An international group of audiology experts, including Miami Miller University School of Medicine, have authored the first-of-its-kind best practice guidelines for managing hearing loss in adults with bimodal hearing configurations. The guidelines are published in Otology and Neurotology Open.

“Anytime you see a group of authors on a key publication like this, it’s really important to have representation from the Miller School Ear Institute, which is an internationally recognized program for the treatment of patients with hearing loss. “said guideline author Meredith A. Holcomb, Au.D., CCC-A, director of the Hearing Implant Program and associate professor of otolaryngology at the Miller School. “It says a lot that we have not one, but two authors on this publication. It highlights not only our ability to contribute to the literature, but also our long-standing commitment to caring for patients with hearing loss. .

Prior to this publication, there were no standard care practice recommendations for fitting adult patients with bimodal hearing technology for the treatment of bilateral hearing loss. It’s a common problem that often goes untreated, according to Dr. Holcomb.

Costs of untreated hearing loss

“Effective management of these patients is important because untreated hearing loss is an enormous burden on patients, family members, quality of life, employment, communication, mental health and cognition,” said said Dr. Holcomb, who is also the outgoing president. of the American Cochlear Implant Alliance.

More than 1.5 billion people worldwide live with hearing loss, and more than 430 million people have hearing loss disabling enough to warrant treatment – ​​a number that could rise to more than 700 million by 2050. Untreated hearing loss costs the global economy $980 billion due to lost productivity, societal costs, etc., according to the World Health Organization.

Cochlear implants are the global standard of care treatment for adults with severe to profound bilateral hearing loss, but their use is low. In the United States, for example, only about 10 percent of adult patients who need cochlear implants have them, according to Dr. Holcomb.

Studies suggest that approximately 80% of patients with a cochlear implant in one ear have residual hearing in the other ear. This means they would likely benefit from a bimodal hearing system in which acoustic input from a hearing aid in one ear is combined with electrical stimulation from a cochlear implant in the other ear, according to the guidelines document. .

Best practices for better results

“We found a huge gap in the literature on how best to manage bimodal patients. Accordingly, we have developed these best practices to educate anyone working with patients with hearing loss, including primary care physicians, hearing care professionals and audiologists. The guidelines should help hearing care providers achieve the best outcomes for their adult patients, with the most appropriate hearing technology available,” said Dr Holcomb.

The new guidelines include the benefits of bimodal hearing; preoperative assessment and surgery for cochlear implants; postoperative adjustment and evaluation of cochlear implants; bimodal hearing aid fitting; evidence of selection of a contralateral signal routing device; evidence supporting the treatment of cochlear implants and hearing aids for tinnitus relief; and when to consider hearing rehabilitation.

Hillary Snapp, Au.D., Ph.D., chief of audiology and associate professor of otolaryngology at the Miller School, author of the guidelines, contributed expertise drawn from her world-renowned research on decrements in patients who only hear in one ear, according to Dr. Holcomb.

“Dr. Snapp has contributed immensely to these guidelines through the work she has done throughout her career in the area of ​​single-sided deafness,” Dr. Holcomb said. “My contributions were primarily from a clinical perspective. management of cochlear implant recipients over the past 15 years.”

Dr Snapp said she and Dr Holcomb are “incredibly proud to join our colleagues from leading institutions including Vanderbilt University Medical Center, University of Iowa and Erasmus Medical Center in the United States. -Bas, in important initiatives like this.

“These guidelines address several important aspects of care for managing patients with hearing implant technology,” she said. “These contributions are important in closing treatment gaps, increasing access to care, and improving the quality of patient care and patient outcomes.”