Citation Information :
Salleh MN, Othman NA, Mansor S, Salehuddin Z, Sidek D, Zakaria MN. In the Wrong Place but Perhaps at the Right Time: A Cochlear Implant Electrode Impinging on Tympanic Membrane. Int J Otorhinolaryngol Clin 2023; 15 (1):51-54.
Aim: This case report demonstrates the incidental finding of a cochlear implant (CI) electrode impinging on the tympanic membrane (TM).
Background: The cochlear implant is the most successful neural prosthesis that has been developed in the last few decades. It has helped thousands of profoundly deaf recipients to have better hearing and improved quality of life. Nevertheless, extracochlear electrode extrusion or migration would occur and this requires special consideration.
Case description: We report a case of a 4-year-old boy who was implanted with bilateral CIs for profound hearing loss postmeningitis at 1 year of age, with an incidental finding of the CI electrode impinging on the medial surface of his left TM. A computed tomography (CT) scan confirmed this finding, and the patient had revision surgery and reimplantation of CI.
Conclusion: It is advisable for patients to continue follow-up postimplantation in the otorhinolaryngology (ORL) clinic even after years of CI surgery. The early detection of electrode malfunction, extrusion, migration, or misplacement is mandatory to improve patients’ quality of life and prevent further complications.
Ismail H, Othman NAN, Zakaria MN, et al. Hearing within the normal limit may not indicate that the middle ear is healthy. Int J Otorhinolaryngol Clin 2021;13(1):23–25. DOI: 10.5005/jp-journals-10003-1363.
Romli M, Wan Mohamad WN, Awang MA, et al. The clinical value of bilateral bone conduction testing in hearing diagnosis. Indian J Otol 2020;26(3):182–185. DOI: 10.4103/indianjotol.INDIANJOTOL_106_20.
Kim CS, Chang SO, Oh SH, et al. Complications in cochlear implantation. Int Congr Ser 2004:1273;145–148. PMID: 18368575.
Raghunandhan S, Kameswaran M, Kumar RSA, et al. A study of complications and morbidity profile in cochlear implantation: The MERF experience. Indian J Otolaryngol Head Neck Surg 2014;66(Suppl. 1):161–168. DOI: 10.1007/s12070-011-0387-3.
Roland JT Jr, Fishman AJ, Waltzman SB, et al. Stability of the cochlear implant array in children. Laryngoscope 1998;108(8 Pt 1):1119–1123. DOI: 10.1097/00005537-199808000-00003.
Farinetti A, Ben Gharbia D, Mancini J, et al. Cochlear implant complications in 403 patients: Comparative study of adults and children and review of the literature. Eur Ann Otorhinolaryngol Head Neck Dis 2014;131(3):177–182. DOI: 10.1016/j.anorl.2013.05.005.
de Rijk SR, Tam YC, Carlyon RP, Bance ML. Detection of extracochlear electrodes in cochlear implants with electric field imaging/transimpedance measurements: A human cadaver study. Ear Hear 2020;41(5):1196–1207. DOI: 10.1097/AUD.0000000000000837.
Holder JT, Kessler DM, Noble JH, et al. Prevalence of extracochlear electrodes: Computerized tomography scans, cochlear implant maps, and operative reports. Otol Neurotol 2018;39(5):e325–e331. DOI: 10.1097/MAO.0000000000001818.
Wang JT, Wang AY, Psarros C, et al. Rates of revision and device failure in cochlear implant surgery: A 30-year experience. Laryngoscope 2014;124(10):2393–2399. DOI: 10.1002/lary.24649.
Dietz A, Wennström M, Lehtimäki A, et al. Electrode migration after cochlear implant surgery: More common than expected? Eur Arch Otorhinolaryngol 2016;273(6):1411–1418. DOI: 10.1007/s00405-015-3716-4.
