Cochlear implants (CI) candidates with chronic otitis media require special attention and management. The need of opening of the inner ear creates potential routes of spread of infection to subarachnoid spaces and lead to meningitis. The aim of the study was to analyse the technique and complications of subtotal petrosectomy (SP) in cochlear implant candidates with chronic otitis media at three different CI centres. A retrospective study was carried out in three Territory Referral Hospitals. The centres follow Fisch’s philosophy and surgical techniques of SP. The study group consisted of 19 patients, 4 men and 15 women, aged 12–82 years. All patients underwent SP with either primary or staged CI implantation. Indications for single or a staged management, difficulties during surgery and complications were analysed. Skin and muscle flap design in primary and revision cases as well as imaging follow-up strategy are discussed. In 14 patients implantation was performed in a single stage and in 5 cases in two stages. Follow-up ranged from 8 months to 10 years. All the patients use their implants and there were no major nor minor complications. The use of subtotal petrosectomy with cochlear implants is a safe and efficient technique when strict surgical steps and rules are applied. Closure of the external ear canal after previous meatoplasty can be challenging and extreme care dissecting the skin flaps is required. In patients with extensive cholesteatoma, active discharge from the ear with resistant bacteria or an “unstable” situation, the procedure can be staged.Electronic supplementary materialThe online version of this article (doi:10.1007/s00405-015-3573-1) contains supplementary material, which is available to authorized users.

The Fisch-type titanium stapes piston prosthesis presented outcomes consistent with the literature and can be used safely in stapedotomy procedures.

Introduction:The implantable prosthesis of osseous conduction (BAHA) is deemed to be an excellent option in the auditory rehabilitation of patients with conductive and mixed hearing loss, unilaterally or bilaterally, and unilateral sensorineural hearing loss. It has been a good advantage over the conservative bone conduction apparatus and those of individual sound-amplifier apparatus (ISAA), when their usage becomes unfeasible because of chronic otitis externa, which has a hard clinic control. Objective:To introduce the first BAHA case performed in Brazil, as duly authorized by ANVISA (National Agency for Sanitary Surveillance), to rehabilitate the mixed hearing loss with occurrences of chronic otitis externa. Method:50-year-old female patient with right-ear moderate and left-ear severe hearing loss, bilateral tinnitus derived from otosclerosis, was submitted to 04 surgeries of stapedotomy and unable to use ISAA as a result of otorrhea and bilateral otalgia. The medical and audiological evaluation indicated the benefit of using BAHA. Having surgery been performed and BAHA implemented, the patient showed a significant improvement in audiometric thresholds, speech perception and distinction, as well as she declared to be extremely satisfied with the esthetic factor. Final commentaries: BAHA surgical process is safe, simple and swift, thus providing excellent audiological results and a higher degree of satisfaction to patients.

Several studies have shown that cochlear implants may reduce or even eliminate tinnitus in patients with bilateral profound hearing loss. However, there are not consistent references regarding ipsilateral tinnitus compared to unilateral profound hearing loss. The aim of this paper is to describe audiological results of a patient with asymmetrical hearing loss with incapacitating ipsilateral tinnitus in the ear subjected to cochlear implant surgery. Audiological exams and responses to perception protocols for tinnitus before and after surgery were analyzed. The tests showed improvements in the hearing threshold on the side with the implant, improvements in speech perception and a significant reduction in tinnitus perception, which consequently led to an improvement in the patient's quality of life.

ResumoIntrodução: O implante coclear é uma solução auditiva concretizada no cenário brasileiro, constituindo-se uma estratégia viável de reabilitação auditiva para perdas auditivas severas e profundas. Porém, apesar dos grandes avanços tecnológicos e dos excelentes resultados obtidos e descritos na literatura, ter um filho implantado pode comprometer a qualidade de vida dos familiares envolvidos no processo. Objetivo: Comparar a qualidade de vida de um grupo de pais e familiares que possuem filhos usuários de implante coclear, antes e depois da implantação. Método: Trata-se de um estudo clínico descritivo transversal. Participaram 30 indivíduos que foram submetidos ao questionário WHOQOLBref antes da cirurgia e depois de seis meses de ativação do implante. O escore geral e os dados relativos aos quatro domínios abrangidos (físico, psicológico, meio ambiente e relações sociais) foram analisados * Universidade Tuiuti do Paraná -UTP, Curitiba, PR, Brasil. Contribuição dos autores:AR: elaboração do projeto de pesquisa, coleta e análise de dados, redação do manuscrito; CMM: coleta de dados e redação do manuscrito; SMSC, GA e RR: análise de dados, redação do manuscrito; AA, RP e TV: coleta de dados. e descritos. Resultados: Houve mudança positiva significativa para os escores dos domínios de meio ambiente e relações sociais do instrumento. Não houve diferença significativa no escore geral e nos domínios físico e psicológico. Conclusão: Foi possível comparar a qualidade de vida de um grupo de pais de crianças usuárias de IC, antes e depois do processo cirúrgico e ativação do dispositivo. A implantação gerou melhora significativa nos domínios: meio ambiente e relações sociais, evidenciando que houve melhora da qualidade de vida dos pais entrevistados. E-mail para correspondência:Palavras-chave: Surdez; Implante coclear; Qualidade de vida; Criança. Abstract Introduction:The cochlear implant is a hearing solution implemented in the Brazilian scenario, becoming a viable strategy for auditory rehabilitation for severe and profound hearing loss. However, despite the great technological advancements and the excellent results obtained and described in the literature, having an implanted child can compromise the quality of life of the families involved in the process. Objective: Compare the quality of life of a group of parents and families who have children users of cochlear implants, before and after implantation. Method: This is a cross-sectional clinical study. The participants were 30 individuals that were submitted to the WHOQOL-Bref questionnaire before surgery and after six months of implant activation. The overall score and the data for the four areas covered (physical, psychological, environmental and social relations) were analyzed and described. Results: There was a significant positive change to the scores of environmental and social relationships domains of the instrument. There was no significant difference in the overall score or on the physical and psychological domains. Conclusion: It was possible to compare t...