Cochlear Implantation in Candidates With Moderate-to-Severe Hearing Loss and Poor Speech Perception

Abstract

Objectives/Hypothesis: To determine the improvement in word recognition score (WRS65) after cochlear implant (CI) surgery in hearing aid (HA) users with preoperative hearing threshold ≤80 dB HL and inadequate speech recognition scores with HA. Secondarily, to identify predictive factors for WRS65 with a CI (WRS65[CI]) 6 months after surgery, derived from the standard German CI preoperative assessment. Study Design: Retrospective chart review. Methods: Retrospective review of all adult patients who received a Nucleus cochlear implant in the ear, nose, and throat department of the University Hospital of Erlangen between January 2010 and April 2019. The inclusion criteria were a preoperative hearing threshold ≤80 dB HL in the ear to receive the implantation, German as the native language, and at least 6 months postimplantation care at our center. Results: The inclusion criteria were met by 128 patients. All but two patients (98.4%) showed a significant improvement, WRS65(CI) versus WRS65 with an (HA) (WRS65[HA]), of at least 15 percentage points (pp). The median improvement was 55 pp with a median WRS65(CI) of 70%. Three preoperative audiometric measures, the maximum word recognition score, age at implantation, and WRS65(HA) were identified as predictive factors for WRS65(CI). For three-quarters of the CI recipients, the score was not poorer than 12 pp below the predicted WRS65(CI). Conclusions: For patients with a hearing loss ≤80 dB HL, cochlear implantation should be considered when speech perception with an HA is insufficient. The prediction model can support counseling in this patient group. Level of Evidence: 4 Laryngoscope, 131:E940–E945, 2021.