Maximum preimplantation monosyllabic score as predictor of cochlear implant outcome

OBJECTIVE: This study investigated the speech perception of cochlear implant (CI) recipients with measurable preoperative ipsilateral speech perception. These data should support improved individual counselling of CI candidates. MATERIALS AND METHODS: Pre- and postoperative speech audiometric parameters were analyzed, including maximum score for phonemically balanced words (PB(max)) and monosyllabic score at a normal conversational level of 65 dB(SPL), with hearing aids one hand and CI on the other. Data of 284 experienced adult CI wearers were grouped and evaluated in terms of preoperative PB(max). RESULTS: The preoperative PB(max) was exceeded by the postoperative monosyllabic score in 96% of cases. The overall median postoperative score was 72.5%. The groups with preoperative PB(max) > 0% showed significantly better speech perception scores with CI than the group with PB(max) = 0%. Median improvement compared to the preoperative monosyllabic score with hearing aids was 65 percentage points, independent of preoperative PB(max). CONCLUSION: The preoperatively measured PB(max) may be used as a predictor for the minimum speech perception obtained with CI. This is of high clinical relevance for CI candidates with a PB(max) above zero.