gms | German Medical Science

81st Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

12.05. - 16.05.2010, Wiesbaden

Cochlear implant indications, surgical techniques and therapeutical results

Meeting Abstract

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  • corresponding author Stan Cotulbea - Univ. Victor Babes, Dept. ENT, Timisoara, Romania
  • V. Drganescu - Univ. Victor Babes, Dept. ENT, Timisoara, Romania
  • Delia Trales - Univ. Victor Babes, Dept. ENT, Timisoara, Romania

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 81. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Wiesbaden, 12.-16.05.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10hnod269

doi: 10.3205/10hnod269, urn:nbn:de:0183-10hnod2693

Published: April 22, 2010

© 2010 Cotulbea et al.
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Outline

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Objective: We present our 6 year experience in cochlear implantation. Screening, evaluation, early diagnosis, surgical treatment, and rehabilitation in children with cochlear severe to profound sensorineural hearing loss raises different problems from those encountered in adults. Our continuing concern is the improvement of early diagnosis and lowering the age of implantation.

Material and methods: 63 patients received cochlear implants between 1/2003 and 8/2009. 60 patients had prelingual (mean age 3.4 years). 3 patients postlingual hearing loss (1 Cogan’s syndrome, 2 postmeningitis). Classic technique (mastoidectomy, facial recess approach, cochleostomy) with both the large and the minimal incision was used. In children the developing skull, the thickness of the skull and the amount of blood loss have to be considered. In 21 selected cases cochlear implantation was performed through minimal incision approach and fixation using periosteal sutures.

Results: We had no major complications, such as flap necrosis with extrusion of the implant, meningitis or facial palsy. 3 patients (4.76%) showed CSF gusher intraoperatively; successful implantation have been accomplished. We encountered 2 late complications (over 1 year): cholesteatoma and a progressive device failure. In minimal incision technique, the combination of a well-formed bony well and periosteal tightening sutures created sufficient fixation to avoid device dislocation and migration.

Conclusions: The cochlear implant has radically changed the outlook for profoundly deaf adults and children. It is not possible to predict the benefit an individual will obtain from a cochlear implant, but children born deaf will have greatest benefit if they are implanted before the age of 5, and preferably by the age of 3.