Cochlear implantation versus auditory brainstem implantation in bilateral total deafness after head trauma: personal experience and review of the literature.
OBJECTIVE
To determine the effectiveness of cochlear implant (CI) in hearing restoration after temporal bone (TB) fractures and investigate the adequacy of auditory brainstem implant (ABI) indication for TB fractures.


METHODS
Retrospective clinical study; a systematic review of the literature in PubMed was also performed to identify all published cases of bilateral TB fractures or bilateral deafness after head trauma treated by means of CI or ABI.


METHODS
Quaternary otology and skull base surgery referral center.


METHODS
Eleven consecutive patients presented with bilateral severe-to-profound sensorineural hearing loss after head trauma.


METHODS
CI as primary intervention or following a previous treatment.


METHODS
CI performances were evaluated in the auditory-only condition in both closed-set and open-set formats.


RESULTS
Fourteen CI were placed, 11 as primary treatment and 3 after ABI failure. At the last follow-up, all patients gained useful open-set speech perception. In secondary CI, all patients obtained better auditory results with the CI if compared with ABI. CI performance did not decrease with time in any case.


CONCLUSIONS
Cochlear implantation after TB fractures has proved to have excellent audiometric results. The aim of the initial evaluation of a patient with bilateral anacoustic ears from head trauma should always be to rehabilitate their hearing with a CI. The incidence of labyrinthitis ossificans, negative electrophysiologic testing, the risk of postoperative meningitis or facial nerve stimulation should not be the determinant factors that favor ABI placement.
*Gruppo Otologico Piacenza-Roma and University of Chieti; †Department of Experimental and Clinical Medicine, Otolaryngology Unit, University Hospital of Parma, Parma, Italy; and ‡Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Marimar
M
Medina
Filippo
F
Di Lella
Giuseppe
G
Di Trapani
Sampath Chandra
SC
Prasad
Andrea
A
Bacciu
Miguel
M
Aristegui
Alessandra
A
Russo
Mario
M
Sanna
D000328:Adult; D001299:Audiometry; D038263:Auditory Brain Stem Implantation; D038262:Auditory Brain Stem Implants; D019929:Cochlear Implantation; D003054:Cochlear Implants; D006259:Craniocerebral Trauma / Q000150:complications*; D003638:Deafness / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013067:Speech Perception / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult