sciences in the National Capital Consortium in Washington, D.C. Dr. Riley is fellowship trained in Rhinology: Advanced Endoscopic Sinus and Skull Base Surgery. He has authored over 70 peer-reviewed publications and textbook chapters. He has presented his research at national and international conferences, and he is on several national committees for otolaryngology societies.

Dr. Riley attended at the University of Connecticut School of Medicine. He then completed his residency in Otorhinolaryngology – Head and Neck Surgery at Tulane University and Ochsner Medical Center in New Orleans, Louisiana. He completed a fellowship in Rhinology: Advanced Endoscopic Sinus and Skull Base Surgery, at the Weill Cornell Medical College and Columbia University Irving Medical Center/NewYork-Presbyterian Hospital in New York, New York.

Anthony M. Tolisano

Dr. Anthony M. Tolisano, MD is a board-certified neurotologist and otolaryngologist who currently practices at the Walter Reed National Military Medical Center and associate professor of surgery at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. He earned his medical degree from the New York University School of Medicine and completed his residency in otolaryngology at Tripler Army Medical Center in Honolulu, Hawaii in 2017. His neurotology fellowship was completed at the University of Texas Southwestern Medical Center in Dallas, Texas. Dr. Tolisano has over 60 peer-reviewed publications in the medical literature and has presented at dozens of national and international meetings over his career.