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Otorhinolaryngology 2022 September;72(3):123-9

DOI: 10.23736/S2724-6302.22.02449-5


language: English

Cochlear implant in inner ear malformations: the experience of the ENT clinic of university of Pisa

Francesco LAZZERINI 1, Francesca FORLI 1 , Luca BRUSCHINI 1, Stefano BERRETTINI 1, 2

1 Unit of Otolaryngology, Audiology and Phoniatrics, University of Pisa, Pisa, Italy; 2 Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

BACKGROUND: Sensorineural hearing losses are frequently associated with inner ear malformations (IEM). Generally, the CI in patients with IEM is related with an incidence of complications and surgical difficulties.
METHODS: In Pisa’s ENT clinic, since 1998, 41 patients with inner ear malformations have been submitted to cochlear implantation (6.7% of all implanted patients).
RESULTS: Within the 41 implanted patients with IEM 26 were children (16 females, 10 males, 8% of all implanted children in our unit) and 15 were adults (10 females, 5 males, 5,3% of all implanted adults). The mean follow-up after the cochlear implantation is 5.9 years (3 month - 18 years). The main surgical issues with CI surgery in patient with IEM are: the occurrence of gusher/oozing/perilymph leakage, the aberrant course of facial nerve that may lead at facial nerve damage and/or facial nerve stimulation, and the need of no-standard facial recess approach at the cochlea, the possibility of an incomplete insertion, the misplacement in the IAC, or a kinking of the electrodes array, and the need of a careful electrode’s choice after the adequate presurgical imaging evaluation.
CONCLUSIONS: In our experience surgical difficulties and complications occurred in a percentage similar or lower to that reported in the literature. Further, patients with IEM that received a CI at the ENT Unit of the University Hospital of Pisa (Pisa, Italy) achieved satisfactory results, in line with those reported in the main reviews on the subject in the literature, even if widely variable, depending on several factors, mainly on the malformation severity, the cochlear nerve integrity and the general status of the patient. Moreover, not severe complications occurred during surgery and the follow-up.

KEY WORDS: Cochlear implants; Congenital abnormalities; Ear

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