Cochlear Reimplantation after Surgery for Electric-Acoustic Stimulation

Background/Aims: Combined electric-acoustic stimulation (EAS) of the auditory system usually results in better speech understanding than electric stimulation only, assuming low-frequency hearing can be preserved. Treatment options and outcomes for 4 subjects experiencing compromised hearing after EAS surgery are discussed. Methods: Each subject underwent revision surgery to replace the original 21-mm electrode arrays used in EAS surgery with cochlear implants (CIs) with 31-mm arrays. Our aims were: (1) to investigate whether deeper insertion is possible, and (2) to evaluate the influence of electrode insertion angle by comparing speech perception scores before and after revision surgery. Results: Deeper insertion was feasible in all subjects. Speech understanding scores after reimplantation were comparable to those seen after the first intervention. Conclusion: A 360-degree insertion under EAS conditions provides sufficient speech understanding, even in cases of additional hearing loss. Reimplantation with a longer electrode array is feasible in former EAS patients.

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