Benefit from bimodal hearing in a group of prelingually deafened adult cochlear implant users.

PURPOSE: People who receive a unilateral cochlear implant find speech perception in acoustically complex situations very challenging, in part because they do not have access to binaural hearing. For cochlear implant patients with some residual hearing in the nonimplanted ear, bilateral auditory input can be obtained by the use of a cochlear implant and a contralateral conventional hearing aid. This condition is referred to as "bimodal hearing." MATERIALS AND METHODS: We evaluated the benefits from bimodal stimulation in a group of 10 prelingually deafened adult cochlear implant users, submitted to unilateral cochlear implantation at the ENT Unit of the University of Pisa. RESULTS: Of 10 patients, 9 decided to continue using bimodal stimulation and demonstrated improvements in speech perception both in quiet and in noise condition from bimodal hearing, in comparison to the cochlear implant alone condition. CONCLUSIONS: Our results show that bimodal hearing offers some advantages in speech understanding in quiet and noise conditions also in prelingually deafened adults. Moreover, most of our patients reported advantages from bimodal hearing in localizing sound and in perceiving a more natural sound.

Exclusive transcanal surgical approach for Vibrant Soundbridge implantation: surgical and functional results.

OBJECTIVE: An alternative transcanal surgical technique named "exclusive transcanal approach" for Vibrant Soundbridge (VSB) implantation is presented. The surgical steps and our experience in a series of 12 patients are reported. STUDY DESIGN: Retrospective study. SETTING: : Tertiary referral center. University hospital. PATIENTS: Twelve patients, 8 women and 4 men, mean age 50 years (range, 41-71 yr), were implanted with the VSB through the exclusive transcanal approach. In 7 patients with moderate sensorineural hearing loss, the floating mass transducer (FMT) was placed on the incus, whereas in 5 patients with a mixed hearing loss for chronic otitis media and/or previous middle ear surgeries, the FMT was placed on the round window. INTERVENTION(S): Hearing rehabilitation. MAIN OUTCOME MEASURE(S): Postoperative surgical and anatomic results. RESULTS: Anatomic results and functional results in patients operated with the FMT on the round window. CONCLUSION: The exclusive transcanal approach proved to be faster, simpler, and safer in comparison to the classic surgical technique through the facial recess, reducing the risk of chorda tympani and facial nerve lesions. All the patients and, in particular, those operated placing the FMT on the round window achieved improvements in hearing thresholds and speech perception tests from the use of the VSB. Moreover, after a mean 21-month follow-up (range, 15-32 mo), we did not observe any complication such as tympanic membrane perforations, external ear canal skin lesions, or extrusion of the coil in the external ear canal.