Evidence for the expansion of adult cochlear implant candidacy

René H. Gifford, Michael Dorman, Jon K. Shallop, Sarah A. Sydlowski

Research output: Contribution to journalArticlepeer-review

144 Scopus citations


Objectives: The primary objective of this study was to determine whether a revision and/or expansion of current audiologic cochlear implant candidacy criteria is warranted. Design: The study design was a retrospective review of postoperative speech perception performance for 22 adult cochlear implant recipients who demonstrated preoperative Consonant Nucleus Consonant word recognition scores of 30% or higher in the best-aided condition. This criterion was chosen to exceed that specified by the North American clinical trial of the Nucleus Freedom cochlear implant system. Results: The mean preoperative best-aided monosyllabic word score for the 22 patients was 41% correct. The degree of postoperative benefit for the best postoperative condition (electric only or bimodal) ranged from 10 to 68 percentage points with a mean benefit of 27 percentage points for the electric-only condition and 40 percentage points for the bimodal condition. Statistical analyses revealed highly significant differences between preoperative-aided, implant-only, and bimodal performance on Consonant Nucleus Consonant monosyllabic word recognition performance. That is, both postoperative scores-electric only and bimodal-were significantly different from one another and from the preoperative best-aided performance. Conclusions: The current results suggest that a large-scale reassessment of manufacturer and Medicare preoperative audiologic candidacy criteria for adults is warranted to allow more hearing-impaired individuals to take advantage of the benefits offered by cochlear implantation.

Original languageEnglish (US)
Pages (from-to)186-194
Number of pages9
JournalEar and hearing
Issue number2
StatePublished - Apr 2010

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Speech and Hearing


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