Mono-syllabic word test score as a pre-operative assessment criterion for cochlear implant candidature in adults with acquired hearing loss.

RATIONALE: Cochlear Implant (CI) candidates with a ski-slope hearing loss may be outside current implantation criteria [< 50% on Bamford-Kowal-Bench (BKB) sentence testing], despite having a significant hearing disability and limited benefit from conventional amplification. AIM: To use existing post-operative performance data to establish a criterion for Arthur Boothroyd (AB) word test for CI candidacy assessment. METHODOLOGY: Retrospective analysis of post-operative AB words scores for 64 CI users was performed and the 10th percentile score selected as a criterion of reasonable chance for post-operative improvement. A follow-up audit was performed 4 years later with a larger patient group of 127 CI users. OUTCOMES: An AB word score of 15% was determined using this method and became the pre-implant criterion for future patients. The same score was achieved on the follow-up audit and was adopted as an All Wales criterion as part of the National Audit process.

Evaluation of bilaterally implanted adult subjects with the nucleus 24 cochlear implant system.

OBJECTIVE: To evaluate the speech perception benefits of bilateral implantation for subjects who already have one implant. STUDY DESIGN: Repeated measures. PATIENTS: Thirty adult cochlear implant users who received their second implant from 1 to 7 years with a mean of 3 years after their first device. Ages ranged from 29 to 82 years with a mean of 57 years. SETTING: Tertiary referral centers across the United Kingdom. MAIN OUTCOME MEASURES: Monosyllabic consonant-nucleus-consonant words and City University of New York sentences in quiet with coincident speech and noise and with the noise spatially separated from the speech by +/-90 degrees . RESULTS: At 9 months, results showed the second ear in noise was 13.9 +/- 5.9% worse than the first ear (p < 0.001); a significant binaural advantage of 12.6 +/- 5.4% (p < 0.001) over the first ear alone for speech and noise from the front; a 21 +/- 6% (p < 0.001) binaural advantage over the first ear alone when noise was ipsilateral to the first ear; no binaural advantage when noise was contralateral to the first ear. CONCLUSIONS: There is a significant bilateral advantage of adding a second ear for this group. We were unable to predict when the second ear would be the better performing ear, and by implanting both ears, we guarantee implanting the better ear. Sequential implantation with long delays between ears has resulted in poor second ear performance for some subjects and has limited the degree of bilateral benefit that can be obtained by these users. The dual microphone does not provide equivalent benefit to bilateral implants.