Long-term outcome of cochlear implant in patients with chronic otitis media: one-stage surgery is equivalent to two-stage surgery

• Published in: Journal of Korean medical science Vol. 30; no. 1; pp. 82 - 87
• Main Authors: Jang, Jeong Hun, Park, Min-Hyun, Song, Jae-Jin, Lee, Jun Ho, Oh, Seung Ha, Kim, Chong-Sun, Chang, Sun O
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.01.2015; 대한의학회
• Subjects: Adult; Aged; Cholesteatoma, Middle Ear - epidemiology; Chronic Disease - therapy; Cochlear Implantation - adverse effects; Cochlear Implants - adverse effects; Female; Hearing Loss, Sensorineural - surgery; Humans; Inflammation - epidemiology; Male; Middle Aged; Original; Otitis Media - surgery; Retrospective Studies; Speech Articulation Tests; Treatment Outcome; Young Adult; 의학일반; Speech Performance; Cochlear Implantation; Otitis Media; Tympanomastoidectomy
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2015.30.1.82

This study compared long-term speech performance after cochlear implantation (CI) between surgical strategies in patients with chronic otitis media (COM). Thirty patients with available open-set sentence scores measured more than 2 yr postoperatively were included: 17 who received one-stage surgeries (One-stage group), and the other 13 underwent two-stage surgeries (Two-stage group). Preoperative inflammatory status, intraoperative procedures, postoperative outcomes were compared. Among 17 patients in One-stage group, 12 underwent CI accompanied with the eradication of inflammation; CI without eradicating inflammation was performed on 3 patients; 2 underwent CIs via the transcanal approach. Thirteen patients in Two-stage group received the complete eradication of inflammation as first-stage surgery, and CI was performed as second-stage surgery after a mean interval of 8.2 months. Additional control of inflammation was performed in 2 patients at second-stage surgery for cavity problem and cholesteatoma, respectively. There were 2 cases of electrode exposure as postoperative complication in the two-stage group; new electrode arrays were inserted and covered by local flaps. The open-set sentence scores of Two-stage group were not significantly higher than those of One-stage group at 1, 2, 3, and 5 yr postoperatively. Postoperative long-term speech performance is equivalent when either of two surgical strategies is used to treat appropriately selected candidates.