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S5 Electric-acoustic stimulation
Influence of insertion angle on speech perception after cochlea implantation
Helbig S. , Rader T. , Stöver T.
University Clinic Frankfurt, ENT Department, Frankfurt, Germany, 2University Clinic Frankfurt, Audiology, Frankfurt, Germany
Cochlear implantation in terms of hearing preservation is performed in patients with residual hearing within the
low frequencies. The aim is to use electric and acoustic stimulation (EAS) after surgery, but what happens if
hearing cannot be preserved? Is the reduction of insertion depth accompanied by reduced speech perception
compared to full cochlear coverage? 93 patients were implanted with Flex electrodes (MedEl Innsbruck, Austria)
of different lengths and with variations in insertion depth resulting in different insertion angles postoperatively.
After at least one year of cochlear implant use speech perception results for monosyllables were tested in best
aided condition (CI only/DUET). Radiological insertion angles were measured postoperatively using the stenvers
view x-ray. Speech perception was then evaluated in relation to insertion depth. The group of patients with the
shallowest insertion angles showed best results for speech perception when using the combined stimulation
strategy (EAS). Within the group of patients who use only electric stimulation a slightly, though not significantly
better, speech perception is evident when comparing 540° insertion to 630/720°-insertion. A limited insertion
angle is beneficial to patients with residual hearing within the low frequencies who use EAS postoperatively,
therefore every effort should be made to preserve residual hearing in these patients. For candidates who are
unlikely to use EAS after surgery an insertion angle of at least 540° should be aimed for. Future prospective
studies will help to further evaluate the influence of insertion angle on outcome.