Hearing Preservation after Cochlear Implantation Using Deeply Inserted Flex Atraumatic Electrode Arrays

Cochlear implantation is indicated in patients with severe to profound hearing loss that cannot be adequately treated by other auditory rehabilitation measures. The definitive indication of cochlear implantation is made on the basis of an extensive interdisciplinary clinical, audiological, radiological, and psychological diagnostic work-up. There are numerous changes are happening in cochlear implant candidacy. These have been associated with concomitant changes in surgical techniques, which enhanced the utility and safety of cochlear implantation. Currently, cochlear implants are approved for individuals with severe to profound unilateral hearing loss rather than previously needed for bilateral profound hearing loss. Studies have begun using the short electrode arrays for shallow insertion in patients with low-frequency residual hearing loss. The advancement in designs of the cochlear implant along with improvements in surgical techniques reduce the complications and result in the safety and efficacy of the cochlear implant which further encourages the use of these devices. This review article aims to discuss the new concepts in the candidacy of the cochlear implant, cochlear implant in younger children and hearing preservation, a cochlear implant for unilateral deafness, bilateral cochlear implant, and cochlear implant with neural plasticity and selection of patients for the cochlear implant.

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Intraoperative Intracochlear Electrocochleography and Residual Hearing Preservation Outcomes When Using Two Types of Slim Electrode Arrays in Cochlear Implantation

Otology & Neurotology ◽

10.1097/mao.0000000000002212 ◽

2019 ◽

Vol 40 ◽

pp. S29-S37 ◽

Cited By ~ 3

Author(s):

Angel Ramos-Macias ◽

Stephen O’Leary ◽

Angel Ramos-deMiguel ◽

Christo Bester ◽

Juan C. Falcon-González

Keyword(s):

Cochlear Implantation ◽

Hearing Preservation ◽

Residual Hearing ◽

Electrode Arrays

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Hearing preservation potential after Cochlear-Implantation: comparison of 6 lateral-wall electrode arrays

10.1055/s-0039-1686519 ◽

2019 ◽

Author(s):

MC Suhling ◽

A Lesinski-Schiedat ◽

T Lenarz ◽

R Salcher ◽

M Schüssler ◽

...

Keyword(s):

Cochlear Implantation ◽

Lateral Wall ◽

Hearing Preservation ◽

Electrode Arrays ◽

Preservation Potential

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The Effects of Gusher-Related Intracochlear Pressure Changes on Hearing Preservation in Cochlear Implantation: A Comparative Series

Audiology and Neurotology ◽

10.1159/000489599 ◽

2018 ◽

Vol 23 (3) ◽

pp. 181-186 ◽

Cited By ~ 1

Author(s):

William Crohan ◽

Jay Krishnaswamy ◽

Gunesh Rajan

Keyword(s):

Cochlear Implantation ◽

Large Change ◽

Lateral Wall ◽

Hearing Preservation ◽

Residual Hearing ◽

Electrode Arrays ◽

Significant Drop ◽

Speech Performance ◽

Intracochlear Pressure ◽

Pressure Changes

Aim: To investigate and compare residual hearing preservation between patients based on the presence of intraoperative gusher. Methodology: We retrospectively compared 2 cohorts of cochlear implant recipients significantly distinguished by whether or not they experienced gusher intraoperatively. Patients underwent cochlear implantation using 24-mm lateral wall electrode arrays as well pharmacologic steroid protection. All patients were assessed by a hearing implant MDT. Hearing preservation rates and speech perception outcomes were assessed at 1, 6, 12, 24, 36, 48, and 60 months. Results: The patients with no gusher demonstrated complete hearing preservation. The patients with gusher demonstrated significant postoperative reduction of hearing thresholds, which declined at a significantly higher pace during follow-up. All patients demonstrated significantly better speech performance after cochlear implantation. Conclusion: The present study suggests that intraoperative gusher is associated with a significant drop in residual hearing, both immediately and over time, which may be related to the large change in intracochlear pressure intraoperatively.

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215107000254 ◽

2007 ◽

Vol 122 (3) ◽

pp. 246-252 ◽

Cited By ~ 36

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.

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Cochlear Implantation in Children with Postlingual Progressive Steeply Sloping High-Frequency Hearing Loss

Journal of the American Academy of Audiology ◽

10.3766/jaaa.16115 ◽

2017 ◽

Vol 28 (10) ◽

pp. 913-919 ◽

Cited By ~ 7

Author(s):

Margaret A. Meredith ◽

Jay T. Rubinstein ◽

Kathleen C. Y. Sie ◽

Susan J. Norton

Keyword(s):

Hearing Loss ◽

Speech Perception ◽

Hearing Aids ◽

Cochlear Implantation ◽

High Frequency ◽

Case Series ◽

Hearing Preservation ◽

Rapid Improvement ◽

Retrospective Case ◽

Monosyllabic Word

Background: Children with steeply sloping sensorineural hearing loss (SNHL) lack access to critical high-frequency cues despite the use of advanced hearing aid technology. In addition, their auditory-only aided speech perception abilities often meet Food and Drug Administration criteria for cochlear implantation. Purpose: The objective of this study was to describe hearing preservation and speech perception outcomes in a group of young children with steeply sloping SNHL who received a cochlear implant (CI). Research Design: Retrospective case series. Study Sample: Eight children with steeply sloping postlingual progressive SNHL who received a unilateral traditional CI at Seattle Children’s Hospital between 2009 and 2013 and had follow-up data available up to 24 mo postimplant were included. Data Collection and Analysis: A retrospective chart review was completed. Medical records were reviewed for demographic information, preoperative and postoperative behavioral hearing thresholds, and speech perception scores. Paired t tests were used to analyze speech perception data. Hearing preservation results are reported. Results: Rapid improvement of speech perception scores was observed within the first month postimplant for all participants. Mean monosyllabic word scores were 76% and mean phoneme scores were 86.7% at 1-mo postactivation compared to mean preimplant scores of 19.5% and 31.0%, respectively. Hearing preservation was observed in five participants out to 24-mo postactivation. Two participants lost hearing in both the implanted and unimplanted ear, and received a sequential bilateral CI in the other ear after progression of the hearing loss. One participant had a total loss of hearing in only the implanted ear. Results reported in this article are from the ear implanted first. Bilateral outcomes are not reported. Conclusions: CIs provided benefit for children with steeply sloping bilateral hearing loss for whom hearing aids did not provide adequate auditory access. In our cohort, significant improvements in speech understanding occurred rapidly postactivation. Preservation of residual hearing in children with a traditional CI electrode is possible.

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