Benefits of cochlear implant and hearing aid in a bimodal solution compared to optimally fitted new hearing aids in patients with asymmetric hearing loss: a randomised controlled trial

Objective: To compare replacement hearing aids (HA) with a cochlear implant (CI) and a HA in the bimodal solution using the Signal to Noise Ratio (SNR) at 70% correct Speech Reception Threshold (SRT70) measured with the Hearing in Noise Test (HINT), Word Recognition Scores (WRS) in quiet and noise and patient reported outcome using Speech Spatial and Quality (SSQ-12) questionnaire. Design/Study Sample: Prospective randomised controlled trial between bimodal use and continuous HA use for additional three months. Study Sample: Sixty-three CI candidates (mean age: 63.4, range: 23–83 years) with asymmetric hearing loss (AHL) fulfilling CI candidacy criteria on one ear. Results: No difference was found between the original and new replacement HAs after one month. However, comparing the bimodal solution with new replacement HAs mean SRT70 improved by −10.26 dB SNR (95%CI:−15.38;−5.13), WRS in quiet by 18.56% (95%CI:9.48;27.64), WRS in noise by 18.18% (95%CI:8.84;27.53), and SSQ12 total scores improved by 2.67 scale points (95%CI:1.81;3.53). Conclusion: Extended use of HAs offers no additional benefit; CI surgery can proceed once one month of acclimatisation is achieved as the addition of a CI outperforms new replacement HAs in CI candidates with AHL.