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Hearing with a cochlear implant: from bionic to bimodal listening

Ingeborg Dhooge (UGent) , Birgit Philips (UGent) and Freya Swinnen (UGent)
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Abstract
Introduction: Currently, cochlear implantation (CI) is the standard procedure for bilateral severe hearing loss in both children and adults. However, a considerable number of hearing-impaired patients, who are candidates for CI, have residual hearing in the low-frequency range. In addition to the refinement of the surgical techniques by the application of the principles of soft surgery, the design of particular, atraumatic electrodes, which are thinner, shorter and more flexible, has contributed to electroacoustic stimulation (EAS). The use of these atraumatic electrodes has resulted in preservation of residual hearing in up to 90% of cases. Electroacoustic hearing is associated with potential advantages over pure electric hearing: better speech understanding in noise, and superior music appreciation and sound quality. In addition, patients with EAS have awareness of sound, even when not wearing their CI. Methods: In the Ghent University Hospital, 6 severely hearing-impaired adult patients with sufficient low-frequency hearing were implanted with atraumatic electrodes. In 5/6 recipients, a Cochlear® Hybrid-L24 implant was used, whereas 1/6 received a Cochlear® CI422 implant. Results: Low-frequency acoustic hearing has been preserved in 5/6 patients. Three out of 6 patients use electroacoustic amplification postoperatively; 2/7 are stimulated electrically for the mid- and high-frequency range and have residual low-frequency hearing without need of amplification; and 1/6 patients is exclusively stimulated electrically for the whole frequency range because of deterioration of preoperative low-frequency hearing thresholds. Conclusion: In candidates for CI, application of soft surgery principles and the use of atraumatic electrodes should be raised to a standard because of the medical advantages, irrespective of the presence of residual hearing. In case of residual hearing, additional benefit is obtained in terms of better speech understanding in noise and a higher level of listening comfort.

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Chicago
Dhooge, Ingeborg, Birgit Philips, and FREYA SWINNEN. 2014. “Hearing with a Cochlear Implant: From Bionic to Bimodal Listening.” In Cochlear Implants and Other Implantable Auditory Technologies, 13th International Conference, Abstracts.
APA
Dhooge, I., Philips, B., & SWINNEN, F. (2014). Hearing with a cochlear implant: from bionic to bimodal listening. Cochlear Implants and Other Implantable Auditory Technologies, 13th International conference, Abstracts. Presented at the 13th International conference on Cochlear Implants and Other Implantable Auditory Technologies (CI 2014).
Vancouver
1.
Dhooge I, Philips B, SWINNEN F. Hearing with a cochlear implant: from bionic to bimodal listening. Cochlear Implants and Other Implantable Auditory Technologies, 13th International conference, Abstracts. 2014.
MLA
Dhooge, Ingeborg, Birgit Philips, and FREYA SWINNEN. “Hearing with a Cochlear Implant: From Bionic to Bimodal Listening.” Cochlear Implants and Other Implantable Auditory Technologies, 13th International Conference, Abstracts. 2014. Print.
@inproceedings{5942175,
  abstract     = {Introduction: Currently, cochlear implantation (CI) is the standard procedure for bilateral severe hearing loss in both children and adults. However, a considerable number of hearing-impaired patients, who are candidates for CI, have residual hearing in the low-frequency range. 
In addition to the refinement of the surgical techniques by the application of the principles of soft surgery, the design of particular, atraumatic electrodes, which are thinner, shorter and more flexible, has contributed to electroacoustic stimulation (EAS). The use of these atraumatic electrodes has resulted in preservation of residual hearing in up to 90\% of cases. 
Electroacoustic hearing is associated with potential advantages over pure electric hearing: better speech understanding in noise, and superior music appreciation and sound quality. In addition, patients with EAS have awareness of sound, even when not wearing their CI. 
Methods: In the Ghent University Hospital, 6 severely hearing-impaired adult patients with sufficient low-frequency hearing were implanted with atraumatic electrodes. In 5/6 recipients, a Cochlear{\textregistered} Hybrid-L24 implant was used, whereas 1/6 received a Cochlear{\textregistered} CI422 implant. 
Results: Low-frequency acoustic hearing has been preserved in 5/6 patients. Three out of 6 patients use electroacoustic amplification postoperatively; 2/7 are stimulated electrically for the mid- and high-frequency range and have residual low-frequency hearing without need of amplification; and  1/6 patients is exclusively stimulated electrically for the whole frequency range because of deterioration of preoperative low-frequency hearing thresholds.
Conclusion: In candidates for CI, application of soft surgery principles and the use of atraumatic electrodes should be raised to a standard because of the medical advantages, irrespective of the presence of residual hearing. In case of residual hearing, additional benefit is obtained in terms of better speech understanding in noise and a higher level of listening comfort.},
  author       = {Dhooge, Ingeborg and Philips, Birgit and Swinnen, Freya},
  booktitle    = {Cochlear Implants and Other Implantable Auditory Technologies, 13th International conference, Abstracts},
  language     = {eng},
  location     = {Munich, Germany},
  title        = {Hearing with a cochlear implant: from bionic to bimodal listening},
  year         = {2014},
}