title: Expanding pediatric cochlear implant candidacy: A case study of electro-natural stimulation (ENS) in partial deafness treatment.
abstract: BACKGROUND
  Some adolescents have hearing impairments characterized by normal or slightly elevated thresholds in the low and mid-frequency bands (below 1500 Hz) and nearly total deafness in the high frequency range. These patients often remain beyond the scope of effective hearing aid treatment.
  
  
  METHODS
  This study presents the case of a 16-year-old adolescent with good hearing in the range 125-1500 Hz and deafness at other frequencies. An implant was used to restore hearing at high frequencies, while preserving low and mid frequency acoustic hearing in the implanted ear. This is described as electro-natural stimulation (ENS) of the inner ear.
  
  
  CONCLUSIONS
  The results demonstrate that low and mid frequency hearing (up to 1500 Hz) can be preserved using the round window surgical technique. A substantial improvement in speech discrimination was also observed when electrical stimulation on one side was combined with acoustic stimulation on both sides. There is scope to extend qualifying criteria for cochlear implantation to include adolescents who are suited to ENS.
authors.affiliation: World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Mokra 17, 05-830 Nadarzyn, Poland.
authors.forename: Henryk
authors.initials: H
authors.lastname: Skarzynski
authors.affiliation: World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Mokra 17, 05-830 Nadarzyn, Poland. Electronic address: a.lorens@ifps.org.pl.
authors.forename: Artur
authors.initials: A
authors.lastname: Lorens
authors.affiliation: World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Mokra 17, 05-830 Nadarzyn, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Dziendziel
authors.affiliation: World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Mokra 17, 05-830 Nadarzyn, Poland; Heart Failure and Cardiac Rehabilitation Department, Medical University of Warsaw, Banacha 1a, 02-097 Warszawa, Poland; Institute of Sensory Organs, Kajetany, Mokra 1, 05-830 Nadarzyn, Poland.
authors.forename: Piotr H
authors.initials: PH
authors.lastname: Skarzynski
mesh_terms: D000161:Acoustic Stimulation; D000293:Adolescent; D019929:Cochlear Implantation / Q000379:methods; D003054:Cochlear Implants; D003638:Deafness / Q000628:therapy*; D004558:Electric Stimulation; D006320:Hearing Tests; D006801:Humans; D008297:Male; D012405:Round Window, Ear / Q000601:surgery; D013067:Speech Perception; D016896:Treatment Outcome
keywords: Cochlear implant; Electric complementation; Electric-acoustic stimulation; Electro-natural stimulation; Hearing preservation; Partial deafness treatment