Functional and surgical outcomes in subtotal petrosectomy and Cochlear implants in patients with chronic otitis media

Objective To evaluate the functional and surgical outcomes of cochlear implantation (CI) following subtotal petrosectomy (SP) in chronic otitis media (COM) and compare them with standard CI recipients. Methods A retrospective case-control study included 34 adults with postlingual deafness: 17 with COM undergoing SP and simultaneous CI (COM group) and 17 with no middle ear disease (CI group). Audiological performance was assessed by pure-tone audiometry (PTA 5 ), speech recognition in quiet and in noise (Oldenburg Sentence Test, OLSA), and the Speech, Spatial, and Qualities of Hearing Scale (SSQ). Results All surgeries were successful, with only two minor postoperative complications (one EAC closure breakdown, one abdominal hematoma). The analysis of hearing outcomes showed similar results between the two groups in terms of PTA 5 (36.6 vs. 35.6, p = 0.09), speech recognition in quiet (74.2 vs. 85.0, p = 0.07), speech-in-noise (2.7 vs. 0.7, p = 0.58). No significant intergroup differences were found in terms of self-perceived listening disability (SSQ) in the Speech (4.73 vs. 4.80, p = 0.69), Spatial (4.22 vs. 4.96, p = 0.50), or Qualities (5.17 vs. 5.25, p = 0.87) domains. There were no reported cases of disease recurrence, infection, or device extrusion during long-term follow-up (mean 36 months). Conclusion Cochlear implantation after SP provides hearing and quality-of-life outcomes comparable to standard CI, confirming its safety and efficacy in COM patients.