Revisiting Cochlear Implant Candidacy
JH is a 48-year-old female with a flat, moderately severe sensorineural hearing loss who was referred to evaluate her candidacy for a cochlear implant (CI) due to a recent decrease in hearing thresholds of 0 to 5 dB across all audiometric test frequencies in the right ear and 5 to 10 dB across all audiometric frequencies in the left ear. This threshold shift was accompanied by a significant decrease in word recognition scores (WRSs). The WRS for the right ear decreased from 84 to 60%, and the WRS for the left ear decreased from 78 to 36%. Initial review of previous audiological examinations indicated more residual hearing than is typically allowable for candidates for a CI (Fig. 61.1) where JH’s audiological evaluation revealed a moderate to moderately severe sensorineural hearing loss that is flat in configuration. Immittance audiometry revealed normal tympanograms and absent acoustic reflex thresholds (ARTs) to contralateral and ipsilateral stimulation at 500 to 1000 Hz. Typically, candidacy for a CI requires the patient to have a moderate to profound hearing loss. It was, however, decided to evaluate JH to determine potential benefit from amplification that could provide greater gain and output and performance than JH was receiving from her current hearing aids.