Review

. 2023 Apr;43(Suppl. 1):S67-S75.

doi: 10.14639/0392-100X-suppl.1-43-2023-09.

Current trends on subtotal petrosectomy with cochlear implantation in recalcitrant chronic middle ear disorders

Pietro Canzi^{1

2}, Stefano Berrettini³, Andrea Albera⁴, Maurizio Barbara⁵, Luca Bruschini³, Andrea Canale⁴, Elena Carlotto², Edoardo Covelli⁵, Domenico Cuda⁶, Francesco Dispenza⁷, Maurizio Falcioni⁸, Francesca Forli³, Sebastiano Franchella⁹, Lorenzo Gaini¹⁰, Salvatore Gallina⁷, Andrea Laborai⁶, Ruggero Lapenna¹¹, Francesco Lazzerini³, Stefano Malpede², Marco Mandalà¹², Domenico Minervini², Enrico Pasanisi⁸, Giampietro Ricci¹¹, Francesca Viberti¹², Diego Zanetti^{13

14}, Elisabetta Zanoletti⁹, Marco Benazzo^{1

2}

Affiliations

¹ Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
² Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
³ Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy.
⁴ Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy.
⁵ Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy.
⁶ Department of Otolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy.
⁷ Department of Biomedicine, Neuroscience and Advanced Diagnostics, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone'', University of Palermo, Palermo, Italy.
⁸ Otorhinolaryngology and Otoneurosurgery Department, University Hospital of Parma, Italy.
⁹ Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy.
¹⁰ Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
¹¹ Department of Surgical and Biomedical Sciences, Section of Otorhinolaryngology, University of Perugia, Perugia, Italy.
¹² Department of Otology and Skull Base Surgery, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
¹³ Audiology Unit, Department of Specialistic Surgical Sciences Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico Milan, Italy.
¹⁴ Department of Clinical Sciences and Community Health University of Milan, Milan, Italy.

PMID: 37698103
PMCID: PMC10159642
DOI: 10.14639/0392-100X-suppl.1-43-2023-09

Review

Current trends on subtotal petrosectomy with cochlear implantation in recalcitrant chronic middle ear disorders

Pietro Canzi et al. Acta Otorhinolaryngol Ital. 2023 Apr.

. 2023 Apr;43(Suppl. 1):S67-S75.

doi: 10.14639/0392-100X-suppl.1-43-2023-09.

Authors

Affiliations

¹ Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
² Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
³ Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy.
⁴ Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy.
⁵ Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy.
⁶ Department of Otolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy.
⁷ Department of Biomedicine, Neuroscience and Advanced Diagnostics, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone'', University of Palermo, Palermo, Italy.
⁸ Otorhinolaryngology and Otoneurosurgery Department, University Hospital of Parma, Italy.
⁹ Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy.
¹⁰ Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
¹¹ Department of Surgical and Biomedical Sciences, Section of Otorhinolaryngology, University of Perugia, Perugia, Italy.
¹² Department of Otology and Skull Base Surgery, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
¹³ Audiology Unit, Department of Specialistic Surgical Sciences Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico Milan, Italy.
¹⁴ Department of Clinical Sciences and Community Health University of Milan, Milan, Italy.

PMID: 37698103
PMCID: PMC10159642
DOI: 10.14639/0392-100X-suppl.1-43-2023-09

Abstract
in English, Italian

Objective: To establish the safety and effectiveness of subtotal petrosectomy with cochlear implantation in patients affected by chronic middle ear disorders to refractory to previous surgical treatments.

Methods: A multicentre, retrospective study was conducted on patients affected by recalcitrant chronic middle ear disorders who underwent cochlear implantation in combination with subtotal petrosectomy. Patients' details were collected from databases of 11 Italian tertiary referral centres. Additionally, a review of the most updated literature was carried out.

Results: 55 patients were included with a mean follow-up time of 44 months. Cholesteatoma was the most common middle ear recurrent pathology and 50.9% of patients had an open cavity. 80% of patients underwent a single stage surgery. One case of explantation for device failure was reported among the 7 patients with post-operative complications.

Conclusions: Subtotal petrosectomy with cochlear implantation is a benchmark for management of patients with recalcitrant chronic middle ear disorders. A single stage procedure is the most recommended strategy. Optimal follow-up is still debated. Further studies are required to investigate the role of this surgery in paediatric patients.

Attualità in tema di petrosectomia subtotale con impianto cocleare nelle patologie croniche dell’orecchio medio recalcitranti.

Obiettivo: Stabilire la sicurezza ed efficacia dell’intervento di petrosectomia subtotale con posizionamento di impianto cocleare nei pazienti affetti da patologia cronica dell’orecchio medio refrattaria a precedenti trattamenti chirurgici.

Metodi: È stato svolto uno studio retrospettivo multicentrico riguardante quei pazienti affetti da patologie croniche dell’orecchio medio recalcitranti, sottoposti a petrosectomia subtotale con posizionamento di impianto cocleare. Le informazioni sono state raccolte dai database di 11 centri di riferimento di III livello in Italia. A complemento, è stata svolta una revisione della più recente letteratura.

Risultati: Nello studio sono stati inclusi 55 pazienti con un follow-up medio di 44 mesi. Il colesteatoma ha rappresentato la più comune patologia ricorrente dell’orecchio medio e il 50,9% dei pazienti aveva una cavità aperta. L’80% dei pazienti è stato sottoposto ad una chirurgia a singolo stadio. Sette pazienti hanno mostrato complicanze post-operatorie, di cui un caso di espianto.

Conclusioni: L’intervento di petrosectomia subtotale con posizionamento di impianto cocleare rappresenta una tecnica chirurgica di riferimento per la gestione dei pazienti affetti da otite media cronica recalcitrante. L’intervento chirurgico a singolo stadio è la strategia più frequentemente raccomandata. Il follow-up ottimale è ancora ad oggi oggetto di dibattito. Sono richiesti ulteriori studi per stabilire il ruolo di questo intervento nei pazienti pediatrici.

Keywords: chronic middle ear disorders; chronic otitis media; cochlear implant; cochlear implantation; recalcitrant; recurrent; refractory; subtotal petrosectomy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1.**
Pre-operative pure tone audiometry. Graphic depiction of PTA for each frequency for both implanted and non-implanted side. Horizontal lines represent PTA trending line, while vertical lines represent SD for each frequency.

**Figure 2.**
Pre- vs post-operative pure tone audiometry. Graphic depiction of PTA for each frequency for the implanted side, pre-operatively and 6 months after surgery. Horizontal lines represent PTA trending line, while vertical lines represent SD for each frequency.

See this image and copyright information in PMC

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Current trends on subtotal petrosectomy with cochlear implantation in recalcitrant chronic middle ear disorders

Affiliations

Current trends on subtotal petrosectomy with cochlear implantation in recalcitrant chronic middle ear disorders

Authors

Affiliations

Abstract
in English, Italian

Conflict of interest statement

Figures

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Abstract in English, Italian

Conflict of interest statement

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Abstract
in English, Italian