Complications and Pitfalls of Cochlear Implantation in Otosclerosis

Sainz, Manuel; García‐Valdecasas, Juan Carlos; Ballesteros, José Manuel Bértolo

doi:10.1097/mao.0b013e31819d34c9

Cited by 44 publications

(47 citation statements)

References 17 publications

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“…Elektrik şarjındaki bu artışın istenmeyen bir sonucu ise fasiyal sinirin uyarımıdır. [7] Bigelow ve ark. [3] üç farklı implantı kullandıkları 58 hastada fasiyal sinir uyarımını %14 oranında (n=8) bildirirken, otoskleroz ve otosifilizi predispozan faktör olarak sunmuşlardır.…”

Section: Discussionunclassified

Cochlear implantation in far advanced otosclerosis: series of four cases

Yılmaz

Akdoğan²,

Özer³

et al. 2016

Kulak Burun Bogaz Ihtis Derg

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ÖZBu yazıda aşırı ilerlemiş otoskleroz nedeniyle koklear implantasyon uygulanan dört hasta sunuldu. Ameliyat öncesi değerlendirmeler, ameliyat sırasındaki bulgular, komplikasyonlar ve ameliyat sonrası faydalar incelendi. Koklear implantasyon aşırı ilerlemiş otosklerozlu hastaların rehabilitasyonunda mükemmel işitsel sonuçlar sunan bir tedavi seçeneğidir. Fakat koklaer implantasyon sonrası fasiyal sinir uyarımı otosklerozlu hastalarda daha sık görülmektedir. Ayrıca, otosklerozlu hastalarda koklear ossifikasyon ve istikrarsız sonuçlar açısından da dikkatli olunmalıdır.Anahtar Sözcükler: Koklear implant; fasiyal sinir uyarımı; ossifikasyon; otoskleroz. ABSTRACTIn this article, we present four patients who underwent cochlear implantation due to far advanced otosclerosis. Preoperative evaluations, intraoperative findings, complications, and postoperative benefits were analyzed. Cochlear implantation is a treatment option providing excellent audiological results for rehabilitation of patients with far advanced otosclerosis. However, facial nerve stimulation after cochlear implantation is observed more frequently in patients with otosclerosis. Also, caution should be paid in patients with otosclerosis in terms of cochlear ossification and inconsistent results. Otoskleroz erişkinlerde ilerleyici iletim tipi işitme kaybının en yaygın nedenidir. Koklear otoskleroz sensörinöral işitme kaybı ile ortaya çıkabilir. Tüm kokleanın otosklerozla çev-relenmesi tam sağırlıkla sonuçlanır. House Ear Institute'de yapılan ilk 57 koklear implant olgusunun 20'si otoskleroz nedeni ile sağır olan olgulardır. İlerlemiş otosklerozda işitme kaybının artması ve işitme cihazına rağmen konuşmayı anlamanın bozulması durumunda koklear implantasyon iyi bir tedavi seçeneğidir. [1] Otosklerozda koklear implant cerrahisinin kokleada ossifikasyon olasılığı, fasiyal sinir uyarımı ve sonuçların istikrarsız olması gibi sorunları olabilir.[2] Bazen implantın çıkarılma-sını gerektirebilen implantasyon sonrası fasiyal sinir uyarımının %75'lere kadar görülebildiği Geliş tarihi /

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Section: Discussionunclassified

Cochlear implantation in far advanced otosclerosis: series of four cases

Yılmaz

Akdoğan²,

Özer³

et al. 2016

Kulak Burun Bogaz Ihtis Derg

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“…Vertigo is a common complication of CI [7,11,14] . Consistent with otosclerosis as a recognized cause of vestibular complaints, four patients experienced vertigo prior to the surgery [14,15] .…”

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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