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

Wanna, George B.; O’Connell, Brendan P.; Francis, David O.; Gifford, René H.; Hunter, Jacob B.; Holder, Jourdan T.; Bennett, Marc; Rivas, Alejandro; Labadie, Robert F.; Haynes, David S.

doi:10.1002/lary.26714

Cited by 80 publications

(69 citation statements)

References 43 publications

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“…The probability of functional improvement after cochlear implantation also decreases with more hearing in the ear to be implanted, particularly as the pre-implant word perception score for this ear approaches the mean post-operative performance with a cochlear implant [35]. Despite improvement in hearing preservation techniques during implantation, the surgery is likely to reduce or eliminate any residual hearing in the ear to be implanted [36][37][38]. When there is significant useful speech perception in either ear, careful consideration is needed on an individual basis with regard to probability of benefit, and risk of losing residual hearing in the implanted ear.…”

Section: Speech Perception Improvement (Efficacy)mentioning

confidence: 99%

Cochlear implantation outcomes in adults: A scoping review

et al. 2020

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Cochlear implantation has become known as "the treatment of choice" for adults with severe to profound hearing loss. Wide variability exists, however, in the way hearing loss severity is measured and in the candidacy criteria used to recommend cochlear implantation. ObjectivesThis study aimed to provide a descriptive analysis of recent evidence available in the literature in relation to the efficacy of unilateral cochlear implantation in adults, the general findings of these studies, and the populations to which these findings apply. It also aimed to appraise the individual success rate and the magnitude of benefit following implantation. DesignA scoping review was conducted to identify English-language, peer-reviewed journal articles published between 2000 and 2018 assessing the outcomes of cochlear implantation in adults who received their first cochlear implant from 2000 onwards. To be included, studies had to report speech perception or self-reported measures of listening or quality of life at least three months after implantation. Systematic searches were conducted in Medline, Embase, Web of Science and Google Scholar. A two-stage screening approach was used, with seven reviewers independently screening titles and abstracts against inclusion criteria and three from this group further reviewing full-texts. A data charting form was developed and trialled, with 10% of the study data extracted in duplicate to compare results and further refine the form. Data relevant for efficacy analyses were extracted from studies with sample sizes of at least 10 participants. ResultsA total of 4182 abstracts were screened against inclusion criteria, and of these, 603 fulltexts were further screened. After exclusion of non-eligible articles, 201 articles were included in the first part of this scoping review. The majority of these articles were case series or comparative studies without a concurrent group, and had small sample sizes. Data PLOS ONECompeting interests: The authors have declared that no competing interests exist. synthesis conducted with the 102 articles with more than 10 participants highlighted that the average word perception ability improved from 8.2% to 53.9% after implantation. Selfreported benefit improved by 21.5 percentage points. At the individual level, 82.0% of adults with postlingual hearing loss and 53.4% of adults with prelingual hearing loss improved their speech perception ability by 15 percentage points or more. A small proportion had poorer ability after implantation or had stopped using the cochlear implant. ConclusionsDespite broad inconsistencies in measurement, research design, and reporting across articles, it is evident that cochlear implantation is beneficial to the majority of adults of any age who have limited aided speech perception abilities. While many adults with severe-to-profound hearing loss may also have poor speech perception abilities with hearing aids, the validity of using hearing loss severity as a criterion for cochlear implantation has not been demonstrated. Clinical and...

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Section: Speech Perception Improvement (Efficacy)mentioning

confidence: 99%

Cochlear implantation outcomes in adults: A scoping review

et al. 2020

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“…This localized stimulation provides superior place-pitch spectral discrimination [15,16], and improved speech perception outcomes [17,18]. However, due to their increased stiffness and size, perimodiolar arrays which use stylets to keep them straight at the point of insertion, have been associated with poorer hearing preservation results and a higher incidence of basilar membrane trauma compared to thin, flexible lateral wall arrays [19,20]. The CI532 does not have a stylet and is introduced into the cochlea using a new deployment method called advance-throughthe-sheath.…”

Section: Introductionmentioning

confidence: 99%

Outcomes for a clinically representative cohort of hearing-impaired adults using the Nucleus® CI532 cochlear implant

Hey¹,

Neben²,

Stöver

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose Hearing performance data was collected from a large heterogeneous group of subjects implanted with the Coch-lear™ Nucleus® CI532 with Slim Modiolar Electrode, for the purposes of postmarket clinical follow-up. Data was analysed for factors which may predict postoperative speech recognition scores. Methods Data was collected retrospectively from five German clinics for 159 subjects from March 2017 to August 2018. Hearing thresholds and recognition scores for monosyllabic words in quiet and sentences in noise were measured preoperatively and at 3 and 6 months postoperatively. Results There was a mean gain of 44% points (95% CI 39-49%) at 6 months in monosyllable scores in quiet for implanted ears. Preoperative hearing thresholds in implant ears increased systematically with decreasing age; however, younger subjects had better baseline monosyllable scores with hearing aids compared with older subjects. Baseline performance alone explained 14% of the variation in postoperative scores. Residual hearing was preserved on average to within 22 dB at 250 Hz and 30 dB at 500 Hz of preoperative levels. Conclusions In a large and varied cohort of routinely treated hearing-impaired adults, speech recognition with the CI532 for German monosyllabic words in quiet at 6 months was equivalent to performance reported at one year or more in other published studies. Although younger subjects had poorer preoperative pure-tone thresholds, they had better preoperative word recognition scores compared with older subjects, and also had higher post implant scores. Further research is required to identify if this phenomenon is just applicable to German health system assessment and referral practices.

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“…Wanna et al performed a retrospective study of 196 patients (225 implants, mean age at time of CI 63.7 years) looking at hearing preservation, which they defined as a postoperative air-conduction threshold <= 80 dB hearing loss (HL) at 250 Hz. 2 They found that LW electrodes were more likely to preserve functional hearing when compared to PM electrodes at both short-term (2-3 weeks postoperative) and long-term (>1 year postoperative) follow-up. Although MS electrodes had 3.4 times higher odds of hearing preservation when compared to PM arrays in the short term, there was no significant difference between these two in the long term.…”

Section: Literature Reviewmentioning

confidence: 97%

“…Other studies have specifically compared which electrode type is better at preserving low‐frequency hearing. Wanna et al performed a retrospective study of 196 patients (225 implants, mean age at time of CI 63.7 years) looking at hearing preservation, which they defined as a postoperative air‐conduction threshold < = 80 dB hearing loss (HL) at 250 Hz . They found that LW electrodes were more likely to preserve functional hearing when compared to PM electrodes at both short‐term (2–3 weeks postoperative) and long‐term (>1 year postoperative) follow‐up.…”

Section: Literature Reviewmentioning

confidence: 99%