Cochlear Implantation in Patients With Bilateral Severe Sensorineural Hearing Loss After Major Blunt Head Trauma

Objective: To highlight issues that impact on cochlear implant candidacy and performance in individuals who have severe bilateral sensorineural hearing loss after major blunt head trauma. Study Design: Retrospective case review. Setting: Tertiary level neurotology center. Patients: Twenty-five patients treated at our institution for severe hearing loss after blunt head trauma Intervention: Assessment of cochlear implant candidacy criteria and postimplant outcomes in patients presenting with severe hearing loss after major blunt head trauma Main Outcome Measures: Cause of injury, pure tone audiology, open set speech perception (preimplant and postimplant), promontory stimulation, and imaging results. Results: Of the 25 patients with severe hearing loss, 11 ultimately underwent cochlear implantation. Fall from a height was the most common cause of injury. Five patients experienced bilateral temporal bone fractures. Seventeen patients satisfied candidacy criteria for implantation. For those patients who did undergo cochlear implantation, the mean postimplant open set speech recognition score was 71. Issues related to cochlear implant candidacy and outcomes for implantation will be discussed. Conclusion: Severe hearing loss after major blunt head trauma presents a number of unique clinical challenges. A significant number of these patients are not suitable for cochlear implantation for a variety of reasons. Clinicians working in the area of cochlear implantation should be aware of the various problems that can impact on effective cochlear implantation in such patients.