Comparison of hearing performance of VSB users with that of CI users with a borderline indication

Introduction In the context of indication for purposes of fitting with implantable hearing systems, there is a small area of overlap in the indication for a VSB or a CI. In the present study,CI patients were retrospectively identified who would still have met the indication criterion for a VSB. The audiological outcomes of these patients were compared with a group of VSB patients.

Material and Methods The inclusion criteria of the CI group were a mean sensorineural hearing loss (PTA) of less than 65 dB with a max sound conduction component of 15 dB and a minimum CI use duration of one year. Patients with (1) a classic anvil coupling or (2) a round window coupling (RW) were included in the VSB group. Preoperative speech understanding (EV) with hearing aid (HG) and postoperative EV(1 year and long-term) with CI and with VSB, respectively, were evaluated (Freifeld,65 dB SPL).

Results We were able to include 20 patients in the CI group and 13 patients in the VSB group. The mean values for preoperative EV with HG were 25.4±18.9% in the CI group and 43.1±30.2% in the VSB group (1):53%;2:36.9%). At 1 year postoperatively, the mean EV was 61.9±25.1% for CI and 67.3±23.1% for VSB (1:66%;2: 65%). The long-term results showed an EV in the CI group of 72.2±16.7% and 76.0±25.4% in the VSB group (1:75%);2:76.7%).

Summary On average, no difference in monosyllabic understanding was found between the CI group and the VSB group.The results show that in cases of a borderline indication very good speech understanding is achieved even with CI fitting, which is not significantly worse than with VSB fitting. However, it remains to be seen whether the CI and VSB groups differ in more complex listening tasks such as speech understanding in a noisy environment.

Publication History

Article published online:
12 May 2023