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Published on: August 4, 2023
Spontaneous bone bed formation in pediatric cochlear implantation is associated with duration of implantation
Khassan Diab1, Olga Pashchinina1, Dmitry Kondratchikov1
1Department of Otology and Lateral Skull Base, Federal State Budgetary Institution "National Medical Research Center of Otorhinolaryngology of the Federal Medico-Biological Agency of the Russian Federation", Moscow, Russia, 123182.
Insights
Pediatric cochlear implant patients can develop a spontaneous bone bed after surgery. Longer implantation duration correlates with a deeper bone bed, potentially offering surgical benefits.
Area of Science:
- Otolaryngology
- Neurosurgery
- Pediatric Medicine
Background:
- Surgical drilling of a bone bed for cochlear implant (CI) placement is standard practice.
- This procedure can increase surgical time and complexity in pediatric patients.
- Investigating alternatives that maintain device stability and reduce operative burden is crucial.
Purpose of the Study:
- To evaluate the long-term spontaneous formation of a bone bed in pediatric cochlear implant recipients.
- To assess the depth and characteristics of this naturally formed bone bed.
- To determine factors influencing spontaneous bone bed development.
Main Methods:
- A cross-sectional observational study involving 37 pediatric patients who received cochlear implants without bone bed drilling.
- Computed tomography (CT) scans were performed at least six months post-implantation.
- Skull thickness under and around the CI receiver/stimulator was measured.
Main Results:
- A spontaneous bone bed formed in all pediatric CI patients by six months post-implantation.
- The average depth of the spontaneously formed bone bed was 1.83 mm.
- Bone bed depth significantly increased with longer duration of implantation (p=0.009).
Conclusions:
- Spontaneous bone bed formation is a consistent finding in pediatric cochlear implant patients.
- The depth of the bone bed is positively associated with the duration of cochlear implant use.
- This natural bone bed formation may offer advantages similar to surgically created beds, potentially reducing surgical time and costs.
Objectives:
This study investigated the long-term postoperative spontaneous formation of a bone bed in pediatric cochlear implant patients for whom no bone bed was drilled during the surgery.
Methods:
A cross-sectional observational study of skull thickness under and on the edges of the cochlear implant receiver/stimulator in children with computed tomography (CT scan) ≥6 months after implantation was performed. In total, 37 pediatric patients from a single tertiary center underwent cochlear implantation without bone bed drilling and with screw fixation of the receiver/stimulator.
Results:
The patients were on average 36.2 ± 20.5 months at implantation (range 8-96 months). At the time of the CT scan, the average duration of implantation was 25.3 ± 17.9 months (range 6-91 months). The average depth of the bone bed that formed spontaneously since implantation was 1.83 ± 0.39 mm (range 0.39-3.04 mm). Linear regression identified that the depth of the bone bed increased significantly with duration of implantation (β = 0.389, p = 0.009), but age at implantation was not associated with bone bed depth.
Conclusions:
A spontaneously formed temporal bone bed was observed in pediatric CI patients already six months after implantation. A deeper bone bed was measured in children who have had their CI for a longer period. A spontaneously formed bone bed is likely to combine the benefits of a surgically drilled bone bed, whilst limiting the duration of the surgery and thereby associated costs.
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