LL104 - Learning Lab: Electric Acoustic Stimulation (EAS): Maximizing Acoustic Hearing Benefit in Combination with Cochlear Implants for Children and Adults (separate ticket required)

Abstract:
Acoustic amplification via hearing aid(s) (HAs) combined with electric hearing via cochlear implant(s) (CIs) offers significant communication and sound qualitative benefits. The benefit afforded by the addition of acoustic hearing is observed for individuals utilizing bimodal hearing (CI + contralateral HA), ipsilateral EAS/Hybrid hearing (CI + ipsilateral HA), and CI(s) plus bilaterally acoustic amplification (i.e., CI(s) + bilateral HAs). Approximately 77% of adult CI recipients and 40% of pediatric CI recipients have functionally aidable hearing in the non-implanted ear. Thus, the audiologic optimization and management of bimodal hearing will expectedly constitute a large proportion of an audiologist’s clinical population. In addition to bimodal hearing, acoustic hearing preservation with cochlear implantation is increasingly prevalent in both adult and pediatric cochlear implant (CI) recipients with residual low-frequency acoustic hearing. Indeed, there are two FDA approved adult-specific indications for EAS/Hybrid CI systems with Cochlear and MED-EL commercially releasing their systems in 2014 and 2016, respectively. Numerous studies have demonstrated the efficacy of acoustic hearing preservation and the benefits of EAS/Hybrid hearing for speech recognition in complex listening environments, horizontal plane localization, spatial hearing abilities, music perception, sound quality, and subjective listening difficulty across the lifespan (note that EAS/Hybrid CI systems are not FDA approved for use in children). Despite the significant benefits documented for both adults and children with EAS/Hybrid hearing, CI evaluation referrals for individuals with EAS-qualifying audiograms (i.e. steeply sloping hearing loss) constitute a relatively small proportion of our prospective candidate population, or approximately 25% and 16% of our adult and pediatric CI candidates, respectively. Furthermore, there’s gross underutilization of EAS/Hybrid technology for CI recipients with acoustic hearing preservation. Published studies have demonstrated that just 36-69% of adult CI recipients with functionally aidable acoustic hearing in the implanted ear(s) are actually using EAS/Hybrid technology; there are no published data on EAS/Hybrid utilization in children with CIs and acoustic hearing preservation. Thus, we have much to learn about identifying bimodal and EAS/Hybrid candidates, differentiating between the different acoustic & electric listening configurations, and optimizing CI and HA programming. During this Learning Lab, we will discuss EAS/Hybrid candidacy including case studies as well as data-driven guidance for EAS/Hybrid and bimodal programming as well as performance trends across the lifespan. We will also have real-time examples for creating and saving an evidence-based maps for bimodal and EAS/Hybrid patients with Advanced Bionics, Cochlear, and MED-EL using the clinical software.