MM301 - Evaluation and Programming for Cochlear Implant Users with Single-Sided Deafness

Candidacy criteria for cochlear implantation expanded in 2019 to include individuals with single sided deafness (SSD). Cochlear implant (CI) users with SSD experience significant improvements on measures of speech recognition in quiet and in noise, sound source localization, and quality of life as compared to preoperative abilities. These benefits are stable or continue to improve with long term CI use. There are unique considerations for the evaluation and mapping of individuals with SSD. This module describes modified pre-operative and post-operative evaluation protocols and mapping procedures aimed at assessing benefit and supporting optimal outcomes for CI users with SSD.

Summary:

This module outlines pre-operative and post-operative evaluation protocols for individuals with single-sided deafness (SSD). The SSD population has unique characteristics and hearing challenges that traditional evaluation protocols do not effectively capture. Also, cochlear implant (CI) users with SSD need modified mapping procedures to create maps that provide each individual with their best outcome.

Patients with SSD report that listening with one normal-hearing ear is not enough – experiencing negative impacts on their speech recognition in dynamic environments, ability to localize sounds, and quality of life. Patients with SSD also often report bothersome tinnitus in the affected ear, contributing to the negative impact on quality of life. Taken together, current evaluation procedures that consider speech recognition in the affected ear alone are not sufficient in addressing the concerns of the SSD population. A modified evaluation procedure should include questionnaires that evaluate quality of life and tinnitus severity (e.g., THI, SSQ, CIQOL). Also, evaluation procedures should be expanded to include spatial hearing measures, such as speech recognition in spatially separated noise. This module will review how a modified evaluation procedure can be completed with the typical clinical configuration.

CI users with SSD also require a modified mapping procedure to create maps that will support their best outcomes. Modified procedures include plugging the contralateral ear to limit the influence of environmental noise when measuring threshold and comfort levels behaviorally. We will also discuss the utility of using objective measures like Electric Stapedial Reflex Thresholds (ESRTs) to establish comfort levels for this patient population.

Patients with SSD have different concerns from traditional CI patients and so modified test batteries are needed to assess their unique needs. This includes subjective questionnaires, creating a test environment that mimickes the situations in which they struggle, and altering mapping protocols to create maps that support the individual’s optimal outcomes.

Upon completion of this session, the participant will be able to expand recommendation options for individuals with UHL as well as evaluate and effectively treat individuals who pursue cochlear implantation with this configuration of hearing loss.