Purpose: We propose theoretical guidelines for cochlear implant selection criteria in adults and children that emphasize the contribution of each ear to the binaural advantage. The guidelines outline options for implanting one ear only, implanting one ear plus use of a contralateral hearing aid, and implanting both ears.
Method: Our method for selecting the best cochlear implant or hearing aid outcome is derived from the amount of usable hearing of the patient. This approach requires the measurement of aided speech perception with each ear separately and then bilaterally. Guidelines are based on the following: (a) overall level of performance with hearing aids relative to what is expected from a cochlear implant, (b) the contributions from each ear, and (c) whether there is a binaural advantage.
Conclusions: Our general recommendation is to provide the patient with the best opportunity for binaural hearing. Since the guidelines put forth in this article are theoretically based, future efforts should be aimed at examining the validity of these guidelines.