Introduction : This retrospective study is based on our experience of difficult cases in 400 implant surgeries at late Dr S N Mehrotra charitable ENT foundation between 2016 to 2019.
Materials and methods: 30 children who presented with different challenges during implantation due to some preexisting abnormalities were included in the study. Outcomes of all the implanted children were analyzed. Scoring system for auditory performance, speech rehabilitation and quality of life were also taken into account for every child implanted taking into consideration practical issues in Indian set up. The results were compared with 30 children implanted having no preexisting abnormality.
Results: Out of 30 cases, 22 had malformed cochlea, 3 had ossified cochlea, 3 children presented with chronic suppurative otitis media, 1 had auditory neuropathy and 1 had iatrogenic complication. Mondini dysplasia was the commonest abnormal cochlea finding.10% attained CAP of 5 at end of 1 year. 20% had maximum SIR score of 5 and 43.33%cases were maximally benefited in terms of quality of life.
Conclusion : Outcome in terms of auditory perception, speech and quality of life was good taking into consideration the difficult anatomy of cochlea and other abnormal findings but were less when compared to children with no preexisting abnormalities. Cochlear implant must be done in all difficult cases as it definitely improves overall outcome.
