The safety of posterior tympanotomy in otitis media with effusion during cochlear implantation: clinical retrospective cohort study

Abstract Background Posterior tympanotomy (PT) is an important step in cochlear implant (CI) surgery, as it is the main access to the round window. Some CI candidates, especially children, may have concomitant otitis media with effusion (OME) which may result in technical issues during PT. There is still a debate whether to wait for OME resolution preoperatively or to proceed to surgery with suspected difficulties. Aims/Objective To evaluate the safety of PT during CI surgery in patients with OME. Material and Methods we included 102 consecutive pediatric candidates in this retrospective study with an age range of 12 months to 6 years. All the patients underwent CI surgery using trans-mastoid, PT to access round window (RW) area. We investigated the effect of the pathology caused by OME on the operative procedure in PT and post-operative consequences. The Results out of 102 patients included in this study, there were 22 patients with OME who had unilateral cochlear implantation with no major operative or post-operative events. Nevertheless, some minor intra operative events and difficulties were encountered. Conclusion and Significance The presence of OME in CI surgery indicates possible surgical challenges such as difficult PT, minor intra-operative risks and with no major post-operative events.