Long-term Hearing Preservation Outcomes After Cochlear Implantation for Electric-Acoustic Stimulation

Helbig, Silke; Adel, Youssef; Rader, Tobias; Stöver, Timo; Baumann, Uwe

doi:10.1097/mao.0000000000001066

Cited by 76 publications

(74 citation statements)

References 30 publications

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“…For recipients of L24 arrays, the proportion of individuals experiencing delayed hearing loss versus stable hearing was not significantly different according to insertion approach, which is consistent with a one-year follow-up study by Adunka and colleagues (2014). In a more recent report, Helbig and colleagues (2016) compared insertion approaches for long-term hearing preservation rates (up to 5 years). A higher proportion of individuals undergoing round window insertions tended to show partial hearing loss immediately follow surgery.…”

Section: Discussionsupporting

confidence: 75%

“…Gstoettner et al 2006; Santa Maria et al 2013; Lenarz et al 2013; Adunka et al 2014; Helbig et al 2016; van Abel et al 2015; Roland et al 2016; Gantz et al 2016), and that is true for the sample included in the present study as well. Approximately 80% of individuals in the present study had hearing thresholds better than 90 dB HL and were using acoustic amplification in combination with electrical stimulation at the conclusion of the study.…”

Section: Discussionsupporting

confidence: 50%

“…Although retention of acoustic hearing following cochlear implant (CI) surgery has become a common outcome, the degree ranges from minimal to complete, with some individuals experiencing total loss of acoustic hearing in the implanted ear (e.g. Helbig et al 2016; Moteki et al 2016; Gantz et al 2016; Roland et al 2016; van Abel et al 2015; Hunter et al 2016; Santa Maria et al 2013). A decrease in hearing sensitivity identified at the first post-operative appointment is commonly attributed to surgical trauma, an acute inflammatory response, or change in the system mechanics due to the presence of the array, but decreases in hearing sensitivity have also been observed months to years after surgery; the cause: undetermined.…”

Section: Introductionmentioning

confidence: 99%

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Delayed changes in auditory status in cochlear implant users with preserved acoustic hearing

et al. 2017

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This retrospective review explores delayed-onset hearing loss in 85 individuals receiving cochlear implants designed to preserve acoustic hearing at the University of Iowa Hospitals and Clinics between 2001 and 2015. Repeated measures of unaided behavioral audiometric thresholds, electrode impedance, and electrically evoked compound action potential (ECAP) amplitude growth functions were used to characterize longitudinal changes in auditory status. Participants were grouped into two primary categories according to changes in unaided behavioral thresholds: (1) stable hearing or symmetrical hearing loss and (2) delayed loss of hearing in the implanted ear. Thirty-eight percent of this sample presented with delayed-onset hearing loss of various degrees and rates of change. Neither array type nor insertion approach (round window or cochleostomy) had a significant effect on prevalence. Electrode impedance increased abruptly for many individuals exhibiting precipitous hearing loss; the increase was often transient. The impedance increases were significantly larger than the impedance changes observed for individuals with stable or symmetrical hearing loss. Moreover, the impedance changes were associated with changes in behavioral thresholds for individuals with a precipitous drop in behavioral thresholds. These findings suggest a change in the electrode environment coincident with the change in auditory status. Changes in ECAP thresholds, growth function slopes, and suprathreshold amplitudes were not correlated with changes in behavioral thresholds, suggesting that neural responsiveness in the region excited by the implant is relatively stable. Further exploration into etiology of delayed-onset hearing loss post implantation is needed, with particular interest in mechanisms associated with changes in the intracochlear environment.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionsupporting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

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Delayed changes in auditory status in cochlear implant users with preserved acoustic hearing

et al. 2017

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“…Ultimately 21% of patients completely lost all low-frequency hearing. 77 As expected, they found that hearing preservation was dependent on electrode array design and surgical approach. They found that patients who lost all low-frequency hearing performed more poorly and they also suggested that these patients be considered for reimplantation with a full-length electrode given prior evidence of the utility of this approach.…”

Section: Hearing Preservation In Cochlear Implantation: Surgical Techsupporting

confidence: 53%

“…79 They found that long-term hearing stabilized with a decline per year consistent with previous studies around 1 dB per year. 77,80 More recent updated results with the L24 electrode array alone demonstrated similar preservation rates at 5 years, with 94% preserving some degree of low-frequency hearing but only 72% using the EAS component of the system. 81 Similarly, Pillsbury et al demonstrated hearing preservation using the MED-EL EAS system, reporting that 79% of patients experienced less than 30 dB change in low-frequency hearing, but they reported a much higher continued use of the EAS system at 97% of patients at 1 year follow-up.…”

Section: Hearing Preservation In Cochlear Implantation: Surgical Techmentioning

confidence: 92%

Electric and Acoustic Stimulation in Cochlear Implant Recipients with Hearing Preservation

2018

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Hearing loss affects 30 million people in the United States, and a subset of these patients have normal low-frequency hearing and ski-sloped high-frequency hearing loss. For these patients, hearing aids alone may not provide adequate benefit. Cochlear implantation alone has been utilized to improve speech perception. The addition of high-frequency electric hearing to low-frequency acoustic hearing in these patients is beneficial. Technical improvements have allowed preservation of low-frequency hearing in cochlear implant recipients, allowing for electric and acoustic stimulation in the same ear with significant improvements in speech perception, sound localization, music appreciation, and quality of life.

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Hearing Preservation and Speech Outcomes After Cochlear Implantation in Meniere's Disease

et al. 2019

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Objectives/Hypothesis: To evaluate speech perception outcomes and hearing preservation after cochlear implantation in patients with Meniere's disease (MD). Study Design: Retrospective chart review. Methods: Fifty-one adult patients, accounting for a total of 63 implants, with MD treated at a tertiary care center were included in the study. Patients with unaided preoperative air-conduction thresholds ≤80 dB at 250 Hz were included in hearing preservation analyses. The primary outcome measure was Consonant-Nucleus-Consonant (CNC) score. Hearing preservation was assessed as follows: 1) maintenance of functional hearing, defined as a postoperative unaided air-conduction threshold ≤80 dB at 250 Hz and 2) low-frequency pure-tone average (LFPTA) shift. Results: Speech perception scores improved significantly postimplantation; specifically, the CNC mean score was 9% preoperatively and increased to 57% by 1 year postoperatively (P < .001). Eighteen ears were included in hearing preservation analysis; the mean preoperative LFPTA was 65 dB (standard deviation [SD] = 10). The mean postoperative LFPTA at activation was 93 dB (SD = 21), and at 1 year was 102 dB (SD = 11). Twenty-seven percent of patients achieved short-term functional hearing preservation, whereas the longer-term outcomes were less favorable (11%). Conclusions: Speech perception scores improve after implantation in patients with MD. Hearing preservation is possible in patients with MD, albeit at lower rates than reported non-MD populations. Our data suggest that there can be degradation in acoustic hearing over time.

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Long-term Hearing Preservation Outcomes After Cochlear Implantation for Electric-Acoustic Stimulation

Cited by 76 publications

References 30 publications

Delayed changes in auditory status in cochlear implant users with preserved acoustic hearing

Delayed changes in auditory status in cochlear implant users with preserved acoustic hearing

Electric and Acoustic Stimulation in Cochlear Implant Recipients with Hearing Preservation

Hearing Preservation and Speech Outcomes After Cochlear Implantation in Meniere's Disease

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