gms | German Medical Science

This presentation describes the changes in the speech recognition of an adult female that was first implanted with a Clarion C2 cochlear implant with a Hi-Focus electrode array with positioner in 2002. She did very well with her first implant as she progressed from a sequence continuous interleaved sampling (CIS) programs to the High Resolution (Hi-Res) speech coding strategy. After about 1.5 years of cochlear implant use she achieved a score of 100% on recorded monosyllabic words. Subsequently, her cochlear implant began to cause distorted signals which resulted in dramatic reductions in her speech perception scores. Eventually after several attempts to resolve her problems, the manufacturer declared the device to be defective and she was re-implanted in the same ear with a Clarion 90k device with a Hi-Focus electrode without positioner. Her speech recognition scores have now plateaued at about 50% for monosyllabic words. The radiographic analysis of her electrode arrays shows very significant different placements of the electrode array relative to the modiolus of the cochlear. The positioner of her first device resulted in an insertion of approximately 420 degrees. The second electrode placement without the positioner resulted in a placement of about 205 degrees. The significant change in the electrode placement is believed to have caused the significant reduction in speech recognition for this patient. Attempts to improve her speech recognition through programming change will be discussed.