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ABSTRACT: To study the outcomes of split electrode array cochlear implantation in ossified cochlea using the CAP scoring system. Retrospective case study. Tertiary referral center. Six cochleae in three adult and three pediatric patients with ossification. Intervention(s): All Patients underwent cochlear implantation with a split electrode array system. Major outcome parameter(s): Number of electrodes inserted during surgery, number of functioning electrodes on follow-up and auditory performance evaluation using the CAP score-Category of Auditory Perception [TSC Revised Version, based on Nottingham CI Program, 1995]. Six patients (three children and three adults) had insertion of split electrode array system. The mean number of electrodes inserted were 18.3 (range 15-21) and functioning electrodes at follow-up were mean of 14.3 (range 7-21). Auditory performance was measured using CAP score at 1 year post implant follow up, mean score in children was six and that in adult was eight. One pt had facial nerve twitching which was corrected by switching off the concerned electrode. No complications in sort of facial palsy or vestibular disorder were observed. Patients of ossified cochlea having profound deafness do well with split electrode array cochlear implantation as evaluated with CAP scoring system. The split electrode array results in more number of electrodes within the cochlear lumen. Retro graded apical array insertion has less chances of facial nerve stimulation as it is placed away from the nerve.
Indian Journal of Otolaryngology and Head & Neck Surgery 07/2011; 63(3):237-42.
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ABSTRACT: Post-meningitis cases with profound sensorineural hearing loss are known to have progressive labyrinthine ossification; such cases need to be implanted early. In our region, often a substantial amount of time is spent procuring the necessary finances for a cochlear implant; therefore, here we describe our technique of maintaining cochlear lumen patency in post-meningitis cases with early ossification, for a complete functional electrode insertion at a later date. This is a descriptive case study of a patient having post-meningitis profound deafness, with imaging studies showing early cochlear ossification, who was rehabilitated with a cochlear implant. At a tertiary referral centre, a 1-year-old child with post-meningitis bilateral profound sensorineural hearing loss was rehabilitated with cochlear implantation. The left cochlea with early ossification was stented with a customised sterile electrode to prevent scalar occlusion; 3 months later the stent was replaced with a commercial Nucleus Contour Advance implant. A complete insertion of the functional electrode array replaced the stent. Categories of auditory performance (CAP) were used to assess the outcome in our case. The pre-operative CAP score was 1 (detects environmental sounds) and the score at 15 months post implant was 6 (understands some spoken words). In post-meningitis cases with progressive cochlear ossification, stenting the cochlear lumen prevents scalar occlusion and ensures a complete insertion of a functional electrode at a later date.
Archives of Oto-Rhino-Laryngology 03/2010; 267(6):985-7. · 1.29 Impact Factor
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ABSTRACT: The advances in endoscopic sinus surgery have made it the procedure of choice for treatment of cerebrospinal fluid rhinorrhea (CSFR). To analyze the efficacy of endoscopic closure of CSFR was the objective of the present study.
We treated 267 patients with CSFR endoscopically. Diagnosis was achieved with the help of CT with or without cisternography, MRI, beta-2 transferrin levels. Fascia lata and fat were used to plug the defects. The patients were followed up for a minimum period of 6 months.
CSFR was successfully plugged in 258 patients. Nine patients required revision surgery. S ix could be plugged successfully endoscopically and 2 patients by a neurosurgical approach.
In our experience with 267 patients of endoscopically treated CSFR, the results of achieving the closure was 96.63% in the first instance and 98.88% after revision surgery.
The transnasal endoscopic approach has excellent results in the treatment of CSFR. We recommend it as the optimum surgical approach for both primary and revisional surgical management of CSFR.
Otolaryngology Head and Neck Surgery 03/2005; 132(2):208-12. · 1.72 Impact Factor
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ABSTRACT: High-resolution CT scan (HRCT) and MRI are routinely performed prior to cochlear implant surgery. These modalities help assess the status of the inner ear structures. A few patients have significant anomalies, which need to be assessed and understood in detail. We present a pictorial essay of these anomalies and described our HRCT and MRI techniques in patients being imaged prior to surgery.
The Indian journal of radiology and imaging 19(2):99-106.
