A 58-year-old woman has bilateral severe-to-profound sensorineural hearing loss since meningitis. Pure tone average is 85 dB HL bilaterally. With optimally fitted powerful hearing aids her word recognition score is 42% in each ear. She has used hearing aids consistently for 4 months. What is the most appropriate next step?
- A Refer for bilateral cochlear implantation evaluation ✓
- B Continue hearing aids alone and review after one year
- C Fit a contralateral routing of signal (CROS) hearing aid
- D Prescribe an FM system to be used with the existing hearing aids
Correct answer: A. Refer for bilateral cochlear implantation evaluation
Explanation
Adult cochlear implant candidacy includes bilateral severe-to-profound sensorineural hearing loss with limited benefit from appropriately fitted hearing aids, conventionally aided word recognition scores of 50% or less. This patient meets both the audiometric and aided benefit criteria after an adequate trial. B CROS aid is for single-sided deafness with a normal contralateral ear, and an FM system only improves signal to noise ratio without addressing the poor aided discrimination.
Reference: Cummings Otolaryngology Head and Neck Surgery, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.