Alan Micco, MD, associate professor of otolaryngology-head and neck surgery at Northwestern University in Chicago, said he agreed, but said,
Explore This IssueMarch 2017
“It’s a mixed bag; the ones with tinnitus seem to love it, but a lot of them don’t like the sound quality particularly when the hearing is very normal in the opposite ear.”
Dr. Buchman said the patient ended up getting a CI as part of a study that has funding for single-sided hearing loss, and has done well. “I think, overall, patients are doing a lot better” with CIs, he said. “I’m hopeful that the kind of information that’s starting to come out of some of these studies will start to change the carriers’ minds.”
Bilateral Hearing Loss
In another case, a 66-year-old patient had experienced bilateral hearing loss for 20 years and was frustrated with his difficulties both in quiet settings and with background noise. The softest sounds he could hear were in the 95- to 100-decibel range at high frequencies and in the 60- to 70-decibel range at low frequencies, with word recognition scores (WRS) of 60% for the right ear and 68% for the left. He’d been wearing hearing aids for 10 years.
Dr. Micco said he would be sure to check on the age and quality of the hearing aid being used to be sure it’s a good fit, and might consider an implantable hearing aid as an intermediate step.
Dr. McKinnon said a patient’s performance with hearing aids is an important factor when considering an implantable aid. “The problem is that if they’re not happy with their hearing aids, there’s a significant likelihood they’re not going to like their middle ear implant,” he said. “I’d be fairly hesitant because he’s not happy with his hearing aids.”
Panelists generally agreed that they’d use a long electrode in this patient, although Dr. McKinnon acknowledged literature showing good results for short ones. He’d approach this as a hearing preservation case, which is how he tends to approach most of these types of cases.
Panelists added that, anecdotally, they’ve had good success with a hearing aid in one ear and a tethered CI in the other. When it comes to bilateral cochlear implants, Dr. Roland said, patients need to be informed that they could lose some of the “finer qualities” and nuances of sound. “I encourage them to wait and take some time and check back with me in another six months to a year,” he said.