Department of Otolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Department of Otolaryngology, Ankara City Hospital, Ankara, Turkey.
ORL J Otorhinolaryngol Relat Spec. 2021;83(4):280-285. doi: 10.1159/000513890. Epub 2021 Mar 30.
Cochlear implant (CI) surgery is a safe and standardized procedure in the presence of normal temporal bone anatomy. However, in the surgery of patients with chronic otitis media (COM), the surgeon may encounter several problems. The aim of this study was to evaluate the impact of COM with and without cholesteatoma on surgical and auditory outcomes of CIs.
The study group consisted of 39 patients with COM who received CIs. Age- and gender-matched 38 standard CI patients served as controls. The surgical techniques and complications, pure tone audiometry (PTA) scores, speech discrimination scores (SDS), and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire results of the groups were compared.
The presence of COM was associated with a higher rate of complication than controls. Staging the surgeries, presence or absence of cholesteatoma, and type of surgical technique were not associated with surgical outcomes and complications (p > 0.05). There was no significant difference between the groups in terms of postoperative PTA scores, SDS, and IOI-HA scores (p > 0.05).
Postoperative complications like device failure and skin breakdown are increased in cases of COM compared to standard CI surgeries. However, that increase is not associated with staging the surgeries, presence or absence of cholesteatoma, and type of ear surgery performed. It is advocated to close the external ear canal and eustachian tube without mastoid obliteration in the presence of a radical mastoidectomy cavity, which will decrease the postoperative complication rates and allow for radiological follow-up with computed tomography for the possibility of cholesteatoma recurrence. The auditory benefits of CI in patients with and without COM are comparable.
在正常颞骨解剖结构存在的情况下，耳蜗植入（CI）手术是一种安全且标准化的程序。然而，在慢性中耳炎（COM）患者的手术中，外科医生可能会遇到一些问题。本研究旨在评估 COM 伴或不伴胆脂瘤对 CI 手术和听觉结果的影响。
研究组由 39 例接受 CI 的 COM 患者组成。年龄和性别匹配的 38 例标准 CI 患者作为对照组。比较了两组的手术技术和并发症、纯音听阈（PTA）评分、言语辨别评分（SDS）和听力助听国际结果问卷（IOI-HA）结果。
COM 的存在与对照组相比，并发症发生率更高。分期手术、有无胆脂瘤以及手术技术类型与手术结果和并发症无关（p > 0.05）。两组术后 PTA 评分、SDS 和 IOI-HA 评分无显著差异（p > 0.05）。
与标准 CI 手术相比，COM 病例术后并发症如设备故障和皮肤破裂的发生率增加。然而，这种增加与分期手术、有无胆脂瘤以及所进行的耳部手术类型无关。提倡在外耳道和咽鼓管关闭而不进行乳突腔闭塞的情况下进行根治性乳突切除术，这将降低术后并发症的发生率，并允许进行 CT 影像学随访，以发现胆脂瘤复发的可能性。COM 患者和无 COM 患者的 CI 听觉获益相当。
