Hearing Preservation and Hearing Improvement After Reimplantation of Pediatric and Adult Patients With Partial Deafness

Jayawardena, Janitha; Kuthubutheen, Jafri; Rajan, Gunesh

doi:10.1097/mao.0b013e318255dd91

Cited by 17 publications

(13 citation statements)

References 20 publications

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“…Jayawardena et al (10) had two patients, one child and one adult with device failure at 12 to 18 months after hearing preservation with a MED-EL FLEX EAS (20-mm) electrode array. Both patients had successful reimplantation, with preservation of residual hearing using a MED-EL FLEX EAS in the child and a longer MED-EL FLEX 28 in the adultVboth with full electrode insertion.…”

Section: Hearing Preservation CI In Adolescentsmentioning

confidence: 99%

Hearing Preservation Cochlear Implantation in Adolescents

Bruce

Felton

Lockley³

et al. 2014

Otology &Amp; Neurotology

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Section: Hearing Preservation CI In Adolescentsmentioning

confidence: 99%

Hearing Preservation Cochlear Implantation in Adolescents

Bruce

Felton

Lockley³

et al. 2014

Otology &Amp; Neurotology

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“…Perimodiolar electrode arrays are primarily designed for cochleostomy and extended round window insertions, 28 while lateral wall arrays can be inserted also through the round window (RW). However, cochleostomy and related surgical approaches were found to be more associated with new bone formation and fibrotic tissue encapsulation of the electrode array due to larger initial intracochlear damage than RW, partly because they can lead to unintended involvement of scala vestibuli.…”

Section: Discussionmentioning

confidence: 99%

Challenging aspects of contemporary cochlear implant electrode array design

Mistrík

Jolly

Sieber

et al. 2017

World j. otorhinolaryngol.-head neck surg.

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ObjectiveA design comparison of current perimodiolar and lateral wall electrode arrays of the cochlear implant (CI) is provided. The focus is on functional features such as acoustic frequency coverage and tonotopic mapping, battery consumption and dynamic range. A traumacity of their insertion is also evaluated.MethodsReview of up-to-date literature.ResultsPerimodiolar electrode arrays are positioned in the basal turn of the cochlea near the modiolus. They are designed to initiate the action potential in the proximity to the neural soma located in spiral ganglion. On the other hand, lateral wall electrode arrays can be inserted deeper inside the cochlea, as they are located along the lateral wall and such insertion trajectory is less traumatic. This class of arrays targets primarily surviving neural peripheral processes. Due to their larger insertion depth, lateral wall arrays can deliver lower acoustic frequencies in manner better corresponding to cochlear tonotopicity. In fact, spiral ganglion sections containing auditory nerve fibres tuned to low acoustic frequencies are located deeper than 1 and half turn inside the cochlea. For this reason, a significant frequency mismatch might be occurring for apical electrodes in perimodiolar arrays, detrimental to speech perception. Tonal languages such as Mandarin might be therefore better treated with lateral wall arrays. On the other hand, closer proximity to target tissue results in lower psychophysical threshold levels for perimodiolar arrays. However, the maximal comfort level is also lower, paradoxically resulting in narrower dynamic range than that of lateral wall arrays. Battery consumption is comparable for both types of arrays.ConclusionsLateral wall arrays are less likely to cause trauma to cochlear structures. As the current trend in cochlear implantation is the maximal protection of residual acoustic hearing, the lateral wall arrays seem more suitable for hearing preservation CI surgeries. Future development could focus on combining the advantages of both types: perimodiolar location in the basal turn extended to lateral wall location for higher turn locations.

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“…The ability to preserve hearing is particularly important in children where there is a very high likelihood of these patients requiring reimplantation at some point during their life. The ability to preserve hearing during cochlear re-implantation has also been demonstrated in children (Jayawardena et al, 2012). From these studies, it is clear that being able to preserve residual hearing is not only possible in a wide variety of situations but rather almost now expected in contemporary CI surgery.…”

Section: Hearing Preservationmentioning

confidence: 91%