Long-term Hearing Preservation and Speech Perception Performance Outcomes With the Slim Modiolar Electrode

Area of Science:

• Audiology
• Otolaryngology
• Neurosurgery

Background:

• Cochlear implantation aims to restore hearing, with hearing preservation (HP) being a key goal.
• Slim modiolar electrodes (SMEs) are designed to minimize cochlear trauma during implantation.
• Assessing audiologic outcomes in HP candidates receiving SMEs is crucial for surgical technique refinement.

Purpose of the Study:

• To evaluate the audiologic outcomes, specifically hearing preservation rates, in cochlear implant candidates receiving a slim modiolar electrode (SME).
• To compare speech perception performance between patients who achieved hearing preservation and those who did not.

Main Methods:

• A retrospective analysis of 203 adult cochlear implant patients who received an SME electrode.
• Hearing preservation was defined as a postoperative low-frequency pure-tone average (LFPTA) ≤80 dB HL.
• Audiologic outcomes and speech perception tests (CNC, AzBio, HINT) were analyzed at early (3 months) and long-term (6-12 months) follow-up intervals.

Main Results:

• The overall hearing preservation rate was 45.5% early and 43.7% long-term for candidates with preoperative LFPTA ≤80 dB HL.
• For patients with better preoperative hearing (LFPTA ≤60 dB HL), early and long-term HP rates were 61.1% and 50.8%, respectively.
• No significant differences in speech perception scores were observed between the HP and non-HP groups at any follow-up point.

Conclusions:

• Hearing preservation is achievable with the use of slim modiolar electrodes in cochlear implant surgery.
• Despite successful HP, there was no discernible benefit in speech perception compared to non-HP patients in this cohort.
• The current criteria for defining hearing preservation candidacy (preoperative LFPTA ≤80 dB HL) may warrant re-evaluation.