Aural Rehabilitation of a Sequential Bilateral Cochlear Implant User
Rehabilitation of a bilateral sequential cochlear implant (CI) user presents many unique challenges. Patients go through an “early acclimation period” with their device as they begin to listen through electrical stimulation presented by the CI. For a bilateral sequential user, the adjustment period will vary based on length of deafness and prior use of amplification. In addition, despite extensive counseling, patients often have preconceived expectations regarding outcomes. A multidisciplinary team is critical to effective management. Furthermore, communication between disciplines ensures patients maximize the use of their devices and support their goals for better listening and spoken communication.
WM was a 69-year-old woman diagnosed with bilateral progressive sensorineural hearing loss due to otosclerosis as a senior in high school. Subsequent to a stapedectomy, she wore hearing aids bilaterally. Her hearing continued to deteriorate and at the age of 58 years, she was referred for CI evaluation. Testing revealed profound hearing loss in the right ear and a mild-to-severe hearing loss in the left ear. At that time, she received a CI in the right ear. Over the next 10 years, her hearing worsened in her left ear and at the age of 68 years, she received an implant in that ear. Following the second implant, she reported difficulty monitoring speech production, voice quality, and loudness of speech. She reported missing parts of conversations, requested clarification frequently, and was a passive communicator in conversations. She felt isolated from family and friends at gatherings and her self-esteem had declined.