Further Evidence for the Expansion of Adult Cochlear Implant Candidacy Criteria.

Objective 1) To complete a follow-up investigation of postoperative outcomes for adult cochlear implant (CI) recipients scoring ≥30% Consonant-Nucleus-Consonant (CNC) preoperatively, and 2) to describe the postoperative performance trajectory for this group of higher performing patients. Study design Retrospective chart review. Setting Tertiary referral center. Patients One hundred four (105 ears) postlingually deafened adults who scored ≥30% CNC word recognition in the ear to be implanted preoperatively. Interventions One hundred four subjects underwent cochlear implantation. Main outcome measures Pre- and postoperative CNC word scores and AzBio sentences in quiet and noise in the ear to be implanted as well as the bilateral-aided condition pre-CI and at 1, 3, 6, and 12 months post-CI. Results Statistically significant improvement was demonstrated for CNC and AzBio sentences in quiet and noise for the CI alone and bilateral listening conditions. Most improvement was demonstrated by 6-months postoperatively (p 40% (n = 47, 48 ears), 89.3% (42 patients) demonstrated either equivocal (n = 24, 50%) or statistically significant improvement (n = 19, 39.6%) for CNC word recognition in the CI-only condition and none demonstrated a significant decrement in the bilateral condition. Conclusions CI candidates with preoperative CNC word scores higher than conventional CI recipients derive statistically significant benefit from cochlear implantation for both the CI ear and best-aided condition. These data provide further support for the expansion of adult CI candidacy up to at least 40% CNC word recognition preoperatively with consideration given to further expansion possibly up to 60%.