Electrode Contacts in the Functional Hearing Region for Pediatric Cochlear Implant Recipients.

OBJECTIVES: Examine the incidence of one or more electrode contacts placed within the region of functional acoustic hearing and the potential influence of electrode positioning on speech recognition for pediatric cochlear implant (CI) recipients. METHODS: A retrospective review for pediatric CI recipients of straight electrode arrays with preserved low-frequency hearing (an unaided threshold of ≤ 80 dB HL at 250 Hz) was conducted at a tertiary referral center. Intraoperative X-rays were used to determine the angular insertion depth (AID) of each electrode. Proximity of contacts to the functional acoustic hearing region was calculated using AID and postoperative unaided thresholds. For electric-acoustic stimulation (EAS) users, the association between proximity values and CNC word recognition in quiet was reviewed at 3-, 6-, and 12-months post-activation. RESULTS: Among 69 ears, 90% had at least one electrode contact within the functional acoustic hearing region. Proximity values ranged from -131° to 450° (mean: 100°, SD: 120°). For EAS users with speech recognition data (n = 29), proximity values were not significantly associated with post-activation CNC scores (p ≥ 0.212). CONCLUSIONS: Most pediatric CI recipients with hearing preservation had at least one electrode contact in the region of functional acoustic hearing. Proximity was not significantly associated with word recognition in quiet for EAS users, though this subgroup was limited in sample size. Further studies in pediatric EAS users are needed to understand the potential relationship with speech recognition in noise and to determine the benefits of individualizing array selection and/or EAS mapping.