Original Research—Otology and Neurotology Fluctuating Hearing Loss in the Only Hearing Ear: Cochlear Implantation in the Contralateral Deaf Side Otolaryngology– Head and Neck Surgery 2018, Vol. 158(6) 1101–1106 Ó American Academy of Otolaryngology–Head and Neck Surgery Foundation 2018 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0194599818763137 http://otojournal.org Francesca Yoshie Russo, MD 1,2 , Daniele De Seta, MD, PhD 1,2 , Ghizlene Lahlou, MD 1,2 , Ste ´ phanie Borel, PhD 2 , Yann Nguyen, MD, PhD 1,2 , Didier Bouccara, MD 1,2 , Olivier Sterkers, MD, PhD 1,2 , Daniele Bernardeschi, MD, PhD 1,2 , and Isabelle Mosnier, MD 1,2 Sponsorships or competing interests that may be relevant to content are dis- closed at the end of this article. Abstract Objective. To investigate the hearing performance of adult patients presenting unilateral deafness with contralateral fluctuating hearing loss who received a cochlear implant on the deaf side. Study Design. Case series with chart review. Setting. University tertiary referral center. Subjects and Methods. Preoperatively and at 6 and 12 months postoperatively, 23 patients underwent pure tone audiome- try and speech audiometry with disyllabic and monosyllabic words in a quiet environment and sentences in quiet and noisy (signal-to-noise ratio 110 dB SPL) environments under best-aided conditions. The Abbreviated Profile of Hearing Aid Benefit (APHAB) inventory was evaluated preo- peratively and at 6 and 12 months postoperatively. Results. No difference was found between pre- and post- operative tests for disyllabic and monosyllabic words. For sentences in quiet and noisy environments, a difference between pre- and postoperative performance was present at 1 year (P = .002 and P = .02, respectively). In a noisy envi- ronment, a difference was present at 6 and 12 months post- operatively as compared with the preoperative value (mean 6 SD: 6 months: 42% 6 7.1% vs 61% 6 6.5%, P = .016). A significant improvement in the APHAB score was found at 6 and 12 months postimplantation (Friedman’s 2-way analysis of variance by ranks, P \ .001). The number of years of hearing deprivation of the deaf ear was not correlated with performance. Conclusion. When incapacitating fluctuating hearing loss occurs in patients presenting a contralateral deaf ear, a cochlear implant is indicated in the latter ear, significantly improving performance in noisy conditions and allowing a better quality of communication to be achieved. Keywords Me ´nie `re’s disease, immune-mediated inner ear disease, cochlear implant, SSD, APHAB, fluctuation Received November 2, 2017; revised January 8, 2018; accepted February 13, 2018. F luctuating sensorineural hearing loss is a condition most commonly seen in patients affected by Me ´nie `re’s disease, but it is also found in patients with immune- mediated inner ear disease and, occasionally, inner ear dis- ease of unknown etiology. Me ´nie `re’s disease classically develops unilaterally; how- ever, it progresses to bilateral disease in 2% to 47% of patients. 1 In these cases, it may lead to unilateral hearing loss and contralateral fluctuating hearing loss. However, immune-mediated inner ear disease usually occurs bilater- ally with episodes of hearing fluctuation or rapidly progres- sive sensorineural hearing loss and with great variability of symptoms, such as dizziness and tinnitus. 2 In 1979, McCabe first described a cohort of patients with bilateral idiopathic progressive sensorineural hearing loss whose hearing improved after treatment with corticosteroids, thereby desig- nating an autoimmune pathogenesis. 3 For such patients, oto- logic symptoms can be isolated or associated with other systemic symptoms. At present, these patients can also 1 Sorbonne Universite ´s, Universite ´ Pierre et Marie Curie Paris 6, Inserm, Unite ´ Re ´habilitation chirurgicale mini-invasive et robotise ´e de l’audition, Paris, France 2 AP-HP, GHU Pitie ´-Salpe ˆtrie `re, Service ORL, Otologie, implants auditifs et chirurgie de la base du cra ˆne, Paris, France The study was presented at the IFOS ENT World Congress; June 24-28, 2017; Paris, France. Corresponding Author: Isabelle Mosnier, MD, AP-HP, GHU Pitie ´-Salpe ˆtrie `re, Service ORL, Otologie, implants auditifs et chirurgie de la base du cra ˆne, 47-83 Boulevard de l’Ho ˆ pital, 75651 Paris Cedex 13, France. Email: isabelle.mosnier@aphp.fr