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The preoperative pure-tone threshold in the implanted ear was between 80 and 115 dB in the frequency range of 500 to 2000 Hz. On the contralateral side the mean threshold was 10 dB better. The mean score for the number test was 11.3%, for the monosyllables below 5%. Postoperatively speech understanding improved significantly up to 97% for numbers and 48% for monosyllables (tested with the Freiburger Speech Test). Cochlear implantation also benefits patients with residual hearing and some speech understanding with hearing aids under optimum conditions. The speech understanding scores must be below certain limits. General selection criteria cannot yet be specified. The individual decision must be based upon several criteria, especially the speech understanding scores in quiet and noise under optimum conditions. A prospective study is needed to develop generally applicable criteria.

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Viele Patienten haben nach der Direktanpassung schon ein gutes Sprachverstehen entwickelt und bewerten dieses subjektiv mit ausreichend. Durch die Erstanpassung mit gezieltem Hörtraining, Beratung und fortlaufender Anpassung verbessert sich das Sprachverstehen nochmals erheblich. Die Direktanpassung bietet somit eine Eingewöhnung in das neue Hören, die fachliche postoperative CI-Nachsorge an der Klinik ist weiterhin erforderlich.