Cochlear Implantation in Candidates With Moderate‐to‐Severe Hearing Loss and Poor Speech Perception

Abstract

Objectives/Hypothesis To determine the improvement in word recognition score (WRS65) after cochlear implant (CI) surgery in hearing aid (HA) users with preoperative hearing threshold ≤80 dB HL and inadequate speech recognition scores with HA. Secondarily, to identify predictive factors for WRS65 with a CI (WRS65[CI]) 6 months after surgery, derived from the standard German CI preoperative assessment. Study Design Retrospective chart review. Methods Retrospective review of all adult patients who received a Nucleus cochlear implant in the ear, nose, and throat department of the University Hospital of Erlangen between January 2010 and April 2019. The inclusion criteria were a preoperative hearing threshold ≤80 dB HL in the ear to receive the implantation, German as the native language, and at least 6 months postimplantation care at our center. Results The inclusion criteria were met by 128 patients. All but two patients (98.4%) showed a significant improvement, WRS65(CI) versus WRS65 with an (HA) (WRS65[HA]), of at least 15 percentage points (pp). The median improvement was 55 pp with a median WRS65(CI) of 70%. Three preoperative audiometric measures, the maximum word recognition score, age at implantation, and WRS65(HA) were identified as predictive factors for WRS65(CI). For three‐quarters of the CI recipients, the score was not poorer than 12 pp below the predicted WRS65(CI). Conclusions For patients with a hearing loss ≤80 dB HL, cochlear implantation should be considered when speech perception with an HA is insufficient. The prediction model can support counseling in this patient group. Level of Evidence 4 Laryngoscope, 131:E940–E945, 2021

Speech Perception Across The Lifespan by Means of Artificial Intelligence

“…A consideration of both age and speci c audiogram type could potentially decrease the variability of results. Other studies [28][29][30][31] have focussed on the WRS max as one criterion within the process of evaluation of candidates for cochlear implant or for predicting the outcome of such an implantation 32,33 . A model may provide more insights into hearing-loss-related pathologies amongst hearing aid users, especially in the cases in which the scores with a hearing aid are far below the WRS max or if the WRS max is unexpectedly low with respect to clinical experience or model prediction.…”

Update Cochlea-Implantation: Indikationsstellung und Operation

“…In den letzten Jahren hat sich das maximale Einsilberverstehen als wesentlicher Prognosefaktor für den Erfolg einer Cochlea-Implantat-Versorgung herauskristallisiert. Es hat Eingang in einen Prognose-Score [19] zur Berechnung des mit Cochlea-Implantat zu erwartenden Einsilberverstehens bei hochgradiger Schwerhörigkeit bei 65 dB gefunden [25]: Cochlea-Implantat-Operation…”

When Should Adults With Bilateral Hearing Loss Be Referred for Cochlear Implant Evaluation?

“…Although a simple equation would be ideal, the decision to refer a patient struggling with HAs with borderline performance is not straightforward. To address this question, Hoppe et al (2020) investigated the improvement in WRS after CI in 128 patients with 4FPTAs better than 80 dB HL but with aided WRS ≤50% (i.e., borderline patients with poor word recognition) 3 . 98% of patients showed improvement in WRS after CI.…”