A Case of Scala Vestibuli Cochlear Implantation in Tympanogenic Labyrinthitis Ossificans

Successful cochlear implantation in the setting of labyrinthitis ossificans is challenging. Various surgical techniques are described to circumvent the region of ossification and retrograde insertion of the electrode array is one such option. While reverse programming is often recommended in the case of retrograde electrode insertion, we present our experience of retrograde electrode insertion for labyrinthitis ossificans, where standard programming was adopted due to patient preference and provided satisfactory outcomes.

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Reversible hearing loss following cryptococcal meningitis: case study

The Journal of Laryngology & Otology ◽

10.1017/s002221511600801x ◽

2016 ◽

Vol 130 (7) ◽

pp. 691-695 ◽

Cited By ~ 2

Author(s):

W L Neo ◽

N Durisala ◽

E C Ho

Keyword(s):

Hearing Loss ◽

Case Report ◽

Bacterial Meningitis ◽

Sensorineural Hearing Loss ◽

Cochlear Implantation ◽

Cryptococcal Meningitis ◽

Sudden Onset ◽

Sensorineural Hearing ◽

Labyrinthitis Ossificans

AbstractBackground:Sensorineural hearing loss is a recognised complication of cryptococcal meningitis. The mechanism of hearing loss in patients with cryptococcal meningitis is different from that in bacterial meningitis.Case report:An immune-competent man with cryptococcal meningitis presented with sudden onset, bilateral, severe to profound sensorineural hearing loss and vestibular dysfunction. He was initially evaluated for cochlear implantation. However, he had a significant recovery; he no longer required surgery and was able to cope without a hearing aid.Conclusion:Typically, cochlear implantation is performed with some urgency in patients with hearing loss post-bacterial meningitis, because of the risk of labyrinthitis ossificans. However, this process has not been described in patients with cryptococcal meningitis. Furthermore, patients with hearing loss associated with cryptococcal meningitis have shown varying degrees of reversibility. In this case report, hearing loss from cryptococcal meningitis is compared with that from bacterial meningitis, and the need for cochlear implantation in patients with cryptococcal meningitis is discussed.

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The Scala Vestibuli for Cochlear Implantation: An Anatomic Study

Archives of Otolaryngology - Head and Neck Surgery ◽

10.1001/archotol.1996.01890140020005 ◽

1996 ◽

Vol 122 (2) ◽

pp. 130-132 ◽

Cited By ~ 16

Author(s):

A. J. Gulya ◽

R. L. Steenerson

Keyword(s):

Cochlear Implantation ◽

Anatomic Study ◽

Scala Vestibuli

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Labyrinthitis Ossificans: Histopathologic Consideration for Cochlear Implantation

Otolaryngology ◽

10.1177/019459989110400306 ◽

1991 ◽

Vol 104 (3) ◽

pp. 320-326 ◽

Cited By ~ 77

Author(s):

J. Douglas Green ◽

Mitchell S. Marion ◽

Raül Hinojosa

Keyword(s):

Cochlear Implantation ◽

Labyrinthitis Ossificans

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Scala vestibuli cochlear implantation after meningitis

JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY ◽

10.5106/jjshns.26.97 ◽

2016 ◽

Vol 26 (1) ◽

pp. 97-101

Author(s):

Kazutomo Niwa ◽

Yasunori Sakuma ◽

Nobuhiko Oridate

Keyword(s):

Cochlear Implantation ◽

Scala Vestibuli

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Otopathologic Analysis of Patterns of Postmeningitis Labyrinthitis Ossificans

Otolaryngology ◽

10.1177/0194599820934748 ◽

2020 ◽

pp. 019459982093474

Author(s):

Danielle R. Trakimas ◽

Renata M. Knoll ◽

Melissa Castillo-Bustamante ◽

Elliott D. Kozin ◽

Aaron K. Remenschneider

Keyword(s):

Temporal Bone ◽

Retrospective Review ◽

Cochlear Implantation ◽

Spiral Ganglion ◽

Continuous Extension ◽

Tissue Formation ◽

Basal Turn ◽

Labyrinthitis Ossificans ◽

Electrode Insertion ◽

Ganglion Neurons

Objective Labyrinthitis ossificans (LO) may occur following meningitis and, in cases where cochlear implantation is indicated, complicate electrode insertion. LO is critical to identify for successful cochlear implantation, and histopathology is more sensitive than imaging for identification of LO. Herein we utilize otopathologic techniques to study the timing and location of intracochlear tissue formation following meningitic labyrinthitis (ML). Study Design Retrospective review. Setting Academic institution. Methods Temporal bone specimens with a history of bacterial ML were histologically evaluated. The location and extent of intracochlear tissue formation within the scala tympani (ST) and scala vestibuli (SV) were graded, and spiral ganglion neurons were counted. Results Fifty-one temporal bones were identified: 32 with no intracochlear tissue formation, 9 with fibrosis alone, and 10 with LO. Fibrosis was identified as early as 1.5 weeks after ML, while ossification was found only in specimens that survived multiple years after ML. All LO cases showed ossification of the ST at the round window membrane (RWM) with continuous extension throughout the basal turn. Extent of SV ossification correlated with that in the ST but showed frequent isolated distal involvement of the cochlea. Spiral ganglion neuron counts were lower than those in age-matched controls. Conclusion In this human temporal bone study, we found that postmeningitic LO results in ossification at the RWM with continuous extension into the ST of the basal turn and variable involvement of the SV. Identification of a patent basal turn beyond RWM ossification of the ST should permit full electrode insertion. Level of Evidence Retrospective review.

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