Exploring the clinical approach to the bimodal fitting of hearing aids and cochlear implants: results of an international survey

Abstract

In all, 65 responses were obtained from 12 different countries. All clinicians said they would advise a CI user to wear a contralateral HA if indicated. However, a significant number (45%) had either never fitted HAs before or had less than 1 year of experience. In general, there were no specific criteria for selecting candidates to fit with an HA. A strategy to balance the HA with the CI was not used as a standard practice for any of the adults and was used in only 12% of the children. Only half the respondents were aware of the bimodal literature. The majority of professionals (18/30) did not refit the HA after CI switch-on. However, if users complained of sound quality or loudness issues or had poor test results, a follow-up session was provided. The main benefit reported by recipients was improvement in overall sound quality.

Bimodal Hearing Aid Retention after Unilateral Cochlear Implantation

“…Although adapting HA and/or CI fitting to optimize bimodal benefit is suggested in the literature [Francart and McDermott, 2013], no generally accepted bimodal fitting method exists. In general, the clinical approach described in this study is characteristic of the current course of bimodal practice in CI centres around the world [Scherf and Arnold, 2014].…”

“…There is no consensus on which patients are good candidates for the simultaneous use of a CI and a contralateral HA [Scherf and Arnold, 2014], except the presence of usable residual hearing [Offeciers et al, 2005]. The degree of residual hearing in CI patients however has progressively increased over the years, therefore lower bimodal rates may be related to stricter CI candidacy criteria in the past [Ching, 2005].…”

“…This was countered by a demographic study among 71 adult CI recipients, showing that 75% tried wearing an HA and 59% continued using bimodal devices in daily life [Cowan and Chin-Lenn, 2004]. Then again, a recent survey study in CI centres around the world revealed that, within the total population of adult unilateral CI recipients, on average 32% are bimodal users [Scherf and Arnold, 2014].…”

Self-Reported Usage, Functional Benefit, and Audiologic Characteristics of Cochlear Implant Patients Who Use a Contralateral Hearing Aid

“…Surveys of “cochlear implant audiologists” reveal that clinicians need guidelines for bimodal candidacy and management (Fielden & Kitterick, 2016; Scherf & Arnold, 2014; Siburt & Holmes, 2015). For instance, it would be helpful to have guidelines regarding the audiologic characteristics of those who actually continue to use a HA postimplantation.…”

Bimodal Hearing in Individuals with Severe-to-Profound Hearing Loss: Benefits, Challenges, and Management

“…20 Despite the known benefits of bimodal hearing, an international survey showed that an average of only 32% of adult and 26% of pediatric CI patients use a contralateral HA. 21 Sheffield and Gifford 22 showed significant bimodal benefit with low-pass filtered speech with a cutoff as low as 250 Hz, indicating that even patients with limited residual hearing should consider use of a HA. 1 The case for bimodal hearing would not be complete without mentioning the negative effects of auditory deprivation.…”