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 ◽  
...  

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.

2019 ◽  
Vol 277 (2) ◽  
pp. 367-375 ◽  
Author(s):  
Matti Iso-Mustajärvi ◽  
Sini Sipari ◽  
Heikki Löppönen ◽  
Aarno Dietz

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.


2020 ◽  
Vol 29 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Margaret T. Dillon ◽  
Emily Buss ◽  
Brendan P. O'Connell ◽  
Meredith A. Rooth ◽  
English R. King ◽  
...  

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


HNO ◽  
2018 ◽  
Vol 66 (S2) ◽  
pp. 56-62 ◽  
Author(s):  
T. Rader ◽  
A. Bohnert ◽  
C. Matthias ◽  
D. Koutsimpelas ◽  
M-A. Kainz ◽  
...  

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.


2017 ◽  
Vol 3 (2) ◽  
pp. 119-122
Author(s):  
Wouter J. van Drunen ◽  
Sarra Kacha Lachheb ◽  
Anatoly Glukhovskoy ◽  
Jens Twiefel ◽  
Marc C. Wurz ◽  
...  

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.


2006 ◽  
Vol 11 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Wolfgang K. Gstoettner ◽  
Silke Helbig ◽  
Nicola Maier ◽  
Jan Kiefer ◽  
Andreas Radeloff ◽  
...  

2015 ◽  
Vol 26 (08) ◽  
pp. 732-740 ◽  
Author(s):  
Margaret T. Dillon ◽  
Andrea L. Bucker ◽  
Marcia C. Adunka ◽  
English R. King ◽  
Oliver F. Adunka ◽  
...  

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.


2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Nandini Vijaya Singham ◽  
Mimiwati Zahari ◽  
Mohammadreza Peyman ◽  
Narayanan Prepageran ◽  
Visvaraja Subrayan

Background. Our study aimed to investigate an association between ocular pseudoexfoliation (PXF) and sensorineural hearing loss (SNHL) and to compare them with age and sex matched controls without pseudoexfoliation.Method. This was a case-control study of 123 patients which included 68 cases with PXF (at least one eye) and 55 controls without pseudoexfoliation. Pure-tone audiometry (PTA) was done for these patients at sound frequencies taken as important for speech comprehension, that is, 250 Hertz (Hz), 500 Hz, 1000 Hz, and 2000 Hz.Results. There were 41 patients with pseudoexfoliation syndrome (PXE) and 27 with pseudoexfoliative glaucoma (PXEG). The majority of patients with hearing loss (60%;n=51) were PXF patients and the remaining 40%(n=34)were controls. Below average hearing thresholds were significantly higher in the pseudoexfoliation group compared to the control group (P=0.01; odds ratio (OR), 3.00; 95% confidence interval (CI), 1.25–7.19). However, there was no significant difference in the mean hearing threshold levels between the three groups (PXE, PXEG, and controls) in either ear (ANOVA, right ear:P=0.46and left earP=0.36).Conclusion. Our study found an association between PXF and SNHL, confirming that PXF can involve organs in the body other than the eye.


2014 ◽  
Vol 134 (7) ◽  
pp. 717-727 ◽  
Author(s):  
Shin-Ichi Usami ◽  
Hideaki Moteki ◽  
Keita Tsukada ◽  
Maiko Miyagawa ◽  
Shin-Ya Nishio ◽  
...  

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