Cochlear Implantation in Cases of Single-Sided Deafness

Launched by UNIVERSITY OF NORTH CAROLINA, CHAPEL HILL · Jul 25, 2014

Keywords

ClinConnect Summary

Single-sided deafness (SSD) can be defined as moderate-to-profound sensorineural hearing loss with limited speech perception benefit in one ear and normal hearing in the contralateral ear. Though one ear is within the normal hearing limits, SSD may result in reduced speech perception in noise, variable abilities on localization tasks, increased subjective report of hearing handicap, and reduced quality of life.

This patient population cannot utilize conventional amplification due to the severity of the hearing loss and poor speech discrimination abilities in the affected ear. Current treat...

Gender

ALL

Eligibility criteria

• Inclusion Criteria (SSD):
• • Unilateral moderate-to-profound sensorineural hearing loss \[Unaided residual hearing thresholds measured from 250-8000 Hertz (Hz) (Pure Tone Average (PTA) ≥70 decibel (dB) Hearing Level (HL) in the ear to be implanted\]
• • Normal to mild residual hearing thresholds from 250-8000 Hz in the contralateral ear (≤35 dB HL at each frequency, 250-8000 Hz)
• • Greater than or equal to 18 years of age at implantation
• • Duration of moderate-to-profound sensorineural hearing loss less than or equal to 5 years \[Either reported by subject or documented in previous audiograms\] \[Can be less than or equal to 10 years if the subject consistently utilized hearing technology (such as a bone conduction device or conventional hearing aid) within the past 5 years\]
• • Previous experience with a current treatment option for SSD, including a conventional hearing aid, bone-conduction device, or CROS/BICROS (Bilateral Contralateral Routing Of the Signal) technology. \[At least one month of listening experience with device\] \[Dissatisfaction with and/or discontinued use of current treatment option due to: insufficient gain, poor sound quality, and/or lack of perceived benefit\]
• • Aided word recognition in the ear to be implanted of 60% or less as measured with Consonant-Nucleus-Consonant (CNC) words (50-word list) \[When listening with an appropriately fit hearing aid and masking applied to the contralateral ear\] \[Aided testing will be conducted in a sound-proof booth with the subject seated 1 meter from the sound source, facing 0° azimuth. Recorded materials will be presented at 60 dB Sound Pressure Level (SPL).\] \[The hearing aid output will be measured using National Acoustic Laboratory-NonLinear (NAL-NL1) targets.\]
• • Realistic expectations
• • Willing to obtain recommended meningitis vaccinations per Center for Disease Control (CDC) recommendations
• • No reported cognitive issues \[Pass the Mini Mental State Examination (MMSE) screener\]
• • Able and willing to comply with study requirements, including travel to investigational site and study-related activities
• Exclusion Criteria (SSD):
• • Non-native English speaker \[Speech perception materials are presented in English\]
• • Conductive hearing loss in either ear
• • Compromised auditory nerve, including those with a history of vestibular schwannoma
• • Ossification
• • Inability to participate in follow-up procedures (i.e., unwillingness, geographic location)
• • History of meningitis, autoimmune disease, or any medical condition that contraindicate middle or inner ear surgery or anesthesia
• • Meniere's disease with intractable vertigo
• • Trauma that precludes inner ear surgery
• • Case of sudden sensorineural hearing loss that has not been first evaluated by a physician
• • Pregnancy \[Subjects who are pregnant or become pregnant prior to surgery are excluded due to the potential risk of anesthesia to an unborn child.\] \[Subjects who become pregnant after surgery may continue to participate in study procedures\]
• • Tinnitus as the primary purpose for seeking cochlear implantation
• • Subject obtains a severe or catastrophic score on the Tinnitus Handicap Inventory (Newman, Jacobson \& Spitzer, 1996).
• Inclusion Criteria (asymmetric hearing loss):
• • a. Ear to be implanted i. Moderate-to-profound sensorineural hearing loss ii. PTA ≥70 dB HL iii. Aided word recognition of 60% or less as measured with CNC words (50-word list).
• • b. Contralateral ear i. PTA ≥35 and ≤55 dB HL ii. Aided word recognition of 80% or more as measured with CNC words (50-word list).
• • iii. Use of conventional amplification c. Greater than or equal to 18 years of age at implantation d. Duration of moderate-to-profound sensorineural hearing loss in the ear to be implanted is less than or equal to 5 years \[Either reported by subject or documented in previous audiograms. Can be up to 10 years if the subject consistently utilized hearing technology in the ear to be implanted (such as a bone conduction device or conventional hearing aid) within the past 5 years\] e. Previous experience with a current treatment option for asymmetric hearing loss, including a conventional hearing aid, bone-conduction device, or CROS/BiCROS technology. \[At least one month of listening experience with device. Dissatisfaction with and/or discontinued use of current treatment option due to: insufficient gain, poor sound quality, and/or lack of perceived benefit.\] f. Realistic expectations g. Willing to obtain recommended meningitis vaccinations per CDC recommendations h. No reported cognitive issues \[Pass the Mini Mental State Examination (MMSE) screener\] i. Able and willing to comply with study requirements, including travel to investigational site and study-related activities
• Exclusion Criteria (Asymmetric hearing loss):
• • 1. Non-English speaker \[Speech perception materials are presented in English\]
• • 2. Medical condition considered a contraindication to undergoing cochlear implantation
• • 3. Conductive hearing loss in either ear
• • 4. Compromised auditory nerve, including those with a history of vestibular schwannoma
• • 5. Ossification
• • 6. Inability to participate in follow-up procedures (i.e., unwillingness, geographic location)
• • 7. History of meningitis, autoimmune disease, or any medical condition that contraindicate middle or inner ear surgery or anesthesia
• • 8. Meniere's disease with intractable vertigo
• • 9. Trauma that precludes inner ear surgery
• • 10. Case of sudden sensorineural hearing loss that has not been first evaluated by a physician
• • 11. Pregnancy \[Subjects who are pregnant or become pregnant prior to surgery are excluded due to the potential risk of anesthesia to an unborn child. Subjects who become pregnant after surgery may continue to participate in study procedures\]
• • 12. Tinnitus as the primary purpose for seeking cochlear implantation
• • 13. Subject obtains a severe or catastrophic score on the Tinnitus Handicap Inventory (Newman, Jacobson \& Spitzer, 1996).