Predictive factors for short‐ and long‐term hearing preservation in cochlear implantation with conventional‐length electrodes

• DOI: 10.1002/lary.26714
• Publication Date: 2017-06-23T04:39:00Z
• Authors: George B. Wanna; Brendan P. O'Connell; David O. Francis; Rene H. Gifford; Jacob B. Hunter; Jourdan T. Holder; Marc L. Bennett; Alejandro Rivas; Robert F. Labadie; David S. Haynes
• Keywords: Adult; Aged, 80 and over; Male; Adolescent; Auditory Threshold; Deafness; Middle Aged; Cochlear Implantation; Electrodes, Implanted; Time; 03 medical and health sciences; 0302 clinical medicine; Hearing; Round Window, Ear; Multivariate Analysis; Odds Ratio; Audiometry, Pure-Tone; Humans; Female; Postoperative Period; Aged; Retrospective Studies

Objectives/HypothesisThe aims of this study were to investigate short‐ and long‐term rates of hearing preservation after cochlear implantation and identify factors that impact hearing preservation.Study DesignRetrospective review.MethodsPatients undergoing cochlear implantation with conventional‐length electrodes and air‐conduction thresholds ≤80 dB HL at 250 Hz preoperatively were included. Hearing preservation was defined as air‐conduction thresholds ≤80 dB HL at 250 Hz.ResultsThe sample included 196 patients (225 implants). Overall, the rate of short‐term hearing preservation was 38% (84/225), with 18% (33/188) of patients preserving hearing long term. Multivariate analysis showed better preoperative hearing was predictive of hearing preservation at short (odds ratio [OR]: 0.93, 95% confidence interval [CI]: 0.91‐0.95, P < .001) and long‐term follow‐up (OR: 0.94, 95% CI: 0.91‐0.97, P < .001). Lateral wall electrodes and mid‐scala electrodes had 3.4 (95% CI: 1.4‐8.6, P = .009) and 5.6‐times (95% CI: 1.8‐17.3, P = .003) higher odds of hearing preservation than perimodiolar arrays at short‐term follow‐up, respectively. Long‐term data revealed better hearing preservation for lateral wall (OR: 7.6, 95% CI: 1.6‐36.1, P = .01), but not mid‐scala (OR: 3.1, 95% CI: 0.4‐23.1, P = .28), when compared to perimodiolar electrodes. Round window/extended round window (RW/ERW) approaches were associated with higher rates of long‐term hearing preservation (21%) than cochleostomy approaches (0%) (P = 0.002) on univariate analysis.ConclusionsBetter preoperative residual hearing, lateral wall electrodes, and RW/ERW approaches are predictive of higher rates of long‐term functional hearing preservation.Level of Evidence4. Laryngoscope, 128:482–489, 2018