TY - JOUR
T1 - Is it necessary to treat Otitis Media with Effusion (OME) prior to cochlear implantation? Results over a long-term follow-up
AU - Sokolov, Meirav
AU - Hilly, Ohad
AU - Ulanovski, David
AU - Shkedy, Yotam
AU - Attias, Joseph
AU - Raveh, Eyal
N1 - Publisher Copyright:
© 2016, Otology & Neurotology, Inc.
PY - 2016/11/28
Y1 - 2016/11/28
N2 - Objectives: Evaluate the intra- and postoperative effects of untreated otitis media with effusion (OME) in cochlear implant (CI) patients, and to assess the role of ventilation tube (VT) introduction before implantation. Study Design: A retrospective chart review. Setting: Tertiary referral center. Patients: CI patients, aged 10 years or younger, implanted during 2009 to 2013. Interventions: Cases were divided into three groups: 1) normal aerated middle ear before CI, 2) OME treated with VT, and 3) untreated OME. Main Outcome Measure(s): Intraoperative and postoperative findings and complications. Results: One hundred ninety-four cases (implanted ears) were included. Ninety-nine aerated, 39 treated with VT, and 56 with untreated OME. Mean age at implantation was 3.1, 2.1, and 1.6 years, respectively. Granulations and edema were significantly more common in untreated OME than aerated ears (62% vs. 7%, p<0.001). VT reduced the rate of these findings (46%) but not with statistical significance ( p=0.1) compared with untreated OME. Intraoperative findings were all manageable and were not associated with higher perioperative complication rates. The rates of early and late postoperative complications were low in all groups, with no significant differences between groups. Tympanic membrane perforations were encountered in two patients after VT extrusion. Rate of otorrhea was 20% during the first year after implantation and 5% at last follow up. Conclusion: Our results suggest that CI candidates with OME can be safely implanted without preimplantation VT insertion. Implanting patients with untreated OME allows earlier implantation. CI surgery can be more challenging in the presence of effusion; however, intraoperative findings are manageable.
AB - Objectives: Evaluate the intra- and postoperative effects of untreated otitis media with effusion (OME) in cochlear implant (CI) patients, and to assess the role of ventilation tube (VT) introduction before implantation. Study Design: A retrospective chart review. Setting: Tertiary referral center. Patients: CI patients, aged 10 years or younger, implanted during 2009 to 2013. Interventions: Cases were divided into three groups: 1) normal aerated middle ear before CI, 2) OME treated with VT, and 3) untreated OME. Main Outcome Measure(s): Intraoperative and postoperative findings and complications. Results: One hundred ninety-four cases (implanted ears) were included. Ninety-nine aerated, 39 treated with VT, and 56 with untreated OME. Mean age at implantation was 3.1, 2.1, and 1.6 years, respectively. Granulations and edema were significantly more common in untreated OME than aerated ears (62% vs. 7%, p<0.001). VT reduced the rate of these findings (46%) but not with statistical significance ( p=0.1) compared with untreated OME. Intraoperative findings were all manageable and were not associated with higher perioperative complication rates. The rates of early and late postoperative complications were low in all groups, with no significant differences between groups. Tympanic membrane perforations were encountered in two patients after VT extrusion. Rate of otorrhea was 20% during the first year after implantation and 5% at last follow up. Conclusion: Our results suggest that CI candidates with OME can be safely implanted without preimplantation VT insertion. Implanting patients with untreated OME allows earlier implantation. CI surgery can be more challenging in the presence of effusion; however, intraoperative findings are manageable.
KW - Cochlear implantation
KW - Complication
KW - Otitis media with effusion
KW - Ventilation tubes
UR - http://www.scopus.com/inward/record.url?scp=84991465793&partnerID=8YFLogxK
U2 - 10.1097/MAO.0000000000001221
DO - 10.1097/MAO.0000000000001221
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C2 - 27749756
AN - SCOPUS:84991465793
SN - 1531-7129
VL - 37
SP - 1529
EP - 1534
JO - Otology and Neurotology
JF - Otology and Neurotology
IS - 10
ER -