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

Abstract

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.

Cochlear Implantation Following Explorative Tympanotomy in Patients With Sudden Sensorineural Hearing Loss: Surgical Features and Audiological Outcomes

“…11 However, electrode insertion may be impaired or even impossible based on changes of the cochlea in patients after head trauma, acute labyrinthitis, or otosclerosis. [12][13][14] In patients with cholesteatoma or chronic suppurative otitis media, CI can be challenging and, in many cases, requires special operative strategies. 15,16 By now, reports on CI in patients treated with ExT and sealing of the round window membrane are scarce.…”

Hearing Loss Etiology in Patients Submitted to Cochlear Implant

“…Most cases were classified as far advanced forms presenting severe sensorineural hearing loss without benefit with hearing aids. 15 Meniиreґs disease was attributed to 2 post lingual cases. This condition is closely related to endolymphatic hydrops and is defined by the presence of two or more spontaneous episodes of vertigo, each lasting 20 minutes to 12 hours; audiometrically documented low-to medium-frequency sensorineural hearing loss in the affected ear on at least 1 occasion before, during, or after one of the epi-sodes of vertigo and fluctuating aural symptoms (hearing, tinnitus, or fullness) in the affected ear.…”

Cochlear Implantation in Advanced Otosclerosis: Pitfalls and Successes

“…These instances are often detected on peri-operative imaging [27•] and in one case, post-operative imaging prompted by persistent vertigo [22]. Similar descriptions of false insertion or entry into the vestibule or lateral canal are also reported [22,61]. CSF gusher has been reported following cochleostomy in cases of severe retrofenestral disease, successfully managed with periosteal plugging [41,62].…”