title: Cochlear Implantation in Inner Ear Malformations: Systematic Review of Speech Perception Outcomes and Intraoperative Findings.
abstract: Objective (1) To analyze reported speech perception outcomes in patients with inner ear malformations who undergo cochlear implantation, (2) to review the surgical complications and findings, and (3) to compare the 2 classification systems of Jackler and Sennaroglu. Data Sources PubMed, Scopus (including Embase), Medline, and CINAHL Plus. Review Methods Fifty-nine articles were included that contained speech perception and/or intraoperative data. Cases were differentiated depending on whether the Jackler or Sennaroglu malformation classification was used. A meta-analysis of proportions examined incidences of complete insertion, gusher, and facial nerve aberrancy. For speech perception data, weighted means and standard deviations were calculated for all malformations for short-, medium-, and long-term follow-up. Speech tests were grouped into 3 categories-closed-set words, open-set words, and open-set sentences-and then compared through a comparison-of-means t test. Results Complete insertion was seen in 81.8% of all inner ear malformations (95% CI: 72.6-89.5); gusher was reported in 39.1% of cases (95% CI: 30.3-48.2); and facial nerve anomalies were encountered in 34.4% (95% CI: 20.1-50.3). Significant improvements in average performance were seen for closed- and open-set tests across all malformation types at 12 months postoperatively. Conclusions Cochlear implantation outcomes are favorable for those with inner ear malformations from a surgical and speech outcome standpoint. Accurate classification of anatomic malformations, as well as standardization of postimplantation speech outcomes, is necessary to improve understanding of the impact of implantation in this difficult patient population.
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Saint Louis University, St Louis, Missouri, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Farhood
authors.affiliation: 2 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Shaun A
authors.initials: SA
authors.lastname: Nguyen
authors.affiliation: 2 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Miller
authors.affiliation: 2 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Meredith A
authors.initials: MA
authors.lastname: Holcomb
authors.affiliation: 2 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Ted A
authors.initials: TA
authors.lastname: Meyer
authors.affiliation: 2 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Habib G
authors.initials: HG
authors.lastname: Rizk
mesh_terms: D002675:Child, Preschool; D003051:Cochlea / Q000601:surgery; D019929:Cochlear Implantation / Q000009:adverse effects / Q000379:methods*; D003054:Cochlear Implants; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000601:surgery*; D007758:Ear, Inner / Q000002:abnormalities* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications / Q000503:physiopathology / Q000601:surgery; D008297:Male; D018570:Risk Assessment; D013067:Speech Perception / Q000502:physiology*; D013068:Speech Production Measurement; D013997:Time Factors; D016896:Treatment Outcome
keywords: cochlear implantation; cochleovestibular dysplasia; inner ear malformations; speech perception