Various Surgical Techniques for Cochlear Implantation in an Ossified Cochlea: A Systematic Review

Cochlear ossification, otherwise known as labyrinthitis ossificans, is not an uncommon encounter in candidates for cochlear implantation (CI) that may necessitate alternative surgical approaches due to the insertion difficulties. We aimed to review the literature for the documented approaches for CI in cases with cochlear ossification.

Cochlear implant surgeons and referring audiologists should be familiar with the range of surgical approaches for ossified cochleas reviewed here; the findings may inform pre-surgical planning and patient counseling regarding expected outcomes and electrode insertion limitations.

Labyrinthitis ossificans represents one of the most technically challenging scenarios in cochlear implantation, and a systematic synthesis of surgical techniques can guide best-practice decisions for this complex patient group.

1. 01Systematic review of surgical techniques for cochlear implantation in ossified (bone-filled) cochleas.
2. 02Standard electrode insertion is often not feasible in labyrinthitis ossificans, requiring modified approaches.
3. 03Multiple techniques (e.g., drill-out, split array) are compared across published literature.
4. 04Electrode coverage and hearing outcomes likely vary by technique and degree of ossification.
5. 05Published peer-reviewed (DOI: 10.65717/iao.2026.252060).

PMID

42345437

DOI

10.65717/iao.2026.252060.

Journal

International Archives of Otorhinolaryngology

Publication type

systematic_review

Evidence level

1a

Population

Patients with ossified cochleas (labyrinthitis ossificans) undergoing cochlear implantation

Intervention

Various surgical techniques for cochlear implantation in ossified cochleas

Comparator

Comparison across multiple described surgical techniques