Results Show Long-Term Success for Hybrid CI in Patients with High- Frequency SNHL

What are the long-term benefits of cochlear implantation in patients with high-frequency (HF) sensorineural hearing loss (SNHL)?

Bottom line
Results demonstrate long-term success of patients with HF hearing loss following Hybrid L24 (Cochlear) implantation, including benefits in speech perception abilities significantly better than those in the preoperative best-aided condition.

Background: Although CIs can provide audibility and improved speech understanding, those with significant residual low-frequency (LF) hearing and a precipitously sloping HF hearing loss have previously been left untreated. In 2007, Cochlear Americas initiated a six-month multicenter clinical trial to study the Nucleus Hybrid L24 Implant System in adults with LF hearing and severe/profound HF SNHL.

Study design: Five-year follow-up on a group of implant recipients who were subjects of the CochlearTM NucleusVR HybridTM L24 Implant System clinical study.

Synopsis: In audiometric air-conduction threshold measurement using insert earphones, 72% of subjects had functional hearing; 94% had measurable hearing; and 6% had a total loss at five years post-activation. At five years post-activation, 87.5% had functional residual hearing at and below 500 Hz of LF hearing. ANOVA results indicated a significant effect of test interval for mean pre- and post-activation LF thresholds over time, along with individual thresholds at five years. At 12 months post-activation, 27 of 32 used the acoustic component; 26 of 32 used it at three years; and 23 of 32 used it at five years. Paired comparisons in speech perception indicated post-activation performance in the unilateral and bilateral conditions was significantly improved over the preoperative condition for each post-activation interval; however, the mean scores were not significantly different after 12 months post-activation. By five years post-activation, 30 of 32 showed the same or better performance over the preoperative condition, while two subjects showed a decline relative to preoperative performance. In the bilateral condition, 31 of 32 showed the same or better performance at five years, while one showed a decline relative to preoperative performance.

Citation: Roland JT Jr., Gantz BJ, Waltzman SB, Parkinson AJ. Long-term outcomes of cochlear implantation in patients with high-frequency hearing loss [published online ahead of print January 13, 2018]. Laryngoscope. doi: 10.1002/lary.27073.