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Cochlear implantation (CI) has been established worldwide as the surgical treatment for individuals with bilateral severe to profound hearing loss. This is a safe and standard procedure in the hands of experienced implant surgeons. Complications due to surgery are minimal and are often encountered in cases with congenital anomalies of the temporal bone and inner ear. Complications in CI are related to malfunctioning of the device or the process of wound healing. In most cochlear implant centers, as the surgeon's skill and clinical expertise in managing various cochlear implant cases improves with years of experience, the complication rates in his series ideally come down over time. Over the years, these well experienced clinics become tertiary referral centers for CI, receiving many difficult cases for implantation and hence such centers report data on complications, which become an important reference for many aspiring implant surgeons. Our study, performed in a premier CI centre in Chennai, looks at the various complications which were encountered in a case series of 300 implantees. Retrospective descriptive study with data collected from operative notes, patient questionnaires, auditory habilitation registers and medical records of cochlear implantees operated between, November 2006 to November 2010. A spectrum of major and minor complications, were categorized. Their incidence rates in relation to the demography of the patient profile and various events during surgical procedure were documented and analyzed.Appropriate management protocols were defined. Our management protocols have been highlighted and the relevant literature reviewed. This report of our experience with 300 cochlear implantees, reveals that complication rates at our center are in comparison with reputed centers worldwide. CI is very safe in the long term and provides optimal auditory awareness with speech perception and intelligibility for profoundly deaf individuals giving them an avid opportunity to integrate within the normal society.

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The aim of this study was to investigate the efficacy and outcomes of intravenous high dose steroids in patients diagnosed with sudden sensori-neural hearing loss (SSNHL). The study also looked at the various co-morbidities influencing the outcomes of IV steroid therapy and also evaluated the improvement in associated symptoms like vertigo and tinnitus. This prospective study involved 30 patients treated during the 1 year period from January 2010 to 2011 in the Department of Otolaryngology, Madras ENT Research Foundation, Chennai. Male: female ratio was 1.3:1 and age range was 19-80 years. For all patients, pre treatment pure tone audiometry (PTA) was compared with post treatment PTA at 1 month. Treatment was given in the form of intravenous high dose methyl prednisolone. The patients were divided into two groups. Group 1 (20 pts) included SSNHL with no co-morbidity, group 2 (10 pts) included SSNHL with various co-morbidities. The mean hearing level improved from an average of 79.53 dB (HL) before treatment to 42.33 dB (HL) after treatment. In patients with predominantly low frequency HL (16 pts) PTA improved from 76.01 to 32.6 dB while in high frequency HL PTA improved from 83.55 to 53.43 dB. In our study of 30 patients, complete recovery occurred in 56.66% cases and marked improvement (>30 dB) in 16.66% patients. There was no improvement in 26.66% cases. Patients in group 2 had co-morbid factors like diabetes mellitus, dys-thyroidism and hypertension. A statistically significant improvement in the associated symptoms of tinnitus/vertigo, were also noted after IV steroid treatment. According to our results, emergency administration of high dose of Intra-venous corticosteroids to patients with SSNHL is highly recommended. Patients with high frequency preservation have better hearing improvement at the end of treatment. The critical time period for commencing IV treatment is less than 6 h from onset of hearing loss in order to restore normal hearing. High dose Intravenous steroids are a safe and effective treatment in sudden sensori-neural hearing loss.