Expanding indications for cochlear implantation: Evaluating outcome measures and therapy

Abstract

To restore the function of sensory organs, cochlear implants (CIs) are considered to be the most effective neural prostheses currently utilized in medicine. The number of CI users worldwide is growing as indications for cochlear implantation expand with time. This thesis focused on the expanding indications for CI, including adult patients with single-sided deafness or tinnitus. In this group of patients, we evaluated therapeutic options and assessed measures of hearing performance in both bilateral and single-sided deaf CI users. We also attempted to raise awareness of different forms of bias in the reporting of outcomes in order to improve research quality and reduce research waste in the field of otology. The findings of this thesis elucidate the effectiveness of cochlear implantation in expanding indications, including adult patients with tinnitus or single-sided deafness. The results from the presented high-level evidence studies further enrich the existing literature on optimal treatment options for these patients. However, further research is needed on patient selection and the cost-effectiveness of the treatment options. The investigated objective and psychophysical measures to evaluate the hearing performance of CI users can assist clinicians in optimizing rehabilitation and improving expectation management of the patient. We raised awareness about publication bias and misrepresentation of results in the field of otology. Hopefully, it will result in higher quality of research that upholds timely and accurate reporting of results, ultimately leading to more evidence-based care with a patient-centered approach.