Cochlear implantation in adults with unilateral deafness: A review of the assessment/evaluation protocols

Abstract

Objectives: Cochlear implantation is becoming widely used outside the tertiary research centers for treatment of unilateral deafness (UD). No consensus exists, however, on the most suitable assessment/evaluation protocols for this group of adult patients. This paper aims to review the assessment and evaluation protocols used by various research groups and to propose a protocol for the use in the clinical setting.Methods: The PubMed, Embase, and Cochrane Library databases were searched with the keywords ‘cochlear’, ‘implant’, ‘single-sided’, ‘deafness’, ‘adults’, ‘unilateral’, and ‘deafness’. The words were either used individually, combined in pairs, or in groups of 5. All articles reporting on prospective studies, retrospective studies, or case studies were included.Results: Sixteen published studies met the inclusion criteria. Measures of hearing performance, tinnitus, subjective quality of hearing, and quality of life varied greatly among studies.Discussion: Adaptive speech in noise testing, localization, tinnitus measurement questionnaires, and self-rated hearing improvement are widely used among the research groups. These tools in conjunction assess and evaluate the main issues associated with UD.Conclusion: The test battery most commonly used to assess and evaluate adult cochlea implant users with UD consists of (a) a subjective self-rating of hearing performance, (b) localization testing, and (c) the adaptive speech in noise testing conducted in at least the following three spatial configurations: speech and noise presented from the front (S0/N0), speech presented from the front and noise presented to the good hearing ear (S0/Nhe), and speech presented to the implanted ear and noise presented to the hearing ear (Sci/Nhe).