Cochlear Implantation in 53 Patients with Otosclerosis: Demographics, Computed Tomographic Scanning, Surgery, and Complications

Rotteveel, Liselotte J. C.; Proops, David W.; Ramsden, R. T.; Saeed, Shakeel R; Olphen, Adriaan F. van; Mylanus, Emmanuel A. M.

doi:10.1097/00129492-200411000-00014

Cited by 142 publications

(177 citation statements)

References 21 publications

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“…Electrode insertion difficulty in FAO is well known and can be caused by cochlear ossification or pericochlear hypodense foci leading to incorrect placement or incomplete insertion of the electrode array [9,12] ( Figure 2). In our case series, one implantation (10%) resulted in partial insertion (10%), with 10 electrodes located outside the cochlea.…”

Section: Discussionmentioning

confidence: 99%

“…In our case series, one implantation (10%) resulted in partial insertion (10%), with 10 electrodes located outside the cochlea. A thorough examination of the occurring anatomy and pathology on the preoperative CT, optionally magnetic resonance imaging, should be routinely performed to optimize orientation during surgery and limit the risk of perioperative complications [9,13] . Among our patients, two experienced three complications in relation to the 10 surgeries performed (25% of patients, 30% of implantations).…”

Section: Discussionmentioning

confidence: 99%

“…However, one of the patients had residual dizziness (not related to surgery) for >6 months after the operation. FNS occurs when the electrode current stimulates the labyrinthine portion of the facial nerve, and this is not an unusual occurrence in patients implanted for otosclerosis [8,9,11,16] . The higher incidence of FNS in otosclerosis may be caused by a dysplastic bone between the cochlea and facial nerve canal allowing the current to escape the otic capsule [17] .…”

Section: Discussionmentioning

confidence: 99%

“…The higher incidence of FNS in otosclerosis may be caused by a dysplastic bone between the cochlea and facial nerve canal allowing the current to escape the otic capsule [17] . Previous estimates range from 0%-75% of otosclerosis patients [6,[9][10][11][16][17][18] . FNS may depend on the implanted device as the perimodiolar array leads less current laterally [6,17,18] .…”

Section: Discussionmentioning

confidence: 99%

“…In cases where this treatment is inadequate, cochlear implantation (CI) is considered the best available option [3,[6][7][8] . Although based on a small case series, it has been reported that CI in FAO may be associated with a variety of challenges both during and after surgery [7,[9][10][11] . Thus, to contribute to the literature, this study presents the surgical results of CI using successful electrode insertion in FAO at our tertiary referral center.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Results and Complications of Cochlear Implantation in Far-Advanced Otosclerosis

West¹,

Brand²,

Foghsgaard³

et al. 2017

Int Adv Otol

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OBJECTIVE:To report surgical results and complications of cochlear implantation in patients with far-advanced otosclerosis (FAO). MATERIALS and METHODS:This was a retrospective chart review of surgical results in terms of electrode insertion as well as peri-and postoperative complications. Ten cochlear implantations (CIs) were performed in eight patients with FAO. A prior stapedotomy had been performed in all cases. RESULTS:Full electrode insertion was achieved in nine of the 10 operations (90%) and partial insertion in one operation. An unintended opening of the vestibule during drilling was the only perioperative complication. Postoperative complications occurred as two cases of vertigo (one prolonged). No chorda tympani syndrome and no cases of facial nerve stimulation were noted. CONCLUSION:Although based on a limited number of cases, we conclude that full electrode insertion can be achieved in almost all cases and that major complications are infrequent in CI in patients with FAO. Postoperative vertigo appears to be the most commonly occurring complication.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical Results and Complications of Cochlear Implantation in Far-Advanced Otosclerosis

West¹,

Brand²,

Foghsgaard³

et al. 2017

Int Adv Otol

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Revision Cochlear Implantation for Facial Nerve Stimulation in Otosclerosis

Polák¹,

Ulubil²,

Hodges³

et al. 2006

Arch Otolaryngol Head Neck Surg

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To find if patients experiencing postsurgical facial nerve stimulation caused by underlying disease process (ie, otosclerosis) can improve their hearing performance with their cochlear implant by reimplantation and by an optimal programming strategy. Design: Retrospective analysis. Setting: Academic tertiary referral center. Patients: Two cochlear otosclerosis patients with resistant facial nerve stimulation (FNS). Both patients were initially implanted with Nucleus 22 devices (Cochlear Corporation, Englewood, Colo) and they developed FNS after a period of use. Owing to the decreasing number of active electrodes, concurrent decreases in speech understanding occurred. Interventions: Various programming approaches were used to address the FNS. Both subjects ultimately received Nucleus 24 devices. One was reimplanted in the same ear, and the other was implanted in the opposite ear. Both have been followed up for 8 months following the reimplantation. Main Outcome Measures: Cochlear implant programming levels, cochlear implant performance, and facial nerve stimulation.

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The importance of intra-operative imaging during cochlear implant surgery

Viccaro

Covelli

Seta

et al. 2009

Cochlear Implants Int.

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Two unusual cases of cochlear implant (CI) surgery complication are reported: introduction of the electrode array into the superior semicircular canal with normal morphology and a growing amplitude of neural potential (neural response imaging, NRI) during intra‐operative monitoring control. In the first case, a two‐year‐old patient affected by congenital sensorineural profound deafness was bilaterally implanted with two Clarion 90 k devices and intra‐operative electrophysiological and radiological controls were performed. After introduction of the array in the right side NRI was performed and a neural potential was found only on two apical electrodes. Radiological intra‐operative control with antero‐posterior trans‐orbital plain films was performed to assess the position of the electrodes inside the cochlea. Radiography showed the electrode array in the superior semicircular canal in the right ear. The electrode array was removed and reinserted correctly. In the second case, a 72‐year‐old man underwent left cochlear implantation for sensorineural profound deafness of unknown origin. Intra‐operative electrophysiological testing (NRI) showed the presence of neural potential on three tested channels. In this case, as routinely employed since 2006, an intra‐operative static fluoroscopy control was performed, this showed the electrode array in the superior semicircular canal. The electrode array was removed and reinserted correctly. In conclusion, intra‐operative monitoring tests during CI surgery play different roles: measurement of impedances and NRI can evaluate the integrity of implant electrodes and the status of the electrode cochlea interface, but they cannot be the only way to confirm correct positioning of the array. In our opinion the intra‐operative radiological check is helpful during CI surgery, especially when there is any doubt about correct electrode insertion. Copyright © 2009 John Wiley & Sons, Ltd.

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Cochlear Implantation in 53 Patients with Otosclerosis: Demographics, Computed Tomographic Scanning, Surgery, and Complications

Cited by 142 publications

References 21 publications

Surgical Results and Complications of Cochlear Implantation in Far-Advanced Otosclerosis

Surgical Results and Complications of Cochlear Implantation in Far-Advanced Otosclerosis

Revision Cochlear Implantation for Facial Nerve Stimulation in Otosclerosis

The importance of intra-operative imaging during cochlear implant surgery

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