Cochlear Implant Candidacy Issues
Amoodi, Mick, Shipp, and colleagues (2011) report their 27 patients may not have been considered “appropriate candidates” at the majority of cochlear implant (CI) centers. However, highly encouraging post-CI patient satisfaction and speech recognition results suggest consideration of revised or expanded CI candidacy is worthy of consideration.
Over the last decades, CI candidacy criteria has clearly become less restrictive. Originally, best aided scores had to be 20 percent correct with regard to sentence recognition scores in quiet and in 1989 that changed to 50 percent. Currently, Med-El states their criteria as a best-aided score of 40 percent or less on the HINT (or HINT-like) test, Advanced Bionics and Cochlear Corp state 50 percent or less in quiet. However, 60 percent HINT scores are often accepted as the candidacy criteria for implantation, allowing greater numbers of unsuccessful hearing aid wearers to be implanted.
Amoodi, Mick, Shipp, and colleagues report 27 patients (14 male, 13 female, mean age 55 years and their average duration of deafness was 5.6 years). Their mean pre-op HINT score in the best-aided condition was 68 percent, whereas one year later, their mean post-op score using “CI only” was 95 percent, which was a statistically significant improvement. With regard to CNC tests, the group’s mean pre-op score was 29 percent correct and the post-op was 66 percent, which was also a statistically significant improvement. With regard to the Hearing Handicap Inventory (HHI), the mean pre-op value was 68 percent, which was statistically significantly reduced to a mean of 35 percent post-op.
The authors conclude due to improved CI technology and improved surgical techniques “consideration of revised or expanded” CI candidacy is warranted so as to allow more people with significant hearing loss to take advantage of the benefits offered through cochlear implantation.
For More Information, References, and Recommendations
Amoodi HA, Mick PT, Shipp DB, Friesen LM, Nedzelski JM, Chen JM, Lin VYW. (2011) Results With Cochlear Implantation in Adults with Speech Recognition Scores Exceeding Current Criteria. Otology & Neurotology 33:6-12.
Gifford RH, Dorman MF, Shallop JK, Sydlowski SA. (2010) Evidence for the Expansion of Adult Cochlear Implant Candidacy. Ear & Hearing 31(2):186–194.
Yoshikawa N, Hirsch B, Telischi FF. (2010) Cochlear Implant Fixation and Dura Exposure. Otology & Neurotology 31(8):1211-1214.