Dissertations, Theses, and Capstone Projects

Date of Degree

6-2025

Document Type

Doctoral Capstone Project

Degree Name

Doctor of Audiology

Program

Audiology

Advisor

Barbara Weinstein

Committee Members

Dorothy DiToro

Subject Categories

Medicine and Health Sciences

Keywords

otosclerosis, cochlear otosclerosis, cochlear implant, outcomes

Abstract

This systematic review evaluates the efficacy and outcomes of cochlear implantation (CI) in adults diagnosed with far-advanced cochlear otosclerosis. This synthesis of audiological outcomes, surgical complexities, and patient-reported quality-of-life (QoL) measures is the first systematic analysis of peer-reviewed studies on this topic. By completing a comprehensive analysis of CI's viability in managing severe-to-profound mixed or sensorineural hearing loss attributed to CO, it is anticipated that CI will be considered an option for persons experiencing the significant communication challenges presented by CO when traditional approaches to management have been ineffective.

Eleven peer-reviewed articles met the inclusion criteria, examining key outcomes including audiological improvements, surgical complexities, and patient-reported outcomes following cochlear implantation. The combined evidence confirms significant improvements in auditory performance, enhanced speech discrimination abilities, and notable increases in patient-reported QoL post-CI intervention in this patient population. Across multiple studies, distinctive surgical challenges unique to CO, including cochlear ossification and facial nerve stimulation, emerged consistently. These challenges, though clinically significant, were predominantly mitigated through extensive preoperative imaging assessments, strategic surgical planning, and postoperative programming.

This review strongly supports cochlear implantation as a clinically effective and beneficial therapeutic approach for adults suffering from advanced CO. It underscores the imperative for expanded candidacy guidelines and advocates for comprehensive, multidisciplinary evaluation protocols. Furthermore, it provides practical clinical recommendations and identifies crucial avenues for future research.

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