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Advances in hearing preservation in cochlear implant surgery
Journal article   Open access

Advances in hearing preservation in cochlear implant surgery

Osama Tarabichi, Megan Jensen and Marlan R. Hansen
Current opinion in otolaryngology & head and neck surgery, Vol.29(5), pp.385-390
10/01/2021
DOI: 10.1097/MOO.0000000000000742
PMCID: PMC9002354
PMID: 34354014
url
https://www.ncbi.nlm.nih.gov/pmc/articles/9002354View
Open Access

Abstract

Purpose of review Advancements in cochlear implant surgical approaches and electrode designs have enabled preservation of residual acoustic hearing. Preservation of low-frequency hearing allows cochlear implant users to benefit from electroacoustic stimulation, which improves performance in complex listening situations, such as music appreciation and speech understanding in noise. Despite the relative high rates of success of hearing preservation, postoperative acoustic hearing outcomes remain unpredictable. Recent findings Thin, flexible, lateral wall arrays are preferred for hearing preservation. Both shortened and thin, lateral wall arrays have shown success with hearing preservation and the optimal implant choice is an issue of ongoing investigation. Electrocochleography can monitor cochlear function during and after insertion of the electrode array. The pathophysiology of hearing loss acutely after cochlear implant may differ from that involved in delayed hearing loss following cochlear implant. Emerging innovations may reduce cochlear trauma and improve hearing preservation. Hearing preservation is possible using soft surgical techniques and electrode arrays designed to minimize cochlear trauma; however, a subset of patients suffer from partial to total loss of acoustic hearing months to years following surgery despite evidence of residual apical hair cell function. Early investigations in robotic-assisted insertion and dexamethasone-eluting implants show promise.
Life Sciences & Biomedicine Otorhinolaryngology Science & Technology

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