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Published on: August 4, 2023
Cochlear implantation for cochlear hypoplasia type I: Surgical considerations and auditory outcomes in a case series
Xingmei Wei1, Shujin Xue1, Zhencheng Gao1
1Key Laboratory of Otolaryngology Head and Neck Surgery, Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, 1, Dongjiaominxiang, Dongcheng District, Beijing, 100730, People's Republic of China.
Background:
Cochlear hypoplasia type I (CH-I) is a severe inner ear malformation often deemed a relative contraindication for cochlear implantation (CI), posing unique challenges for patients.
Objectives:
This study aimed to evaluate surgical techniques, challenges, and postoperative auditory outcomes in CH-I patients undergoing CI, identifying key prognostic factors.
Material And Methods:
A retrospective analysis of six CH-I patients (11-222 months old) who underwent CI between 2012 and 2023 was conducted. Five patients used the transmastoid facial nerve recess approach (TFNRA) with a short straight electrode, while one employed the transmastoid slot labyrinthotomy approach (TSLA) with a customized electrode. Outcomes were assessed via Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR), and both closed-set and open-set speech tests, including the Mandarin Lexical Neighborhood Test (MLNT).
Results:
Five patients achieved useable auditory function, with three demonstrating good open-set speech recognition. No significant differences were observed between unilateral and bilateral implantation.
Conclusions And Significance:
CI is viable for CH-I patients when TFNRA are combined with systematic auditory training. Preoperative cochlear morphology assessment and short straight electrodes are crucial for optimizing outcomes, emphasizing the need for long-term rehabilitation.