Cochlear implantation in patients with canal wall down mastoidectomy cavities

Abstract

Background: Safe cochlear implantation (CI) is challenging in patients with a canal wall down (CWD) mastoidectomy cavity.

Objectives: We reviewed the outcomes of CI and proposed surgical management principles according to the presentation status of CWD mastoidectomy cavity.

Material and methods: The cases of eight patients (nine ears) with CWD mastoidectomy cavity who underwent CI were retrospectively reviewed. The basis of the surgical decision, postoperative complications, and postimplant auditory performance were analysed.

Results: In seven patients (eight ears), implantation was performed in a single stage; in six ears, the external auditory canal (EAC) was oversewn. In two patients with ossification, the electrode array was inserted into the scala tympani by drilling of the basal turn or in the second turn of the cochlea through a drill-out procedure. Seven patients had a follow-up of 12–50 months and one patient was lost to follow-up. None of the followed-up seven patients suffered complications.

Conclusions: CI is safe and effective in patients with profound hearing loss after radical mastoidectomy. In patients with CWD mastoidectomy cavity, CI does not cause a higher rate of postoperative complications relative to standard CI procedures. The outcome is excellent and comparable to that in the general CI population.

Chinese abstract

背景：对于耳道壁向下（CWD）乳突切除空腔的患者, 安全的人工耳蜗植入（CI）具有挑战性。

目的：我们回顾性分析了CI的治疗效果, 并根据CWD乳突切除空腔的状况, 提出手术治疗原则。

材料与方法：回顾性分析8例（9耳）CWD乳突切除空腔患者接受人工耳蜗植入的临床资料。分析了手术决策依据、术后并发症及术后听力表现。

结果：七位患者（8只耳）单期植入；6只耳外耳道缝合。对于两位骨化患者, 通过钻入耳蜗基底转孔或耳蜗第二转孔, 将电极阵列插入鼓阶。对7名患者进行了12至50个月的随访, 而1名患者不知去向。7名随访患者均未出现并发症。

结论：CI对治疗乳突根治切除术后的重度听力损失是安全有效的。在CWD乳突空腔切除术患者中, 与标准的CI手术相比, CI不会导致更高的术后并发症发生率。治疗结果很好, 与一般CI人群的结果相当。

Keywords:

• Cochlear implantation
• canal wall down
• mastoidectomy cavity

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study funded by National Natural Science Foundation of China.