Abstract
Disabling hearing loss is an important health issue worldwide. Exact numbers of hearing
disability are not available for the Netherlands. In 2011 about 800.000 people visited the
general practice because of hearing loss, which is thought to be an underestimation (Gommer
et al., 2013). For specific subpopulations, i.e. adolescents and elderly, this number is
estimated to grow. There are indications that the prevalence of noise induced hearing loss
increases in adolescents due to the increased exposure to potentially damaging sound levels
(Shargorodsky et al., 2010). Also, the prevalence of age related SNHL is expected to increase
due to aging (due to both an increase of the percentage of elderly in the population and the
increase of life expectancy).
Annually, ~450 patients with severe to profound SNHL receive a cochlear implant in the
Netherlands. This number is expected to grow the following years. Due to a generally improving
hearing performance of CI users, the criteria for cochlear implantation are expanded.
Patients with a substantial degree of residual hearing are implanted nowadays. Protection of
cochlear structures is regarded of general importance, for both CI recipients with or without
residual hearing, with as goal to improve cochlear implant hearing performance. Therefore,
much attention is given to optimize surgical strategies. Some of these strategies are common
clinical practice and are assumed to improve the outcome in cochlear implant patients. In this
thesis we investigated the effect of some of these strategies on a biological level (protection
of the auditory nerve in guinea pigs) and a clinical level (residual hearing outcome and hearing
performance in cochlear implant patients). On the one hand, this thesis looks back and
evaluates outcome variables in patients, thereby contributing to a scientific basis of the best
clinical practice. On the other hand, animal research providing more insight on the actual
effect of treatments on the auditory nerve contributes to improvement of current strategies
used in patients and the development of clinical applications in the future.
disability are not available for the Netherlands. In 2011 about 800.000 people visited the
general practice because of hearing loss, which is thought to be an underestimation (Gommer
et al., 2013). For specific subpopulations, i.e. adolescents and elderly, this number is
estimated to grow. There are indications that the prevalence of noise induced hearing loss
increases in adolescents due to the increased exposure to potentially damaging sound levels
(Shargorodsky et al., 2010). Also, the prevalence of age related SNHL is expected to increase
due to aging (due to both an increase of the percentage of elderly in the population and the
increase of life expectancy).
Annually, ~450 patients with severe to profound SNHL receive a cochlear implant in the
Netherlands. This number is expected to grow the following years. Due to a generally improving
hearing performance of CI users, the criteria for cochlear implantation are expanded.
Patients with a substantial degree of residual hearing are implanted nowadays. Protection of
cochlear structures is regarded of general importance, for both CI recipients with or without
residual hearing, with as goal to improve cochlear implant hearing performance. Therefore,
much attention is given to optimize surgical strategies. Some of these strategies are common
clinical practice and are assumed to improve the outcome in cochlear implant patients. In this
thesis we investigated the effect of some of these strategies on a biological level (protection
of the auditory nerve in guinea pigs) and a clinical level (residual hearing outcome and hearing
performance in cochlear implant patients). On the one hand, this thesis looks back and
evaluates outcome variables in patients, thereby contributing to a scientific basis of the best
clinical practice. On the other hand, animal research providing more insight on the actual
effect of treatments on the auditory nerve contributes to improvement of current strategies
used in patients and the development of clinical applications in the future.
| Original language | English |
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| Print ISBNs | 978-94-6233-749-7 |
| Publication status | Published - 26 Oct 2017 |