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Residual hearing preservation using the suprameatal approach for cochlear implantation

Restgehörerhalt bei Cochlea Implantation über den suprameatalen Zugang

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Zusammenfassung

EINLEITUNG: Die Cochlea Implantation von Patienten mit Hochtonhörverlust jedoch erhaltenem Hörvermögen im Tieftonbereich ist in den letzten Jahren zu einer neuem Standard der Versorgung geworden. Das Ziel dieser Studie war es, die Rate des Restgehörerhalts bei Patienten, die sich einer Cochlea Implantation für die elektrisch-akustische Stimulation per suprameatalem Zugang unterzogen, zu ermitteln. METHODE: 5 Patienten (mittleres Alter 48,2 Jahre), die mit Cochlea Implantaten der Firma MedEl (Combi 40+, Pulsar) und unterschiedlichen Elektroden (Custom made, Flex soft, Flex EAS) versorgt wurden, wurden bezüglich Restgehörerhalt nach einem mittleren Nachbeobachtungszeitraum von 35,6 Monaten (24 bis 77 Monate) untersucht. RESULTATE: 3 Patienten zeigten einen partiellen Hörerhalt, bei 2 Patienten wurde ein kompletter Verlust des Restgehörs beobachtet. SCHLUSSFOLGERUNG: Obwohl die Rate des Restgehörerhalts in der vorliegenden Patientengruppe, die mittels suprameatalem Zugang operiert wurde, geringer ist, als bei jenen Patienten, die einen konventionellen Mastoidektomie-Zugang erhielten, so zeigt diese Studie jedoch erstmalig, daß es in der Tat möglich ist, das Restgehör auch bei einem Zugang ohne Mastoidektomie zu erhalten. Dennoch, um die Frage zu beantworten, ob diese Technik grundsätzlich bei Patienten mit elektrisch-akustischer Stimulation empfohlen werden kann, ist weitere Erfahrung notwendig.

Summary

OBJECTIVE: Cochlear implantation of patients with high-frequency hearing loss and residual low-frequency hearing has become a new treatment standard within the last years. The objective of this study was to evaluate the rate of hearing preservation in cochlear implantation for electric-acoustic stimulation using the suprameatal approach. METHODS: Five patients (mean age 48.2 years) who were supplied with Med El (Combi 40+, Pulsar) cochlear implants and various different electrodes (Custom made, Flex soft, Flex EAS) were evaluated for residual hearing preservation after a mean follow-up time of 35.6 months (range 24 to 77 months). RESULTS: Three patients showed partial hearing preservation, whereas 2 patients experienced a complete loss of residual hearing. CONCLUSION: Although hearing preservation rates in this series of patients operated on using the suprameatal approach were inferior as compared with a series using the standard mastoidectomy approach, this study shows that it is in fact possible to preserve residual hearing using a non-mastoidectomy surgical technique for cochlear implantation. Nevertheless, more experience is necessary to answer the question whether this technique can be thoroughly recommended in cochlear implantation for electric-acoustic stimulation.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria

    Christoph Arnoldner, Wolfgang Gstoettner, Dominik Riss, Clemens Honeder, Michaela Blineder, Jafar-Sasan Hamzavi, Alexandra Jappel & Wolf-Dieter Baumgartner

  2. Department of Otorhinolaryngology, Johann Wolfgang Goethe University, Frankfurt/Main, Germany

    Jens Wagenblast

Authors
  1. Christoph Arnoldner
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  2. Wolfgang Gstoettner
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  3. Dominik Riss
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  4. Jens Wagenblast
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  5. Clemens Honeder
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  6. Michaela Blineder
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  7. Jafar-Sasan Hamzavi
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  8. Alexandra Jappel
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  9. Wolf-Dieter Baumgartner
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Correspondence to Christoph Arnoldner.

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Arnoldner, C., Gstoettner, W., Riss, D. et al. Residual hearing preservation using the suprameatal approach for cochlear implantation. Wien Klin Wochenschr 123, 599–602 (2011). https://doi.org/10.1007/s00508-011-0043-7

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  • DOI: https://doi.org/10.1007/s00508-011-0043-7

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