Subtotal Petrosectomy and Mastoid Obliteration in Adult and Pediatric Cochlear Implant Recipients

作者：Baranano Christopher F; Kopelovich Jonathan C; Dunn Camille C; Gantz Bruce J^*; Hansen Marlan R

来源：Otology & Neurotology, 2013, 34(9): 1656-1659.

DOI：10.1097/mao.0b013e3182a006b6

• Adult
• Canal closure
• Cochlear implant
• Mastoid obliteration
• Otitis media
• Pediatric
• Recurrent acute otitis media
• Subtotal petrosectomy

Objective: To investigate the effect of subtotal petrosectomy and mastoid obliteration (SPMO) on the overall success of adult and pediatric cochlear implant (CI) recipients.
Study Design: Retrospective case series.
Setting: Tertiary care referral center.
Patients: Thirty-nine ears in 36 patients (23 adults and 13 children) received both surgeries between 1990 and 2012.
Intervention: CI candidates underwent SPMO to permit implantation and minimize the risks of infectious complications in the recipient ear. SPMO was performed before (69.3%), at the time of (25.6%), and after CI (5.13%). Mastoids were obliterated with fat (30.8%), muscle (66.7%), and bone pate (2.56%).
Main Outcome Measure: Feasibility, complications, and success of SPMO and CI were assessed with standard statistical analysis and Fisher's exact test with 2-sided p values.
Results: Ear disease was definitively managed, and CI was successfully placed in all but one case. Complications including abscess (n = 3), subcutaneous emphysema (n = 1), ear canal granulation formation (n = 1), and electrode extrusion (n = 1) occurred in 15.4% of patients. Predisposing syndromes were present in children more often than adults (43.8% versus 13.0%, p = 0.0598). Adults more often than children had previous mastoid surgery for middle ear disease (30.4% versus 0.0%, p = 0.0288). CIs were placed under local anesthetic and sedation (n = 3) and after radiation treatment for nasopharyngeal cancer (n = 2) in adult ears.
Conclusion: SPMO is an effective and safe procedure for definitively managing middle ear disease and implanting adult and pediatric CI candidates.

• 出版日期2013-12