Time Course of Speech Perception Performance Related to Advanced Bionics V1 Device Revision

OBJECTIVE: To report the failure rates, revision rates, and time course of speech perception performance changes for recipients of the Advanced Bionics HiRes Ultra and Ultra 3D V1 internal devices at a large cochlear implant program. STUDY DESIGN: Retrospective case series. SETTING: Tertiary referral center. PATIENTS: Adults and children implanted with Advanced Bionics HiRes Ultra or Ultra 3D V1 internal devices. MAIN OUTCOME MEASURES: Device failure rates, revision surgery rates, and speech perception performance over time. RESULTS: As of February 2025, a total of 72 of the 105 devices monitored were identified at our institution as having device failure consistent with voluntary field corrective action (FCA). The device survival rate is 30.6% in 36 adult ears and 33.3% in 69 pediatric ears. Of those with subsequent revision surgery, routine speech perception testing showed declines in speech in quiet performance as early as ~12 months before revision for adult ears and ~6 months pre-revision for pediatric ears. Both patient groups experienced similar speech perception recovery as early as 3 months and stabilized by 9 months post-revision. CONCLUSIONS: The 7-year survival rate of initial V1 devices is around 30% to 33%, with the anticipation of an even lower survival rate over a longer period. Although speech perception recovers over time, it may take as long as 9 months post-revision for patients to return to pre-failure levels. We recommend rigorous monitoring using speech perception testing, both during V1 integrity monitoring and post-revision, to understand the impact of device failure in individual patients, particularly for children.