An adult has bilateral severe-to-profound sensorineural deafness and derives inadequate benefit from appropriately fitted acoustic hearing aids after structured assessment. Which principle best guides the next step?
Cochlear implantation is considered after confirming severe-to-profound deafness and inadequate benefit from optimal hearing aids. A specialist team evaluates audiology, communication needs, anatomy, expectations and rehabilitation—not the audiogram alone.
A. Exclude implantation because the patient developed speech before deafness: Post-lingual deafness does not exclude implantation and can support useful speech outcomes.
B. Offer an implant without a hearing-aid trial or rehabilitation discussion: Candidacy requires evidence of inadequate aided benefit and informed multidisciplinary assessment.
C. Refer to a specialist cochlear-implant team for multidisciplinary assessment: Cochlear implantation is considered after confirming severe-to-profound deafness and inadequate benefit from optimal hearing aids. A specialist team evaluates audiology, communication needs, anatomy, expectations and rehabilitation—not the audiogram alone.
D. Implant both ears automatically at the first consultation: Laterality and simultaneous bilateral implantation depend on eligibility, individual circumstances and shared decision-making.
E. Use pure-tone thresholds as the sole determinant: Functional aided speech benefit and broader multidisciplinary factors are essential.
If usable aided speech understanding were demonstrated, optimisation of hearing aids and communication support might remain preferable.
Independent Clinora educational preparation material; not official JCIE content, an accredited programme, clinical advice, or a substitute for local policy and specialist judgement.
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