Surgical management of cochlear implant in chronic otitis media patients: safe and sound.

2020 
INTRODUCTION Cochlear implantation (CI) in cases with chronic otitis media (COM) was previously contraindicated but recent advances have made it possible. OBJECTIVE To review surgical and audiological outcomes of COM patients that underwent CI. MATERIAL AND METHODS Retrospective review of patients above 18 years old. RESULTS Ten patients with complete data were included. Patients were aged 24-69 years old. Tympanoplasty and mastoidectomy were performed before CI. Imaging was performed to rule out ossifications. Eight patients underwent a standard canal wall up with either cochleostomy or round window approach. One patient had additional canalplasty and tympanoplasty and another one had blind sac procedure respectively. Analysis of the hearing aided level with CI and hearing aid showed significant benefit provided by the CI (Z = 2.803, p = .005). DISCUSSION Creating a dry and safe ear is important prior to CI. Definite hearing improvement is seen in all our cases that helped them to become independent again in their daily life. Hearing aid usage pre-CI might not be important as the hearing aids may continue to cause discharging ears and the benefits of hearing aids in severe to profound hearing loss are very minimal. CONCLUSIONS Cochlear implant is safe and effective in COM patients.
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