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Subtotal Petrosectomy and Mastoid Obliteration in Adult and Pediatric Cochlear Implant Recipients

Objective To investigate the effect of subtotal petrosectomy and mastoid obliteration (SPMO) on the overall success of adult and pediatric cochlear implant (CI) recipients. Study Design Retrospective case series. Setting Tertiary care referral center. Patients Thirty-nine ears in 36 patients (23 adults and 13 children) received both surgeries between 1990 and 2012. Intervention CI candidates underwent SPMO to permit implantation and minimize the risks of infectious complications in the recipient ear. SPMO was performed before (69.3%), at the time of (25.6%), and after CI (5.13%). Mastoids were obliterated with fat (30.8%), muscle (66.7%), and bone pate (2.56%). Main Outcome Measure Feasibility, complications, and success of SPMO and CI were assessed with standard statistical analysis and Fisher’s exact test with 2-sided p values. Results Ear disease was definitively managed, and CI was successfully placed in all but one case. Complications including abscess (n = 3), subcutaneous emphysema (n = 1), ear canal granulation formation (n = 1), and electrode extrusion (n = 1) occurred in 15.4% of patients. Predisposing syndromes were present in children more often than adults (43.8% versus 13.0%, p = 0.0598). Adults more often than children had previous mastoid surgery for middle ear disease (30.4% versus 0.0%, p = 0.0288). CIs were placed under local anesthetic and sedation (n= 3) and after radiation treatment for nasopharyngeal cancer (n = 2) in adult ears. Conclusion SPMO is an effective and safe procedure for definitivelymanaging middle ear disease and implanting adultand pediatric CI candidates.