The edition · ENT & Head and Neck Surgery
Long-standing deafness in one ear need not rule out a cochlear implant
A five-centre series finds most adults deaf in one ear for over a decade still gained speech recognition, implants also helped after nasopharyngeal radiotherapy, and over half of US adults aged 55 and over have measurable hearing loss.
The edition in brief
In 68 adults implanted after more than ten years of unilateral severe to profound deafness (median 17 years), word recognition improved by a mean of 28.4 percentage points, more than half gained at least 20 points, and mean daily device use was 7 to 8 hours; duration of deafness did not independently predict outcome. A systematic review of 12 small studies (69 ears) found cochlear implantation after radiotherapy for nasopharyngeal carcinoma improved hearing in about 91% with few complications, even after a mean of 6.5 years of profound loss. A screening device in a US national cohort of 12,756 adults aged 55 and over estimated hearing loss in 54.8%, matching audiometry-based national estimates, with 6% having moderate to severe difficulty. A single children's hospital series of 1,734 intracapsular tonsillotomies found coblation was about two minutes faster than the microdebrider, with similar bleeding (about 1%) and revision rates. The pearl: sudden sensorineural hearing loss is an urgent referral.
Hearing loss affects over half of adults aged 55 and over
Ask adults over 55 about hearing, screen where audiometry is not at hand, and refer positives for formal testing.
Cochlear implants after nasopharyngeal radiotherapy: 91% gained hearing
Survivors of nasopharyngeal cancer with severe radiation-induced hearing loss should be considered for cochlear implant assessment.
Tonsillotomy: coblation slightly faster than microdebrider, bleeding similar
Coblation and microdebrider tonsillotomy gave similar bleeding and revision rates in children; younger age predicted revision.
Sudden hearing loss in one ear is an urgent referral
Sudden one-sided hearing loss with a normal drum and Weber lateralising to the good ear is sensorineural until proven otherwise; refer urgently.
Implant after more than ten years of unilateral deafness: most still benefit
Long-standing unilateral deafness should not by itself rule out a cochlear implant; assess each adult individually with realistic counselling.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this one is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for ent & head and neck surgery, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free