title: Management options for cochlear implantation in patients with chronic otitis media.
abstract: OBJECTIVE
  Patients with chronic otitis media with/without cholesteatoma present a significant challenge to safe cochlear implantation (CI). The aim of our study is to describe our experience and propose management options for CI in patients with chronic otitis media.
  
  
  METHODS
  Retrospective case study.
  
  
  METHODS
  Tertiary academic center.
  
  
  METHODS
  We enrolled the 9 ears of 8 subjects who received CI in the ear with chronic otitis media from 2006 to 2013 by a single surgeon. CI was performed as a single-stage or staged operation with mastoid surgery according to the activity of ear infection.
  
  
  RESULTS
  Six patients had bilateral chronic otitis media and 2 patients had long history of sensorineural hearing loss at contralateral ear. CI was performed with simultaneous radical mastoidectomy with closure of the EAC as a single-stage in 3 ears with a history of previous open cavity mastoidectomy and no active discharge. Staged CI was performed in 6 ears, after radical mastoidectomy with closure of the EAC in 3 ears and after intact canal wall mastoidectomy in 3 ears, due to active inflammation or complications related to otitis media. In one patient, wound infection had occurred, and implant was removed along with implantation at contralateral ear. Other subjects showed no evidence of recurrence.
  
  
  CONCLUSIONS
  Decision whether implantation as a single-stage or staged operation depends on the presence of active inflammation. Single-stage CI with proper mastoid surgery can be performed in patients without active inflammation. Staged procedure need to be done in ears with active inflammation. Proper application of mastoid surgery leads to safe CI for patients with chronic otitis media.
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Myung Hoon
authors.initials: MH
authors.lastname: Yoo
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Hong Ju
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: thyoon@amc.seoul.kr.
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Yoon
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D018424:Cholesteatoma, Middle Ear / Q000150:complications; D002908:Chronic Disease; D019929:Cochlear Implantation / Q000379:methods; D000075202:Contraindications; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications*; D012189:Retrospective Studies