Hillman Todd A, Chen Douglas A, Rathe Kristin M, Rago Amanda, Weber Michael M, Tint Derrick R
Pittsburgh Ear Associates, Pittsburgh, Pennsylvania.
South Florida ENT Associates, Miami, Florida.
Otol Neurotol. 2025 Oct 1;46(9):1070-1076. doi: 10.1097/MAO.0000000000004584. Epub 2025 Jun 25.
To determine if cochlear implant recipients who have low-frequency hearing preservation after surgery can benefit from electric-acoustic stimulation (EAS) even after a period of electric-only stimulation.
Prospective, crossover controlled, clinical study.
Private practice single-specialty clinic.
Patients who are native English speakers, implanted with a 28-mm lateral wall electrode, had residual low-frequency hearing post-cochlear implantation and had at least 3 months of electric-only stimulation before enrollment.
Participants were reprogrammed from electric-only stimulation to EAS-A (with electric and acoustic overlap in the preserved frequencies) for 3 months. Outcomes were measured, and then the participants were changed to EAS-B, a non-overlap program. Outcomes and the patients' map preferences were recorded.
Speech perception for each programming strategy was measured with CNC and AzBio testing. Participants subjective performance was measured with CCIQ and APHAB testing for each modality.
Out of a total of 117 consecutive CI patients with preoperative low-frequency hearing thresholds of at least 65 db HL, 43 (36.8%) had at least one low-frequency threshold less than 65 dB allowing the use of EAS. Twelve participants with 16 implanted ears were enrolled and completed the study. Statistical analysis showed that participants performed significantly better ( p < 0.05) on CNC words with EAS-A (overlap, 71.6%) versus electric (65.5%) or EAS-B (non-overlap, 68%). There was not a difference between the strategies on AzBio testing. The overall scores on CCIQ and APHAB were also not statistically significant. A chi-squared test was performed for subjects' preferred programming strategy, revealing that there was a preference of the EAS strategies over electric only ( p = 0.04).
There may be an advantage to EAS over electric-only stimulation in patients with low-frequency hearing preservation after cochlear implant even after a period of electric-only stimulation.
确定术后保留低频听力的人工耳蜗植入者即使经过一段时间的纯电刺激后，是否仍能从电声刺激（EAS）中获益。
前瞻性、交叉对照临床研究。
私立单专科诊所。
以英语为母语、植入28毫米侧壁电极、人工耳蜗植入术后仍保留低频听力且在入组前至少接受了3个月纯电刺激的患者。
参与者从纯电刺激重新编程为EAS-A（在保留频率上有电声重叠），持续3个月。测量结果，然后将参与者改为EAS-B，即非重叠程序。记录结果和患者的图谱偏好。
使用CNC和AzBio测试测量每种编程策略的言语感知。使用CCIQ和APHAB测试针对每种模式测量参与者的主观表现。
在术前低频听力阈值至少为65 dB HL的117例连续人工耳蜗植入患者中，43例（36.8%）至少有一个低频阈值低于65 dB，从而可以使用EAS。12名植入16只耳朵的参与者入组并完成了研究。统计分析表明，与纯电刺激（65.5%）或EAS-B（非重叠，68%）相比，参与者在使用EAS-A（重叠，71.6%）时对CNC单词的表现明显更好（p < 0.05）。在AzBio测试中，各策略之间没有差异。CCIQ和APHAB的总体得分在统计学上也没有显著差异。对受试者首选的编程策略进行了卡方检验，结果显示，与仅使用电刺激相比，受试者更倾向于EAS策略（p = 0.04）。
对于人工耳蜗植入术后保留低频听力的患者，即使经过一段时间的纯电刺激，EAS可能比纯电刺激更具优势。
