Hearing Preservation Cochlear Implant Surgery.

Cochlear implantation (CI), with attempted preservation of residual natural low-frequency hearing, is an increasingly accepted application of this technology, with potential benefits to the patient when listening in noise and in music appreciation. The full extent of the benefits of combining preserved natural hearing and electrical stimulation remain under evaluation. Various factors appear to influence the success of hearing preservation (HP) during CI, including electrode design, surgical approach, insertional trauma, steroid usage and patient factors. Currently, combining or contrasting outcomes of CI with attempted HP is difficult due to the use of heterogeneous outcome measures. Until we have a full understanding of the benefits of preserving residual low-frequency hearing during CI, there is merit in attempting to preserve all residual hearing. Likewise, preserving residual low-frequency hearing is a useful surrogate marker for atraumatic electrode design and insertion.