Twenty years ago, the use of bilateral implants would have headlined any conference on innovations in cochlear implantation. Today, the procedure has become routine for children and adults. Here’s a look at procedures that now represent the cutting edge of cochlear implant (CI) surgery.
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August 2012Hybrid Devices
There are several candidates for top billing, but one of the more exciting advances involves hybrid implants and techniques that preserve residual hearing, according to Bruce Gantz, MD, professor and head of the department of otolaryngology-head and neck surgery at the University of Iowa Hospitals and Clinics in Iowa City.
“It isn’t all that long ago that implanting a cochlea of a patient with residual hearing would have been unthinkable,” said Dr. Gantz. That’s the case, he noted, because standard-length cochlear implant electrodes that extend more than 20 mm into the scala tympani can obliterate key structures and almost wipe out residual hearing (Acta Otolaryngol. 2004;124:272-280). Although “soft surgery” techniques with the standard-length electrode implants can prevent some of that damage (Otol Neurotol. 2006;27:1083-1088), Dr. Gantz noted, shorter-length hybrid devices offer a dual benefit: They preserve residual hearing in adults and children, while also sparing cells in the organ of Corti, which preliminary studies have shown may respond to future advances in molecular or genetic treatments of the inner ear (Nature. 2006;441:984-987).