Multichannel cochlear implantation in the scala vestibuli.
OBJECTIVE
Sensorineural hearing loss resulting from otosclerosis, meningitis, chronic otitis media, autoimmune ear disease, and trauma can be associated with partial or total obstruction of the cochlear scalae. Multichannel cochlear implantation may be difficult in a cochlea with an obstructed scala tympani. The purpose of this study is to determine the safety and efficacy of scala tympani electrode insertion.


METHODS
Retrospective chart review.


METHODS
Academic medical center.


METHODS
Eight children and adults with profound sensorineural hearing loss who underwent cochlear implantation with known scala vestibuli electrode array insertion were subjects for this study.


METHODS
Eight study subjects underwent implantation: five with the Nucleus 24RCS (Contour) device and three with the Nucleus 24M device.


METHODS
Imaging findings, operative findings, and age-appropriate speech perception testing.


RESULTS
All patients had full electrode insertion. Various obstructive patterns on computed tomography and magnetic resonance imaging were found, and there was a range of speech perception results. All but one patient improved based on age-appropriate monosyllabic word and sentence tests.


CONCLUSIONS
Scala vestibuli multielectrode insertion is a viable alternative when scala tympani insertion is not possible because of abnormal anatomy or anatomical changes secondary to disease or previous implantation. We will also present an algorithm of options for decision making for implantation when encountering cochlear obstruction and difficult electrode insertion.
Lin
Karen
K
Department of Otolaryngology, New York School of Medicine, New York, New York, USA.
Marrinan
Michelle S
MS
Waltzman
Susan B
SB
Roland
J Thomas
JT
D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003051:Cochlea / Q000601:surgery*; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D004567:Electrodes, Implanted; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012449:Safety; D012533:Scala Tympani / Q000473:pathology / Q000601:surgery; D013067:Speech Perception; D016896:Treatment Outcome