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Cochlear implantation in advanced otosclerosis: utility of pre-operative radiological assessment in predicting intra-operative difficulty and final electrode position

Published online by Cambridge University Press:  05 April 2023

D Wong Open the ORCID record for D Wong [Opens in a new window] ,
B Copson ,
J-M Gerard ,
F Hill ,
J Leigh  and
R Dowell
D Wong*
Affiliation:
Department of Otolaryngology, Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia
B Copson
Affiliation:
Department of Radiology, St Vincent's Hospital, Melbourne, Australia Department of Surgery (Otolaryngology), University of Melbourne, Parkville, Australia
J-M Gerard
Affiliation:
Department of Otolaryngology, Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia
F Hill
Affiliation:
Department of Otolaryngology, Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia
J Leigh
Affiliation:
Department of Otolaryngology, Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia Department of Audiology, University of Melbourne, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia
R Dowell
Affiliation:
Department of Otolaryngology, Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia Department of Audiology, University of Melbourne, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia
*
Corresponding author: Daniel Wong; Email: [email protected]
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Abstract

Objective

This study aimed to determine if pre-operative radiological scoring can reliably predict intra-operative difficulty and final cochlear electrode position in patients with advanced otosclerosis.

Method

A retrospective cohort study of advanced otosclerosis patients who underwent cochlear implantation (n = 48, 52 ears) was compared with a larger cohort of post-lingually deaf adult patients (n = 1414) with bilateral hearing loss and normal cochlear anatomy. Pre-operative imaging for advanced otosclerosis patients and final electrode position were scored and correlated with intra-operative difficulty and speech outcomes.

Results

Advanced otosclerosis patients benefit significantly from cochlear implantation. Mean duration of deafness was longer in the advanced otosclerosis group (19.5 vs 14.3 years; p < 0.05).

Conclusion

Anatomical changes in advanced otosclerosis can result in increased difficulty of surgery. Evidence of pre-operative cochlear luminal changes was associated with intra-operative difficult insertion and final non-scala tympani position. Nearly all electrodes implanted in the advanced otosclerosis cohort were peri-modiolar. No reports of facial nerve stimulation were observed.

Keywords

Otosclerosiscochlear implantationhearing loss, sensorineuralradiologyfacial nerve
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 11 , November 2023 , pp. 1248 - 1255
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr D Wong takes responsibility for the integrity of the content of the paper

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