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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: daniel.jy.wong@gmail.com
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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

References

Castillo, F, Polo, R, Gutierrez, A, Reyes, P, Royuela, A, Alonso, A. Cochlear implantation outcomes in advanced otosclerosis. Am J Otolaryngol 2014;35:558–64CrossRefGoogle ScholarPubMed
Kabbara, B, Gauche, C, Calmels, M-N, Lepage, B, Escude, B, Deguine, O et al. Decisive criteria between stapedotomy and cochlear implantation in patients with far advanced otosclerosis. Otol Neurotol 2015;36:e73–e8CrossRefGoogle ScholarPubMed
Marchioni, D, Soloperto, D, Bianconi, L, Guarnaccia, MC, Genovese, E, Presutti, L. Endoscopic approach for cochlear implantation in advanced otosclerosis: a case report. Auris Nasus Larynx 2016;43:584–90CrossRefGoogle ScholarPubMed
Assiri, M, Khurayzi, T, Alshalan, A, Alsanosi, A. Cochlear implantation among patients with otosclerosis: a systematic review of clinical characteristics and outcomes. Eur Arch Otorhinolaryngol 2022;279:3327–39CrossRefGoogle ScholarPubMed
Vashishth, A, Fulcheri, A, Rossi, G, Prasad, SC, Caruso, A, Sanna, M. Cochlear implantation in otosclerosis: surgical and auditory outcomes with a brief on facial nerve stimulation. Otol Neurotol 2017;38:e345–e53CrossRefGoogle ScholarPubMed
Frau, GN, Luxford, WM, Lo, WW, Berliner, KI, Telischi, FF. High-resolution computed tomography in evaluation of cochlear patency in implant candidates: a comparison with surgical findings. J Laryngol Otol 1994;108:743–8CrossRefGoogle ScholarPubMed
Bettman, R, Beek, E, Van Olphen, A, Zonneveld, F, Huizing, E. MRI versus CT in assessment of cochlear patency in cochlear implant candidates. Acta Otolaryngol 2004;124:577–81CrossRefGoogle ScholarPubMed
Marshall, AH, Fanning, N, Symons, S, Shipp, D, Chen, JM, Nedzelski, JM. Cochlear implantation in cochlear otosclerosis. Laryngoscope 2005;115:1728–33CrossRefGoogle ScholarPubMed
Merkus, P, van Loon, MC, Smit, CF, Smits, C, de Cock, AF, Hensen, EF. Decision making in advanced otosclerosis: an evidence-based strategy. Laryngoscope 2011;121:1935–41CrossRefGoogle ScholarPubMed
Rotteveel, LJ, Proops, DW, Ramsden, RT, Saeed, SR, van Olphen, AF, Mylanus, EA. Cochlear implantation in 53 patients with otosclerosis: demographics, computed tomographic scanning, surgery, and complications. Otol Neurotol 2004;25:943–52CrossRefGoogle ScholarPubMed
Cohen, J. Statistical Power Analysis for the Behavioral Sciences. New York: Routledge, 1988Google Scholar
Ramsden, R, Rotteveel, L, Proops, D, Saeed, S, van Olphen, A, Mylanus, E. Cochlear implantation in otosclerotic deafness. Otosclerosis and Stapes Surgery: Karger Publishers, 2007;65:328–34CrossRefGoogle ScholarPubMed
Matterson, AG, O'Leary, S, Pinder, D, Freidman, L, Dowell, R, Briggs, R. Otosclerosis: selection of ear for cochlear implantation. Otol Neurotol 2007;28:438–46CrossRefGoogle ScholarPubMed
Semaan, MT, Gehani, NC, Tummala, N, Coughlan, C, Fares, SA, Hsu, DP et al. Cochlear implantation outcomes in patients with far advanced otosclerosis. Am J Otolaryngol 2012;33:608–14CrossRefGoogle ScholarPubMed
O'Connell, BP, Hunter, JB, Wanna, GB. The importance of electrode location in cochlear implantation. Laryngoscope Invest Otolaryngol 2016;1:169–74CrossRefGoogle ScholarPubMed
Shaul, C, Dragovic, AS, Stringer, AK, O'Leary, SJ, Briggs, RJ. Scalar localisation of peri-modiolar electrodes and speech perception outcomes. J Laryngol Otol 2018;132:1000–6CrossRefGoogle ScholarPubMed
Lin, K, Marrinan, MS, Waltzman, SB, Roland, JT Jr. Multichannel cochlear implantation in the scala vestibuli. Otol Neurotol 2006;27:634–8CrossRefGoogle ScholarPubMed
Steenerson, RL, Gary, LB, Wynens, MS. Scala vestibuli cochlear implantation for labyrinthine ossification. Am J Otol 1990;11:360–3Google ScholarPubMed
Niparko, JK, Oviatt, DL, Coker, NJ, Sutton, L, Waltzman, SB, Cohen, NL. Facial nerve stimulation with cochlear implantation. VA Cooperative Study Group on Cochlear Implantation. Otolaryngol Head Neck Surg 1991;104:826–30CrossRefGoogle Scholar
Weber, BP, Lenarz, T, Battmer, RD, Hartrampf, R, Dahm, MC, Dietrich, B. Otosclerosis and facial nerve stimulation. Ann Otol Rhinol Laryngol Suppl 1995;166:445–7Google ScholarPubMed
Muckle, RP, Levine, SC. Facial nerve stimulation produced by cochlear implants in patients with cochlear otosclerosis. Am J Otol 1994;15:394–8Google ScholarPubMed
Bigelow, DC, Kay, DJ, Rafter, KO, Montes, M, Knox, GW, Yousem, DM. Facial nerve stimulation from cochlear implants. Am J Otol 1998;19:163–9Google ScholarPubMed
Rayner, MG, King, T, Djalilian, HR, Smith, S, Levine, SC. Resolution of facial stimulation in otosclerotic cochlear implants. Otolaryngol Head Neck Surg 2003;129:475–80CrossRefGoogle ScholarPubMed
Seyyedi, M, Herrmann, BS, Eddington, DK, Nadol, JB Jr. The pathologic basis of facial nerve stimulation in otosclerosis and multi-channel cochlear implantation. Otol Neurotol 2013;34:1603–9CrossRefGoogle ScholarPubMed
Van Horn, A, Hayden, C, Mahairas, AD, Leader, P, Bush, ML. Factors influencing aberrant facial nerve stimulation following cochlear implantation: a systematic review and meta-analysis. Otol Neurotol 2020;41:1050–9CrossRefGoogle ScholarPubMed
Frijns, JH, Kalkman, RK, Briaire, JJ. Stimulation of the facial nerve by intracochlear electrodes in otosclerosis: a computer modeling study. Otol Neurotol 2009;30:1168–74CrossRefGoogle ScholarPubMed