Objective: To compare the current metrics used in adult cochlear implant candidacy evaluations for consistency and applicability, and to make a recommendation for an updated assessment battery. Study Design: Prospective, multicenter, within-subject clinical trial. Setting: North American cochlear implant programs including private practices, universities, and hospital centers. Patients: One hundred adult hearing aid users scoring 40% or less on monosyllabic words in quiet in the aided test ear who presented for cochlear implantation evaluation. Intervention: Subjects underwent unilateral cochlear implantation. Main Outcome Measures: Speech perception measured via Consonant-Nucleus-Consonant words in quiet and AzBio sentences in noise. Patient-reported hearing disability measured via the Speech, Spatial, and Qualities of Hearing Scale administered preoperatively and at 6 months postoperatively. Results: Significant group mean improvement on all speech perception measures and SSQ subscales postoperatively with possible floor effects observed in objective background noise testing preoperatively and a broad range of variability seen postoperatively. Conclusions: Consonant-Nucleus-Consonant words are an effective tool to clinically evaluate hearing ability over time. Adjustment of cochlear implant screening protocols to prioritize monosyllabic words over sentences in noise as the chief determining factor appears justified, and this test can be supplemented by the SSQ for a holistic and applicable assessment of cochlear implant candidacy.
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