Cochlear implants revolutionized the way we approach rehabilitation of patients with severe-to-profound hearing impairment in restoring speech understanding.

Recently, indications  for cochlear implantation have been widened, allowing better electric and acoustic stimulation in patients who could not be stimulated efficiently with conventional hearing aids.

Scientific research in the area of residual hearing inspired improvement in surgical techniques and technological developments providing the possibility of preserving residual hearing after cochlear implantation.

The pursuit for proving surgical aspects of the theory of conservation of residual hearing resulted in application of the so-called round window approach in cochlear implantation which was backed with data obtained in patients treated since 1996.

These promising and repeatable results inspired us to commence a new program of treatment for those with so-called partial deafness.  

The concept proved to be an optimized form of  treatment in patients with good sound perception in low frequency tones and total deafness in the high frequency range, who received either electric stimulation alone (PDCI) or effective hybrid electric and acoustic stimulation (EAS).  

Our International Center of Hearing and Speech located in Warsaw/Kajetany has extensive experience with cochlear implantations, averaging about 350 CIs a year which enables us to apply own algorithms of surgical treatment and rehabilitation in patients with particular hearing impairment.

Combination of choosing the most suitable cochlear implant systems and specially designed electrode array along with the application of proper surgical method results in safe implantation and best hearing result in a new group of patients who require electric and acoustic stimulation.

We present results of 18 children who received cochlear implants according to standards of our PDCI method of round window insertion to preserve residual hearing. In all cases hearing results and difficulties in accessing the round window are discussed.

Post operative results show preservation of residual hearing in all cases, yet in two subjects, where cochleostomy was applied due to absence of the round window, a considerable loss of hearing was noted.

Proposed surgical procedure provides hearing conservation in the range of low frequencies and is worth to recommend as a new method in treatment of partial deafness in children.