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CLINICAL CASE
Year : 2018  |  Volume : 20  |  Issue : 1  |  Page : 37-41

Operative challenges in doing cochlear implant in an ossified cochlea, is it worth it? Case report and reviewing the literature


King Abdullah Ear Specialist Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia

Correspondence Address:
Farid Alzhrani
King Abdullah Ear Specialist Center, College of Medicine, PO Box 245 Riyadh 11411
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-8491.273917

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In the past, cochlear implantation was a contraindicated procedure in profoundly deaf patients with radical mastoid cavities. This was due to high risk of infection spread into the cochlea with possible destruction of the remainder surviving cochlear neural elements. We report on King Abdulaziz University Hospital, Riyadh, Saudi Arabia experience in managing, two postlingual profoundly deaf patients (both male and adult) with radical mastoid cavities due to chronic cholesteatomatous otitis media by cochlear implantation. Two different open techniques were used, cochlear implantation with (in the first patient) and without (in the second patient) obliteration of the pre-existing mastoid cavity. One patient (first) suffered infection of mastoid cavity with extrusion of electrode, 55 months postimplantation. The infection could not be controlled without explantation, so the patient was explanted. The other (second) patient suffered facial nerve twitching, ear discharge and later failure of the implant as proved by integrity testing, 22 months post-implantation. The infection subsided after explantation. We recommend regular clinical and audiological follow-up of such patients in the same cochlear implantation center to avoid any complications which may lead to implant failure or electrode extrusion. This is also useful to discover and treat early any potential recurrent infection or cholesteatoma. High-resolution computed tomography scan of temporal bone is a good tool in the follow-up of patient with post-implantation complications or those implanted with closed blind sac technique which may be a better alternative technique than the open technique.


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