A new electrode for residual hearing preservation in cochlear implantation: first clinical results

Abstract

Hearing preservation was achieved in all patients (complete preservation 44.44%) after a mean follow-up period of 9.73 months. Mean monosyllabic test scores improved from 9% correct with the hearing aid alone to 48% with the cochlear implant and to 65% in the electric-acoustic mode.

Strategies to Improve Music Perception in Cochlear Implantees

“…This study showed that of nine patients who had lowfrequency residual hearing ≤50dBHL at 500Hz, the mean increase in thresholds at this frequency was 19dB. Similarly, Gstoettner and colleagues (Gstoettner et al, 2009) reported on the outcomes of 9 patients implanted with the MED-EL Flex EAS (with increased flexibility of the array) showing that 4 patients had full hearing preservation and 5 showed partial preservation. However, Baumgartner et al (Baumgartner et al, 2007) reported hearing preservation in 10 of 16 patients fitted with the MED-EL Flex soft at 1 month postimplantation but this declined to only 4 patients at 6 months post-implantation, suggesting variable outcomes which may or may not reflect the array per se, or the surgical technique or the underlying pathology or combination of the above.…”

“…Despite these benefits, Briggs and colleagues (Briggs et al, 2006) identified the possibility that shortening of the electrode array to 10mm may cause a place-frequency mismatch because only the basal portion of the cochlea will be stimulated, causing a disproportionately higher frequency percept than with a standard array. Further, should hearing not be preserved, then concerns have been raised that speech perception outcomes will be impaired for individuals who only receive electrical stimulation in such a limited region of the cochlea (Gstoettner et al, 2009). Nonetheless, in the clinical trial of the commercially-available 16mm Hybrid-L24, Lenarz et al (Lenarz et al, 2009) showed good post-operative hearing preservation in 24 recipients implanted with a round-window surgical approach.…”

The effects of spectral smearing and elevated thresholds on speech-in-noise recognition in simulated electric-acoustic hearing

“…4.1.1 In studies with actual EAS recipients Gstoettner et al (2009) found speech recognition scores for sentences in quiet of 30%…”

“…Since then, clinical results from a large number of studies have indicated improved speech recognition for individuals receiving both electric and acoustic stimulation compared to either electric or acoustic stimulation alone (Gantz et al, 2005;Gantz et al, 2006;Gstoettner et al, 2009;Kiefer et al, 2005;Lorens et al, 2008;Turner et al, 2004;Turner et al, 2008). Although evident for speech in quiet, this benefit provided by EAS is most pronounced for speech in noise.…”

“…A majority of clinical trials report the use of additional amplification to increase audibility of low frequency sound in cases of reduced hearing thresholds in this region (Gantz et al, 2005;Gantz et al, 2006;Gstoettner et al, 2009;Kiefer et al, 2004;Kiefer et al, 2005;Kong et al, 2005;Luetje et al, 2007;Turner et al, 2004). However, details regarding the use of this amplification such as how many participants received amplification, what hearing loss was considered appropriate for additional amplification, whether it was provided through a separate hearing aid device or through a hybrid cochlear implant device, and what fitting procedures were used, was usually not clearly specified.…”