The safety of posterior tympanotomy in otitis media with effusion during cochlear implantation: clinical retrospective cohort study

Abstract

Background

Posterior tympanotomy (PT) is an important step in cochlear implant (CI) surgery, as it is the main access to the round window. Some CI candidates, especially children, may have concomitant otitis media with effusion (OME) which may result in technical issues during PT. There is still a debate whether to wait for OME resolution preoperatively or to proceed to surgery with suspected difficulties.

Aims/Objective

To evaluate the safety of PT during CI surgery in patients with OME.

Material and Methods

we included 102 consecutive pediatric candidates in this retrospective study with an age range of 12 months to 6 years. All the patients underwent CI surgery using trans-mastoid, PT to access round window (RW) area. We investigated the effect of the pathology caused by OME on the operative procedure in PT and post-operative consequences.

The Results

out of 102 patients included in this study, there were 22 patients with OME who had unilateral cochlear implantation with no major operative or post-operative events. Nevertheless, some minor intra operative events and difficulties were encountered.

Conclusion and Significance

The presence of OME in CI surgery indicates possible surgical challenges such as difficult PT, minor intra-operative risks and with no major post-operative events.

Chinese abstract

背景：后鼓室切开术（PT）是耳蜗植入（CI）手术的重要一步, 因为它是接近圆窗的主要途径。一些CI接受者, 尤其是孩子们, 可能会伴发渗出性中耳炎（OME）, 这可能在PT过程中导致出现技术问题。是否在术前等待OME解决或虽疑有困难却仍进行手术, 这点还存在着争议。

目的：评价OME患者CI手术期间PT的安全性。

材料和方法：我们在这项回顾性研究中纳入了102位连续的儿童患者, 年龄范围为12个月至6岁。所有患者均使用反乳突入路进行CI手术, PT进入圆形窗口（RW）区域。我们调查了由OME引起的病理学特征对PT手术程序和术后后果的影响。

结果：本研究纳入的102位患者中, 有22位患有OME的患者接受单侧人工耳蜗植入, 无重大术中或术后事件。不过, 还是遇到一些较小的术中事件和困难。

结论和意义：在CI手术中有OME的存在, 表明可能存在着手术挑战, 例如困难的PT、术中小风险且无重大术后事件。

Keywords:

• Cochlear implantation
• posterior tympanotomy
• OME
• intra-operative difficulties

Disclosure statement

The authors declare that there are no conflicts of interest.

Ethical approval

In this study, all procedures performed involving human participants were in accordance with the ethical standards of the institutional research editorial boards and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Formal consent was signed by the parents of the participant for sharing data in this research.

Author contributions

S.Z; methodology, idea formulation and reference collection, editing final draft H.E; review writing and revision - I.N; data collection, revision, statics final revision - A.M; data collection.