Cochlear Implantation After Traumatic Brain Injury

Saturday, September 28, 2024

10:00 AM – 10:06 AM EDT

Location: MBCC, 231

Disclosure(s):

Russell W. De Jong, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

John P. Marinelli, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Samuel A. Spear, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Isaac D. Erbele, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Traumatic brain injury (TBI) may cause sensory and cognitive deficits. These deficits could interfere with successful cochlear implant (CI) results. The objective of this study was to evaluate hearing outcomes in patients with CI surgery after TBI among military beneficiaries.

Methods: A database of 1,085 CI surgeries identified by Current Procedure Terminology (CPT) code was built by selecting current and archived Department of Defense electronic health record systems between January 2005 and November 2023. From that population, patients with a history of TBI were identified via ICD9/10 code. These charts were reviewed for TBI timing and severity as well as post-cochlear implantation audiometric data including CI-threshold pure-tone averages (PTA) and AzBio scores.

Results: Patients with CI after TBI represent 3% of the CI surgeries performed over the 18-year period, including 27 patients who underwent 29 surgeries. Fourteen patients and 15 surgeries had available hearing outcomes for analysis. Of these, the average age at implantation was 41 (SD=15). Ten patients had mild TBI, 2 had moderate, and 3 had severe. Four patients had temporal bone fractures, but only one involved the otic capsule. In 15 surgeries, CI surgery resulted in open-set speech perception; in one patient with mild TBI, only sound awareness was achieved. The average post-operative CI-threshold PTA and AzBio score were 30dB (SD=19) and 76% (SD=24), respectively. The mild TBI group had mean postoperative thresholds of 32dB (SD=24) and AzBio scores of 79% (SD=17), moderate had 26dB (SD=1) and 96% (SD=4), and severe had 26dB (SD=3) and 54 (SD=41).

Conclusions: Cochlear implantation after TBI is uncommon but represents a non-trivial number of implants performed in military beneficiaries. This study demonstrates that acceptable hearing results are achievable, regardless of the severity of TBI.

Presenting Author(s)

Russell W. De Jong, MD

Resident physician
Brooke Army Medical Center
Converse, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

AD

Amanda Dao, MD

San Antonio Military Medical Center, United States

Disclosure information not submitted.
John P. Marinelli, MD

Fellow, Neurotology
Mayo Clinic
San Antonio, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Samuel A. Spear, MD

Staff ENT/Otology & Neurotology
ENT and Allergy Associates of Florida
Jupiter, FL, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

IE

Isaac D. Erbele, MD

Chief of Neurotology, Associate Program Director
Brooke Army Medical Center, Joint Base San Antonio, TX
San Antonio, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.