New trends with cochlear implants and atraumaticity demonstrated by deep electrode insertion and hearing preservation

Cochlear implantation (CI) combined with residual hearing preservation is a fascinating concept which is possible due to recent improvements in surgical technique and advanced electrode design. Current candidacy includes adults and children with significant residual hearing. Residual hearing must be maximally protected during cochlear implantation, since preservation of cochlear sensorineural structures contribute to a better outcome with electrical stimulation. Further pharmacological therapies for paediatric patients also necessitate maximum functionality of intracochlear structures to be effective. Results obtained in several implantation centres over the world with soft, standard size Med-El electrodes demonstrate that full electrode insertion (around 28 mm) is possible without compromising residual hearing. Such an approach provides the benefit of complete cochlear coverage for electrical stimulation combined with low-frequency acoustic hearing. The use of such soft electrodes in atraumatic surgery can therefore improve sound perception in difficult hearing conditions.