Cochlear implantation in the presence of chronic suppurative otitis media.
Nine patients are presented who underwent cochlear implantation in the presence of chronic suppurative otitis media. Four had a simple tympanic membrane perforation, four had a pre-existing mastoid cavity and one had cholesteatoma in the ear chosen for implantation. Patients with a simple perforation had a staged procedure with myringoplasty followed by cochlear implantation after an interval of three months. Patients with cholesteatoma or with an unstable mastoid cavity were also staged. A mastoidectomy or revision mastoidectomy was performed with obliteration of the middle ear and mastoid using a superiorly pedicled temporalis muscle flap and blind sac closure of the external meatal skin. After a further six months a second stage procedure was performed to confirm that the middle-ear cleft was healthy and to insert the implant. Patients presenting with a stable mastoid cavity underwent obliteration of the cavity and implantation of the electrode as a one-staged procedure. To date there have been no serious problems such as graft breakdown, recurrence of disease or implant extrusion, and all patients are performing well.
Axon
P R
PR
Department of Otolaryngology, Manchester Royal Infirmary, UK.
Mawman
D J
DJ
Upile
T
T
Ramsden
R T
RT
D002675:Child, Preschool; D002908:Chronic Disease; D003054:Cochlear Implants; D003638:Deafness / Q000628:therapy*; D006801:Humans; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D009225:Myringoplasty; D010035:Otitis Media, Suppurative / Q000601:surgery*