Electrode Migration after Cochlear Implantation in Association with External Auditory Canal Closure

Abstract

Objectives:

(1) Review the occurrence of electrode migration following cochlear implantation. (2) Compare the rate of migration in those patients who underwent concurrent radical mastoidectomy.

Methods:

A retrospective case series of all patients who underwent cochlear implantation at our institution, with a single surgeon, between 2001 and 2013. The specific outcome studied was implant migration. A total of 224 patients underwent cochlear implantation with a total of 294 implants performed. Four patients (1.3%) underwent radical mastoidectomy with Rambo type obliteration of the external auditory canal.

Results:

This approach was used in 2 young children with congenital malformations to provide adequate exposure for cochleostomy, and both of these patients experienced electrode migration. In 2 older patients this approach was used due to chronic infections, and neither of these patients has electrode migration. Of the 224 patients in the series who underwent cochlear implantation, these 2 children are the only patients who have experienced implant migration.

Conclusions:

Electrode migration is a rare complication following cochlear implantation. In our experience, there seems to be a higher incidence of electrode migration in patients who have undergone cochlear implantation in association with radical mastoidectomy with external auditory canal obliteration. Alternative techniques to avoid the need for the canal-wall-down mastoidectomy with Rambo closure have been used with success and are described in detail.