Question: A 77 year old male with presbycusis is referred for possible cochlear implantation. He notes that he has used hearing aids for about 20 years with gradual decline in benefit. In the ear to be implanted, his preoperative CNC word score is 38% and AzBio sentence score in quiet is 12%. In the contralateral ear, CNC word score is 42% and AzBio sentence score is 18%. An MRI was performed 18 months previously that showed normal 7th and 8th nerve complexes and inner ear morphology. Which of the following is the next best step in management?

a) Evaluation of cognition to rule out dementia

b) Proceed with cochlear implantation

c) Obtain repeat MRI as this is suggestive of new retrocochlear pathology

d) Continue with conventional amplification due to his average CNC word score of 40%

[Answer will be posted with next week's new question]

Answer to last week's question, “What Could Go Wrong, Will Go Wrong” (July 27, 2020)

D - Bleeding.