Electro-natural Stimulation (ENS) in Partial Deafness Treatment: Pediatric Case Series

Objective: To report the improvement in hearing preservation and speech understanding of five pediatric patients who received cochlear implantation via Electro-natural Stimulation Partial Deafness Treatment, the largest group so far treated. Study Design: Retrospective case review. Setting: Tertiary referral center. Patients: A series of five children aged 9 to 16 years old with bilateral normal hearing at 125 to 1500 Hz and severe-to-profound hearing loss above 1500 Hz, who were subjected to unilateral cochlear implantation. Intervention: All the patients underwent unilateral cochlear implantation by the same senior otosurgeon. Surgery involved six principal steps using an approach to scala tympani through the round window and use of an extremely delicate electrode with active length of up to 21 mm. Main Outcome Measures: Pre- and postoperative hearing for air- and bone-conduction was assessed using pure-tone audiometry. Speech understanding was evaluated with the Pruszewicz monosyllabic word test in free field. Hearing preservation was assessed using the Hearing Preservation Calculator developed by the HEARRING group. Results: Over the 3-year observation period, preoperative hearing thresholds were completely preserved in three children (60%) and partially in the remaining two (40%). A useful improvement in speech understanding of about 30% (compared with the best fitted hearing aids in the preoperative period) was observed in both quiet and noise. Conclusions: Cochlear implantation seems to be a successful way of restoring hearing ability in ENS-Partial Deafness Treatment patients who are beyond the scope of effective rehabilitation with hearing aids. Excellent results of hearing preservation in ENS patients encourage discussion on extending the inclusion criteria for cochlear implantation.

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