Auditory Outcomes of Cochlear Implantation in Chronic Otitis Media Compared to Standard Implantation

Abstract

Objectives: To compare postoperative auditory outcomes after cochlear implantation (CI) between patients with chronic otitis media (COM) and those with noninflammatory sensorineural hearing loss (SNHL) and to evaluate the impact of labyrinthitis and duration of deafness. Methods: We retrospectively analyzed 33 postlingual COM cases and 70 age- and sex-matched SNHL controls. Pre- and postoperative audiologic tests were obtained, and preoperative computed tomography and magnetic resonance imaging were reviewed for labyrinthitis. The surgical status and stage (single- or 2-stage procedure) of cases with COM cases were documented. Results: Postoperative aided thresholds and word recognition scores (WRS) did not differ significantly between the groups. Complete bone conduction scale-out was more frequent in the SNHL group (P = .003). Labyrinthitis, found in 3 patients with COM (9.1%), was associated with a significantly lower WRS (P = .007 vs SNHL; P = .024 vs COM without labyrinthitis). In contrast to the SNHL group, patients with COM maintained stable WRS even with long-term deafness (>20 years). Conclusion: CI in COM yields auditory outcomes comparable to non-COM cases. In the absence of labyrinthitis, patients with COM showed preserved speech performance despite long-standing deafness, suggesting preserved cochlear/neural integrity. Preoperative imaging is valuable for detecting labyrinthitis, which predicts poorer postoperative results.