OBJECTIVES: To demonstrate the possibility of atraumatic insertion with the free-fitting FLEX electrode by evaluating the degree of hearing preservation postoperatively. DESIGN: Retrospective study. SETTING: Academic tertiary care center. PARTICIPANTS: Twenty-two severely to profoundly hearing impaired subjects with measurable residual hearing preoperatively. INTERVENTION: Atraumatic implantation with the 31.5-mm-long, free-fitting, and highly flexible FLEX electrode using either the round window approach or a cochleostomy technique. MAIN OUTCOME MEASURES: Subjects were tested preoperatively in unaided condition and at varying intervals postoperatively. Preoperative and postoperative low-frequency pure-tone average (PTA) and PTA shifts were calculated. Speech perception was measured preoperatively and postoperatively using the Freiburger monosyllabic word test in quiet. RESULTS: Preoperative low-frequency hearing could be preserved to a certain degree in 77.3% of subjects (17/22) after insertion of the FLEX electrode up to the point of first resistance. Complete loss of residual hearing was observed in 22.7% of subjects (5/22). In 18.2% of the subjects (4/22), the preoperative PTA was preserved within 10 dB. Pure-tone average results between preoperative and most recent testing showed statistically significant differences (p < 0.001 to p = 0.031) for almost all loudness levels ranging from 125 Hz to 1.5 kHz. The maximum threshold shift was 40 dB at 250 Hz for the lower frequencies up to 1 kHz. Monosyllable testing in quiet demonstrated significant improvement over time (p < 0.001). CONCLUSION: This study showed that preservation of residual hearing is possible in a high number of subjects when a flexible electrode and atraumatic surgical techniques are used.
OBJECTIVES: To demonstrate the possibility of atraumatic insertion with the free-fitting FLEX electrode by evaluating the degree of hearing preservation postoperatively. DESIGN: Retrospective study. SETTING: Academic tertiary care center. PARTICIPANTS: Twenty-two severely to profoundly hearing impaired subjects with measurable residual hearing preoperatively. INTERVENTION: Atraumatic implantation with the 31.5-mm-long, free-fitting, and highly flexible FLEX electrode using either the round window approach or a cochleostomy technique. MAIN OUTCOME MEASURES: Subjects were tested preoperatively in unaided condition and at varying intervals postoperatively. Preoperative and postoperative low-frequency pure-tone average (PTA) and PTA shifts were calculated. Speech perception was measured preoperatively and postoperatively using the Freiburger monosyllabic word test in quiet. RESULTS: Preoperative low-frequency hearing could be preserved to a certain degree in 77.3% of subjects (17/22) after insertion of the FLEX electrode up to the point of first resistance. Complete loss of residual hearing was observed in 22.7% of subjects (5/22). In 18.2% of the subjects (4/22), the preoperative PTA was preserved within 10 dB. Pure-tone average results between preoperative and most recent testing showed statistically significant differences (p < 0.001 to p = 0.031) for almost all loudness levels ranging from 125 Hz to 1.5 kHz. The maximum threshold shift was 40 dB at 250 Hz for the lower frequencies up to 1 kHz. Monosyllable testing in quiet demonstrated significant improvement over time (p < 0.001). CONCLUSION: This study showed that preservation of residual hearing is possible in a high number of subjects when a flexible electrode and atraumatic surgical techniques are used.
Authors: Emily S Hollis; Michael W Canfarotta; Margaret T Dillon; Meredith A Rooth; Andrea L Bucker; Sarah A Dillon; Allison Young; Kristen Quinones; Harold C Pillsbury; Matthew M Dedmon; Brendan P O'Connell; Kevin D Brown Journal: Otol Neurotol Date: 2021-09-01 Impact factor: 2.619
Authors: Manuel Christoph Ketterer; A Aschendorff; S Arndt; I Speck; A K Rauch; R Beck; F Hassepass Journal: Eur Arch Otorhinolaryngol Date: 2020-10-22 Impact factor: 2.503