Evaluating the Decision for Cochlear Implantation in Individuals With Single-Sided Deafness (SSD); Implementing the SSD Consensus Protocol Into Clinical Routine

Evaluating the Decision for Cochlear Implantation in Individuals With Single-Sided Deafness (SSD); Implementing the SSD Consensus Protocol Into Clinical Routine: Objective:

To implement a unified testing framework into clinical routine that can be used by adults with single-sided deafness (SSD) to assess alternative treatment options before cochlear implantation.

Study Design:

Retrospective data analysis.

Setting:

Tertiary referral center with a large CI program.

Subjects and Methods:

Thirty four participants underwent the new implemented testing procedure, including a test trial with contralateral routing of the signal (CROS) hearing aids and bone conduction devices (BCD) on a headband, before deciding whether to proceed with cochlear implantation. A test battery was used to assess speech in noise, binaural effects (head shadow, squelch, summation, spatial release from masking), sound localization, and quality of life. For participants that chose a CI, the same test battery was repeated during the 6 and 12 months follow-up appointments.

Results:

Of the 34 participants involved in the study, 11 were implanted with a CI and finished their 12 month evaluation. Sixteen participants decided to stop after the CROS/BCD trial. In the CI-recipient group, a significant head shadow effect of 5.1 to 7.1 dB was achieved with the CI. Recipients in this group received only a limited benefit with either CROS or BCD before implantation. In the non-CI-recipient group, a significant difference between the CROS and BCD, in favor for the CROS device, was found calculating the head shadow and squelch effect. Localization abilities with the CI improved significantly in the CI-recipient group, even between the 6- and 12-month follow-up appointments. In the non-CI-recipient group, localization was significantly better with the BCD during the trial period. Higher scores were obtained from the speech and spatial categories of the Speech, Spatial, and Qualities of Hearing (SSQ) questionnaire with the CI. No subjective difference could be determined in the non-CI-recipient group.

Conclusion:

Implementing the unified testing framework into a clinical routine was challenging but provided helpful insight into the best treatment option for each individual.

Address correspondence and reprint requests to Anja Kurz, Ph.D., Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany; E-mail: Kurz_A@ukw.de

The Würzburg University Hospital is receiving research funding from MED-EL and Cochlear. This study was supported by HEARRING.

Ethical approval: All procedures performed in this study involving human participants were in the accordance with ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration. Because of the retrospective study design, formal consent was not required. The study was approved by the Ethical Commission of the Medical University of Würzburg, Germany (Nr. 20180808 02).

The authors disclose no conflicts of interest.

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