Cochlear Implants w/o Loss of Residual Hearing?

Hi –

New guy here. I’ve been seriously considering getting a cochlear implant.

I’m finding mixed information from a variety of professional and non-professional sources and I was hoping I could get some straight-talk in here:

Is it possible to maintain residual hearing with a cochlear implant? I have been told yes, I have been told no and I have also seen studies from Stanford? several years ago where they maintained residual hearing.

I went through the CI Eval process myself. I was told it can be preserved but there are no guarantees. Some surgeons have better track records with residual hearing preservation so you need to do your homework.

1 Like

I also have gone through the evaluation process for a CI here in Australia as recently as January this year. Cochlear have removed the short array L24 from the market here in Aus and some parts of the US. But it depends on what type of CI you choose to have. If and when I go ahead I will have the N7 or the current version at the time.

I was told it was because if a person who had the L24 hearing deteriorated further the surgeons were faced with a greater problem. Whereas if they use a longer array the long term longevity of the array is better. But that said the fact that now with the longer array that being used there’s absolutely no guarantees for your residual hearing being retained. As mentioned by @Abarsanti it depends a lot on the surgeons experience and skills. If you are lucky enough to retain your residual the will fit the AC to the N7.

@Abarsanti @monolithic here in Aus Cochlear have a trial underway which uses a piece if equipment to guide the surgeon when he’s inserting the array into the Cochlear. This piece of equipment is being used to preserve the residual hearing at time of operation. But as we know they can’t guarantee the longevity of the residual hearing.

I have a friend who was in the trial, she’s 5 weeks post op now. She can hear high frequencies for the first time in 20 yrs, so it’s looking promising. I’ve also signed up to be part of this trial.

I had some residual hearing after surgery but it was a 30 db drop, wearing the earpiece almost impossible
I am glad I opted for the CI532 perimodiolar long electrode. Also, the hearing aid component has a reduced SCAN program feature set which will perform poorly in noise, you may end up rejecting the hearing aid component and go full electrical simulation if you want better performance in noise.
I really don’t care about my residual hearing because I hear far better and music sound the same to me,

pre-implant to post-implant residual hearing testing after activation
125 hz ----- 250 hz ----- 500 hz
40 to 70, 50 to 80 db, 80 to 100 db

My advice: seek care at a well established medical center where otologists implant hundreds of people every year. I’ve seen patients maintain usable hearing after implantation, and some completely lose residual hearing. It partly comes down to the surgeon. Some are better than others. Period. Some believe maintaining residual hearing is more important than others do. If a surgeon tells you it isn’t important, do NOT let him/her operate on you. Go with the one who tells you that he/she will do everything possible to preserve your existing hearing. Also, find a great CI audiologist who can work with you through this process. Different electrode arrays tend to result in different outcomes. For someone with a good amount of residual hearing prior to implantation, I’m much more likely to recommend a lateral wall electrode, which is less traumatic than a perimodiolar. If a patient has little to no usable hearing, I tend to recommend periomodialar. It all depends on your situation. A good audiologist and an experienced otologist are who you need.

In my case, I was told cochlear has an average loss of 30 db loss with ci 522 and ci532. hybrid L had a 20 db loss.

I did not go with med el due to low battery life and no accessory which they told me had a better preserving of hearing loss than cochlear due to their soft electrode.

AB had a bad reputation selling bad receiver simulator and not informing FDA about it.

@ssa I’m going with Cochlea N7 and the CI 522. The short hybrid array the CI L 24 (I think it was) Cochlear Australia have removed it from the market here. Because of the problems it was creating for patients, when their hearing deteriorated as it can do with age.

Abarsanti, I have a question. I’m considering a CI. How can I figure out a surgeon’s track record with preserving residual hearing? I mentioned that in a Facebook CI group, and was shot down, being told there was no way to find that out. I have pretty decent residual hearing in the lower ranges in the ear that I would have implanted, so this is an important issue for me.

I’m leaning towards one particular surgeon. Do I just ask him?

Ask the CI Audiologist. He will tell you about residual hearing preservation, How much a person loses on average for each companies… 20-30 db loss is very typical for CI after surgery. I don’t regret losing my residual hearing. CI produce good bass, far better than the hearing aid ear even though, i have a moderate loss in < 500hz low freq range

1 Like

@wtmcgowin someone mentioned in one of the FB CI groups the other day who they recommended for a CI from the US and Germany.

1 Like

In my case when considering it, I did ask the surgeon directly and be was honest that he wasn’t confident it would be preserved. There’s a few websites and people out there that claim to have the scoop on which surgeons best preserve residual hearing but who knows how valid their info is or is it just opinions. I also agree that asking the audiologist who works with that surgeon is a good recommendation.

I’m new here to this forum. I just joined and I think (but not sure) I put in my profile the results from one of my latest audograms, if you’re interested. I am in the pipeline for a CI but have yet to take the AzBio test which is scheduled in two days. Upon the recommendation of several friends who have CI’s I went to see Dr. Loren Bartels at Tampa Hearinig and Balance in Tampa, FL. I live only an hour away so it is convenient for me. I also have several CI recipient friends who used Dr. Jack Wazon, who’s with the Silverstein Institute in Sarasota, FL. Both of the cochlear surgeons are very highly recommended. If you would like to look at a web blog with half-hour interviews with a cochlear audiologist, several recipients of CI’s, and one with Dr. Bartels, visit: cochlearimplantbasics.com. Unfortunately the sound quality is not very good, but the transcript of the entire interview is there for you to read along with the audio. I found this to be very informative. Dr. Bartels talks about his background, education, and experience with implant surgery. He is VERY HIGHLY recommended by many local audiologists and doctors. Hope this helps.