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COCHLEAR IMPLANTS IN OBLITERATED OR OSSIFIED COCHLEAS
Elisabeth Masgoret1, Jorge Merán2, Ángel Osorio1, José Maria Cuyás1, Ángel Ramos1
1Complejo Hospitalario Universitario Insular MaternoInfantil,Las Palmas de Gran Canaria, Spain/2Hospital Universitario Joan XXIII, Tarragona, Spain
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INTRODUCTION: Ossified cochleas disables partially or totally the insertion of the conventional advice. . Therefore, the primary target of this surgery is to place the greater number of electrodes in the proximity of the surviving ganglionary population to the labyrinthitis. To this end, several types of electrodes have been designed with the purpose of making use to the maximum of the scarce capacity cochlear offered in this situation.■ METHODS: There is realized a retrospective study of 182 implanted adult patients (with ages between 18 and 78 years), being 19 cases of severe otosclerosis.
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RESULTS: The surgical findings during the intervention of the 19 cases of cochlear obliteration are: Stimulation of face nerve (spread of the current across the spongiotic bone) (4), looping back of the Array (it breathes basal extended) (1), labyrinthine ossification drill out of the labyrinthine ossification in obliterative otosclerosis (1), extensive cochlear demineralization (0), CSF leak (0), severe modification of the mapping (2) and explantation (1). Discussion: The appreciation of the cochlear obliteration is going to depend on the radiological surveys and the surgical confirmation. As far as the image techniques, the most important test is the RM, witch will allow us to appreciate three characteristics defined by Chouad greater density of the channel cochlear. After the studies contributed by TC and RM, the election of the device to use is necessary, are conventional implants, short or compressed implant, or the one of double-array. The obtained postsurgical results are bound directly to the number of nervous fibers, included in the fibro-bony weave of the ossification, that lead to a deterioration of the spiral ganglion.■
CONCLUSION: The cochlear ossification does not contraindicate cochlear implants. We considered that the present techniques for the implantation in the case of ossificated cochlea allow the laying of the device, in main lines, the totality of the cases and the benefit with regard to hearing is always greater that the surgical abstention. In addition, the present designs of the device facilitate the development of the technique and there make possible the insertion and use of all his channels.