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Updated: Jul 30, 2025
Author Spotlight: Optimizing EAS with Long Electrodes for Enhanced Cochlear Coverage and Hearing Preservation
Published on: October 11, 2024
Acceptance and Benefit of Electroacoustic Stimulation in Children
Emily R Spitzer1, Emily Kay-Rivest, Susan B Waltzman
1Department of Otolaryngology-Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY.
Insights
Cochlear implantation with electroacoustic stimulation (EAS) in children with residual hearing did not show improved speech perception, regardless of hearing preservation. All implanted children achieved good outcomes.
Area of Science:
- Audiology
- Otolaryngology
- Pediatric Medicine
Background:
- Cochlear implantation is considered for children with severe hearing loss and residual low-frequency hearing.
- Hearing preservation for electroacoustic stimulation (EAS) is established in adults but less studied in children.
- This study investigates hearing preservation, EAS acceptance, and benefits in pediatric patients.
Purpose of the Study:
- To explore factors influencing hearing preservation in children undergoing cochlear implantation.
- To assess the acceptance and benefits of electroacoustic stimulation (EAS) in pediatric patients.
- To compare outcomes between children with and without hearing preservation and between EAS users and nonusers.
Main Methods:
- Retrospective review of 40 children (48 ears) with low-frequency residual hearing undergoing cochlear implantation.
- Standard-length electrode insertion was used for all patients.
- Audiometric thresholds, speech perception, and EAS usage were tracked at multiple postoperative intervals.
Main Results:
- Hearing preservation rates were similar to adults, but lower in children with enlarged vestibular aqueduct.
- Less than half of eligible children opted for EAS due to various reasons.
- No significant differences in speech perception were found across groups (hearing preservation, EAS use).
Conclusions:
- Hearing preservation and EAS use did not yield superior speech perception in children with preoperative residual hearing.
- All children demonstrated good performance after cochlear implantation.
- Cochlear implantation is effective for this pediatric population, irrespective of hearing preservation or EAS adoption.
Objective:
Children with high-frequency severe-to-profound hearing loss and low-frequency residual hearing who do not derive significant benefit from hearing aids are now being considered for cochlear implantation. Previous research shows that hearing preservation is possible and may be desirable for the use of electroacoustic stimulation (EAS) in adults, but this topic remains underexplored in children. The goal of this study was to explore factors relating to hearing preservation, acceptance, and benefits of EAS for children.
Study Design:
Retrospective review.
Setting:
Tertiary academic medical center.
Patients:
Forty children (48 ears) with preoperative low-frequency pure-tone averages of 75 dB HL or less at 250 and 500 Hz (n = 48).
Intervention:
All patients underwent cochlear implantation with a standard-length electrode.
Main Outcome Measure:
Low-frequency audiometric thresholds, speech perception, and EAS usage were measured at initial stimulation, and 3 and 12 months postoperatively. Outcomes were compared between children with and without hearing preservation, and between EAS users and nonusers.
Results:
Hearing was preserved at similar rates as adults but worse for children with an enlarged vestibular aqueduct. Fewer than half of children who qualified to use EAS chose to do so, citing a variety of audiologic and nonaudiologic reasons. No differences were detected in speech perception scores across the groups for words, sentences, or sentences in noise tests.
Conclusions:
Neither hearing preservation nor EAS use resulted in superior speech perception in children with preoperative residual hearing; rather, all children performed well after implantation.
