Results of Partial Deafness Cochlear Implantation Using Various Electrode Designs

Abstract

Nineteen adults and 9 children who received a unilateral cochlear implant between 2002 and 2007 were included in the study. All subjects were preoperatively diagnosed with significant residual hearing in low frequencies, termed as ‘partial deafness’, and were implanted according to a 6-step round window surgical technique for partial deafness cochlear implantation. Hearing was preserved to a great extent in the partial deafness cochlear implantation (PDCI) group. After a short period following activation of the cochlear implant, highly significant improvement in the recognition of monosyllabic words was observed. With a developed round window surgical procedure and limited electrode insertion, hearing can be preserved in the majority of patients with partial deafness. PDCI is a feasible means of treating individuals who have good low-frequency hearing but severe to profound hearing loss in the mid to high frequencies.

Electric-Acoustic Stimulation of the Auditory System: A Review of the First Decade

“…In addition, monosyllables tested at a 10-dB signal-to-noise ratio (SNR) should not exceed a score of 40% in the bestaided condition. In a more recent study by the Warsaw group, preoperative average monosyllable scores of 40% in quiet (SD: 18%) were reported in 28 partial deafness CI users [Skarzynski et al, 2009].…”

“…In a contradictory publication, Neumann et al [2005] described a retrospective series of 47 recipients showing that high-frequency hearing (500-8000 Hz) was less impaired with a deep electrode insertion (25 mm) than with a partial insertion. However, more recent publications demonstrate that, after progressive improvements in surgical technique and newly designed electrodes (see Electrode Design), equally high degrees of hearing preservation are possible following an 18-to 22-mm insertion Gstoettner et al, 2009;Lenarz et al, 2009;Skarzynski and Podskarbi-Fayette, 2009;Skarzynski et al, 2009]. When using a three-dimensional computer model of the inner ear, one group could demonstrate that an electrode array, when introduced into the basal partition of the cochlea, did not interfere with basilar membrane movement in the apical low-frequency area .…”

“…The most expanded indication for EAS has been reported by the Warsaw group, who implanted candidates with markedly better acoustic hearing in the frequencies between 125 and 500 Hz. Some of the recipients showed extremely sloping audiograms, using the natural preserved acoustic LFH, without the need of any additional acoustic amplification [Skarzynski et al, 2003[Skarzynski et al, , 2007a[Skarzynski et al, , 2009Lorens et al, 2008].…”

“…As main factors for the poor performance with EAS, low preoperative word scores and long DOHL were suggested . Most of the clinical reports agree that EAS may require some adaptation time before recipients are able to reach their optimal performance [Adunka et al, 2008;Gstoettner et al, 2008;Lorens et al, 2008;Skarzynski et al, 2009]. This is particularly true for poor performers who have only a modest degree of acoustic hearing before or after surgery, or for those with a long duration of high-frequency hearing loss .…”

Residual hearing preservation using the suprameatal approach for cochlear implantation

“…Cochlear implantation with preservation of residual hearing has become a widely accepted method of treatment for patients with high-frequency hearing loss [1][2][3]. Audiological performance was proven to be superior in the bimodal electric-acoustic stimulation (EAS) mode as compared with either acoustic or electric stimulation alone.…”