Long-Term Preservation of High-Frequency Hearing After Cochlear Implantation in a Child with Substantial Residual Hearing: A Case Report
6 affiliations
- 1Oto-Rhino-Laryngology Surgery Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Kajetany, Poland
- 2Rehabilitation Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland
- 3Implants and Auditory Perception Department, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Kajetany, Poland
- 4Teleaudiology and Screening Department, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Kajetany, Poland
- 5Heart Failure and Cardiac Rehabilitation Department, Medical University of Warsaw, 02-091 Warsaw, Poland
- 6Institute of Sensory Organs, 05-830 Kajetany, Poland
Abstract
Background/Objectives: Cochlear implantation (CI) in children with substantial residual hearing remains challenging because of the risk of hearing loss. Partial deafness treatment and hearing preservation have traditionally focused on functionally useful low-frequency hearing, while residual hearing in the high-frequency range has not been specifically addressed in established classifications. Long-term data on preservation of substantial high-frequency residual hearing after CI in children remain limited. We present a pediatric case demonstrating 5-year preservation of high-frequency residual hearing after CI. Methods: A 14-year-old girl with bilateral sensorineural hearing loss underwent left CI with a MED-EL FLEX 28 electrode inserted through the round window. Pure-tone thresholds were assessed preoperatively and at 1, 12, 24, and 60 months postoperatively. Hearing preservation was evaluated using the Skarzynski classification, and speech perception was assessed before implantation and at 24 months. Results: Preoperatively, air-conduction thresholds were ≤70 dB HL at 2000–8000 Hz. Overall hearing preservation was complete at 1, 12, and 24 months and partial at 60 months. Importantly, hearing preservation at 2000–8000 Hz remained complete throughout the 60-month follow-up, with S-values of 90.7%, 76.7%, 79.1%, and 76.7%, respectively. At 24 months, word recognition in the implanted ear improved by 35 percentage points in quiet and 70 percentage points in noise compared with the preoperative aided condition. Conclusions: This case demonstrates 5-year preservation of substantial high-frequency residual hearing after CI in an adolescent with an atypical preoperative hearing profile. These findings suggest that cochlear implantation may be considered in selected patients with substantial residual hearing when conventional hearing aids provide insufficient functional benefit. However, broader conclusions regarding cochlear implant candidacy cannot be drawn from a single case.
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BibTeX
@article{skarzynski2026longterm,
title = {{Long-Term Preservation of High-Frequency Hearing After Cochlear Implantation in a Child with Substantial Residual Hearing: A Case Report}},
author = {Henryk Skarzynski and Elzbieta Wlodarczyk and Artur Lorens and Beata Dziendziel and Piotr H. Skarzynski},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208133},
url = {https://www.mdpi.com/2077-0383/15/20/8133},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Long-Term Preservation of High-Frequency Hearing After Cochlear Implantation in a Child with Substantial Residual Hearing: A Case Report
AU - Henryk Skarzynski
AU - Elzbieta Wlodarczyk
AU - Artur Lorens
AU - Beata Dziendziel
AU - Piotr H. Skarzynski
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208133
UR - https://www.mdpi.com/2077-0383/15/20/8133
AB - Background/Objectives: Cochlear implantation (CI) in children with substantial residual hearing remains challenging because of the risk of hearing loss. Partial deafness treatment and hearing preservation have traditionally focused on functionally useful low-frequency hearing, while residual hearing in the high-frequency range has not been specifically addressed in established classifications. Long-term data on preservation of substantial high-frequency residual hearing after CI in children remain limited. We present a pediatric case demonstrating 5-year preservation of high-frequency residual hearing after CI. Methods: A 14-year-old girl with bilateral sensorineural hearing loss underwent left CI with a MED-EL FLEX 28 electrode inserted through the round window. Pure-tone thresholds were assessed preoperatively and at 1, 12, 24, and 60 months postoperatively. Hearing preservation was evaluated using the Skarzynski classification, and speech perception was assessed before implantation and at 24 months. Results: Preoperatively, air-conduction thresholds were ≤70 dB HL at 2000–8000 Hz. Overall hearing preservation was complete at 1, 12, and 24 months and partial at 60 months. Importantly, hearing preservation at 2000–8000 Hz remained complete throughout the 60-month follow-up, with S-values of 90.7%, 76.7%, 79.1%, and 76.7%, respectively. At 24 months, word recognition in the implanted ear improved by 35 percentage points in quiet and 70 percentage points in noise compared with the preoperative aided condition. Conclusions: This case demonstrates 5-year preservation of substantial high-frequency residual hearing after CI in an adolescent with an atypical preoperative hearing profile. These findings suggest that cochlear implantation may be considered in selected patients with substantial residual hearing when conventional hearing aids provide insufficient functional benefit. However, broader conclusions regarding cochlear implant candidacy cannot be drawn from a single case.
SN - 2077-0383
ER -