MEDICAL AUDIOLOGY: A Randomised Controlled Trial Evaluating the Benefits from Bimodal Solution with Cochlear Implant and Hearing Aid vs. Bilateral Hearing Aids in Patients with Asymmetric Speech Identification Scores

This randomised controlled trial compare Cochlear implant (CI) combined with hearing aid (HA) (bimodal solution) users with bilateral HAs users.
The study is designed to test if the bimodal solution results in better speech intelligibility objectively tested by speech intelligibility tests and subjectively by patient self-reported outcomes.
We will evaluate if listening effort, which is the mental resources allocated to overcome obstacles as poor hearing, when carrying out a task as the HINT (hearing in noise test). It is hypothesized that this listening effort can be measured objectively by pupillometry, which is a camera capturing the dilation of the pupil, when the patient is listening to and repeats a sentence in noise.
All CI referred patients will receive new replacement HAs.
They will be randomly assigned (1:1) to the intervention group (CI+HA) or to the delayed intervention control group (HA+HA). The intervention group (CI+HA) will receive a CI on the ear with a poorer speech recognition score and continue using HA on the other ear after one month of HA acclimatisation.
The control group (HA+HA) will receive a CI after a total of 4 months of bilateral HA use. All patients will be tested at 3, 6 and 12 months of follow-up post CI surgery.
The results will be evaluated and may improve the preoperative clinical decision-making for Cochlear implant candidacy for patients with asymmetric hearing.