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Results showed that some degree of hearing preservation was possible in 15718 patients. All subjects showed statistically significant benefit on all three speech perception tests over time. These significant benefits were also reflected in the subjective benefit outcomes.

201areas, MED-EL's research focuses on providing additional pitch information. One means to achieve this could be to increase the information per time unit (information rate) delivered to the cochlea; this can be done by increasing the stimulation rate. Another way would be to add additional information into the stimulation patterns such as temporal as well as spatial fine structure information. This will be further discussed in the development of speech-coding strategies section.In addition, this article provides an overview of the new technology incorporated in the MED-EL MAESTRO CI system, reviews recent research on bilateral cochlear implantation and electric-acoustic stimulation, and describes current research efforts on developing a CI device with drug delivery capability. The MAESTRO CI SystemThe MED-EL MAESTRO CI system comprises the PULSARCI 100 and SONATATI 100 CIs, which incorporate the I 100 electronics platform; the speech processors and the MAESTRO system software, together with the Diagnostic Interface Box II, is the link C ochlear implants (CIs) are a well-known and accepted treatment method for adults and children with severe to profound hearing loss. There has been much progress in the CI field since the article detailing trends in cochlear implantation. 1 Advances in technology, increased confidence in experience, and changes in candidacy have led to CIs being made available to a larger population.Recent CI recipients perform much better than those who received implants many years ago. Back then, CI performance focused on differentiating between the presence and absence of sound or female versus male voice. Expectations for recent CI recipients, however, have changed. Their performances have been tested under increasingly difficult listening conditions. The general experiences in the CI community are that CI users usually perform very well in quiet but worse in noise, and not all CI users are able to enjoy music. For further improvements in these Cochlear implantation is an accepted treatment method for adults and children with severe to profound hearing loss. Confidence in technology has led to changes in individuals who can receive a cochlear implant and changes in expected benefit with a cochlear implant. This article describes the research and development activities at MED-EL, which make possible the implementation of new speech-coding strategies as well as the application of acoustic and electric stimulation via a combined speech processor in MED-EL devices. Research on benefits from bilateral cochlear implantation and electric-acoustic stimulation are also reviewed. Finally, the potential of drug delivery systems is considered as a way to improve cochlear implant outcomes, and results from preliminary evaluations of a hybrid cochlear implant system with drug delivery capabilities are reported. between software and speech processors or implants. The MAESTRO CI system provides fine structure information for CI users (refer to the section on speech-coding strategies). In addition, audiologi...

Hearing was preserved in 9 of 10 cases. One subject uses a hearing aid to amplify low frequency hearing, the remainder use natural low frequency hearing. Improvements in monosyllabic scores over time in both quiet and noise were significant, particularly within the first 3 months of PDCI use.

Objective: To investigate whether the residual hearing of severely hearing-impaired children and adults could be preserved using the soft surgery approach. Patients and Methods: This project employed a prospective study design. All testing and surgery took place in the Institute of Physiology and Pathology of Hearing, Warsaw, Poland. Twenty-six patients (7 children and 19 post-lingually deafened adults) with residual hearing were assessed. Subjects were assessed using conventional pure-tone audiometry at least 1 month prior to surgery. Cochlear implant surgery with a Med-El Combi 40/40+ standard electrode array was conducted, using the soft surgery approach. Pure-tone audiometry thresholds were re-assessed at least 1 month after surgery. The researchers assessed change in auditory thresholds using pure-tone audiometry to determine preservation of residual hearing. Results: Sixteen of 26 patients (62%) retained their residual hearing within 5 dB HL of pre-operative scores. Only 5 of 26 patients (19%) lost all measurable residual hearing after cochlear implantation. This suggests that surgeons are often able to preserve residual hearing during cochlear implant surgery using the soft surgery technique. Conclusions: Preservation of residual hearing is an important consideration in cochlear implantation in the light of changing selection criteria for cochlear implant candidates, and as younger children are receiving implants. This is important, as we do not know yet the long-term effects of inner ear damage due to traumatic insertions of electrodes. This finding suggests a good prognosis for future possibilities of re-implantation.

Hearing could be preserved in all subjects. Speech understanding showed significant improvement in all tests over time with the EAS condition outperforming the cochlear implant-only condition at all intervals. These considerable effects were also reflected in the subjective benefit outcome.

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The hearing aid should be fit to a patient-specific modified audiogram at least up to the point where low-frequency hearing is not measurable. The cochlear implant should be fit from a higher frequency point than is standard in patients without residual hearing in the implanted ear, to provide reduced overlap with the amplification provided by the hearing aid. Therefore, a small amount of overlap between the frequency ranges used by the hearing aid and the cochlear implant seems beneficial.