Key points are not available for this paper at this time.
In Brief Objectives: The primary objective of this study was to determine whether a revision and/or expansion of current audiologic cochlear implant candidacy criteria is warranted. Design: The study design was a retrospective review of postoperative speech perception performance for 22 adult cochlear implant recipients who demonstrated preoperative Consonant Nucleus Consonant word recognition scores of 30% or higher in the best-aided condition. This criterion was chosen to exceed that specified by the North American clinical trial of the Nucleus Freedom cochlear implant system. Results: The mean preoperative best-aided monosyllabic word score for the 22 patients was 41% correct. The degree of postoperative benefit for the best postoperative condition (electric only or bimodal) ranged from 10 to 68 percentage points with a mean benefit of 27 percentage points for the electric-only condition and 40 percentage points for the bimodal condition. Statistical analyses revealed highly significant differences between preoperative-aided, implant-only, and bimodal performance on Consonant Nucleus Consonant monosyllabic word recognition performance. That is, both postoperative scores—electric only and bimodal—were significantly different from one another and from the preoperative best-aided performance. Conclusions: The current results suggest that a large-scale reassessment of manufacturer and Medicare preoperative audiologic candidacy criteria for adults is warranted to allow more hearing-impaired individuals to take advantage of the benefits offered by cochlear implantation. Audiologic criteria for adult cochlear implant candidacy has been in place for over a decade in the U.S. To determine whether new recommendations are warranted, a retrospective review of postoperative performance was completed for 22 cochlear implant recipients demonstrating preoperative word scores of 30% or higher. Postoperative benefit ranged from 16 to 66%. Statistical analysis revealed a significant difference between preoperative aided, implant only, and bimodal performance for monosyllabic word recognition. These data suggest that a reassessment of manufacturer and Medicare candidacy criteria for adults is warranted to allow more hearing impaired individuals to take advantage of the benefit offered by cochlear implantation.
Gifford et al. (Thu,) studied this question.