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Performing Repeated Intraoperative Impedance Telemetry Measurements during Cochlear Implantation
Published on: August 4, 2023
Cochlear implantation in children with otitis media
Jose N Fayad1, Abtin Tabaee, Jennifer N Micheletto
1Department of Otolaryngology-Head & Neck Surgery, Columbia University College of Physicians and Surgeons, The New York-Presbyterian Hospital, 180 Fort Washington Avenue, Harkness Pavilion, Suite 813, New York, NY 10032, USA. jfayed@hei.org
Insights
Cochlear implantation in children with otitis media history showed reduced ear infections post-surgery. Ventilation tubes at implantation time help prevent complications, so don't delay this hearing restoration procedure.
Area of Science:
- Pediatric Otolaryngology
- Auditory Implants
- Infectious Disease Prevention
Background:
- Otitis media is common in children, potentially complicating cochlear implant outcomes.
- Understanding the impact of otitis media on pediatric cochlear implant recipients is crucial for surgical planning and post-operative care.
Purpose of the Study:
- To evaluate the outcomes of cochlear implantation in pediatric patients with a history of otitis media.
- To assess the incidence and management of otitis media following cochlear implantation.
Main Methods:
- Retrospective review of medical records for 126 pediatric patients (<48 months) undergoing cochlear implantation.
- Analysis of demographics, complications, and history of otitis media and ventilation tube (VT) placement.
- Follow-up phone survey for 76 patients (mean 46 months) to determine long-term otitis media natural history.
Main Results:
- 72% of patients had a history of otitis media; 31% had >3 episodes.
- 23% received bilateral myringotomy and ventilation tubes (VT) around the time of implantation.
- Significant decrease in otitis media incidence post-cochlear implantation, irrespective of prior VT history.
Conclusions:
- Cochlear implantation can be safely performed in children with a history of otitis media.
- Placing ventilation tubes concurrently with cochlear implantation appears to prevent infectious complications in otitis-prone children.
- Cochlear implantation should not be deferred; otitis media episodes can be managed conventionally post-surgery.
Objective:
To describe the outcome of cochlear implantation in a cohort of pediatric patients with a history of otitis media.
Study Design:
Retrospective chart review and follow-up phone survey.
Methods:
The medical records of patients younger than 48 months of age who underwent cochlear implantation were reviewed for demographics, complications, and history of otitis media and bilateral myringotomy and ventilation tubes. A follow-up phone survey was performed to determine the long-term natural history of otitis media.
Results:
The records of 126 profoundly deaf pediatric patients were reviewed. Seventy-two percent had a history of at least one episode of otitis media, 31% had a history of greater than three episodes, and 2% had a history of chronic serous otitis media. Twenty-three percent underwent bilateral myringotomy and tubes in the distant past, 6 to 8 weeks before implantation, at the time of implantation, or after implantation. A phone survey was successfully completed for 76 patients with a mean follow-up period of 46 months. There was a significant decrease in the incidence of otitis media after the cochlear implantation in the majority of patients with a history of otitis media with and without a history of bilateral myringotomy and tubes.
Conclusions:
Placement of ventilation tubes either before or at the time of cochlear implantation seems to adequately prevent infectious disease-related complications in otitis-prone children. Therefore, implantation should not be delayed, and subsequent episodes of otitis media can be managed by conventional therapy.
