title: Subtotal petrosectomy and mastoid obliteration in adult and pediatric cochlear implant recipients.
abstract: OBJECTIVE
  To investigate the effect of subtotal petrosectomy and mastoid obliteration (SPMO) on the overall success of adult and pediatric cochlear implant (CI) recipients.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Tertiary care referral center.
  
  
  METHODS
  Thirty-nine ears in 36 patients (23 adults and 13 children) received both surgeries between 1990 and 2012.
  
  
  METHODS
  CI candidates underwent SPMO to permit implantation and minimize the risks of infectious complications in the recipient ear. SPMO was performed before (69.3%), at the time of (25.6%), and after CI (5.13%). Mastoids were obliterated with fat (30.8%), muscle (66.7%), and bone pate (2.56%).
  
  
  METHODS
  Feasibility, complications, and success of SPMO and CI were assessed with standard statistical analysis and Fisher's exact test with 2-sided p values.
  
  
  RESULTS
  Ear disease was definitively managed, and CI was successfully placed in all but one case. Complications including abscess (n = 3), subcutaneous emphysema (n = 1), ear canal granulation formation (n = 1), and electrode extrusion (n = 1) occurred in 15.4% of patients. Predisposing syndromes were present in children more often than adults (43.8% versus 13.0%, p = 0.0598). Adults more often than children had previous mastoid surgery for middle ear disease (30.4% versus 0.0%, p = 0.0288). CIs were placed under local anesthetic and sedation (n= 3) and after radiation treatment for nasopharyngeal cancer (n = 2) in adult ears.
  
  
  CONCLUSIONS
  SPMO is an effective and safe procedure for definitively managing middle ear disease and implanting adult and pediatric CI candidates.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A.
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Barañano
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Kopelovich
authors.forename: Camille C
authors.initials: CC
authors.lastname: Dunn
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Gantz
authors.forename: Marlan R
authors.initials: MR
authors.lastname: Hansen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000601:surgery; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D004432:Ear, Middle / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D010579:Petrous Bone / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome