A patient with bilateral profound sensorineural hearing loss and absent auditory brainstem response has cochlear implant evaluation. Pre-operative high-resolution CT shows bilateral cochlear ossification following bacterial meningitis. What is the surgical implication of this finding?
- A Cochlear implantation is absolutely contraindicated
- B Drilling through the ossified cochlea may allow partial or full electrode insertion via cochleostomy or scala vestibuli approach ✓
- C Bone-anchored hearing aid is the only viable option
- D Auditory brainstem implant is preferred over cochlear implant in all cases of ossification
Correct answer: B. Drilling through the ossified cochlea may allow partial or full electrode insertion via cochleostomy or scala vestibuli approach
Explanation
Post-meningitic cochlear ossification does not absolutely contraindicate cochlear implantation. Surgeons can drill through ossified bone using a cochleostomy or scala vestibuli approach to insert the electrode, though full insertion may not be achievable. Split array or compressed electrodes may also be used. Auditory brainstem implants are reserved for patients with absent cochlear nerves, not ossification alone.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.