Considerable advancements in cochlear implant technology (e.g., electric acoustic stimulation) and assessment materials have yielded expanded criteria. Despite this, it is unclear whether individuals with better audiometric thresholds and speech understanding are being referred for cochlear implant workup and pursuing cochlear implantation. The purpose of this study was to characterize the mean auditory and demographic profile of adults presenting for preoperative cochlear implant workup. Data were collected prospectively for all adult preoperative workups at Vanderbilt from 2013 to 2015. Subjects included 287 adults (253 postlingually deafened) with a mean age of 62.3 years. Each individual was assessed using the minimum speech test battery, spectral modulation detection, subjective questionnaires, and cognitive screening. Mean consonant-nucleus-consonant word scores, AzBio sentence scores, and pure-tone averages for postlingually deafened adults were 10%, 13%, and 89 dB HL, respectively, for the ear to be implanted. Seventy-three individuals (25.4%) met labeled indications for Hybrid-L and 207 individuals (72.1%) had aidable hearing in the better hearing ear to be used in a bimodal hearing configuration. These results suggest that mean speech understanding evaluated at cochlear implant workup remains very low despite recent advancements. Greater awareness and insurance accessibility may be needed to make cochlear implant technology available to those who qualify for electric acoustic stimulation devices as well as individuals meeting conventional cochlear implant criteria.

For patients using a bimodal hearing configuration with substantial residual hearing in the non-CI ear, bilateral cochlear implantation yields improved audiologic performance and better subjective quality of life, irrespective of the ability to preserve acoustic hearing during the second sided implantation.

Objective: The objective of this study was to investigate the effects of signal processing strategy on speech understanding and auditory function for adult cochlear implant (CI) users with a focus on the effects of sequential versus paired stimulation.Design: Within-subjects, repeated measures design was utilised to compare performance between processing strategies and stimulation type on various measures of auditory function and subjective sound quality. Testing with subsequent strategies was completed after a total familiarisation time of two weeks. Study Sample:Ten post-lingually deafened adult CI users were recruited from a clinical population. Participants had a minimum of 13 months CI experience. Ages ranged from 25-78 years. All participants had long-term experience with the optima strategy; eight with sequential stimulation and two with paired stimulation. Results:We found no statistically significant effect of processing strategy. We observed an effect of stimulation type with sequential stimulation yielding significantly higher performance than paired stimulation for speech understanding in quiet and in noise, and subjective estimates of sound quality. No significant differences were noted across strategy or stimulation for music perception, spectral resolution or temporal resolution. Conclusions:Many patients utilise paired stimulation -the default stimulation type in the clinical software; however, sequential stimulation yielded significantly higher outcomes on multiple measures.