Reimplanting the cochlea with a second electrode array - a rare cause of necessity

Introduction We report on a 22-year-old female patient with congenital bilateral inner ear hearing loss. The first implantation of a cochlear implant on the left side took place in 1994; a revision with a dorsal displacement of the receiver stimulator followed in 2004. In 2014 the patient presented herself with pain in the area of ??the cochlear implant. The implant was displaced, therefore a soft failure was anticipated and surgical revision by reimplantation was indicated.

Method Intraoperatively, the electrode could not be extracted from the scala tympani due to ossification around the electrode. Even after revision of the cochleostomy, removal was not possible. After successfully inserting a trial electrode, it was decided to leave the original electrode in its place and to insert a new electrode.

Result The insertion was complete to a depth of 25mm. The postoperative rotational angiography showed the correct position of the newly inserted electrode in the scala vestibuli with the original electrode still in place. The patient achieved good hearing results on the left side. The cochlear implantation of the right side was carried out in the same year.

Discussion Cochlear implantation is an effective measure to establish hearing rehabilitation for patients with hearing loss. The need for reimplantation is unavoidable in the event of complications as in the case described. Ossification of the cochlea to the point of impossibility of explantation is rare, but must be anticipated. The case shows that the indication for reimplantation in the event of possible complications, such as the ossification of the cochlea, should be viewed critically.

Poster-PDF A-1709.pdf

Publication History

Article published online:
13 May 2021