Tahir Ahmed, Faseeh.
Cochlear Implant.
Pak Armed Forces Med J Jan ;51(1):58-9.

A patient of 11 years of age, resident of a village in Rahim Yar Khan, developed sudden total deafness following a high-grade fever in 1998. Physical examination revealed : normal tympanic membranes, normal impedance with absent stapedial reflex. Pure tone audiometer revealed no hearing at the maximum of audiometer output. Brain stem evoked response confirmed that patient has no hearing at all. The diameter of cochlea was 2.5mm on left side quid 1.7mm on right side on CT scan of temporal bone. The patient was assessed by speech therapist preoperatively. It was decided to implant House Cochlear Implant.

Right ear was selected as the left ear tympanic membrane has some doubtful dullness. A cortical mastoidectomy was carried out through a U shaped flap based towards pima, posterior tympanotomy was performed, round window was identified and cochleostomy was done at the anterior lip of round window. The cochlea was osseous and further drilling was performed for about 0.5 mm and cochlear duct was found to be patent. ITH (In The Head) receiver template was placed on temporal bone for marking the site. The temporal bone was drilled to create the bed for ITH receiver. Rat holes were made on the none for fixing of ITH. After fixing the ITH, electrodes were introduced through the posterior tympanotomy into the cochleostomy made ii the cochlea.

On the head (OTH) receiver was over the implanted ITH and switched on after 6 weeks. Patient was started on speech therapy. The open set result of sentences was 70% in the first week and 90% in the second week. In the closed set the patient has 40% recognition of words and 30 to 40 recognition of sentences. Patient responded on mobile phone.

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