Labyrinthitis ossificans may complicate the insertion of a multichannel
cochlear implant in patients deafened after
meningitis. Two children who initially underwent partial insertion of a 22-channel
cochlear implant because of severe cochlear ossification required
revision surgery after several months of unsuccessful device use. At the time of revision, resection of the car canal, tympanic membrane, malleus, and incus provided access to the lateral wall of the cochlea, permitting extensive drilling of the basal turn and a circumodiolar placement of the
electrode. Functional integrity of the electronic components of the original device was documented intraoperatively, avoiding the expense of a new receiver-stimulator. Complete insertion of the active
electrodes was accomplished in both cases, and electrophysiologic responsiveness to the implant was documented using intraoperative electrically evoked auditory brainstem response recordings. Postoperative performance has been similar to that of
cochlear implant patients with nonossified ears. Experience with these two cases suggests that efforts to optimize
electrode insertion at the original
surgical procedure are appropriate and may help to avoid the disappointment of an unsuccessful
cochlear implant.