success was: GI�82.4% and GII�96.9%, (p0.05); while at 12months it was: GI�8.0dB and GII�7.6dB, (p�0.05).CONCLUSION: The cartilage graft offers better anatomicalresults and comparable functional results than the temporalisfascia in tympanoplasty, so we consider the cartilage as thegraft of choice.

Hearing Conservation with Conventional Cochlear

Implantation

Matthew Carlson, MD (presenter); Rene Gifford,PhD; Nicole Tombers, BS; Colin Driscoll, MD

OBJECTIVE: To describe the prevalence of hearing preser-vation following cochlear implantation (CI) using conventionallength electrodes and minimally-traumatic surgical techniqueamong patients with measurable preoperative audiometricthresholds.METHOD: Retrospective chart review (2004-2009) at a ter-tiary academic referral center. All patients with measurablepreoperative hearing who underwent CI with a newer genera-tion implant model (Nucleus N24 Contour series or later,Advanced Bionics HR90K, and Med El Sonata) were in-cluded. Pre- and post-implant audiometric thresholds andspeech recognition scores were recorded.RESULTS: Data for 292 implant patients were reviewed. Themean preoperative low-frequency pure-tone average (125, 250,500 Hz) was 63.5 dB HL. Hearing preservation was observedin 61% of patients with the remaining 39% having no measur-able hearing postoperatively. Post-implant monosyllabic wordrecognition was found to be significantly correlated with de-gree of hearing preservation.CONCLUSION: Conservation of acoustic hearing followingconventional long electrode CI is unpredictable but remains arealistic goal. The combination of improved technology andrefined surgical technique may allow for conservation of someresidual hearing in over 60% of patients. Preserved acoustichearing potentially allows for combined electroacoustic stim-ulation in a select group of patients. Perhaps more germane tothe conventional length CI recipient, minimally-traumatic elec-trode insertion may preserve delicate intracochlear neuralstructures allowing for improved speech perception in theelectric-only condition.

Hearing Evaluation in Exfoliative Glaucoma

Vassiliki Paliobei, MD, PhD (presenter); GeorgePsillas; Anna-Bettina Haidich, PhD; JannisConstantinidis, MD, PhD; Anastasios Konstas, MD,PhD

OBJECTIVE: The aim of this prospective study was to au-diologically evaluate glaucomatous patients with or withoutexfoliation.METHOD: We enrolled consecutive subjects with XFG orPOAG aged between 50 and 70 years. Auditory thresholds at

0.5, 1.0, 2.0, 4.0, 8.0 Hz were measured bilaterally. Cochlearactivity was also assessed by recording distortion product oto-acoustic emissions (DPOEs). Functional changes in the retro-cochlear auditory pathway were evaluated by auditory brain-stem responses (ABRs). In cases with pathological ABRmorphology, we carried out MRI scans to detect any lesions.RESULTS: We investigated 110 patients with exfoliativeglaucoma (XFG) and 85 patients with primary open-angleglaucoma (POAG) presented in our glaucoma clinic. The meanage of study patients was 66.2 5.6 years (range: 50-70 yearsold). 102 patients (52%) were male and 93 (47%) were female.The odds of pathologic ABR central transmission time (inter-peak latencies I-V, wave V) were 4.34 times higher in patientswith XFG than in patients with POAG (95% confidence inter-val [CI]: 2.22 8.49, p�0.001). This significant associationremained after adjusting for sex and age (odds ratio [OR]: 4.12,95% CI: 2.07 8.22, p�0.001). Furthermore, the odds of ABRremained significantly higher in patients with XFG than inpatients with POAG (OR: 4.36 95% CI: 2.10 9.06, p�0.001)after controlling for diabetes, arterial pressure, coronary heartdisease, cholesterol, and stroke (aee).CONCLUSION: Monitoring of peripheral as well as centralauditory pathway showed that patients with XFG show ahigher incidence of retrocochlear pathology.

Hearing Results with the Esteem Totally

Implantable Device

Jack Shohet, MD (presenter); Peter Catalano, MD

OBJECTIVE: 1) Demonstrate efficacy of the Envoy EsteemTotally Implantable Middle Ear Device as measured by hear-ing results compared to pre-implant unaided and aided condi-tions. 2) Determine safety of the Esteem.METHOD: During 2008 and 2009, a prospective, multi-cen-ter, non-randomized, FDA clinical trial was performed. Fifty-seven adult hearing aid users with bilateral, mild-to-severesensorineural hearing losses, with discrimination greater than40 percent, were implanted. Implanted components were: anon-rechargeable sound processor and two piezoelectric trans-ducers (a sensor and a driver). The sound processor was im-planted postauricularly. The sensor was interfaced with theincus to serve as a microphone. The driver was coupled to thestapes. Hearing results were measured at four, six, and twelvemonths post-implant and were compared to pre-implant un-aided and aided hearing.RESULTS: Hearing improved over 12 months. Pure toneaverages increased by 27 dB. There were no changes in boneconduction. Aided SRTs improved from 41.2 dB to 29.4 dB(p��0.001). Aided word recognition scores at 50 dB HLimproved from 46.3% to 68.9%. QuickSIN results showed nochange. Global APHAB scores demonstrated statistically sig-nificant improvement in mean benefit of 8.9�2.6. Three pa-tients experienced delayed facial paresis that resolved. Twoincisions dehisced. One was closed successfully. One patient

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