Radiologic Results and Hearing Preservation With a Straight Narrow Electrode via Round Window Versus Cochleostomy Approach at Initial Activation

Hassepaß, Frederike; Aschendorff, Antje; Bulla, Stefan; Arndt, Susan; Maier, Wolfgang; Laszig, Roland; Beck, Rainer

doi:10.1097/mao.0000000000000726

Cited by 35 publications

(42 citation statements)

References 23 publications

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“…Table 1 gathers results of clinical human studies comparing the RW versus the cochleostomy approach, showing that RW approach causes the same 10 11 or significantly less trauma to the cochlea. 12 13 …”

Section: Discussionmentioning

confidence: 99%

Methods of Hearing Preservation during Cochlear Implantation

Khater

El‐Anwar

2016

Int Arch Otorhinolaryngol

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Introduction Recent advances in surgical techniques and electrode design have made residual hearing preservation during cochlear implantation (CI) possible, achievable, and desirable. Objectives The objective of this study was to review the literature regarding methods used for hearing preservation during CI surgery. Data Synthesis We performed a search in the LILACS, MEDLINE, SciELO, PubMed databases, and Cochrane Library, using the keywords CI, hearing preservation, CI electrode design, and CI soft surgery. We fully read about 15 studies that met the criteria described in “study selection”. The studies showed that several factors could contribute to possible cochlear damage during or after CI surgery and must be kept in mind; mechanical damage during electrode insertion, shock waves in the perilymph fluid due to implantation, acoustic trauma due to drilling, loss of perilymph and disruption of inner ear fluid homeostasis, potential bacterial infection, and secondary intracochlear fibrous tissue formation. The desire to preserve residual hearing has led to the development of the soft-surgery protocols with its various components; avoiding entry of blood into the cochlea and the use of hyaluronate seem to be reasonably supported, whereas the use of topical steroids is questionable. The site of entry into the cochlea, electrode design, and the depth of insertion are also important contributing factors. Conclusion Hearing preservation would be useful for CI patients to benefit from the residual low frequency, as well as for the children who could be candidate for future regenerative hair cell therapy.

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Section: Discussionmentioning

confidence: 99%

Methods of Hearing Preservation during Cochlear Implantation

Khater

El‐Anwar

2016

Int Arch Otorhinolaryngol

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“…Recently, Hassepass et al reported a lower success rate than the former study. The author found that only 27 (65.8%) of 41 patients were able to undergo the RW approach during the CI surgery . In the current study, the RW approach was achieved in 70 (83.3%) of 84 patients.…”

Section: Discussionmentioning

confidence: 44%

“…We calculated the sample size using a two‐sided binomial test. The sample size was determined by setting the success rate of RW approach in the null proportion (P0) and the alternative proportion (P1) to 65% and 83% according to the previous study and this study, respectively. Type 1 error and type 2 error were set to 0.05 and 0.20, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…However, the RW approach is not always possible. According to previous studies, RW approach can only be used in two‐thirds of the patients, and the PC approach had to be used in the remaining one‐third of patients due to difficulties in exposing the RW . Knowing the imaging parameters related to the success of the RW approach in CI can be of great value, especially when it is necessary to preserve residual hearing.…”

Section: Introductionmentioning

confidence: 99%

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Radiological parameters related to success of the round window approach in cochlear implantation: A retrospective study

Kang

Chung

Park

et al. 2018

Clinical Otolaryngology

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“…Other authors reported that similar levels of lowfrequency hearing preservation could be achieved using straight narrow electrode inserted with either approaches. [23][24][25] One possible difference contrasting both approaches is the relatively important anatomical variability of the round window itself, which could compromise insertion in certain cases and would make the cochleostomy a better option. 26 Extensive studies including more patients and looking at the detailed relationship between ore-operative anatomical characteristics of the RW region and how these should constrain the choice of the surgical approach are necessary.…”

mentioning

confidence: 99%

Short-Term Clinical Outcome of Neuro One<sup>®</sup> System Cochlear Implantation in Korean Adults

Lee¹,

Kim²,

Chang³

2018

Korean J Otorhinolaryngol-Head Neck Surg

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Introduction The preservation of residual hearing is currently an important challenge for cochlear implant surgeries. Indeed, if patients exhibit functional hearing after cochlear implantation, they can benefit from the combination of acoustical stimulation, usually in the low-frequencies and electrical stimulation in the high-frequencies. This combined mode of stimulation has proven to be beneficial both in terms of speech perception and of sound quality. Finding the right procedures for conducting softsurgeries and designing electrode arrays dedicated to hearing preservation is an open issue. Objective The objective of this study is to evaluate the combination of a soft-surgery procedure implicating round-window insertion and the use of dexamethasone and hyaluronic acid during surgery, with the use of a specifically designed straight soft electrode array, on hearing preservation in patients with functional hearing in the low frequencies. Methods This pre-clinical trial was conducted on seven patients with residual hearing in the low frequencies. The surgical method used employed a round window insertion and the use of topical dexamethasone. Results The soft-surgery protocol could be successfully followed in five patients. In this group, the average hearing threshold shift compared with pre-operative values was of 18.7 þ/À 16.1 dB HL up to 500 Hz and 15.7 þ/À 15.1 up to 1 kHz, demonstrating satisfying levels of hearing preservation. Conclusion We were able to demonstrate the possibility of preserving residual hearing in most of the patients using the EVO electrode. Significant residual hearing preservation levels were was obtained when a soft surgical approach involving round window insertion, dexamethasone and hyaluronic use during the surgery.

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Radiologic Results and Hearing Preservation With a Straight Narrow Electrode via Round Window Versus Cochleostomy Approach at Initial Activation

Cited by 35 publications

References 23 publications

Methods of Hearing Preservation during Cochlear Implantation

Methods of Hearing Preservation during Cochlear Implantation

Radiological parameters related to success of the round window approach in cochlear implantation: A retrospective study

Short-Term Clinical Outcome of Neuro One<sup>®</sup> System Cochlear Implantation in Korean Adults

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