Skip to main content Accessibility help

Preservation of cochlear structures and hearing when using the Nucleus Slim Straight (CI422) electrode in children

  • H Skarzynski (a1) (a2), M Matusiak (a1) (a2), A Lorens (a1) (a2), M Furmanek (a1) (a2), A Pilka (a1) (a2) and P H Skarzynski (a1) (a2) (a3) (a4)...



In cochlear implantation, there are two crucial factors promoting hearing preservation: an atraumatic surgical approach and selection of an electrode that does not damage cochlear structures. This study aimed to evaluate hearing preservation in children implanted with the Nucleus Slim Straight (CI422) electrode.


Nineteen children aged 6–18 years, with partial deafness, were implanted using the 6-step Skarzynski procedure. Electrode insertion depth was 20–25 mm. Hearing status was assessed with pure tone audiometry before surgery, and at 1, 5, 9, 12 and 24 months after surgery. Electrode placement was confirmed with computed tomography.


Mean hearing preservation in the study group at activation of the cochlear implant was 73 per cent (standard deviation = 37 per cent). After 24 months, it was 67 per cent (standard deviation = 45 per cent). On a categorical scale, hearing preservation was possible in 100 per cent of cases.


Hearing preservation in children implanted with the Nucleus CI422 slim, straight electrode is possible even with 25 mm insertion depth, although the recommended insertion depth is 20 mm. A round window approach using a soft, straight electrode is most conducive to hearing preservation.


Corresponding author

Address for correspondence: Associate Prof Piotr H Skarzynski, Institute of Physiology and Pathology of Hearing, Mochnackiego 10, 02-042 Warsaw, Poland Fax: +48 22 3560367 E-mail:


Hide All
1Skarzynski, H, Lorens, A, Piotrowska, A. A new method of partial deafness treatment. Med Sci Monit 2003;9:CS204
2Hogan, CA, Turner, CW. High-frequency audibility: benefits for hearing-impaired listeners. J Acoust Soc Am 1998;104:432–41
3Skarzynski, H, Lorens, A, Matusiak, M, Porowski, M, Skarzynski, PH, James, CJ. Partial deafness treatment with the Nucleus Straight Research Array cochlear implant. Audiol Neurotol 2012;17:8291
4Skarzynski, H, Lorens, A, Piotrowska, A, Anderson, A. Partial deafness cochlear implantation in children. Int J Pediatr Otorhinolaryngol 2007;71:1407–13
5Skarzynski, H, Lorens, A, Piotrowska, A, Skarzynski, PH. Hearing preservation in partial deafness treatment. Med Sci Monit 2010;16:CR55562
6Lenarz, T, Stóver, T, Buechner, A, Paasche, G, Briggs, R, Risi, F et al. Temporal bone results and hearing preservation with a new straight electrode. Audiol Neurotol 2006;11(suppl 1):3441
7Skarzynski, H, Lorens, A, Zgoda, M, Piotrowska, A, Skarzynski, PH, Szkielkowska, A. Atraumatic round window deep insertion of cochlear electrodes. Acta Otolaryngol 2011;131:740–9
8Carlson, ML, Colin, LW, Driscoll, W, Gifford, RH, Service, GJ, Tombers, NM et al. Implication of minimizing trauma during conventional cochlear implantation. Otol Neurotol 2011;32:962–8
9Skarzynski, H, Matusiak, M, Piotrowska, A, Skarzynski, P. Surgical techniques in partial deafness treatment. J Hear Sci 2012;2:RA913
10Skarzynski, H, Lorens, A, Piotrowska, A, Anderson, I. Preservation of low frequency hearing in partial deafness cochlear implantation (PDCI) using the round window surgical approach. Acta Otolaryngol 2007;127:41–8
11Cohen, TL, Xu, J, Xu, SA, Clark, GM. Improved and simplified methods for specifying positions of the electrode bands of a cochlear implant array. Am J Otol 1996;17:859–65
12Skarzynski, H, Lorens, A, Matusiak, M, Porowski, M, Skarzynski, PH, James, CJ. Cochlear implantation with the Nucleus slim straight electrode in subjects with residual low-frequency hearing. Ear Hear 2014;35:e3343
13Skarzynski, H, Podskarbi-Fayette, R. A new cochlear implant electrode design for preservation of residual hearing: a temporal bone study. Acta Otolaryngol 2010;130:435–42
14Tyler, RS, Wood, EJ. A comparison of manual methods for measuring hearing levels. Audiology 1980;19:316–29
15Xu, J, Xu, SA, Cohen, LT, Clark, GM. Cochlear view: postoperative radiography for cochlear implantation. Am J Otol 2000;21:4956
16Verbist, BM, Skinner, MW, Cohen, LT, Leake, PA, James, C, Boex, C et al. Consensus panel on a cochlear coordinate system applicable in histologic, physiologic and radiologic studies of the human cochlea. Otol Neurotol 2010;31:722–30
17Skarzynski, H, Van de Heyning, P, Agrawal, S, Arauz, SL, Atlas, M, Baumgartner, W et al. Towards a consensus on a hearing preservation classification system. Acta Otolaryngol 2013;133(suppl 564):313
18Kuthubutheen, J, Hedne, CN, Krishnaswamy, J, Rajan, GP. A case series of pediatric hearing preservation cochlear implantation: a new treatment modality for children with drug-induced or congenital partial deafness. Audiol Neurootol 2012;17:321–30
19Brown, RF, Hullar, TE, Cadieux, JH, Chole, RA. Residual hearing preservation after pediatric cochlear implantation. Otol Neurotol 2010;31:1221–6
20Adunka, OF, Dillon, MT, Adunka, MC, King, ER, Pillsbury, HC, Buchman, CA. Hearing preservation and speech perception outcomes with electric-acoustic stimulation after 12 months of listening experience. Laryngoscope 2013;123:2509–15
21Bruce, IA, Bates, JE, Melling, C, Mawman, D, Green, KM. Hearing preservation via a cochleostomy approach and deep insertion of a standard length cochlear implant electrode. Otol Neurotol 2011;32:1444–7
22Jeyakumar, A, Peña, SF, Brickman, TM. Round window insertion of precurved electrodes is traumatic. Otol Neurotol 2014;35:52–7
23Sampaio, AL, Araújo, MF, Oliveira, CA. New criteria of indication and selection of patients to cochlear implant. Int J Otolaryngol 2011;2011:573968
24Skarzynski, H, Matusiak, M, Lorens, A, Skarzynski, PH, Porowski, M. Partial deafness treatment in children by using Cochlear SRA electrode: round window surgical technique and evaluation by comparison of preservation of residual hearing and insertion depth angle. Int J Pediatr Otorhinolaryngol 2011;75(suppl 1):27
25Wright, CG, Roland, PS. Vascular trauma during cochlear implantation: a contributor to residual hearing loss? Otol Neurotol 2013;34:402–7
26Erixon, E, Köbler, S, Rask-Andersen, H. Cochlear implantation and hearing preservation: results in 21 consecutively operated patients using the round window approach. Acta Otolaryngol 2012;132:923–31
27Mick, P, Amoodi, H, Shipp, D, Friesen, L, Symons, S, Lin, V et al. Hearing preservation with full insertion of the FLEXsoft electrode. Otol Neurotol 2014;35:e404
28Nguyen, Y, Miroir, M, Kazmitcheff, G, Sutter, J, Bensidhoum, M, Ferrary, E et al. Cochlear implant insertion forces in microdissected human cochlea to evaluate a prototype array. Audiol Neuorotol 2012;17:290–8
29Prentiss, S, Sykes, K, Staecker, H. Partial deafness cochlear implantation at the University of Kansas: techniques and outcomes. J Am Acad Audiol 2010;21:197203



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed