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Reimplantation of Hybrid Cochlear Implant Users With a Full-Length Electrode After Loss of Residual Hearing

Fitzgerald, Matthew B.; Sagi, Elad; Jackson, Michael; Shapiro, William H.; Roland, J. Thomas Jr.; Waltzman, Susan B.; Svirsky, Mario A.

doi: 10.1097/MAO.0b013e31815c4875
Original Articles

Objective: To assess word recognition and pitch-scaling abilities of cochlear implant users first implanted with a Nucleus 10-mm Hybrid electrode array and then reimplanted with a full length Nucleus Freedom array after loss of residual hearing.

Background: Although electroacoustic stimulation is a promising treatment for patients with residual low-frequency hearing,a small subset of them lose that residual hearing. It is not clear whether these patients would be better served by leaving in the 10-mm array and providing electric stimulation through it, or by replacing it with a standard full-length array.

Methods: Word recognition and pitch-scaling abilities were measured in 2 users of hybrid cochlear implants who lost their residual hearing in the implanted ear after a few months. Tests were repeated over several months, first with a 10-mm array, and after, these patients were reimplanted with a full array. The word recognition task consisted of 2 50-word consonant nucleus consonant (CNC) lists. In the pitch-scaling task, 6 electrodes were stimulated in pseudorandom order, and patients assigned a pitch value to the sensation elicited by each electrode.

Results: Shortly after reimplantation with the full electrode array, speech understanding was much better than with the 10-mm array. Patients improved their ability to perform the pitch-scaling task over time with the full array, although their performance on that task was variable, and the improvements were often small.

Conclusion: 1) Short electrode arrays may help preserve residual hearing but may also provide less benefit than traditional cochlear implants for some patients. 2) Pitch percepts in response to electric stimulation may be modified by experience.

Department of Otolaryngology, New York University School of Medicine, New York, New York, U.S.A.

Address correspondence and reprint requests to Mario A. Svirsky, Ph.D., Department of Otolaryngology, New York University School of Medicine, 550 First Ave., NBV-5E5, New York, NY 10016; E-mail: mario.svirsky@med.nyu.edu

This work was supported by National Institutes of Health/National Institute on Deafness and Other Communication Disorders (grant no. R01-DC03937). Cochlear Corporation provided a free copy of the Custom Sound fitting software, as well as technical information and support.

© 2008 Otology & Neurotology, Inc.