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Can Routine Office-Based Audiometry Predict Cochlear Implant Evaluation Results?

Objectives: Determining cochlear implant candidacy status requires a specific sentence-level testing paradigm in best-aided conditions. Correlation of the findings on routine audiometry with those of formal cochlear implant (CI) evaluation has not been performed. Our objective was to determine if findings on routine office-based audiometry could predict the results of a formal CI candidacy evaluation. Methods: The charts of all adult patients who were evaluated for CI candidacy at a tertiary care center from June 2008 through June 2013 were included. Routine, unaided audiologic measures (pure-tone hearing thresholds and recorded monosyllabic word recognition test [MWRT] results) were then correlated with best-aided sentence-level word discrimination test (SWDT) results using either the Hearing in Noise Test (HINT) or AzBio sentences. Results: The degree of hearing loss at 250 to 4000 Hz significantly correlated with SWDT results. Additionally, 87% of patients who scored <30% in MWRT qualified for implantation using HINT sentences. Similarly, in patients whose MWRT scores were <35%, 81%, and 93% met CI candidacy criteria when using AZBio sentence testing in quiet and noise, respectively. Conclusions: Routine office-based audiometry can be used to identify patients who would highly likely meet CI candidacy upon formal testing. For example, a pure tone threshold of ≥55 dB at 250 Hz and a MWRT score of ≤35% when evaluating using AzBio sentences collectively identifies a patient who is likely to meet candidacy criteria. Using these predictive patterns during routine audiometry may assist hearing health professionals in deciding when to refer patients for a formal CI evaluation.