Search tips
Search criteria 


Logo of skullbasesurgInstructions for AuthorsSubscribe to Skull BaseAbout Skull BaseEditorial BoardThieme Medical PublishingSkull Base An Interdisciplinary Approach ...
Skull base surgery. 1998; 8(3): 127–131.
PMCID: PMC1656671

Cochlear Implantation in Patients with Chronic Otitis

Indications for Subtotal Petrosectomy and Obliteration of the Middle Ear


Normally, active chronic suppurative otitis media is regarded as a contraindication for cochlear implantation. In case of a radical cavity after surgical treatment for cholesteatoma, the electrode covered by the epithelial lining of the mastoid will likely become exposed or extruded. Under these circumstances we suggest the subtotal petrosectomy, obliteration of the middle ear cleft with abdominal fat, and the blindsac closure of the external ear canal before cochlear implantation.

Fourteen patients with chronic otitis media were successfully implanted with an intracochlear multichannel cochlear implant. After an average follow-up of 28 months a temporary facial palsy in one patient and an insufficient closure of a retroauricular fistula over the mastoid cavity in two cases were observed as postoperative complications. One patient with a tumefactive inflammatory pseudotumor developed a massive inflammation in the implanted ear 2 months after surgery which could not be controlled by conservative treatment. The implant had to be removed and after administration of cyclophosphamide she could be successfully reimplanted 7 months later.

Implantation of a foreign body in a potentially infected space which communicates with the endocranium means a surgical challenge which can be managed by obliteration of the middle ear. In case of massive inflammation we prefer a two-stage procedure.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.7M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Cohen NL, Hoffman RA. Complications of cochlear implant surgery in adults and children. Ann Otol Rhinol Laryngol. 1991 Sep;100(9 Pt 1):708–711. [PubMed]
  • Hoffman RA, Cohen NL. Surgical pitfalls in cochlear implantation. Laryngoscope. 1993 Jul;103(7):741–744. [PubMed]
  • Hoffman RA, Cohen NL. Complications of cochlear implant surgery. Ann Otol Rhinol Laryngol Suppl. 1995 Sep;166:420–422. [PubMed]
  • Laszig R. Komplikationen bei Cochlear Implants im Kindesalter. HNO. 1996 Mar;44(3):119–120. [PubMed]
  • Webb RL, Lehnhardt E, Clark GM, Laszig R, Pyman BC, Franz BK. Surgical complications with the cochlear multiple-channel intracochlear implant: experience at Hannover and Melbourne. Ann Otol Rhinol Laryngol. 1991 Feb;100(2):131–136. [PubMed]
  • Parnes LS, Gagne JP, Hassan R. Cochlear implants and otitis media: considerations in two cleft palate patients. J Otolaryngol. 1993 Oct;22(5):345–348. [PubMed]
  • Dahm MC, Clark GM, Franz BK, Shepherd RK, Burton MJ, Robins-Browne R. Cochlear implantation in children: labyrinthitis following pneumococcal otitis media in unimplanted and implanted cat cochleas. Acta Otolaryngol. 1994 Nov;114(6):620–625. [PubMed]
  • Gacek RR. Mastoid and middle ear cavity obliteration for control of otitis media. Ann Otol Rhinol Laryngol. 1976 May-Jun;85(3 Pt 1):305–309. [PubMed]
  • Donnelly MJ, Pyman BC, Clark GM. Chronic middle ear disease and cochlear implantation. Ann Otol Rhinol Laryngol Suppl. 1995 Sep;166:406–408. [PubMed]
  • Gray RF, Irving RM. Cochlear implants in chronic suppurative otitis media. Am J Otol. 1995 Sep;16(5):682–686. [PubMed]
  • Laurenzo JF, Graham SM. Tumefactive fibroinflammatory lesion of the head and neck: a management strategy. Ear Nose Throat J. 1995 Feb;74(2):87–94. [PubMed]
  • Mulder JJ, Cremers WR, Joosten F, Wiersma A, van den Broek P. Fibroinflammatory pseudotumor of the ear. A locally destructive benign lesion. Arch Otolaryngol Head Neck Surg. 1995 Aug;121(8):930–933. [PubMed]
  • Schönermark MP, Issing P, Stöver T, Ruh S, Lenarz T. Fibroinflammatory pseudotumor of the temporal bone. Skull Base Surg. 1998;8(1):45–50. [PMC free article] [PubMed]

Articles from Skull Base Surgery are provided here courtesy of Thieme Medical Publishers