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REVIEW PAPER
TREATMENTS FOR PARTIAL DEAFNESS USING COMBINED
ELECTRIC AND ACOUSTIC STIMULATION OF THE AUDITORY
SYSTEM
1
Co-Director, Duke Hearing Center, Duke University Medical Center, Durham, NC, USA; Adjunct Professor,
Department of Surgery, DUMC; Adjunct Professor, Department of Electrical & Computer Engineering, Duke
University; Chief Strategy Advisor, Med-El Medical Electronics GmbH, Innsbruck, Austria; The Overseas Expert,
Marie Curie Project for the Remediation of Hearing Loss, five centers in Europe including the primary site at
the International Center of Hearing and Speech in Kajetany, Poland; Senior Fellow Emeritus, RTI International
(previously known as the Research Triangle Institute), Research Triangle Park, NC, USA
Publication date: 2012-06-30
J Hear Sci 2012;2(2):19–32
KEYWORDS
electric-acoustic stimulationcochlear implantpartial deafnesspartial deafness cochlear implantationhearing preservationauditory prostheses
ABSTRACT
This paper provides a summary of the experience to date with (1) combined electric and acoustic stimulation of the auditory
system (combined EAS) for persons with some residual hearing at low frequencies, and (2) a procedure called “partial deafness cochlear implantation” (PDCI) for persons with higher levels of residual hearing at low frequencies, including persons
with normal or nearly normal hearing at 500 Hz and lower frequencies. The paper also presents new results on the dependence of outcomes according to the levels of the residual hearing. In broad terms, both combined EAS and PDCI are highly
beneficial treatments, especially for speech reception in noise. In some cases synergistic effects are found, in which the speech
reception score for combined EAS or PDCI is greater than the sum of the scores for electric or acoustic stimulation only. In
addition, the new results demonstrate that patients with high levels of residual hearing (PDCI levels) receive benefits from
cochlear implantation that are at least as great as the benefits received by patients with lower levels of residual hearing. This
finding strongly supports the concept of providing cochlear implants for persons with substantial residual hearing at low frequencies; indeed, a “point of diminishing returns” has yet to be identified.
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