Short‐ Versus Long‐Term Hearing Preservation and Speech Recognition Outcomes in Precurved and Straight Electrode Arrays

Objective Compare audiologic outcomes between precurved and straight electrode arrays in cochlear implant (CI) recipients while controlling for age and preoperative hearing in a large cohort. Study Design Retrospective chart review. Setting Tertiary referral center. Methods Adult CI recipients who underwent surgery from 2018 to 2025 with Cochlear Americas slim modiolar CI532/632 (precurved) or slim straight CI522/622 (straight) electrode arrays were included. Preimplantation and postimplantation low‐frequency pure tone average (LFPTA) in the short‐ (1‐ and 6‐months) and long‐term (≥12 months) and speech recognition testing (CNC, AzBio in quiet) at 1‐, 3‐, 6‐, and 12‐months postactivation were recorded. Hearing preservation (LFPTA shift) and speech recognition scores were evaluated using multivariate linear regression analysis. Results One hundred seventy‐two patients (190 ears) were included. 124 (65.3%) and 66 (34.7%) ears were implanted with a precurved or straight electrode, respectively. 47 (24.7%) ears had residual hearing (LFPTA ≤ 80) preoperatively. Precurved electrode recipients had significantly better hearing preservation compared to straight electrode recipients in the short‐term ( F = 4.016, P = .039), though this advantage diminished in long‐term follow‐up after controlling for age, sex, and preoperative LFPTA. CNC and AzBio scores were not significantly different between electrode arrays at any timepoint postimplantation. Conclusion Precurved electrodes were associated with small but statistically significant greater hearing preservation in the short‐term compared to straight electrodes, but this difference did not persist in the long‐term. Speech recognition outcomes were similar for precurved and straight electrodes at all timepoints. These findings should be considered during preoperative decision‐making for potential CI recipients.