1. Impact of Perioperative Anticoagulation and Antiplatelet Therapy on Hearing Preservation Outcomes.
- Author
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Ma CC, Patro A, Schauwecker NR, Lindquist NR, Freeman MH, Perkins EL, Haynes DS, and Tawfik KO
- Abstract
Objective: To report hearing preservation (HP) outcomes based on anticoagulation/antiplatelet use (blood thinner, BT) following cochlear implantation (CI)., Study Design: Retrospective cohort., Setting: Tertiary referral center., Patients: Three hundred twenty-six adults (361 ears: no BT = 210, BT held = 86, BT continued = 65) implanted between 2012 and 2021 with preoperative low-frequency pure-tone average (LFPTA) of 65 dB HL or better., Main Outcome Measure: Postoperative HP, defined as LFPTA ≤80 dB HL, at 1, 3, 6, and 12 months., Results: Compared to no BT, the BT held and continued groups were older (60.6 vs 72.7 vs 73.0 yrs, p < 0.001) and had diabetes (10% vs 28% vs 22%, p < 0.001). Electrode type, steroid use, surgical approach, and preoperative LFPTA were equivalent among groups. Postoperative HP rates were significantly higher for no BT than the BT held and continued groups at 1 month (62% vs 48% vs 43%, p = 0.008), with equivalent results at 3, 6, and 12 months. When patients were stratified by BT type, there were no significant differences in HP outcomes. On multivariate analysis, BT status was not a significant predictor of HP rates at 1 or 12 months. Younger age (OR 0.95, 95% CI 0.94-0.97, p < 0.001) was the only significant predictor of 1- but not 12-month HP., Conclusions: BT use, regardless of whether held for surgery, was associated with inferior early HP outcomes. After controlling for age, BT status was not a significant predictor of HP, suggesting inherently poorer cochlear health in patients who are on BTs., Competing Interests: Conflicts of Interest: M.H.F. is an advisor for Endotheia, Inc. D.S.H. is a consultant for Advanced Bionics, Cochlear Americas, MED-EL GmbH, Stryker, Synthes, Grace Medical, and Oticon. K.O.T. has served as an advisory board member for GlaxoSmithKline. Abstract was presented as a poster presentation at the 2024 Combined Otolaryngology Spring Meeting, American Otological Society, Chicago, Illinois, May 15 to 19., (Copyright © 2024, Otology & Neurotology, Inc.)
- Published
- 2024
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