One-stage cochlear implantation in patients with chronic otitis media using canal wall up mastoidectomy

Abstract

Background Cochlear implantation (CI) with subtotal petrosectomy was recommended to avoid the complications for patients with chronic otitis media (COM). Objectives To evaluate the surgical outcomes of CI in patients with COM using a one-stage operation with canal wall up mastoidectomy (CWUM). Methods Thirty-five patients with COM who underwent CI with CWUM as a one-stage between 2009 and 2017 were participated. They divided into those with inactive COM and active COM. The anatomical success rate, postoperative complication, and hearing outcomes were analyzed. Results Twenty-four patients had inactive COM and seven with active COM. Three of the 31 patients (9.7%) had otorrhea from the ear undergone surgery. Two of these three patients had myringitis after CI and their symptoms improved after conservative management. Although infection of the tympanic membrane in the third patient was controlled after conservative management, a perforation was left. Postoperative otorrhea occurred in two patients (8.3%) in the inactive COM group and one patient (14.3%) in the active COM group. Conclusion This study indicates that infection control and successful implantation can be achieved through a one-stage CI operation with CWUM in selected patients with COM. HIGHLIGHTS Although COM was once considered a contraindication to CI, CI in patients with COM has been made feasible by STP before CI or simultaneously with CI. Simultaneous CI with CWUM was performed for 31 patients with COM. Three patients (9.7%) had minor complications after the surgery and only one patient experienced device explantation which was due to device failure.