ORIGINAL RESEARCH article
Front. Audiol. Otol.
Sec. Clinical Research in Auditory Implants and Hearing Aids
Positive intra-operative electrocochleography track patterns with the HiFocus SlimJ electrode array are associated with stable and improved hearing preservation rates
Provisionally accepted
Javier Gisbert Aguilar1*Amparo Platero Zamarreño1Carlos De Paula Vernetta2Abel Guzmán Calvete2Juan Martín-Lagos Martínez3Nicolás Müller Locatelli3Marta Martínez Martínez3
Unai Martínez De Estíbariz Cerdán4*- 1Hospital Universitari de La Ribera, Alzira, Spain
- 2Hospital Universitari i Politècnic La Fe / Universitat de Valencia, Valencia, Spain
- 3Hospital Universitario Clínico San Cecilio, Granada, Spain
- 4Advanced Bionics GmbH, Hannover, Germany
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Introduction: electrocochleography (ECochG) has emerged as a valuable intra-operative monitoring tool in cochlear implantation, particularly for preserving residual hearing. This study evaluates the correlation between intra-operative ECochG responses and post-operative hearing outcomes in cochlear implant recipients. Materials and Methods: a cohort of 23 adult subjects with residual acoustic hearing in the low frequencies undergoing cochlear implantation were included. All subjects received Advanced Bionics' HiRes Ultra 3D implants and HiFocus SlimJ electrode arrays, with ECochG monitored during surgery via the AIM system. Intra-operative ECochG responses were categorized into positive, negative, and flat track patterns. Post-operative hearing outcomes were assessed at 1, 3, 6, and 12 months, focusing on hearing preservation. Results: in 70% of participants, recordable ECochG responses were obtained, with positive track patterns correlating with significantly lower mean hearing loss (17.1 dB) compared to negative (27.5 dB) and flat patterns (30.7 dB). At the 12-month post-operative mark, 83% of all participants retained complete or partial hearing preservation, with 100% complete or partial preservation in subjects exhibiting positive track patterns. Discussion: this study highlights the association between intra-operative ECochG responses and postoperative acoustic hearing outcomes, indicating its potential as a monitoring tool during cochlear implantation. While ECochG provides real-time insights into cochlear function, this observational study did not evaluate whether acting on ECochG feedback improves outcomes. Therefore, these findings should be interpreted as correlational rather than interventional. Future research should include larger cohorts and investigate whether integrating ECochG-guided strategies into surgical protocols can enhance hearing preservation and long-term outcomes.
Keywords: Cochlear Implants, Electrocochleography, intra-operative monitoring, hearingpreservation, Track patterns
Received: 19 Sep 2025; Accepted: 12 Dec 2025.
Copyright: © 2025 Gisbert Aguilar, Platero Zamarreño, De Paula Vernetta, Guzmán Calvete, Martín-Lagos Martínez, Müller Locatelli, Martínez Martínez and Martínez De Estíbariz Cerdán. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Javier Gisbert Aguilar
Unai Martínez De Estíbariz Cerdán
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