Preservation of residual hearing following cochlear implantation: comparison between three surgical techniques

TLDR

Preserving residual hearing in cochlear implant surgery is increasingly important because it improves speech understanding, provides stable long‑term performance, and permits combined electro‑acoustic stimulation. The study aimed to determine which electrode array and cochleostomy technique best preserves residual hearing. A retrospective comparison was performed on three patient groups implanted with different electrode arrays and cochleostomy approaches. The combination of the Contour Advance array, Advance Off‑Stylet technique, and modified anterior inferior cochleostomy preserved hearing in 81.8 % of patients by minimizing lateral‑wall trauma.

Abstract

The preservation of residual hearing is becoming a high priority in cochlear implant surgery. It allows better speech understanding and ensures long-lasting and stable performance; it also allows the possibility, in selected cases, of combining electro-acoustic stimulation in the same ear. We present the results of a retrospective study of the conservation of residual hearing in three different groups of patients who had undergone cochlear implantation using three different cochlear implant electrode arrays, combined with three different surgical techniques for the cochleostomy. The study aimed to evaluate which approach allowed greater preservation of residual hearing. The best residual hearing preservation results (i.e. preservation in 81.8 per cent of patients) were achieved with the Contour Advance electrode array, using the Advance Off-Stylet technique and performing a modified anterior inferior cochleostomy; this combination enabled reduced trauma to the lateral wall of the cochlea during electrode insertion.