title: Complications and pitfalls of cochlear implantation in otosclerosis: a 6-year follow-up cohort study.
abstract: OBJECTIVE
  To describe and discuss the midterm complications and pitfalls reported in patients with otosclerosis who received a cochlear implant.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Fifteen patients who received a cochlear implant for otosclerosis, followed up for a minimum of 6 years. Onset of hearing loss occurred at a mean age (+/-standard deviation [SD]) of 32.6 +/- 8.6 years. Mean duration (+/-SD) of hearing loss was 26.8 +/- 7.9 years, and mean age (+/-SD) at implant surgery was 58.7 +/- 9.5 years.
  
  
  METHODS
  Before cochlear implantation, hearing thresholds were tested, and temporal bone anatomy and otosclerotic lesions were documented by high-resolution computed tomography and magnetic resonance imaging. All patients were implanted with a Med-El Combi 40 + device and a Standard Electrode Array.
  
  
  METHODS
  The number of inserted electrodes was checked by x-ray. After cochlear implantation, hearing skills were tested, fitting parameters were recorded, and complications were noted.
  
  
  RESULTS
  As the disease progressed, the number of electrodes decreased, and the electrical thresholds, maximum comfort levels, and electric charge increased; these changes were more evident in the middle electrodes. Although facial nerve stimulation rate was lower than previously reported (13.3%), it increased during follow-up. Two patients (13.3%) had untreatable tinnitus. Nevertheless, all speech discrimination parameters improved significantly in all patients.
  
  
  CONCLUSIONS
  Despite the need for special fitting strategies and the appearance of complications, facial nerve stimulation, and tinnitus, improvements in speech discrimination tests support the use of cochlear implantation for patients with otosclerosis.
authors.affiliation: Otolaryngology Service, Hospital Universitario San Cecilio, Granada, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Sainz
authors.forename: Juan
authors.initials: J
authors.lastname: Garcia-Valdecasas
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Ballesteros
mesh_terms: D000328:Adult; D001307:Auditory Perception / Q000502:physiology; D001309:Auditory Threshold / Q000502:physiology; D019929:Cochlear Implantation / Q000009:adverse effects*; D003054:Cochlear Implants / Q000009:adverse effects*; D015331:Cohort Studies; D020220:Facial Nerve Injuries / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006309:Hearing / Q000502:physiology; D034381:Hearing Loss / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010040:Otosclerosis / Q000601:surgery*; D011446:Prospective Studies; D011475:Prosthesis Failure; D013063:Speech Discrimination Tests; D013067:Speech Perception / Q000502:physiology; D014012:Tinnitus / Q000209:etiology; D016896:Treatment Outcome