SPANISH STUDY-GROUP ON COCHLEAR IMPLANTS FOR PERSONS WITH MARGINAL BENEFIT FROM ACOUSTIC AMPLIFICATION

Recently the U.S. Food and Drug Administration approved the use of coc hlear implants (CI) in patients with severe-to-profound sensorineural hearing loss with marginal benefit (< 30% speech discrimination) from hearing aids (HA). A multicentre trial was developed to determine whet her this approval could be applied to the Spanish population. Nine pos tlingual adults from 3 centres were selected for the study. The mean p reoperative unaided PTA threshold (0.25 to 4 KHz) was 108.6 dB HL for the poorer ear and 99.8 dB HL for the better. In all subjects the poor er ear was implanted with a Mini Nucleus(R) 22 device. A single subjec t design study was used to compare performance with HA preoperatively and with CI postoperatively, or CI with contralateral HA. PTA measures and Spanish open set speech recognition tests were used. Comparing pr e-implant levels with results after 6 months of CI use, all subjects i mproved significantly on all test measures: i) Mean aided soundfield t hreshold: 73.6 dB vs 39.8 dB ii) Mean bisyllablic recognition: 20% vs 57% iii) Mean consonant discrimination: 20% vs 49% iv) Mean CID senten ces: 22% vs 73%. Five subjects discontinued use of the contralateral H A after implantation, three continued occasionally to use the RA, and one continued to use both on a full-time basis. Patients performed sig nificantly better post-implant on speech recognition compared with the ir best pre-implant IIA scores. Therefore the CI appears an appropriat e treatment for Spanish speakers with a severe-to-profound hearing los s and marginal benefits with HA.