Benefits of Bimodal Hearing with Cochlear and Middle Ear Implants: Preliminary Results in Four Patients

Objective: Conventional hearing AIDS have some limitations in overcoming a large air-bone gap or in cases of severe high-frequency hearing loss. The authors aimed to evaluate the benefit of a new bimodal hearing configuration combining cochlear implantation (CI) and middle ear implant (MEI) in patients with severe mixed conductive and ski-slope hearing loss. Study Design: Retrospective case review. Setting: Tertiary referral center. Patients: Four patients with severe to profound hearing loss, who underwent CI in one ear and MEI in the other, were enrolled. Intervention: Audiological outcomes were assessed at least 6 months after the MEI/CI operation. Pure-tone audiometry (PTA) in unaided, CI-aided, and MEI-aided conditions were measured. Main Outcome Measures: Average threshold changes in bands of frequencies (<1 kHz, ≥1 kHz) were compared between MEI-aided and HA-aided conditions. The Korean version of the Hearing-in-Noise Test (K-HINT), and speech perception score in noisy and quiet conditions were evaluated in the bimodal configuration (i.e., MEI with CI). Results: MEI-aided PTA was especially increased in high-frequency areas (≥1 kHz). Speech perception in noisy and quiet conditions demonstrated better scores in the bimodal configuration. K-HINT also demonstrated better scores in the bimodal configuration. Conclusions: There is an increasing number of patients with unilateral CI and residual hearing in the contralateral ear. The benefits of a new bimodal hearing configuration with CI and MEI were demonstrated in patients with severe high-frequency hearing loss or mixed conductive hearing loss in the contralateral ear.