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Cochlear implantation in the presence of otitis media with effusion: Postoperative risks and functional outcomes
Serdal Celik1, Mehmet Berk Erdogan1, Arda Buyukasik1
1Istanbul Medeniyet University Faculty of Medicine, Department of Otorhinolaryngology, Istanbul, Türkiye; Goztepe Prof. Dr. Süleyman Yalcin City Hospital, Department of Otorhinolaryngology, Istanbul, Türkiye.
Insights
Otitis media with effusion (OME) during pediatric cochlear implant (CI) surgery increases infection risk but does not impact auditory outcomes. OME is not a contraindication for CI with proper management.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Neurosurgery
Background:
- Otitis media with effusion (OME) is common in children and can be detected during cochlear implant (CI) surgery.
- Understanding the impact of OME on CI outcomes is crucial for surgical planning and patient management.
Purpose of the Study:
- To evaluate clinical characteristics, readmission causes, complications, and auditory outcomes in pediatric CI patients with intraoperatively detected OME.
- To compare audiological performance and complication rates between pediatric CI patients with and without OME.
Main Methods:
- Retrospective review of medical and audiological data from 243 pediatric patients (461 ears) undergoing CI surgery.
- Analysis of postoperative complications in the entire cohort.
- Comparison of audiological outcomes between 25 ears with OME and 25 matched control ears without OME.
Main Results:
- No significant differences in age or gender distribution between OME and control groups.
- Similar pure-tone average and most audiological parameters between groups.
- Significantly lower Speech Recognition Threshold (SRT) in the OME group (p=0.012, d=-0.741).
- Higher incidence of postoperative infection in the OME group (12.0% vs. 2.5%, p=0.035).
Conclusions:
- Intraoperative OME in pediatric CI surgery is linked to a higher risk of postoperative infection, though the clinical effect is limited.
- OME does not significantly impair overall auditory performance after cochlear implantation.
- OME should not be an absolute contraindication for pediatric CI with appropriate perioperative care and follow-up.
Objective:
This study aimed to evaluate the clinical characteristics, causes of readmission, postoperative complications, and auditory outcomes of pediatric patients in whom otitis media with effusion (OME) was detected during cochlear implant (CI) surgery.
Materials And Methods:
This retrospective study reviewed medical records and audiological follow-up data of 461 ears from 243 patients who underwent CI surgery. Postoperative complications were analyzed in the entire cohort. For audiological outcome analysis, 25 ears with intraoperatively detected OME were compared with 25 randomly selected ears without OME and with similar clinical characteristics to ensure balanced group sizes and reduce potential confounding. Appropriate parametric tests were applied, and effect sizes were calculated using Cohen's d and Cramér's V.
Results:
There were no significant differences between the OME and control groups regarding age or gender distribution (p > 0.05). Pure-tone average and most audiological parameters did not differ significantly between groups. However, the Speech Recognition Threshold (SRT) was significantly lower in the OME group compared with the control group (p = 0.012, d = -0.741). Postoperative infection occurred more frequently in ears with OME than in those without (12.0% vs. 2.5%), and this difference was statistically significant (p = 0.035).
Conclusion:
Although the presence of OME during CI surgery is associated with an increased risk of postoperative infection, the clinical effect size is limited. OME does not appear to adversely affect overall auditory performance. With appropriate perioperative management and follow-up, OME should not be considered an absolute contraindication for cochlear implantation in pediatric patients.
