Predictive factors for short‐ and long‐term hearing preservation in cochlear implantation with conventional‐length electrodes

<jats:sec><jats:title>Objectives/Hypothesis</jats:title><jats:p>The aims of this study were to <jats:bold>i</jats:bold>nvestigate short‐ and long‐term rates of hearing preservation after cochlear implantation and identify factors that impact hearing preservation.</jats:p></jats:sec><jats:sec><jats:title>Study Design</jats:title><jats:p>Retrospective review.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Patients undergoing cochlear implantation with conventional‐length electrodes and air‐conduction thresholds ≤80 dB HL at 250 Hz preoperatively were included. Hearing preservation was defined as air‐conduction thresholds ≤80 dB HL at 250 Hz.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The sample included 196 patients (225 implants). Overall, the rate of short‐term hearing preservation was 38% (84/225), with 18% (33/188) of patients preserving hearing long term. Multivariate analysis showed better preoperative hearing was predictive of hearing preservation at short (odds ratio [OR]: 0.93, 95% confidence interval [CI]: 0.91‐0.95, <jats:italic>P</jats:italic> < .001) and long‐term follow‐up (OR: 0.94, 95% CI: 0.91‐0.97, <jats:italic>P</jats:italic> < .001). Lateral wall electrodes and mid‐scala electrodes had 3.4 (95% CI: 1.4‐8.6, <jats:italic>P</jats:italic> = .009) and 5.6‐times (95% CI: 1.8‐17.3, <jats:italic>P</jats:italic> = .003) higher odds of hearing preservation than perimodiolar arrays at short‐term follow‐up, respectively. Long‐term data revealed better hearing preservation for lateral wall (OR: 7.6, 95% CI: 1.6‐36.1, <jats:italic>P</jats:italic> = .01), but not mid‐scala (OR: 3.1, 95% CI: 0.4‐23.1, <jats:italic>P</jats:italic> = .28), when compared to perimodiolar electrodes. Round window/extended round window (RW/ERW) approaches were associated with higher rates of long‐term hearing preservation (21%) than cochleostomy approaches (0%) (<jats:italic>P</jats:italic> = 0.002) on univariate analysis.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Better preoperative residual hearing, lateral wall electrodes, and RW/ERW approaches are predictive of higher rates of long‐term functional hearing preservation.</jats:p></jats:sec><jats:sec><jats:title>Level of Evidence</jats:title><jats:p>4. <jats:italic>Laryngoscope</jats:italic>, 128:482–489, 2018</jats:p></jats:sec>