Introduction: The Nucleus Straight Research Array (SRA) cochlear implant has a new 25-mm electrode carrier designed to minimize insertion trauma, in particular allowing easy insertion via the round window. The aims of this study were to measure preoperative to postoperative benefit in terms of speech recognition in quiet and in noise in three groups of patients (electrical complement, EC; electrical stimulation, ES; electro-acoustic stimulation, EAS) with varying levels of low-frequency hearing, and to evaluate the preservation of residual hearing after implantation with the SRA cochlear implant. Methods: The study design was prospective with sequential enrolment and within-subject comparisons: 23 adult cochlear implant candidates were divided into three groups according to their level of preoperative residual hearing at 500 Hz (EC ≤50 dB; 50 dB < EAS < 80 dB; ES ≧80 dB). Monosyllabic word recognition using the SRA cochlear implant in combination with residual low-frequency hearing was assessed at 4 and 13 months after implantation. Hearing threshold levels were also monitored over time. Results: Subjects across all three groups had significant improvements in speech recognition scores (i.e. >20 percentage points) both for listening in quiet (71% of subjects) and in noise (100% of subjects). The average score at 4 months after operation for words presented in quiet was 61.7%, and in 10 dB SNR noise 46.5%, compared to 34.4 and 10.6% preoperatively (p < 0.001). All subjects retained measurable hearing at 500 Hz in the implanted ear at 4 months after the operation; mean increases were 19, 29 and 1 dB for the EC, EAS and ES groups (n = 21). Across frequencies of 125–1000 Hz, the median increase in thresholds was 15 dB up to 13 months postoperatively (n = 15). Conclusions: Speech recognition performance of subjects with various levels of residual low-frequency hearing was significantly improved with the SRA cochlear implant. A high level and rate of hearing preservation was achieved with the SRA implanted using a round window surgical technique. Subjects with preoperative low-frequency hearing levels between 50 and 80 dB HL (EAS group) tended to lose more hearing than those with either better or worse hearing.

1.
Adunka O, Unkelbach MH, Mack M, Hambek M, Gstoettner W, Kiefer J: Cochlear implantation via the round window membrane minimizes trauma to cochlear structures: a histologically controlled insertion study. Acta Otolaryngol 2004;124:807–812.
2.
Briggs RJ, Tykocinski M, Xu J, Risi F, Svehla M, Cowan R, Stover T, Erfurt P, Lenarz T: Comparison of round window and cochleostomy approaches with a prototype hearing preservation electrode. Audiol Neurootol 2006;11(suppl 1):42–48.
3.
Ching TYC, Dillon H, Byrne D: Speech recognition of hearing-impaired listeners: prediction from audibility and the limited role of high-frequency amplification. J Acoust Soc Am 1998;103:1128–1140.
4.
Escudé B, James C, Deguine O, Cochard N, Eter E, Fraysse B: The size of the cochlea and predictions of insertion depth angles for cochlear implant electrodes. Audiol Neurotol 2006;11(suppl 1):27–33.
5.
Fitzgerald MB, Sagi E, Jackson M, Shapiro WH, Roland JT Jr, Waltzman SB, Svirsky MA: Reimplantation of hybrid cochlear implant users with a full-length electrode after loss of residual hearing. Otol Neurotol 2008;29:168–173.
6.
Fraysse B, Ramos A, Sterkers O, et al: Residual hearing conservation and electro-acoustic stimulation with the Nucleus Contour Advance cochlear implant. Otol Neurotol 2006;27:624–633.
7.
Gantz BJ, Turner CW: Combining acoustic and electrical hearing. Laryngoscope 2003;113:1726–1730.
8.
Gantz BJ, Turner C: Combining acoustic and electrical speech processing: Iowa/Nucleus hybrid implant. Acta Otolaryngol 2004;124:344–347.
9.
Gstoettner W, Kiefer J, Baumgartner WD, Pok S, Peters S, Adunka O: Hearing preservation in cochlear implantation for electric acoustic stimulation. Acta Otolaryngol 2004;124:348–352.
10.
Gstoettner WK, Helbig S, Maier N, Kiefer J, Radeloff A, Adunka OF: Ipsilateral electric acoustic stimulation of the auditory system: results of long-term hearing preservation. Audiol Neurootol 2006;11(suppl 1):49–56.
11.
Gstoettner W, Helbig S, Settevendemie C, Baumann U, Wagenblast J, Arnoldner C: A new electrode for residual hearing preservation in cochlear implantation: first clinical results. Acta Otolaryngol 2009;129:372–379.
12.
Hogan CA, Turner CW: High-frequency audibility: benefits for hearing-impaired listeners. J Acoust Soc Am 1998;104:432–441.
13.
James CJ, Fraysse B, Deguine O, Lenarz T, Mawman D, Ramos A, Ramsden R, Sterkers O: Combined electroacoustic stimulation in conventional candidates for cochlear implantation. Audiol Neurootol 2006;11(suppl 1):57–62.
14.
Kiefer J, Gstoettner W, Baumgartner W, Pok SM, Tillein J, Ye Q, von Ilberg C: Conservation of low-frequency hearing in cochlear implantation. Acta Otolaryngol 2004;124:272–280.
15.
Lehnhardt E: Intracochlear placement of cochlear implant electrodes in soft surgery technique (in German). HNO 1993;41:356–359.
16.
Lenarz T, Stöver T, Buechner A, et al: Temporal bone results and hearing preservation with a new straight electrode. Aud Neurotol 2006;11(suppl 1):34–41.
17.
Lenarz T, Stöver T, Buechner A, Lesinski-Schiedat A, Patrick J, Pesch J: Hearing conservation surgery using the Hybrid-L electrode: results from the first clinical trial at the Medical University of Hannover. Audiol Neurootol 2009;14(suppl 1):22–31.
18.
Li PM, Somdas MA, Eddington DK, Nadol JB Jr: Analysis of intracochlear new bone and fibrous tissue formation in human subjects with cochlear implants. Ann Otol Rhinol Laryngol. 2007;116:731–738.
19.
Nadol JB Jr, Eddington DK: Histopathology of the inner ear relevant to cochlear implantation. Adv Otorhinolaryngol 2006;64:31–49.
20.
Pruszewicz A, Demenko G, Richter L, Wika T: New articulation lists for speech audiometry. Part II. Otolaryngol Pol 1994;48:56–62.
21.
Roland JT, Zeitler DM, Jethanamest D, Huang TC: Evaluation of the short hybrid electrode in human temporal bones. Otol Neurotol 2008;29:482–488.
22.
Roland PS, Wright CG: Surgical aspects of cochlear implantation: mechanisms of insertional trauma. Adv Otorhinolaryngol 2006;64:11–30.
23.
Skarzynski H, Lorens A, Piotrowska A: A new method of partial deafness treatment. Med Sci Monit 2003;9:CS20–CS24.
24.
Skarzynski H, Lorens A, Piotrowska A, Anderson I: Preservation of low frequency hearing in partial deafness cochlear implantation (PDCI) using the round window surgical approach. Acta Otolaryngol 2007;127:41–48.
25.
Skarzyński H, Lorens A, Piotrowska A, Podskarbi-Fayette R: Results of partial deafness cochlear implantation using various electrode designs. Audiol Neurootol 2009;14(suppl 1): 39–45.
26.
Skarzynski H, Lorens A: Partial deafness treatment. Cochlear Implant Int 2010;11(suppl 1): 29–41.
27.
Skarzynski H, Podskarbi-Fayette R: A new cochlear implant electrode design for preservation of residual hearing: a temporal bone study. Acta Otolaryngol 2010;130:435–442.
28.
Skinner MW, Ketten DR, Holden LK, Harding GW, Smith PG, Gates GA, Neely JG, Kletzker GR, Brunsden B, Blocker B: CT-derived estimation of cochlear morphology and electrode array position in relation to word recognition in Nucleus-22 recipients. J Assoc Res Otolaryngol 2002;3:332–350.
29.
von Ilberg C, Kiefer J, Tillien J, et al: Electric-acoustic stimulation of the auditory system: new technology against severe hearing loss. ORL J Otorhinolaryngol Relat Spec 1999;61:334–340.
30.
Woodson EA, Reiss LA, Turner CW, Gfeller K, Gantz BJ: The Hybrid cochlear implant: a review. Adv Otorhinolaryngol 2010;67:125–134.
31.
Xu J, Xu SA, Cohen LT, Clark GM: Cochlear view: postoperative radiography for cochlear implantation. Am J Otol 2000;21:49–56.
32.
Yukawa K, Cohen L, Blamey P, Pyman B, Tungvachirakul V, O’Leary S: Effects of insertion depth of cochlear implant electrodes upon speech perception. Audiol Neurootol 2004;9:163–172.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.