Long-term Hearing Preservation and Speech Perception Performance Outcomes with the Slim Modiolar Electrode

Matthew A. Shew, Amit Walia, Nedim Durakovic, Carla Valenzuela, Cameron C. Wick, Jonathan McJunkin, Craig A. Buchman, Jacques A. Herzog

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Objective:Describe audiologic outcomes in hearing preservation (HP) cochlear implant candidates using a slim modiolar electrode (SME).Study Design:Retrospective.Setting:Tertiary referral center.Patients:Two hundred three adult cochlear implant patients with preoperative low-frequency pure-tone average (LFPTA)≤80dB HL that received the SME.Intervention:Implantation with a SME electrode.Main Outcome Measures:Primary outcome was postoperative HP, defined as LFPTA ≤80dB HL. HP status was analyzed at "early" (activation or 3mo) and "long-term" (6 or 12mo) time frames using the patient's worst audiogram. Speech perception tests were compared between HP and non-HP cohorts.Results:Of the 203 HP candidates, the tip fold-over rate was 7.4%. The mean shifts in LFPTA at the "early" and "long-term" time points were 25.9±16.2dB HL and 29.6±16.9dB HL, respectively. Of 117 patients with preoperative LFPTA ≤60dB HL, the early and long-term mean LFPTA shifts were 19.5±12.3dB HL and 32.6±17.2dB HL, respectively; early and long-term HP rates were 61.1% and 50.8%, respectively. For patients with preoperative LFPTA ≤80dB HL, early and long-term HP rates were 45.5% and 43.7%, respectively. No significant difference was observed in postoperative speech perception performance (CNC, AzBio, HINT) at 3, 6, or 12months between HP versus non-HP groups.Conclusions:HP is feasible using the SME. While electroacoustic stimulation was not studied in this cohort, HP provided no clear advantage in speech perception abilities in this group of patients. The current reporting standard of what constitutes HP candidacy (preoperative LFPTA ≤80dB HL) should be reconsidered.

Original languageEnglish
Pages (from-to)E1486-E1493
JournalOtology and Neurotology
Issue number10
StatePublished - Dec 1 2021


  • CI532
  • CI632
  • Cochlear implant
  • Hearing preservation
  • Perimodiolar electrode


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