Residual hearing preservation using the suprameatal approach for cochlear implantation

Objective: Cochlear implantation of patients with high-frequency hearing loss and residual low-frequency hearing has become a new treatment standard within the last years. The objective of this study was to evaluate the rate of hearing preservation in cochlear implantation for electric-acoustic stimulation using the suprameatal approach. Methods: Five patients (mean age 48.2 years) who were supplied with Med El (Combi 40+, Pulsar) cochlear implants and various different electrodes (Custom made, Flex soft, Flex EAS) were evaluated for residual hearing preservation after a mean follow-up time of 35.6 months (range 24 to 77 months). Results: Three patients showed partial hearing preservation, whereas 2 patients experienced a complete loss of residual hearing. Conclusion: Although hearing preservation rates in this series of patients operated on using the suprameatal approach were inferior as compared with a series using the standard mastoidectomy approach, this study shows that it is in fact possible to preserve residual hearing using a non-mastoidectomy surgical technique for cochlear implantation. Nevertheless, more experience is necessary to answer the question whether this technique can be thoroughly recommended in cochlear implantation for electric-acoustic stimulation.