Current adult cochlear implant candidacy criteria (per AAO-HNS/ASHA guidelines) have been expanded from historical thresholds. Which best reflects current candidacy?

• A Profound bilateral SNHL (>90 dB HL) only, with no measureable speech discrimination
• B Severe-to-profound bilateral SNHL with aided speech discrimination scores below ~50% on sentence tests in the best-aided condition ✓
• C Any bilateral SNHL if the patient has progressive loss or suffers significant tinnitus affecting daily life
• D Moderate-to-severe unilateral SNHL (>55 dB HL) unresponsive to hearing aids in the speech frequency range

Explanation

Current adult CI candidacy has been liberalised beyond the historic 'profound bilateral' requirement. Modern criteria include: severe-to-profound bilateral SNHL (average ≥70 dB HL PTA), AND poor aided sentence discrimination (typically <50% on HINT or AzBio sentences in quiet in the best-aided condition). The paradigm shift is from unaided PTA thresholds to aided speech performance. Single-sided deafness (SSD) is now an expanding indication, particularly when associated with debilitating tinnitus or when the contralateral ear has normal hearing. Bilateral CI in cases of bilateral profound SNHL offers the best outcomes.

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.