ABSTRACT
OBJECTIVE: The role of long-term hearing deprivation in cochlear implant performance is not well established, and the limits for implanting an auditory deprived ear are still unknown. The objective of this study was to evaluate the effect of long-term auditory deprivation time on cochlear implant results. STUDY DESIGN: Retrospective case review study. SETTING: Cochlear implantation tertiary referral center. PATIENTS: Adult patients with postlingual deafness. INTERVENTION: Unilateral cochlear implantation between 2001 and January 2015. MAIN OUTCOME MEASURES: Age at implantation, sex, etiology of hearing loss, and duration of auditory deprivation in the implanted ear were collected. Cochlear implants results were expressed in terms of vowel identification, disyllabic word recognition, and sentence recognition.Spearman's correlation test was applied to determine the relationship between auditory deprivation time and speech recognition scores. Additionally, patients were divided according to their auditory deprivation time before implantation in group A (less than 10 yr) and group B (more than 10 yr). RESULTS: One hundred three patients met inclusion criteria for this study. There were 61 patients in group A, with a mean deprivation time of 2.52 years. There were 42 patients in group B, with a mean deprivation time of 19.67 years.There were no statistically significant differences between both groups regarding speech recognition scores.Deprivation time in the implanted ear was not statistically correlated with cochlear implantation performance. CONCLUSIONS: Long-term auditory deprivation in the ear to be implanted does not negatively influence cochlear implantation results and should not be considered criterion to reject cochlear implantation.
Subject(s)
Cochlear Implantation , Deafness/surgery , Speech Perception , Adolescent , Adult , Cochlear Implantation/methods , Cochlear Implants , Female , Humans , Male , Middle Aged , Retrospective Studies , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVES: The purpose of this study was to review the indications for subtotal petrosectomy for cochlear implantation, report our management of complications, as well as review those technical factors that are critical for successful implantation. METHODS: Patients (n = 104) that underwent subtotal petrosectomy with closure of the external auditory canal and obliteration of the cavity with abdominal fat in combination with cochlear implantation were analyzed. RESULTS: The most frequent indication for subtotal petrosectomy was the existence of a previous canal wall down technique. Postoperative complications occurred in 13 patients (11.83%). Extrusion of the device took place in 5 cases (4.55%). CONCLUSIONS: Subtotal petrosectomy in cochlear implantation permits obtaining a cavity isolated from the external environment, and when needed, it improves the access and visibility during the surgical procedure. Subtotal petrosectomy is a safe technique, with a low rate of complications.
Subject(s)
Cochlear Implantation/methods , Ear Canal/surgery , Ear, Middle/surgery , Petrous Bone/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Postoperative Complications/epidemiology , Prosthesis Failure , Retrospective Studies , Temporal Bone/surgery , Young AdultABSTRACT
Cochlear implantation through the standard posterior tympanotomy approach may sometimes be challenging. In cases with complicated anatomy or malformations, an alternative surgical technique may be chosen. The transattical approach is a simple technique based on a mastoidectomy and a transmeatal cochleostomy. The electrode is driven to the middle ear through the attic. This way it overcomes some of the standard technique's drawbacks. Our aim is to assess the value of this alternative approach in cochlear implant surgery. We conducted a comparative retrospective study; we included 74 patients operated by transattical approach and 59 patients operated with the standard technique. Auditory performance and complications at long term follow-up were compared. The consequences of the different trajectory of the electrode in the transattical approach were also studied. No significant differences were found between both groups regarding complication rates and cochlear implant performance. The electrode's integrity was not significantly affected by its different position and angles, when compared to the standard approach. We conclude that transattical approach is a safe technique for cochlear implantation. It may be considered as an alternative to the posterior tympanotomy approach for those cases where this cannot be performed.
Subject(s)
Cochlear Implantation/methods , Adult , Child, Preschool , Cochlear Implants , Female , Humans , Intraoperative Complications , Male , Postoperative Complications , Retrospective StudiesABSTRACT
INTRODUCTION: Several studies support the use of cochlear implants (CI) in far-advanced otosclerosis (FAO). MATERIAL AND METHODS: We compared our results of CI in patients with FAO and unknown origin hearing loss (UOHL) and our incidence of facial electrical stimulation and difficult insertion of the electrode bundle up to 3 to 5 years from surgery. RESULTS: We found 17 patients with CI in FAO and UOHL. FAO patients achieved better results on the pure tone average (PTA) and recognition of monosyllables by GEE test (p=0.022; p=0.006), and particularly at 1 year on the PTA (p=0.002), at 6 months and a year in monosyllables (p=0.002; p=0.001), and at 6 months in disyllables (p=0.004). There were no differences toward complications. CONCLUSION: In our experience, placement of CI in FAO has proven successful, with results comparable to other similar cohorts, and with low complications.
