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Published on: January 9, 2019
Cochlear implantation in patients profoundly deafened after head injury
Sadie Khwaja1, Deborah Mawman, Jaya Nichani
1Department of Otolaryngology-Head and Neck Surgery, Manchester Royal Infirmary, University of Manchester, Manchester, North West England, UK. sadiekhwaja@doctors.org.uk
Objective:
There is very little information in the literature regarding outcomes of cochlear implantation in patients profoundly deafened after head injury. The aim of this study was to assess outcomes in this group of patients.
Study Design:
Retrospective case review.
Setting:
The Manchester Cochlear Implant Programme, University of Manchester.
Patients:
Profoundly deafened patients after head injury who proceeded to cochlear implantation for auditory rehabilitation.
Main Outcome Measures:
Mean age and duration of deafness at implantation. Preimplantation and postimplantation speech perception outcomes were measured using Bench Kowel Bamford (BKB) sentences in quiet and noise, City University of New York sentences with lip reading and Arthur Boothroyd words scoring the percentage phonemes correct.
Results:
Twenty patients received 23 cochlear implants. Mean age at implantation was 51 years (standard deviation, 12 yr). Mean duration of deafness at implantation was 12 years (range, 1-30 yr).Preimplantation BKB score in quiet of 0%. Mean postimplantation BKB score in quiet was 64% (range, 0%-100%) and in noise was 61% (range, 0%-97%). Three were nonusers, and 1 required reimplantation. There was a moderately negative correlation between outcome and age at implantation (r = -0.41, p < 0.05) and between outcome and duration of deafness (r = -0.52, p < 0.05).
Conclusion:
Cochlear implantation is an effective method for hearing rehabilitation in profoundly deafened patients after head injury. However, negative factors, such as significant injury to the central auditory pathway, basal turn obliteration, long duration of deafness, and nonauditory stimulation, should be considered in the preoperative assessment of these patients.