Residual Hearing Loss After Chronic Cochlear Implantation in Guinea Pigs is Primarily Conductive

Abstract

It is desirous to preserve residual low-frequency hearing in cochlear implant recipients, as dual stimulation using electrical and acoustic signals results in superior speech-in-noise processing and musicality. However, cochlear implant recipients commonly lose their residual acoustic hearing gradually following surgical placement of the array. The governing mechanism is not understood and is likely due to multiple factors including surgical trauma, inflammation, and the foreign body induced immune response to the array, including formation of intracochlear fibrosis. Normal mechanical function of the cochlea is expected to underpin residual hearing but has not been directly studied. This function includes efficient transmission of sound to the cochlea via the middle ear, sound propagation via the basilar membrane travelling wave, mechanical tuning characteristics, and the non-linear cochlear amplification of responses to low-frequency stimulation. Here, we examined these features in cochleae and middle ears of unimplanted, acutely and chronically implanted guinea pigs using our minimally invasive preparation and optical coherence tomography vibrometry. We observed that mechanical tuning and amplification is not significantly altered by either acute or chronic implant. However, the response threshold was raised and proportional to middle ear responses. Additionally, the organ of Corti phase, and its sound intensity dependent changes, are unaltered by CI. Finally, a cluster analysis revealed sensitivity loss in chronically implanted animals is caused by middle ear dysfunction. Hence, in the guinea pig model, the dominant etiology of residual hearing loss is conductive. More research is required to establish whether residual hearing loss in humans similarly shares conductive elements.