International Session 10　　Head & Neck 1

Background :Cochlear implantation(CI)is increasingly used in adults with single-sided deafness(SSD)and asymmetric hearing loss (AHL) , but comparative single-center outcome data remain limited.We evaluated 1-year changes in patient-reported auditory benefit, tinnitus burden, device use, and objective speech perception after CI. MethodsWe retrospectively reviewed 124 adults(SSD n＝88, AHL n＝36)who underwent CI at Samsung Medical Center(2019-2024) .Outcomes included CI-aided thresholds, daily device usage, Tinnitus Handicap Inventory(THI) , Hearing Handicap Inventory for the Elderly(HHIE) , and Speech, Spatial and Qualities of Hearing Scale(SSQ) .Group comparisons and prepost analyses were performed.A subgroup(SSD n＝50, AHL n＝15)underwent CI-ear-isolated speech testing via Bluetooth-assisted direct streaming.Results At baseline, SSD patients were younger(SSD 51． 7±13． 2 vs AHL 58． 3±13． 5 years ; p＝0． 003)and had shorter deafness duration(SSD 4． 5±6． 3 vs AHL 15． 0±15． 3 years ; p＜0． 001) .SSD patients had worse baseline auditory handicap with lower SSQ speech scores(47． 4±21． 7 vs 76． 7±26． 6 ; p＜0． 001) , higher HHIE(66． 3±26． 8 vs 47． 3±23． 4 ; p＜ 0． 001) , and higher THI(44． 3±25． 0 vs 30． 0±30． 3 ; p＝0． 042) .Baseline CNC scores were comparable.At 1 year, both groups improved in SSQ domains and HHIE, with no between-group differences in change(all p＞0． 40) .THI improvement was greater in SSD than AHL(20． 7±23． 3 vs 2． 2±30． 7 ; p＝0． 008) .Daily device use was similar(10． 6±3． 8 vs 10． 7± 4． 2 h/day ; p＝0． 68) .CI-ear-isolated speech perception favored SSD for monosyllabic(52． 4±19． 1％ vs 35． 4±23． 0％ ; p＝0． 014) , bisyllabic(83． 6±15． 1％ vs 65． 7±28． 3％ ; p＝0． 011) , and sentence recognition(94． 5±14． 0％ vs 81． 1±26． 8 ％ ; p＝0． 005) .Conclusion CI provided comparable patient-perceived benefit and device acceptance in SSD and AHL despite differing baseline characteristics.CI-ear-isolated speech outcomes indicate distinct auditory performance profiles, supporting tailored counseling in asymmetric hearing loss.