Evaluation of a revised indication for determining adult cochlear implant candidacy

TLDR

The study evaluates whether monosyllabic word recognition can be used to determine cochlear implant candidacy and predict long‑term benefit, using a prospective multi‑center single‑subject design. The study used the CNC word test as the primary pre‑ and post‑operative measure, supplemented by the Hearing in Noise Test and AzBio sentences, and assessed quality of life with the Abbreviated Profile of Hearing Aid Benefit and Health Utilities Index. Sentence recognition scores plateaued at ceiling within three months, while CNC word scores never exceeded 80% even after 12 months, yet quality‑of‑life measures improved significantly, supporting the use of monosyllabic words for candidate selection and long‑term performance assessment. Published in Laryngoscope 127:2368‑2374 (2017).

Abstract

To evaluate the use of monosyllabic word recognition versus sentence recognition to determine candidacy and long-term benefit for cochlear implantation.Prospective multi-center single-subject design.A total of 21 adults aged 18 years and older with bilateral moderate to profound sensorineural hearing loss and low monosyllabic word scores received unilateral cochlear implantation. The consonant-nucleus-consonant (CNC) word test was the central measure of pre- and postoperative performance. Additional speech understanding tests included the Hearing in Noise Test sentences in quiet and AzBio sentences in +5 dB signal-to-noise ratio (SNR). Quality of life (QoL) was measured using the Abbreviated Profile of Hearing Aid Benefit and Health Utilities Index.Performance on sentence recognition reached the ceiling of the test after only 3 months of implant use. In contrast, none of the participants in this study reached a score of 80% on CNC word recognition, even at the 12-month postoperative test interval. Measures of QoL related to hearing were also significantly improved following implantation.Results of this study demonstrate that monosyllabic words are appropriate for determining preoperative candidate and measuring long-term postoperative speech recognition performance.2c. Laryngoscope, 127:2368-2374, 2017.