Cochlear implantation in chronic otitis media

ABSTRACT

OBJECTIVES: The objectives of this study are to describe the experience on cochlear implantation among patients with chronic otitis media (COM) and to describe the management of patients with otitis media before and after cochlear implantation (CI). METHODS: The records of one hundred five consecutive patients who have undergone cochlear implantation were reviewed and the patients with chronic otitis media either before or after surgery were included in the study. Data such as age at implantation, etiology of deafness, laterality of otitis media, radiologic studies, medications and intraoperative findings in these patients were reviewed then recorded in a separate database file. Outcomes in terms of complications during or after surgery were likewise noted. RESULTS: Of 105 patients who had cochlear implantation, twelve patients had history of chronic otitis media or recurrent acute otitis media. There were three patients, 2 adults with bilateral COM as the cause for deafness and one child with bilateral COM and middle ear foreign body mimicking a cholesteatoma. All three had to undergo mastoidectomy and tympanoplasty for the surgical management of active suppurative chronic otitis media. No further episodes of otitis media were noted and all were otitis free subsequently at the time of cochlear implantation. Five prelingually deaf children had otitis media following cochlear implantation (one week to 4 months), two of whom had to undergo revision cochlear implant surgery without explantation for definitive management. Four additional patients had episodes of recurrent otitis media prior to and after cochlear implantation which required only medical management with broad spectrum.antibiotics. CONCLUSION: Despite high prevalence of otitis media in the Philippines, our data supports literature reports that cochlear implantation is a safe and effective procedure in patients with bilateral profound hearing loss both in the pediatric and adult.