Rainer Linus Beck

Background: The cochlear implant (CI) is an established treatment option for patients with inadequate speech understanding and insufficient aided scores. Nevertheless, reliable predictive models and specific therapy goals regarding achievable speech understanding are still lacking. Method: In this retrospective study, 601 cases of CI fittings between 2005 and 2021 at the University Medical Center Freiburg were analyzed. We investigated the preoperative unaided maximum word recognition score (mWRS) as a minimum predictor for post-interventional scores at 65 dB SPL, WRS₆₅(CI). The WRS₆₅(CI) was compared with the preoperative-aided WRS, and a previously published prediction model for the WRS₆₅(CI) was reviewed. Furthermore, the effect of duration of hearing loss, duration of HA fitting, and etiology on WRS₆₅(CI) were investigated. Results: In 95.5% of the cases, a significant improvement in word recognition was observed after CI. WRS₆₅(CI) achieved or exceeded mWRS in 97% of cases. Etiology had a significant impact on WRS₆₅(CI). The predicted score was missed by more than 20 percentage points in 12.8% of cases. Discussion: Our results confirmed the minimum prediction via mWRS. A more precise prediction of the expected WRS₆₅(CI) is possible. The etiology of hearing loss should be considered in the indication and postoperative care to achieve optimal results.

Objectives: Cochlear implant is regarded as a treatment option for hearing rehabilitation of adults with unilateral sensorineural hearing loss. A clear benefit has been experienced in regard to speech comprehension in noise, localization, and quality of life. The aim of this study was to investigate the benefit of cochlear implantation for children with congenital unilateral hearing loss. Study Design: Retrospective case series. Setting: Tertiary referral center; cochlear implant program. Patients: Ten children with congenital unilateral hearing loss. Intervention: After extensive consultation with the families and intensive counseling, the children received a cochlear implant. Main Outcome Measures: Categories of auditory performance, speech discrimination in open set, subjective assessment by Speech, Spatial and Qualities scale questionnaire. Conclusion: Eight of ten children use their cochlear implant consistently on a daily basis. Two children who were equipped with an implanted device at a later age tend to nonuse of the device. The evaluation of binaural hearing in small children is still difficult and methods have to be developed to allow objective assessment.