scholarly journals Low-Frequency Hearing Preservation With Long Electrode Arrays: Inclusion of Unaided Hearing Threshold Assessment in the Postoperative Test Battery

2020 ◽  
Vol 29 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Margaret T. Dillon ◽  
Emily Buss ◽  
Brendan P. O'Connell ◽  
Meredith A. Rooth ◽  
English R. King ◽  
...  
Keyword(s):  
Hearing Threshold ◽  
Low Frequency ◽  
Electrode Array ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
Electrode Arrays ◽  
Hearing Sensitivity ◽  
Hearing Thresholds ◽  
Electric Acoustic Stimulation ◽  
Initial Activation

Purpose The goal of this work was to evaluate the low-frequency hearing preservation of long electrode array cochlear implant (CI) recipients. Method Twenty-five participants presented with an unaided hearing threshold of ≤ 80 dB HL at 125 Hz pre-operatively in the ear to be implanted. Participants were implanted with a long (31.5-mm) electrode array. The unaided hearing threshold at 125 Hz was compared between the preoperative and postoperative intervals (i.e., initial CI activation, and 1, 3, 6, 9, and 12 months after activation). Results Eight participants maintained an unaided hearing threshold of ≤ 80 dB HL at 125 Hz postoperatively. The majority ( n = 5) demonstrated aidable low-frequency hearing at initial activation, whereas 3 other participants experienced an improvement in unaided low-frequency hearing thresholds at subsequent intervals. Conclusions CI recipients can retain residual hearing sensitivity with fully inserted long electrode arrays, and low-frequency hearing thresholds may improve during the postoperative period. Therefore, unaided hearing thresholds obtained within the initial weeks after surgery may not reflect later hearing sensitivity. Routine measurement of postoperative unaided hearing thresholds—even for patients who did not demonstrate aidable hearing thresholds initially after cochlear implantation—will identify CI recipients who may benefit from electric–acoustic stimulation. Supplemental Material https://doi.org/10.23641/asha.11356637

scholarly journals Preservation of residual hearing after cochlear implant surgery with slim modiolar electrode

2019 ◽  
Vol 277 (2) ◽  
pp. 367-375 ◽  
Author(s):  
Matti Iso-Mustajärvi ◽  
Sini Sipari ◽  
Heikki Löppönen ◽  
Aarno Dietz
Keyword(s):  
Low Frequency ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
Residual Hearing ◽  
Insertion Depth ◽  
Cochlear Implant Surgery ◽  
Computed Tomography Scans ◽  
Electric Acoustic Stimulation ◽  
Speech Recognition In Noise

Abstract Purpose To evaluate the insertion results and hearing preservation of a novel slim modiolar electrode (SME) in patients with residual hearing. Methods We retrospectively collected the data from the medical files of 17 patients (18 ears) implanted with a SME. All patients had functional low frequency hearing (PTA (0.125–0.5 kHz) ≤ 80 dB HL). The insertion results were re-examined from the postoperative cone-beam computed tomography scans. Postoperative thresholds were obtained at the time of switch-on of the sound processors (mean 43 days) and at latest follow-up (mean 582 days). The speech recognition in noise was measured with the Finnish matrix sentence test preoperatively and at follow-up. Results The mean insertion depth angle (IDA) was 395°. Neither scala dislocations nor tip fold over were detected. There were no total hearing losses. Functional low-frequency hearing was preserved in 15/18 (83%) ears at switch-on and in 14/17 (82%) ears at follow-up. According to HEARRING classification, 55% (10/18) had complete HP at switch-on and 41% (7/17) still at follow-up. Thirteen patients (14 ears) were initially fitted with electric–acoustic stimulation and seven patients (8 ears) continued to use it after follow-up. Conclusions The preliminary hearing preservation results with the SME were more favorable than reported for other perimodiolar electrodes. The results show that the array may also be feasible for electro-acoustic stimulation; it is beneficial in that it provides adequate cochlear coverage for pure electrical stimulation in the event of postoperative or progressive hearing loss.

Impact of Electric Stimulation on Residual Hearing

2015 ◽  
Vol 26 (08) ◽  
pp. 732-740 ◽  
Author(s):  
Margaret T. Dillon ◽  
Andrea L. Bucker ◽  
Marcia C. Adunka ◽  
English R. King ◽  
Oliver F. Adunka ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Electric Stimulation ◽  
Bone Conduction ◽  
Low Frequency ◽  
Electrode Array ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
First Year ◽  
Residual Hearing ◽  
Listening Experience

Background: Candidacy criteria for cochlear implantation are expanding to include patients with substantial low-to-mid frequency hearing sensitivity. Postoperative hearing preservation has been achieved in cochlear implant recipients, though with variable outcomes. Previous investigations on postoperative hearing preservation outcomes have evaluated intraoperative procedures. There has been limited review as to whether electric stimulation influences hearing preservation. Purpose: The purpose of this analysis was to evaluate whether charge levels associated with electric stimulation influence postoperative hearing preservation within the first year of listening experience. Research Design: Retrospective analysis of unaided residual hearing and charge levels. Study Sample: Twenty-eight cochlear implant recipients with postoperative residual hearing in the operative ear and at least 12 mo of listening experience with electric-acoustic stimulation (EAS). Data Collection and Analysis: Assessment intervals included initial cochlear implant activation, initial EAS activation, and 3-, 6-, and 12-mo postinitial EAS activation. A masked low-frequency bone-conduction (BC) pure-tone average (PTA) was calculated for all participants at each assessment interval. Charge levels for each electrode were determined using the most comfortable loudness level and pulse width values. Charge levels associated with different regions of the electrode array were compared to the change in the low-frequency BC PTA between two consecutive intervals. Results: Charge levels had little to no association with the postoperative change in low-frequency BC PTA within the first year of listening experience. Conclusions: Electric charge levels do not appear to be reliably related to the subsequent loss of residual low-frequency hearing in the implanted ear within the first year of EAS listening experience.

scholarly journals Hearing Preservation in Cochlear Implant Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Priscila Carvalho Miranda ◽  
André Luiz Lopes Sampaio ◽  
Rafaela Aquino Fernandes Lopes ◽  
Alessandra Ramos Venosa ◽  
Carlos Augusto Costa Pires de Oliveira
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Surgical Techniques ◽  
Low Frequency ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
Electrode Design ◽  
High Frequency Region ◽  
Electric Acoustic Stimulation ◽  
New Treatment

In the past, it was thought that hearing loss patients with residual low-frequency hearing would not be good candidates for cochlear implantation since insertion was expected to induce inner ear trauma. Recent advances in electrode design and surgical techniques have made the preservation of residual low-frequency hearing achievable and desirable. The importance of preserving residual low-frequency hearing cannot be underestimated in light of the added benefit of hearing in noisy atmospheres and in music quality. The concept of electrical and acoustic stimulation involves electrically stimulating the nonfunctional, high-frequency region of the cochlea with a cochlear implant and applying a hearing aid in the low-frequency range. The principle of preserving low-frequency hearing by a “soft surgery” cochlear implantation could also be useful to the population of children who might profit from regenerative hair cell therapy in the future. Main aspects of low-frequency hearing preservation surgery are discussed in this review: its brief history, electrode design, principles and advantages of electric-acoustic stimulation, surgical technique, and further implications of this new treatment possibility for hearing impaired patients.

scholarly journals One Year Assessment of the Hearing Preservation Potential of the EVO Electrode Array

2021 ◽  
Vol 10 (23) ◽  
pp. 5604
Author(s):  
Nicolas Guevara ◽  
Cécile Parietti-Winkler ◽  
Benoit Godey ◽  
Valerie Franco-Vidal ◽  
Dan Gnansia ◽  
...  
Keyword(s):  
Full Range ◽  
Low Frequency ◽  
Electrode Array ◽  
Pure Tone Audiometry ◽  
Hearing Preservation ◽  
Hearing Thresholds ◽  
One Year ◽  
Prospective Longitudinal ◽  
Time Point

Background: A prospective longitudinal multicentre study was conducted to assess the one-year postsurgical hearing preservation profile of the EVOTM electrode array. Methods: Fifteen adults presenting indications of electro-acoustic stimulation (pure-tone audiometry (PTA) thresholds ≤70 dB below 750 Hz) were implanted with the EVO™ electrode array. Hearing thresholds were collected at five time-points from CI activation to twelve months (12M) after activation. Hearing thresholds and hearing preservation profiles (HEARRING group classification) were assessed. Results: All subjects had measurable hearing thresholds at follow-up. No case of complete loss of hearing or minimal hearing preservation was reported at any time point. At activation (Nact = 15), five participants had complete hearing preservation, and ten participants had partial hearing preservation. At the 12M time point (N12m = 6), three participants had complete hearing preservation, and three participants had partial hearing preservation. Mean hearing loss at activation was 11 dB for full range PTA and 25 dB for PTAs low-frequency (125–500 Hz). Conclusions: This study provides the first longitudinal follow-up on associated hearing profiles to the EVO™ electrode array, which are comparable to the literature. However, other studies on larger populations should be performed.

scholarly journals Cochlear Implantation in Elderly Patients with Residual Hearing

2021 ◽  
Vol 10 (19) ◽  
pp. 4305
Author(s):  
Farnaz Matin ◽  
Eralp-Niyazi Artukarslan ◽  
Angelika Illg ◽  
Anke Lesinski-Schiedat ◽  
Thomas Lenarz ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Pure Tone Audiometry ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
Speech Comprehension ◽  
Residual Hearing ◽  
Hearing Thresholds ◽  
Electric Acoustic Stimulation ◽  
System Benefit ◽  
Speech Recognition In Noise

This retrospective study aimed to investigate the range of hearing levels in a cochlear implant (CI) elderly population receiving electric-acoustic-stimulation (EAS) or electric-stimulation (ES) alone. The investigation evaluates the degree of hearing preservation (HP) and the speech comprehension resulting from EAS or ES-only to identify audiometric factors that predict adequate EAS and ES use. We analyzed the pure tone audiometry and speech perception in quiet and noise preoperatively and 12-months after activation of 89 elderly adults (age of 65 years old or older), yielding in total 97 CIs. Thirty-two (33.1%) patients were potential EAS candidates preoperatively, of which 18 patients used EAS at the time of first fitting and the other 14 patients continued to use their residual hearing for EAS at 12-months. Post-treatment, patients with EAS system and ES-only users’ with longer electrodes showed better results in monosyllable word scores in quiet than ES-only users with shorter electrodes. A similar trend was revealed for the speech recognition in noise. Patients with an EAS system benefit from maintaining their natural residual hearing. Nevertheless, strict preoperative patient selection is warranted particularly in elderly patients, in whom the hearing thresholds for EAS indication differ slightly from that in younger adults.

Preservation of residual hearing following cochlear implantation: comparison between three surgical techniques

2007 ◽  
Vol 122 (3) ◽  
pp. 246-252 ◽  
Author(s):  
S Berrettini ◽  
F Forli ◽  
S Passetti
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Surgical Techniques ◽  
Electrode Array ◽  
Lateral Wall ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
Residual Hearing ◽  
Electrode Arrays ◽  
Electrode Insertion

AbstractThe preservation of residual hearing is becoming a high priority in cochlear implant surgery. It allows better speech understanding and ensures long-lasting and stable performance; it also allows the possibility, in selected cases, of combining electro-acoustic stimulation in the same ear.We present the results of a retrospective study of the conservation of residual hearing in three different groups of patients who had undergone cochlear implantation using three different cochlear implant electrode arrays, combined with three different surgical techniques for the cochleostomy. The study aimed to evaluate which approach allowed greater preservation of residual hearing.The best residual hearing preservation results (i.e. preservation in 81.8 per cent of patients) were achieved with the Contour Advance electrode array, using the Advance Off-Stylet technique and performing a modified anterior inferior cochleostomy; this combination enabled reduced trauma to the lateral wall of the cochlea during electrode insertion.

scholarly journals Hearing preservation in children with electric-acoustic stimulation after cochlear implantation

HNO ◽  
2018 ◽  
Vol 66 (S2) ◽  
pp. 56-62 ◽  
Author(s):  
T. Rader ◽  
A. Bohnert ◽  
C. Matthias ◽  
D. Koutsimpelas ◽  
M-A. Kainz ◽  
...  
Keyword(s):  
Cochlear Implantation ◽  
Low Frequency ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
Residual Hearing ◽  
Short Term ◽  
Mean Values ◽  
Minimal Trauma ◽  
Electric Acoustic Stimulation ◽  
The Mean

Abstract Background Cochlear implantation in patients with functional residual low-frequency hearing is performed according to an established hearing-preserving surgical technique in order to cause minimal trauma of inner ear structures. Due to the increasing number of cochlear implants in children, the preservation of residual hearing is becoming increasingly important in this patient collective. Objectives Short- and mid-term hearing preservation outcome in pediatric patients is investigated. Materials and methods A group of 9 children (12 ears) between 5 and 12 years of age were examined after hearing-assisted cochlear implantation with respect to the pure tone audiometric thresholds. Retrospectively, short-term hearing preservation (up to 3 months after surgery) was examined. In a subgroup of 5 children, mid-term hearing preservation (7.5 to 16 months after surgery) was also analyzed. The mean values of hearing preserved (HL%) and hearing loss (HL) due to electrode insertion were calculated as measured values. Results In the whole group, the mean values of the preoperative PTAlow were 29.8 dB and the short-term postoperative PTAlow 42.6 dB. The mean value of the HL% was 73.6%, corresponding to an HL of 9.4 dB. In the subgroup, the mean PTAlow postoperatively was 46.0 dB in the mid-term and the HL% at 80.7% with a HL of 6.6 dB. Conclusions The results in children are consistent with the results in adults. Electric-acoustic stimulation (EAS) should be used in the treatment of children with existing low-frequency residual hearing, as good residual hearing preservation can also be achieved in children after implantation.

scholarly journals Investigation of intracochlear dual actuator stimulation in a scaled test rig

2017 ◽  
Vol 3 (2) ◽  
pp. 119-122
Author(s):  
Wouter J. van Drunen ◽  
Sarra Kacha Lachheb ◽  
Anatoly Glukhovskoy ◽  
Jens Twiefel ◽  
Marc C. Wurz ◽  
...  
Keyword(s):  
Low Frequency ◽  
Acoustic Stimulation ◽  
Residual Hearing ◽  
Frequency Range ◽  
Test Rig ◽  
Profound Hearing Loss ◽  
Ongoing Research ◽  
Electric Acoustic Stimulation ◽  
Single Implant

AbstractFor patients suffering from profound hearing loss or deafness still having respectable residual hearing in the low frequency range, the combination of a hearing aid with a cochlear implant results in the best quality of hearing perception (EAS – electric acoustic stimulation). In order to optimize EAS, ongoing research focusses on the integration of these stimuli in a single implant device. Within this study, the performance of piezoelectric actuators, particularly the dual actuator stimulation, in a scaled uncoiled test rig was investigated.

Immediate and 1-Year Outcomes with a Slim Modiolar Cochlear Implant Electrode Array

2020 ◽  
Vol 162 (5) ◽  
pp. 731-736
Author(s):  
Nedim Durakovic ◽  
Dorina Kallogjeri ◽  
Cameron C. Wick ◽  
Jonathan L. McJunkin ◽  
Craig A. Buchman ◽  
...  
Keyword(s):  
Pure Tone ◽  
Signal To Noise Ratio ◽  
Case Series ◽  
Low Frequency ◽  
Electrode Array ◽  
Hearing Preservation ◽  
X Rays ◽  
Case Volume ◽  
Pure Tone Average ◽  
Academic Center

Objective To explore the immediate and 1-year outcomes of patients who underwent implantation with the slim modiolar electrode (SME). Study Design Consecutive case series with chart review. Setting Tertiary referral academic center. Subject and Methods Between May 2016 and August 2018, a total of 326 cochlear implantations (CIs) were performed. Intraoperative x-rays were performed in all cases to identify tip rollovers. Scalar location was identified for 76 CIs that had postoperative computed tomography reconstructions. Speech outcomes were measured at 3, 6, and 12 months with consonant-nucleus-consonant word and AzBio sentences in quiet and noise (+10-dB signal-to-noise ratio). Preservation of hearing was defined as maintaining a low-frequency pure tone average ≤80 dB at 250 and 500 Hz. Results Among 326 CIs, 23 (7%) had tip rollovers. Postoperative reconstructions revealed 5 of 76 (6.6%) scalar translocations. A subset of 177 cases met criteria for evaluation of speech perception scores. The marginal mean differences between presurgery and 12 months for speech tests were as follows: consonant-nucleus-consonant, 43.7 (95% CI, 39.8-47.6); AzBio in quiet, 49.7 (95% CI, 44.9-54.4); and AzBio in noise, 29.9 (95% CI, 25.2-34.7). Sixty-one patients were identified with preservable hearing (low-frequency pure tone average ≤80 dB), and 12 of 61 (20%) preserved hearing at 1 year. Conclusion CI with SME provides reliable scala tympani insertion in a consistent perimodiolar position. An initially increased tip rollover rate improved with case volume and sheath design improvement. For long-term outcomes, speech performance was comparable to that of other cochlear implants. While hearing preservation for the SME may be better than prior perimodiolar electrodes, consistent outcomes are unlikely.

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