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Is It Necessary to Treat Otitis Media With Effusion (OME) Prior to Cochlear Implantation? Results Over a Long-term Follow-up.
Otol Neurotol. 2016 12; 37(10):1529-1534.ON

Abstract

OBJECTIVES

Evaluate the intra- and postoperative effects of untreated otitis media with effusion (OME) in cochlear implant (CI) patients, and to assess the role of ventilation tube (VT) introduction before implantation.

STUDY DESIGN

A retrospective chart review.

SETTING

Tertiary referral center.

PATIENTS

CI patients, aged 10 years or younger, implanted during 2009 to 2013.

INTERVENTIONS

Cases were divided into three groups: 1) normal aerated middle ear before CI, 2) OME treated with VT, and 3) untreated OME.

MAIN OUTCOME MEASURE(S)

Intraoperative and postoperative findings and complications.

RESULTS

One hundred ninety-four cases (implanted ears) were included. Ninety-nine aerated, 39 treated with VT, and 56 with untreated OME. Mean age at implantation was 3.1, 2.1, and 1.6 years, respectively. Granulations and edema were significantly more common in untreated OME than aerated ears (62% vs. 7%, p <0.001). VT reduced the rate of these findings (46%) but not with statistical significance (p = 0.1) compared with untreated OME. Intraoperative findings were all manageable and were not associated with higher perioperative complication rates. The rates of early and late postoperative complications were low in all groups, with no significant differences between groups. Tympanic membrane perforations were encountered in two patients after VT extrusion. Rate of otorrhea was 20% during the first year after implantation and 5% at last follow up.

CONCLUSION

Our results suggest that CI candidates with OME can be safely implanted without preimplantation VT insertion. Implanting patients with untreated OME allows earlier implantation. CI surgery can be more challenging in the presence of effusion; however, intraoperative findings are manageable.

Authors+Show Affiliations

*Department of Otolaryngology, Schneider Children Medical Center of Israel, and Rabin Medical Center, Petah Tikva†Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv‡Communications Disorder Program, Haifa University, Haifa, Israel.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27749756

Citation

Sokolov, Meirav, et al. "Is It Necessary to Treat Otitis Media With Effusion (OME) Prior to Cochlear Implantation? Results Over a Long-term Follow-up." Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, vol. 37, no. 10, 2016, pp. 1529-1534.
Sokolov M, Hilly O, Ulanovski D, et al. Is It Necessary to Treat Otitis Media With Effusion (OME) Prior to Cochlear Implantation? Results Over a Long-term Follow-up. Otol Neurotol. 2016;37(10):1529-1534.
Sokolov, M., Hilly, O., Ulanovski, D., Shkedy, Y., Attias, J., & Raveh, E. (2016). Is It Necessary to Treat Otitis Media With Effusion (OME) Prior to Cochlear Implantation? Results Over a Long-term Follow-up. Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 37(10), 1529-1534.
Sokolov M, et al. Is It Necessary to Treat Otitis Media With Effusion (OME) Prior to Cochlear Implantation? Results Over a Long-term Follow-up. Otol Neurotol. 2016;37(10):1529-1534. PubMed PMID: 27749756.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is It Necessary to Treat Otitis Media With Effusion (OME) Prior to Cochlear Implantation? Results Over a Long-term Follow-up. AU - Sokolov,Meirav, AU - Hilly,Ohad, AU - Ulanovski,David, AU - Shkedy,Yotam, AU - Attias,Joseph, AU - Raveh,Eyal, PY - 2016/10/18/pubmed PY - 2017/9/2/medline PY - 2016/10/18/entrez SP - 1529 EP - 1534 JF - Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology JO - Otol. Neurotol. VL - 37 IS - 10 N2 - OBJECTIVES: Evaluate the intra- and postoperative effects of untreated otitis media with effusion (OME) in cochlear implant (CI) patients, and to assess the role of ventilation tube (VT) introduction before implantation. STUDY DESIGN: A retrospective chart review. SETTING: Tertiary referral center. PATIENTS: CI patients, aged 10 years or younger, implanted during 2009 to 2013. INTERVENTIONS: Cases were divided into three groups: 1) normal aerated middle ear before CI, 2) OME treated with VT, and 3) untreated OME. MAIN OUTCOME MEASURE(S): Intraoperative and postoperative findings and complications. RESULTS: One hundred ninety-four cases (implanted ears) were included. Ninety-nine aerated, 39 treated with VT, and 56 with untreated OME. Mean age at implantation was 3.1, 2.1, and 1.6 years, respectively. Granulations and edema were significantly more common in untreated OME than aerated ears (62% vs. 7%, p <0.001). VT reduced the rate of these findings (46%) but not with statistical significance (p = 0.1) compared with untreated OME. Intraoperative findings were all manageable and were not associated with higher perioperative complication rates. The rates of early and late postoperative complications were low in all groups, with no significant differences between groups. Tympanic membrane perforations were encountered in two patients after VT extrusion. Rate of otorrhea was 20% during the first year after implantation and 5% at last follow up. CONCLUSION: Our results suggest that CI candidates with OME can be safely implanted without preimplantation VT insertion. Implanting patients with untreated OME allows earlier implantation. CI surgery can be more challenging in the presence of effusion; however, intraoperative findings are manageable. SN - 1537-4505 UR - https://www.unboundmedicine.com/medline/citation/27749756/Is_It_Necessary_to_Treat_Otitis_Media_With_Effusion__OME__Prior_to_Cochlear_Implantation_Results_Over_a_Long_term_Follow_up_ L2 - http://dx.doi.org/10.1097/MAO.0000000000001221 DB - PRIME DP - Unbound Medicine ER -