Conservation of residual acoustic hearing after cochlear implantation.
OBJECTIVE
This study was designed to test the hypothesis that partial hearing conservation is attainable after cochlear implantation with a long perimodiolar electrode. Surgical strategies for hearing conservation during cochlear implantation are described.


METHODS
Prospective, single-subject, repeated-measures design.


METHODS
Academic tertiary care center.


METHODS
Twenty-eight severely to profoundly hearing-impaired adult cochlear implant recipients who had some measurable hearing preoperatively.


METHODS
Cochlear implantation using Nucleus Freedom Contour Advance electrode.


METHODS
Preimplant and postimplant pure-tone thresholds and speech recognition scores were obtained to determine the incidence and degree of conserved hearing at a mean interval of 9 (+/-3.9) months.


RESULTS
Thirty-two percent of subjects experienced complete conservation of hearing (0- to 10-dB loss), and 57% experienced partial conservation of hearing (>11 dB) after implantation. However, open-set speech recognition was partially conserved in only one subject. Cochlear implant performance was not better in patients with conservation of residual hearing.


CONCLUSIONS
Conservation of pure-tone hearing was possible in 89% of implanted patients; however, residual speech perception was not conserved with this long perimodiolar electrode. A ceiling effect tends to inflate the prevalence of hearing conservation in implantation studies of severely to profoundly hearing-impaired patients.
Balkany
Thomas J
TJ
Department of Otolaryngology, University of Miami Ear Institute, Miller School of Medicine, Miami, Florida 33101, USA. TBalkany@miami.edu
Connell
Sarah S
SS
Hodges
Annelle V
AV
Payne
Stacy L
SL
Telischi
Fred F
FF
Eshraghi
Adrien A
AA
Angeli
Simon I
SI
Germani
Ross
R
Messiah
Sarah
S
Arheart
Kristopher L
KL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology*; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D004558:Electric Stimulation; D004566:Electrodes; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome