Streamlining the Cochlear Implant Evaluation

About 2% of adults aged 45 to 54 have disabling hearing loss. The rate increases to 8.5% for adults aged 55 to 64. Nearly 25% of those aged 65 to 74 and 50% of those who are 75 and older have disabling hearing loss. Only about 16% of adults who would benefit from hearing aids have ever even tried hearing aids. Hearing aid technology has progressed – they are incredible little instruments. But they are limited in that they are only able amplify sound. For many, they hearing loss also limits a person’s ability to understand speech. A cochlear implant (CI) is capable of improving speech understanding. When there are so many people that haven’t received hearing aids when they need them, imagine how much more difficult it is to get to the next level – a cochlear implant. It’s been estimated that only 6% of adults who could benefit from a CI have received one.

The evaluation process for a cochlear implant takes some time and involves additional tests just beyond the standard hearing test. Oftentimes, an audiologist in the community will recognize a patient is having trouble understanding speech – even with hearing aids. A standard hearing test also includes a test of understanding and generates a “Word Recognition Score” (WRS). A WRS of <40% has been shown to a be a good indication that someone would benefit from a CI. At that point, hopefully, they will send that person for a formal CI evaluation. Typically, the audiologist at the cochlear implant center will repeat the basic audiogram, confirm that a CI evaluation is warranted, and then schedule yet another appointment for the formal evaluation.

However, each health care visit has an associated cost – both in time and money. It also adds another small barrier to the process. A recent study looked at a way to cut out at least one of those visits.1 They determined that there was no reason to repeat the basic audiogram. If the community audiologist found a WRS of <40%, it was best to proceed straight to formal CI evaluation.

In summary, if you have hearing loss that seems to not benefit from hearing aids, or if you have a patient with WRS of <40%, send them to the Idaho Ear Clinic for CI evaluation.

1. Shah, Ravi R.∗; Jeon, Jun W.∗; Naples, James G.†; Hwa, Tiffany P.∗; Davis, Sherrie∗; Eliades, Steven J.∗; Brant, Jason A.∗; Bigelow, Douglas C.∗; Ruckenstein, Michael J.∗ Streamlining the Cochlear Implant Evaluation: Utility of Community Audiometry in Cochlear Implant Candidacy Assessment, Otology & Neurotology: March 2021 - Volume 42 - Issue 3 - p 402-407 doi: 10.1097/MAO.0000000000002942