Revision cochlear implantation using a double array device in the post-meningitis ossified cochlea.

Area of Science:

• Otolaryngology
• Neurosurgery
• Biomedical Engineering

Background:

• Meningitis can lead to cochlear ossification, complicating initial cochlear implantation.
• Patients with ossified cochleae often experience poor outcomes with standard cochlear implants.
• Revision surgery is necessary for individuals with malfunctioning devices and severe cochlear changes.

Purpose of the Study:

• To describe the surgical technique and outcomes of revision cochlear implantation using double array or split electrode devices.
• To evaluate the efficacy of a novel surgical approach in patients with completely ossified cochleae.
• To compare pre- and post-revision auditory and speech function.

Main Methods:

• Retrospective analysis of four pediatric patients (ages 4-15) who underwent revision cochlear implantation.
• Utilized double-array cochlear implant devices with a two-tunnel surgical technique in completely ossified cochleae.
• Assessed the number of inserted and active electrodes, and compared pre- and post-revision auditory and speech function.

Main Results:

• Revision surgery successfully increased the number of active electrodes from 0-5 to 8-12.
• The two-tunnel technique allowed for insertion of 5-11 electrodes per tunnel in ossified cochleae.
• Patients demonstrated improved auditory and speech function following revision implantation.

Conclusions:

• Revision cochlear implantation with a double array device and two-tunnel technique is effective in increasing active electrodes.
• This approach offers improved outcomes for children with post-meningitis ossified cochleae and previously poor-functioning implants.
• The study highlights a viable solution for complex cases of cochlear implant revision.