Preservation of residual hearing after cochlear implant surgery with slim modiolar electrode

Eur Arch Otorhinolaryngol. 2020 Feb;277(2):367-375. doi: 10.1007/s00405-019-05708-x. Epub 2019 Oct 31.

Abstract

Purpose: To evaluate the insertion results and hearing preservation of a novel slim modiolar electrode (SME) in patients with residual hearing.

Methods: We retrospectively collected the data from the medical files of 17 patients (18 ears) implanted with a SME. All patients had functional low frequency hearing (PTA (0.125-0.5 kHz) ≤ 80 dB HL). The insertion results were re-examined from the postoperative cone-beam computed tomography scans. Postoperative thresholds were obtained at the time of switch-on of the sound processors (mean 43 days) and at latest follow-up (mean 582 days). The speech recognition in noise was measured with the Finnish matrix sentence test preoperatively and at follow-up.

Results: The mean insertion depth angle (IDA) was 395°. Neither scala dislocations nor tip fold over were detected. There were no total hearing losses. Functional low-frequency hearing was preserved in 15/18 (83%) ears at switch-on and in 14/17 (82%) ears at follow-up. According to HEARRING classification, 55% (10/18) had complete HP at switch-on and 41% (7/17) still at follow-up. Thirteen patients (14 ears) were initially fitted with electric-acoustic stimulation and seven patients (8 ears) continued to use it after follow-up.

Conclusions: The preliminary hearing preservation results with the SME were more favorable than reported for other perimodiolar electrodes. The results show that the array may also be feasible for electro-acoustic stimulation; it is beneficial in that it provides adequate cochlear coverage for pure electrical stimulation in the event of postoperative or progressive hearing loss.

Keywords: Cochlear implant; Electro-acoustic stimulation; Hearing preservation; Modiolar electrode.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Cochlea / diagnostic imaging
  • Cochlea / surgery
  • Cochlear Implantation / adverse effects
  • Cochlear Implantation / instrumentation
  • Cochlear Implantation / methods*
  • Cochlear Implants* / adverse effects
  • Cone-Beam Computed Tomography
  • Disease Progression
  • Electric Stimulation / methods
  • Female
  • Hearing / physiology
  • Hearing Loss / etiology
  • Hearing Loss / physiopathology
  • Hearing Loss / surgery*
  • Hearing Loss, Sensorineural / surgery
  • Humans
  • Male
  • Meniere Disease / surgery
  • Middle Aged
  • Postoperative Period
  • Prosthesis Design
  • Retrospective Studies
  • Young Adult