Current trends on subtotal petrosectomy with cochlear implantation in recalcitrant chronic middle ear disorders

Abstract

SUMMARY Objective To establish the safety and effectiveness of subtotal petrosectomy with cochlear implantation in patients affected by chronic middle ear disorders to refractory to previous surgical treatments. Methods A multicentre, retrospective study was conducted on patients affected by recalcitrant chronic middle ear disorders who underwent cochlear implantation in combination with subtotal petrosectomy. Patients’ details were collected from databases of 11 Italian tertiary referral centres. Additionally, a review of the most updated literature was carried out. Results 55 patients were included with a mean follow-up time of 44 months. Cholesteatoma was the most common middle ear recurrent pathology and 50.9% of patients had an open cavity. 80% of patients underwent a single stage surgery. One case of explantation for device failure was reported among the 7 patients with post-operative complications. Conclusions Subtotal petrosectomy with cochlear implantation is a benchmark for management of patients with recalcitrant chronic middle ear disorders. A single stage procedure is the most recommended strategy. Optimal follow-up is still debated. Further studies are required to investigate the role of this surgery in paediatric patients.

The Issue of Extrusion and Dislocation in Titanium Middle Ear Prostheses: A Literature Review

“…Since the 1990s to date, technologies that bypass the ME sound-conducting mechanism have spread within the market [5,6]; however, passive ME implants continue to be widely used and studied. At present, titanium is widely being used for its physical properties, being lightweight with high stiffness and allowing for easy individual adaptation to anatomical variations.…”