Hearing Preservation in Adolescent Cochlear Implantation

Abstract

Objectives: Soft surgical techniques are increasingly being used in an attempt to preserve residual low frequency hearing in adults undergoing cochlear implantation. We describe our experience of cochlear implantation with hearing preservation in adolescents. Methods: Attempts at cochlear implantation with hearing preservation in adolescents were identified from the Manchester Auditory Implant Centre, UK. A retrospective case note review was performed, with emphasis on: functional hearing deficit pre-operatively, surgical technique, age at implantation, type of electrode implanted, and functional hearing ability at sequential follow up. Functional outcomes were evaluated with the aim of evaluating both the potential benefit of preserving residual low-frequency hearing and the maintenance of preserved hearing over time. Results: Sixteen adolescents (10 girls, 6 boys) received 18 cochlear implants over a 5 year period. The average age at implantation was 13 years, 5 months (range 10.5 to 17 years, 11 months). Average follow up was 2.5 years (range 1 year to 4 years, 3 months). Varying degrees of hearing preservation were achieved across the group, with hearing preservation being successful in all cochlear implantations. Detailed analysis of the audiological outcomes will be presented. Functional hearing significantly improved in all patients over time, including 3 patients whose low frequency hearing diminished with time. Conclusions: Residual hearing can be preserved in adolescents using a soft surgical technique. Adolescents may require several re-insertions of their cochlear implants over a lifetime and therefore increasing emphasis is being placed on atraumatic electrode insertion, in order to limit intra-cochlear scarring.