Profound Mixed Hearing Loss: Bone-Anchored Hearing Aid System or Cochlear Implant?

Abstract

Objectives:

We evaluated 5 patients who were changed over from a Baha Cordelle to a cochlear implant (CI). Moreover, the level of phoneme score was determined at which a Baha Cordelle user was better helped with a CI.

Methods:

We offer descriptive case reports and a retrospective evaluation of speech recognition in Baha Cordelle users and CI users.

Results:

In the CI users with noncompromised cochleas, the 10th percentile of the aided phoneme score in quiet at 65 dB sound pressure level (PS65) was 42%. We consider this PS65 as the cutoff level for switching from a Baha Cordelle to a CI. When patients with mixed hearing loss were using the Baha Cordelle, the PS65 of 42% was obtained at a mean sensorineural hearing loss component of about 70 dB hearing level (HL). This 70–dB HL component was used to consider Baha Cordelle users for cochlear implantation. The results of the 5 patients support these transition criteria.

Conclusions:

A CI is a valuable option in patients with mixed hearing loss when the sensorineural hearing loss component exceeds 70 dB HL or when the PS65 with a Baha Cordelle is less than about 40%. In such patients, the implantation procedure should be individualized on the basis of the clinical findings in the middle ear and mastoid cavity.