Cochlear implantation outcomes in patients with otosclerosis: a single-centre study.

PURPOSE: To analyse surgical and auditory outcomes after cochlear implantation in otosclerosis and to compare them to the outcomes in patients with post-lingual hearing loss with different aetiology. METHODS: Medical records of 17 subjects (22 ears) diagnosed with otosclerosis were compared to 21 controls (25 ears) matched by age, sex, duration of hearing loss and experience with cochlear implant in years. Demographic characteristics, surgical complications, facial nerve stimulation, number and reason for deactivated electrodes and auditory outcome (monosyllabic word score) were analysed. The auditory outcome was further evaluated according to the anatomical localisation of the otosclerotic lesions (grades) and compared between patients with active and deactivated electrodes. RESULTS: Otosclerotic patients showed similar surgical outcome in comparison to the controls. A low frequency (13.6%) of facial nerve stimulation was observed in otosclerosis. A significantly higher (p = 0.014) number of deactivated electrodes (4.3%) in subjects with otosclerosis in comparison to non-otosclerosis patients (1.6%) was found. A trend of less speech discrimination of monosyllabic words (65%) in otosclerosis than in non-otosclerosis patients (80%) (p = 0.109) and no difference in the postoperative auditory assessment with regard to the disease grade and electrode disabling was found. CONCLUSIONS: Cochlear implantation by otosclerosis provides excellent auditory outcome with a low rate of surgical complications. Alteration in fitting strategy as electrodes disabling is frequently needed to overcome complications as incomplete insertion, facial nerve stimulation and poor sound quality.

[The Impact of Subtotal Petrosectomy in Cochlea Implantation]. / Der Stellenwert der subtotalen Petrosektomie im Rahmen der Cochlea Implantation.

INTRODUCTION: Cochlear Implantation (CI) in patients with chronic otitis media or existing open mastoid cavity can be challenging. Subtotal petrosectomy (STP) is an option to improve the safety of this procedure. MATERIAL AND METHODS: Retrospective study with cases of STP prior CI. RESULTS: 25 patients could be enrolled in this investigation. Over all 26 STP were performed approximately 6 months before CI. The majority of the patients suffered from a chronic otitis media or had a preexisting open cavity; in one case a complex temporal bone fracture with destruction of the external auditory canal was the reason for this technique. After STP we observed three times a delayed wound healing at the closure of the external auditory meatus and a bleeding at the periumbilical region after harvesting fat of the abdominal wall. All patients could be provided with a CI. A recurrence of a cholesteatoma did not appear so far. CONCLUSION: With this method CI is feasible even in cases of concurrent chronic otitis media or canal wall down situation. We are in favour of a staged procedure, nevertheless a simultaneous STP and CI is justifiable in individual patients.