One-stage cochlear implantation in patients with chronic otitis media using canal wall up mastoidectomy

Abstract

Background

Cochlear implantation (CI) with subtotal petrosectomy was recommended to avoid the complications for patients with chronic otitis media (COM).

Objectives

To evaluate the surgical outcomes of CI in patients with COM using a one-stage operation with canal wall up mastoidectomy (CWUM).

Methods

Thirty-five patients with COM who underwent CI with CWUM as a one-stage between 2009 and 2017 were participated. They divided into those with inactive COM and active COM. The anatomical success rate, postoperative complication, and hearing outcomes were analyzed.

Results

Twenty-four patients had inactive COM and seven with active COM. Three of the 31 patients (9.7%) had otorrhea from the ear undergone surgery. Two of these three patients had myringitis after CI and their symptoms improved after conservative management. Although infection of the tympanic membrane in the third patient was controlled after conservative management, a perforation was left. Postoperative otorrhea occurred in two patients (8.3%) in the inactive COM group and one patient (14.3%) in the active COM group.

Conclusion

This study indicates that infection control and successful implantation can be achieved through a one-stage CI operation with CWUM in selected patients with COM.

HIGHLIGHTS

• Although COM was once considered a contraindication to CI, CI in patients with COM has been made feasible by STP before CI or simultaneously with CI.

• Simultaneous CI with CWUM was performed for 31 patients with COM.

• Three patients (9.7%) had minor complications after the surgery and only one patient experienced device explantation which was due to device failure.

Chinese abstract

背景：建议采用人工耳蜗植入（CI）联合次全切除术, 以避免慢性中耳炎（COM）患者的并发症。

目的：通过一期手术行耳道壁上乳突切除术（CWUM）来评估COM患者的CI手术效果。

方法：2009年至2017年间接受了CWUM 一期CI手术的35例COM患者参与了研究。他们分为不发作COM和发作COM两类。分析了解剖学成功率、术后并发症和听力结果。

结果：24例COM不发作, 7例COM发作。 31例患者中有3例（9.7％）接受耳部手术治疗的耳发生耳漏。这三例患者中有两例在CI后发生了脊髓炎, 保守治疗后其症状有所改善。尽管在保守治疗后控制了第三例患者的鼓膜感染, 但仍留下了穿孔。非发作型COM组有2例患者（8.3％）发生术后耳漏, 而发作型COM组有1例患者（14.3％）发生术后耳漏。

结论：这项研究表明, 通过CVUM一期CI手术, 可以对部分COM患者进行感染控制和成功CI植入。

Keywords:

• Chronic otitis media
• cochlear implantation
• one-stage operation
• canal wall up mastoidectomy
• ear surgery

Disclosure statement

No potential conflict of interest was reported by the authors.