Implantation of the ossified cochlea: management with the split electrode array.
OBJECTIVE
To describe indications for, the surgical technique required, and the expected functional results of split electrode array cochlear implants.


METHODS
Retrospective chart review.


METHODS
Data collected included etiology of deafness, radiographic findings, pre- and postoperative aided pure tone thresholds, and speech perception testing. Adult speech perception outcomes were measured using the Consonant Nucleus Consonant (CNC) monosyllable words and Hearing in Noise Test (HINT) in quiet/noise (+10 dB). The children were assessed using the Infants and Toddlers Meaningful Auditory Integration Scale.


RESULTS
Five patients were implanted with a split electrode array. This included two adults and three children. Both adults had preoperative binaural aided pure tone averages worse than 50 dB and scores of 0% on both HINT quiet and CNC words. The children had undetectable preoperative aided thresholds and scored an average 4/40 on the IT-MAIS. Postimplant, the average threshold gain was 38.5 dB in the adults and 81.5 dB in the children. One adult improved to score 51%/22% on HINT quiet/noise at 6 months and 72%/30% at 12 months. The other adult continued to score 0% on HINT at 12 months but claimed substantial subjective auditory improvement after the first year of device use. The children averaged 28/40 on the IT MAIS at 6 months after implantation. Forty-two of 48 implanted electrodes were functional.


CONCLUSIONS
The split electrode array is a useful alternative to traditional cochlear implants in treating deafened patients with cochlear ossification. Patients implanted with the split array show marked improvement in sound and speech perception.
Millar
D A
DA
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
Hillman
Todd A
TA
Shelton
Clough
C
D000328:Adult; D001301:Audiometry, Pure-Tone; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000295:instrumentation*; D004567:Electrodes, Implanted; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D009999:Ossification, Heterotopic; D012189:Retrospective Studies; D013067:Speech Perception; D016896:Treatment Outcome