Hearing Preservation With a Midscalar Electrode Comparison of a Regular and Steroid/Pressure Optimized Surgical Approach in Patients With Residual Hearing

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Abstract

Objective:

The aim of this study was to observe the rate of hearing preservation with a midscalar electrode with two surgical approaches.

Study Design:

Prospective study.

Setting:

Tertiary referral center.

Patients:

Twenty patients with residual hearing. Group A: 11 patients (mean age 56.1, 4 men, 7 women) mean HL 250 Hz, 36.4 dB; 500 Hz, 50.0 dB and 1 kHz, 81.4 dB. Group B: nine patients (mean age, 52.8 yr, 7 women, 2 men), 250 Hz, 36.7 dB; 500 Hz, 49.4 dB and 1 kHz, 87.8 dB.

Intervention:

Implantation with a midscalar electrode with two surgical approaches. Group A approach consisted of a slow insertion (2 min), careful round window opening, tool insertion, intraoperative and postoperative iv. prednisone, tool insertion and 24 hour postoperation bed-rest. In group B additionally the round window was widely opened and the electrode was wetted with triamcinolone.

Main Outcome Measure:

Measurement of the mean hearing loss in both groups.

Results:

We observed a statistically significant different hearing preservation for groups A and B. Although group A reached a mean hearing loss (250, 500, 1 kHz) of 42.6 dB, group B showed a mean loss of residual hearing of 9.1 dB after 1 month.

Conclusion:

A substantial rate of hearing preservation can be achieved with a midscalar electrode. A hearing preserving approach focusing on decreasing the intracochlear fluid pressure and local steroids has a strong effect on the hearing preservation.

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