Overview

In order to preserve the residual hearing in patients with sensorineural hearing loss (SNHL) receiving a cochlear implant (CI), the insertion trauma to the delicate and microscopic structures of the cochlea needs to be minimized. The surgical procedure starts with the conventional mastoidectomy-posterior tympanotomy (MPT) approach to the middle ear, and is followed by accessing the cochlea, with either a cochleostomy (CO) or via the round window (RW). Both techniques have their benefits and disadvantages. Another aspect is the design of the electrode array. There are fundamentally two different designs: a straight lateral wall lying electrode array (LW), or a pre-curved perimodiolar cochlear lying electrode array (PM). Interestingly, until now, the best surgical approach and type of implant is unknown. Our hypothesis is that the combination of a RW approach and a LW lying electrode array minimizes insertion trauma, leading to better hearing outcome for SNHL patients.

Eligibility

Inclusion Criteria:

• Severe hearing loss, CI candidate
• 18 years of age or older
• normal function of middle ear (i.e. no acute middle ear infections)
• dutch language proficiency
• choice for Advanced Bionics implant

Exclusion Criteria:

• prior otologic surgery in the implanted ear (excluding tympanostomy tube placement)
• inner ear malformation present in the ear to be implanted (i.e. ossification, Mondini malformation)
• retrocochlear pathology present in the auditory system to be implanted
• neurocognitive disorders
• sudden deafness