Audiologic and patient perceived benefit in cochlear implantation for single-sided deafness

Abstract

Background CI in SSD strives to restore binaural hearing. With normal acoustic hearing on one ear, the benefits of rehabilitating the deaf ear with an implant are not well established. Objectives We investigate audiologic and quality-of-life measures, and long-term usage patterns of cochlear implantation (CI) in patients with single-sided deafness (SSD) Methods Eight patients with idiopathic sudden sensorineural hearing loss of less than 5-year duration were recruited. Pure tone average (PTA), speech discrimination score (SDS), hearing-in-noise test (HINT), tinnitus handicap inventory (THI), quality-of-life speech spatial qualities (SSQ) scale tests were performed before, and one-year after CI. Long-term usage of CI four-years post-operatively was determined. Results The median PTA of the deaf ear was 96 dBHL (IQR = 90–120) before, and 30 dBHL (IQR = 27–33) after CI (p = 0.0156). SDS improved from median of 0% (IQR = 0–3) to 33% (IQR = 24–58) (p = 0.0360). Median signal-to-noise ratio (SNR), particularly of the S0Nbetter setting of HINT showed improvement from 6.4 dB (IQR = 5.7–7) to 0.9 dB (IQR = −2.25–6.2) (p = 0.1094). Despite median THI improving from 24 (IQR = 6–47) to 4 (IQR = 2–7) (p = 0.1563), two patients experienced worsening of tinnitus. SSQ scores in all subscales showed modest improvement not approaching significance. 5 of 8 (62%) patients stopped using their implant four years after surgery. Conclusion Despite improved audiologic and tinnitus outcome measures, our patients’ SDS remained in non-serviceable range, while quality-of-life measures showed only modest improvement. Majority of our patients stopped using their implant four years post-surgery. Our study suggests that objective measurable benefits of CI in SSD may not translate to actual patient perceived benefits.