ANS008 - Further Evidence for Individual Ear Consideration in Cochlear Implant Candidacy Evaluation
Saturday, April 30, 2022
2:38 PM – 2:45 PM CT
Location: Landmark A
Ankita Patro, MD, MS
Nathan R. Lindquist, MD
Jourdan T. Holder, AuD, PhD
Kareem O. Tawfik, MD
David S. Haynes, MD, MMHC
Rene H. Gifford, PhD
Elizabeth L. Perkins, MD
Objective: To report speech and quality-of-life outcomes after cochlear implantation (CI) for asymmetric hearing loss (AHL) and assess the influence of contralateral hearing.
Study Design: Retrospective review.
Setting: Tertiary referral center.
Patients: 168 adults undergoing CI for AHL from 2015-2020. Candidacy included pure-tone average (PTA) > 70 dB HL and AzBio in quiet < 60% in the implanted ear and AzBio in quiet > 40% in the contralateral ear.
Main Outcome Measures: PTA; CNC, AzBio scores; speech, spatial and qualities of hearing scale (SSQ-12).
Results: Mean preoperative PTA and AzBio in the implanted and contralateral ears were 85 and 67 dB HL and 22% and 69%, respectively. Average CNC in the implanted ear increased from 17% preoperatively to 45% (p < 0.0001) at 6 months and 49% (p < 0.0001) at 12 months. Mean AzBio in the implanted ear improved from 22% preoperatively to 60% (p < 0.0001) at 6 months and 64% (p < 0.0001) at 12 months. AHL patients demonstrated significant improvement in all SSQ-12 domains at 6 and 12 months. When comparing patients with preoperative contralateral AzBio above 60% versus 41-60%, no significant differences existed in postoperative CNC scores (6-month: 47% vs. 41%, p=0.08; 12-month: 50% vs. 46%, p=0.25). There were no significant differences in 6-month (p=0.36) or 12-month (p=0.87) CNC scores between AHL patients and 212 unilateral CI patients with preoperative contralateral AzBio < 40%.
Conclusions: CI recipients for AHL derive significant speech and quality of life improvements, supporting individual ear consideration for CI candidacy and patient benefit outside of current Medicare criteria. Define Professional Practice Gap & Educational Need: AHL is a more recent indication for cochlear implantation. Outcomes data for AHL patients, especially in comparison to traditional candidates, are sparse. These data are important for increasing access to CI care and improving patient counseling with regards to treatment options for AHL.
Learning Objective: To understand average speech and quality-of-life outcomes after cochlear implantation for asymmetric hearing loss as well as to determine the potential impact of contralateral hearing on CI outcomes.
Desired Result: Providers will have additional knowledge about postoperative speech perception and quality-of-life outcomes in the AHL population. These results can be utilized to support reassessment of Medicare preoperative CI candidacy criteria to allow more adults to benefit from this technology.
Level of Evidence: Level IV – Historical cohort or case-controlled studies.
Indicate IRB or IACUC: IRB Exempt (211355, Vanderbilt University).