MSTB-3 Insights “Best Aided Condition”

Simply the Best

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Apologies if you now have Tina Turner’s song stuck in your head.  On second thought, maybe that is not a bad idea to have a musical prompt to remind us of a new way of thinking.  Over the years, clinical practice and research have led me to experience varying definitions of the “better ear”.  Quite honestly, it was a bit confusing.  The new MSTB-3 has been developed to ensure consistency by cochlear implant practitioners.  That consistency will serve to ensure proper identification of cochlear implant candidates, implementation and access to standardized care, and proper documentation for optimal reimbursement.

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The big question you may be asking is why now or why has the “best aided condition” been defined as the best aided performance of the ear to be implanted following confirmation of optimized hearing aid fitting?  The MSTB-3 consensus panel explored this question in great detail. In 2011, when the last MSTB was written, we were not serving individuals with more residual hearing or those with asymmetric or single sided deafness.  As new cochlear implant indications have been approved by the FDA, we need to place a greater emphasis on the ear to be implanted.  We still remain committed to assessing proper aided function but now we need to explore each ear independently to assist our clinical decision-making for appropriateness of implantation and monitoring of outcome data.  We also need to address that we are now serving patients with varying levels of performance in the contralateral ear.  It is our responsibility to be isolating each ear to ensure that we are making proper recommendations.  

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Simply put, to ensure optimal patient care, we need to identify the best ear for implantation through individual ear assessment.

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Pro Tip:

If you are not already doing so, you should consider implementing documentation that separates right and left ear audibility results with a separate section to address speech perception performance.

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