Cochlear implant surgery has been introduced successfully and is now one of the commonly performed surgeries. However, the surgical strategy of cochlear implantation in patients with chronic middle ear diseases, such as chronic otitis media and cholesteatoma, has not yet been fully established. In the present report, we describe the surgical technique adopted and prognosis of two patients with severe adhesive otitis media who underwent cochlear implant surgeries. Both underwent one-stage cochlear implantation combined with external auditory canal closure (blind-sac closure). Mastoidectomy with removal of the whole canal wall was performed to remove the otitis lesion thoroughly, and external auditory canal wall closure was performed to prevent recurrence of the lesion. A pneumatized tympanic cavity was observed and canal wall closure was maintained in both cases. Both patients acquired fair hearing ability with the cochlear implants. No severe complications have occurred until now, four years since the cochlear implantation. Although external ear canal closure destroys the natural structure of the external ear, one-stage cochlear implant surgery combined with canal closure is useful for elderly patients with systemic complications who desire shortening of hearing-deprived period.
