Loss of residual hearing after cochlear implantation

Boggess, William J.; Baker, Jane; Bałkany, Thomas J.

doi:10.1288/00005537-198210000-00005

Cited by 42 publications

(10 citation statements)

References 4 publications

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“…It has been suggested that even very limited preserved residual hearing below 500Hz could be sufficient to significantly improve speech perception outcomes (15). However, minimizing the impact of cochlear implantation on residual hearing remains challenging, as damage to the cochlea can worsen or destroy this residual hearing in the majority of patients (16). In response to the desire to preserve residual hearing, special focus has been placed on the surgical technique (“soft surgery”) (8).…”

Section: Discussionmentioning

confidence: 99%

Round Window Versus Cochleostomy Technique in Cochlear Implantation

Richard

Fayad²,

Doherty³

et al. 2012

Otology &Amp; Neurotology

114

102

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Hypothesis Cochleostomy or round window enlargement techniques for cochlear implant electrode insertion result in more abnormal tissue formation in the basal cochlea and are more apt to produce endolymphatic hydrops than round window electrode insertion. Methods Twelve temporal bones from implanted patients were examined under light microscopy and reconstructed with 3D reconstruction software to determine cochlear damage and volume of neo-ossification and fibrosis following electrode insertion. Amount of new tissue was compared between three groups of bones: insertion through the round window (RW), after enlarging the round window (RWE) and cochleostomy (Cochl). The probable role of the electrode was evaluated in each case with hydrops. Results More initial damage occurred in the Cochl and RWE groups than in the RW group, and the difference was significant between RWE and RW in cochlear segment I (p<0.026). The volume of new bone in segment I differed significantly between groups (p<.012) and was greater in the RWE group than in either the Cochl or RW groups (post hoc p’s <.035 and .019). Hydrops was seen in 5 cases, all in the Cochl and RWE groups. Blockage of the duct was due to new tissue formation in 4 of the 5 hydrops cases. Conclusion With the electrodes in this serie, implantation through the round window minimized initial intracochlear trauma and subsequent new tissue formation, while the round window extension technique used at the time of these implantations produced the greatest damage. Future studies may clarify whether today’s techniques and electrodes will produce these same patterns of damage.

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Section: Discussionmentioning

confidence: 99%

Round Window Versus Cochleostomy Technique in Cochlear Implantation

Richard

Fayad²,

Doherty³

et al. 2012

Otology &Amp; Neurotology

114

102

View full text Add to dashboard Cite

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“…In older patients (72 years), Pseudomonas bacteremia can coexist with disseminated fusariosis in wounds [16]. Up to the 1980s, it was generally accepted that EG complicating Pseudomonas bacteremia/sepsis is fatal to most patients, especially infants [3,34]. Further development of antibiotic therapy helped to reduce the number of fatalities.…”

Section: Eg With and Without Septicemiamentioning

confidence: 99%

“…The face and the whole head and neck region are affected much more often than is usually thought. At least 14 cases of EG lesions were described as being located within the head and neck region [11,[33][34][35][53][54][55][56][57][58][59][60][61]. The last two references are case reports describing EG of the nasal cavity.…”

Section: Location Of the Lesionsmentioning

confidence: 99%

Ecthyma gangrenosum and ecthyma-like lesions: review article

Vaiman

Lazarovitch

Heller

et al. 2014

Eur J Clin Microbiol Infect Dis

175

192

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The generally accepted definition of ecthyma gangrenosum (EG) states that this condition is pathognomonic of Pseudomonas septicemia (Pseudomonas aeruginosa) and that it should usually be seen in immunocompromised patients, particularly those with underlying malignant disease. The cases described in the literature present a somewhat different picture. Our objective was to analyze this controversy. The review analyzes 167 cases of EG that were described in the literature from 1975 to 2014. All articles on EG cases with EG-specific tissue defect that had signs of general and/or local infection and skin necrosis were included and analyzed, whatever the etiology detected. Necrotic lesions of the skin diagnosed as EG have various microbiological etiology, can occur in immunocompetent or even healthy persons, and are not necessarily connected with septicemia. In published cases, P. aeruginosa was detected in 123 cases (73.65%); of them, there were only 72 cases (58.5%) with sepsis. Other bacterial etiology was detected in 29 cases (17.35%) and fungi were detected in 15 cases (9%). While the clinical picture of the disease and the treatment strategy remain the same, there is no need to invent two separate definitions for Pseudomonas and non-Pseudomonas cases. We suggest accepting a broader definition of EG.

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“…Rizer et al [77] suggested that, following cochlear implantation, an inflammatory reaction occurred that ultimately resulted in residual hearing loss. A further suggestion was that the presence of the electrode and/or fibrosis within the scala tympani following implantation could act as a space-occupying foreign body that interferes with the natural mechanics of the cochlea [78]. These issues remain current.…”

Section: Potential Causes Of Hearing Loss Following Cochlear Implamentioning

confidence: 99%

Electroacoustic Stimulation: Now and into the Future

Irving

Gillespie

Richardson

et al. 2014

BioMed Research International

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Cochlear implants have provided hearing to hundreds of thousands of profoundly deaf people around the world. Recently, the eligibility criteria for cochlear implantation have been relaxed to include individuals who have some useful residual hearing. These recipients receive inputs from both electric and acoustic stimulation (EAS). Implant recipients who can combine these hearing modalities demonstrate pronounced benefit in speech perception, listening in background noise, and music appreciation over implant recipients that rely on electrical stimulation alone. The mechanisms bestowing this benefit are unknown, but it is likely that interaction of the electric and acoustic signals in the auditory pathway plays a role. Protection of residual hearing both during and following cochlear implantation is critical for EAS. A number of surgical refinements have been implemented to protect residual hearing, and the development of hearing-protective drug and gene therapies is promising for EAS recipients. This review outlines the current field of EAS, with a focus on interactions that are observed between these modalities in animal models. It also outlines current trends in EAS surgery and gives an overview of the drug and gene therapies that are clinically translatable and may one day provide protection of residual hearing for cochlear implant recipients.

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Loss of residual hearing after cochlear implantation

Cited by 42 publications

References 4 publications

Round Window Versus Cochleostomy Technique in Cochlear Implantation

Round Window Versus Cochleostomy Technique in Cochlear Implantation

Ecthyma gangrenosum and ecthyma-like lesions: review article

Electroacoustic Stimulation: Now and into the Future

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