Outcome of Cochlear Implantation in Children and Adults with Asymmetric Hearing Loss and Single Sided Deafness

Background: Current data show that binaural hearing is superior to unilateral hearing, in the understanding of speech in noisy environments and in the ability to localize sound. In many countries patients with asymmetric hearing loss fall outside current audiological guidelines for cochlear implantation and need to rely only on their better ear without the advantage of bimodal stimulation.

Objectives: To evaluate the audiological outcomes, compliance, quality of life in patients with asymmetric hearing loss and SSD after cochlear implantation and bimodal usage (CI+HA)

Study Design: retrospective cohort study.

Material and Methods: In single center study 23 patients, 19 adults and 4 children with asymmetric hearing loss were treated with cochlear implantation (CI). They were divided into 3 groups according to PTA of their better ear (0-30DB, 30-60DB, >60DB). They were evaluated preop and one-year post implantation using speech perception tests in quiet and in noise, and with quality of life questionnaires.

Results: 19 patients used their CI consistently. 16 patients used their CI + HA consistently. There was significant improvement in all speech perception tests especially those in noise, in all bimodal users compared to their scores before the implantation. The QQL questionnaires and auditory performance questionnaires (APHAB, ABEL, LITTLE EARS) showed significant improvement in all CI patients.

Conclusions: This study demonstrate that CI and bimodal usage of CI+HA in patients with good or serviceable hearing in the non implanted ear is effective, both in children and in adults. We should broaden our criteria for cochlear implantation and include this group of patients as candidates for CI.