Hearing Preservation With a Midscalar Electrode Comparison of a Regular and Steroid/Pressure Optimized Surgical Approach in Patients With Residual Hearing. Issue 9 (October 2016)

• Record Type: Journal Article
• Authors: Todt, Ingo; Mittmann, Philipp; Ernst, Arne
• Is Part Of: Otology & neurotology. Volume 37:Issue 9(2016)
• Publication Date: 2016-10
• Subjects: Hearing preservation -- Intracochlear pressure -- Midscalar; Otology -- Periodicals; Ear -- Diseases -- Periodicals; Skull base -- Surgery -- Periodicals; 617.8005
• DOI: 10.1097/MAO.0000000000001068
• Languages: English
• ISSNs: 1531-7129

Abstract

Abstract : Objective: The aim of this study was to observe the rate of hearing preservation with a midscalar electrode with two surgical approaches. Study Design: Prospective study. Setting: Tertiary referral center. Patients: Twenty patients with residual hearing. Group A: 11 patients (mean age 56.1, 4 men, 7 women) mean HL 250 Hz, 36.4 dB; 500 Hz, 50.0 dB and 1 kHz, 81.4 dB. Group B: nine patients (mean age, 52.8 yr, 7 women, 2 men), 250 Hz, 36.7 dB; 500 Hz, 49.4 dB and 1 kHz, 87.8 dB. Intervention: Implantation with a midscalar electrode with two surgical approaches. Group A approach consisted of a slow insertion (2 min), careful round window opening, tool insertion, intraoperative and postoperative iv. prednisone, tool insertion and 24 hour postoperation bed-rest. In group B additionally the round window was widely opened and the electrode was wetted with triamcinolone. Main Outcome Measure: Measurement of the mean hearing loss in both groups. Results: We observed a statistically significant different hearing preservation for groups A and B. Although group A reached a mean hearing loss (250, 500, 1 kHz) of 42.6 dB, group B showed a mean loss of residual hearing of 9.1 dB after 1 month. Conclusion: A substantial rate of hearing preservation can be achieved with a midscalar electrode. A hearing preserving approach focusing on decreasing the intracochlear fluid pressure and local steroids has a strong effect on the hearing preservation.