Kleine Punte Andrea, Vermeire Katrien, Van de Heyning Paul
Adv Otorhinolaryngol. 2010;67:144-152. doi: 10.1159/000262606. Epub 2009 Nov 25.
BACKGROUND/AIMS: A patient with bilateral severe, sloping, high-frequency hearing loss was treated with sequential bilateral electric acoustic stimulation (EAS) using the MED-EL Duet EAS cochlear implant. On one side, a partial 18-mm insertion of the electrode array (M-type) in the cochlea was performed. The contralateral side was implanted 39 months later with a deep 30-mm insertion of the electrode array (FLEX(soft) type). The aims were to assess whether low-frequency hearing could be preserved after deep electrode insertion, as well as to assess the benefit of bilateral EAS surgery compared to monaural EAS.
Hearing thresholds and speech recognition outcomes were measured preoperatively and up to 48 months postoperatively. Outcomes from the partial and deep insertion side are compared. The benefit of EAS in daily life was assessed with the Abbreviated Profile of Hearing Aid Benefit questionnaire. Benefits of bilateral EAS were calculated from speech reception thresholds measured using the LINT speech-in-noise number test. Speech was always presented from the front. Noise was either presented from the front, from the left side, or from the right side. Each condition was measured for unilateral and bilateral EAS use.
Partial as well as deep insertion of the electrode array resulted in hearing preservation and significant speech recognition in this particular case. Both EAS devices provided more than 80% speech recognition in noise at a 10-dB signal-to-noise ratio. Bilateral EAS was beneficial for speech reception in noise compared to monaural EAS. A head shadow effect of 3.4 dB, binaural squelch effect of 1.2 dB and binaural summation effect of 0.5 dB were measured.
Hearing preservation is also possible after cochlear implantation using a FLEX(soft) electrode array with a near-full insertion (30 mm) into the cochlea. Bilateral EAS was successfully implemented in this patient providing better speech recognition compared to monaural EAS.
背景/目的：一名患有双侧重度、倾斜性、高频听力损失的患者接受了使用MED-EL Duet EAS人工耳蜗的序贯双侧电声刺激（EAS）治疗。一侧在耳蜗中进行了电极阵列（M型）的部分18毫米插入。对侧在39个月后植入了深度为30毫米的电极阵列（FLEX（软）型）。目的是评估在电极深插入后低频听力是否能够保留，以及评估双侧EAS手术与单耳EAS相比的益处。
在术前和术后长达48个月测量听力阈值和言语识别结果。比较部分插入侧和深插入侧的结果。使用助听器益处简表问卷评估EAS在日常生活中的益处。双侧EAS的益处通过使用LINT言语噪声测试测量的言语接受阈值来计算。言语总是从前方呈现。噪声要么从前方、左侧或右侧呈现。对单耳和双耳使用EAS的每种情况进行测量。
在这个特定病例中，电极阵列的部分插入以及深插入均导致了听力保留和显著的言语识别。两种EAS装置在10分贝信噪比下的噪声中均提供了超过80%的言语识别率。与单耳EAS相比，双侧EAS对噪声中的言语接受有益。测量到了3.4分贝的头影效应、1.2分贝的双耳静噪效应和0.5分贝的双耳总和效应。
使用FLEX（软）电极阵列在耳蜗中近乎完全插入（30毫米）进行人工耳蜗植入后，听力保留也是可能的。该患者成功实施了双侧EAS，与单耳EAS相比提供了更好的言语识别。
