Operative Challenges in Doing Cochlear Implant in an Ossified Cochlea, is it Worth it? Case Report and Reviewing the Literature

Abstract

Objectives: To present an unusual way of cochlear implant electrode insertion and discuss the audiological as well as the speech outcome. Study Design: Case report. Method: Will be reviewing a file of a deaf patient who underwent retrograde insertion of cochlear implant array. Once the audiological and speech findings are evaluated then the literature for similar cases and alternative techniques will be discussed. Results: A case of a 24-year-old male patient that underwent cochlear implantation due to post meningitis deafness. Considering an ossified cochlea a cochlear implant array was inserted in a retrograde manner from the apex toward the basal turn of the cochlea. There was neither an intraoperative nor postoperative complication. The post implantation audiological outcome was comparable with those subjects who have no ossification in the cochlea. The patient started to use a mobile phone 4 months post- op. 76% speech discrimination score at 60 dB has been achieved within 5 months post implantation. Conclusion: The apical cochleostomy with descending cochlear implant array insertion is an efficient procedure that has very good postoperative results.