Cochlear implantation outcomes in advanced otosclerosis

Castillo, Felipe; Polo, Rubén; Gutiérrez, Auxiliadora; Reyes, Pablo; Royuela, Ana; Alonso, Antonio López

doi:10.1016/j.amjoto.2014.03.011

Cited by 29 publications

(42 citation statements)

References 39 publications

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“…Cochlear ossification has been postulated as a cause of facial nerve stimulation (FNS) in approximately 20% of patients with advanced otosclerosis due to increase of conductivity due to bone spongiosis. 4 Facial nerve stimulation is found most commonly due to electrodes in close proximity with the geniculate and labyrinthine segment of the facial nerve. Patients with a higher CT classification are significantly more likely to develop FNS.…”

Section: Discussionmentioning

confidence: 99%

“…Rotteveel et al described the factors contributing to the success of a CI, namely little spongiosis of the cochlea on CT scans, full insertion of the electrode array, and little or no facial electrical stimulation. 4 The management of advanced otosclerosis can pose challenges to the otologist. The pre-operative air-bone gap, speech discrimination and extent of involvement on CT scans are the main criteria in deciding on the choice of treatment in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…The effectiveness with regard to the improvement of the level of speech discrimination varies around 38%-75%. 4 The advantages of stapedotomy for advanced otosclerosis include simple and safe procedure, reduced cost, good sound quality, and lack of any adverse effect on outcomes of future cochlear implantation. In 1996, Glasscock et al showed that stapedectomy was effective in 60% of patients with advanced and far-advanced otosclerosis.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Management of advanced otosclerosis: experience in a tertiary care centre

Alam¹,

Natarajan

Singh

et al. 2018

Int J Otorhinolaryngol Head Neck Surg

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Background: Advanced otosclerosis affects approximately 10% of patients with otosclerosis. Ossification of the cochlea increases with the course of the disease and may cause sensori-neural or mixed hearing loss. Hearing aids, stapedotomy and cochlear implants are management options for hearing loss associated with advanced otosclerosis. Methods: A retrospective study of 153 patients with advanced otosclerosis was done in a tertiary ENT centre. 110 patients with advanced otosclerosis underwent stapedotomy and 43 patients with advanced otosclerosis underwent cochlear implantation (CI) from 1997 till date. Exclusion criteria included patients with profound hearing loss from causes other than otosclerosis. The aim was to study the indications, selection criteria, as well as surgical issues of stapedotomy and cochlear implantation in patients with advanced otosclerosis. Results: Stapedotomy followed by use of hearing aid was found to give good outcomes in advanced otosclerosis. Patients with advanced otosclerosis who had poor pre-operative speech discrimination underwent CI. Complete insertion was possible in 39 patients and partial insertion was done in 4 patients. The outcomes of cochlear implantation were found to be satisfactory. Facial nerve stimulation was seen in 5 patients who underwent CI; however this was successfully managed by reprogramming or switching off the concerned electrodes. Conclusions: In our experience, stapedotomy or CI in advanced otosclerosis has proven successful, with a low complication rate. The selection criteria for stapedotomy versus CI have to be stringent for optimal outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Management of advanced otosclerosis: experience in a tertiary care centre

Alam¹,

Natarajan

Singh

et al. 2018

Int J Otorhinolaryngol Head Neck Surg

View full text Add to dashboard Cite

show abstract

“…The higher incidence of FNS in otosclerosis may be caused by a dysplastic bone between the cochlea and facial nerve canal allowing the current to escape the otic capsule [17] . Previous estimates range from 0%-75% of otosclerosis patients [6,[9][10][11][16][17][18] . FNS may depend on the implanted device as the perimodiolar array leads less current laterally [6,17,18] .…”

Section: Discussionmentioning

confidence: 99%

“…Previous estimates range from 0%-75% of otosclerosis patients [6,[9][10][11][16][17][18] . FNS may depend on the implanted device as the perimodiolar array leads less current laterally [6,17,18] . Although the complete absence of FNS among our patients is noticeable, an explanation could be the precurved feature that characterizes all the implanted devices.…”

Section: Discussionmentioning

confidence: 99%

Surgical Results and Complications of Cochlear Implantation in Far-Advanced Otosclerosis

West¹,

Brand²,

Foghsgaard³

et al. 2017

Int Adv Otol

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OBJECTIVE:To report surgical results and complications of cochlear implantation in patients with far-advanced otosclerosis (FAO). MATERIALS and METHODS:This was a retrospective chart review of surgical results in terms of electrode insertion as well as peri-and postoperative complications. Ten cochlear implantations (CIs) were performed in eight patients with FAO. A prior stapedotomy had been performed in all cases. RESULTS:Full electrode insertion was achieved in nine of the 10 operations (90%) and partial insertion in one operation. An unintended opening of the vestibule during drilling was the only perioperative complication. Postoperative complications occurred as two cases of vertigo (one prolonged). No chorda tympani syndrome and no cases of facial nerve stimulation were noted. CONCLUSION:Although based on a limited number of cases, we conclude that full electrode insertion can be achieved in almost all cases and that major complications are infrequent in CI in patients with FAO. Postoperative vertigo appears to be the most commonly occurring complication.

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Cochlear Implantation in Far Advanced Otosclerosis: A Systematic Review and Meta‐Analysis

et al. 2022

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Objective To evaluate speech outcomes and facial nerve stimulation (FNS) rates in patients with far advanced otosclerosis (FAO) after cochlear implantation. Methods A systematic review was performed using standardized methodology of Medline, EMBASE, PubMed, Cochrane, and Web of Science databases. Studies were included if adults with FAO underwent cochlear implantation. Exclusion criteria included concurrent otologic history (e.g., Meniere's disease, superior canal dehiscence), non‐English‐speaking implant users, case reports, abstracts, and letters/commentaries. Bias was assessed using the Newcastle‐Ottawa Scale for cohort studies and the National Institute of Health Scale for case series. The primary outcome measure was speech discrimination and the secondary outcomes were rates of partial insertion and FNS. Results Twenty‐seven studies evaluated cochlear implantation in FAO. Due to the heterogeneity of testing methods, statistical pooling of speech discrimination was not feasible, but qualitative synthesis indicated a positive effect of implantation. Pooled rates of FNS were 18% (95% confidence interval, CI 12%–27%) and the rate of partial insertion was 10% (95% CI 7%–15%). Conclusion Cochlear implantation in FAO demonstrates significant gains in speech discrimination scores with higher rates of FNS and partial insertion. Laryngoscope, 133:1288–1296, 2023

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Cochlear implantation outcomes in advanced otosclerosis

Cited by 29 publications

References 39 publications

Management of advanced otosclerosis: experience in a tertiary care centre

Management of advanced otosclerosis: experience in a tertiary care centre

Surgical Results and Complications of Cochlear Implantation in Far-Advanced Otosclerosis

Cochlear Implantation in Far Advanced Otosclerosis: A Systematic Review and Meta‐Analysis

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