{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:49:28Z","timestamp":1786978168802,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T00:00:00Z","timestamp":1608508800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives\/Hypothesis<\/jats:title>\n                    <jats:p>To describe the pre\u2010implant audiometric profile of adult cochlear implant (CI) recipients to investigate whether current binaural candidacy requirements prevent access to patients who could benefit from CI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective review from 2016 to 2018 evaluating preoperative pure\u2010tone thresholds and speech perception scores in the ipsilateral and contralateral ear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 252 adult CI recipients undergoing 270 implants were identified. Median age at time of implantation was 70.5\u2009years (IQR 61.3\u201378.3) for those undergoing unilateral implantation and 59.0 (IQR 48.0\u201372.3) for those undergoing bilateral implantation (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01). For unilateral implantation, median pre\u2010implantation speech perception performance in the ear to be implanted was 8.0% (IQR 0%\u201326.0%) for CNC word scores, and 9.0% (IQR 0%\u201334.0%) for AzBio sentence scores in quiet. Median speech perception performance in the contralateral ear was 36.0% (IQR 14.0%\u201360.0%) on CNC word scores, and 48.5% (IQR 17.5%\u201376.0%) on AzBio sentence tests. Speech perception scores were significantly different between ears for word and sentence tests (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01). Patients older than age 65 were significantly less likely to undergo bilateral implantation (\n                      <jats:italic>P<\/jats:italic>\n                      = .03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adult CI recipients exhibit substantially poorer pre\u2010implant speech perception scores than the commonly utilized ipsilateral qualifying threshold of 50% on sentence testing. Yet, existing insurance paradigms limit patients by excessively stringent binaural best\u2010aided requirements. This limitation likely leads to worse device performance as patients often wait years for their binaural hearing to qualify while their ear to be implanted potentially experiences an unnecessarily extended duration of deafness. Older patients also experience a unique delay in referral for cochlear implantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      3\u2010 Retrospective review\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 131:E2007\u2013E2012, 2021\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.29334","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T09:11:07Z","timestamp":1608628267000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Audiometric Profile of Cochlear Implant Recipients Demonstrates Need for Revising Insurance Coverage"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5640-0359","authenticated-orcid":false,"given":"Jason H.","family":"Barnes","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8515-2051","authenticated-orcid":false,"given":"Linda X.","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2350-8942","authenticated-orcid":false,"given":"John P.","family":"Marinelli","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4925-8593","authenticated-orcid":false,"given":"Matthew L.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota U.S.A."},{"name":"Department of Neurologic Surgery Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,21]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"AllianceACI.Cochlear Implant Candidacy for Adults. Available at:https:\/\/www.acialliance.org\/page\/AdultCandidacy. Accessed 6\/2\/2020."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31363-6"},{"key":"e_1_2_6_4_1","first-page":"24","article-title":"Identifying cochlear implant candidates in the hearing aid dispensing practice","volume":"16","author":"Huart SSC","year":"2009","journal-title":"Hear Rev"},{"key":"e_1_2_6_5_1","unstructured":"FrostS.Barriers in the ENT referral channel to the adoption of CI as a standard of care for severe to profound hearing loss patients. US Medical Devices Market Outlook2008."},{"key":"e_1_2_6_6_1","unstructured":"National Coverage Determination (NCD) for Cochlear Implantation. Available at:https:\/\/www.cms.gov\/medicare-coverage-database\/details\/ncd-details.aspx?NCDId=245&ver=2. Accessed 6\/2\/2020."},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/2331216518755288"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001763"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000000548"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.1744"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1904407"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(95)70101-X"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812437156"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1044\/jshd.2701.62"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0b013e31822c2549"},{"key":"e_1_2_6_16_1","unstructured":"Administration USFaD.MED\u2010EL Cochlear Implant System \u2010 P000025\/S104. Available at:https:\/\/www.fda.gov\/medical-devices\/recently-approved-devices\/med-el-cochlear-implant-system-p000025s104. Accessed 6\/2\/2020."},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2012.06.003"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001575"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000448581"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002449"},{"key":"e_1_2_6_21_1","article-title":"Health disparities in geriatric Cochlear implantation","volume":"39","author":"Choi JBS","year":"2020","journal-title":"Am Acad Otolaryngol Head Neck Surg Bull"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.10.009"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/509049"},{"key":"e_1_2_6_24_1","article-title":"Cochlear implantation in adults with asymmetric hearing loss: benefits of bimodal stimulation","volume":"38","author":"Loon MC","year":"2017","journal-title":"Otol Neurotol"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00106-016-0297-5"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2011.11.009"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29334","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.29334","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29334","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T01:10:23Z","timestamp":1698109823000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.29334"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,21]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1002\/lary.29334"],"URL":"https:\/\/doi.org\/10.1002\/lary.29334","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,21]]},"assertion":[{"value":"2020-09-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}