Cochlear Implantation in Cochlear Ossification: Retrospective Review of Etiologies, Surgical Considerations, and Auditory Outcomes

Vashishth, Ashish; Fulcheri, Andrea; Prasad, Sampath Chandra; Bassi, Margherita; Rossi, Gianluca; Caruso, Antonio; Sanna, Mario

doi:10.1097/mao.0000000000001613

Cited by 41 publications

(30 citation statements)

References 36 publications

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“…CI is an acknowledged method for hearing rehabilitation in patients with severe to profound SNHL with relatively low complication rate [2]. In difficult situations, such as malformed or ossified cochlea, middle ear or intralabyrinthine tumors, chronic suppurative otitis media (CSOM), cholesteatoma and radical cavity from previous surgeries and its postoperative secondary infections, it is recommended to perform simultaneous STP [1][2][3][4][5][6]. This surgical approach provides an excellent exposure of the cochlea during CI and enables total isolation of surgical cavity from the outside environment, preventing secondary infectious complications.…”

Section: Discussionmentioning

confidence: 99%

“…Far-advanced or retrofenestral forms of otosclerosis may cause profound SNHL by narrowing the cochlear lumen with distortion of the basilar membrane and by lytic enzymatic activity in the perilymph [14]. Conventional CI in patients with severe SNHL as a result of otosclerosis may present a difficulty to the surgeon due to otospongiotic cochlea and possible obliteration of its lumen [5]. The latter could make finding the RW and identifying the BT of the cochlea through narrow posterior tympanotomy very challenging.…”

Section: Cochlear Ossificationmentioning

confidence: 99%

“…The importance of simultaneous STP in CI has been highlighted in recent literature [1][2][3][4][5][6]. Candidates for CI may coincidentally have various middle ear inflammatory pathologies or challenging anatomical conditions, which make conventional CI very difficult to undertake.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The role of subtotal petrosectomy in cochlear implant recipients: Our preliminary results

Chetverikova

Kasenõmm

2020

Acta Oto-Laryngologica Case Reports

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Conventional cochlear implantation (CI) is challenging in patients with coincidental anatomical or inflammatory middle ear pathologies. Performing subtotal petrosectomy (STP) simultaneously with CI allows to effectively overcome aforementioned problems. The aim of this study is to describe the benefits of simultaneous STP for our CI patients, review its indications, and analyze short-term outcomes. We describe five cases of successful CI using STP method, the indications for operation were advanced otosclerosis, vestibular schwannoma, chronic mastoiditis, cholesteatoma and previous implant bed infection. Five patients had a follow-up of 7-16 months. We had minor complications, which did not require medical intervention. We provide analysis of surgical strategy, postoperative complications and auditory performance of those patients. In this study, we found clear advantages of STP for our selected CI candidates. These were better exposure in cases with modified anatomy, radical eradication of the underlying disease and reduction of the secondary infection risk.

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Section: Discussionmentioning

confidence: 99%

Section: Cochlear Ossificationmentioning

confidence: 99%

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The role of subtotal petrosectomy in cochlear implant recipients: Our preliminary results

Chetverikova

Kasenõmm

2020

Acta Oto-Laryngologica Case Reports

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“…In 1998, Issing et al and Bendet et al 9,10 proposed SP as the technique of choice for cochlear implantation in ears affected by chronic otitis media (COM). Over the past few years, SP has been progressively applied to a variety of difficult situations in CI surgery [1][2][3][4][5][6][7][8][9][10][11][12][13][14] , slowly overcoming the initial resilience of the majority of the CI surgeons. In fact, through the closure of the tubal orifice and the EAC, SP permits complete isolation of the surgical cavity from the external environment, decreasing the risk of postoperative infection, cerebrospinal fluid (CSF) leakage and meningitis 14,15 .…”

Section: Introductionmentioning

confidence: 99%

“…Finally, the wide angle of approach to the round window area, obtained by removing the postero-superior wall of the EAC, makes each manoeuvre during array insertion much easier. These advantages are particularly important in presence of surgical difficulties such as cochlear obliteration or distorted anatomy 13,17 . The purpose of this study is to report our experience in a group of 30 patients who underwent SP combined with CI.…”

Section: Introductionmentioning

confidence: 99%

Subtotal petrosectomy and cochlear implantation

D’Angelo

Donati

Bacciu

et al. 2020

Acta Otorhinolaryngol Ital

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Objective. The objective of this study is to analyse surgical outcomes in a series of patients who underwent subtotal petrosectomy in combination with cochlear implantation. Methods. Retrospective chart review. Thirty patients (32 ears) underwent subtotal petrosectomy and cochlear implantation in one stage. Indications for subtotal petrosectomy included the following: cholesteatoma, chronic otitis media, previous canal wall-down, osteoradionecrosis, revision surgery for clinical reasons, inner ear malformations, middle ear anatomical variations and severe cochlear ossification. Results. Follow-up ranged from 2 to 54 months. Only 2 complications related to the subtotal petrosectomy (1 subcutaneous abdominal haematoma and 1 subcutaneous abdominal seroma) occurred in this series. Complete electrode insertion was achieved in all but 4 cases. Conclusions. Subtotal petrosectomy is a safe procedure and can offer technical advantages in some cases of complex cochlear implantation.

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Subtotal Petrosectomy and Cochlear Implantation

Yan

Reddy

Isaac

et al. 2021

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Subtotal petrosectomy (STP) has been more frequently performed to prepare ears with unfavorable conditions for cochlear implantation.OBJECTIVES To provide an overview of indications for and complications of STP and cochlear implantation and to compare outcomes between single vs multistage procedures and between pediatric vs adult populations.DATA SOURCES A search of PubMed, Scopus, Ovid, and the Cochrane Library was performed from the databases' inception to January 23, 2020, for studies evaluating STP for cochlear implantation.STUDY SELECTION Studies with a minimum follow-up of 3 months and no missing data regarding postoperative outcomes were included. Of the initial 570 studies identified, 27 (4.7%) met selection criteria. DATA EXTRACTION AND SYNTHESISTwo reviewers independently assessed study eligibility according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines; discrepancies were resolved by a third reviewer. Extracted data included patient demographics, indications for STP, rates of complications, and cholesteatoma recidivism when applicable. Data were pooled using a random-or a fixed-effects model when appropriate. MAIN OUTCOMES AND MEASURESThe primary study outcome was rate of global complications stratified by patient-and surgery-level characteristics. RESULTSTwenty-seven unique studies with 377 unique patients (54.2% male; mean age, 50.6 [range, 1-99] years) undergoing 397 STP procedures and cochlear implantation were included. Of these procedures, 299 of 394 cases with the information reported (75.9%) were single procedures and 95 (24.1%) were multistage procedures. Of the total 397 STP procedures, most common indications included chronic otitis media (220 cases [55.4%]), previous open mastoid cavity (141 [35.5%]), cholesteatoma (74 [18.6%]), and cochlear ossification (29 [7.3%]). The overall complication rate was 12.4% (95% CI, 9.4%-15.9%); overall cholesteatoma recidivism rate was 9.3% (95% CI, 4.3%-17.1%). Complication rates did not significantly differ based on stage or age of patients. Cases with cholesteatoma more often underwent multistage vs single-stage procedures (23 of 54 [42.6%] vs 35 of 174 [20.1%]).CONCLUSIONS AND RELEVANCE Across all age groups, STP has been shown to be an effective surgical operation in preparing an ear with unfavorable conditions for cochlear implantation. The potential indications for which cochlear implantation can be performed have expanded with the use of STP. Presence of cholesteatoma might indicate that a multistage procedure should be performed. Lastly, with complication rates comparable to those in adult patients, STP can be considered in children requiring cochlear implantation to minimize ear-related issues and allow benefit from cochlear implantation.

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Cochlear Implantation in Cochlear Ossification: Retrospective Review of Etiologies, Surgical Considerations, and Auditory Outcomes

Abstract: Cochlear implantation in cochlear ossification is feasible despite surgical challenges and modifications. Auditory outcomes in basal turn ossification appear to be comparable to cases with no ossification with extent of ossification having no significant association with outcomes.

Cited by 41 publications

References 36 publications

The role of subtotal petrosectomy in cochlear implant recipients: Our preliminary results

The role of subtotal petrosectomy in cochlear implant recipients: Our preliminary results

Subtotal petrosectomy and cochlear implantation

Subtotal Petrosectomy and Cochlear Implantation

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