Surgical management of cochlear implant in chronic otitis media patients: safe and sound

Abstract

Introduction

Cochlear implantation (CI) in cases with chronic otitis media (COM) was previously contraindicated but recent advances have made it possible.

Objective

To review surgical and audiological outcomes of COM patients that underwent CI.

Material and methods

Retrospective review of patients above 18 years old.

Results

Ten patients with complete data were included. Patients were aged 24–69 years old. Tympanoplasty and mastoidectomy were performed before CI. Imaging was performed to rule out ossifications. Eight patients underwent a standard canal wall up with either cochleostomy or round window approach. One patient had additional canalplasty and tympanoplasty and another one had blind sac procedure respectively. Analysis of the hearing aided level with CI and hearing aid showed significant benefit provided by the CI (Z = 2.803, p = .005).

Discussion

Creating a dry and safe ear is important prior to CI. Definite hearing improvement is seen in all our cases that helped them to become independent again in their daily life. Hearing aid usage pre-CI might not be important as the hearing aids may continue to cause discharging ears and the benefits of hearing aids in severe to profound hearing loss are very minimal.

Conclusions

Cochlear implant is safe and effective in COM patients.

Chinese abstract

简介：以前禁忌患有慢性中耳炎（COM）的患者进行耳蜗植入（CI）, 但最近的发展使之成为可能。

目的：探讨接受CI的COM患者的手术和听力结果。

材料和方法：回顾性研究18岁以上的患者。

结果：包括十例具有完整数据的患者。患者年龄为24-69岁。CI之前行鼓膜成形术和乳突切除术。进行成像检查以排除骨化。八名患者接受了耳蜗切开或圆窗切开的标准耳道扩张术。一名患者进行了额外的耳道成形术和鼓室成形术, 另一名患者进行了盲囊手术。 对CI和助听器的助听水平所进行的分析显示, CI带来显著收益（Z¼2.803, p¼.005）。

讨论：在进行CI之前, 保证耳朵的干燥安全非常重要。在我们所有的病例中可以看到明显的听力改善, 这使得他们在日常生活中再次变得独立。CI之前的助听器的使用可能并不重要, 因为助听器可能会继续导致耳朵出耳, 并且助听器对重度至深度听力损失带来的益处非常小。

结论：人工耳蜗对COM患者安全有效。

Keywords:

• Cochlear implant
• chronic otitis media
• sensorineural hearing loss
• tympanoplasty

Acknowledgements

This study had been presented as a poster presentation at the 12th Asia Pacific Symposium on Cochlear Implants and Related Sciences on 27–30 November 2019.

Disclosure statement

No potential conflict of interest was reported by the author(s).