title: Patterns of Long-term Hearing Loss in Hearing Preservation Cochlear Implant Surgery.
abstract: To describe patterns of hearing loss in patients with low-frequency residual hearing after cochlear implantation.
  
  
  
  Retrospective chart review.
  
  
  
  Tertiary referral center.
  
  
  
  Cochlear implant candidates with immediate postoperative residual low-frequency hearing.
  
  
  
  Hybrid or traditional cochlear implant.
  
  
  
  Audiograms to measure postoperative hearing.
  
  
  
  Of the 166 patients reviewed, 17 ears met the inclusion criteria. The age ranged from 3 years 2 months to 86 years. Etiology was unknown (n = 6), presbycusis (n = 5), genetic (n = 4), acoustic trauma (n = 1), and measles virus (n = 1). The Nucleus Hybrid S8 and S12 (n = 7) was the most common electrode array, and then Nucleus 422 (n = 6), Nucleus Contour Advance (n = 2), Med-El Flex 28 (n = 2), and Advanced Bionics Mid Scala (n = 1). Cochleostomy was performed in nine, and round window approach in nine patients. Average follow-up was 28 months (2-68 mo). Postoperative loss was mixed in eight and purely sensorineural in eight. The most common patterns of hearing loss were gradual decline (n = 7), and then fluctuating hearing (n = 6), stable (n = 3), and sudden loss (n = 1). One patient only had one postoperative audiogram.
  
  
  
  Some long-term hearing preservation was achieved in 94% of patients with immediate postoperative hearing preservation. Patients developed both mixed and sensorineural loss postoperatively. A majority of patients with mixed hearing loss had a supra-preoperative bone curve. Gradual decline and fluctuating hearing loss were the most common patterns of hearing loss; few patients had stable hearing and one had a sudden loss.
authors.affiliation: *Department of Otolaryngology, University of Washington Medical Center †Department of Otolaryngology, Seattle Children's Hospital ‡Virginia Merrill Bloedel Hearing Research Center §Department of Audiology, University of Washington Medical Center ||Department of Pediatric Audiology and Speech-Language Pathology, Seattle Children's Hospital, Seattle, Washington, U.S.A.
authors.forename: Kavita
authors.initials: K
authors.lastname: Dedhia
authors.forename: Tina
authors.initials: T
authors.lastname: Worman
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Meredith
authors.forename: Jay T
authors.initials: JT
authors.lastname: Rubinstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000009:adverse effects*; D003054:Cochlear Implants; D005260:Female; D006309:Hearing; D006319:Hearing Loss, Sensorineural / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D055815:Young Adult