Evaluation of Subtotal Petrosectomy Technique in Difficult Cases of Cochlear Implantation.
Audiol Neurootol
; 25(6): 323-335, 2020.
Article
em En
| MEDLINE
| ID: mdl-32474562
ABSTRACT
OBJECTIVES:
To assess the validity of the subtotal petrosectomy (STP) technique in problematic cases of cochlear implant (CI) surgery, and review indications, outcomes, and related controversies. STUDYDESIGN:
This is a retrospective review of data from a private quaternary referral center of otology and skull base surgery. PATIENTS ANDMETHODS:
A review of patients who underwent CI with STP (STP-CI) as the leading approach was performed. Demographics, indications, surgical details, and main outcomes were evaluated. The surgeries performed were usually single-stage procedures encompassing a comprehensive mastoidectomy, blind sac closure of the external auditory canal (EAC), and mastoid obliteration with autologous fat.RESULTS:
A total of 107 cases were included. Mean follow-up was 7.1 years (range 1-13 years). The most frequent indication for STP-CI was chronic otitis media with/without cholesteatoma (32.7%), followed by open mastoid cavity (26.1%), and cochlear ossification (17.7%). Other difficult conditions where STP facilitates successful implantation include inner-ear malformations, temporal-bone trauma, unfavorable anatomic conditions, and revision surgery. A planned staged procedure was performed in 3 cases. The rate of major complications was 5.6% (n = 6). Three patients developed postauricular wound dehiscence which eventually resulted in device extrusion. No cases of recurrent/entrapped cholesteatoma, EAC breakdown, or meningitis were encountered. This is the largest single-center series of STP-CI reported in the literature.CONCLUSIONS:
When CI is intended in technically challenging cases or associated with a high risk of complications, STP is effective and reliable. Safe implantation and excellent long-term outcomes can be achieved provided surgical steps are properly followed. Single-stage procedures can be performed in most cases, even when there is active middle-ear disease.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Otite Média
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Colesteatoma
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Implantes Cocleares
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Cóclea
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Implante Coclear
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
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Adult
/
Aged
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Aged80
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Child
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Child, preschool
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Audiol Neurootol
Assunto da revista:
AUDIOLOGIA
/
PSICOFISIOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article