Abstract
This study describes the clinical profile, operative findings, surgical technique, type of implant and complications encountered in implantation of abnormal cochlea by the transcanal (veria) technique in a tertiary care centre. This is a retrospective study done amongst 337 patients who underwent cochlear implantation by veria technique between January 2013 to August 2023. Based on pre-operative imaging with high-resolution computed tomography and magnetic resonance imaging the cochleovestibular malformations in this study were classified according to Sennaroglu classification and the cochlear ossification was graded from I to IV. Amongst the 337 patients who underwent cochlear implantation during the study period there were 79 cases (23.4%) with abnormalities of cochlea. This included 45 patients (13.4%) with congenital malformations, 20 patients (5.9%) with cochlear fibrosis and 14 patients (4.2%) with cochlear ossification. The commonest cochlear malformation was Incomplete Partition 2 which was present in 21 patients (46.7%). The other common malformations were cochlear hypoplasia (31.1%), Incomplete Partition 1(13.3%) and common cavity (8.9%). Out of the 20 patients with cochlear fibrosis, 17 patients had fibrosis only in the basal turn. Out of the 14 patients with cochlear ossification 8 patients (57.1%) had a grade 1 ossification, 2 patients (14.3%) had a grade 2 ossification and 4 patients (28.6%) had a grade 3 ossification. One of the patients required re-exploration for correcting the placement of electrode. The type of implant were chosen depending on individual malformation or length of ossification and fibrosis. In the past, inner ear anomalies were considered as a contraindication for cochlear implantation however it is now possible to implant most of these abnormal cochlea by careful planning, a modification of the surgical technique and the type of electrode used.
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References
Jensen S (1969) Malformation of the inner ear in deaf children. Acta Radiol 286(suppl):1–97.
Tucci DL, Telian SA, Zimmerman-Philips S, et al. Cochlear implantation in patients with cochlear malformations. Arch Otolaryngol Head Neck Surg 1995;121:833Y8.
Schmidt JM. Cochlear neuronal populations in developmental defects of the inner ear. Acta Otolaryngol (Stockh) 1985;99:14Y20.
Mangabeira-Albernaz PL. The Mondini dysplasia from early diagnosis to cochlear implant. Acta Otolaryngol 1983;95:627Y 31.
Sennaroğlu L, Bajin MD. Classification and current management of inner ear malformations. Balkan Med J. 2017;34(5):397–411.
Sanna M, Free R, Merkus P, Falcioni M. Surgery for Cochlear and Other Auditory Implants. eds; Stuttgart:Thieme,2016.
Sennaroglu L. Histopathology of inner ear malformations: do we have enough evidence to explain pathophysiology? Cochlear Implants Int. 2016;17(1):3–20.
Jackler RK, Luxford WM, House WF (1987) Congenital malformations of the inner ear: a classification based on embryogenesis. Laryngoscope 97: 2–14.
Sennaroglu L, Saatci I, Aralasmak A, Gursel B, Turan E (2002) Magnetic resonance imaging versus computed tomography in pre-operative evaluation of cochlear implant candidates with congenital hearing loss. Journal of Laryngology and Otology 116: 804–810.
Sennaroglu L, Sarac S, Turan E (2006) Surgical results of Cochlear Implantation in Malformed Cochlea. Otology & Neurotology 27: 615–623.
Grover M, Sharma S, Bhargava S, Singh SN, Gupta G, Sharma MP. Cochlear implantation in children with anomalous Cochleovestibular anatomy: our experience. Indian J Otolaryngol Head Neck Surg. 2017;69(4):504–508.
Green JD Jr, Marion MS, Hinojosa R. Labyrinthitis ossificans: histopathologic consideration for cochlear implantation. Otolaryngol Head Neck Surg 1991;104:320–6.
Kotzias SA, Linthicum FH Jr. Labyrinthine ossification: differences between two types of ectopic bone. Am J Otol 1985;6:490–4.
Kaya S, Paparella MM, Cureoglu S. Pathologic findings of the cochlea in labyrinthine ossificans associated with the round window membrane. Otolaryngol Head Neck Surg 2016;155:635–40.
Wang L, Zhang D. Surgical methods and postoperative results of cochlear implantation in 79 cases of ossified cochlea. Acta Otolaryngol 2014;134:1219–24.
Rottoveel LJ, Proops DW, Ramsden RT, Saeed SR, van Olphen AF, Mylanus EA. Cochlear implants in 53 patients with otosclerosis: demographics, computed tomographic scanning, surgery and complications. Otol Neurotol 2004;25:943–52.
Bacciu A, Pasanisi E, Di Lella F, Guida M, Bacciu S, Vincenti V. Cochlear implantation in patients with Cogan syndrome: long term results. Eur Arch Otorhinolaryngol 2015;272:3201–7.
Coelho DH, Roland JT Jr. Implanting obstructed and malformed cochleae. Otolaryngol Clin North Am 2012;45:91–110.
Nabili V, Brodie HA, Neverov NI, Tinling SP. Chronology of labyrinthitis ossificans induced by Streptococcus pneumoniae meningitis. Laryngoscope. 1999;109(6):931–5.
Tinling SP, Colton J, Brodie HA. Location and timing of initial osteoid deposition in postmeningitic labyrinthitis ossificans determined by multiple fluorescent labels. Laryngoscope. 2004;114(4):675–80.
Sanna M, Free R, Merkus P, et al. Surgery for Cochlear and other auditory implants. Stuttgart: Georg Thieme Verlag; 2016.
Durisin M, Buchner A, Lesinski-Schiedat A, Bartling S, Warnecke A, Lenarz T. Cochlear implantation in children with bacterial meningitic deafness: the influence of the degree of ossification and obliteration on impedance and charge of the implant. Cochlear Implants Int 2015;16:147–58.
Connell SS, Balkany TJ, Hodges AV, Telischi FF, Angeli SI, Eshraghi AA. Electrode migration after cochlear implantation. Otol Neurotol 2008;29:156–9.
Sennaroglu L, Aydin E (2002) Anteroposterior approach with split ear canal for cochlear implantation in severe malformations. Otology & Neurotology 23: 39–43.
Weber BP, Dillo W, Dietrich B, Maneke I, Bertram B, Lenarz T (1998) Pediatric cochlear implantation in cochlear malformations. American Journal of Otology 19: 747–753.
Jain R, Tiwari P, Kumar S, Mishra P, Pearly PK, Keshri A. A clinico-radiological study: Veria technique of Cochlear Implant-A Study of 50 cases. Indian J Otolaryngol Head Neck Surg. 2019;71(Suppl 2):1553–1561.
Hans JM, Prasad R. Cochlear Implant surgery by the Veria technique: how and why? Experience from 1400 cases. Indian J Otolaryngol Head Neck Surg. 2015;67(2):107–109.
Singhal P, Nagaraj S, Verma N, et al. Modified Veria technique for Cochlear Implantation by Postaural Approach. Indian J Otolaryngol Head Neck Surg. 2020;72(3):370–374.
Kiratzidis T (2000) ‘Veria operation’: cochlear implantation without a mastoidectomy and a posterior tympanotomy. A new surgical technique. Advances in Otorhinolaryngology 57: 127–130.
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Hameed, N., Keshri, A., Manogaran, R.S. et al. Cochlear Implantation by Veria Technique in Abnormal Cochlea: Our Experience. Indian J Otolaryngol Head Neck Surg (2024). https://doi.org/10.1007/s12070-024-04492-3
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DOI: https://doi.org/10.1007/s12070-024-04492-3