Electric-Acoustic Stimulation Outcomes in Children

Objectives: This study investigates outcomes in children fit with electric-acoustic stimulation (EAS) and addresses three main questions: (1) Are outcomes with EAS superior to outcomes with conventional electric-only stimulation in children? (2) Do children with residual hearing benefit from EAS and conventional electric-only stimulation when compared with the preoperative hearing aid (HA) condition? (3) Can children with residual hearing derive benefit from EAS after several years of listening with conventional electric-only stimulation? Design: Sixteen pediatric cochlear implant (CI) recipients between 4 and 16 years of age with an unaided low-frequency pure tone average of 75 dB HL in the implanted ear were included in two study arms. Arm 1 included new recipients, and Arm 2 included children with at least 1 year of CI experience. Using a within-subject design, participants were evaluated unilaterally with the Consonant-Nucleus-Consonant (CNC) word list in quiet and the Baby Bio at a +5 dB SNR using an EAS program and a conventional full electric (FE) program. Arm 1 participants' scores were also compared with preoperative scores. Results: Speech perception outcomes were statistically higher with the EAS program than the FE program. For new recipients, scores were significantly higher with EAS than preoperative HA scores for both the CNC and Baby Bio in noise; however, after 6 months of device use, results in the FE condition were not significantly better than preoperative scores. Long-term FE users benefited from EAS over their FE programs based on CNC word scores. Conclusions: Whether newly implanted or long-term CI users, children with residual hearing after CI surgery can benefit from EAS. Cochlear implantation with EAS fitting is a viable option for children with HAs who have residual hearing but have insufficient access to high-frequency sounds and poor speech perception. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. ACKNOWLEDGMENTS: The authors wish to thank Dr. Emily Buss for her assistance with statistical analysis. This study was supported by Cochlear Americas. Holly Teagle serves on the audiology advisory board for Cochlear. The authors have no other conflicts of interest to disclose. Portions of this article were presented at The 13th International Conference on Cochlear Implants and Other Implantable Technologies, Toronto, Ontario, Canada, May 12, 2016, and at The 15th International Conference on Cochlear Implants and Other Implantable Technologies, Antwerp, Belgium, June 29, 2018. Received February 10, 2018; accepted August 10, 2018. Address for correspondence: Lisa R. Park, The Children's Cochlear Implant Center at UNC, University of North Carolina at Chapel Hill, 5501 Fortunes Ridge Drive, Suite A, Durham, NC 27713, USA. Phone: 919-419-1449. Fax: 919-419-1399. E-mail: Lisa_Park@med.unc.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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