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Hearing Preservation after Cochlear Implantation: UNICAMP Outcomes

DOI: 10.1155/2013/107186

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Background. Electric-acoustic stimulation (EAS) is an excellent choice for people with residual hearing in low frequencies but not high frequencies and who derive insufficient benefit from hearing aids. For EAS to be effective, subjects' residual hearing must be preserved during cochlear implant (CI) surgery. Methods. We implanted 6 subjects with a CI. We used a special surgical technique and an electrode designed to be atraumatic. Subjects' rates of residual hearing preservation were measured 3 times postoperatively, lastly after at least a year of implant experience. Subjects' aided speech perception was tested pre- and postoperatively with a sentence test in quiet. Subjects' subjective responses assessed after a year of EAS or CI experience. Results. 4 subjects had total or partial residual hearing preservation; 2 subjects had total residual hearing loss. All subjects' hearing and speech perception benefited from cochlear implantation. CI diminished or eliminated tinnitus in all 4 subjects who had it preoperatively. 5 subjects reported great satisfaction with their new device. Conclusions. When we have more experience with our surgical technique we are confident we will be able to report increased rates of residual hearing preservation. Hopefully, our study will raise the profile of EAS in Brazil and Latin/South America. 1. Introduction Just over a decade ago people with sensorineural hearing loss had 2 main hearing (re)habilitation options: (1) a hearing aid (HA) if they had mild to moderate hearing loss and (2) a cochlear implant (CI) if they had severe to profound hearing loss. These 2 device options improved most users’ hearing. However, people who could hear in the low frequencies (up to 1000?Hz) but not the medium and high frequencies—the downward or “ski slope” audiogram—had too much high frequency hearing loss to benefit from their hearing aid(s) but were not CI candidates because surgeons feared the surgery would destroy their residual hearing. A solution for such people is electric-acoustic stimulation (EAS), a concept developed by von Ilberg and colleagues in 1999 [1]. EAS provides synergistic unilateral acoustic (via the HA) and electrical (via the CI) stimulation and provides its users with better hearing than they had had with their HA or HAs [2–4] and better hearing than enjoyed by unilateral CI-only users [1–5], especially in noisy environments [2–4, 6–9]. EAS also provides better sound quality and more natural hearing than unilateral CIs or HAs [4, 10]. These benefits are, however, only possible if surgeons do not damage the cochlea

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