Evaluation of hearing preservation in adults with a slim perimodiolar electrode

Abstract

Purpose Numerous endeavors have been undertaken to preserve hearing in cochlear implant (CI) patients. Particularly, optimization of electrode array design aims at preservation of residual hearing (RH). This study examines whether a slim perimodiolar (PM) electrode array could bear the capability to preserve hearing. Methods A total of 47 patients underwent cochlear implantation receiving the PM electrode. (i) Patients with pure tone audiogram (PTA) thresholds better than 85 dB and/or hearing loss for Freiburg speech test numbers less than 60 dB and more than 50% maximum monosyllabic understanding were assigned to the RH group (n = 17), while all others belonged to the noRH group (n = 30). (ii) Another group implanted with a slim straight, lateral wall (LW) electrode was recruited for comparison. Results We compared 17 RH–30 noRH patients all receiving the PM electrode. RH in PM recipients decreased faster than in LW recipients. No significant differences were observed between both (RH v/s noRH) groups in NRT thresholds, Freiburg speech test and A§E® phonemes. Analogous satisfaction levels were indicated through the questionnaires in terms of sound quality, hearing in silence, noise and directional hearing in both groups. Conclusions The results suggest that hearing preservation is influenced not only by electrode shape but various factors. This study opens an avenue for further investigations to elucidate and enumerate the causes for progressive hearing loss.

A Multicenter Comparison of 1-yr Functional Outcomes and Programming Differences Between the Advanced Bionics Mid-Scala and SlimJ Electrode Arrays

“…HP was better with the SlimJ compared with the Mid-Scala array. This aligns with previous studies showing better HP for LW than PM electrodes (23,43,44). Although HP may be better with LW arrays, it is still often possible to preserve hearing with precurves designs (45,46).…”

“…Here, the best HP results were for SlimJ recipients whose preoperative hearing fell within EAS candidacy. This relationship between preoperative hearing and HP has previously been reported (44,48). However, not all studies have supported this correlation (49).…”

Cochlear implantation impairs intracochlear microcirculation and counteracts iNOS induction in guinea pigs

“…Loss of residual hearing after CI is still a clinically relevant problem in modern cochlear implant surgery, especially in patients who are suitable for electric acoustic stimulation ( Ludwig et al, 2021 ; Tarabichi et al, 2021 ). In concordance with these established clinical findings, the experimental data of the present study showed significant and progressive hearing loss 1 h and 2 h after CI electrode array insertion compared to sham.…”

“…The functional replacement of the organ of Corti with a cochlear implant (CI) not only improves the hearing ability itself but reduces social isolation among these patients significantly ( Singh et al, 2015 ; Davis et al, 2016 ). Particularly in patients undergoing cochlear implantation with functional residual hearing, the preservation of it is of utmost importance not only for electric-acoustic stimulation but also for optimal outcomes in patients with relevant hearing remnants ( Ludwig et al, 2021 ; Tarabichi et al, 2021 ). Residual hearing preservation in cochlear implantation relies on two principles.…”

Mythbusters! The Truth about Common Misconceptions in Cochlear Implantation

“…Even in circumstances of profound postoperative acoustic hearing, patients perform much better post-CI than pre-CI, and rate their satisfaction with their CI the same. 21 The new FDA indications for these partial length arrays opened a new window of opportunity to patients living with partial hearing loss. Concurrent with the refinement of the Hybrid, each of the CI manufacturers on the U.S. market developed less traumatic electrode arrays that could potentially spare LF residual hearing and allow for EAS: the Cochlear Nucleus 622, 632, the MED-EL FLEXþ 28, and the Advanced Bionics (Valencia, CA) HiFocus MidScala and Slim J.…”