FDA Approves CIs for Single-Sided Deafness, Asymmetric Hearing Loss

Purpose The purpose of this clinical report is to present case studies of children who are nontraditional candidates for cochlear implantation because they have significant residual hearing in 1 ear and to describe outcomes and considerations for their audiological management and habilitation. Method Case information is presented for 5 children with profound hearing loss in 1 ear and normal or mild-to-moderate hearing loss in the opposite ear and who have undergone unilateral cochlear implantation. Pre- and postoperative assessments were performed per typical clinic routines with modifications described. Postimplant habilitation was customized for each recipient using a combination of traditional methods, newer technologies, and commercial materials. Results The 5 children included in this report are consistent users of their cochlear implants and demonstrate speech recognition in the implanted ear when isolated from the better hearing ear. Conclusions Candidacy criteria for cochlear implantation are evolving. Children with single-sided deafness or asymmetric hearing loss who have traditionally not been considered candidates for cochlear implantation should be evaluated on a case-by-case basis. Audiological management of these recipients is not vastly different compared with children who are traditional cochlear implant recipients. Assessment and habilitation techniques must be modified to isolate the implanted ear to obtain accurate results and to provide meaningful therapeutic intervention.

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On the Effect of Bimodal Rehabilitation in Asymmetric Hearing Loss

Journal of Clinical Medicine ◽

10.3390/jcm10173927 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3927

Author(s):

Simonetta Monini ◽

Chiara Filippi ◽

Alessandra De Luca ◽

Gerardo Salerno ◽

Maurizio Barbara

Keyword(s):

Hearing Loss ◽

Hearing Aid ◽

Free Field ◽

Hearing Threshold ◽

Beneficial Effects ◽

Auditory Performance ◽

Contralateral Ear ◽

Single Sided Deafness ◽

Asymmetric Hearing Loss

Background: Bone conductive implants (BCI) have been reported to provide greater beneficial effects for the auditory and perceptual functions of the contralateral ear in patients presenting with asymmetric hearing loss (AHL) compared to those with single-sided deafness (SSD). The aim of the study was to assess the effects of wearing a conventional hearing aid in the contralateral ear on BCI in terms of an improved overall auditory performance. Methods: eleven AHL subjects wearing a BCI in their worse hearing ear underwent an auditory evaluation by pure tone and speech audiometry in free field. This study group was obtained by adding to the AHL patients those SSD subjects that, during the follow-up, showed deterioration of the hearing threshold of the contralateral ear, thus presenting with the features of AHL. Four different conditions were tested and compared: unaided, with BCI only, with contralateral hearing aid (CHA) only and with BCI combined with CHA. Results: all of the prosthetic conditions caused a significant improvement with respect to the unaided condition. When a CHA was adopted, its combination with the BCI showed significantly better auditory performances than those achieved with the BCI only. Conclusions: the present study suggests the beneficial role of a CHA in BCI-implanted AHL subjects in terms of overall auditory performance.

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Cochlear implantation as a treatment for single-sided deafness and asymmetric hearing loss: a randomized controlled evaluation of cost-utility

BMC Ear Nose and Throat Disorders ◽

10.1186/s12901-019-0066-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 6

Author(s):

Mathieu Marx ◽

Nadège Costa ◽

Benoit Lepage ◽

Soumia Taoui ◽

Laurent Molinier ◽

...

Keyword(s):

Hearing Loss ◽

Cochlear Implantation ◽

Cost Utility ◽

Randomized Controlled ◽

Controlled Evaluation ◽

Single Sided Deafness ◽

Asymmetric Hearing Loss

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Comparative analysis with regard to tinnitus distress, quality of life and hearing improvement between CI patients with single-sided deafness, asymmetric hearing loss and bilateral deafness

10.1055/s-0039-1686390 ◽

2019 ◽

Author(s):

SM Häußler ◽

S Knopke ◽

S Gräbel ◽

H Olze

Keyword(s):

Quality Of Life ◽

Hearing Loss ◽

Comparative Analysis ◽

Hearing Improvement ◽

Tinnitus Distress ◽

Single Sided Deafness ◽

Bilateral Deafness ◽

Asymmetric Hearing Loss

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Expanding Cochlear Implant Criteria: Real World Applications and Outcomes

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp2.sig8.3 ◽

2017 ◽

Vol 2 (8) ◽

pp. 3-8

Author(s):

Joseph E. Dansie ◽

Sarah A. Cordingley ◽

Brittany Brown

Keyword(s):

Hearing Loss ◽

Cochlear Implant ◽

Cochlear Implants ◽

Drug Administration ◽

Real World ◽

Off Label ◽

Current Trends ◽

Real World Applications ◽

Single Sided Deafness ◽

Asymmetric Hearing Loss

This article discusses the evolution, current criteria, expanded/expanding indications, and potential future indications for cochlear implants. Some of these areas of expansion include earlier implantation in pediatrics, electroacoustic stimulation for both adults and pediatrics, cochlear implants for single-sided deafness, significant asymmetric hearing loss, and cases of severe debilitating tinnitus associated with hearing loss. Note: Some of the discussion in this article is viewed/regarded as off label from the current Food and Drug Administration (FDA) criteria. The authors' intent for this article is for it to be a helpful overview in the current trends that are changing in cochlear implants. This article is not indented to be a definitive paper about new trends in cochlear implants.

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Evolving Criteria for Adult and Pediatric Cochlear Implantation

Ear Nose & Throat Journal ◽

10.1177/0145561320947258 ◽

2020 ◽

Vol 100 (1) ◽

pp. 31-37

Author(s):

Varun V. Varadarajan ◽

Sarah A. Sydlowski ◽

Michael M. Li ◽

Samantha Anne ◽

Oliver F. Adunka

Keyword(s):

Hearing Loss ◽

Cochlear Implantation ◽

The United States ◽

Residual Hearing ◽

Younger Age ◽

Ear Malformations ◽

Potential Benefits ◽

Single Sided Deafness ◽

Asymmetric Hearing Loss ◽

Cochlear Nerve Deficiency

The indications for cochlear implantation have gradually expanded as advancements in technology have evolved, resulting in improved audiologic outcomes for both adult and children. There remains a significant underutilization of cochlear implant technology in the United States, and recognition of the potential benefits of cochlear implantation for non-traditional indications is critical for encouraging the evolution of candidacy criteria. Adult cochlear implantation candidacy has progressed from patients with bilateral profound sensorineural hearing loss (SNHL) to include patients with greater degrees of residual hearing, single-sided deafness and asymmetric hearing, and atypical etiologies of hearing loss (eg, vestibular schwannoma, Ménière’s disease, and otosclerosis). Indications for pediatric cochlear implantation have similarly evolved from children with bilateral severe to profound SNHL to implanting children at a younger age, including those with residual hearing, asymmetric hearing loss, inner ear malformations, as well as cochlear nerve deficiency. In this editorial, the literature investigating cochlear implantation for nontraditional indications is reviewed with an aim to use the best available evidence to encourage the evolution of candidacy criteria.

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