Cochlear Implantation In Patients Research Articles

Audiologists' attitudes and practice toward referring for psychosocial intervention with cochlear implant patients.

Hearing loss is associated with a range of poor psychosocial outcomes. Cochlear implants (CI) are an available treatment option for significant hearing loss and have been linked to improved quality of life in patients. Evidence suggests that audiologists lack the skills to appropriately detect, address, and refer for psychosocial needs among patients with hearing loss. The objective of this study is to examine the attitudes and practice patterns related to psychosocial care among audiologists who work with CI users. A cross-sectional survey was administered to clinical audiologists who work with CI recipients in the United States. The survey evaluated participants' attitudes toward psychosocial services and factors that contribute to their abilities to address the psychosocial needs of their patients. Additionally, participants were surveyed about their practice patterns including the use of psychosocial screeners, clinical protocols regarding psychosocial care, and referral patterns for coordinated psychosocial services. Descriptive statistics were used to summarize survey responses. Sixty-eight audiologists completed the survey. Of these audiologists, a majority (73.6%) held the attitude that most or all CI patients would benefit from psychosocial intervention. Despite clinicians' recognition of psychosocial needs in this population, over 90% of participants reported never screening for psychosocial symptoms. Additionally, a majority of respondents indicated that they seldom refer their patients for psychosocial services, with referrals occurring less than half the time (58%) or never (27%). Additionally, few audiologists reported utilizing protocols or resources for guiding psychosocial practices. Audiologists indicated that the primary factors that influence their psychosocial practices include time available to spend with the patient and their comfort level in counseling. Audiologists working with CI patients recognize the potential benefit of psychosocial intervention in this population. Nevertheless, audiologists encounter barriers in clinical practice which limit their ability to identify and address the psychosocial needs of their patients. Strategies designed to enhance audiologists' capacity to recognize the psychosocial needs of CI users, in addition to improved interprofessional practice on CI teams, implies significant opportunities to improve the provision of patient-centered hearing care.

Auditory and speech outcomes of cochlear implantation in patients with Waardenburg syndrome: a meta-analysis.

This study aims to assess the potential efficacy of cochlear implantation as a treatment for patients with Waardenburg syndrome (WS) and to guide clinical work by comparing the effect of auditory and speech recovery after cochlear implantation in patients with WS and non-WS. PubMed, the Cochrane Library, CNKI, and Wanfang Data were sources for retrieving literature on cochlear implantation in WS, and clinical data meeting the inclusion criteria were meta-analyzed using RevMan5.41. A total of nine articles were included in this study, including 132 patients with WS and 815 patients in the control group. Meta-analysis showed that there are no significant differences in the scores for categories of audit performance (CAP), speech intelligibility rating (SIR), and parents' evaluation of aural/oral performance of children (PEACH) between the WS group and the control group. Cochlear implantation demonstrates comparable auditory and speech recovery outcomes for WS patients and non-WS patients.

Возможности и перспективы технологии функциональной ближней инфракрасной спектроскопии у пациентов, нуждающихся в высокотехнологичном слухопротезировании

One of the most notable features of auditory prosthetics at the present stage of development is the close interdisciplinary interaction of related medical, scientific, and social specialties. The solution of practical problems in audiology has long gone beyond the range of selecting a method of acoustic or electrical amplification. The priorities in decision making have increasingly shifted from purely engineering efficiency toward improving the quality of life in general. A personalized approach to choosing optimal solutions for each specific case inevitably led specialists to study the cognitive potential and neurophysiological characteristics of the patient. That is why various methods of functional neuroimaging are increasingly being introduced into the scientific and practical activities of an audiologist. Functional near infrared spectroscopy (fNIRS) is considered one of the youngest and most promising technologies. It allows us to research the metabolic activity of the cerebral cortex, which is an important source of feedback when working with sensory functions of the body. The potential of its use can vary from evaluating the effectiveness of measures already taken to solving complex controversial issues of selecting patients for high-tech treatment methods, which do not always remain regulated in methodological documents: the choice of prosthetics, the expediency of performing cochlear implantation in patients with ambiguous indications and contraindications, assessment of rehabilitation potential in neurological comorbidity, etc. In this article, we have tried to systematize and reflect the relevant aspects of the use of fNIRS for audiology patients with a description of the essence of the method, its comparison with alternative methods of functional imaging such as functional magnetic resonance imaging, electroencephalography, magnetoencephalography, positron emission tomography.

Caregivers’ Satisfaction with Telemedicine for Aural Rehabilitation of Cochlear Implant Patients during Coronavirus Disease 2019: A Cross-sectional Study

Abstract Objective: During the coronavirus disease 2019 (COVID-19) pandemic, teletherapy was a reasonable alternative to in-person therapy. However, teletherapy has certain limitations, including technological issues, reduced rapport, and challenging difficulties in engaging with patients. Therefore, this study aimed to investigate the effectiveness of virtual rehabilitation sessions during the COVID-19 pandemic in children with cochlear implants (CIs). Materials and Methods: This cross-sectional study was conducted in a specialized tertiary care ear center to assess virtual aural rehabilitation after cochlear implantation during the COVID-19 pandemic. We included prelingually deaf children aged ≤7 years who underwent unilateral or bilateral CIs and were enrolled in aural rehabilitation with a minimum of one virtual rehabilitation session during the COVID-19 pandemic. Children with other disabilities or technical issues related to the implant devices were excluded. Parental experience and satisfaction with the virtual rehabilitation were evaluated using an interview-based questionnaire scored on a five-point Likert scale. Results: We recruited 34 participants, including 19 males (55.9%) and 15 females (44.1%). Only nine participants (26.5%) had siblings with CIs. None of the participants disagreed with the survey questionnaire. When caregivers were stratified based on their level of education, family experience with CIs, and place of residence, no significant differences were found in ease of access to the virtual sessions. Conclusion: High levels of satisfaction were observed between caregivers and professionals regarding usage comfort. However, future studies are required to evaluate the effectiveness of telemedicine rehabilitation compared with conventional methods, particularly after the COVID-19 pandemic, with respect to different age groups.

Digital Health Literacy: Evaluating the Readability and Reliability of Cochlear Implant Patient Information on the Web.

Hearing aids and implants are used to treat hearing loss, with cochlear implants being the most successful option for severe sensorineural hearing loss. Patients frequently use the internet as a trusted source of clinical information before committing to any therapeutic procedure, including receiving a cochlear implant. A health resource's readability and dependability influence its value to patients. Readability refers to how easily language can be understood, whereas reliability refers to the correctness and consistency of the information presented. JAMA standards and the DISCERN tool were used to assess the reliability of the websites listed. For readability analysis, the FRE, FKG and GFI were chosen. The acceptable readability level was set to < 7 for the FKG, GF score over 17 as the equivalent of college-level education and ≥ 80.0 for the FRE. The readability scores vary across the sources, suggesting a range of comprehension levels required for understanding the cochlear implant patient information found on Google. There was a statistical difference detected in Discern score between the groups (p = 0.008). The mean discern score was significantly higher in hospital generated sources when compared to industry (3.13±0.69 vs. 2.11±0.78, p = 0.03).

Genetic Characteristics and Audiological Performance After Cochlear Implantation in Patients With Incomplete Partition Type III.

Genetic Characteristics and Audiological Performance After Cochlear Implantation in Patients With Incomplete Partition Type III.

Calculation of the Faradaic Impedance of the Electrode-Tissue Interface Improves Prediction of Behavioral T/C Levels in Cochlear Implant Patients.

Fitting of cochlear implants is a labor-intensive process, and therefore automated fitting procedures are being sought. The objective of this study was to evaluate if decomposition of the complex impedance of the electrode-tissue interface could provide additional parameters that show improved correlation with the behavioral T/C levels. A new method for decomposing the complex impedance of the electrode-tissue interface was developed and tested in 18 patients in a prospective study in a tertiary otologic referral center. The averaged near-field Faradaic resistance (RF) calculated in study subjects shows a very strong correlation (R2=0.80) with the behavioral C levels and can be used for automated fitting in most patients. The standard deviation for the T levels and the C levels calculated for each of the electrode contacts in all study subjects is in the range of 10-15 CL and 15-20 CL, respectively. These higher values of the standard deviations are caused by a few outliers who require that additional parameters have to be added to the metric equation, allowing for the automated prediction of the T/C levels. A new method for deriving information from the electrode impedance measurements shows excellent correlation of the Faradaic resistance with the behavioral T/C levels in most patients and can be very useful for fitting cochlear implants based on objective measures. Since some patients still show discrepancies between the predicted T/C levels based on the RF calculation, additional parameters have to be added to the metric equation, allowing for automated prediction of the T/C levels.

Lack of Methylation Changes in GJB2 and RB1 Non-coding Regions of Cochlear Implant Patients with Sensorineural Hearing Loss.

Recent advances in epigenetic studies continue to reveal novel mechanisms of gene regulation and control, however little is known on the role of epigenetics in sensorineural hearing loss (SNHL) in humans. We aimed to investigate the methylation patterns of two regions, one in RB1 and another in GJB2 in Filipino patients with SNHL compared to hearing control individuals. We investigated an RB1 promoter region that was previously identified as differentially methylated in children with SNHL and lead exposure. Additionally, we investigated a sequence in an enhancer-like region within GJB2 that contains four CpGs in close proximity. Bisulfite conversion was performed on salivary DNA samples from 15 children with SNHL and 45 unrelated ethnically-matched individuals. We then performed methylation-specific real-time PCR analysis (qMSP) using TaqMan® probes to determine percentage methylation of the two regions. Using qMSP, both our cases and controls had zero methylation at the targeted GJB2 and RB1 regions. Our study showed no changes in methylation at the selected CpG regions in RB1 and GJB2 in the two comparison groups with or without SNHL. This may be due to a lack of environmental exposures to these target regions. Other epigenetic marks may be present around these regions as well as those of other HL-associated genes.

Gene mutations as a non-invasive measure of adult cochlear implant performance: Variable outcomes in patients with select TMPRSS3 mutations.

The cochlear implant (CI) has proven to be a successful treatment for patients with severe-to-profound sensorineural hearing loss, however outcome variance exists. We sought to evaluate particular mutations discovered in previously established sensory and neural partition genes and compare post-operative CI outcomes. Utilizing a prospective cohort study design, blood samples collected from adult patients with non-syndromic hearing loss undergoing CI were tested for 54 genes of interest with high-throughput sequencing. Patients were categorized as having a pathogenic variant in the sensory partition, pathogenic variant in the neural partition, pathogenic variant in both sensory and neural partition, or with no variant identified. Speech perception performance was assessed pre- and 12 months post-operatively. Performance measures were compared to genetic mutation and variant status utilizing a Wilcoxon rank sum test, with P<0.05 considered statistically significant. Thirty-six cochlear implant patients underwent genetic testing and speech understanding measurements. Of the 54 genes that were interrogated, three patients (8.3%) demonstrated a pathogenic mutation in the neural partition (within TMPRSS3 genes), one patient (2.8%) demonstrated a pathogenic mutation in the sensory partition (within the POU4F3 genes). In addition, 3 patients (8.3%) had an isolated neural partition variance of unknown significance (VUS), 5 patients (13.9%) had an isolated sensory partition VUS, 1 patient (2.8%) had a variant in both neural and sensory partition, and 23 patients (63.9%) had no mutation or variant identified. There was no statistically significant difference in speech perception scores between patients with sensory or neural partition pathogenic mutations or VUS. Variable performance was found within patients with TMPRSS3 gene mutations. The impact of genetic mutations on post-operative outcomes in CI patients was heterogenous. Future research and dissemination of mutations and subsequent CI performance is warranted to elucidate exact mutations within target genes providing the best non-invasive prognostic capability.

A Case of Bilateral Sequential Sudden Sensorineural Hearing Loss in Protein S Deficiency and Successful Recovery of Hearing After Cochlear Implantation

Bilateral sequential sudden sensorineural hearing loss (SSHL) is a rare and challenging clinical condition, but its association with protein S deficiency has received limited attention. This paper reports a case of bilateral sequential SSHL in a patient with protein S deficiency who underwent cochlear implantation and achieved significant improvement in hearing. The patient received high-dose systemic corticosteroids and anticoagulation therapy before the implantation, which had no significant effect. Cochlear implantation was then performed in the left ear, and the patient showed significant improvement in speech understanding and overall hearing ability. A year later, the patient underwent surgery for the opposite ear with favorable outcome. This case highlights the potential benefits of cochlear implantation in patients with bilateral sequential SSHL and protein S deficiency and emphasizes the importance of considering cochlear implantation as a treatment option in such patients.

Preoperative EABR evaluation of auditory pathway integrity in patients with different etiology and postoperative effect estimation.

To evaluate the effect of electrical auditory brainstem response (EABR) on the integrity evaluation of auditory pathway and the prediction of postoperative effect of cochlear implantation in patients with different etiology of hearing loss. A total of 580 patients with neuropathic deafness who underwent cochlear implantation surgery from August 2011 to December 2020 were selected for EABR test. The preoperative EABR waveform was analyzed, and parameters such as V wave amplitude, threshold, latency and interval of each wave, and slope of V wave I/O curve were measured. Neural response telemetry (NRT) test was performed during MAP 1month after operation, and C and T values of the machine were recorded. The total EABR extraction rate was 98.45% among 580 patients, including 100% for the normal structure group and enlarged vestibular aqueduct group (LVAS), 92.44% for other malformed group. The average threshold of V wave in patients with normal cochlear structure was significantly better than the malformation groups (p < 0.05). The total extraction rate of NRT was 78.62%, including 99.72% in the group with normal structure, 95.65% in the LVAS group, 1.85-88.24% in the group with other malformations, and 0% in the cochlear ossification group. The correlation analysis showed a statistically significant correlation between the average preoperative EABR threshold and the C value of NRT. Preoperative EABR could evaluate the integrity of auditory conduction pathway of patients with cochlear implantation and predict the postoperative hearing rehabilitation effect.

Cochlear Implantation or Stapes Surgery in Far Advanced Otosclerosis

Abstract Background Otosclerosis is a process of bone resorption of the labyrinthine capsule followed by reparative deposition of new, immature sclerotic bone. It usually occurs during the postlingual period between the second and fifth decade of life. The most commonly affected location is around the oval window (fenestral otosclerosis), which results in conductive hearing loss due to stapes footplate fixation. As it undergoes a maturation process, the sclerotic bone increases in size and depth. Objective To compare the hearing outcomes and complications of stapes surgery vs cochlear implantation in patients with far advanced otosclerosis. Data Sources Medline databases (PubMed, Medscape, Scopus, Google Scholar, Cochrane, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021. Data Extraction If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Patients and Methods The current review followed the guidelines of preferred reporting items for systematic reviews and meta-analysis statement 2009 (PRISMA). The detailed steps of methods were described elsewhere as well as PRISMA checklist. Results The results of this meta-analysis show that comparing the outcomes and complications of cochlear implantation and stapes surgery in far advanced otosclerosis patients have different results, in some of them there was a highly favorable and recommended procedure than the other, other results declared no significant difference in postoperative outcomes. Conclusion Both Stapes surgery and CI are reliable treatment options for FAO with very close success rates. Statistics of CI are greater than Stapes surgery and CI has a consistent improvement in speech discrimination scores in comparison to Stapes surgery. Patients must receive adequate counseling regarding all the factors mentioned above and the decision must be made by surgeons and the informed patients.

Features of processor fitting in patients with different types of cochlear implant electrode array

Introduction. The results of cochlear implantation in patients with bilateral sensorineural hearing loss are influenced by many factors, including the type of electrode array. The location of the electrodes in relation to neurons of spiral ganglion affects on levels of perception of the patient's hearing sensations.Aim. To evaluate the dependence of electrically evoked compound action potential (ECAP) thresholds values and comfortable levels depends on electrode array type.Materials and methods. 26 patients with bilateral sensorineural hearing loss with cochlear implantation systems were examined. The patients were divided into 2 groups: 1) patients with a straight electrode array (n = 14); 2) patients with a perimodiolar electrode array (n = 12). We tested speech intelligibility and ECAP thresholds. The difference in the values of both parameters was estimated.Results. For both groups of patients, the relationship between the threshold's profiles of ECAP thresholds and maximum comfortable stimulation levels was detected. For patients from the first group (straight electrode array), the differences in values between the studied parameters were 30.6 ± 6.1%. In patients from the second group, the differences in the values of the thresholds for ECAP thresholds and the levels of comfortable stimulation ranged 2.4 ± 2.1%.Conclusion. The perimodiolar electrode array is located closer to the neurons of the spiral ganglion, which may explain the greater relationship between the values of the ECAP thresholds and the levels of comfortable stimulation. This pattern must be considered when programming the processor of the cochlear implantation system.

Prospective comparative analysis of cochlear implant patients with single-sided deafness and asymmetric hearing loss with regard to health-related quality of life, tinnitus distress and psychological comorbidities

Patients with single-sided deafness (SSD) and asymmetric hearing loss (AHL) are increasingly being treated with cochlear implants (CI) due to the demonstrated improvements in auditory abilities and quality of life. To date, there are few published studies in which these two groups are comparatively studied. The aim of the current study was to examine which factors differ between those two patient groups, especially preoperatively. Asecondary analysis of the previously published raw data of 66prospectively recruited CI patients (21SSD/45AHL) was performed. In addition to the hearing outcome, tinnitus distress (tinnitus questionnaire), health-related quality of life (Nijmegen Cochlear Implant Questionnaire, NCIQ), stress (Perceived Stress Questionnaire, PSQ), and psychological comorbidities (General Depression Scale, ADS‑L and Generalized Anxiety Disorder scale, GAD-7) were assessed in SSD and AHL patients pre- and postoperatively. Preoperatively, SSD patients showed significantly higher scores in the NCIQ subdomains "elementary" and "advanced sound perception" than the AHL group. Stress (PSQ) and anxiety symptoms (GAD-7) were significantly higher preoperatively in SSD patients than in AHL patients. After CI, these differences were strongly reduced, with minimal differences being detectable between the groups in the investigated domains postoperatively. SSD and AHL patients differ significantly preoperatively in terms of their subjective hearing assessment and psychosocial parameters. In SSD patients, psychological stress factors may have astronger impact on the quality of life than in AHL patients. These aspects should be taken into account in the preoperative counseling and postoperative rehabilitation.

Outcomes of Cochlear implantation in early-deafened patients with Waardenburg syndrome: A systematic review and narrative synthesis.

This systematic review aims to establish the expected hearing and speech outcomes following cochlear implantation (CI) in patients with profound congenital deafness secondary to Waardenburg syndrome (WS). A systematic review of the literature and narrative synthesis was performed in accordance with the PRISMA statement. Databases searched: Medline, Pubmed, Embase, Web of Science, Cochrane Collection, and ClinicalTrials.gov. No limits were placed on language or year of publication. Searches identified 186 abstracts and full texts. Of these, 16 studies met inclusion criteria reporting outcomes in 179 patients and at least 194 implants. Hearing outcomes of those receiving cochlear implantation were generally good. Five studies included genetic analysis of one or more of the participants. A total of 11 peri/post-operative complications were reported. The methodological quality of included studies was modest, mainly comprising noncontrolled case series with small cohort size. All studies were OCEBM grade III-IV. Cochlear implantation in congenitally deafened children with Waardenburg Syndrome is a well-established intervention as a method of auditory rehabilitation. Due to the uncommon nature of the condition, there is a lack of large-scale high-quality studies examining the use of cochlear implantation in this patient group. However, overall outcomes following implantation are positive with the majority of patients demonstrating improved audiometry, speech perception and speech intelligibility supporting its use in appropriately selected cases.

An audit of outcomes of cochlear implantation in patients following temporal bone fracture

An audit of outcomes of cochlear implantation in patients following temporal bone fracture

Bilateral sequential cochlear implantation in a patient with the CAPOS syndrome – postsynaptic auditory neuropathy related toa missense mutation within the ATP1A3 gene

ntroduction: This paper presents a boy with CAPOS syndrome (Cerebellar ataxia, Areflexia, Pes calvus, Optic atrophy, Sensorineural hearing loss) and postsynaptic auditory neuropathy who underwent bilateral, sequential cochlear implantation. Aim: The aim of the study is to describe the development of communication skills after bilateral cochlear implantation in a child with multiple disabilities including profound hearing loss and vision impairment. Material and methods: The patient’s medical history, including the results of diagnostic tests is presented. Sequential, bilateral cochlear implantation was performed at the age of 7 (right ear) and 8 years (left ear). Results: The results of audiometric tests confirmed postsynaptic auditory neuropathy. Molecular testing revealed a diseasecausing heterozygous c.3007C&gt;A variant in the ATP1A3 gene encoding the Na+/K+ ATPase. 14 months after surgery, the ability to speak had not been regained, but the patient was able to distinguish the environmental sounds. Conclusions: Cochlear implantation is recommended for patients with CAPOS syndrome. The development of communication skills improved the functioning of the child in the family and school environment. Meaning: The results observed in the presented patient differ from the results achieved by patients with cochlear hearing loss and presynaptic neuropathies, but indicate the validity of bilateral cochlear implantation in patients with postsynaptic neuropathy in the CAPOS syndrome.

PRE AND POST- OPERATIVE ELECTROCOCHLEOGRAPHY IN COCHLEAR IMPLANT CASES - A STUDY TO PRESERVE RESIDUAL HEARING

INTRODUCTION E l e c t r o c o c h l e o g r a p h y ( E C o c h G ) i s a n electrophysiological technique that records electrical potentials generated by different components of the inner ear and peripheral cochlear nerve in response to acoustic stimulation. Electrical evoked potential has been long used in cochlear implant to record the neural responses during intra or post-surgery. During cochlear implant electrically evoked compound action potential(E-CAP) or neural response telemetry (NRT) test used to measure the neural responses. Historically, ECochG found its main application in the diagnostic evaluation of Meniere's disease. However, in the last decade, the focus has shifted towards cochlear implantation (CI). MATERIAL AND METHOD The aim of the study is to measure residual hearing in pre and post operative cochlear implant patients using electrocochleography. With the help of ASSR and ECochG test it could be identified thatresidual hearing is preserved or not.Less traumatic CI electrode array design and the use of “soft surgery” techniques allow for the preservation of residual low-frequency acoustic hearing. In patients with residual hearing after CI, combined electric and acoustic stimulation has resulted in improved hearing and speech outcomes. CONCLUSION Preservation of acoustic hearing allows individuals with CIs to take advantage of periodicity, commonly referred to as voice pitch, and temporal fine structure, offering improved spectral resolution and supports in speech intelligibility better understanding in CI users. Pre implant and Post implant electrocochleography r e s u l t s w e r e c o m p a r e d a n d e v a l u a t e d . Comparison was made by comparing of pre and post implant peak and wave morphology, Summation Potential (SP) /Action Potential(AP) Area ratio and SP/AP Amplitude ratio. Keywords Meniere's disease, Soft surgery, Residual hearing.

Tissue-Engineered Cochlear Fibrosis Model Links Complex Impedance to Fibrosis Formation for Cochlear Implant Patients.

Cochlear implants are a life-changing technology for those with severe sensorineural hearing loss, partially restoring hearing through direct electrical stimulation of the auditory nerve. However, they are known to elicit an immune response resulting in fibrotic tissue formation in the cochlea that is linked to residual hearing loss and suboptimal outcomes. Intracochlear fibrosis is difficult to track without postmortem histology, and no specific electrical marker for fibrosis exists. In this study, a tissue-engineered model of cochlear fibrosis is developed following implant placement to examine the electrical characteristics associated with fibrotic tissue formation around electrodes. The model is characterized using electrochemical impedance spectroscopy and an increase in the resistance and a decrease in capacitance of the tissue using a representative circuit are found. This result informs a new marker of fibrosis progression over time that is extractable from voltage waveform responses, which can be directly measured in cochlear implant patients. This marker is tested in a small sample size of recently implanted cochlear implant patients, showing a significant increase over two postoperative timepoints. Using this system, complex impedance is demonstrated as a marker of fibrosis progression that is directly measurable from cochlear implants to enable real-time tracking of fibrosis formation in patients, creating opportunities for earlier treatment intervention to improve cochlear implant efficacy.

Algorithm for selecting patients for cochlear implantation. Lecture for physicians

At the present stage in the world there are many methods for restoring hearing in humans, but, unfortunately, not all methods are effective for high-grade hearing loss or deafness. Carrying out timely rehabilitation of patients with a deep degree of hearing loss, especially in childhood, is extremely important for social and psychological adaptation in society. In patients with severe hearing loss, cochlear implant surgery is the most effective treatment. This operation is possible while maintaining the anatomy of the inner ear and the conduction of the auditory nerve. This lecture details the general principles of rehabilitation of patients with hearing impairments of various etiologies, the tactics of selecting patients for cochlear implantation, which is of great importance for choosing a method for treating patients with hearing loss and their psychosocial adaptation.