A 70-year-old man with bilateral moderately severe sensorineural hearing loss (averaging 65 dB HL) trials conventional hearing aids but finds them unsatisfactory due to poor speech discrimination in noise. The most appropriate next rehabilitation option is:
- A Bone-anchored hearing aid (BAHA)
- B Auditory brainstem implant
- C Cochlear implantation if speech discrimination score is below 50% in the best-aided condition ✓
- D Cross-hearing aid (CROS aid)
Correct answer: C. Cochlear implantation if speech discrimination score is below 50% in the best-aided condition
Explanation
Adult cochlear implant candidacy has expanded beyond severe-to-profound loss. Current FDA/NICE criteria include patients with moderate-to-profound bilateral SNHL and speech recognition scores ≤50% in the best-aided listening condition. At 65 dB bilateral SNHL with poor discrimination in noise, if aided speech scores fall below threshold, cochlear implantation is indicated. BAHA requires functional cochlear reserve; auditory brainstem implant is for absent auditory nerves; CROS is for single-sided deafness with a good contralateral ear.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.