An ultrapower BTE will give the best chance at providing amplification at the most severe thresholds. HOWEVER, realistically, it is often the case in losses like these that the damage to the ear is such that the sound quality for amplified sounds up at that profound range is going to be poor and will not contribute to better understanding. That’s why earlier I think I indicated that the ears were likely unaidable above ~600 Hz in the right and ~1000 Hz in the left. Given that, a UP RIC may be doing okay. I would expect, with a loss like this, that lipreading support and closed captions would always be necessary. That said, I think it’s worth trying a BTE because some patients can tolerate gain in that profound range and find it helpful. One can always return to a RIC, although they would be out the cost of the earmolds and whatever fitting fees may be associated. But then they will know.
That right ear cannot be contributing that much speech recognition at this point. I think that even if one isn’t that interested in cochlear implants, it is worth going through the candidacy process because you gain a lot more information to better make an informed decision. I understand the magnitude of the decision to get a CI and yet. . . and yet. . . I’ve had five patients implanted recently all of whom have had tremendous outcomes. The main thing I see is how massively listening effort has been reduced for them.
