title: Conservation of residual acoustic hearing after cochlear implantation.
abstract: 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.
authors.affiliation: Department of Otolaryngology, University of Miami Ear Institute, Miller School of Medicine, Miami, Florida 33101, USA. TBalkany@miami.edu
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Balkany
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Connell
authors.forename: Annelle V
authors.initials: AV
authors.lastname: Hodges
authors.forename: Stacy L
authors.initials: SL
authors.lastname: Payne
authors.forename: Fred F
authors.initials: FF
authors.lastname: Telischi
authors.forename: Adrien A
authors.initials: AA
authors.lastname: Eshraghi
authors.forename: Simon I
authors.initials: SI
authors.lastname: Angeli
authors.forename: Ross
authors.initials: R
authors.lastname: Germani
authors.forename: Sarah
authors.initials: S
authors.lastname: Messiah
authors.forename: Kristopher L
authors.initials: KL
authors.lastname: Arheart
mesh_terms: 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