Reimplantation of Hybrid Cochlear Implant Users With a Full-Length Electrode After Loss of Residual Hearing

Fitzgerald, Matthew B.; Sagi, Elad; Jackson, Michael; Shapiro, William H.; Roland, J. Thomas; Waltzman, Susan B.; Svirsky, Mario A.

doi:10.1097/mao.0b013e31815c4875

Cited by 70 publications

(45 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Hybrid-S is a much shorter electrode of only 10 mm with 6 active electrode contacts to be inserted through cochleostomy to only 195-205° of insertion depth . Although a short electrode may minimize insertion trauma, the speech discrimination outcomes could be compromised, especially in cases where there is not enough residual hearing or in the case of naturally progressing loss of hearing over time [Fitzgerald et al, 2008].…”

Section: Discussionmentioning

confidence: 99%

Partial Deafness Treatment with the Nucleus Straight Research Array Cochlear Implant

et al. 2011

View full text Add to dashboard Cite

Introduction: The Nucleus Straight Research Array (SRA) cochlear implant has a new 25-mm electrode carrier designed to minimize insertion trauma, in particular allowing easy insertion via the round window. The aims of this study were to measure preoperative to postoperative benefit in terms of speech recognition in quiet and in noise in three groups of patients (electrical complement, EC; electrical stimulation, ES; electro-acoustic stimulation, EAS) with varying levels of low-frequency hearing, and to evaluate the preservation of residual hearing after implantation with the SRA cochlear implant. Methods: The study design was prospective with sequential enrolment and within-subject comparisons: 23 adult cochlear implant candidates were divided into three groups according to their level of preoperative residual hearing at 500 Hz (EC ≤50 dB; 50 dB < EAS < 80 dB; ES ≧80 dB). Monosyllabic word recognition using the SRA cochlear implant in combination with residual low-frequency hearing was assessed at 4 and 13 months after implantation. Hearing threshold levels were also monitored over time. Results: Subjects across all three groups had significant improvements in speech recognition scores (i.e. >20 percentage points) both for listening in quiet (71% of subjects) and in noise (100% of subjects). The average score at 4 months after operation for words presented in quiet was 61.7%, and in 10 dB SNR noise 46.5%, compared to 34.4 and 10.6% preoperatively (p < 0.001). All subjects retained measurable hearing at 500 Hz in the implanted ear at 4 months after the operation; mean increases were 19, 29 and 1 dB for the EC, EAS and ES groups (n = 21). Across frequencies of 125–1000 Hz, the median increase in thresholds was 15 dB up to 13 months postoperatively (n = 15). Conclusions: Speech recognition performance of subjects with various levels of residual low-frequency hearing was significantly improved with the SRA cochlear implant. A high level and rate of hearing preservation was achieved with the SRA implanted using a round window surgical technique. Subjects with preoperative low-frequency hearing levels between 50 and 80 dB HL (EAS group) tended to lose more hearing than those with either better or worse hearing.

show abstract

Section: Discussionmentioning

confidence: 99%

Partial Deafness Treatment with the Nucleus Straight Research Array Cochlear Implant

et al. 2011

View full text Add to dashboard Cite

show abstract

“…However, the functional results of a 6-mm implantation were not sufficient for speech recognition and clearly improved after subjects received a 10-mm insertion [Gantz and Turner, 2003;Turner et al, 2004]. Even a 10-mm implant may have a limited effect on speech understanding compared with a longer electrode [Dorman et al, 2005[Dorman et al, , 2007[Dorman et al, , 2009Fitzgerald et al, 2008] when considering individuals with complete or progressive hearing loss and/ or those with poor acoustic hearing preoperatively [Dorman et al, 2003], so that in case of failure a secondary implantation with a deep insertion is deemed necessary. More recently, a 16-mm implantation depth was advocated as a compromise .…”

Section: Insertion Depthmentioning

confidence: 99%

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

Ilberg

Baumann²,

Kiefer³

et al. 2011

Audiol Neurotol

178

View full text Add to dashboard Cite

Electric-acoustic stimulation (EAS) was developed for individuals with a profound hearing loss in the high frequencies and a substantial residual low-frequency hearing (LFH). For this group of candidates, conventional hearing aids often neither provided sufficient amplification nor were they considered suitable for cochlear implantation due to the possible destruction of residual hearing capabilities. With EAS, combining electric stimulation with an ipsilateral acoustic stimulation, preservation of residual LFH and the development of a new speech processor uniting both strategies became essential. Over the last years, EAS has developed further and advanced in electrode design and surgery techniques. This paper summarizes the history of EAS and acknowledges the tremendous work of the many research groups who contributed to the success of EAS.

show abstract

“…Still, it is obvious that shallower insertion depths do not lead to the same benefit in speech understanding for the patient [11] . Therefore, research and development efforts now focus on the development of longer, yet more atraumatic, electrodes to allow sufficient speech understanding as well as better hearing preservation.…”

Section: Introductionmentioning

confidence: 99%

Cochlear Reimplantation after Surgery for Electric-Acoustic Stimulation

Helbig¹,

Helbig²,

Mack

et al. 2009

ORL

View full text Add to dashboard Cite

Background/Aims: Combined electric-acoustic stimulation (EAS) of the auditory system usually results in better speech understanding than electric stimulation only, assuming low-frequency hearing can be preserved. Treatment options and outcomes for 4 subjects experiencing compromised hearing after EAS surgery are discussed. Methods: Each subject underwent revision surgery to replace the original 21-mm electrode arrays used in EAS surgery with cochlear implants (CIs) with 31-mm arrays. Our aims were: (1) to investigate whether deeper insertion is possible, and (2) to evaluate the influence of electrode insertion angle by comparing speech perception scores before and after revision surgery. Results: Deeper insertion was feasible in all subjects. Speech understanding scores after reimplantation were comparable to those seen after the first intervention. Conclusion: A 360-degree insertion under EAS conditions provides sufficient speech understanding, even in cases of additional hearing loss. Reimplantation with a longer electrode array is feasible in former EAS patients.

show abstract

Reimplantation of Hybrid Cochlear Implant Users With a Full-Length Electrode After Loss of Residual Hearing

Abstract: 1) Short electrode arrays may help preserve residual hearing but may also provide less benefit than traditional cochlear implants for some patients. 2) Pitch percepts in response to electric stimulation may be modified by experience.

Cited by 70 publications

References 10 publications

Partial Deafness Treatment with the Nucleus Straight Research Array Cochlear Implant

Partial Deafness Treatment with the Nucleus Straight Research Array Cochlear Implant

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

Cochlear Reimplantation after Surgery for Electric-Acoustic Stimulation

Contact Info

Product

Resources

About