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

Abstract

ObjectiveTo investigate surgical indications, operative techniques, complications and auditory and speech rehabilitation for cochlear implant (CI) in children with otitis media with effusion (OME).Material and methodsThis is a retrospective review of records of 24children with bilateral profound sensorineural hearing loss and OME who were implanted during January 2011 to November 2014 in the Department of Otorhinolaryngology and Head and Neck Surgery at the PLA Hospital, using one-stage implantation via the facial recess approach and round window insertion. The incus was removed in 8 cases during the implantation procedure. Local infiltration of dexamethasone and adrenaline in the middle ear was also performed. Postoperative complications were examined. Preoperative and postoperative questionnaires including Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR), and the Meaningful Auditory Integration Scale (MAIS) were collected.ResultsAll electrodes were implanted successfully without any immediate or delayed complications. Inflammatory changes of middle ear mucosa with effusion were noted in all implanted ears. The scores of post-implant CAP and SIR increased significantly in all 24 cases (t = −25.95 and −14.09, respectively for CAP and SIR, p < 0.05).ConclusionsOne-stage CI via the facial recess approach with round window insertion is safe and effective in cochlear implant candidates with OME, as seen in the 24 children in our study who achieved improved auditory performance and speech intelligibility after CI.

The Risk of Meningitis After Cochlear Implantation: A Systematic Review and Meta‐Analysis

“…The titles and abstracts of the remaining 1931 unique articles were screened, yielding 659 articles. Full‐text screening of these studies confirmed that 116 of these articles met the inclusion criteria 5,16‐130 . The selection process, including reasons for exclusion, is shown through a PRISMA flowchart in Figure 1.…”

“…These patients would have also been implanted after the link with postoperative meningitis received significant attention in 2002, and after preventative recommendations such as pneumococcal vaccination were strongly put forth by organizations such as the CDC. 135 Of the 26 studies reporting the number of children under 5 years implanted, 12 studies reported that all implantations occurred from 2003 onward 20,39,43,49,59,66,100,[109][110][111]129,130 (Table 6 in Supplemental File S3, available online). We identified 1307 children in this age group implanted after this time (ie, without a positioner) and only 1 case of postoperative meningitis.…”