Subtotal petrosectomy and mastoid obliteration in adult and pediatric cochlear implant recipients.

Abstract

OBJECTIVE:

To investigate the effect of subtotal petrosectomy and mastoid obliteration (SPMO) on the overall success of adult and pediatric cochlear implant (CI) recipients.

STUDY DESIGN:

Retrospective case series.

SETTING:

Tertiary care referral center.

PATIENTS:

Thirty-nine ears in 36 patients (23 adults and 13 children) received both surgeries between 1990 and 2012.

INTERVENTION:

CI candidates underwent SPMO to permit implantation and minimize the risks of infectious complications in the recipient ear. SPMO was performed before (69.3%), at the time of (25.6%), and after CI (5.13%). Mastoids were obliterated with fat (30.8%), muscle (66.7%), and bone pate (2.56%).

MAIN OUTCOME MEASURE:

Feasibility, complications, and success of SPMO and CI were assessed with standard statistical analysis and Fisher's exact test with 2-sided p values.

RESULTS:

Ear disease was definitively managed, and CI was successfully placed in all but one case. Complications including abscess (n = 3), subcutaneous emphysema (n = 1), ear canal granulation formation (n = 1), and electrode extrusion (n = 1) occurred in 15.4% of patients. Predisposing syndromes were present in children more often than adults (43.8% versus 13.0%, p = 0.0598). Adults more often than children had previous mastoid surgery for middle ear disease (30.4% versus 0.0%, p = 0.0288). CIs were placed under local anesthetic and sedation (n= 3) and after radiation treatment for nasopharyngeal cancer (n = 2) in adult ears.

CONCLUSION:

SPMO is an effective and safe procedure for definitively managing middle ear disease and implanting adult and pediatric CI candidates.

• Authors: Christopher F Barañano, Jonathan C Kopelovich, Camille C Dunn, Bruce J Gantz, Marlan R Hansen
• Journal: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (Otol Neurotol) Vol. 34 Issue 9 Pg. 1656-9 (Dec 2013) ISSN: 1537-4505 [Electronic] United States
• PMID: 24136310 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Topics

• Adult
• Aged
• Aged, 80 and over
• Child
• Child, Preschool
• Cholesteatoma, Middle Ear (surgery)
• Cochlear Implantation (methods)
• Cochlear Implants
• Ear, Middle (surgery)
• Female
• Humans
• Infant
• Male
• Mastoid (surgery)
• Middle Aged
• Petrous Bone (surgery)
• Retrospective Studies
• Treatment Outcome