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Cochlear implantation in human immunodeficiency virus-infected patients
J Thomas Roland1, George Alexiades, Alexis H Jackman
1Department of Otolaryngology, New York University Medical Center, New York 10016, USA. tom.roland@med.nyu.edu
Objective:
To evaluate the efficacy of cochlear implants in human immunodeficiency virus-infected individuals and correlate these results with a proposed pathophysiological mechanism of human immunodeficiency virus-associated hearing loss.
Study Design:
Retrospective case series and temporal bone analysis of deceased human immunodeficiency virus-positive patients.
Setting:
Tertiary care hospital.
Patients:
Seven human immunodeficiency virus-positive individuals with profound sensorineural hearing loss.
Intervention:
Cochlear implantation at New York University Medical Center.
Methods:
The surgical outcomes and complications were analyzed. Additionally, electron microscopic and immunohistochemical findings of cadaver temporal bone specimens of other known human immunodeficiency virus-positive individuals were reviewed. The performance results of the human immunodeficiency virus-positive cochlear implant patients were then correlated with the previously hypothesized pathophysiological mechanism of human immunodeficiency virus-associated hearing loss.
Results:
The patients had a varied performance with cochlear implantation, and as a group performance was good. There were no surgical complications or postoperative complications. The good performance of these patients supports the hypothesis that the mechanism of human immunodeficiency virus-associated deafness involves infiltration, malfunction, and premature degeneration of the hair cells and supportive cells of the cochlea.
Conclusions:
Human immunodeficiency virus-positive individuals benefit from cochlear implantation without increased surgical risk.