Cochlear Implantation in Chronic Otitis Media

Kim, Chong Sun; Shim, Woo Sub; Chang, Sun O; Oh, Seung Ha; Kim, Young Ho; Lee, Hyo Jeong; Choi, Byung Yoon

Abstract

BACKGROUND AND OBJECTIVES
Profound hearing loss can be followed by the process of chronic otitis media. The aim of the study is to evaluate management options in cochlear implantation in patients with chronic middle ear disease. MATERIALS AND METHOD: Two senior authors performed a total of 367 cases of cochlear implantation from November 1988 to August 2003. Among these, nine patients with chronic middle ear disease received cochlear implantation. The medical records and radiological findings were reviewed retrospectively. RESULTS: Of these nine patients, three patients with active inflammation underwent two open cavity and one closed cavity tympanomastoidectomy. Cochlear implantation was followed after a 3 to 6 months interval. Six patients who had undergone a prior tympanomastoidectomy showed no active inflammation. Two of these patients (case 4, 5) underwent revision surgery with mastoid obliteration as a staged procedure. Cochlear implantation was performed after 5 to 12 months interval. Another four patients had well-obliterated mastoid cavity by previous surgery, and received cochlear implantation as a single-stage procedure. To date, no patient has experienced postoperative wound problems. CONCLUSION: It is mandatory to secure an infection-free ear before implantation. Two-stage procedures must be performed if there is any doubt concerning the eradication of disease. It is also essential to create a strong protective layer of tissue capable of covering the electrode array especially in the mastoid cavity.