title: Bilateral cochlear implantation under local anaesthesia in a young adult - A case report.
abstract: OBJECTIVE
  Cochlear implantation is routinely performed under general anaesthesia in most centres in the world. There have been reports of this surgery being performed under local anaesthesia and sedation for unilateral cochlear implantation. Our case study reports the first bilateral cochlear implantation carried out under local anaesthesia with sedation. This paper outlines the protocol used and discusses the challenges and advantages of the procedure being performed under local anaesthesia.
  
  
  METHODS
  A 28-year-old female with a history of multidrug-resistant tuberculosis presented with bilateral severe to profound sensorineural hearing loss. On evaluation, she was found to be a suitable candidate for cochlear implantation. However, she was clinically unfit to undergo the surgery under general anaesthesia. After counselling the patient, the decision to undertake the procedure under local anaesthesia was made. The procedure took 105 min and was uneventful. The patient was discharged the next day Conclusion: In the hands of an experienced surgeon and anaesthesiology team, bilateral cochlear implantation is possible under local anaesthesia. Patient motivation and cooperation are extremely important for the procedure to be done under local anaesthesia. This is an option for patients needing cochlear implantation who are medically unfit for general anaesthesia.
authors.affiliation: a Department of E.N.T. , K.E.M. Hospital , Pune , India.
authors.forename: Neelam
authors.initials: N
authors.lastname: Vaid
authors.affiliation: b Department of Anaesthesiology , K.E.M. Hospital , Pune , India.
authors.forename: Joyshankar J
authors.initials: JJ
authors.lastname: Jana
authors.affiliation: a Department of E.N.T. , K.E.M. Hospital , Pune , India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Kothadiya
authors.affiliation: c BIG EARS , K.E.M. Hospital , Pune , India.
authors.forename: Shweta
authors.initials: S
authors.lastname: Deshpande
authors.affiliation: d Star Imaging & Research Centre , Pune 411001 , India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Vaid
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D000772:Anesthesia, Local / Q000379:methods*; D019929:Cochlear Implantation / Q000379:methods*; D000075202:Contraindications; D005260:Female; D006312:Hearing Loss, Bilateral / Q000382:microbiology / Q000601:surgery*; D006319:Hearing Loss, Sensorineural / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000150:complications
keywords: Bilateral cochlear implantation; Local anaesthesia