title: Outcomes of cochlear implantation in adults with asymmetric hearing loss.
abstract: OBJECTIVE
  To analyze speech recognition outcomes in adult cochlear implant recipients who have asymmetric sensorineural hearing loss between the two ears.
  
  
  METHODS
  Retrospective cohort study of 35 adults with asymmetric hearing loss. Preoperative unaided pure-tone averages (PTA), and pre- and post-op (6 and 12 mo) aided Consonant Nucleus Consonant (CNC) words and sentence recognition scores were obtained for ears in isolation (opposite ear plugged). Patients were categorized according to the PTA of the implanted and contralateral ears as (a) moderate-severe, (b) moderate-profound, and (c) severe-profound.
  
  
  METHODS
  A single tertiary care center.
  
  
  METHODS
  Adults with asymmetric PTA implanted unilaterally at our institution.
  
  
  METHODS
  Cochlear implantation with devices approved by the U.S. Food and Drug Administration.
  
  
  METHODS
  Post-implantation word, phoneme, and sentence recognition in the cochlear implant alone testing condition.
  
  
  RESULTS
  Patients who were implanted in the worse-hearing ear (n = 21) performed significantly better on CNC words and phonemes at 6 and 12 months than patients who were implanted in the better-hearing ear (n = 14). Patients with the worse ear implanted also obtained 6 to 12% higher sentence recognition scores than the group received an implant in their better ear, although this difference is not statistically significant (p = 0.06 at 6 mo; p = 0.1 at 12 mo).
  
  
  CONCLUSIONS
  Patients with asymmetrical hearing loss who were implanted in the worse-hearing ear achieved 15% greater CNC word scores and 6 to 12% greater sentence scores than patients implanted in the better-hearing ear in the first year after surgery. Our results provide further support for clinicians to use caution if considering implanting the better-hearing ear in patients with asymmetric hearing loss.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
authors.forename: Emily
authors.initials: E
authors.lastname: Franko-Tobin
authors.forename: Phillip Ryan
authors.initials: PR
authors.lastname: Camilon
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Camposeo
authors.forename: Meredith A
authors.initials: MA
authors.lastname: Holcomb
authors.forename: Ted A
authors.initials: TA
authors.lastname: Meyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D015331:Cohort Studies; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology / Q000601:surgery*; D046088:Hearing Loss, Unilateral / Q000503:physiopathology / Q000601:surgery*; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013067:Speech Perception / Q000502:physiology*; D016896:Treatment Outcome; D014481:United States