Earphone and Aided Word Recognition Differences in Cochlear Implant Candidates.

Objective: Compare word recognition scores for adults undergoing cochlear implant evaluations (CIE) measured using earphones and hearing aids.

Study Design: Retrospective review of data obtained during adult CIEs.

Setting: Tertiary cochlear implant center.

Patients: Two hundred eight ears in 183 subjects with greater than 10% word recognition scores measured with earphones.

Interventions/main Outcomes Measured: Preoperative pure-tone thresholds and word recognition scores measured with earphones and hearing aids.

Results: A review of audiological data obtained from 2012 to 2017 during adult CIEs was conducted. Overall, a weak positive correlation (r = 0.33, 95% confidence interval 0.17-0.40, p < 0.001) was observed between word recognition scores measured with earphones and hearing aids. Earphone to aided differences (EAD) ranged from -38 to +72% (mean 14.3 ± 19.9%). Consistent with EADs, 108 ears (51.9%) had earphone scores that were significantly higher than aided word recognition scores (+EAD), as determined by 95% confidence intervals; for 14 ears (6.7%), earphone scores were significantly lower than aided scores (-EAD). Moreover, of the patients with earphone word recognition scores ≥50%, 82.6% were CI candidates based on aided AzBio+10 dB SNR scores.

Conclusion: These results demonstrate the limited diagnostic value of word recognition scores measured under earphones for patients undergoing CIE. Nevertheless, aided word recognition is rarely measured before CIEs, which limits the information available to determine CI candidacy and referral for CIEs. Earlier and routine measurement of aided word recognition may help guide clinical decision making by determining the extent to which patients are achieving maximum benefit with their hearing aids or should consider cochlear implantation.