Cochlear Implantation in Patients with Chronic Suppurative Otitis Media: Surgical Outcomes and a Management Algorithm

2020 ◽  
Vol 25 (3) ◽  
pp. 151-157 ◽  
Author(s):  
Young Hoon Yoon ◽  
Jong Bin Lee ◽  
Jee-Hye Chung ◽  
Ki Wan Park ◽  
Bong Jik Kim ◽  
...  
Keyword(s):  
Otitis Media ◽  
Cochlear Implantation ◽  
Surgical Outcomes ◽  
Open Cavity ◽  
Single Stage ◽  
Suppurative Otitis Media ◽  
Mastoid Pneumatization ◽  
Management Algorithm ◽  
Speech Performance ◽  
Surgical Options

Background: Chronic suppurative otitis media (CSOM) was considered as a contraindication of cochlear implantation (CI) in the past. Recently, various surgical options have been adopted for CI in CSOM patients with showing a low complication rate. Objectives: To evaluate surgical outcomes of CI in patients with CSOM and to propose a management algorithm for those patients. Methods: Thirty-six consecutive patients with CSOM who underwent single stage or staged CI were enrolled. Speech performance, including Categories of Auditory Performance (CAP) test and sentence score, and complications were retrospectively analyzed. Results: The average follow-up was 3.1 years (range 0.5–9.2 years). Postoperative median CAP and sentence scores were 6 and 78%, respectively. Three (8.3%) of the 36 patients had postoperative complications. One experienced breakdown of the ear canal closure. Recurrence of the pars tensa retraction was observed in another patient with adhesive otitis media who underwent CI and cartilage tympanoplasty as a single stage operation. Electrode extrusion occurred in another patient who underwent staged CI with maintenance of a previous open cavity. Subtotal petrosectomy and cavity obliteration were used to manage the latter 2 complications. All implant patients with good mastoid pneumatization exhibited no complications. There were no significant differences in postoperative speech performance and complication rates between single stage CI and staged CI. Based on these current findings, a management algorithm was proposed according to type of CSOM, presence of open cavity, and mastoid pneumatization. Conclusions: Patients with CSOM show good postoperative speech performance after CI. Proper surgical options according to type of CSOM, presence of open cavity, and mastoid pneumatization may help in reducing complications.

Long-term results in cochlear implantation in chronic suppurative otitis media

2004 ◽  
Vol 5 (sup1) ◽  
pp. 171-174 ◽  
Author(s):  
Peter KM Ku ◽  
Virgil Yue ◽  
Michael CF Tong ◽  
Terence KC Wong ◽  
Eric KS Leung ◽  
...  
Keyword(s):  
Otitis Media ◽  
Cochlear Implantation ◽  
Chronic Suppurative Otitis Media ◽  
Long Term Results ◽  
Suppurative Otitis Media

scholarly journals Cochlear implantation in the presence of chronic suppurative otitis media

1997 ◽  
Vol 111 (3) ◽  
pp. 228-232 ◽  
Author(s):  
P. R. Axon ◽  
D. J. Mawman ◽  
T. Upile ◽  
R. T. Ramsden
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Cochlear Implantation ◽  
Muscle Flap ◽  
Tympanic Membrane Perforation ◽  
Chronic Suppurative Otitis Media ◽  
Mastoid Cavity ◽  
Suppurative Otitis Media ◽  
Temporalis Muscle Flap ◽  
Blind Sac Closure

AbstractNine patients are presented who underwent cochlear implantation in the presence of chronic suppurative otitis media. Four had a simple tympanic membrane perforation, four had a pre-existing mastoid cavity and one had cholesteatoma in the ear chosen for implantation. Patients with a simple perforation had a staged procedure with myringoplasty followed by cochlear implantation after an interval of three months. Patients with cholesteatoma or with an unstable mastoid cavity were also staged. A mastoidectomy or revision mastoidectomy was performed with obliteration of the middle ear and mastoid using a superiorly pedicled temporalis muscle flap and blind sac closure of the external meatal skin. After a further six months a second stage procedure was performed to confirm that the middle-ear cleft was healthyand to insert the implant. Patients presenting with a stable mastoid cavity underwent obliteration of the cavity and implantation of the electrode as a one-staged procedure. To date there have been no serious problems such as graft breakdown, recurrence of disease or implant extrusion, and all patients are performing well.

Long-term results in cochlear implantation in chronic suppurative otitis media

2004 ◽  
Vol 5 (S1) ◽  
pp. 171-174 ◽  
Author(s):  
Peter Km Ku ◽  
Virgil Yue ◽  
Michael Cf Tong ◽  
Terence Kc Wong ◽  
Eric Ks Leung ◽  
...  
Keyword(s):  
Otitis Media ◽  
Cochlear Implantation ◽  
Chronic Suppurative Otitis Media ◽  
Long Term Results ◽  
Suppurative Otitis Media

The role of subtotal petrosectomy in cochlear implantation

2016 ◽  
Vol 130 (S4) ◽  
pp. S35-S40 ◽  
Author(s):  
P Casserly ◽  
P L Friedland ◽  
M D Atlas
Keyword(s):  
Otitis Media ◽  
Cochlear Implantation ◽  
Chronic Otitis Media ◽  
External Auditory Meatus ◽  
Suppurative Otitis Media ◽  
Surgical Access ◽  
Subtotal Petrosectomy ◽  
Blind Sac Closure ◽  
Cavity Obliteration ◽  
Radical Cavity

AbstractBackground:Subtotal petrosectomy combined with cochlear implantation is a procedure required in specific situations.Methods:A retrospective review of all cases of subtotal petrosectomy in cochlear implant surgery over a five-year period was performed. The indications, complications and outcomes for this procedure are outlined.Results:Sixteen patients underwent cochlear implantation in combination with subtotal petrosectomy and blind sac closure of the external auditory meatus from 2008 to 2013. Seventy-five per cent of these were completed as a two-stage procedure and 25 per cent as a single-stage procedure. The most common indications for the procedure were chronic otitis media, previous radical cavity, and for surgical access in challenging anatomy or in drill-out procedures. Mastoids were obliterated with fat or musculoperiosteal flaps. The complication rate relating to blind sac closure was 6 per cent. Cochlear implants were successfully placed in all cases and there was no incidence of device failure.Conclusion:For patients with chronic suppurative otitis media or existing mastoid cavities, subtotal petrosectomy with blind sac closure of the external auditory canal, closure of the eustachian tube, and cavity obliteration is an effective technique to facilitate safe cochlear implantation.

scholarly journals Evaluation of single stage tympanomastoid surgery in unsafe chronic suppurative otitis media in Kashmiri population: a cross sectional study

2020 ◽  
Vol 6 (5) ◽  
pp. 939
Author(s):  
Parvez Ahmed Mir ◽  
Owais Makhdoomi ◽  
Syed Waseem Abbas
Keyword(s):  
Otitis Media ◽  
Ossicular Chain ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
Single Stage ◽  
Chronic Suppurative Otitis Media ◽  
Cross Sectional ◽  
Suppurative Otitis Media ◽  
Ossicular Chain Reconstruction ◽  
Operative Findings

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is typically a persistent disease insidious in ONSET, affecting the mucoperiosteal lining of middle ear cleft, often capable of causing severe destruction and irreversible sequelae and manifests clinically with hearing impairment and discharge. Successful management of unsafe CSOM has posed challenge before otolaryngologists for ages.</p><p class="abstract"><strong>Methods:</strong> The prospective study is based on 40 patients of unsafe CSOM who were managed and followed up in the post graduate department of otorhinolaryngology and head and neck surgery of Government medical college Srinagar with relevant data was recorded on the proforma.  </p><p class="abstract"><strong>Results:</strong> All the patients who underwent single stage tympanomastoid surgery with or without ossicular chain reconstruction had no evidence of recurrent disease at follow up with 82.5% were below the age of 40, of which 40% were between 21 to 30 years. Males were more involved than females (1.2:1), also CT scan findings were co related with intra operative findings during our study.</p><p class="abstract"><strong>Conclusions:</strong> In conclusion a perfectly performed canal wall down mastoidectomy with tympanoplasty with us without ossiculoplasty in same sitting give good and acceptable post-operative results as far as the hearing improvement and dry and safe ear is concerned.</p>

scholarly journals Single Sitting Bilateral Myringoplasty: Outcomes and Complications

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Hassan ◽  
M S Hassaballah ◽  
P M Mikahail ◽  
M S D Mahmoud
Keyword(s):  
Hearing Loss ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Psychological Trauma ◽  
Single Stage ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Graft Take

Abstract Background Tympanoplasty is the standard and well established procedure for closure of tympanic membrane perforations. Traditionally each ear drum is taken up for grafting sequentially in two different sittings. The reluctance to deal with both sides at the same sitting has been primarily due to a theoretical risk of iatrogenic sensory-neural hearing loss, need of bilateral ear canal gauze packing and chances of graft intake failure. Chronic Suppurative Otitis Media (CSOM) is a widely prevalent public health problem presenting with discomfort, hearing loss, otorrhea and psychological trauma. CSOM is characterized by an inflammatory process of the middle ear often associated with irreversible tissue alterations. It may be further classified into safe chronic otitis media and unsafe chronic otitis media according to the absence or presence of a cholesteatoma. Aim This study aim at assessing the single stage bilateral surgical procedure in bilateral tympanic membrane perforation caused by chronic otitis media as regard the graft take and hearing improvement as outcomes. Methodology A meta-analysis study is done to assess the feasibility and the possibility of operating the bilateral perforation in tympanic membrane in chronic otitis media cases on same session rather than doing it in separate sessions. The outcomes that were selected to evaluate such approach are graft take and hearing improvement. Hospital stay, cost of the operation and time were supposed to be evaluated however, there was no sufficient data to treat such outcomes in this meta analytic study upon that these outcomes are going to be appraised and stated bases on the available data. Results The graft take was evaluated on the bases paper by ototscopic examination post operative from 3 weeks to 3 months by closure of the perforation. It was estimated in this study to be 88%. This percent is matching the result obtained by Ihsan et al 2016 “who operated on 50 patients with a graft uptake rate of 86 %”, Olusesi et al, 2017 " with a total of 38 participants underwent either bilateral sequential same-day tympanoplasty (18 patients, 36 ears) or bilateral sequential different-day tympanoplasty (20 patients, 40 ears). The overall graft take rate was 88 per cent (32 out of 36 ears in the same-day tympanoplasty group, 35 out of 40 ears in the different-day tympanoplasty group; p = 0.96, odds ratio = 0.984)" (88 %), and Katsura et al, 2005 who revised the SUM using a 17 patients who underwent bilateral same-day surgery with a success rate of (85%). Conclusion Simultaneous bilateral myringoplasty is safe and effective as a single-stage operation with a high success rate as regard the graft take and hearing improvement.

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