title: Hearing Preservation With a Midscalar Electrode Comparison of a Regular and Steroid/Pressure Optimized Surgical Approach in Patients With Residual Hearing.
abstract: The aim of this study was to observe the rate of hearing preservation with a midscalar electrode with two surgical approaches.
  
  
  
  Prospective study.
  
  
  
  Tertiary referral center.
  
  
  
  Twenty patients with residual hearing. Group A: 11 patients (mean age 56.1, 4 men, 7 women) mean HL 250 Hz, 36.4 dB; 500 Hz, 50.0 dB and 1 kHz, 81.4 dB. Group B: nine patients (mean age, 52.8 yr, 7 women, 2 men), 250 Hz, 36.7 dB; 500 Hz, 49.4 dB and 1 kHz, 87.8 dB.
  
  
  
  Implantation with a midscalar electrode with two surgical approaches. Group A approach consisted of a slow insertion (2 min), careful round window opening, tool insertion, intraoperative and postoperative iv. prednisone, tool insertion and 24 hour postoperation bed-rest. In group B additionally the round window was widely opened and the electrode was wetted with triamcinolone.
  
  
  
  Measurement of the mean hearing loss in both groups.
  
  
  
  We observed a statistically significant different hearing preservation for groups A and B. Although group A reached a mean hearing loss (250, 500, 1 kHz) of 42.6 dB, group B showed a mean loss of residual hearing of 9.1 dB after 1 month.
  
  
  
  A substantial rate of hearing preservation can be achieved with a midscalar electrode. A hearing preserving approach focusing on decreasing the intracochlear fluid pressure and local steroids has a strong effect on the hearing preservation.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery at ukb, Hospital of the University of Berlin (Charite), Berlin, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Todt
authors.forename: Philipp
authors.initials: P
authors.lastname: Mittmann
authors.forename: Arne
authors.initials: A
authors.lastname: Ernst
mesh_terms: D000328:Adult; D000368:Aged; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D005260:Female; D006309:Hearing; D034381:Hearing Loss / Q000209:etiology / Q000601:surgery*; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D011446:Prospective Studies