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Comparing the Performance Plateau in Adult Cochlear Implant Patients Using HINT and AzBio

Massa, Sean T.; Ruckenstein, Michael J.

doi: 10.1097/MAO.0000000000000264
Cochlear Implants

Objective This study aims to characterize the performance plateau in adult cochlear implant recipients after the initial postimplantation increase by using word recognition testing and an explicit definition of performance plateau.

Study Design Retrospective review.

Setting Urban, tertiary referral center.

Patients One hundred twenty-five patients with 138 devices tested with AzBio were matched to 130 patients with 138 devices tested with HINT based on performed on CNC monosyllable tests.

Intervention Patient’s performance was measured overtime using AzBio and HINT tests to determine when and at what score their performance reached a plateau.

Main Outcome Measure(s) Time from implantation to reach a performance plateau and plateau score with each test.

Results Thirty-four devices reached a HINT plateau and 30 devices reached an AzBio plateau. Patients reached plateaus at similar times postoperatively using HINT and AzBio, 18.8 and 16.5 weeks, respectively (p = 0.476). Five patients tested with HINT plateaued at scores of 99% to 100%, whereas no patients plateaued above 92% with AzBio.

Conclusion Patients reached a plateau in performance at similar median times using AzBio and HINT, despite the ceiling effect of HINT in some patients. Most patients who reach a plateau did so within 4 months, but exactly when and if a patient’s performance plateaus varies significantly among individuals. Further study is required to determine which test best reflects when a patient reaches his or her maximal performance in natural listening conditions.

From the Department of Otolaryngology–Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.

Address correspondence and reprint requests to Sean T. Massa, MD, 4251 Shenandoah Ave, St Louis, MO 63110; E-mail:

The authors have no conflicts of interest to disclose.

Copyright © 2014 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company