Cochlear implantation in Single-Sided Deafness

This survey is designed to investigate trends in Cochlear implant (CI) candidacy assessment for individuals with single sided deafness (SSD). For the purpose of this survey, we are defining SSD as:

- traditional CI candidacy in the ear to be implanted

- normal, unaidable hearing (<25 db PTA) in the contralateral ear.

This survey should take less than 5 min to complete

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* 1. In the past 12 months, my center has implanted this many adult patients for SSD:

1-10

11-25

>50

None yet but planning to do in the future

Not sure

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* 2. In the past 12 months, my center has implanted this many pediatric patients (<18 yrs old) with SSD:

1-10

>10

We perform SSD in adults but not children

Not yet but would if we had the right candidate

Not sure

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* 3. At my center, we consider CI in an option in an SSD patient with pre-lingual deafness in the ear to be implanted

Yes

In some cases

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* 4. At my center, length of severe/profound hearing loss in the ear to be implanted is a consideration in cochlear implantation in SSD

Yes

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* 5. Regarding timing of implantation in patients with SSD, we limit cochlear implantation to those with hearing loss in the ear to be implanted of

< 1 year

< 3 years

< less than 10 years

Length of hearing loss in the ear to be implanted is discussed, but my center does not follow a specific protocol regarding length of deafness in the ear to be implanted

Question Title

* 6. The next question attempts to assess how vigorously your center requires a patient to experience or pursue other options prior to pursuing a cochlear implant.
At my center, the CI candidacy protocol for patients with SSD involves:

A discussion of bone anchored hearing aids and CROS-hearing aids

A discussion AND a minimum of an in-office trial of a soft-band Bone anchored hearing device

A discussion AND a trial (of any length) of a CROS hearing aid

B and C (ie a trial of a bone anchored hearing aid AND a CROS aid)

We discuss the options with the patient and allow them to decide if they might want to pursue any prior to cochlear implantation. If they have no interest, we do not require

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* 7. This question relates to timing of CI after a sudden profound SNHL. Following an episode of unilateral, sudden SNHL (including those that have been unresponsive to pharmacotherapy such as oral and/or intra-tympanic steroids), we typically

Implant under 3 months or as soon as the patient has completed CI candidacy evaluation

Wait at least 3 months before CI

Wait at least 6 months – 1 year before CI

We wait at least 1 year before performing a CI

We have no standard waiting period or protocol

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* 8. The following question relates to CI in patients with normal hearing in one ear and partial deafness (ie residual low-frequency hearing) in the ear to be implanted.

We do not consider these SSD individuals to be candidates for cochlear implantation. We perform CI in SSD only when the ear to be implanted meets traditional CI candidacy criteria.

We may consider these individuals to be candidates for cochlear implantation on a case by case basis.

We have experience with electro-acoustic hearing in the SSD population (specifically with an EAS process or an implanted ear and no amplification on the contralateral ear)

Not sure

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* 9. The following question relates to pre-operative speech testing to determine CI candidacy in patients with SSD.

We perform aided speech testing in the ear to be implanted and binaural

We perform aided speech testing in the ear to be implanted only

Not sure

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* 10. For pre-operative speech testing to determine CI candidacy in patients with SSD, we assess

Words only

Sentences only

Words and sentences

Not sure

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* 11. For pre-operative speech testing to determine CI candidacy in patients with SSD, we perform testing in:

Quiet only

Quiet and noise at +10 dB SNR

Quiet and noise at +5 dB SNR

Quiet and noise at 0 dB SNR

Quiet and a variable noise protocol depending on the individual’s performance

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* 12. Regarding masking of the normal hearing ear during candidacy evaluation, we use the following parameters:

We plug and muff the normal hearing ear during testing

We provide masking at 45 dB in the normal ear

We provide masking at another level in the normal ear

Not sure

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* 13. Following cochlear implantation, we typically activate the CI

At the same time as traditional candidates, approx. 2-4 weeks post-implantation

In an alternate protocol

On a case by case basis

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* 14. When programming a CI in an SSD population, we:

Plug and muff the normal hearing ear

We provide masking (at any level) in the normal ear

Use direct connect or other similar technology

None of the above

Not sure

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* 15. When performing post-operative speech testing following CI in an SSD population, we:

Plug and muff the normal hearing ear

We mask the normal hearing ear

Use direct connect or other similar technology

None of the above

Not sure

We do not do post-operative speech testing in this population

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* 16. Regarding post-operative habilitation/auditory training following CI in an SSD population

We encourage/use the same techniques and protocols used in traditional CI candidates

We encourage/use unique techniques in this population (such as streaming audio books to the CI so as to isolate the implanted ear)

A&B

We do not discuss any particular post-op habilitation or auditory training techniques

Not sure

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* 17. In general, for patients with SSD, we often administer (ether pre- or post-op or both)

The SSQ (Speech, Spatial and Qualities of Hearing Scale)

Other validated surveys (such as the Tinnitus Hearing Handicap, etc)

Our own questionnaire

We do not routinely employ any surveys

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* 18. In my experience, the primary barriers to CI in SSD are:

Insurance approval

Lack of available patients with SSD that are interested in CI

Audiologist or surgeon experience with CI in SSD

Lack of evidence to support best practices in this population

Cochlear implantation in Single-Sided Deafness

Question Title

* 1. In the past 12 months, my center has implanted this many adult patients for SSD:

Question Title

* 2. In the past 12 months, my center has implanted this many pediatric patients (<18 yrs old) with SSD:

Question Title

* 3. At my center, we consider CI in an option in an SSD patient with pre-lingual deafness in the ear to be implanted

Question Title

* 4. At my center, length of severe/profound hearing loss in the ear to be implanted is a consideration in cochlear implantation in SSD

Question Title

* 5. Regarding timing of implantation in patients with SSD, we limit cochlear implantation to those with hearing loss in the ear to be implanted of

Question Title

* 6. The next question attempts to assess how vigorously your center requires a patient to experience or pursue other options prior to pursuing a cochlear implant. At my center, the CI candidacy protocol for patients with SSD involves:

Question Title

* 7. This question relates to timing of CI after a sudden profound SNHL. Following an episode of unilateral, sudden SNHL (including those that have been unresponsive to pharmacotherapy such as oral and/or intra-tympanic steroids), we typically

Question Title

* 8. The following question relates to CI in patients with normal hearing in one ear and partial deafness (ie residual low-frequency hearing) in the ear to be implanted.

Question Title

* 9. The following question relates to pre-operative speech testing to determine CI candidacy in patients with SSD.

Question Title

* 10. For pre-operative speech testing to determine CI candidacy in patients with SSD, we assess

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* 11. For pre-operative speech testing to determine CI candidacy in patients with SSD, we perform testing in:

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* 12. Regarding masking of the normal hearing ear during candidacy evaluation, we use the following parameters:

Question Title

* 13. Following cochlear implantation, we typically activate the CI

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* 14. When programming a CI in an SSD population, we:

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* 15. When performing post-operative speech testing following CI in an SSD population, we:

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* 16. Regarding post-operative habilitation/auditory training following CI in an SSD population

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* 17. In general, for patients with SSD, we often administer (ether pre- or post-op or both)

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* 18. In my experience, the primary barriers to CI in SSD are:

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* 19. Please feel free to share any comments that you feel may be pertinent to this topic of to the survey.

* 6. The next question attempts to assess how vigorously your center requires a patient to experience or pursue other options prior to pursuing a cochlear implant.
At my center, the CI candidacy protocol for patients with SSD involves: