SRF301 - Evaluation of Candidacy and Benefit from Cochlear Implantation for Single-Sided Deafness in Adults

Abstract:
Until 2019, FDA approved treatment options for single-sided deafness (SSD) included observation, use of a CROS transmitter, and osseointegrated devices. With the recent FDA approval of cochlear implantation as a treatment for single-sided deafness, clinical guidelines for assessing candidacy and benefit outcomes have been variable across implant centers in the United States. In this session, a review of current practices for evaluating cochlear implant candidacy and benefit outcomes for SSD will be reviewed and current research findings will be discussed.

Summary:
Single-sided deafness (SSD) is defined as thresholds in the poorer-ear in the severe to profound range, while thresholds of the better ear are within normal limits or in the mild range. (U.S. Food and Drug Administration, 2019). Barriers to communication associated with SSD include impairments to speech recognition, difficulty understanding conversations, especially on the side of the deaf ear, bothersome unilateral tinnitus, and localizing sounds (Jakob et. al, 2020). SSD deprives the auditory cortex from direct stimulation from the affected side, which can create irreversible damage (Gordon et. al, 2015).

Until 2019, FDA approved treatment options for single-sided deafness (SSD) included observation, use of a Cros transmitter, and osseointegrated devices (Varadarajan, Sydlowski & Li, 2020). With the recent FDA approval of cochlear implantation as a treatment for single-sided deafness, clinical guidelines for assessing candidacy and benefit outcomes have been variable across implant centers in the United States which may lead to a patient qualifying for a cochlear implant at one center and not another. The American Cochlear Implant Alliance (ACIA, 2022) published assessment guidelines for SSD candidacy and benefit evaluations for the pediatric population, however, there are no such published guidelines for adults.

The purpose of this study was to identify most-common clinical practices among audiologists in (1) assessing cochlear implant candidacy and (2) benefit of patients with single-sided deafness. The results from this study will be compared to the current clinical guidelines published by ACIA for children with SSD. Furthermore, collection of this data will provide beneficial information for the creation, implementation, and outcome measurement of aural rehabilitation measures for SSD patients.

Audiologists based in the United States and/or internationally were invited to participate in this study. Inclusion criteria for participants were as follows: (1) A practicing professional in the who currently holds their Masters degree or AuD in audiology (or equivalent) and (2) at least one year of post-graduate clinical experience in adult cochlear implants.

A survey was administered using the Qualtrics platform with results analyzed by the most recent version of SPSS. The survey contains questions aimed to collect information on participants’ protocols used to evaluate cochlear implant candidacy for SSD patients and subjective and objective benefit from unilateral cochlear implantation for SSD.

Findings from this study can be used to guide the development of universal protocols for evaluating adult candidacy and benefit within a clinical setting. Universal protocols will help guide audiologists in their decision making processes for providing treatment recommendations.

The current study has received IRB approval, data collection is ongoing, and completion is expected by February 2023.