![]() When the cochlea is obliterated or ossified to a particularly significant degree, the conventional insertion of the mechanically flexible electrode array may be impossible, and alternative surgical techniques, such as incomplete insertion, the implantation of double arrays, implantation into the scala vestibuli, or a radical cochleostomy, must be considered. Obliteration of the cochlea, for example, occurs after meningitis, trauma, or infection which result in hearing loss and subsequent intracochlear tissue growth, such as connective tissue or bone formation. Special cases, however, such as the implantation of patients with anatomical malformations, obliterations of the cochlea, or re-implantations pose a challenge in cochlear implantation and may require special devices. The surgical technique and the insertion technique are largely standardised, and regular CI electrodes can be inserted in the majority of cases. Patients with severe sensorineural hearing loss are treated with a cochlear implant (CI). Thus, the IES CMD can successfully be used in patients with obliterated cochleae who would otherwise be non-users, candidates for a Split-Array CMD, or candidates for partial insertion with insufficient cochlear coverage. Patients with a Split-Array CMD had a poor speech perception when compared to patients treated with the IES CMD device. Impedances and speech perception data of patients treated with the IES CMD and the double array were retrospectively compared to patients treated with a STANDARD or FLEX electrode array (the REGULAR group). ![]() A retrospective analysis was conducted to analyse our cases on obliterated cochleae treated with MED-EL devices in order to allow the different cases to be compared. Data on outcomes after implantation in obliterated cochleae are usually based on individual case reports since standardised procedures are lacking. ![]() In addition, a stiff electrode array, e.g., the IE stiff (IES) custom-made device (CMD, MED-EL), was prescribed individually for those special cases and pre-inserted prior to facilitate cochlear implantation in challenging cases. Treatment methods rely on radiological and intraoperative findings and include incomplete insertion, the implantation of a double array, and radical cochleostomy. Anatomical malformations, obliterations of the cochlea, or re-implantations pose particular challenges in cochlear implantation.
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