Ipsilateral Electric Acoustic Stimulation of the Auditory System: Results of Long-Term Hearing Preservation

TLDR

The study evaluates long‑term ipsilateral hearing preservation in cochlear‑implant patients receiving combined electric‑acoustic stimulation. Twenty‑three patients received MED‑EL C40+ electrodes via an atraumatic anterior‑inferior cochleostomy with 18‑24 mm (360°) insertions, and were followed prospectively for hearing outcomes. Approximately 70% of patients maintained complete or partial residual hearing for about 27 months, with 39% achieving complete preservation and 30% partial, while word‑recognition scores rose from 13% to 75% in those with full preservation.

Abstract

To evaluate long-term ipsilateral hearing preservation in patients who underwent cochlear implantation for the combined electric acoustic stimulation of the auditory system.This was a prospective observational study conducted at a tertiary referral center. Twenty-three subjects were implanted with the MED-EL C40+ standard or C40+ medium electrode using an atraumatic surgical protocol via an anterior-inferior cochleostomy approach. The desired insertion depth was 18-24 mm or 360 degrees. All patients showed significant low-frequency hearing prior to surgery and monosyllabic word scores did not exceed 40% in the best aided condition. Pure-tone audiometry was performed prior to implantation and at distinct intervals after surgery.Nine patients (39.1%) showed complete pure-tone audiometric hearing preservation (0-10 dB) over an average of 29 months. Seven subjects (30.4%) showed partial preservation of residual hearing (hearing loss 15-40 dB) until an average of 25 months. Delayed loss of residual hearing was observed in 5 cases (21.7%) and 2 patients (8.6%) completely lost residual hearing during or immediately after surgery. Freiburger Monosyllabic word understanding scores in a group of patients with complete hearing preservation increased from 13.1% preoperatively to 75% in the electric acoustic stimulation condition.This study documents that complete and partial preservation of ipsilateral hearing after cochlear implantation can be achieved in about 70% of cases over an average period of 27.25 months when using 360 degrees electrode insertions.