Complications and pitfalls of cochlear implantation in otosclerosis: a 6-year follow-up cohort study.

OBJECTIVE

To describe and discuss the midterm complications and pitfalls reported in patients with otosclerosis who received a cochlear implant.

STUDY

DESIGN

Prospective cohort study.

SETTING

Tertiary referral center.

PATIENTS: Fifteen patients who received a cochlear implant for otosclerosis, followed up for a minimum of 6 years. Onset of hearing loss occurred at a mean age (+/-standard deviation [SD]) of 32.6 +/- 8.6 years. Mean duration (+/-SD) of hearing loss was 26.8 +/- 7.9 years, and mean age (+/-SD) at implant surgery was 58.7 +/- 9.5 years.

INTERVENTIONS: Before cochlear implantation, hearing thresholds were tested, and temporal bone anatomy and otosclerotic lesions were documented by high-resolution computed tomography and magnetic resonance imaging. All patients were implanted with a Med-El Combi 40 + device and a Standard Electrode Array.

MAIN OUTCOME MEASURES: The number of inserted electrodes was checked by x-ray. After cochlear implantation, hearing skills were tested, fitting parameters were recorded, and complications were noted.

RESULTS

As the disease progressed, the number of electrodes decreased, and the electrical thresholds, maximum comfort levels, and electric charge increased; these changes were more evident in the middle electrodes. Although facial nerve stimulation rate was lower than previously reported (13.3%), it increased during follow-up. Two patients (13.3%) had untreatable tinnitus. Nevertheless, all speech discrimination parameters improved significantly in all patients.

CONCLUSION

Despite the need for special fitting strategies and the appearance of complications, facial nerve stimulation, and tinnitus, improvements in speech discrimination tests support the use of cochlear implantation for patients with otosclerosis.