Hearing Preservation With Full Insertion of the FLEXsoft Electrode

Mick, Paul; Amoodi, Hosam; Shipp, David; Friesen, Lendra; Symons, Sean; Lin, Vincent; Nedzelski, Julian M.; Chen, Joseph

doi:10.1097/mao.0b013e318291c66d

Cited by 42 publications

(34 citation statements)

References 16 publications

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“…Similarly, Roland et al (22) reported the results of the U.S. clinical trial for the Hybrid-L; though they did not report mean or median threshold elevation data, they reported that 66.6% of patients retained aidable hearing postoperatively (lowfrequency thresholds 85 dB HL). Comparable to our Recognizing that the mean threshold elevation is between 15 and 20 dB for long electrodes following CI, if patients begin with thresholds around 80 dB HL, we must assume they will not have aidable hearing preserved postoperatively (17)(18)(19)23,24). Thus, we analyzed a subgroup of patients who had preoperative thresholds at 250 Hz at 65 dB HL or better.…”

Section: Discussionmentioning

confidence: 95%

Hearing Preservation Outcomes With a Mid-Scala Electrode in Cochlear Implantation

Hunter

Gifford

Wanna

et al. 2016

Otology &Amp; Neurotology

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Section: Discussionmentioning

confidence: 95%

Hearing Preservation Outcomes With a Mid-Scala Electrode in Cochlear Implantation

Hunter

Gifford

Wanna

et al. 2016

Otology &Amp; Neurotology

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“…This may result in poor performance. 28 Therefore, investigators are actively searching for an electrode that maximizes acoustic potential without compromising electric potential. …”

Section: Discussionmentioning

confidence: 99%

Methods of Hearing Preservation during Cochlear Implantation

Khater

El‐Anwar

2016

Int Arch Otorhinolaryngol

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Introduction Recent advances in surgical techniques and electrode design have made residual hearing preservation during cochlear implantation (CI) possible, achievable, and desirable. Objectives The objective of this study was to review the literature regarding methods used for hearing preservation during CI surgery. Data Synthesis We performed a search in the LILACS, MEDLINE, SciELO, PubMed databases, and Cochrane Library, using the keywords CI, hearing preservation, CI electrode design, and CI soft surgery. We fully read about 15 studies that met the criteria described in “study selection”. The studies showed that several factors could contribute to possible cochlear damage during or after CI surgery and must be kept in mind; mechanical damage during electrode insertion, shock waves in the perilymph fluid due to implantation, acoustic trauma due to drilling, loss of perilymph and disruption of inner ear fluid homeostasis, potential bacterial infection, and secondary intracochlear fibrous tissue formation. The desire to preserve residual hearing has led to the development of the soft-surgery protocols with its various components; avoiding entry of blood into the cochlea and the use of hyaluronate seem to be reasonably supported, whereas the use of topical steroids is questionable. The site of entry into the cochlea, electrode design, and the depth of insertion are also important contributing factors. Conclusion Hearing preservation would be useful for CI patients to benefit from the residual low frequency, as well as for the children who could be candidate for future regenerative hair cell therapy.

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“…Although shorter electrodes may minimize trauma to the apical cochlea, they may fail to electrically stimulate the distal cochlear neurons in some with a longer duration of high-frequency hearing loss. This may result in poor performance in the event that LFSH is not preserved after surgery or preserved hearing is lost across time (15). It is important to note that, even when using the shortest electrodes, 100% HP has not been feasible (15).…”

Section: Discussionmentioning

confidence: 99%

“…This may result in poor performance in the event that LFSH is not preserved after surgery or preserved hearing is lost across time (15). It is important to note that, even when using the shortest electrodes, 100% HP has not been feasible (15). Therefore, investigators are actively searching for an electrode that maximizes acoustic potential without compromising electric potential.…”

Section: Discussionmentioning

confidence: 99%

Hearing Preservation Among Patients Undergoing Cochlear Implantation

Abel

Dunn

Sladen

et al. 2015

Otology &Amp; Neurotology

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Introduction Despite successful preservation of low-frequency hearing in patients undergoing cochlear implantation (CI) with shorter electrode lengths, there is still controversy regarding which electrodes maximize hearing preservation (HP). The thin straight electrode array (TSEA) has been suggested as a full cochlear coverage option for HP. However, very little is known regarding its HP potential. Methods A retrospective review was performed at two tertiary academic medical centers, reviewing the electronic records for 52 patients (mean, 58.2 yr; range, 11–85 yr) implanted with the Cochlear Nucleus CI422 Slim Straight (Centennial, CO, USA) electrode array, referred to herein as the thin straight electrode array or TSEA. All patients had a preoperative low-frequency pure-tone average (LFPTA) of 85 dB HL or less. Hearing thresholds were measured at initial activation (t1) and 6 months after activation (t2). HP was assessed by evaluating functional HP using a cutoff level of 85 dB HL PTA. Results At t1, 54% of the subjects had functional hearing; 33% of these subjects had an LFPTA between 71 and 85 dB HL, and 17% had an LFPTA between 56 and 70 dB HL. At t2, 47% of the patients had functional hearing, with 31% having an LFPTA between 71 and 85 dB HL. Discussion Preliminary research suggests that the TSEA has the potential to preserve functional hearing in 54% of patients at t1. However, 22% (n = 6) of the patients who had functional hearing at t1 (n = 28) lost their hearing between t1 and t2. Further studies are needed to evaluate factors that influence HP with the TSEA electrode and determine the speech perception benefits using electric and acoustic hearing over electric alone.

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Hearing Preservation With Full Insertion of the FLEXsoft Electrode

Abstract: 4.

Cited by 42 publications

References 16 publications

Hearing Preservation Outcomes With a Mid-Scala Electrode in Cochlear Implantation

Hearing Preservation Outcomes With a Mid-Scala Electrode in Cochlear Implantation

Methods of Hearing Preservation during Cochlear Implantation

Hearing Preservation Among Patients Undergoing Cochlear Implantation

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