You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Residual Hearing Preservation After Pediatric Cochlear Implantation

Brown, Ryan F.*; Hullar, Timothy E.*†‡; Cadieux, Jamie H.‡§; Chole, Richard A.*‡∥

Otology & Neurotology:
doi: 10.1097/MAO.0b013e3181f0c649
Cochlear Implants

Objective: This study is designed to test the hypothesis that preservation of residual hearing in a pediatric population is possible using standard electrode arrays with full-length insertions. Surgical technique during implantation also is described.

Study Design: Retrospective review of patient medical records.

Setting: Academic tertiary care center.

Patients: Thirty-one severely to profoundly hearing impaired pediatric patients with some residual hearing precochlear implantation.

Intervention: Cochlear implantation using a modified "soft surgery" protocol.

Main Outcome Measures: Preimplant and postimplant pure tone thresholds and pure-tone average were calculated from unaided preoperative and postoperative audiograms from 250, 500, and 1,000 Hz. Hearing preservation rates were determined to be complete (loss of ≤10 dB), moderate (loss of 11-20 dB), marginal (loss of 21-40 dB), or none (loss of >40 dB or no response at the limits of the audiometer). Functional residual hearing rates (defined in this study as at least 1 threshold better than or equal to 75 dB HL for 250, 500, or 1,000 Hz were calculated.

Results: Complete hearing preservation was achieved in 14 (45.2%) of 31 patients, whereas 28 (90.3%) of 31 had at least partial hearing preservation (loss of ≤40 dB). The preoperative to postoperative low-frequency pure-tone average had a mean change of 18.5 dB and median change of 20 dB. Of the patients who had preoperative functional hearing, 9 (50.0%) of 18 maintained functional residual hearing postoperatively for at least 1 pitch.

Conclusion: Preservation of residual hearing is feasible in pediatric cochlear implant patients using standard-length electrode arrays with full insertions. These data have implications for cochlear implantation in pediatric patients who are at higher risk of progressive hearing loss than adults.

Author Information

Departments of *Otolaryngology-Head and Neck Surgery, and †Anatomy and Neurobiology, ‡Program in Audiology and Communication Sciences, Washington University School of Medicine; §Cochlear Implant Program, Saint Louis Children's Hospital; and ∥Department of Developmental Biology, Washington University School of Medicine, St. Louis, Missouri, U.S.A.

Address correspondence and reprint requests to Richard A. Chole, M.D., Ph.D., Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, Campus Box 8115, 660 South Euclid Avenue, St. Louis, MO 63110; E-mail:

Supported by grants NIH/NIDCD R01 DC000263 (RAC) and NIH/NIDCD K08 DC 006869 (TEH).

© 2010 Otology & Neurotology, Inc.