Head & Neck Institute Outcomes
Hearing Outcomes After Cochlear Implant Surgery in Patients With Residual Hearing
Criteria for cochlear implantation (CI) have expanded to include patients with increasing amounts of residual acoustic hearing. The expectation of improved speech understanding exists with or without residual acoustic hearing; however, hearing preservation (HP) is of emerging relevance to CI surgeons. If low-frequency hearing (LFH) is preserved at aidable levels, patients typically have better performance in background noise and have a greater ability to appreciate music.¹
In 2021, Cleveland Clinic’s Hearing Implant Program used 4 different electrode arrays in hearing preservation cases: Cochlear Americas (Denver, Colorado) Cochlear™ slim perimodiolar array (Nucleus® 532 and 632), Nucleus slim lateral wall array (Nucleus 522, 622 and 624), Hybrid™ L24, and Advanced Bionics (Valencia, California) HiFocus™ Ultra 3D Midscala. The initial choice of platform was made by the patient. Surgeon preference or anatomy steered the choice of the perimodiolar or lateral wall arrays intraoperatively, except where patient specifically met Hybrid criteria. Whenever possible a round window insertion technique was used.
The Hearing Implant Program identifies CI candidates as having potential for HP if they have an aidable low-frequency (125–500 Hz) pure-tone average (LFPTA) ≤ 80 dB HL (hearing level). The average preoperative LFPTA for HP candidates in 2021 was 55.3 dB. Postoperative hearing thresholds were assessed 4 weeks after surgery.
Average change in hearing
HP = hearing preservation