Bimodal cochlear implantation in elders

ABSTRACT Objective: Bimodal stimulation is a standard option for asymmetric hearing loss. Questions have been raised whether receiving two stimulations may conflict in elderly subjects where the central integration of an acoustic/electrical signal may be critical. Design: Clinical retrospective study Study sample: The outcomes from 17 bimodal cochlear implant (CI) users were analyzed. The test material consisted of speech audiometry (quiet and noise), and two speech recognition adaptive noise tests (Matrix and STARR). Results: Age negatively influenced the bimodal auditory outcomes. In subjects where the better ear was the hearing aid (HA) side (n=9), the CI speech perception score was on average: 62±5.2% (quiet), 22±8.4% (SNR+10), 32±7.3dB (STARR), and 16±2.8dB (Matrix). CI showed no bimodal advantage in quiet but a significant advantage in noise. In subjects where the better ear was the CI side (n=8), the HA speech perception score was: 16±6.6% (quiet); none of these patients received an advantage from using the HA. Conclusion: Elderly patients having asymmetrical severe/profound hearing loss were shown to benefit from bimodal stimulation. The Matrix test was reliable, but too difficult for elderly patients, whereas the STARR test was easier. HA STARR >20dB in bimodal users might be used as an indication for bilateral CI.