Cochlear stenting: how I do it.
Post-meningitis cases with profound sensorineural hearing loss are known to have progressive labyrinthine ossification; such cases need to be implanted early. In our region, often a substantial amount of time is spent procuring the necessary finances for a cochlear implant; therefore, here we describe our technique of maintaining cochlear lumen patency in post-meningitis cases with early ossification, for a complete functional electrode insertion at a later date. This is a descriptive case study of a patient having post-meningitis profound deafness, with imaging studies showing early cochlear ossification, who was rehabilitated with a cochlear implant. At a tertiary referral centre, a 1-year-old child with post-meningitis bilateral profound sensorineural hearing loss was rehabilitated with cochlear implantation. The left cochlea with early ossification was stented with a customised sterile electrode to prevent scalar occlusion; 3 months later the stent was replaced with a commercial Nucleus Contour Advance implant. A complete insertion of the functional electrode array replaced the stent. Categories of auditory performance (CAP) were used to assess the outcome in our case. The pre-operative CAP score was 1 (detects environmental sounds) and the score at 15 months post implant was 6 (understands some spoken words). In post-meningitis cases with progressive cochlear ossification, stenting the cochlear lumen prevents scalar occlusion and ensures a complete insertion of a functional electrode at a later date.
Kirtane
Milind V
MV
P D Hinduja Hospital, Mumbai, India.
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Yogesh I
YI
Mankekar
Gauri
G
D001309:Auditory Threshold; D015834:Cochlear Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D003638:Deafness / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D004567:Electrodes, Implanted; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications*; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000534:rehabilitation; D011474:Prosthesis Design; D013069:Speech Reception Threshold Test; D015607:Stents; D014057:Tomography, X-Ray Computed