Download 13th International Conference on Cochlear Implants and Other

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Clinical results with a direct acoustic cochlear implant
Lenarz T. , Maier H. , Schwab B. , Kludt E.
Medical University of Hannover, Department of Otolaryngology, Hannover, Germany
Currently available conventional hearing aids normally do not provide sufficient benefit to patients with severe-toprofound mixed hearing losses (MHL). On the other hand, as the sensorineural hearing loss (SNHL) component
is only from moderate degree, cochlear implants also may be a less than optimal alternative. The Codacs Direct
Acoustic Cochlear Implant is a new implantable hearing system, which was developed for treatment of this
specific patient group. This device is intended to stimulate the cochlea fluid directly by a conventional stapes
piston that is attached to an actuator and vibrates the perilymph through the oval window.
Here we report clinical results from patients implanted at the Medical University of Hannover that were assessed
3 month (n = 18), one year (n = 9) and two years (n = 7) after activation. The audiological protocol included preand postoperative air conduction and bone conduction (BC) pure tone thresholds and speech intelligibility by
headphone as well as in sound field. In patients wearing hearing aids pre-operatively, measurements in sound
field were performed in unaided and in aided condition. The preoperative BC thresholds (0.5 - 6 kHz) were
between 43 and 60 dB HL (mean 55 dB), with an additional air bone gap between 30 und 44 dB HL (mean 34
The comparison of pre- and postoperative BC thresholds showed on average no decrease in the inner ear
function within two years after the implantation. Five month after the implantation, aided speech perception in
quiet improved significantly from 26 % word recognition score with conventional hearing aids to 81 % with
Codacs. Speech intelligibility in noise (OLSA, S0N0) was significantly better with Codacs (range 4.5 to -4.5 dB
SNR, mean +0.1 dB SNR) than with hearing aids (range 12 to -1.5 dB SNR, mean +7.6 dB SNR).
These results indicate that Codacs is an effective and safe treatment for severe to profound mixed hearing loss.