Clinical Fellow Vanderbilt University Medical Center Nashville, Tennessee
Objective: To report our experience for adults undergoing cochlear implantation (CI) for single-sided deafness (SSD).
Study Design: Retrospective case series.
Setting: Tertiary referral center.
Patients: Adults cochlear implantation recipients for SSD between 2013 and 2021. Interventions: Unilateral CI.
Main Outcome Measures: Tinnitus handicap inventory (THI), speech, spatial and qualities of hearing scale (SSQ-12), CT mean modiolar distance (MMD), CNC and AzBio speech recognition scores.
Results: 67 adults underwent CI for SSD (mean 50.6 years, SD = 15.9 years). Mean CNC word recognition scores were 8% (SD = 12%) pre-operatively and 45% (SD = 26%) at 6 months post-activation (p = 0.0001). 23 patients (35.4%) received perimodiolar electrodes (MMD 0.45, SD = 0.35 mm) while 44 patients (65.7%) had lateral wall electrodes (MMD 1.12, SD = 0.13 mm, p = 0.0001). There was no significant difference in CNC scores between perimodiolar (47%, SD = 28%) and lateral wall (44%, SD = 25%) electrodes at 6 months (p = 0.6982). Patients did demonstrate significant improvement in SSQ-12 scores in ‘speech’ and ‘spatial’ sections but not in the ‘qualities’ domain at six months. THI was significantly improved from a mean score of 55 ± 24 preoperatively to 21 ± 23 at 6 months (p < 0.0001).
Conclusions: Herein, we present the largest cohort of patients with SSD treated with CI to date. This group demonstrates significant benefit with regards to speech recognition scores, tinnitus measures, and quality of life metrics including speech in noise and spatial subdomains as early as 6 months post-operatively.
*Professional Practice Gap & Educational Need: CI for patients with SSD is a relatively recent trend, with many prior implantations occurring outside of FDA approval. Increased data surrounding the speech recognition outcomes, quality of life metrics, and importance of electrode type for these patients will help guide patient counseling and decision-making for patients, surgeons, and audiologists.
*Learning Objective:
For patients undergoing CI for SSD
1. Describe speech recognition scores, tinnitus measures, and quality of life metrics for these patients, and
2. Understand how this may translate to clinical guidance, counseling, and expectations for this cohort.
*Desired Result: Increased data surrounding the speech recognition outcomes, quality of life metrics, and importance of electrode type for these patients will help guide patient counseling and decision-making for patients, surgeons, and audiologists.
*Level of Evidence: Level IV
*Indicate IRB or IACUC: Vanderbilt University Medical Center IRB# 211355