Cochlear Implant in Far Advanced Otosclerosis

Abstract

Objective: To evaluate clinical characteristics of these patients, with otosclerosis, complications,and observations of the benefits of implants to medium and long term. Method: Thirty two adult patients, age 50 years old, 22 women and 10 men, with profound sensorineural hearing loss, and otosclerosis far advanced, were treated with multi-channel cochlear implants. All had otological examination, psychological, audiometry, and 0% of speech discriminations with-well-fitted hearing aid, CTS (4 with RMI) to determine hypodensity or morphologic changes. Results: CTS with morphologic changes in the cochlea in 24/32 patients (Rottevel’s grading): 9 had type 2 (localized retrofenestral disease), 6 type 3 (retrofenestral diffuse). Full insertion inside the cochlea in 28/32 cases, where in 6 patients it was necessary to drill the bone in 4 to 6 mm in the tympanic basal turn. four patients had partial insertion of electrodes, 1 of them with 2 electrodes in IAC and leakage of CSF, 1 with stimulation of the facial nerve (type 3). Three patients were reinplanted. Tinnitus with sensation of resounds was observed in 5 patients. Good discriminations in speech was evidenced in 26/32 patients. Conclusion: Patients with far advanced otosclerosis demonstrated good performance with CI in 26/32 cases. In otosclerosis type 3, 5 out of 6 patients had more difficulty in the insertion of electrodes, 1 of them with 2 electrodes within the IAC and leakage of LCR, and 5 of them with tinnitus and smaller auditory outcome.