This is the case coming from my CI surgeon as well. In my opinion this is not always what’s best for the patient but who knows.
My situation was both ears were bad so it didn’t matter which ear was done first. I did pick the worst ear to be done first.
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In this case, the good ear is normal, so absolutely not. The CI would be for the poor ear or not at all.
If the choice is to have only one CI if you have two bad ears and you are hoping for the best outcome, it may absolutely make sense to go for the better ear, the one that has experienced less long-term auditory deprivation. However, in a lot of cases they may still do the worse ear if the patient is fearful of losing what is there in the better ear.
In Canada, historically public health only paid for one CI and if you had one good ear you wouldn’t be a candidate. Things shifted to two CIs for children born with bilateral hearing loss and one CI for children born with unilateral loss, and as solid data on the benefit of two hearing ears has increased things are just starting to change and ears are starting to be considered individually for adults as well–so adults may be eligible for one even if their hearing in the other ear is pretty good, in which case it would be the worse ear implanted. But this change is very new. I don’t know where things are in the UK right now.
If I suddenly lost hearing in one ear and didn’t qualify for a CI per Canadian public health guidelines, I would probably remortgage my house and travel to the States to have one put in privately (or there may be private options here now, I’m not sure). But I would also expect better outcomes from quick implantation after a sudden loss than I would after a slow long-term decline. My expectation is that in the long run, ears will be considered individually and our public health will pay for two in cases where two are warranted.
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Thank you for your replies @Neville & @Raudrive most probably, one of my main reasons for refusing an CI evaluation, I didn’t want to risk getting my good ear done ( I use the term loosely 
) just in case, I was unfortunate to have a failure, leaving me up sh1t creek, without a paddle… Cheers Kev 
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When I said ‘good’ I meant it in relative terms! I still benefitted from an aid in that ear- but it allowed me to ‘hear’ either side.
However, if your good ear has perfect hearing, I wouldn’t recommend this solution!
In my CI assessment, the doctor told me that a CI is used in the ear that is primarily NOT used for balance- I hadn’t realised that one has a ‘dominant’ ear for balance. If that ear turns out to be the better ear, then it is a tough choice.
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That’s interesting, I have never heard that before.
How would they know if that ear is best or worst for balance?
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They typically do balance testing prior to implantation. If implantation results in damage to the connected vestibular organ, which is possible, and the other one is already shot, quality of life can really drop.
BUT, in the OP’s case we’re talking about a sudden loss likely due to neuritis or labyrinthitis. This is often accompanied by vestibular damage anyway. The other ear is normal. The bad ear would still be the implantation ear.
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Unfortunately @nglfriend, my balance is questionable… MD (Meniers Disease) basically destroyed my vestibular, and sometimes I am a bit wobbly on my feet, especially in the dark, I have a habit of walking into walls, in low light… Cheers Kev
Apparently, they can conduct tests to identify which ear leads on ballance- but this is a UK NHS approach, and may not be the same in the USA.
I cannot imagine that the tests are pleasant; you are advised not to drive immediately after them.
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I’m in a similar boat having suffered MD for years. I am in the last stage, where hearing is gradually destroyed but vertigo attacks stop. However, balance remains a problem- particularly at night. Apparently, we often learn to control balance issues by relying more on visual indicators- but these disappear in the dark!
It’s all part of the fun of growing old…
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Yeah @nglfriend, MD is extremely difficult to live with, perhaps even more difficult for family, especially in those vertigo years! Any forward planning, was usually shot down in flames… Holidays, where always a hit or miss, and invariably, I would get cluster attacks, right on the holiday week, I recall one holiday, that was downright disastrous, my wife & 4 kids, in a caravan, it rained constantly for the whole week, and I couldn’t stand up with vertigo attacks, stress levels where through the roof, my wife always refers to that week as, “The holiday from hell”… I always felt so guilty, for spoiling everyones fun! I am glad you are past the vertigo stage, it was at times (for me) a living nightmare, but you survived, and lived to tell the tale…But you appear to have a good sense of humour, and that will see you through the later stages of MD… Its probably, near 20 years since my last vertigo attack, I remember praying really hard, praying the vertigo would just go away, and I would except the profound & total deafness as my penance, such was my despair! In the end, I was left with some residual hearing, not a lot, but enough to get bye… Take Care, cheers Kev
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I’m my case my surgeon opted for my good ear. Both my ears are candidates for Ci. My L is a congenital loss and hadn’t heard high frequencies ever. My R had a SSHL 3 years prior to CI. My surgeon opted for my R ear as he said it would give me a better result than my L. My L ear
needs doing as I can’t discern any speech without my processor on. I’ll bite the bullet one day when I don’t have any choice but until then I’ll remain bimodal.
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Thank you Sheryl… It would appear, in most instances, but not all, the CI Surgeon will predominantly choose the better ear, which to my mind is logical, as this offers the best prospect of a favourable outcome… From my perspective, I wouldn’t risk that, I am acutely aware, there is much to be gained, but in the rare event of failure, then I am most probably goosed! Although my audiogram suggests otherwise, I hear pretty well, with the Roger system, I hear exceptionally well, my left ear doesn’t get much contextual information, but I do notice “Big Time”, if it’s unaided… Last night, I was invited down to play pool at a friend’s “Man Cave”, he likes to chat amongst the pool play, he had music playing, and I was struggling slightly to hear every word, so I took one of my Roger Selects out my pocket, fired it up, and placed it on the side rail, on top of the pool table, “Bingo”, we where now cooking with gas, the difference in clarity was night & day, I am not saying, I heard absolutely everything, but it was almost everything… Cheers Kev 
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