Bimodal Hearing or Bilateral Cochlear Implants? Ask the Patient.
René H Gifford, Michael F Dorman
PMID 30285977WHAT IT FOUND
Standard clinic tests failed to distinguish between bimodal hearing and bilateral implants, but a complex noise test showed bilateral users performed better.
Asking patients if they need a second implant predicted their performance in this noise accurately, with no false positives.
Key findings
01In a complex restaurant noise environment, bilateral cochlear implant users had significantly better speech reception thresholds than bimodal listeners.
02Standard clinical tests using a single loudspeaker showed no significant difference in performance or binaural summation between bimodal and bilateral users.
03Patients who said they needed a second implant accurately identified their own lack of benefit from the hearing aid, with none scoring better than the bilateral group's 25th percentile.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was cross-sectional, comparing different people at one time point rather than tracking the same patients before and after getting a second implant. The participants used hearing technology from the late 2010s (data collected 2010-2013), which may not reflect the performance of current devices. Device wear time was self-reported and not verified by data logging, so actual daily use may have varied. The hearing aids used by the bimodal group varied by manufacturer and model, which could influence outcomes. The question asked to patients was verbal and unstructured, which might bias responses compared to a written survey.
Declared interests
The authors declared no specific conflicts of interest in the provided text, though the study was supported by the N.I.H. The text notes that hearing aid manufacturers (Phonak, Unitron, etc.) were listed for participant equipment, but no commercial funding or involvement in design/analysis was stated.
The easy way to misread this
Do not assume that patients who say they do not need a second implant are optimal candidates for bimodal hearing. The study found that 23% of those who said no actually performed worse than the majority of bilateral users in complex noise, meaning they might have benefited from a second implant but chose not to pursue it.