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Oto-Rhino-Laryngology Surgery Clinic, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
Heart Failure and Cardiac Rehabilitation Department of the Medical University of Warsaw, Warsaw, Poland
Institute of Sensory Organs, Warsaw/Kajetany, Poland
Publication date: 2014-12-31
Corresponding author
Piotr Henryk Skarżyński   

Piotr H. Skarżyński, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mochnackiego 10 Str., 02-042 Warsaw, Poland, e-mail:
J Hear Sci 2014;4(4):67–71
There is a significant group of elderly patients whose hearing impairment is characterized by normal or slightly elevated thresholds in the low and mid frequency bands (below 1500 Hz) with nearly total deafness in the high frequency range. These patients very often remain beyond the scope of effective treatment by hearing aids.

Case Report:
This study presents the case of a 75-year-old patient with good hearing in the range 125–1500 Hz and deafness at other frequencies. An implant was used to restore hearing at high frequencies, while preserving low and mid frequency acoustic hearing in the implanted ear. This can be described as electro-natural stimulation (ENS) of the inner ear.

The results demonstrate that low and mid frequency hearing (up to 1500 Hz) can be preserved using the round window surgical technique. A substantial improvement in speech discrimination was also observed when electrical stimulation on one side was combined with acoustic stimulation on both sides. There is scope to extend qualifying criteria for cochlear implantation to include elderly patients suitable for ENS.

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