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Background <p>Acquired severe-to-profound unilateral sensorineural hearing loss (USNHL) in adults can lead to significant auditory and psychosocial challenges, including impaired binaural hearing and reduced quality of life. Although the benefits of cochlear implant (CI) use for adults with USNHL are well documented, long-term data remain scarce on clinical outcomes and hours of daily audio processor use.</p> Aim <p>To evaluate long-term outcomes and adherence to device use in all adults with USNHL who received a CI at the Antwerp University Hospital from April 2004 to June 2025.</p> Results <p>All 78 patients with USNHL who underwent cochlear implantation were included in the study analysis, comprising 59 individuals with pure single-sided deafness (SSD) and 19 with asymmetric hearing loss (AHL). The most common etiology (32%) was idiopathic sudden deafness. The CI aided hearing thresholds averaged 38&#xa0;dB hearing level. In the AHL group, 21% experienced progression of contralateral hearing thresholds to levels meeting CI criteria. Both the SSD and AHL groups exhibited significant binaural benefits, notably in sound localization and speech understanding in noise, mediated by head shadow and binaural summation effects. All but 2 patients reported preoperative ipsilateral tinnitus, with an average visual analog scale (VAS) rating of 7 out of 10. CI use significantly reduced ipsilateral tinnitus loudness, lowering the score to 2.2/10 in the CION condition when averaged across all intervals. In the postoperative CIOFF condition, the average score was 6.21. Data logging records indicated an average of 12&#xa0;h of CI use per day. During follow-up, 8% of the cohort discontinued CI use, on average 47&#xa0;months after implantation, due to ipsilateral hyperacusis, ipsilateral long deafness duration, severe depression, and the postoperative occurrence of more severe medical conditions not related to the implantation hindering CI use. None of the implanted patients were lost to follow-up. Therefore, we can state with certainty that all non-users have been identified and reported in this study.</p> Conclusion <p>Cochlear implantation is an effective and durable treatment option for USNHL, when inclusion criteria are stringent. Long-term follow-up demonstrates CI use significantly improves auditory outcomes in USNHL and suppresses ipsilateral tinnitus. Adults with USNHL use their device most of their waking hours, even 20&#xa0;years after implantation.</p>

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More than 20 years of cochlear implantation in adults with acquired single-sided deafness or asymmetric hearing loss: long term clinical outcomes of 78 subjects implanted at the Antwerp University Hospital

  • 期刊论文

  • 发表日期：

    2026年3月28日

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  • Griet Mertens,
  • Paul Van de Heyning,
  • Emilie Heuninck,
  • Ellen Andries,
  • Laure Jacquemin,
  • Iris Joossen,
  • Charis Clement,
  • Hanne Vermeersch,
  • Anouk Hofkens,
  • Ellen Cochet,
  • Olivier Vanderveken,
  • Marc Jan-Willem Lammers,
  • Vincent Van Rompaey

摘要

Background

Acquired severe-to-profound unilateral sensorineural hearing loss (USNHL) in adults can lead to significant auditory and psychosocial challenges, including impaired binaural hearing and reduced quality of life. Although the benefits of cochlear implant (CI) use for adults with USNHL are well documented, long-term data remain scarce on clinical outcomes and hours of daily audio processor use.

Aim

To evaluate long-term outcomes and adherence to device use in all adults with USNHL who received a CI at the Antwerp University Hospital from April 2004 to June 2025.

Results

All 78 patients with USNHL who underwent cochlear implantation were included in the study analysis, comprising 59 individuals with pure single-sided deafness (SSD) and 19 with asymmetric hearing loss (AHL). The most common etiology (32%) was idiopathic sudden deafness. The CI aided hearing thresholds averaged 38 dB hearing level. In the AHL group, 21% experienced progression of contralateral hearing thresholds to levels meeting CI criteria. Both the SSD and AHL groups exhibited significant binaural benefits, notably in sound localization and speech understanding in noise, mediated by head shadow and binaural summation effects. All but 2 patients reported preoperative ipsilateral tinnitus, with an average visual analog scale (VAS) rating of 7 out of 10. CI use significantly reduced ipsilateral tinnitus loudness, lowering the score to 2.2/10 in the CION condition when averaged across all intervals. In the postoperative CIOFF condition, the average score was 6.21. Data logging records indicated an average of 12 h of CI use per day. During follow-up, 8% of the cohort discontinued CI use, on average 47 months after implantation, due to ipsilateral hyperacusis, ipsilateral long deafness duration, severe depression, and the postoperative occurrence of more severe medical conditions not related to the implantation hindering CI use. None of the implanted patients were lost to follow-up. Therefore, we can state with certainty that all non-users have been identified and reported in this study.

Conclusion

Cochlear implantation is an effective and durable treatment option for USNHL, when inclusion criteria are stringent. Long-term follow-up demonstrates CI use significantly improves auditory outcomes in USNHL and suppresses ipsilateral tinnitus. Adults with USNHL use their device most of their waking hours, even 20 years after implantation.