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Pediatric Cochlear Implantation for Single-Sided Deafness After Temporal Bone Fracture
Taylor J Mendenhall1,2, Eric E Babajanian3,4, Cody M Anderson5
1Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah.
Insights
Cochlear implantation (CI) is a viable option for children with single-sided deafness (SSD) after temporal bone fractures. However, outcomes vary, and early intervention within six months may improve results.
Area of Science:
- Otolaryngology
- Neurosurgery
- Pediatric Audiology
Background:
- Single-sided deafness (SSD) in pediatric patients can result from temporal bone fractures.
- Cochlear implantation (CI) is a potential treatment for SSD.
Purpose of the Study:
- To evaluate the effectiveness of CI in pediatric patients with SSD caused by temporal bone fractures.
- To identify factors influencing CI outcomes in this population.
Main Methods:
- Retrospective chart review at two academic centers.
- Inclusion of pediatric patients (<18 years) with SSD from temporal bone fractures undergoing CI (2012-2022).
- Analysis of postoperative audiometric testing and outcomes.
Main Results:
- Seven pediatric subjects with SSD post-temporal bone fracture received CI.
- Median time to CI was 7 months; 85% had otic capsule involvement.
- Variable speech perception outcomes were observed; 4/7 achieved open/closed set, 3/7 achieved sound awareness only. No complications occurred.
Conclusions:
- CI is a feasible treatment for pediatric SSD post-temporal bone fracture, though results are inconsistent.
- Timely CI, ideally within 6 months, may enhance outcomes.
- Cochlear ossification, from fracture or meningitis, can negatively impact CI results.
Objective:
To examine the benefit of cochlear implantation (CI) in pediatric patients with a history of temporal bone fracture resulting in single-sided deafness (SSD).
Study Design:
Retrospective chart review.
Setting:
Two tertiary academic centers.
Patients:
Pediatric patients less than 18 years of age with SSD secondary to temporal bone fracture who underwent CI from 2012 to 2022.
Interventions:
CI.
Main Outcome Measures:
Postoperative audiometric testing.
Results:
Seven subjects were identified (median age: 10 years (y); Q1 to Q3: 5 to 16 y). Median time from temporal bone trauma to CI was 7 months (mo) (Q1 to Q3: 3 to 7 mo) and 85% had otic capsule involvement. Subjects were followed for a median length of 12 months (Q1 to Q3: 6 to 24 mo) after CI. All patients achieved full electrode insertion, though 2 required scala vestibuli insertion due to ossification of the scala tympani (one of whom had a history of meningitis after temporal bone fracture). Postoperative audiometric testing revealed variable speech perception outcomes with 4 of 7 obtaining open or closed set speech perception and 3 of 7 obtaining only sound awareness. No postoperative complications occurred.
Conclusions:
CI is a feasible intervention for SSD following pediatric temporal bone fractures, but outcomes are variable. Early evaluation and timely CI, ideally within 6 months of temporal bone fracture, may optimize outcomes. Cochlear ossification, either as a result of otic capsule fracture or subsequent meningitis, may lead to suboptimal outcomes.
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