Expanding Cochlear Implant Criteria?
Hughes et al (2014) retrospectively evaluated post-cochlear implant (CI) performance for CI recipients who had better hearing than the established FDA criteria. Charts from 37 patients (26 adults, 11 children) from 1991 to 2013 were included and three groups were established as follows.
- Patients with pre-implant sentence recognition scores in quiet of better than 50 percent in the pre-implant ear, or better than 60 percent sentence recognition scores in the best aided condition.
- Pure-tone thresholds better than 70 dB HL at two frequencies.
- Patients with both 1 and 2 (above).
Hughes et al report that 28 of the 38 patients had significantly improved post-implant speech perception (compared to pre-implant). Of the 28 patients, 12 were from Group 1, 10 patients (11 ears) were from Group 2, and five patients were from Group 3. Further, they report that five patients demonstrated no change in their pre versus post performance, three patients showed decreased performance, and two patients had inconclusive data. The authors report the distribution of patients with “limited” or “successful” outcomes was similar across the groups. They stated “in other words, the likelihood of success with the CI (or lack thereof) was not different for individuals with better pre-implant speech perception, better audiometric thresholds, or both.”
Hughes et al concluded that in general, based on their study, people with better hearing ability than “traditional” CI candidates perform better with CIs than with hearing aids. They suggest CI candidacy should be expanded to include people with more residual hearing, although the exact suggested criteria has not yet been determined.
For More Information, Recommendations, References
Gifford RH, Dorman MF, Shallop JK, Sydlowski SA. (2010) Evidence for the Expansion of Adult Cochlear Implant Candidacy. Ear & Hearing 31(2):186–194.
Hughes ML, Neff DL, Simmons JL, Moeller MP. (2014) Performance Outcomes for Borderline Cochlear Implant Recipients with Substantial Preoperative Residual Hearing. Otology & Neurotology. 35(8):1373-1384.