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Cochlear ossification and implantation in patients with profound hearing loss following bacterial
Rubek N. , Dam M.S. , Omland S.H. , Mantoni M. , Caye-Thomasen P.
University Hospital Copenhagen, ORL-HNS and Audiology F2074, Copenhagen, Denmark
Objective: To investigate the pre-operative occurrence and degree of cochlear ossification in CI implantees with
bilateral profound hearing loss following bacterial meningitis. To determine the correlation between pre-operative
imaging and per-operative findings, as well as electrode insertion success.
Methods: Forty-seven cochlear implantations were performed in 34 consecutive candidates suffering from
bilateral profound hearing loss following bacterial meningitis. A retrospective review of patient files and
preoperative CT and MR images was performed.
Results: Cochlear ossification occurred in 35% of patients and 26% of ears on CT.
S.pneumoniae meningitis caused ossification more frequently than N.meningitidis, whereas age at infection had
no impact. Overall, normal per-operative findings occurred in 72% of the implantations and full electrode
insertion was achieved in 83% (complete failure in 2%). In 36% of ears with CT pathology, normal findings
occurred at surgery. Full electrode insertion was achieved in 73% of ears with a pathological pre-operative CT,
partial insertion in 27%. Cochlear ossification/fibrosis was found in 17% of ears with a normal pre-operative
CT/MR. Full electrode insertion was achieved in 86% of ears with a normal CT, whereas partial insertion
occurred in 11% and complete failure in 3%.
Conclusion: Cochlear ossification following bacterial meningitis is related to causative pathogen, but not age at
disease. Full electrode insertion is achieved in the majority of cases, even in case of partial cochlear ossification.