title: Results with cochlear implantation in adults with speech recognition scores exceeding current criteria.
abstract: OBJECTIVE
  The primary purpose of this study was to evaluate a group of postlingually deafened adults, whose aided speech recognition exceeded commonly accepted candidacy criteria for implantation. The study aimed to define performance and qualitative outcomes of cochlear implants in these individuals compared with their optimally fitted hearing aid(s).
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  All postlingually deafened subjects (N = 27), who were unsuccessful hearing aid users implanted between 2000 and 2010 with a preimplantation Hearing in Noise Test (HINT) score of 60% or more were included.
  
  
  METHODS
  We compared patients' preoperative performance (HINT score) with hearing aids to postoperative performance with the cochlear implant after 12 months of device use. In addition, the Hearing Handicap Inventory questionnaire was used to quantify the hearing-related handicap change perceived after the implantation.
  
  
  RESULTS
  The study group demonstrated significant postoperative improvement on all outcome measures; most notably, the mean HINT score improved from 68.4% (standard deviation, 8.3) to 91.9% (standard deviation, 9.7). Additionally, there was a significant improvement in hearing-related handicap perceived by all patients.
  
  
  CONCLUSIONS
  The envelope of implantation candidacy criteria continues to expand as shown by this study's cohort. Patient satisfaction and speech recognition results are very encouraging in support of treating those who currently perform at a level above the conventional candidacy threshold but struggle with optimally fitted hearing aids.
authors.affiliation: Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. hosamamodi@hotmail.com
authors.forename: Hosam A
authors.initials: HA
authors.lastname: Amoodi
authors.forename: Paul T
authors.initials: PT
authors.lastname: Mick
authors.forename: David B
authors.initials: DB
authors.lastname: Shipp
authors.forename: Lendra M
authors.initials: LM
authors.lastname: Friesen
authors.forename: Julian M
authors.initials: JM
authors.lastname: Nedzelski
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Chen
authors.forename: Vincent Y W
authors.initials: VY
authors.lastname: Lin
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D019929:Cochlear Implantation; D015331:Cohort Studies; D003638:Deafness / Q000628:therapy*; D004185:Disability Evaluation; D004192:Discrimination, Psychological; D005260:Female; D006310:Hearing Aids; D006801:Humans; D008297:Male; D008875:Middle Aged; D009622:Noise; D017060:Patient Satisfaction; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013067:Speech Perception / Q000502:physiology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome