Cochlear implantation outcome in straightforward cases: can we do more for adults who cannot understand speech using hearing aids alone?

Abstract

Background: Many adults with moderate–profound hearing loss whose speech recognition has deteriorated and are no longer benefitting from hearing aids (HAs) could benefit from cochlear implantation (CI). Of these, only <5% are implanted. In order to inform eligible patients about expected results and ease the route to implantation, better guidelines for candidate selection are needed.

Objectives: To provide reliable guidelines by determining, in a well-characterized group of implantees, the minimal expected post-CI scores for monosyllabic (MS) word recognition.

Patients and methods: In total, 20 adults unilateral implantees considered (prior to implantation) straightforward CI candidates were assessed ≥20 months post-CI. Their post-CI CI-aided thresholds and MS word recognition were compared to their pre-CI scores. In addition, SSQ12 scores were evaluated post-CI.

Results: Post-CI, thresholds were 40 dB or better in all participants, and 35 dB or better in 95% of them. 90% scored 60% or better on MS words in quiet. In speech noise all scored 15–60% and 50% scored 45–60%. Poorer unaided pre-CI thresholds yielded greater patient satisfaction.

Conclusions: Adults with moderate–profound hearing loss, whose speech recognition has deteriorated, are no longer benefitting from HAs and fulfil defined criteria for straightforward CI, should be referred for formal CI candidacy evaluation.

背景：许多中度 - 严重听力损失, 语言识别已经退化到不能再受益于助听器（HA）的成人, 可以得益于人工耳蜗植入（CI）。这些人当中, 仅不到<5％接受了植入。为了让符合条件的患者知道预期结果并简化植入手续, 必须有更好的患者选择指南。

目的：通过在一群特征显著的植入者中, 确定单音节（MS）单词识别的最低预期CI后评分来提供可靠的指南。

患者和方法：共有20名成人单侧植入者在接受植入前被认为是直接耳蜗植入对象, 在植入≥20个月后接受检测。对他们的植入后 CI辅助阈值和MS单词识别与植入前评分进行了比较。此外, 在植入后评估了SSQ12评分。

结果：植入后, 所有参与者的阈值均为40 dB或更好, 而95％参与者的阈值为35 dB或更好。在安静环境下的MS单识别方面, 90％参与者的得分为60％或更高。在噪音环境下的语音识别方面, 所有所有参与者得分均为15-60％, 50％参与者得分为45-60％。较差的无辅助植入前阈值产生较好的患者满意度。

结论：中度 - 严重听力损失, 语言识别已经退化的成年人不再受益于助听器。他们满足直接耳蜗植入既定标准, 应该被介绍去接受正式耳蜗植入评估。

Keywords:

• CI candidacy
• monosyllabic word recognition
• thresholds with CI
• SSQ12

Disclosure statement

• There is no potential conflict of interest.