Behavioral Feedback during Cochlear Implant Array Insertion under Local Anesthesia: A New Frontier in Cochlear Implant Care and Research

Abstract

Objective To describe the potential applications of awake cochlear implantation (CI). Patients Adult patients with sensorineural hearing loss who qualify for CI. Interventions CI under local anesthesia, without any form of systemic analgesia or anesthesia. Main Outcome Measures Acoustic hearing preservation, subjective patient report of cochlear implant pitch matching, and subjective patient report of cochlear implant sound quality. Results Four illustrative cases are presented, highlighting the potential uses of CI performed under local anesthesia for optimizing outcomes in hearing preservation, implant pitch matching, and implant sound quality. Conclusions CI under local anesthesia allows surgeons to use real-time patient feedback during electrode array insertion to minimize intracochlear trauma, particularly in cases where hearing preservation is a goal of CI, and to potentially improve implant performance by optimizing pitch matching and sound quality.