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Cochlear implants in children with congenital inner ear malformations
M Luntz1, T Balkany, A V Hodges
1University of Miami Ear Institute, Fla, USA.
Archives of Otolaryngology--Head & Neck Surgery
|September 26, 1997
Summary
Multichannel cochlear implantation in children with inner ear malformations shows promising hearing outcomes, especially for incomplete partitions and enlarged vestibules. Surgical techniques for common cavity malformations require further refinement for optimal results.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Neurosurgery
Background:
- Inner ear malformations present unique challenges for hearing restoration in children.
- Multichannel cochlear implantation (CI) is a potential solution, but outcomes vary based on malformation type.
Observation:
- This study reviewed 10 pediatric cases of CI for inner ear malformations, including common cavity, incomplete partition, and enlarged vestibule.
- High-resolution computed tomography (HRCT) identified specific malformation types, while some membranous anomalies were only noted intraoperatively (cerebrospinal fluid gushers).
Findings:
- Children with incomplete partitions, enlarged vestibules, or membranous anomalies achieved functional electrode insertion and comparable hearing thresholds to those with normal cochleas.
- Speech awareness thresholds were excellent (≤25 dB) across all groups.
- Open-set word recognition was achieved in 75% of cases with sufficient follow-up, including one with a common cavity.
Implications:
- Multichannel CI is effective for most inner ear malformations, offering significant auditory benefits.
- Specific surgical approaches may improve outcomes for common cavity malformations.
- Cerebrospinal fluid gushers, though frequent, are manageable during surgery.