On the stability of speech understanding after cochleosacculotomy with simultaneous cochlear implantation

Introduction Cochleosacculotomy is an established intervention to ablate labyrinth function in advanced Meniere’s disease with loss of communicative residual hearing. In this context, simultaneous cochlear implantation (CI) is often used for hearing rehabilitation. We asked to what extent the invasive intervention in the vestibule leads to a deterioration of hearing threshold under CI in the long term, as is known from labyrinthectomy, for example.

Material and Methods Over a period of 10 years and 1 month, 35 patients (24 male, 13 female) underwent cochleosacculotomy for advanced Meniere’s disease. Of these, 29 received a CI in the same session (10 left, 19 right; manufacturer: 11 MedEl, 18 Cochlear). We examined CI hearing threshold and speech audiogram after completion of hearing rehabilitation 2 to 13 months postoperatively and compared the results with the further course after 1 to 7.5 years.

Results After completion of rehabilitation, the best possible monosyllabic word understanding was between 5 and 95% at an optimal sound level between 75 and 85 dB[HL], in the further course between 15 and 95% at 65 to 85 dB[HL]. An improvement in monosyllabic word understanding occurred in 15 patients with a delta of 5 to 90%, a worsening in 13 patients with 5 to 50%.

Conclusion Speech understanding with CI after cochleosacculotomy usually remains stable or improves over time. A deterioration of more than 20% monosyllabic understanding (5 patients) might be attributed to intracochlear fibrosis. There was no functional loss of the CI in our group. The cessation of rotary vertigo attacks after labyrinth ablation makes the procedure an option for the treatment of advanced stages of Meniere’s disease.

Publication History

Article published online:
12 May 2023