FORM24 electrode array and perioperative cerebrospinal fluid leakage in cochlear implant recipients with cochleovestibular malformations

BACKGROUND: Cochlear implant (CI) recipients with a cochleovestibular malformation (CVM) are at a higher risk of experiencing an intraoperative cerebrospinal fluid (CSF) gusher and, therefore are at greater risk of developing postoperative meningitis than are CI recipients with normal cochlear anatomy. To control CSF gushers, the FORM electrode array was developed. OBJECTIVES: To assess the ability of the FORM24 electrode array in managing intraoperative CSF gushers and preventing postoperative CSF leakage in a population of CI recipients. DESIGN: Retrospective. SETTING: Tertiary health care center. PATIENTS AND METHODS: All CIs in which a FORM24 was used between January 2014 and March 2018 were reviewed for demographic and safety results. MAIN OUTCOME MEASURES: Safety results were assessed as the intraoperative or postoperative presence of an episode of CSF leakage or meningitis. SAMPLE SIZE: 177 CI recipients. RESULTS: Thirty-six (20.3%) had a CVM and 141 had normal anatomy (79.7%). Of the 36 participants with a CVM, 20 (55.6%) experienced an intraoperative CSF gusher, all of which were resolved. No cases of postoperative leakage or meningitis were recorded after a mean follow-up time of 36 months. CONCLUSION: The FORM24 array is able to help surgeons stop intraoperative CSF gushers and prevent postoperative CSF leakage and meningitis in CI recipients with a CVM. LIMITATIONS: Further studies are needed.