A 3-year-old child develops bilateral profound deafness after pneumococcal meningitis. Preoperative CT shows partial obliteration of the basal turn of the cochlea. During implantation, if the round window and basal turn are found ossified, the standard surgical strategy is:
- A Drill open the ossified basal turn and insert the electrode into the scala vestibuli or a drilled channel ✓
- B Abandon implantation and offer auditory brainstem implant
- C Insert a shortened electrode into the middle turn via the promontory
- D Perform endolymphatic sac decompression before retrying
Correct answer: A. Drill open the ossified basal turn and insert the electrode into the scala vestibuli or a drilled channel
Explanation
Post-meningitic labyrinthitis ossificans typically begins as a fibrous plug in the scala tympani of the basal turn near the round window. The accepted approach is drill-out of the ossified scala tympani or insertion into the patent scala vestibuli, often with a double-array or split electrode. Auditory brainstem implantation is reserved for complete cochlear ossification where no channel can be created.
Reference: Cummings Otolaryngology Head and Neck Surgery, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.