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Cochlear implants in chronic suppurative otitis media

R F Gray1, R M Irving

  • 1East of England Cochlear Implant Centre, Addenbrooke's Hospital, Cambridge, United Kingdom.

The American Journal of Otology
|September 1, 1995
PubMed
Summary
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Chronic suppurative otitis media (CSOM) can be treated surgically to allow cochlear implantation in deafened patients. This two-stage surgical approach prepares septic ears for sterile cochlear implant devices, achieving good hearing outcomes.

Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Medical Engineering

Background:

  • Chronic suppurative otitis media (CSOM) is a contraindication for cochlear implantation.
  • CSOM can lead to deafness, excluding otherwise suitable candidates for cochlear implants.
  • Preparing septic ears for sterile cochlear implant devices presents a surgical challenge.

Observation:

  • This study evaluated a two-stage surgical preparation for cochlear implantation in four patients with CSOM.
  • Patients had conditions including wet radical cavities with residual cholesteatoma and discharging safe perforations.
  • The surgical technique involved obliteration of the middle ear cleft with blind pit closure of the ear canal.

Findings:

  • Cochlear implants were successfully installed 3-6 months after the initial preparation surgery.

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  • Hearing results in these patients were comparable to those without CSOM.
  • One patient had a cholesteatoma pearl found during the second operation, the only complication.

    • Implications:

    • Fat obliteration of the mastoid and middle ear, combined with blind pit closure, can prepare chronic ears for implantation.
    • This surgical strategy expands cochlear implantation candidacy to patients with CSOM.
    • Careful patient selection and surgical planning are crucial for successful outcomes in complex cases.