Side selection of cochlear implant in patients after head trauma: a new perspective.

Background: Head trauma often leads to bilateral sensorineural hearing loss (SNHL), and determining the optimal side for cochlear implantation (CI) remains a critical issue that requires further investigation. Objective: To evaluate the role of preoperative aided threshold (AT) testing in selecting the optimal CI side for patients with bilateral SNHL caused by head trauma.

Methods: This study included 9 patients with bilateral SNHL resulting from head trauma. Preoperative audiological and radiological evaluations were performed. The correlation between preoperative AT, duration of deafness (DoD), radiological findings, and Nijmegen Cochlear Implant Questionnaire (NCIQ) scores was analyzed.

Results: Preoperative AT showed a tendency for a negative correlation with advanced sound perception scores (r = -0.740,  = 0.057), while DoD exhibited a significant negative correlation with auditory self-confidence (r = -0.803,  = 0.029). Imaging combined with AT provides a foundational framework for selecting the implantation side; however, the limited sample size restricts the generalizability of the findings.

Conclusion: Lower preoperative AT and shorter DoD may predict better auditory rehabilitation outcomes following CI. It is recommended to integrate imaging and audiological evaluations for individualized decision-making. Future studies with larger sample sizes are necessary to validate these findings and explore the clinical implications of early CI.