Sharing the Experience of Two Hundred Patients in A Novel Cochlear Implant Programme At Combined Military Hospital, Rawalpindi

Abstract

Objective: To share our experience of difficulties encountered while implanting different types of cochlear implants and ascertain the affordability of cochlear implant surgery among the Pakistani population to treat sensorineural hearing loss in a novel cochlear implant programme. Study Design: Retrospective longitudinal study. Place and Duration of Study: Department of ENT, Combined Military Hospital (CMH), Rawalpindi Pakistan, from Apr 2017 to May 2021. Methodology: The study included patients who underwent cochlear implant surgeries. Patient demographics and causes of deafness, were collected. Intraoperative difficulties were encountered, and round window accessibility was also recorded. Results: Out of 200 patients, 112(56%) were males, while 88(44%) were females. 193(96.5%) patients were pre-lingual under 12 years of age, while post-lingual patients were 7(3.5%) and were adults. Cochlear implants from Med-El 186(93%), Cochlear 2(1%) and Advance Bionic 1(0.5%) were implanted through a transmastoid, facial recess approach, while Neubio 11(5.5%) was implanted through a postauricular transcanal approach. Congenital deafness with consanguinity was the leading cause of deafness, while round window variation was the most frequently encountered surgical challenge. Conclusion: In developing countries, financial restraints cause delays in surgery, leading to limited access to cochlear implant programmes. Surgical challenges are frequently encountered during surgery, and better understanding is required for easy implantation.

Keywords

• Bilateral Deafness
• Cochlear implant
• Cochlear Round Window