Electrophonic hearing and cochlear implants.

It has been difficult to explain the good speech understanding obtained by some cochlear implant patients fitted with a single-channel electrode and analog transmissions of the speech signal (Vienna/3M implant). It has also been difficult to explain the variation in results reported by different groups using the same implant. One hypothesis asserts that the above differences can be explained by the observation that electric stimulation with an implanted electrode might result in two different auditory sensations, the first resulting from the stimulation of the remaining hair cells (electrophonic component) and the second from the electric stimulation of the auditory nerve (electro-neural component). The two sensations are very different. As a result of different definitions of total deafness (functional or threshold definition), patients with remaining hair cells are operated on by some groups, but not by other groups. Some published results from different studies are discussed with reference to the above hypothesis and the possible consequences for the selection of the patients, the use of extra- or intracochlear electrodes, and the selection of the speech coding strategy are discussed.