Evaluation of a revised indication for determining adult cochlear implant candidacy

Sladen, Douglas P.; Gifford, René H.; Haynes, David S.; Kelsall, David C.; Benson, Aaron G.; Lewis, Kristen A.; Zwolan, Teresa A.; Fu, Qian-Jie; Gantz, Bruce J.; Gilden, Jan; Westerberg, Brian D.; Gustin, Cindy; O'Neil, Lori Ross; Driscoll, Colin L. W.

doi:10.1002/lary.26513

Cited by 72 publications

(60 citation statements)

References 35 publications

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“…The results are similar to those for other languages [3,4,9]. In addition, CI users' scores on the iCI2004 were slightly worse than those on the 67-S [13,15].…”

Section: Discussionsupporting

confidence: 84%

“…the Vibrant SoundBridge, BONEBRIDGE, and bone-anchored hearing aids), and electric acoustic stimulation (EAS) have dramatically improved the hearing thresholds even in people with profound hearing loss. To measure the effects of hearing aid (HA) and hearing implant use, speech perception tests are commonly used as indices reflecting hearing ability in daily life in many countries [1][2][3][4][5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Development and validation of an iPad-based Japanese language monosyllable speech perception test (iCI2004 monosyllable)

Nishio

Tono

Iwaki

et al. 2020

Acta Oto-Laryngologica

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“…The results are similar to those for other languages [3,4,9]. In addition, CI users' scores on the iCI2004 were slightly worse than those on the 67-S [13,15].…”

Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Development and validation of an iPad-based Japanese language monosyllable speech perception test (iCI2004 monosyllable)

Nishio

Tono

Iwaki

et al. 2020

Acta Oto-Laryngologica

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“…The results described above endorse the idea that in countries that hold on to more conservative criteria for CI candidacy, expansion of CI indication is beneficial for long-term benefit [ 2 – 4 , 28 , 29 ]. CI performance has improved and more evidence was found for the positive effect of residual hearing on CI outcome, strengthening the growing need for a shift of CI indication.…”

Section: Discussionsupporting

confidence: 67%

Expanding unilateral cochlear implantation criteria for adults with bilateral acquired severe sensorineural hearing loss

Huinck

Mylanus

Snik

2019

Eur Arch Otorhinolaryngol

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Objectives To report on a retrospective cohort study on the effects of expanding inclusion criteria for application of cochlear implants (CIs) on the performance 1-year post-implantation. Methods Based on pre-implantation audiometric thresholds and aided speech recognition scores, the data of 164 CI recipients were divided into a group of patients that fulfilled conservative criteria (mean hearing loss at 0.5, 1 and 2 kHz > 85 dB HL and phoneme scores with hearing aids < 30%), and the remaining group of patients that felt outside this conservative criterion. Speech recognition scores (in quiet) and quality of life (using the NCIQ) of both groups, measured at 1-year post-implantation, were compared. Results The group that felt outside the conservative criterion showed a higher phoneme score at 1-year post-implantation compared to the conservative group, suggesting that relaxed criteria have a positive influence on the speech recognition results with CI. With respect to quality of life, both groups significantly improved 1-year post-implantation. The conservative group showed a higher benefit on the advanced perception domain of the NCIQ. Based on their worse pre-implantation hearing, this was expected. Conclusions The data suggest that relaxation of CI indication positively affects the speech recognition performance of patients with severe hearing loss. Both groups of patients showed a positive effect of CI on the quality of life. This benefit relates to communication skills and the subjective day-to-day functioning in society.

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“…Referencing the clinical MSTB measures, the upper cutoff for those expressing need for a second implant was 30% CNC, 45% AzBio quiet, and 18% AzBio in noise at +5 dB SNR. There is a precedent for choosing 30% CNC word recognition for determining ear specific CI candidacy as two North American multi-site studies-Nucleus Freedom (Balkany et al 2007) and Cochlear Revised Indications Study (Sladen et al 2017)-both used 30% CNC word recognition in the ear to be implanted as the criterion guiding CI candidacy. Furthermore, both studies demonstrated significant speech recognition benefit for the CI recipients using this criterion.…”

Section: Discussionmentioning

confidence: 99%

Bimodal Hearing or Bilateral Cochlear Implants? Ask the Patient

Gifford

Dorman

2019

Ear &Amp; Hearing

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Objective: The objectives of this study were to assess the effectiveness of various measures of speech understanding in distinguishing performance differences between adult bimodal and bilateral cochlear implant (CI) recipients and to provide a preliminary evidence-based tool guiding clinical decisions regarding bilateral CI candidacy. Design: This study used a multiple-baseline, cross-sectional design investigating speech recognition performance for 85 experienced adult CI recipients (49 bimodal, 36 bilateral). Speech recognition was assessed in a standard clinical test environment with a single loudspeaker using the minimum speech test battery for adult CI recipients as well as with an R-SPACE™ 8loudspeaker, sound-simulation system. All participants were tested in three listening conditions for each measure including each ear alone as well as in the bilateral/bimodal condition. In addition, we asked each bimodal listener to provide a yes/no answer to the question, "Do you think you need a second CI?" Results: This study yielded three primary findings: 1) there were no significant differences between bimodal and bilateral CI performance or binaural summation on clinical measures of speech recognition, 2) an adaptive speech recognition task in the R-SPACE™ system revealed significant differences in performance and binaural summation between bimodal and bilateral CI users, with bilateral CI users achieving significantly better performance and greater summation, and 3) the patient's answer to the question, "Do you think you need a second CI?" held high sensitivity (100% hit rate) for identifying likely bilateral CI candidates and moderately high specificity (77% correct rejection rate) for correctly identifying listeners best suited with a bimodal hearing configuration. Conclusions: Clinics cannot rely on current clinical measures of speech understanding, with a single loudspeaker, to determine bilateral CI candidacy for adult bimodal listeners nor to accurately document bilateral benefit relative to a previous bimodal hearing configuration. Speech recognition in a complex listening environment, such as R-SPACE™, is a sensitive and appropriate measure for determining bilateral CI candidacy and also likely for documenting bilateral benefit relative to a previous bimodal configuration. In the absence of an available R-SPACE™ system, asking the patient whether or not s/he thinks s/he needs a second CI is a highly sensitive measure which may prove clinically useful.

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Evaluation of a revised indication for determining adult cochlear implant candidacy

Cited by 72 publications

References 35 publications

Development and validation of an iPad-based Japanese language monosyllable speech perception test (iCI2004 monosyllable)

Development and validation of an iPad-based Japanese language monosyllable speech perception test (iCI2004 monosyllable)

Expanding unilateral cochlear implantation criteria for adults with bilateral acquired severe sensorineural hearing loss

Bimodal Hearing or Bilateral Cochlear Implants? Ask the Patient

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