Asymmetric Hearing Loss in Adult Cochlear Implant Recipients: Results and Recommendations From a Multisite Prospective Clinical Trial.
Jill B Firszt, Laura K Holden, Noël Y Dwyer and 2 others
PMID 37018114WHAT IT FOUND
Adding a cochlear implant to the severely impaired ear while keeping a hearing aid in the better ear improved word and sentence scores by 3 months, with plateau by 6 months.
Localization gains were small unless compared with everyday listening.
Key findings
01Poor ear word recognition improved from 11% to 48% by 3 months after implantation.
02With the implant and hearing aid together, word and sentence scores were better than pre-implant bilateral hearing aids by 3 months.
03Quiet localization was not better against bilateral hearing aids before 12 months, but was better against everyday listening by 3 months.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only adults with postlingual onset hearing loss in the poor ear were included, so the results do not apply to people with pre- or perilingual onset loss. The study did not document aural rehabilitation for each participant, so the effect of rehabilitation on outcomes is unknown. Device choice was not controlled, and CI program settings were not datalogged, so performance differences may reflect device or programming variation. Post-implant testing was not complete for every scheduled session; 12 of 160 sessions were not completed and 10 were delayed. Localization results changed depending on whether pre-implant testing used bilateral hearing aids or the everyday listening condition, and most participants did not use bilateral hearing aids daily. The better ear hearing range was restricted to 40 to 70 dB HL in the four-frequency average, so people with normal or near-normal better ears were not the study population.
Declared interests
The study was funded by the National Institutes of Health NIDCD. One author, JBF, serves on audiology advisory boards for Advanced Bionics and Cochlear Americas.
The easy way to misread this
Do not conclude that cochlear implantation will restore normal localization. Against bilateral hearing aids, quiet localization did not improve until 12 months and localization in noise did not improve at any post-implant interval, and the model-predicted 6-month bimodal RMS error was 41.5 degrees, compared with about 5 degrees in normal-hearing participants.