Far-advanced otosclerosis and cochlear implantation.
OBJECTIVE
To report the radiographic and surgical findings, speech perception performance, and complications of cochlear implantation for patients who were affected by far-advanced otosclerosis.


METHODS
Five patients, 2 males and 3 females, with a family history of otosclerosis and who previously underwent stapedectomy to improve hearing were included in this study. CT scans of all ears were graded according to Rotteveel's grading system. All patients underwent cochlear implantation according to standard procedures. A control group of 10 non-otosclerotic postlingual implanted adults matched for age was used.


RESULTS
On CT scanning, one patient had solely fenestral disease (type 1), 3 patients had localized retrofenestral disease (type 2), and 1 had diffuse retrofenestral disease with loss of the normal architecture of the cochlea (type 3). In all otosclerotic patients, the electrode array was fully inserted. However, in two patients (type 2 and 3) a thickened otic capsule was present and required more drilling than normal. One patient (type 3) experienced postoperatively facial nerve stimulation with normal fitting parameters. Otosclerotic patients showed excellent speech perception after implantation and obtained similar results to those achieved by the non-otosclerotic patients.


CONCLUSIONS
Patients suffering from far-advanced otosclerosis may benefit from cochlear implantation and achieve speech performance scores comparable to non-otosclerotic implantees. Regarding surgery and facial nerve stimulation, attention should be taken to these cases in which the extension of otosclerosis is more severe on CT scanning (type 2 and mainly 3). Postoperative facial nerve stimulation can be managed successfully by resetting the current levels for comfort level.
1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital 1, Thessaloniki, Greece. psillasgeo@the.forthnet.gr
G
G
Psillas
G
G
Kyriafinis
J
J
Constantinidis
V
V
Vital
D000368:Aged; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010040:Otosclerosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D013067:Speech Perception / Q000502:physiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome