Auditory rehabilitation after temporal bone fracture with cochlear implants – a case control study

Abstract

Objectives:

Temporal bone fracture can cause posttraumatic deafness. Sequelae like ossification or obliteration of the cochlea can impact the outcome of cochlear implantation. This study highlights the effect of localisation of the fracture to morphologic, electric and functional criteria.

Methods:

The study group consists of patients suffering from hearing loss caused by temporal bone fracture (n = 61 ears). Patients were divided into otic capsule sparing (OCS) and otic capsule involving (OCI) fractures. The OCI group was additionally divided into subgroups with or without signs of ossification inside the cochlea. Postoperative imaging, hearing tests and electrode impedances were analysed.

Results:

The results of postoperative hearing rehabilitation showed lower speech understanding scores for the OCI group, especially for the ossification group. OCI fractures with signs of ossification showed increased impedances. Patients in the OCI group suffered more frequently from facial nerve stimulation (FNS). FNS was most frequently observed within the ossification group.

Conclusion:

Cochlear implantation in patients with temporal bone fracture is adequate therapy for the treatment of fracture-induced deafness. In long-term observation, these patients show comparable results with regular cochlear implant (CI) patients. Implantation should be performed as soon as possible after hearing loss, before obstructing obliteration or ossification of the cochlea start.

Keywords:

• Cochlear Implant
• Temporal Bone Fracture
• Cochlear Ossification
• Cochlear Obliteration

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or non-profit sectors.

Notes on contributors

Katharina Heine

Katharina Heine Graduated as a dentist from Hannover Medical School in November 2018. Working on her doctorate at the Department of Otolaryngology at Hannover Medical School since September 2017.

Max Eike Timm

Dr. med. Max Eike Timm Resident of the ENT clinic at Hannover Medical School.

Lutz Gärtner

Dr. rer. nat. Dipl.-Ing.Lutz Gärtner Graduate physicist, graduate engineer. Joined the cochlear implant team at Hannover Medical School in June 2001. Speciality: fitting of Auditory Brainstem Implant patients, electrophysiological measurements in cochlear and brainstem implant patients.

Thomas Lenarz

Prof. Prof. h.c. Dr. med. Thomas Lenarz Professor of Otorhinolaryngology, Chairman of the Department of Otolaryngology and Deutsches Hörzentrum at Hannover Medical School. Internationally recognised specialist in cochlear implants and implantable hearing systems.

Anke Lesinski-Schiedat

Prof. Dr. med. Anke Lesinski-Schiedat Senior Consultant Department of Otolaryngology, Hannover Medical School, Medical Head of Deutsches Hörzentrum Department of Otolaryngology, Hannover Medical School.