This retrospective study analyzed outcomes of cochlear implantation in patients with otosclerosis compared to a control group without this condition. The study involved 49 otosclerotic patients and a control group of 729 patients, all implanted with CI type Nucleus 512 or Freedom 24RE CA between 2009 and 2015.

Otosclerosis was confirmed by CT scans or a history of stapes surgery. Outcomes were measured using Freiburger monosyllables and HSM sentence tests in noise, electrode impedances, C-levels, and electrode deactivation rates at several postoperative intervals.

The study found no significant differences in speech understanding between the otosclerotic and control groups. Otosclerotic patients initially had higher electrode impedances, which equalized with the control group over time. Neural Response Telemetry (NRT) and comfortable loudness levels (C-levels) were similar across groups, indicating that otosclerosis did not require different electrical charge levels for auditory perception.

Deactivation of at least one electrode contact was slightly higher in the otosclerotic group (31%) compared to the control group (26%), but the difference was not significant. Postoperative facial nerve stimulation was more frequent in otosclerotic patients (29% versus 3% in controls).

The angle of electrode insertion, measured via postoperative CT, significantly correlated with speech outcomes in the otosclerotic group for Freiburger monosyllables but not for HSM sentence tests. Patients with insertion angles less than 250° showed no speech understanding in noise.

In conclusion, while otosclerosis may influence certain technical aspects of cochlear implants, it does not significantly affect the functional hearing outcomes when compared to patients without otosclerosis.

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