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Cochlear Implantation in Children with Congenital Inner Ear Malformations

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Abbas A. M., Hamed M. S., Ahmed A. S.
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2022
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vol. 11
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issue 4
1-12
EN
Introduction: Cochlear Implantation has proven beneficial in patients with profound congenital hearing impairments. Performing cochlear implantation in patients with inner ear malformation has always been a matter of dispute as congenitally deaf ears may have anatomical malformations and thus meet difficulties during operation. Therefore, it is important to focus on problems and complications encountered by surgeons performing such operations. Aim: To evaluate problems and surgical difficulties encountered in patients with congenital inner ear malformation, who underwent cochlear implantation. Material and methods: A series of 21 pediatric cochlear implant (CI) patients with known inner ear malformations determined on computed tomography (CT) of the temporal bone who underwent cochlear implantation in the Department of Otolaryngology of Martyr Ghazi Al-Hariri and AL-Yarmouk Teaching Hospital, Baghdad, Iraq, from January 2018 to January 2021. The study aimed to determine intraoperative adverse effects of these anomalies regarding electrode array insertion depths, predisposition to cerebrospinal fluid (CSF) leak through the cochleostomy, and associated facial nerve anomalies that can create problems with access to scala tympani. Results: The most common inner ear anomalies were wide vestibular aqueduct (15 patients, which makes 71.4%), incomplete partitions (5 patients, 23.8%), and common cavity (1 patient, 4.8%). As concerns CSF leak, the most common was CSF ooze (11 patients, 52.4%), CSF gusher (6 patients, 28.6%), and no CSF leak (4 patients, 19%). Among facial nerve anomalies there was only one case (4.8%) of abnormal position (more superficial and not injured) and 20 cases (95.2%) in which no anomaly was detected. As concerns electrode insertion depth, full insertion was achieved in 17 patients (81%), while incomplete insertion in 4 patients (19%). Conclusion: Cochlear implant can be successfully and safely inserted in patients with selected congenital inner ear anomalies. Surgery can be challenging in certain cases of gusher and facial nerve abnormalities, but proper radiology and good surgical technique will help avoid complications.
2
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Current indications for cochlear implantation in adults and children

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Szyfter W., Karlik M., Sekula A., Harris S., Gawęcki W.
Otolaryngologia Polska
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2019
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vol. 73(3)
1-5
EN
Introduction: Surgical treatment of deafness by cochlear implants is used for more than 40 years, and during this period permanently, gradual and significant expansion of indications for this surgery has been observed. Material and methods: In our Department in the years 1994-2018 1480 cochlear implantations were performed, both in adults (647) and in children (883). In this study current indications and the rules for eligibility of patients based on 25 years of experience are presented. Results: Indications for cochlear implantation in adults are: 1) bilateral postlingual deafness, 2) bilateral sensorineural hearing loss - in pure tone audiometry > 70 dB HL (average 500-4000 Hz) and in speech audiometry in hearing aids understanding < 50% of words for the intensity of the stimulus 65 dB, in the absence of the benefits of hearing aids, 3) bilateral profound hearing loss for high frequency with good hearing for low frequency, in the absence of the benefits of hearing aids, 4) some cases of asymmetric hearing loss with intensive tinnitus in the deaf ear. An indication in children is bilateral sensorineural hearing loss > 80dB HL confirmed by hearing tests, after about 6 months of rehabilitation with the use of hearing aids. Discussion: Although cochlear implantation is used for more than 40 years, the indications for this treatment underlies constant modifications. They concern the age of eligible patients, implantation in patients with partially preserved hearing, as well as treatment for patients with difficult anatomical conditions. In many countries, bilateral implantations are commonly performed, and more and more centers recommend this treatment in the case of unilateral deafness or asymmetric hearing loss, especially with the accompanying tinnitus in the deaf ear.
3
Publication available in full text mode
Content available

Current indications for cochlear implantation in adults and children

100%
Szyfter W., Karlik M., Sekula A., Harris S., Gawęcki W.
Polish Journal of Otolaryngology
|
2019
|
vol. 73
|
issue 3
1-5
EN
Introduction: Surgical treatment of deafness by cochlear implants is used for more than 40 years, and during this period permanently, gradual and significant expansion of indications for this surgery has been observed. Material and methods: In our Department in the years 1994-2018 1480 cochlear implantations were performed, both in adults (647) and in children (883). In this study current indications and the rules for eligibility of patients based on 25 years of experience are presented. Results: Indications for cochlear implantation in adults are: 1) bilateral postlingual deafness, 2) bilateral sensorineural hearing loss - in pure tone audiometry > 70 dB HL (average 500-4000 Hz) and in speech audiometry in hearing aids understanding < 50% of words for the intensity of the stimulus 65 dB, in the absence of the benefits of hearing aids, 3) bilateral profound hearing loss for high frequency with good hearing for low frequency, in the absence of the benefits of hearing aids, 4) some cases of asymmetric hearing loss with intensive tinnitus in the deaf ear. An indication in children is bilateral sensorineural hearing loss > 80dB HL confirmed by hearing tests, after about 6 months of rehabilitation with the use of hearing aids. Discussion: Although cochlear implantation is used for more than 40 years, the indications for this treatment underlies constant modifications. They concern the age of eligible patients, implantation in patients with partially preserved hearing, as well as treatment for patients with difficult anatomical conditions. In many countries, bilateral implantations are commonly performed, and more and more centers recommend this treatment in the case of unilateral deafness or asymmetric hearing loss, especially with the accompanying tinnitus in the deaf ear.
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