Clinical, surgical, and electrical factors impacting residual hearing in cochlear implant surgery

Abstract

The overall hearing preservation rate for all implanted patients was 64%. Loss of residual hearing was significantly more observed in cases of cochleostomy and/or non-soft surgical techniques. No correlation was observed with age at implantation, gender, side of implant, device manufacturer, and presence of pre-lingual deafness vs post-lingual, full or partial electrode insertion. In addition, there was a small but significant decrease in hearing between pre-stimulation and post-stimulation audiograms at 6000 Hz.

Predictive factors for short‐ and long‐term hearing preservation in cochlear implantation with conventional‐length electrodes

“…Furthermore, Anagiotos et al and Cosetti et al both reported that hearing preservation correlated with younger age in patients implanted with conventional‐length electrodes . In contrast to these studies, Eshraghi et al did not find a significant relationship between either age or gender and loss of residual hearing; patients of all ages were included in this report . Zanetti et al also failed to demonstrate a significant association between age and hearing preservation .…”

“…While a recent systematic review comparing approaches failed to demonstrate differences between approaches, a meta‐analysis suggested that cochleostomy approaches were associated with higher rates of hearing preservation than RW approaches . In contrast, others have demonstrated worse hearing preservation with cochleostomy approaches …”

“…Lastly, neither age nor gender was found to impact short‐ or long‐term functional hearing preservation. No consensus exists in current literature regarding the impact of age on hearing preservation in adults; however, preservation in children and adolescents generally seems more favorable than in adults . Kopelovich et al studied 85 adults who received hybrid electrode arrays, and found that younger age and female gender were associated with better long‐term hearing preservation .…”

Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing Preservation

“…Previous studies have demonstrated the benefits associated with low frequency acoustic hearing, but given current resources, surgeons are able to achieve hearing preservation—defined as postoperative audiometric thresholds within 10 dB of preoperative levels—in, at most, 50% of cases (Jurawitz et al, 2014; Santa Maria et al, 2014; Van Abel et al, 2015; Dedhia et al, 2016; Eshraghi et al, 2016; Skarzynski et al, 2016). The pathophysiology of hearing loss during and following surgery is still largely unknown, but it is believed to be a result of (1) intraoperative physical trauma including fracture of the osseous spiral lamina, trans-scalar dislocation, and/or insult to spiral ligament or stria vascularis and/or (2) postoperative inflammatory responses and subsequent fibrosis, neo-osteogenesis and/or cellular apoptosis (e.g., Eshraghi and Van de Water, 2006; Eshraghi et al, 2013; Kamakura and Nadol, 2016).…”

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

“…The significance of intraoperative trauma to the cochlea during hearing preservation implantation is well established, and several mechanical factors, such as insertional force, underwater insertion, the presence of blood or bone dust, and electrode specifications, have been identified as being of significance [Roland, 2005;Bas et al, 2012;Rajan et al, 2013;Anagiotos et al, 2016;Todt et al, 2016a;Eshraghi et al, 2017] [Basta et al, 2007;Mittmann et al, 2014Mittmann et al, , 2016Mittmann et al, , 2017Mittmann et al, , 2018Todt et al, 2014aTodt et al, , b, 2016aTodt et al, , b, 2017a.…”