In Brief:
The better-hearing ear has frequently been chosen for cochlear implantation because of the unproven idea that better neural preservation in this ear would equate to better speech perception outcomes. We propose, however, that the audiological advantage of residual hearing in a patient with asymmetric severe and profound hearing loss is not negatively impacted by implanting the ear with profound hearing loss. The speech recognition scores of individuals with bilateral severe hearing loss, asymmetric severe and profound hearing loss, and bilateral profound hearing loss were compared at 6, 12 and 24 months after surgery. Participants with asymmetric severe and profound hearing loss had the same speech recognition in quiet and noise whether the better- or worse-hearing ear was implanted, and were similar to individuals with bilateral severe hearing loss. These observations suggest that the worse-hearing ear can be implanted without compromising speech understanding, while preserving residual hearing in the contralateral ear for the use of a hearing aid or future technologies.
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