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Surgical considerations and safety of cochlear implantation in otitis media with effusion
Rasit Cevizci1, Alper Dilci2, Fatih Celenk3
1Department of Otolaryngology and Head & Neck Surgery, Istanbul Medipol University, Istanbul, Turkey.
Insights
Otitis media with effusion does not increase cochlear implantation risks but prolongs surgery. Pre-implantation treatment for otitis media with effusion is unnecessary, despite potential intraoperative challenges.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Audiology
Background:
- Otitis media with effusion (OME) is common in children undergoing cochlear implantation.
- The impact of OME on cochlear implantation outcomes and surgical parameters requires evaluation.
Purpose of the Study:
- To assess the effects of OME on surgical parameters, patient safety, and perioperative/postoperative complications in pediatric cochlear implantation.
Main Methods:
- A retrospective study of 890 children (12-63 months) who underwent cochlear implantation between 2006-2015.
- Patients were categorized into OME (n=105) and non-OME (n=785) groups.
- Surgical duration, intraoperative findings, and complications were compared between groups.
Main Results:
- Surgery duration was significantly longer in the OME group (90 min) compared to the non-OME group (60 min).
- Intraoperative findings in the OME group included granulation tissue and edematous mucosa.
- No significant differences in overall complications were observed between the OME and non-OME groups.
Conclusions:
- OME does not necessitate pre-implantation surgical treatment as it does not elevate cochlear implantation risks.
- OME is associated with longer operation times and intraoperative difficulties, including bleeding and visualization challenges.
- Ventilation tube insertion in 5 OME patients did not alter implantation outcomes.
Objective:
To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications.
Methods:
Total 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group.
Results:
Of 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60min (ranged from 28 to 75min) in non-otitis media group, and 90min (ranged from 50 to 135min) in otitis media with effusion group (p<0.05). Granulation tissue and edematous middle ear and mastoid mucosa were observed in all cases of otitis media with effusion during the surgery. There was no significant difference between the complications of groups with or without otitis media with effusion (p>0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation.
Conclusion:
There is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells.
