Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-14T04:51:54.021Z Has data issue: false hasContentIssue false

Pseudo mastoid obliteration with conchal cartilage may be a safe alternative technique for cochlear implantation in canal wall down mastoidectomy with large meatoplasty

Published online by Cambridge University Press:  19 June 2020

C Carnevale*
Affiliation:
Otorhinolaryngology, Head and Neck Surgery Department, Son Espases University Hospital, Palma de Mallorca, Spain
G Til-Pérez
Affiliation:
Otorhinolaryngology, Head and Neck Surgery Department, Son Espases University Hospital, Palma de Mallorca, Spain
D Arancibia-Tagle
Affiliation:
Otorhinolaryngology, Head and Neck Surgery Department, Son Espases University Hospital, Palma de Mallorca, Spain
M Tomás-Barberán
Affiliation:
Otorhinolaryngology, Head and Neck Surgery Department, Son Espases University Hospital, Palma de Mallorca, Spain
P Sarría-Echegaray
Affiliation:
Otorhinolaryngology, Head and Neck Surgery Department, Son Espases University Hospital, Palma de Mallorca, Spain
*
Author for correspondence: Dr Carnevale Claudio, Carretera Valldemossa 79, 07210, Palma de Mallorca, Spain E-mail: claudio.carnevale.orl@gmail.com

Abstract

Objective

Safe cochlear implantation is challenging in patients with canal wall down mastoid cavities, and the presence of large meatoplasties increases the risk of external canal overclosure. This paper describes our results of obliteration of the mastoid cavity with conchal cartilage as an alternative procedure in cases of canal wall down mastoidectomy with very large meatoplasty.

Methods

The cases of seven patients with a canal wall down mastoidectomy cavity who underwent cochlear implantation were retrospectively reviewed. Post-operative complications were analysed. The mean follow-up duration was 4.5 years.

Results

There was no hint of cholesteatoma recurrence and all patients have been free of symptoms during follow up. Only one patient showed cable extrusion six months after surgery, and implantation of the contralateral ear was needed.

Conclusion

Pseudo-obliteration of the mastoid cavity with a cartilage multi-layered palisade reconstruction covering the electrode may be a safe alternative in selected patients with a large meatoplasty.

Type
Main Articles
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr C Carnevale takes responsibility for the integrity of the content of the paper

References

Hunter, JB, O'Connell, BP, Wanna, GB. Systematic review and metaanalysis of surgical complications following cochlear implantation in canal wall down mastoid cavities. Otolaryngol Head Neck Surg 2016;155:555–63CrossRefGoogle Scholar
Issing, PR, Schonermark, MP, Winkelmann, S, Kempf, HG, Ernst, A. Cochlear implantation in patients with chronic otitis: indications for subtotal petrosectomy and obliteration of the middle ear. Skull Base Surg 1998;8:127–31CrossRefGoogle ScholarPubMed
Kojima, H, Sakurai, Y, Rikitake, M, Tanaka, Y, Kawano, A, Moriyama, H. Cochlear implantation in patients with chronic otitis media. Auris Nasus Larynx 2010;37:415–21CrossRefGoogle ScholarPubMed
El-Kashlan, HK, Arts, HA, Telian, SA. External auditory canal closure in cochlear implant surgery. Otol Neurotol 2003;24:404–8CrossRefGoogle ScholarPubMed
Free, RH, Falcioni, M, Di Trapani, G, Giannuzzi, AL, Russo, A, Sanna, M. The role of subtotal petrosectomy in cochlear implant surgery: a report of 32 cases and review on indications. Otol Neurotol 2013;34:1033–40CrossRefGoogle ScholarPubMed
Olgun, L, Batman, C, Gultekin, G, Kandogan, T, Cerci, U. Cochlear implantation in chronic otitis media. J Laryngol Otol 2005;119:946–9CrossRefGoogle ScholarPubMed
Bento, RF, Bittencourt, AG, Goffi-Gomez, MV, Samuel, P, Tsuji, RK, de Brito, R. Cochlear implantation via the middle fossa approach: surgical and programming considerations. Otol Neurotol 2012;33:1516–24CrossRefGoogle ScholarPubMed
Colletti, V, Fiorino, FG, Carner, M, Sacchetto, L, Giarbini, N. New approach for cochlear implantation: cochleostomy through the middle fossa. Otolaryngol Head Neck Surg 2000;123:467–74CrossRefGoogle ScholarPubMed
Casserly, P, Friedland, PL, Atlas, MD. The role of subtotal petrosectomy in cochlear implantation. J Laryngol Otol 2016;130(suppl 4):S3540CrossRefGoogle ScholarPubMed
Bernardeschi, D, Nguyen, Y, Smail, M, Bouccara, D, Meyer, B, Ferrary, E et al. Middle ear and mastoid obliteration for cochlear implant in adults: indications and anatomical results. Otol Neurotol 2015;36:604–9CrossRefGoogle ScholarPubMed
Hamzavi, J, Baumgartner, W, Franz, P, Plenk, H. Radical cavities and cochlear implantation. Acta Otolaryngol 2001;121:607–910.1080/000164801316878908CrossRefGoogle ScholarPubMed
Postelmans, JT, Stokroos, RJ, Linmans, JJ, Kremer, B. Cochlear implantation in patients with chronic otitis media: 7 years’ experience in Maastricht. Eur Arch Otorhinolaryngol 2009;266:1159–65CrossRefGoogle ScholarPubMed
Carnevale, C, Tomás-Barberán, M, Til-Pérez, G, Sarría-Echegaray, P. The bonebridge bone conduction system: a fast and safe technique for a middle fossa approach. J Laryngol Otol 2019;133:344–710.1017/S0022215119000501CrossRefGoogle ScholarPubMed
Prasad, SC, Roustan, V, Piras, G, Caruso, A, Lauda, L, Sanna, M. Subtotal petrosectomy: surgical technique, indications, outcomes, and comprehensive review of literature. Laryngoscope 2017;127:2833–42CrossRefGoogle ScholarPubMed
Polo, R, Del Mar Medina, M, Aristegui, M, Lassaletta, L, Gutierrez, A, Aranguez, G et al. Subtotal petrosectomy for cochlear implantation: lessons learned after 110 cases. Ann Otol Rhinol Laryngol 2016;125:485–94CrossRefGoogle ScholarPubMed
Karatzanis, AD, Chimona, TS, Prokopakis, EP, Kyrmizakis, DE, Velegrakis, GA. Cochlear implantation after radical mastoidectomy: management of a challenging case. ORL J Otorhinolaryngol Relat Spec 2003;65:375–810.1159/000076058CrossRefGoogle ScholarPubMed
Vincenti, V, Pasanisi, E, Bacciu, A, Bacciu, S, Zini, C. Cochlear implantation in chronic otitis media and previous middle ear surgery: 20 years of experience. Acta Otorhinolaryngol Ital 2014;34:272–7Google Scholar
Szymanski, M, Ataide, A, Linder, T. The use of subtotal petrosectomy in cochlear implant candidates with chronic otitis media. Eur Arch Otorhinolaryngol 2016;273:363–70CrossRefGoogle ScholarPubMed
Lyutenski, S, Schwab, B, Lenarz, T, Salcher, R, Majdani, O. Impact of the surgical wound closure technique on the revision surgery rate after subtotal petrosectomy. Eur Arch Otorhinolaryngol 2016;273:3641–6CrossRefGoogle ScholarPubMed
Himi, T, Harabuchi, Y, Shintani, T, Yamaguchi, T, Yoshioka, I, Kataura, A. Surgical strategy of cochlear implantation in patients with chronic middle ear disease. Audiol Neurootol 1997;2:410–17CrossRefGoogle ScholarPubMed
Manrique, M, Cervera-Paz, FJ, Espinosa, JM, Perez, N, Garcia-Tapia, R. Cochlear implantation in radical cavities of mastoidectomy. Laryngoscope 1996;106:1562–5CrossRefGoogle ScholarPubMed
Craig, M, Lavy, J. How I do it/short communication: the middle temporal artery flap for coverage of an exposed cochlear implant cable in the mastoid cavity. Cochlear Implants Int 2006;7:214–18CrossRefGoogle Scholar
Tamura, Y, Shinkawa, A, Ishida, K, Sakai, M. Cochlear implant after reconstruction of the external bony canal wall and tympanic cavity in radically mastoidectomized patients with cholesteatoma. Auris Nasus Larynx 1997;24:361–6CrossRefGoogle Scholar
Balk, M, Schwarz, D, Wolber, P, Anagiotos, A, Gostian, AO. Cochlear implantation after canal wall down mastoidectomy. Outcomes after partial mastoid obliteration. Auris Nasus Larynx 2019;46:487–92CrossRefGoogle ScholarPubMed