Cochlear Implant Users with Otosclerosis: Are Hearing and Quality of Life Outcomes Worse than in Cochlear Implant Users without Otosclerosis?

Abstract

Background: The otosclerotic process may influence the performance of the cochlear implant (CI). Difficulty in inserting the electrode array due to potential ossification of the cochlea, facial nerve stimulation, and instability of the results are potential challenges for the CI team. Objectives: To evaluate hearing results and subjective outcomes of CI users with otosclerosis and to compare them with those of CI users without otosclerosis. Method: Retrospective review of 239 adults with bilateral profound postlingual deafness who underwent unilateral cochlear implantation between 1992 and 2017. Hearing and speech understanding were assessed via pure-tone audiometry and speech perception tests. Subjective outcomes were assessed via the Nijmegen Cochlear Implant Questionnaire (NCIQ), the Glasgow Benefit Inventory (GBI), and the Hearing Implant Sound Quality Index (HISQUI₁₉) at 6 months, 12 months, and at the last follow-up. Results: Subjects were 22 CI users with otosclerosis and 217 without otosclerosis. Both groups had a similar duration of deafness and age at CI implantation. Results did not significantly differ according to group: no significant intergroup difference was found regarding the frequency of complete electrode insertion, facial stimulation, reimplantation, or PTA4 scores at the last follow-up. Regarding speech perception, no significant intergroup difference was found on any test or at any interval. Further, subjective outcomes, as measured by the GBI, NCIQ, and HISQUI₁₉, did not significantly differ between groups. Conclusions: Adults with otosclerosis and profound hearing loss derive significant benefit from CI use. Audiological and self-reported outcomes are not significantly different from that of other CI users with postlingual deafness.

Cochlear Implant Outcomes in Patients With Otosclerosis: A Systematic Review

“…Five tools were used: Nijmegen Cochlear Implant Questionnaire (NCIQ), Glasgow Benefit Inventory (GBI), Hearing Implant Sound Quality Index, dizziness handicap index, and the Abbreviated Profile of Hearing Aid Benefit. Calvino et al (24) reported statistically significant improvement in all subdomains of the NCIQ after implantation ( p < 0.001) and no statistical difference between NCIQ, GBI, and Hearing Implant Sound Quality Index scores between otosclerotic and nonotosclerotic patient groups. Flook et al (27) reported GBI scores in 20 of 35 patients with a mean of 53, which suggests good benefit from the cochlear implant.…”

“…Kraaijenga et al (69) looked only at patients at 1 year of follow-up with unilateral cochlear implantations and did not include PROMs as outcomes. Of the nine studies mentioned previously, three had periods of follow-up over 2 years (range, 60-89.6 mo; minimum, 52 patients) (24,32,56). Two of these studies showed noninferior outcomes (24,32), and one showed significantly better outcomes in the otosclerosis group (56).…”

Understanding the Cost-Effectiveness of Hearing Aids and Surgery for the Treatment of Otosclerosis

“…Cochlear implantation is also used in cases of advanced otosclerosis with significant sensorineural hearing loss, or in individuals who developed sensorineural hearing loss after stapes surgery. Individuals with otosclerosis and severe hearing loss show similar quality of life improvement after cochlear implantation as other users of cochlear implants with post-lingual deafness [38].…”

Evolving Criteria for Adult and Pediatric Cochlear Implantation

“…Patients with advanced otosclerosis may develop cochlear ossification or round window obliteration, requiring an extended cochleostomy. 36,37 Cochlear ossification may impact the electrode-neural interface, affecting performance. 38 Posttraumatic SNHL (eg, temporal bone fracture) may be associated with intracochlear fibrosis.…”