Xenelis Ioannis, MD,  Professor of Otorhinolaryngology, ENT Department, Athens University, Hippocration Hospital, Athens, Greece

OBJECTIVE: To report the long-term results of cochlear implantation in cases with chronic otitis media or atelectasis using a single surgical technique performed in a single cochlear implant center.

PATIENTS: Nine patients who were implanted using the blind-pit closure of the external ear canal technique (4 patients with adhesive otitis media and 5 with radical mastoid cavities). Follow-up ranged from 18 months to 12 years (mean, 7.05 yr).

INTERVENTION: The surgical procedure was performed in 2 stages. The first stage included canal wall down or lowering any high facial ridge in previous mastoidectomies, removal of all skin, and blind-pit closure of the external ear canal without mastoid cavity obliteration or eustachian tube obliteration. Cochlear implantation was performed 6 months after the first surgical procedure.

RESULTS: All operations were uneventful, and during cochlear implantation, as a second stage, no epithelia or other problems were encountered. No serious complications were encountered during the follow-up period. One case had a minor disruption of the external canal closure that was reclosed successfully under local anesthesia. All patients were using the device at the last follow-up interval with no device problems.

CONCLUSION: Blind-sac closure of the external ear canal without obliteration is a rather safe surgical procedure in cases with chronic otitis media or atelectasis. Meticulous surgical technique and proper patient selection are of paramount importance. However, a 2-stage procedure may not always be necessary and might best be confined to those patients who have active inflammatory disease at the primary procedure.

Xenellis J, Nikolopoulos TP, Marangoudakis P, Vlastarakos PV, Tsangaroulakis A, Ferekidis E. Cochlear implantation in atelectasis and chronic otitis media: long-term follow-up. Otol Neurotol. 2008 Jun;29(4):499-501