Jim R. Dornhoffer, M.D.

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SUMMARY

Jim R. Dornhoffer, M.D., performs research on all aspects of otology, neurotology and lateral skull base surgery. However, his primary research interests are cochlear implantations and vestibular schwannomas. Dr. Dornhoffer's work focuses on improving outcomes and holistic care for these patient populations. This complete care is from diagnosis to resolution of treatment. This extensive treatment streamlines cochlear implant programming and allows the development of algorithms for auditory training of new implant recipients. Dr. Dornhoffer also evaluates new cochlear implantation technology and new indications for the use of such devices in patients with vestibular schwannomas.

Focus areas

• Auditory training for adult cochlear implant recipients. Cochlear implantation is a remarkably successful intervention but individual variability in outcomes remains high. Some of this variability may be related to a patient's ability to learn to hear with their device. Outside of programming changes, there are few interventions to improve this process. Dr. Dornhoffer's research team details the use of various types of patient-directed interventions that may improve implant speech and quality of life in new adult implant recipients.
  
  His research has identified that computer-based training programs, unique among various interventions, may afford greater improvement in speech and quality of life outcomes. Dr. Dornhoffer is currently directing a randomized trial to better understand the true influence of such interventions. Development of post-implantation training algorithms may help to maximize implant outcomes in a free or affordable manner for many patients.
• Cochlear implantation in vestibular schwannomas. Many to most patients with vestibular schwannomas will lose functional hearing in their involved ear. Traditionally, auditory brainstem implants have been offered for auditory rehabilitation in such patients but outcomes are generally poor. More recently, cochlear implants have gained some acceptance in managing schwannoma-related hearing loss.
  
  Dr. Dornhoffer and his colleagues have studied the effects of cochlear implantation in various cohorts with vestibular schwannomas. In doing so they have demonstrated superior outcomes with cochlear implantation as compared to classically available implants, and have linked implant outcomes to tumor intervention strategies.
• New programming strategies and implantable devices. While cochlear implants have great success in managing advanced sensorineural hearing loss, challenges remain with respect to patient access, care and managing their devices. Two areas of focus for the Mayo research team are streamlining implant programming and evaluating a new, fully implanted cochlear implant. Streamlining of cochlear implant programming allows for a reduction in the financial burden for both implant recipients and centers and may allow centers to evaluate more implant candidates.
  
  Successful use of a fully implanted cochlear implant may mitigate many of the limitations that current users may face from a reliance on external device components. Dr. Dornhoffer currently directs a randomized clinical trial of a deescalated programming algorithm for new cochlear implant recipients.
• Cochlear implant outcomes and quality of life conditions. Cochlear implant candidacy and success is often decided on the basis of speech recognition testing. However, common speech recognition testing may be insufficient to capture many functional or "real-life" outcomes. Dr. Dornhoffer and his collaborators have studied the influence of commonly used speech recognition tests on quality-of-life outcomes under various conditions.
  
  His team evaluates the influence of speech recognition scores on the pursuit and outcomes of other interventions such as bilateral cochlear implantation or auditory training in cochlear implant recipients. In doing so, Dr. Dornhoffer developed a better understanding of the association and, oftentimes, disconnect between common speech testing values and functional outcome measures in cochlear implant recipients.

Significance to patient care

Dr. Dornhoffer's goal is to transfer his research into meaningful clinical changes for those receiving cochlear implants and patients with vestibular schwannomas. By improving the understanding of how to best train and program new implant users, Dr. Dornhoffer and his colleagues strive to develop a holistic approach to cochlear implant care that will improve patient outcomes and satisfaction with their devices. Research on cochlear implants in patients with vestibular schwannomas will hopefully improve access to speech and sound for this unique population.

Dr. Dornhoffer is grateful to be working toward these goals with his colleagues and a robust multidisciplinary research team at Mayo Clinic.