Cochlear implantation in adults with unilateral deafness: A review of the assessment/evaluation protocols

Abstract

Objectives: Cochlear implantation is becoming widely used outside the tertiary research centers for treatment of unilateral deafness (UD). No consensus exists, however, on the most suitable assessment/evaluation protocols for this group of adult patients. This paper aims to review the assessment and evaluation protocols used by various research groups and to propose a protocol for the use in the clinical setting.

Methods: The PubMed, Embase, and Cochrane Library databases were searched with the keywords ‘cochlear’, ‘implant’, ‘single-sided’, ‘deafness’, ‘adults’, ‘unilateral’, and ‘deafness’. The words were either used individually, combined in pairs, or in groups of 5. All articles reporting on prospective studies, retrospective studies, or case studies were included.

Results: Sixteen published studies met the inclusion criteria. Measures of hearing performance, tinnitus, subjective quality of hearing, and quality of life varied greatly among studies.

Discussion: Adaptive speech in noise testing, localization, tinnitus measurement questionnaires, and self-rated hearing improvement are widely used among the research groups. These tools in conjunction assess and evaluate the main issues associated with UD.

Conclusion: The test battery most commonly used to assess and evaluate adult cochlea implant users with UD consists of (a) a subjective self-rating of hearing performance, (b) localization testing, and (c) the adaptive speech in noise testing conducted in at least the following three spatial configurations: speech and noise presented from the front (S0/N0), speech presented from the front and noise presented to the good hearing ear (S0/Nhe), and speech presented to the implanted ear and noise presented to the hearing ear (Sci/Nhe).

Keywords:

• Unilateral deafness
• Cochlear implant
• Assessment protocol

Disclaimer statements

Contributors D.T.-V., R.M., A.A., and G.R. participated in designing the study and writing up the manuscript.

Funding None.

Conflict of interest None.

Ethics approval Ethical approval received from the HREC Fremantle Hospital.

Acknowledgments

MT has edited a version of this manuscript.