Hearing outcomes of cochlear implant recipients with pre-operatively identified cochlear dead regions

Abstract

Objectives: To determine how patients who did not meet UK TA166 NICE criteria for cochlear implantation (CI) but were subsequently found to have cochlear dead regions (DRs) performed with CI.

Methods: A retrospective review of medical records was performed on CI recipients: 152 controls and 40 in the DR group. Of these, 34 pairs were matched by pre-operative Bamford-Kowal-Bench (BKB) scores and compared.

Results: The forty DR patients had a median age at implantation of 56 years. Their mean pre-operative BKB score of 23% increased to 78% after CI. Thirty-seven experienced improvements in BKB scores. In matched case-control analysis, the improvement in mean BKB score with CI was no different (p = 0.19) between the DR group and control group; a similar proportion of patients benefitted in each group.

Discussion: This study is the largestreport to date of performance of patients with DRs, before and after CI. The DR group gain similar benefit as the controls.

Conclusion: Patients with DRs, who did not meet TA166 NICE criteria, received the same benefit as those who did. TEN testing to detect DRs should be included in routine CI work-up where standard criteria are not met.

Keywords:

• Cochlear implant
• Dead region
• TEN

Acknowledgements

Thanks to the staff at the Emmeline Centre for their work in helping the patients who receive Cochlear Implants at our hospital.

Notes on contributors

Manu Shrivastava is a final-year medical student at the University of Cambridge. He has an interest in audiology and in ENT.

Susan Eitutis is a research audiologist at the Emmeline Centre, University of Cambridge.

Jennifer Lee is a Consultant Otolaryngologist from Sydney, Australia and is completing an otology and hearing implants fellowship in Cambridge.

Patrick Axon is a Consultant Neurotologist & Skull Base Surgeon. He is currently President of the British Skull Base Society and leads both the Eastern region Hearing Implant Programme and the Eastern and Central U.K. Neurofibromatosis type 2 (NF2) Programme.

Neil Donnelly is a Consultant Neurotologist & Skull Base Surgeon.

James Tysome is a Consultant Otologist, Hearing Implant & Skull Base Surgeon. He leads the Regional Skull Base Unit and is a member of the NICE Interventional Procedures Advisory Committee.

Manohar Bance is a clinician-scientist, working as an ENT surgeon and the Professor of Otology and Skull Base Surgery at the University of Cambridge.

Disclaimer statements

Contributors None.

Funding None.

Conflict of interest None.

Ethics approval None.