THE CLARION MULTI-STRATEGY COCHLEAR IMPLANT - SURGICAL TECHNIQUE, COMPLICATIONS, AND RESULTS - A SINGLE INSTITUTIONAL EXPERIENCE

Objective: This study aimed to review a single institution's experienc e with Clarion Multi-Strategy Cochlear Implant with respect to surgica l technique, surgical complications, and rehabilitative outcome. Study Design: This study was a review of patients implanted with the Clario n Multi-Strategy Cochlear Implant. Setting: The setting was a tertiary referral center with cart: delivered in the inpatient and outpatient environment. Patients: The first 37 patients were implanted under an I nvestigational Device Exemption as part of the Food and Drug Administr ation (FDA) clinical trial of the Clarion implant. Subsequent patients were implanted after the device received FDA approval. Patients met t he following criteria for implantation: 18 years of age or older, psyc hological and emotional stability, profound postlingual deafness witho ut evidence of middle ear disease, one cochlea at least partially pate nt, and marginal or no benefit from conventional hearing aids. Interve ntion: Patients received implantation with the Clarion Multi-Strategy Cochlear Implant. Main Outcome Measures: Measured were presence or abs ence of surgical complications and auditory performance with open-and closed-set word and sentence recognition testing. Results: A total of 47 patients have been implanted. Three patients have suffered complica tions: two cases of delayed-onset facial palsy both resolved with ster oid therapy and one case of internal cochlear stimulator migration req uired refixation. Significant improvement in speech understanding has been seen in the majority of patients who were implanted within the fi rst 6 months of device use. Specifically, at 6 months, scores on CID ( Central Institute for the Deaf) sentences (implant alone) improved fro m a preoperative mean of 9% to a mean of 72%, and scores on the NU-6 ( Northwestern University) monosyllabic word test increased from a preop erative mean of 3% (range, 0-20%) to a mean of 32% (range, 0-70%). Mor e than two thirds (68%) of the adults were able to understand at least 50% of sentences over the telephone, and half were able to understand at least 75% of the sentence material. Conclusions: The authors' inst itutional experience with the Clarion Multi-Strategy Cochlear Implant shows minimal surgical morbidity and significant improvement on all op en-set test measures of sentence and word recognition.