Hearing Preservation after Cochlear Implantation: UNICAMP Outcomes

Abstract

Background. Electric-acoustic stimulation (EAS) is an excellent choice for people with residual hearing in low frequencies but not high frequencies and who derive insufficient benefit from hearing aids. For EAS to be effective, subjects' residual hearing must be preserved during cochlear implant (CI) surgery. Methods. We implanted 6 subjects with a CI. We used a special surgical technique and an electrode designed to be atraumatic. Subjects' rates of residual hearing preservation were measured 3 times postoperatively, lastly after at least a year of implant experience. Subjects' aided speech perception was tested pre- and postoperatively with a sentence test in quiet. Subjects' subjective responses assessed after a year of EAS or CI experience. Results. 4 subjects had total or partial residual hearing preservation; 2 subjects had total residual hearing loss. All subjects' hearing and speech perception benefited from cochlear implantation. CI diminished or eliminated tinnitus in all 4 subjects who had it preoperatively. 5 subjects reported great satisfaction with their new device. Conclusions. When we have more experience with our surgical technique we are confident we will be able to report increased rates of residual hearing preservation. Hopefully, our study will raise the profile of EAS in Brazil and Latin/South America.

Tinnitus Suppression by Intracochlear Electrical Stimulation in Single-Sided Deafness: A Prospective Clinical Trial - Part I

“…Almost two centuries later, House [1976] reported tinnitus suppression in one of the first cochlear implant (CI) patients. Although the primary goal of cochlear implantation is to provide a sense of sound to a person who suffers from severe to profound hearing loss, during decades of research it has become clear that tinnitus suppression is a common side effect [Ito and Sakakihara, 1994;Aschendorff et al, 1998;House, 1999;Steenerson and Cronin, 1999;Ruckenstein et al, 2001;Miyamoto and Bichey, 2003;Di Nardo et al, 2007;Tyler et al, 2008;Olze et al, 2011Olze et al, , 2012de Carvalho et al, 2013]. Nevertheless, tinnitus can also be a complication after cochlear implantation [Di Nardo et al, 2007;Postelmans et al, 2007;Hou et al, 2010], possibly related to cochlear damage due to the surgery [Nordfalk et al, 2014;Todt et al, 2014].…”

Residual hearing preservation for cochlear implantation surgery

“…Therefore, surgeons should insert the electrode array as slow as possible. There are some other studies which have recorded the insertion speed [ 38 39 40 ] [ Table 2 ]. Unfortunately, the detail and impact of insertion speed was not discussed in these papers.…”

Involvement of Oxidative Stress, Inflammation, and Glutamate in Ototoxicity, and their Attenuation by Simultaneous Activation of Nrf2 and Elevation of Antioxidant Compounds

“…The treatment of hearing disorders that includes steroids [32,33], glutamate antagonist [34,35], various types of hearing aids [36][37][38], and cochlear implants [39,40]. Although these treatments produce varying degrees of improvements but they are considered unsatisfactory.…”