What can we learn from adult cochlear implant recipients with single-sided deafness who became elective non-users?

Abstract

Objective: This retrospective study investigates the incidence of elective cochlear implant (CI) non-use amongst a cohort of adult CI recipients with single-sided deafness (SSD), identifies the causes that led to non-use, and assesses how non-use could be prevented.

Methods: All adults with SSD who received a CI between 2008 and 2018 and who became elective CI non-users were included. Elective non-users were defined as CI recipients who decided to stop using their CI or, if explantation was necessary, refused reimplantation.

Results: 5/114 (4.4%) adults with SSD who received a CI became elective non-users. The 5 non-users were a mean 44.2 years old (range 33–70 years) at implantation, had a mean duration of deafness of 7.1 years (range 0.5–20 years) at implantation, and used their CI for a mean 11.5 months (range 1.5–60 months) before (fully) discontinuing use. The primary cause of elective non-use was postoperative discouragement due to unrealistic expectations (4 participants) regarding sound perception with the CI or about the greater than expected level of commitment necessary for rehabilitation.

Conclusions: Elective non-use among adult CI recipients with single-sided deafness was very rare and could be further prevented by comprehensive counselling to ensure that candidates have realistic expectations about the rehabilitation requirements and the outcomes with the CI.

Keywords:

• Single-sided Deafness
• Cochlear implant
• Non-use
• Disuse
• Preoperative counselling

Acknowledgements

Michael Todd (MED-EL) collaborated on the writing and editing of a version of this manuscript.

Additional information

Notes on contributors

Dayse Távora-Vieira

Dr Dayse Távora-Vieira is a well published expert in the field of cochlear implantation and is an active researcher with several research projects aimed at determining the benefit of hearing rehabilitation and intervention.

Aanand Acharya

Dr Aanand Acharya is an otorhinolaryngologist with a subspecialty clinical practice and research interest in otology and auditory implant surgery.

Gunesh P. Rajan

Prof. Gunesh P. Rajan completed his Otolaryngology training at the ENT Dept., University Hospital Zurich, Switzerland (under Prof. Ugo Fisch & Prof. Stephan Schmid), followed by head & neck as well neurotology and skull base fellowships in Barcelona, Spain and Perth, Australia. He is currently appointed as Professor & Head of Otolaryngology, Head & Neck Surgery at the University of Western Australia in Perth.