Cochlear Implantation with Round Window Insertion in Children with Otitis Media with Effusion

Abstract

Aims: To discuss indications and surgical techniques for cochlear implantation (CI) in children with profound sensorineural hearing loss and otitis media with effusion (OME). Methods: Between January 2003 and May 2013, a total of 550 patients received cochlear implants at the Anhui Provincial Hospital, Hefei, China. Of these, 30 children with OME underwent CI with round window insertion in one stage. Results: One-stage operations of CI with round window insertion were carried out in 30 children with OME. All electrodes were implanted successfully. CI was performed without complications and the electrode arrays were protected well. All implant devices worked normally and all patients performed well during an average follow-up period of 12 months. None of the patients experienced any immediate or delayed postoperative infection-related complications. Conclusions: CI with round window insertion could be safely and effectively performed in one stage in children with profound sensorineural hearing loss and OME. It is unnecessary to delay implantation to control OME, but it remains a challenging problem in operation.

One-stage coclear implantation via a facial recess approach in children with otitis media with effusion

“…Middle ear infection can spread via a cochlear implant electrode into the labyrinth and even intracranial space to cause post-operative infection, meningitis or fatal intracranial complications ( Melton and Backous, 2011 , Vincenti et al., 2014 , Luntz et al., 2004 , Barañano et al., 2010 , Sun et al., 2014 ). The presence of chronic and recurrent inflammation in mastoid and middle ear cavities is considered a risk factor for cochlear implant electrode impairment and/or extrusion ( Luntz et al., 2004 , Barañano et al., 2010 ).…”

“…The presence of chronic and recurrent inflammation in mastoid and middle ear cavities is considered a risk factor for cochlear implant electrode impairment and/or extrusion ( Luntz et al., 2004 , Barañano et al., 2010 ). Additionally, effusion and bleeding from inflamed middle ear mucosa can obscure the operative field and challenge even the most experienced surgeons intraoperatively ( Vincenti et al., 2014 , Luntz et al., 2004 , Barañano et al., 2010 , Sun et al., 2014 , Wong et al., 2014 ). Based on these considerations, the current recommendation for cochlear implant candidates is to treat chronic otitis media with effusion before CI surgery.…”

Outcome of Cochlear Implantation in Deaf Children with Co-Existing Otitis Media with Effusion

“…Cochlear implantation (CI) is the standard of care in management of children with profound sensorineural hearing loss (SNHL). [2][3][4][5][6][7][8][9][10][11][12][13][14][15] In our health care system, children with a confirmed diagnosis of profound SNHL will be evaluated for potential CI. The indications of CI in our study group were congenital, infection (e.g.…”

“…3,16 Management of OME in children who are the candidates for the CI is the subject of debate on whether the OME should be treated prior to CI or not. The presence of OME has been reported to increase the risk of post-operative surgical site infection, meningitis and device extrusion [4][5][6][7][8][9][10][11] as well as impaired visualization and bleeding in the presence of inflamed middle ear mucosa, leading to a high risk of complications in the post-operative period. 5,6,7 Some surgeons insert a ventilation tube (VT), 7 while others treat it medically, with some operating regardless.…”

“…The presence of OME has been reported to increase the risk of post-operative surgical site infection, meningitis and device extrusion [4][5][6][7][8][9][10][11] as well as impaired visualization and bleeding in the presence of inflamed middle ear mucosa, leading to a high risk of complications in the post-operative period. 5,6,7 Some surgeons insert a ventilation tube (VT), 7 while others treat it medically, with some operating regardless. [4][5][6][8][9][10][11] This study describes our experience of CI in patients with OME prior to and at the time of surgery.…”