Bimodal stimulation in cochlear implant users: matrix test speech-in-noise performance and audiological characteristics

BACKGROUND: Unilateral cochlear implant (CI) recipients with contralateral moderate-to-profound hearing loss may either adopt a contralateral hearing aid (HA) or rely on CI-only listening. Bimodal stimulation (BS), combining electric and acoustic input, has been shown to improve speech perception in noise; however, some patients decline contralateral amplification despite residual hearing. AIMS/OBJECTIVES: This study aimed to characterize the audiological profiles of CI recipients who refuse contralateral HA use and to compare their speech-in-noise performance with that of BS users using the Italian Matrix Sentence Test. MATERIAL AND METHODS: Unilateral CI users with contralateral moderate-to-profound sensorineural hearing loss were enrolled and divided into BS users and CI-only users. Pure-tone audiometry (PTA), word recognition score (WRS), and speech-in-noise performance were assessed. BS users were tested in both CI-only and CI+HA conditions. RESULTS: = 0.008). CI-only users showed slightly better residual contralateral hearing. CONCLUSION: Refusal of contralateral amplification may reflect an experience-driven perception of limited benefit, highlighting the importance of individualized counselling and outcome-based hearing device selection.