Preservation of low frequency hearing in partial deafness cochlear implantation (PDCI) using the round window surgical approach

TLDR

Successful hearing preservation is possible in individuals with excellent low‑frequency hearing. This paper reports a round‑window surgical technique for partial insertion of MED‑EL cochlear implant electrodes to preserve low‑frequency hearing in partial deafness patients. Ten subjects underwent partial insertion of a standard MED‑EL electrode via the round window, with pure‑tone audiometry performed pre‑op, at fitting, and at 1, 3, 6, and 12 months post‑implant. Nine of ten subjects preserved low‑frequency hearing with stable audiometry up to one year; eight used the implant with natural hearing, one used a hearing aid for low frequencies, and one subject lost all hearing two weeks post‑implant.

Abstract

Successful hearing preservation is possible in individuals with excellent low frequency hearing. This is possible due to the partial insertion of an atraumatic electrode using an atraumatic round window surgical technique.This paper describes the round window surgical technique used to preserve excellent low frequency hearing in patients receiving partially inserted MED-EL cochlear implant electrodes. Results of preserved low frequency hearing in partial deafness cochlear implantation (PDCI) are reported.The surgical approach is described in detail. Ten subjects received a partial insertion of a standard electrode, using the round window approach. Pure tone audiometry was conducted in the implanted and non-implanted ear preoperatively, at implant fitting and then at 1, 3, 6 and 12 months after initial device fitting.Results show hearing preservation in 9 of the 10 subjects. One subject lost all hearing 2 weeks after cochlear implantation. Hearing has remained essentially stable up to the 1 year postoperative period. Eight of the nine subjects use the cochlear implant together with their natural low frequency hearing; one subject uses a hearing aid in the implanted ear to amplify the low frequencies.