Janitha Jayawardena1, Jafri Kuthubutheen, Gunesh Rajan. 1. Division of Otolaryngology, Head and Neck Surgery, School of Surgery, University of Western Australia, Perth, Australia. janithami6@gmail.com
Abstract
OBJECTIVE: To report and review the clinical experiences of patients who required reimplantation from an ongoing trial of patients with partial deafness who were treated with electroacoustic stimulation (EAS) cochlear implantation. STUDY DESIGN: Retrospective case series review. SETTING: Tertiary referral center. PATIENTS: Two patients with partial deafness, 1 child and 1 adult, who required reimplantation because of device failure occurring 12 to 18 months after hearing preservation cochlear implantation with a Med-El Sonata Flex-EAS electrode array. INTERVENTION: Reimplantation (with full insertion) of a Med-El Sonata Flex-EAS array (child) and the new complete cochlear coverage Med-El Sonata Flex-28 electrode array (adult). Surgical techniques used include round window insertion with slow insertion speed and the use of preoperative systemic steroids and preoperative, perioperative, and postimplantation intratympanic steroids. MAIN OUTCOME MEASURE: Preservation of residual hearing. RESULTS: Both patients had complete preservation of residual hearing after reimplantation. The adult patient had stable improvement in hearing from 750 to 2,000 Hz of 5 to 10 dB. Both patients reported increased benefit after reimplantation. CONCLUSION: We report a case series of successful pediatric and adult EAS reimplantation, in the adult hearing improvement after reimplantation with a deep insertion electrode was observed. Reimplantation with preservation of residual hearing in patients with EAS is possible with current surgical hearing preserving techniques and atraumatic electrode arrays of variable length.
OBJECTIVE: To report and review the clinical experiences of patients who required reimplantation from an ongoing trial of patients with partial deafness who were treated with electroacoustic stimulation (EAS) cochlear implantation. STUDY DESIGN: Retrospective case series review. SETTING: Tertiary referral center. PATIENTS: Two patients with partial deafness, 1 child and 1 adult, who required reimplantation because of device failure occurring 12 to 18 months after hearing preservation cochlear implantation with a Med-El Sonata Flex-EAS electrode array. INTERVENTION: Reimplantation (with full insertion) of a Med-El Sonata Flex-EAS array (child) and the new complete cochlear coverage Med-El Sonata Flex-28 electrode array (adult). Surgical techniques used include round window insertion with slow insertion speed and the use of preoperative systemic steroids and preoperative, perioperative, and postimplantation intratympanic steroids. MAIN OUTCOME MEASURE: Preservation of residual hearing. RESULTS: Both patients had complete preservation of residual hearing after reimplantation. The adult patient had stable improvement in hearing from 750 to 2,000 Hz of 5 to 10 dB. Both patients reported increased benefit after reimplantation. CONCLUSION: We report a case series of successful pediatric and adult EAS reimplantation, in the adult hearing improvement after reimplantation with a deep insertion electrode was observed. Reimplantation with preservation of residual hearing in patients with EAS is possible with current surgical hearing preserving techniques and atraumatic electrode arrays of variable length.
Authors: Paul H Van de Heyning; Stefan Dazert; Javier Gavilan; Luis Lassaletta; Artur Lorens; Gunesh P Rajan; Henryk Skarzynski; Piotr H Skarzynski; Dayse Tavora-Vieira; Vedat Topsakal; Shin-Ichi Usami; Vincent Van Rompaey; Nora M Weiss; Marek Polak Journal: Front Surg Date: 2022-07-01