Determination of Bimodal/Bilateral Cochlear Implant Candidacy
The patient, Harper, now 10 years old, was seen at a pediatric audiology clinic at 9 years of age for an audiologic evaluation to determine the optimal hearing technology required to best meet her diverse needs.
Harper was diagnosed via visual reinforcement audiometry (VRA) using insert earphones with a moderate to moderately severe, bilateral, sensorineural hearing loss (see audiogram in ▶ Fig. 1) at a university medical center at 8 months of age. A tone burst auditory brainstem response evaluation conducted shortly after the VRA assessment confirmed the results of the behavioral evaluation. She was fitted with behind-the-ear (BTE) hearing aids when she was 8 months old. Real ear probe microphone assessment indicated an excellent match to the Desired Sensation Level (DSL) 5.0 targets for multiple speech input levels (e.g., 55, 65, and 75 dB Sound Pressure Level, SPL). Harper was enrolled into Auditory-Verbal therapy where she and her family received therapy from a Listening and Spoken Language Specialist (LSLS) on a weekly basis. Of note, Harper passed her newborn hearing screening for both ears. The cause of her hearing loss is unknown.