TY - JOUR
T1 - Residual hearing preservation after pediatric cochlear implantation
AU - Brown, Ryan F.
AU - Hullar, Timothy E.
AU - Cadieux, Jamie H.
AU - Chole, Richard A.
PY - 2010/10
Y1 - 2010/10
N2 - Objective: This study is designed to test the hypothesis that preservation of residual hearing in a pediatric population is possible using standard electrode arrays with full-length insertions. Surgical technique during implantation also is described. Study Design: Retrospective review of patient medical records. Setting: Academic tertiary care center. PATIENTS: Thirty-one severely to profoundly hearing impaired pediatric patients with some residual hearing precochlear implantation. Intervention: Cochlear implantation using a modified "soft surgery" protocol. Main Outcome Measures: Preimplant and postimplant pure tone thresholds and pure-tone average were calculated from unaided preoperative and postoperative audiograms from 250, 500, and 1,000 Hz. Hearing preservation rates were determined to be complete (loss of ≤10 dB), moderate (loss of 11-20 dB), marginal (loss of 21-40 dB), or none (loss of >40 dB or no response at the limits of the audiometer). Functional residual hearing rates (defined in this study as at least 1 threshold better than or equal to 75 dB HL for 250, 500, or 1,000 Hz were calculated. Results: Complete hearing preservation was achieved in 14 (45.2%) of 31 patients, whereas 28 (90.3%) of 31 had at least partial hearing preservation (loss of ≤40 dB). The preoperative to postoperative low-frequency pure-tone average had a mean change of 18.5 dB and median change of 20 dB. Of the patients who had preoperative functional hearing, 9 (50.0%) of 18 maintained functional residual hearing postoperatively for at least 1 pitch. Conclusion: Preservation of residual hearing is feasible in pediatric cochlear implant patients using standard-length electrode arrays with full insertions. These data have implications for cochlear implantation in pediatric patients who are at higher risk of progressive hearing loss than adults.
AB - Objective: This study is designed to test the hypothesis that preservation of residual hearing in a pediatric population is possible using standard electrode arrays with full-length insertions. Surgical technique during implantation also is described. Study Design: Retrospective review of patient medical records. Setting: Academic tertiary care center. PATIENTS: Thirty-one severely to profoundly hearing impaired pediatric patients with some residual hearing precochlear implantation. Intervention: Cochlear implantation using a modified "soft surgery" protocol. Main Outcome Measures: Preimplant and postimplant pure tone thresholds and pure-tone average were calculated from unaided preoperative and postoperative audiograms from 250, 500, and 1,000 Hz. Hearing preservation rates were determined to be complete (loss of ≤10 dB), moderate (loss of 11-20 dB), marginal (loss of 21-40 dB), or none (loss of >40 dB or no response at the limits of the audiometer). Functional residual hearing rates (defined in this study as at least 1 threshold better than or equal to 75 dB HL for 250, 500, or 1,000 Hz were calculated. Results: Complete hearing preservation was achieved in 14 (45.2%) of 31 patients, whereas 28 (90.3%) of 31 had at least partial hearing preservation (loss of ≤40 dB). The preoperative to postoperative low-frequency pure-tone average had a mean change of 18.5 dB and median change of 20 dB. Of the patients who had preoperative functional hearing, 9 (50.0%) of 18 maintained functional residual hearing postoperatively for at least 1 pitch. Conclusion: Preservation of residual hearing is feasible in pediatric cochlear implant patients using standard-length electrode arrays with full insertions. These data have implications for cochlear implantation in pediatric patients who are at higher risk of progressive hearing loss than adults.
KW - Cochlearimplant
KW - Electroacoustic stimulation
KW - Hearing conservation
KW - Hearing loss
KW - Hearing preservation
KW - Pediatric
KW - Soft surgery
UR - http://www.scopus.com/inward/record.url?scp=77958084569&partnerID=8YFLogxK
U2 - 10.1097/MAO.0b013e3181f0c649
DO - 10.1097/MAO.0b013e3181f0c649
M3 - Article
C2 - 20818293
AN - SCOPUS:77958084569
VL - 31
SP - 1221
EP - 1226
JO - Otology and Neurotology
JF - Otology and Neurotology
SN - 1531-7129
IS - 8
ER -