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

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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

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