Contralateral acoustic hearing aid use in adult unilateral cochlear implant recipients: current provision, practice, and clinical experience in the UK

Objectives: The study surveyed practising cochlear implant audiologists with the aim of: (1) characterising UK clinical practice around the management and fitting of a contralateral hearing aid in adult unilateral cochlear implant users (‘bimodal aiding’); (2) identifying factors that may limit the provision of bimodal aiding; and (3) ascertaining the views of audiologists on bimodal aiding. Methods: An online survey was distributed to audiologists working at the 20 centres providing implantation services to adults in the UK. Results: Responses were received from 19 of the 20 centres. The majority of centres reported evaluating hearing aids as part of the candidacy assessment for cochlear implantation. However, a majority also indicated that they do not take responsibility for the contralateral hearing aid following implantation, despite identifying few practical limiting factors. Bimodal aiding was viewed as more beneficial than wearing the implant alone, with most respondents actively encouraging bimodal listening where possible. Respondents reported that fitting bimodal devices to take account of each other’s settings was potentially more beneficial than independently-fit devices, but such sympathetic fitting was not routine practice in any centre. Discussion: The results highlight some potential inconsistencies in the provision of bimodal aiding across the UK as reported by practising audiologists. The views of audiologists about what is best practice appear to be at odds with the nature and structure of the services currently offered. Conclusion: Stronger evidence that bimodal aiding can be beneficial for UK patients would be required in order for service providers to justify the routine provision of bimodal aiding and to inform guidelines to shape routine clinical practice