title: Residual hearing preservation after pediatric cochlear implantation.
abstract: OBJECTIVE
  This study is designed to test the hypothesis that preservation of residual hearing in a pediatric population is possible using standard electrode arrays with full-length insertions. Surgical technique during implantation also is described.
  
  
  METHODS
  Retrospective review of patient medical records.
  
  
  METHODS
  Academic tertiary care center.
  
  
  METHODS
  Thirty-one severely to profoundly hearing impaired pediatric patients with some residual hearing precochlear implantation.
  
  
  METHODS
  Cochlear implantation using a modified "soft surgery" protocol.
  
  
  METHODS
  Preimplant and postimplant pure tone thresholds and pure-tone average were calculated from unaided preoperative and postoperative audiograms from 250, 500, and 1,000 Hz. Hearing preservation rates were determined to be complete (loss of ≤10 dB), moderate (loss of 11-20 dB), marginal (loss of 21-40 dB), or none (loss of >40 dB or no response at the limits of the audiometer). Functional residual hearing rates (defined in this study as at least 1 threshold better than or equal to 75 dB HL for 250, 500, or 1,000 Hz were calculated.
  
  
  RESULTS
  Complete hearing preservation was achieved in 14 (45.2%) of 31 patients, whereas 28 (90.3%) of 31 had at least partial hearing preservation (loss of ≤40 dB). The preoperative to postoperative low-frequency pure-tone average had a mean change of 18.5 dB and median change of 20 dB. Of the patients who had preoperative functional hearing, 9 (50.0%) of 18 maintained functional residual hearing postoperatively for at least 1 pitch.
  
  
  CONCLUSIONS
  Preservation of residual hearing is feasible in pediatric cochlear implant patients using standard-length electrode arrays with full insertions. These data have implications for cochlear implantation in pediatric patients who are at higher risk of progressive hearing loss than adults.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
authors.forename: Ryan F
authors.initials: RF
authors.lastname: Brown
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Hullar
authors.forename: Jamie H
authors.initials: JH
authors.lastname: Cadieux
authors.forename: Richard A
authors.initials: RA
authors.lastname: Chole
mesh_terms: D000293:Adolescent; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods; D003054:Cochlear Implants; D004567:Electrodes, Implanted; D005260:Female; D034381:Hearing Loss / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
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