Single-Sided Deafness and Cochlear Implant Utilization: Are Traditional Speech Performance Factors Associated With Usage in Adult Patients?

OBJECTIVE

To characterize adults with single-sided deafness (SSD) and cochlear implant (CI) utilization with associated clinical predictors.

STUDY

DESIGN

Retrospective cohort study.

SETTING

Tertiary care academic center.

PATIENTS: Adults with SSD (pure tone average in contralateral ear ≤30 dB).

INTERVENTIONS: Cochlear implantation in SSD ear.

MAIN OUTCOME MEASURES: Datalogging (hours/day of CI usage) and associated usage categories (full-time: ≥8 h/d; partial: 2 to 7.99 h/d; limited: 0.01 to 1.99 h/d; nonuse: 0 h/d).

RESULTS

Ninety-six CI patients were identified, and 70 patients had longitudinal datalogging follow-up. At final follow-up, 33 were full-time users (47.1%), 27 were partial users (38.5%), 8 were limited users (11.4%), and 2 were nonusers (2.8%). Longitudinal datalogging showed that patients, as early as 1 month, display strong utilization patterns that reflect their final usage at 12 months. Traditional CI factors, including duration of hearing loss, speech performance in both quiet and in noise, and hearing loss etiology, had no association with final user status. Younger patients had a higher likelihood of becoming partial/limited users (-7.8 y; 95% CI -14.8 to -2.6; P =0.004). A subset of patients who transitioned from initial full-time users to partial/limited users also tended to be younger, but nonsignificant after Bonferroni correction (-8.0 y; 95%CI -17.5 to -0.7; P =0.034).

CONCLUSIONS

Receiving a CI remains a meaningful treatment option for patients with SSD. While utilization patterns vary, over 80% will use their device regularly (full-time or part-time). Speech perception performance does not appear to correlate with final device utilization, but device usage behavior as early as one month appears to be strongly associated with usage at the final 12-month follow-up.

LEVEL OF EVIDENCE: Level IV.