Cochlear implantation after head and neck radiotherapy: A multicentric study and systematic review

Marzia Ariano; Mosè Sozzi; Francesco Lazzerini; Cosimo De Filippis; Gino Marioni; Sebastiano Franchella; Davide Brotto

doi:10.1016/j.amjoto.2023.104203

Cochlear implantation after head and neck radiotherapy: A multicentric study and systematic review

Am J Otolaryngol. 2023 Dec 18;45(3):104203. doi: 10.1016/j.amjoto.2023.104203. Online ahead of print.

Authors

Marzia Ariano¹, Mosè Sozzi², Francesco Lazzerini³, Cosimo De Filippis⁴, Gino Marioni⁴, Sebastiano Franchella², Davide Brotto²

Affiliations

¹ Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Padua, Italy; Unit of Otolaryngology, University-Hospital of Padova, Padua, Italy. Electronic address: marzia.ariano@studenti.unipd.it.
² Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Padua, Italy; Unit of Otolaryngology, University-Hospital of Padova, Padua, Italy.
³ Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, 56126 Pisa, Italy.
⁴ Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy.

PMID: 38157590
DOI: 10.1016/j.amjoto.2023.104203

Abstract

Objective: The objective of this study is to assess whether cochlear implantation is feasible in patients treated with radiotherapy of the temporal bone (for diseased other than vestibular schwannoma), in terms of surgical management and auditory outcome.

Methods: A systematic review of the literature was performed, screening PubMed, Embase, and Scopus databases, according to PRISMA criteria, retrieving 12 articles. Moreover, 9 cases coming from a multicentric study involving Padova and Pisa University Hospitals, were added, for a total of 62 cases of irradiated patients receiving cochlear implantation.

Results: In our multicentric study we included a total of 9 patients, 6 males, and 3 females (mean age at first cochlear implantation was 53.89 years ± 21.07), while from the literature we considered 53 cases (mean age at first cochlear implantation 48.78 years ± 12.41). We considered for both groups a set of preoperative imaging abnormalities, intraoperative complications and possible postoperative complications. In our cohort, the preoperative pure tone average (PTA) in the implanted ear was 105.6 dB, and the postoperative one was 34.6 dB. In the literature the preoperative PTA was 111.5 dB (when reported), and the postoperative one 52.8 dB.

Conclusion: Both our experience and the literature suggest that cochlear implantation in an irradiated ear is feasible with a good auditory outcome. Surgical difficulties and fitting challenges can be easily managed by professionals aware of these findings, making these patients good candidates to this rehabilitative option.

Keywords: Cochlear implant; Head and neck tumor; Hearing loss; Radiotherapy.

Publication types

Review