Binaural cochlear implantation after bilateral temporal bone fractures

Abstract

Abstract

In this clinical note we discuss the indications, feasibility, and outcomes of binaural simultaneous cochlear implantation (CI) following bilateral transverse temporal bone (TB) fractures. A 41-year-old male, totally deaf after a bilateral TB fracture, underwent an audiological, electrophysiological, and imaging investigation in order to assess the integrity of the VIIIth cranial nerves. Five months later he received a simultaneous bilateral CI. Speech perception tests were conducted at different time points. A significant advantage by dichotic listening was observed since the beginning of the habilitation program. The patient achieved a 100% word and sentences recognition in quiet at 12 months. His listening skills in noisy conditions were improved by the use of two implants. A CI in TB fractures is feasible if the VIII nerve is intact and the cochlea is spared by the fracture rim. The early timing of the procedure probably contributed to its success by preventing cochlear fibrosis and ossification.

Sumario

En esta nota clínica discutimos las indicaciones, la factibilidad, y los resultados de la implantación coclear (CI) bilateral simultánea posterior a fracturas transversas bilaterales del hueso temporal (TB). Un varón de 41 años de edad, totalmente sordo después de una fractura bilateral del TB, fue sometido a una investigación audiológica, electrofisiológica y por imágenes, para evaluar la integridad de ambos octavos nervios craneales. Cinco meses después, el sujeto recibido IC bilaterales simultáneos. Se realizaron pruebas de percepción de lenguaje en diferentes momentos. Se observó una ventaja significativa en la audición dicótica desde el inicio del programa de habilitación. El paciente logró un 100% de reconocimiento de palabras y frases en silencio a los 12 meses. Sus habilidades para escuchar mejoraron con el uso de dos implantes. Una IC en fracturas del TB es factible si el VIII par está intacto y la cóclea no está involucrada en el trazo de la fractura. La oportuna realización del procedimiento probablemente contribuyó al éxito al prevenir la fibrosis coclear y la osificación.

Key Words:

• Cochlear implant
• Binaural
• Temporal bone fracture
• Bilateral

Acknowledgements

Dr. Chiara Barbara Campovecchi received a grant from the University of Brescia, Italy, to support her researches in the field of cochlear implants. The grant is sponsored by Cochlear Corporation Italia Srl, Via A. Murri 45, Bologna, Italy. The publication expenses for this paper are covered by Associazione Progetto Udire Onlus, a non-profit organization based in Brescia (Italy), active in the support of research on deafness.

This paper has been presented at the XXIst Congress of the Italian Society of Audiology and Phoniatrics, Ferrara (Italy), September 29^th, 2007.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.