Comparison between outcomes of hearing aids use and cochlear implants in patients with severe to profound hearing loss

Abstract

Hearing is one of the most important senses for human beings; permanent HL with all its types has auditory, language, cognitive, academic and psychological consequences which affect both patients and their families. There are a number of devices that can improve hearing, language and speech in those who are hearing impaired or deaf or allow people with these conditions to manage better in their lives, such as HAs, CIs and ABIs. Therapy remains the major challenge in management of SNHL. Amplification in the form of HAs or CIs is the mainstay for the treatment of permanent hearing impairment in most cases. Using either HAs or CIs in patients with severe to profound SNHL has many outcomes that are affected by various factors. Some of the detrimental effects of hearing impairment can be avoided by early fitting of HAs. Nevertheless, for children with profound HL a complete compensation with acoustic HAs is generally not possible. CI has dramatically changed outcomes for patients with severe to profound HL by providing them with auditory information not available through conventional HA technology. Auditory, language, speech, academic and psychological outcomes in these patients have been so encouraging that attention has also been directed to the implantation of patients with less severe HL. As candidacy criteria for CI has relaxed to allow individuals with more residual hearing to be implanted, it has become common to combine acoustic stimulation via HA with electrical stimulation via the CI. The  Summary 70 most common combination currently is the bimodal fitting, where the user wears a HA on the contralateral ear from the implant. Bimodal fitting has been shown to yield binaural hearing benefits over time. Finally, we can consider that decision-making regarding the optimal technology for children with severe to profound HL has become more complex due to the very positive outcomes documented for children with CIs, but it is important to continue documenting the benefits of both management options to ensure that children have access to optimal care to permit both parents and practitioners to make decisions informed by the best available evidence.