title: Hearing Preservation Outcomes With a Mid-Scala Electrode in Cochlear Implantation.
abstract: OBJECTIVE
  To evaluate hearing preservation (HP) outcomes in adult cochlear implant recipients with a mid-scala electrode.
  
  
  METHODS
  Tertiary academic center.
  
  
  METHODS
  Adult patients implanted with a mid-scala electrode between May 2013 and July 2015.
  
  
  METHODS
  Cochlear implantation.
  
  
  METHODS
  Age, sex, surgical approach, residual hearing changes post cochlear implantation, HP rates using different published classifications, and speech perception scores.
  
  
  RESULTS
  Fifty ears for 47 patients (mean age, 58.2 yr; range, 23-86) were implanted with the electrode. Recognizing that not all patients were true HP candidates and/or underwent generally accepted HP surgical techniques, 39 ears had preoperative low-frequency hearing (audiometric threshold ≤ 85dB HL at 250Hz), 24 preserved acoustic hearing postoperatively (75.0%). Patients who had preserved acoustic hearing were implanted via round window (N = 18), extended round window (N = 4), or via cochleostomy (N = 2) approaches. Mean threshold elevation for low-frequency pure-tone average (125, 250, and 500  Hz) was 20.2  dB after surgery. 43.8% of patients had aidable low-frequency hearing at activation, 30.0% at 6-months postoperatively, and 30.8% 1-year postopera tively. Using a formula outlined by Skarzynski and colleagues, at 6-months postoperatively, 15.0% of patients had complete HP, whereas 40.0% had partial HP. At 1-year, these percentages decreased to 0% and 38.5%, respectively. Age, type of approach, and perioperative steroid use were not correlated with HP outcomes at activation and 6-months postoperatively (p > 0.05).
  
  
  CONCLUSIONS
  The mid-scala electrode evaluated allows preservation of low-frequency hearing in patients undergoing cochlear implantation at rates and degrees of preservation close to other reports in the cochlear implant literature.
authors.affiliation: The Otology Group of Vanderbilt University, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Jacob B
authors.initials: JB
authors.lastname: Hunter
authors.forename: René H
authors.initials: RH
authors.lastname: Gifford
authors.forename: George B
authors.initials: GB
authors.lastname: Wanna
authors.forename: Robert F
authors.initials: RF
authors.lastname: Labadie
authors.forename: Marc L
authors.initials: ML
authors.lastname: Bennett
authors.forename: David S
authors.initials: DS
authors.lastname: Haynes
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rivas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D005260:Female; D006309:Hearing / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013067:Speech Perception / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult
references.citation: Otol Neurotol. 2011 Aug;32(6):962-8
references.pmid: 21659922
references.citation: Acta Otolaryngol. 2009 Apr;129(4):372-9
references.pmid: 19140036
references.citation: Otol Neurotol. 2014 Jan;35(1):e40-4
references.pmid: 24080974
references.citation: Audiol Neurootol. 2009;14 Suppl 1:8-13
references.pmid: 19390170
references.citation: Audiol Neurootol. 2014;19(5):293-309
references.pmid: 25277083
references.citation: Otol Neurotol. 2014 Dec;35(10):1765-72
references.pmid: 25133472
references.citation: Adv Otorhinolaryngol. 2010;67:51-60
references.pmid: 19955721
references.citation: ORL J Otorhinolaryngol Relat Spec. 2011;73(6):321-9
references.pmid: 21997337
references.citation: Laryngoscope. 2014 Nov;124 Suppl 6:S1-7
references.pmid: 24764083
references.citation: Acta Otolaryngol. 2005 May;125(5):481-91
references.pmid: 16092537
references.citation: Audiol Res. 2011 Mar 23;1(1):e24
references.pmid: 26557309
references.citation: Otol Neurotol. 2013 Apr;34(3):526-31
references.pmid: 23503094
references.citation: J Rehabil Res Dev. 2008;45(5):769-78
references.pmid: 18816425
references.citation: J Speech Hear Disord. 1962 Feb;27:62-70
references.pmid: 14485785
references.citation: Otol Neurotol. 2015 Sep;36(8):1343-8
references.pmid: 26176556
references.citation: Acta Otolaryngol Suppl. 2013;(564):3-13
references.pmid: 24328756
references.citation: Otol Neurotol. 2015 Jan;36(1):43-50
references.pmid: 25275867
references.citation: Hear Res. 2014 Jun;312:28-37
references.pmid: 24607490
references.citation: Audiol Neurootol. 2009;14 Suppl 1:22-31
references.pmid: 19390172
references.citation: Ear Hear. 2013 Jul-Aug;34(4):413-25
references.pmid: 23446225
references.citation: Otol Neurotol. 2014 Sep;35(8):1415-20
references.pmid: 24836594
references.citation: Ear Hear. 2012 Jan-Feb;33(1):112-7
references.pmid: 21829134
references.citation: Ear Hear. 2014 Mar-Apr;35(2):e33-43
references.pmid: 24556970
references.citation: Int J Audiol. 2013 Dec;52(12):838-48
references.pmid: 23992489
references.citation: J Am Acad Audiol. 2010 Jan;21(1):44-51
references.pmid: 20085199
references.citation: Laryngoscope. 2016 Jan;126(1):175-81
references.pmid: 26152811