Samuel P Gubbels1,2, Brian C Gartrell2,3, Jennifer L Ploch4, Kevin D Hanson5. 1. Department of Otolaryngology, University of Colorado, School of Medicine, Aurora, Colorado. 2. Department of Surgery, Division of Otolaryngology, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wisconsin. 3. Department of Family Medicine, University of Nebraska Medical Center, Omaha, Nebraska. 4. Department of Surgery, Division of Audiology, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wisconsin. 5. University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wisconsin, U.S.A.
Abstract
OBJECTIVES/HYPOTHESIS: Determining cochlear implant candidacy requires a specific sentence-level testing paradigm in best-aided conditions. Our objective was to determine if findings on routine audiometry could predict the results of a formal cochlear implant candidacy evaluation. We hypothesize that findings on routine audiometry will accurately predict cochlear implant evaluation results in the majority of candidates. STUDY DESIGN: Retrospective, observational, diagnostic study. METHODS: The charts of all adult patients who were evaluated for implant candidacy at a tertiary care center from June 2008 through June 2013 were included. Routine, unaided audiologic measures (pure-tone hearing thresholds and recorded monosyllabic word recognition testing) were then correlated with best-aided sentence-level discrimination testing (using either the Hearing in Noise Test or AzBio sentences test). RESULTS: The degree of hearing loss at 250 to 4,000 Hz and monosyllabic word recognition scores significantly correlated with sentence-level word discrimination test results. Extrapolating from this association, we found that 86% of patients with monosyllabic word recognition scores at or below 32% (or 44% for patients with private insurance) would meet candidacy requirements for cochlear implantation. CONCLUSIONS: Routine audiometric findings can be used to identify patients who are likely to meet cochlear implant candidacy upon formal testing. For example, patients with pure-tone thresholds (250, 500, 1,000 Hz) of ≥75 dB and/or a monosyllabic word recognition test score of ≤40% have a high likelihood of meeting candidacy criteria. Utilization of these predictive patterns during routine audiometric evaluation may assist hearing health professionals in deciding when to refer patients for a formal cochlear implant evaluation. LEVEL OF EVIDENCE: 4 Laryngoscope, 127:216-222, 2017.
OBJECTIVES/HYPOTHESIS: Determining cochlear implant candidacy requires a specific sentence-level testing paradigm in best-aided conditions. Our objective was to determine if findings on routine audiometry could predict the results of a formal cochlear implant candidacy evaluation. We hypothesize that findings on routine audiometry will accurately predict cochlear implant evaluation results in the majority of candidates. STUDY DESIGN: Retrospective, observational, diagnostic study. METHODS: The charts of all adult patients who were evaluated for implant candidacy at a tertiary care center from June 2008 through June 2013 were included. Routine, unaided audiologic measures (pure-tone hearing thresholds and recorded monosyllabic word recognition testing) were then correlated with best-aided sentence-level discrimination testing (using either the Hearing in Noise Test or AzBio sentences test). RESULTS: The degree of hearing loss at 250 to 4,000 Hz and monosyllabic word recognition scores significantly correlated with sentence-level word discrimination test results. Extrapolating from this association, we found that 86% of patients with monosyllabic word recognition scores at or below 32% (or 44% for patients with private insurance) would meet candidacy requirements for cochlear implantation. CONCLUSIONS: Routine audiometric findings can be used to identify patients who are likely to meet cochlear implant candidacy upon formal testing. For example, patients with pure-tone thresholds (250, 500, 1,000 Hz) of ≥75 dB and/or a monosyllabic word recognition test score of ≤40% have a high likelihood of meeting candidacy criteria. Utilization of these predictive patterns during routine audiometric evaluation may assist hearing health professionals in deciding when to refer patients for a formal cochlear implant evaluation. LEVEL OF EVIDENCE: 4 Laryngoscope, 127:216-222, 2017.
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